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BACKGROUND: An exploratory baseline study was conducted to ascertain the state of play in the field of spinal cord injury, vocational rehabilitation and employment in Queensland, Australia. OBJECTIVE: The aim of this study was to establish the rate of return to work and better understanding of vocational expectations and the vocational rehabilitation culture in the Queensland Spinal Injuries Unit, prior to the introduction of an early vocational rehabilitation intervention for people with spinal cord injury. METHODS: A mixed methods approach was utilised, involving administration of either an online survey tool or paper questionnaire to people who had sustained a spinal cord injury within the preceding three years. Statistical analysis of the quantitative data and thematic analysis of the qualitative free-text data was undertaken with the 34 eligible responses. RESULTS: The findings demonstrate a dramatic change in the rate of employment following spinal cord injury, and a lack of vocationally focused support whilst participants were undergoing in-patient rehabilitation. CONCLUSIONS: The study indicates a return to work rate of approximately 35%, and provides support for an individualised vocational rehabilitation intervention, fully integrated into the multidisciplinary spinal injuries unit rehabilitation program. [ABSTRACT FROM AUTHOR]

Objective: This study examined the methods and frequency of professional supervision in Queensland's work rehabilitation sector. Professional supervision is regarded as an important aspect of professional development and hence, critical to the improvement of services delivered by practitioners. However, there is little documented on the extent of supervision of practitioners in this setting and even less on the impact and effectiveness of supervision. Participants: Eighty-two (82) work rehabilitation professionals participated in the study. Methods: The majority of participants (76) responded to a web-based survey that had been sent to them by a web-link, and 6 completed a paper based survey version of the survey, which evaluated the extent, practice methods, and barriers to the delivery and receipt of supervision. A follow-up focus group was held with key opinion holders to examine possible barriers to supervision in the industry. Results: 59% of the participants had not received any form of supervision in the past two years. Those who received or delivered supervision reported it to be a valuable practice. The follow-up focus group identified barriers to supervision as being pressures of commercial targets, lack of exposure to work rehabilitation in university curricula, high staff turn-over, relative inexperience of case managers and purchasers dictating product outcomes. Conclusions: The development of industry standards for supervision practice is recommended to overcome the barriers to supervision. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Back2Work Early Intervention Vocational Rehabilitation (EIVR) program was developed in response to the low employment rate of people with spinal cord injuries (SCI) and their lack of access to early, specialised vocational rehabilitation (VR). The program has been delivered by qualified rehabilitation counsellors to hospital patients with newly acquired SCI since 2016. OBJECTIVE: The objective of the study was to evaluate the effectiveness and consumer perspective of the Back2Work EIVR program. METHODS: The program was evaluated using a mixed-methods, longitudinal, prospective design. RESULTS: Data analysis revealed a return to work rate (RTW) of 43% by 12 months post-discharge. Qualitative data indicated positive participant experiences with the program, emphasising the hopefulness brought about by early vocational support. CONCLUSIONS: The Back2Work program has a positive impact on participants' RTW outcomes, through the provision of early specialist vocational rehabilitation interventions. This includes building a positive culture around RTW after SCI and engagement with employers to maximise the likelihood of timely and sustainable re-employment. The RTW outcomes and emergent themes will help inform service development in the field of early vocational rehabilitation after SCI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Focusing on employees with psychological strain, this research draws on Fredrickson's 'undoing hypothesis' to examine praise and recognition from one's supervisor as an organizational resource. OBJECTIVE: A model is tested in which psychological strain is a mediator in the positive relationship between role demands and employees' intentions to take sick leave and seek medical advice, and positions supervisor praise and recognition as a buffer of psychological strain on such intentions. METHODS: The model was tested using two Australian samples in the tourism sector, consisting of motel workers (n = 104) and museum workers (n = 168). RESULTS: For museum workers, but not motel workers, there was a positive indirect effect of each role demand on sick leave intentions through psychological strain that weakened as a function of supervisor praise and recognition. The proposed moderated mediated model was supported for both samples in regards to intentions to seek medical advice. CONCLUSIONS: This research contributes new evidence regarding the antecedents of employees' intentions to take sick leave and seek medical advice for work stress-related problems. It also contributes to the limited evidence regarding supervisor praise and recognition as a protective factor for employees exhibiting the symptoms of psychological strain. [ABSTRACT FROM AUTHOR]

Reports on the appeal filed by Murrandoo Yanner, an Aboriginal Australian on the case related to aboriginal rights and fauna protection legislation in Queensland. Decision of High Court of Australia; Struggle for land rights; Wildlife protection and conservation laws.

