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Health literacy comprises an individual's ability to adequately access, understand and utilise health information, enabling effective navigation of the healthcare system. Low health literacy is a problem for people living with substance use disorders (SUDs). This study aims to examine whether health literacy changes for people discharged from specialist SUD treatment services. Two hundred thirty-one people recruited from residential SUD treatment services across New South Wales, Australia, completed a questionnaire upon entry into the service and again at 6 months post-treatment. Treatment outcomes were also measured. Three health literacy profiles were identified: lowest (n = 52, 22.5%), moderate (n = 111, 48.1%) and highest health literacy (n = 68, 29.4%). Lowest and moderate profiles showed improved health literacy at 6 months. However, the lowest profile still had significantly lower health literacy, quality of life and higher levels of psychological distress compared with participants in the highest profile at 6 months. People within the lowest health literacy profile improved, although they continued to experience lower health literacy and some poorer treatment outcomes. Health literacy interventions tailored for people within lowest health literacy profiles should be implemented and assessed for effectiveness within specialist SUD treatment services. [ABSTRACT FROM AUTHOR]

Introduction: In the USA, lumbar discectomy is one of the most commonly performed spinal procedures. As certain sports are considered to be major risk factors for disc herniation, the question remains as to when highly active patients should return to their previous level of activity. This study aimed to analyze spine surgeons' opinions on when patients may return to activities following discectomy as well as their underlying rationale for their decision. Methods: A questionnaire was designed by five different fellowship-trained spine surgeons for the 168 members of the Spine Society of Australia. Questions on the surgeons experience, decision making, preferred surgical technique, the postoperative rehabilitation and the response to patient expectations were included. Results: In total, 83.9% of surgeons discuss the postoperative level of activity with their patients. Sport is considered as an important contributor for good functional outcome by 71.0% of surgeons. Surgeons recommend avoiding, often permanently, weightlifting (35.7%) of the time, rugby (21.4%), horseback riding (17.9%) as well as martial arts (14.3%) postoperatively even with previous training. The return to high levels of activity is considered as a major risk factor for disc herniation recurrence by 25.8% of surgeons. Return to high level of activity is typically recommended after 3 months by 48.4% of surgeons. Conclusion: So far no consensus on the rehabilitation protocol and return to level of activity exists. Recommendations depend on personal experience as well as the individuals' training, and typically, a period of avoidance of sport for up to 3 months is recommended. Level of evidence: Level III, therapeutic and prognostic study. [ABSTRACT FROM AUTHOR]

This paper communicates findings from a doctoral research project which used dance/movement therapy (DMT) to engage two women navigating the criminal justice system in Australia. A feminist-informed participatory research design was applied to learn about each woman's experience and to explore the possible health promoting benefits of community-based DMT. Women serving time on community correctional orders were invited to attend drop-in DMT workshops which were held in a drug and alcohol recovery centre. Participants were invited to offer feedback which was analyzed using reflexive and interpretative methods of ethnographic data generation. Three themes emerged through the data which were understood to reflect simple notions of fun, fitness, and relaxation in DMT. Although limited to a small number of participants, this study undertook a close reading of each woman's feedback and considered themes in light of trauma theory. Drawing from the women's responses, the study articulates the beginnings of an 'exercisePLUS' perspective: a theoretical rationale which validates the role of exercise in DMT and discusses its potential therapeutic significance. Neurobiological trauma frameworks are used to articulate the findings, however, the research seeks to challenge assumptions within the medical model, such as the 'expert' positioning of the therapist. In doing so, this research aims to contribute toward the further development of community-based perspectives in DMT practice, and, offers a theoretical rationale for the use of DMT within a forensic context. [ABSTRACT FROM AUTHOR]

Objectives: Geriatric rehabilitation inpatients are at a higher risk of 25-hydroxyvitamin D (25(OH)D) deficiency due to poor nutrition and low sunlight exposure. This study aimed to evaluate the prevalence of 25-hydroxyvitamin (25(OH)D) deficiency and supplementation and to investigate their association with adverse health outcomes in geriatric rehabilitation inpatients. Design: Prospective, observational and longitudinal study. Setting and Participants: Geriatric rehabilitation inpatients admitted to geriatric rehabilitation wards at the Royal Melbourne Hospital (Melbourne, Australia) from 16th, October 2017 and discharged until 18th, March 2020 in the REStORing health of acutely unwell adulTs (RESORT) study were included. Methods: 25(OH)D levels measured close to rehabilitation admission were classified as sufficiency (>54 nmol/L), insufficiency (26–54 nmol/L), or deficiency (<26 nmol/L). The usage of vitamin D supplementation was extracted from medication records. Outcomes included incidence of institutionalization at three-month post-discharge, in-hospital mortality and post-discharge mortality. Results: The median age of 1328 geriatric rehabilitation inpatients was 83.9 years (IQR: 78.1–88.7, 58.6% female). 25(OH)D deficiency and insufficiency were present in 8.1% and 26.4% of inpatients, respectively; 74.2% used vitamin D supplementation. 25(OH)D deficiency was associated with higher odds of institutionalization (odds ratio (OR): 1.88, 95% confidence interval (CI): 1.14–3.11), in-hospital mortality (OR: 3.30, 95% CI: 1.54–7.07) and higher risks of one-year mortality (hazard ratio (HR): 1.77, 95% CI: 1.17–2.69) compared to 25(OH)D sufficiency but not with three-month mortality. 25(OH)D insufficiency was not associated with outcomes. Patients who did not use supplementation and had 25(OH)D insufficiency or deficiency had significantly higher in-hospital mortality compared to those who used supplementation. Conclusions: Among geriatric rehabilitation inpatients, 25(OH) D deficiency was associated with institutionalization, in-hospital mortality and one-year mortality. Attention to monitor the vitamin D status is of upmost importance during hospitalization. [ABSTRACT FROM AUTHOR]

