Discussions surrounding nursing shortages typically focus on recruitment, but retention is also a problem. Emerging research suggests that intimidation in the nursing workforce is a problem that planners need to deal with as part of an overall strategy aimed at maintaining a balance between supply and demand. This paper explores issues surrounding intimidation in the nursing workforce and looks at how one major teaching hospital in Australia attempted to address the problem. Fo r e c a s t e r s h av e e s t i m at e d that the supply of registered nurses in the United States will no longer meet the demand for nursing services by 2010. 1 Much has been written about changing the image of nursing and innovative recruitment strategies to address this imbalance, but this may not be enough, as nurse retention also continues to be a problem. Indeed, the International Council of Nurses conference in Copenhagen in 2001 identified retention issues as the major factor in the international shortage of nurses. 2 A little-studied but potentially important factor in retention involves intimidation (bullying) of and by nurses and a management culture that dismisses this as a problem. Retention And BullyingLyn Quine's study of the extent of workplace bullying in the United Kingdom found that 38 percent of nurses reported being bullied in the previous year and that 42 percent reported witnessing the bullying of nurses by other staff. She compares this with a study showing that one in eight non-health care staff experience bullying. 3 Another British study of 462 midwives found that 46 percent reported being bullied and that of these, 55 percent were considering leaving within the year. 4 Moreover, the intimidation factor seems to be more than a minor annoyance, and improving the way that management addresses such issues in nursing may be critical for improving retention. Terry Misener's U.S. study found that one of the main components of job satisfaction for nurses was "intra-practice partnership and collegiality." 5 But recent evidence suggests that management may turn a deaf ear to such complaints; Linda Aiken and colleagues' study of 43,000 nurses across five countries showed that fewer than half of nurses are satisfied with the way that "administration listens and responds to nurses' concerns." 6 n Reasons for bullying behavior. A British study suggests that nursing has always condoned intimidating behavior. 7 The profession established itself at a time when public health was a reform movement, requiring its F r o m t h e

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This study investigates carer perceptions of the adequacy of assistance received by comparing two populations: those with a mental disability and those with a physical disability in Australia by using data representing 12.5% of the total population. This very large sample provides robust evidence for the study's findings. Of those caring for individuals with severe core disabilities, 21.6% of those with a mental disability compared to only 8.3% of carers of those with a physical disability reported inadequate service assistance. Greater involvement of consumers and their families in health care service planning will provide opportunities to deliver more appropriate services and enhance equities within this sector.

Purpose-The perception among carers and health professionals is that the health care system remains limited in its effectiveness and accessibility to non-institutionalized people with a mental illness. The objective of this study is to determine the effect of the care recipient's main disabling condition (either physical or mental) on the carer's perceived need for assistance in their role as carer. Design-Based on the data collected from the Australian Survey of Disability, Ageing and Carers, the investigation involved the non-institutionalized recipients of care with profound and severe disabilities, aged 15 years and over, residing in private dwellings and their primary informal carers. Findings-Regression analysis revealed that carers of those with a mental disability were 2.7 times more likely to report care needs unmet compared to carers of those with a physical disability. Further analysis using interactions showed that carers who were the adult children of mentally disabled parents reported a comparatively very large amount of perceived unmet need. Originality/value-If equity is measured in terms of perceived need rather than finite resources a case is made that primary carers of people with a mental disability experience greater burdens in care.

Purpose – The Australian Dietary Guidelines support good health and disease prevention. Children with healthy eating habits established early in life have been shown to continue these habits into adulthood compared with those children who have poor eating habits in their younger years. The nutritional intake of many Australian children is not in accordance with the national guidelines. The reasons children make the food choices they do are unclear from the literature. The paper aims to discuss these issues. Design/methodology/approach – This study used participatory action research methods to explore why primary school-aged children make the food choices that they do. A non-government primary school requested assistance in encouraging their children to make healthier choices from the school canteen menu. The authors gathered opinions from the children in two different ways; a group discussion during class and a “discovery day” that involved four class grades. The authors identified children’s food preferences and food availability in canteens. The authors explored how the children perceived healthy foods, the importance of a healthy food environment and what criteria children use to decide what foods to buy. Findings – Children’s food preferences were mostly for unhealthy foods, and these were readily available in the canteen. The perception about what foods were healthy was limited. Despite being asked to develop a “healthy” menu, the majority of choices made by the children were not healthy. Children described unhealthy choices as preferable because of taste of the food, if it was sugary, if it was quick to eat, available and cheap, the relationship of food and weather, the connection to health conditions and peer dominance. Practical implications – This study suggests that children make their food choices based on simple concepts. The challenge lies around producing healthy options in collaboration with the school community that match the children’s food choice criteria. Originality/value – This paper provides a modern and inspiring whole school approach based on equity and empowerment of the children. Discovering why children make food choices from the children’s perspective will help to present healthy options that will be more appealing for children. The methodology used to uncover why children make their food choices has also provided valuable insight into a study design that could be used to address other childhood research questions. The methodology offers an educative experience while gathering rich information directly from the children. This information can be used by the school to support children to have more control over their health and to develop behaviours to increase their health for the rest of their lives.

Objective: To assess the use of the ONI (Ongoing Needs Identification) survey to predict resource requirements in the home care sector. Methods:Data from an urban community-based services provider was used to test whether certain indicators captured in the ONI survey may also predict professional service time. Results:The data revealed a link between several ONI indicators and professional service time. This explained 30% and 40% of the variance in nursing and allied health time, respectively. Both functional profile and gender impacted on nursing time. There was also an inverse relationship between allied health and nursing service time. The overall needs priority rating (OPR) score, derived from the ONI survey, was found to be less effective as a predictor. Conclusion:ONI variables impacted differently on nursing and allied health hours. It is therefore important to consider variables based on profession when planning for resources in the community sector. As labour costs are the largest component of home-based service provision, the ONI survey has the potential to become a cost predictor which is integrated into the processes of clinical care, and hence acceptable to clinicians.

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Health service integration seems a logical and desirable strategy to improve both the efficiency and quality of service delivery. Failure of implementation is common but may not be inevitable. This paper reports on a case study involving structured interviews and focus groups within one health service which has attempted to integrate one area of its acute and community health services. Health service integration was regarded very positively by clinicians and administrators in this case study but the change management process utilised in its implementation was not, suggesting a need for