BACKGROUND: A deficits approach to understanding psychological adjustment in family caregivers of individuals with a neurological disability is extensive, but further research in the field of positive psychology (spirituality, resilience, hope) may provide a potential avenue for broadening knowledge of the family caregiver experience after traumatic brain injury (TBI) or spinal cord injury (SCI). OBJECTIVE: To test a proposed model of spirituality among family caregivers of individuals with TBI or SCI, using structural equation modelling (SEM). METHODS: A cross-sectional design was employed to survey ninety-nine family participants (TBI = 76, SCI = 23) from six rehabilitation units from NSW and Queensland. Assessments comprised Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale-Expanded, Connor –Davidson Resilience Scale, Herth Hope Index, and three measures of psychological adjustment including Caregiver Burden Scale, Positive and Negative Affect Scale, and Depression Anxiety Stress Scale. RESULTS: SEM showed the proposed model was a good fit. The main findings indicated spirituality had a direct negative link with burden. Spirituality had a direct positive association with hope which, in succession, had a positive link with resilience. Spirituality influenced positive affect indirectly, being mediated by resilience. Positive affect, in turn, had a negative association with depression in caregivers. CONCLUSIONS: This study contributes to better targeting strength-based family interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Australia is one of the world's foremost mining nations. Over the past decade, the number of resources sector employees has risen steadily. It is increasingly suggested in lay press and popular discourse that mining industry employees (the majority of whom are men) face an elevated risk of suicide relative to the general population, and that suicide rates are higher among mining industry employees relative to other occupations. However, there has been no empirical evaluation of this proposal, which impedes the ability to develop appropriate policy responses. OBJECTIVE: This study begins to fill knowledge gaps, by providing the first quantitative examination of suicide rates in the mining industry. METHODS: Data from the Queensland Suicide Register were used to examine suicide rates in the resources sector, relative to other sectors. RESULTS: The mining industry was found to have lower male suicide rates relative to other occupations and the working-age male population overall. CONCLUSIONS: These findings do not support the view that mining industry employment is necessarily associated with elevated suicide rates. Many factors, ranging from individual personality characteristics through to workplace policies, may contribute to this observation. [ABSTRACT FROM AUTHOR]

BACKGROUND: A good motor outcome after stroke is often equated with independence in functional performance. However, for patients with severe motor disability a good outcome is unlikely, but an important change may be achievable. OBJECTIVE: Determine if patients admitted to inpatient rehabilitation with severe motor disability can achieve clinically important improvements in motor function. METHODS: A prospective observational study of 239 patients with stroke admitted to inpatient rehabilitation in Brisbane, Australia was conducted. On admission and discharge, participants were assessed using the motor items of the Functional Independence Measure (m-FIM). The importance of change achieved on the m-FIM was evaluated according to: 1) a statistical significant outcome; 2) achievement of a MCID based on a physician-anchored rating of change; and 3) shift in disability status e.g., severe to moderate disability. RESULTS: Patients with severe motor disability achieved a significant improvement in motor function (p < 0.001), which saw up to 83% achieve a MCID and 85% shift out of 'severe' to either moderate or mild motor disability on discharge from inpatient rehabilitation. CONCLUSION: This study demonstrates that patients admitted to inpatient rehabilitation with severe motor disability can achieve clinically important improvements in motor function on discharge from inpatient rehabilitation. [ABSTRACT FROM AUTHOR]

This study reports the five-year outcomes of a prospective population-based study of clinical hip surveillance for children with cerebral palsy (CP) according to evidence-based standards of care. Systematic hip surveillance commenced in Queensland, Australia as a state-wide program in 2005. Queensland represents a dispersed population across a large geographical area, creating unique challenges in terms of service delivery. Over five years, 1,115 children with CP were recruited, representing 73% of the expected population based on 1.9 to 2.1 per 1,000 live births. Standardized clinical and radiological assessments have been provided, with a median follow-up of 1.2 years (range 1 month -5^{+8} yrs). Of the 1,115 children, 423 (38%) have been discharged and 692 (62%) remain on surveillance with 314 (28%) identified as having hip displacement with Migration Percentage (MP) equal to or greater than 30% (&ges; 30). The incidence of marked hip displacement (MP &ges; 30) was directly related to gross motor function, classified according to the gross motor function classification system (GMFCS), with distribution of GMFCS I=10, (3%), II=40 (13%), III=53 (43%), IV=96 (59%), and V=115 (64%). This state-wide surveillance program has been successful in correctly identifying children with hip displacement (MP &ges; 30), fast tracking children for orthopedic review and discharging those at minimal risk. No child has progressed to dislocation while on surveillance without orthopedic review. [ABSTRACT FROM AUTHOR]