During the twentieth century, inadequate management of mine waste at the Mount Lyell Copper Mine affected the ecology of the Queen–King Rivers and Macquarie Harbour, western Tasmania, Australia. Over the past two decades, the water quality of the river system has been measured semi-annually to investigate the long-term hydrochemical and environmental impacts caused by these historical mine practices and the waste associated with the Mount Lyell mine to the Queen–King Rivers. At sample sites below the confluence of Haulage Creek, the water pH was below pH 3.5, remaining below pH 5 across all sites to Macquarie Harbour. Local baseline rivers ranged from pH 4.0 to 8.4. Elemental concentrations of dissolved metals in water samples downstream of Haulage Creek were above the Australian and New Zealand Environment and Conservation Council (ANZECC) water quality guidelines. Copper, Fe, and Zn were not attenuated along the length of the river, with concentrations remaining elevated to the King River Delta. Mineralogical analyses demonstrated secondary minerals in sediments at Haulage Creek and pyrite concentrated at the King River Delta. Static tests on mining-affected sediments indicated risk of AMD and metal(loid) leaching in the river system. Since 2016, after flooding of the Prince Lyell mine, dissolved metal levels in the Queen–King Rivers have decreased; however, concentrations remain above guidelines. Almost three decades after legacy mine waste disposal ended, it still poses a long-term risk to the downstream environment, implying that without effective management of these historical mine wastes, the Queen–King Rivers will continue to be severely impacted. [ABSTRACT FROM AUTHOR]

Context: Successful conservation requires a detailed understanding of critical habitats required to support different plant and animal populations. This is particularly important for rewilding programs where locally extinct species are often introduced into novel or reintroduced into areas that have been dramatically altered since they were extirpated. Objectives: Here, we explored changes in the volume of foraging pits of three engineers under different vegetation patch types and different landforms in an arid woodland in Australia based on field experiment. Methods: In this study, we examined the foraging habitat of three ecosystem engineers in the arid eastern Australia: a reintroduced mammal, the greater Bilby (Macrotis lagotis), the Small-beaked echidna (Tachyglossus aculeatus) and a varanid, Gould's sand goanna (Varanus gouldii). The soil disturbing activities of these three animals has been shown to lead to marked and persistent changes in a range of critical ecosystem functions and services. We tracked the density, size and habitat location of 4102 foraging pits over 3 years, as the measure of habitat favourability and the time taken for these foraging pits to infill (pit longevity). Results: We found that foraging was non-random, and animals tended to forage more within shrub patches when accounting for the relative cover of shrubs. There were also some differences among different habitat patch types, with generally larger echidna foraging pits beneath shrubs and trees than in the open interspaces. Pit longevity also varied among animal and patch types, with no differences for bilby or goanna pits across all patches, but greater longevity of echidna foraging pits beneath shrubs. Larger pits tended to persist for longer, and those beneath trees were closer together. Conclusion: Our work shows that foraging, and therefore the ecological effects of these animals vary with the target engineer and the biophysical features of the rewilded habitat. Land restoration programs that aim to restore degraded habitat and ecosystem functions must be cognisant of the idiosyncratic effects of different reintroduced engineers, and the makeup of different patch elements within the target restoration area. [ABSTRACT FROM AUTHOR]

This observational study compared the outcomes of consumers receiving community-based residential mental health rehabilitation support in Australia under a clinical staffing model and an integrated staffing model where Peer Support Workers are the majority component of the staffing profile. Reliable and clinically significant (RCS) change between admission and discharge in functional and clinical assessment measures were compared for consumers receiving care under the clinical (n = 52) and integrated (n = 93) staffing models. Covariate analyses examined the impact of known confounders on the outcomes of the staffing model groups. No statistically significant differences in RCS improvement were identified between the staffing models. However, logistic regression modelling showed that consumers admitted under the integrated staffing model were more likely to experience reliable improvement in general psychiatric symptoms and social functioning. The findings support the clinical and integrated staffing models achieving at least equivalent outcomes for community-based residential rehabilitation services consumers. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic markedly changed how healthcare services are delivered and telehealth delivery has increased worldwide. Whether changes in healthcare delivery borne from the COVID-19 pandemic impact effectiveness is unknown. Therefore, we examined the effectiveness of exercise physiology services provided during the COVID-19 pandemic. Methods: This prospective cohort study included 138 clients who received exercise physiology services during the initial COVID-19 pandemic. Outcome measures of interest were EQ-5D-5L, EQ-VAS, patient-specific functional scale, numeric pain rating scale and goal attainment scaling. Results: Most (59%, n = 82) clients received in-person delivery only, whereas 8% (n = 11) received telehealth delivery only and 33% (n = 45) received a combination of delivery modes. Mean (SD) treatment duration was 11 (7) weeks and included 12 (6) sessions lasting 48 (9) minutes. The majority (73%, n = 101) of clients completed > 80% of exercise sessions. Exercise physiology improved mobility by 14% (β = 0.23, P = 0.003), capacity to complete usual activities by 18% (β = 0.29, P < 0.001), capacity to complete important activities that the client was unable to do or having difficulty performing by 54% (β = 2.46, P < 0.001), current pain intensity by 16% (β = − 0.55, P = 0.038) and goal attainment scaling t-scores by 50% (β = 18.37, P < 0.001). Effectiveness did not differ between delivery modes (all: P > 0.087). Conclusions: Exercise physiology services provided during the COVID-19 pandemic improved a range of client-reported outcomes regardless of delivery mode. Further exploration of cost-effectiveness is warranted. [ABSTRACT FROM AUTHOR]

Health care consumers have emphasised the importance of being able to express themselves in a sexual nature, regardless of their health conditions. Unfortunately, literature based on experienced occupational therapists and students, indicates sexuality is poorly addressed, despite being a meaningful occupation. There is limited literature based on Australian experiences or the experiences of recent graduates, therefore this study aimed to explore how comfortable and prepared 11 recent graduates who studied in Australia, were in addressing sexuality, as well as the enablers and challenges experienced. A qualitative research design was utilized, with results demonstrating that undergraduate curricula are not adequately preparing new graduates to feel equipped with the knowledge, skills, comfort and preparedness to address sexuality. Enablers such as education, professional development and supportive workplaces, can aid to facilitate positive change in this area of practice, which may improve client outcomes. [ABSTRACT FROM AUTHOR]

Background: Fatigue is a common and often debilitating symptom experienced by many stroke survivors. Significant post stroke fatigue may predispose individuals to other health complications, such as falls, which can lead to fractures and soft tissue injuries. Only limited research has examined the association between fatigue and falls in stroke survivors. Methods: Data were obtained from the Sax Institute's 45 and Up Study, from a subset of individuals who had experienced a stroke. The Modified Fatigue Impact Scale—5-item version (MFIS-5) was used to measure the level of fatigue. A logistic regression model, adjusted for stroke characteristics and comorbidities, was used to determine the magnitude of association between change in fatigue score and odds of having had a fall. Results: A total of 576 participants completed the questionnaire. A total of 214 (37.2%) participants reported having had a fall in the previous 12 months. There was a statistically significant association between fatigue scores and fall status (p < 0.001). Specifically, for every 1-point increase in the fatigue score (MFIS-5) (i.e. higher level of fatigue), the odds of a person having a fall is 1.10 times greater (AOR = 1.10; 95% CI 1.05, 1.15; p < 0.001). Conclusion: This study revealed an association between an increasing risk of falls with increasing severity of post stroke fatigue. Accurate detection and management of fatigue may help reduce the risk of falls and should be the focus of future research. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has led to a shift in healthcare towards telehealth delivery, which presents challenges for exercise physiology services. We aimed to examine the impact of the COVID-19 pandemic on the reach, efficacy, adoption and implementation of telehealth delivery for exercise physiology services by comparing Australian practises before (prior to 25 January 2020) and during the COVID-19 pandemic (after 25 January 2020). Methods: This retrospective audit included 80 accredited exercise physiology clinicians. We examined relevant dimensions of the RE-AIM framework (reach, effectiveness, adoption and implementation) from the clinician perspective. Results: During the COVID-19 pandemic, 91% (n = 73/80) of surveyed clinicians offered telehealth delivery service, compared to 25% (n = 20/80) prior. Mean (SD) telehealth delivery per week doubled from 5 (7) to 10 (8) hours. In-person delivery decreased from 23 (11) to 15 (11) hours per week. Typical reasons for not offering telehealth delivery were client physical/cognitive incapacity (n = 33/80, 41%) and safety (n = 24/80, 30%). Clinician-reported reasons for typical clients not adopting telehealth delivery were personal preference (n = 57/71, 80%), physical capacity (n = 35/71, 49%) and access to reliable delivery platforms (n = 27/71, 38%). Zoom (n = 54/71, 76%) and telephone (n = 53/71, 75%) were the most commonly used platforms. Of the reasons contributing to incomplete treatment, lack of confidence in delivery mode was sevenfold higher for telehealth compared to in-person delivery. No serious treatment-related adverse events were reported. Conclusions: During the COVID-19 pandemic, telehealth delivery of exercise physiology services increased and in-person delivery decreased, which suggests the profession was adaptable and agile. However, further research determining comparative efficacy and cost-effectiveness is warranted. [ABSTRACT FROM AUTHOR]