Genomic science has the potential to rapidly advance understanding of human biology in the medical context and the subsequent provision of tailored healthcare. Implementing such a disruptive and transformative technology into an existing and stretched health system will require a whole of system approach and a keen understanding of the limitations to be navigated in broadening the system to include genomic healthcare. This paper reports on the barriers to implementation faced by clinical demonstration projects in integrating into the existing infrastructure in Queensland.

Genomic testing is rapidly moving into healthcare practice. However it comes with informatics challenges that the healthcare system has not previously faced - the raw data can be hundreds of gigabytes per test, the compute demands can be thousands of CPU hours, and the test can reveal deeply private health-srelated information that can have implications for anyone related to the person tested. While not a panacea, cloud computing has particular properties that can ameliorate some of these difficulties. This paper presents some of the key lessons learned while deploying a set of genomic analyses on cloud computing for Queensland Genomics.

Effecting early discharge is a widely recommended strategy for improving patient flow in acute hospitals. This paper analyses the impact of inpatient discharge timing on Emergency Department (ED) flow parameters such as access block and length of stay, while comparing this to the effect on hospital occupancy, to arrive at an understanding of a 'whole of hospital' response to discharge timing. The impact of hospital size is also investigated. The analysis reveals that, on days when the discharge peak lags the peak in inpatient admissions, hospitals of all sizes exhibit increased levels of occupancy, inpatient and ED length of stay, and access block. The findings corroborate the efficacy of early discharge initiatives and 'whole of hospital' flow improvement initiatives for addressing overcrowding and efficiency issues in hospitals.

The ability of hospital staff to get a patient to the right bed at the right time is dependent on bed occupancy, and is a key issue in all acute hospitals. This paper seeks to identify the impact of admission and discharge timing on hospital occupancy with reference to the peak in daily admissions and discharges. Patient admissions data from 23 Queensland public hospitals was classified into categories based on the relative timing of daily admission and discharge curves. We found statistically significant differences in mean and peak occupancy and patient length of stay between categories (one-way univariate ANOVA p&lt;0.0001). The results support early patient discharge initiatives to reduce hospital occupancy rates.

Telemedicine may have a useful role in neonatal care, particularly in regionalised health care systems where there may be impediments to access. Following the development of a system for neonatal teleconsultation, we assessed its efficacy, usability and preliminary effectiveness. While results were positive, uptake in routine clinical use was less than expected. The study described in this paper examined aspects of clinicians' perceptions of telemedicine in neonatal care. Overall, clinicians had positive perceptions of telemedicine. Further work is required to understand the negative perceived usefulness of telemedicine held by some clinicians and to determine whether this may be overcome.

The emergence of Multi Modal Distraction (MMD) has occurred following appraisal of the developmental and clinical concerns surrounding Virtual Reality's (VR) applicability to pediatric pain management. MMD was developed to expand current distraction tools and technology available for pain management in the pediatric population. This paper will examine how the challenges faced by VR have motivated the collaborative design and development process of MMD. It will then outline the continuous clinical trialling being undertaken to ensure its efficacy in managing childhood procedural anxiety and pain.

In a global information society all students regardless of discipline need to have or acquire basic computing and information literacy skills. The Faculty of Health Science at the Central Queensland University now includes a compulsory and introductory course in Health Informatics at the undergraduate level for all its first year students to meet these educational needs for the future health industry workforce. This paper describes the teacher and student lived experiences encountered throughout the concurrent use of a variety of delivery modes to teach an introductory unit of health informatics to this varied student population. It will include a discussion about the unit itself, educational philosophy adopted, strengths and weaknesses of the technologies and delivery methods adopted and the results of the student evaluation.

This paper provides an overview of casemix development and usage in Australia and reviews the process undertaken to design a graduate subject to educate clinicians and managers on the potential use of casemix data to support decision making. The aim of the subject is to enable hospital staff to identify critical casemix information needs, evaluate and select suitable software, analyze and interpret hospital input and output relationships using casemix based information systems, and use the results to establish decision support information requirements. The paper also describes the content and method of delivery of the new subject, available in several graduate programs and also through CQU's continuing education program. This work was undertaken to meet the objectives of a Commonwealth funded Casemix Study Grant.