Purpose To identify whether there were differences in work disability duration between injured workers employed by small, medium, large, and self-insured firms and whether these differences varied between workers' compensation jurisdictions in Canada and Australia. Methods Workers' compensation data were used to identify comparable lost-time, work-related injury and musculoskeletal disorder claims in five Canadian and five Australian jurisdictions between 2011 and 2015. Work disability duration was measured using cumulative disability days paid up to one-year post-injury. Jurisdiction-specific quantile regression models were used to estimate differences in cumulative disability days paid to claims from small (< 20 full-time equivalents (FTEs)) medium (20–199 FTEs), large (200 + FTEs) and self-insured firms at the 25th, 50th, and 70th percentiles in the disability distribution, adjusting for confounders. Results Compared to large firms, workers in small firms generally had longer work disability duration at each percentile, particularly in Saskatchewan and Alberta (Canada), Victoria and Australian Capital Territory (Australia), where an additional 31.1, 18.4, 58.5 and 37.0 days were paid at the 75th percentiles, respectively. The disability duration of workers from self-insured firms was longer than large firms in all Canadian jurisdictions but was shorter or no different in Australian jurisdictions. Smaller differences were observed between claims from large and medium-sized firms. Conclusions Workers in small firms had longer work disability duration than those in large firms in all but one of the study jurisdictions. Claims management processes need to be sensitive to the challenges that small firms face in accommodating and returning injured workers back to work. [ABSTRACT FROM AUTHOR]

Saltmarshes provide many valuable ecosystem services including storage of a large amount of 'blue carbon' within their soils. To date, up to 50% of the world's saltmarshes have been lost or severely degraded primarily due to a variety of anthropogenic pressures. Previous efforts have aimed to restore saltmarshes and their ecosystem functions, but the success of these efforts is rarely evaluated. To fill this gap, we used a range of metrics, including organic carbon stocks, root production, soil respiration and microbial communities to compare natural and a 20-year restoration effort in saltmarsh habitats within the Sydney Olympic Park in New South Wales, Australia. We addressed four main questions: (1) Have above- and belowground plant biomass recovered to natural levels? (2) Have organic carbon stocks of soils recovered? (3) Are microbial communities similar between natural and regenerated saltmarshes? and (4) Are microbial communities at both habitats associated to ecosystem characteristics? For both soil organic carbon stocks and belowground biomass, we found no significant differences between natural and regenerated habitats (F(1,14) = 0.47, p = 0.5; F(1,42) = 0.08, p = 0.76). Aboveground biomass was higher in the natural habitat compared to the regenerated habitat (F(1,20) = 27.3, p < 0.0001), which may result from a site-specific effect: protection from erosion offered by a fringing mangrove forest in the natural habitat but not the regenerated habitat. Our microbial community assessment indicated that restored and natural saltmarsh habitats were similar at a phylum level, with the exception of a higher proportion of Proteobacteria in the rhizosphere of saltmarshes from the regenerated habitat (p < 0.01). Abundance of both Desulfuromonas and Geobacter was associated with high carbon and nitrogen densities in soils indicating that these genera may be key for the recovery of ecosystem characteristics in saltmarshes. Our restored and natural saltmarsh soils store at 30 cm depth similar levels of organic carbon: 47.9 Mg OC ha−1 to 64.6 Mg OC ha−1. Conservation of urban saltmarshes could be important for 'blue carbon' programmes aimed at mitigating atmospheric carbon dioxide. [ABSTRACT FROM AUTHOR]

Sexual esteem is the positive regard for and confidence in an individual's capacity to experience their sexuality in a satisfying and enjoyable way. Body esteem is the overall positive or negative evaluation of one's body. Physical disability can have an adverse impact on both of these constructs. This project aimed to study the sexual esteem and body esteem in people with spinal cord damage (SCD). A comprehensive survey (August 2013-June 2014) was conducted of people with SCD (n = 154) living in the community, Australia. The survey included the Physical Disability Sexual and Body Esteem (PDSBE) scale. There were 146 participants who completed the PDSBE scale. Most were male (n = 100, 68.5%), average age of 47.9 years (SD = 13.5) and a median of 11 years (IQR 4-20) post SCD. The mean PDSBE score was 22.2 (SD = 7.9). There was a moderate correlation (r = 0.35) between the total PDSBE score and quality of life as a whole (P = .001) and a weak correlation (r = 0.22) with function (P = 0.01). There was no significant influence of gender or sexual orientation on PDSBE scores. However, people with non-traumatic SCD and paraplegia tended to have higher scores (non-traumatic SCD mean 25.8 [SD = 6.7] vs traumatic SCD mean 21.0 [SD = 8.0], P = .002; paraplegia mean 23.4 [8.1] vs tetraplegia mean 20.6 [7.5], P = 0.04). The mean PDSBE scores for the people with SCD in this study were lower than that reported for non-SCD disabled (mean 25.9, SD = 9.2). Sexual and body esteem are psychological-sexual constructs that complement existing outcomes used when evaluating the impact of SCD. [ABSTRACT FROM AUTHOR]

Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure. Methods: A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15-70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years’ post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt. Results: 17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital. Conclusions: Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes. [ABSTRACT FROM AUTHOR]

Summary: We pilot-tested a trial of home exercise on individuals with osteoporosis and spine fracture.Our target enrollment was met, though it took longer than expected. Participants stayed in the study and completed the exercise program with no safety concerns.Future trials should expand the inclusion criteria and consider other changes.Purpose: Osteoporotic fragility fractures create a substantial human and economic burden. There have been calls for a large randomized controlled trial examining the effect of exercise on fracture incidence. The B3E pilot trial was designed to evaluate the feasibility of a large trial examining the effects of home exercise on individuals at high risk of fracture.Methods: Community-dwelling women ≥ 65 years with radiographically confirmed vertebral compression fractures were recruited at seven sites in Canada and Australia. We randomized participants in a 1:1 ratio to a 12-month home exercise program or equal attention control group, both delivered by a physiotherapist (PT). Participants received six PT home visits in addition to monthly phone calls from the PT and a blinded research assistant. The primary feasibility outcomes of the study were recruitment rate (20 per site in 1 year), retention rate (75% completion), and intervention adherence rate (60% of weeks meeting exercise goals). Secondary outcomes included falls, fractures and adverse events.Results: One hundred forty-one participants were recruited; an average of 20 per site, though most sites took longer than anticipated. Retention and adherence met the criteria for success: 92% of participants completed the study; average adherence was 66%. The intervention group did not differ significantly in the number of falls (IRR 0.97, 95% CI 0.58 to 1.63) or fragility fractures (OR 1.11, 95% CI 0.60 to 2.05) compared to the control group. There were 18 serious adverse events in the intervention group and 12 in the control group.Conclusion: An RCT of home exercise in women with vertebral fractures is feasible but recruitment was a challenge. Suggestions are made for the conduct of future trials. [ABSTRACT FROM AUTHOR]

Purpose To determine whether the delayed recovery often observed in simple musculoskeletal injuries occurring at work is related to poor workplace and home social support. Method A four question psychosocial screening tool called the “How are you coping gauge?” (HCG) was developed. This tool was implemented as part of the initial assessment for all new musculoskeletal workplace injuries. Participants were excluded if they did not meet the strict criteria used to classify a musculoskeletal injury as simple. The HCG score was then compared to the participant’s number of days until return to full capacity (DTFC). It was hypothesised that those workers indicating a poorer level of workplace and home support would take longer time to return to full capacity. Results A sample of 254 participants (316 excluded) were included in analysis. Significant correlation (p < 0.001) was observed between HCG scores for self-reported work and home support and DTFC thereby confirming the hypothesis. Path analysis found workplace support to be a significant moderate-to-strong predictor of DTFC (−0.46). Conclusion A correlation was observed between delayed workplace injury recovery and poor perceived workplace social support. The HCG may be an effective tool for identifying these factors in musculoskeletal workplace injuries of a minor pathophysiological nature. There may be merit in tailoring injury rehabilitation towards addressing psychosocial factors early in the injury recovery process to assist with a more expedient return to full work capacity following simple acute musculoskeletal injury. [ABSTRACT FROM AUTHOR]

Purpose Research suggests that for many cancer survivors, returning to work has a range of benefits. However, considerable barriers have been identified as influencing the quality of return to work outcomes. This study explored the perspectives of Australian cancer survivors, managers and employee assistance program (EAP) professionals to gain an understanding of the return to work process and factors that affect the experience. Methods Focus groups and interviews were conducted with cancer survivors (n = 15), managers (n = 12), and EAP professionals / psychologists (n = 4) from public and private sectors. Thematic analysis was used to analyse the data to identify common and unique themes from the three participant groups. Results A range of drivers were identified including maintaining normality and regaining identity, which could act positively or negatively depending on survivors' coping ability and self awareness. Analysis revealed communication difficulties in the workplace that impact on emotional and practical support. Negotiating an employee's return is complex, influenced by the level of consultation with the employee and use of an ad hoc or structured process. Direct and indirect ways of supporting employees with cancer were identified, as was the need for colleague and manager support. Conclusion This study supports previous research findings of the impact of cancer on work, and reveals managers' lack of knowledge on how to respond appropriately. The process of returning to work is complex, influenced by employees' and managers' attitudes, communication skills and coping abilities. Areas for workplace interventions to optimise support for the cancer survivor are described. [ABSTRACT FROM AUTHOR]

This paper investigates the attitudes and beliefs that the public hold about criminal behaviour in Japanese and Australian society, with a view to uncovering sources of resistance to, and support for, restorative justice. The study draws on a survey of 1,544 respondents from Japan and 1,967 respondents from Australia. In both societies, restorative justice met with greater acceptance among those who were (1) strong in social capital, (2) believed in offender reintegration and rehabilitation, (3) saw benefits for victims in forgiveness, and (4) were advocates for victims' voices being heard and amends made. The alternative 'just deserts' and deterrence models for dealing with crime were grounded in attitudes of punitiveness and fear of moral decay, and reservations about the value of reintegrating and rehabilitating offenders. Like restorative justice supporters, 'just deserts' and deterrence supporters expressed concern that victims' voices be heard and amends made. Winning public support for competing institutional arrangements may depend on who does best in meeting expectations for meeting the needs of victims. [ABSTRACT FROM AUTHOR]

In the 1970s, acid sulfate soils (ASS) distributed within about 720 ha of predominantly mangrove and salt pan wetlands at East Trinity in north Queensland were developed after the area was isolated from tidal flooding by a surrounding seawall and the installation of tidal gates on major drainage creeks. Following drainage and oxidation of these estuarine acidic sediments, resultant acid leachate caused considerable, ongoing environmental problems including regular fish kills. A rehabilitation program covering much of these former tidal wetlands commenced in 2000 using a lime-assisted tidal exchange management regime. Changes in the established populations of estuarine fish and crustaceans were monitored in the two creeks (Firewood and Hills Creeks) where tidal flows were reinstated. In Firewood Creek between 2001 and 2005, there was a progressive increase in fish species richness, diversity and abundance. The penaeid prawn Fenneropenaeus merguiensis was a major component of the cast net catches in the lower sections of both Firewood and Hills Creeks but its relative abundance decreased upstream of the tidal gates on the seawall. Well established stocks of predominantly juvenile, male Scylla serrata resident upstream of the tidal gates indicated suitable habitats with acceptable water and sediment quality and adequate availability of food. The regular fish kills that occurred prior to the management regime abated and, overall, the implementation of the rehabilitation program is yielding positive benefits for the local fisheries. [ABSTRACT FROM AUTHOR]

To examine factors impacting long-term health-related outcomes in survivors of Guillain-Barre syndrome (GBS). Seventy-six consecutive patients with definite GBS admitted to the Royal Melbourne Hospital (1996-2009) were reviewed in the neurorehabilitation clinics. They underwent a structured interview designed to assess the impact of GBS on their current activity and restriction in participation using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact of Problem Profile (PIPP) and Depression Anxiety Stress Scale (DASS). Their sociodemographic and disease severity data were obtained from the medical record. The 76 patients [60% male, mean age 56 years, median time since GBS 6 years (range 1-14 years)] showed good functional recovery (median motor FIM score 90). However, 16% reported moderate to extreme impact on their ability to participate in work, family, and social activities; and 22% substantial impact on mood, confidence and ability to live independently. More reported moderate to extreme depression (18%), anxiety (22%) and stress (17%) compared with the normative Australian population (13%). Factors associated with poorer current level of functioning and wellbeing included: females, older patients (57+ years), acute hospital stay (>11 days), those treated in intensive care and those discharged to rehabilitation. No associations were found between the Medical Research Council (MRC) Motor Scale Rating scores at admission, nor time since GBS diagnosis (≤6 vs. >6 years) on outcomes used. Conclusion: GBS is complex and requires long-term management of psychological sequelae impacting activity and participation. [ABSTRACT FROM AUTHOR]

Soil organic matter (SOM) increases with time as landscape is restored. Studying SOM development along restored forest chronosequences would be useful in clarifying some of the uncertainties in quantifying C turnover rates with respect to forest clearance and ensuing restoration. The development of soil organic matter in the mineral soils was studied at four depths in a 16-year-old restored jarrah forest chronosequence. The size-separated SOM fractionation along with δC isotopic shift was utilised to resolve the soil C temporal and spatial changes with developing vegetation. The restored forest chronosequence revealed several important insights into how soil C is developing with age. Litter accumulation outpaced the native forest levels in 12 years after restoration. The surface soils, in general, showed increase in total C with age, but this trend was not clearly observed at lower depths. C accumulation was observed with increasing restoration age in all three SOM size-fractions in the surface 0-2 cm depth. These biodiverse forests show a trend towards accumulating C in recalcitrant stable forms, but only in the surface 0-2 cm mineral soil. A significant reverse trend was observed for the moderately labile SOM fraction for lower depths with increasing restoration age. Correlating the soil δC with total C concentration revealed the re-establishment of the isotopically depleted labile to enriched refractory C continuum with soil depth for the older restored sites. This implied that from a pedogenic perspective, the restored soils are developing towards the original native soil carbon profile. [ABSTRACT FROM AUTHOR]

Background/objectives: Routine nutrition screening is recommended for all older patients admitted to hospital however data on the prevalence of malnutrition in rehabilitation settings is sparse. This study assessed the nutritional status of older patients admitted to rehabilitation hospitals over a 5 year period and described the association between nutritional status and length of hospital stay (LOS) in this context. The usefulness of a recently revised version of the shortened MNA (MNA-SF) was also investigated. Methods: A retrospective analysis was conducted of patients aged 65 + y admitted to two rehabilitation hospitals in New South Wales, Australia between 1st March 2003-30th June 2004, and 11th January 2005-10th December 2008. Nutritional status was determined on admission by trained dieitians using the full MNA instrument and the MNA-SF. Information on diagnosis-related grouping and length of stay (LOS) was obtained. Results: Data was available for 2076 patients with a mean age of 80.6 (27.7) y. Thirty-three percent and 51.5 % of patients were classified as malnourished and at nutritional risk, respectively. Controlling for date of admission and diagnosis related grouping, LOS was higher in malnourished and at risk groups compared to their well nourished peers (P<0.001) by 18.5 and 12.4 days, respectively. MNA-SF demonstrated high sensitivity but relatively low specificity against the full MNA. Conclusion: The majority of older patients in the rehabilitation setting are nutritionally compromised which adversely influences LOS. In order to encourage more widespread screening, the MNA-SF may be able to replace the full MNA. [ABSTRACT FROM AUTHOR]

Introduction This study investigated the perceptions and practices of Australian health professionals in relation to the use of functional capacity evaluations (FCE’s). Methods A quantitative cross-sectional study design was used to survey health professionals who conduct FCE’s and who were working for one of 219 rehabilitation providers in NSW, Australia. Seventy seven returned surveys were eligible for inclusion. Results Eleven different FCE’s were being utilised with many health professionals using more than one FCE. The most commonly used FCE was non-standardised (56%, n = 43) followed by 52% ( n = 40) using the Workhab, and 18% ( n = 14) using Valpar. Both non-standardised and standardised assessments were being used by 90% ( n = 69) of respondents. Health professionals reported using all or parts of the FCE, and indicated identical FCE’s are not always conducted, with adaptation of the FCE, due to client injury (82%, n = 62) and job (80%, n = 43) occurring. About 60% of respondents had no choice in the type of FCE they conducted, and of the 40% with a choice, this was not influenced by other stakeholders in the process. Accreditation and training, characteristics of assessment tasks, standardisation, reliability, cost, length and flexibility were all identified as factors affecting the selection of an FCE. Conclusions This study demonstrated that health professionals in NSW Australia, are not routinely using standardised tools for FCE’s. Health professional perceptions suggest accreditation, training and the characteristics of the FCE were important factors in FCE selection. In practice, participants tended to use parts of an FCE rather than the whole FCE. Adaptation of FCE’s was common, due to client injury and specific job requirements. [ABSTRACT FROM AUTHOR]

Introduction The aim of this study was to compare the clinical management of patients with occupational low back pain (LBP) presenting to secondary care practitioners in Australia with national and international practice guidelines. Methods A consecutive cohort of 401 patients with LBP following a work injury was assembled at the time of referral to secondary rehabilitation. A comprehensive assessment was performed to collect demographic, clinical and occupational data, which were analysed using descriptive statistics. Clinical and occupational management data were compared with evidence-based guidelines for the management of LBP. Results This study revealed that in this cohort presenting to secondary care, referral for guideline-based active treatment was delayed until, on average, 10 months post-injury; radiographic investigations had been ordered for almost every patient, including those presenting in the first three months of their injury; the prevalence of co-morbidities was high and there were signs that psychological distress was under-diagnosed. Conclusions This study reveals a lack of compliance with clinical guidelines for occupational back pain management in Australia. [ABSTRACT FROM AUTHOR]

It is clear that saltmarshes are a unique and important component of the coastal biosphere of Australia. Their contribution ranges from stabilisation of fine sediments and providing an excellent protective buffer between land and sea, to their diverse blend of terrestrial and marine fauna. Further, saltmarsh plants are highly specialised and adapted to fill a harsh niche allowing them to act in roles that other vegetation types cannot. Saltmarsh habitats are recognised for their importance to migratory waders under the Ramsar convention, but it is becoming increasingly evident that they are also important to a variety of commercially valuable fish and native mammal species. Activities that are detrimental to saltmarshes continue and need to be addressed in order to conserve remaining saltmarsh areas. In general, urbanisation of the catchment has lead to filling of saltmarshes, tidal restriction, use by recreational vehicles, grazing, trampling and increased sedimentation and nutrient runnoff allowing colonisation and invasion of mangroves. These disturbances have a number of ecological consequences ranging from weed infestation to complete changes in the species composition and ecology. Reversing the disturbance is not always simple and can require extensive groundwork to be successful. Rehabilitation of existing saltmarsh areas has been a successful means to enhance this habitat. In general, it requires relatively little effort to remove weeds and fence off areas to regenerate naturally. Saltmarsh areas have been shown to respond well to this type of manipulation. Restoration and creation require substantial effort and planning to ensure a successful outcome. However, given the right environmental combinations of elevation, tide and salinity, saltmarsh will establish and grow. To speed the process transplantation of saltmarsh plants can be considered either from donor sites or plants propagated in green houses. [ABSTRACT FROM AUTHOR]

This article describes an airborne γ survey of a 7 × 5 km region around the rehabilitated Nabarlek uranium mine in northern Australia. An unusually tight line spacing (100 m) and low aircraft height (50 m) were used, enabling the survey to distinguish man-made structures such as ponds and accommodation areas, as well as creek lines. Positive correlations between airborne data and ground-based readings enabled an estimation of the average absorbed dose rate arising from terrestrial γ radiation over large areas of the site to be derived. For the fenced minesite area this estimate was 0.31 μ Gy hr− 1. The airborne survey data were found to be invaluable in helping to plan further ground-level investigations and showed promise as an assessment tool for rehabilitated minesites. [ABSTRACT FROM AUTHOR]

In this study, dry season radon flux densities and radon fluxes have been determined at the rehabilitated Nabarlek uranium mine in northern Australia using conventional charcoal canisters. Environmental background levels amounted to 31± 15 milli Becquerel per m2 per second (mBq m−2 s−1). Radon flux densities within the fenced rehabilitated mine area showed large variations with a maximum of 6500 mBq m−2 s−1 at an area south of the former pit characterised by a disequilibrium between 226Ra and 238U. Radon flux densities were also high above the areas of the former pit (mean 971 mBq m−2 s−1) and waste rock dump (mean 335 mBq m−2 s−1). The lower limit for the total pre-mining radon flux from the fenced area (140 ha) was estimated to 214 kBq s−1, post-mining radon flux amounted to 174 kBq s−1. Our study highlights that the results of radon flux studies are vitally dependant on the selection of individual survey points. We suggest the use of a randomised system for both the selection of survey points and the placement of charcoal canisters at each survey point, to avoid over estimation of radon flux densities. It is also important to emphasize the significance of having reliable pre-mining radiological data available to assess the success of rehabilitation of a uranium mine site. [ABSTRACT FROM AUTHOR]

Urbanization is acknowledged as one of the most severe threats to stream health, spawning recent research efforts into methods to ameliorate these negative impacts. Attention has focused on streams in densely-populated cities but less populous regional urban centres can be equally prone to some of the same threats yet might not meet the conventional definitions of urban. Several recent reviews have identified the changes to streams that occur during urbanization but they note that few ecological studies have explored ecosystem-level responses, typically focusing instead on state variables such as invertebrate abundance. In many regional urban streams, changes to the extent of impervious drainage have implications for their hydrology and channel morphology but the influence of these changes on fundamental ecosystem processes of leaf litter breakdown and transport compared with those in nearby rural streams are poorly known. The widespread practice of planting exotic trees along riparian zones and street margins draining into urban streams further exacerbates the disruption of natural organic matter dynamics. The combination of seasonal leaf fall by exotic species and the altered drainage patterns through urbanization in Armidale, a regional town in New South Wales, Australia, resulted in contrasting patterns of benthic organic matter storage over 18 months compared to nearby reference and rural streams. Macroinvertebrate detritivore densities were low in the urban stream, implying disruption of the usual biological pathways of leaf breakdown. Understanding the interactions of hydrology, drainage pattern, leaf input and biological attributes of a stream is crucial for managers trying to restore stream ecosystem services without incurring public concern about the appearance of regional urban streams. [ABSTRACT FROM AUTHOR]

The decline of the endangered Mary River cod, Maccullochella peelii mariensis, of Queensland, Australia, has been attributed to anthropomorphic habitat alterations, however, the relationships between this subspecies and its physical environment are poorly understood. We used radiotelemetry to investigate the movements and use of habitats by nine Mary River cod (total length 420–760 mm; weight 1.3–5.5 kg) in the Mary River system over a 20 month period. The mean distance moved each month was positively correlated with monthly stream discharge, but the direction of movements was unpredictable. Patterns of movement varied considerably among individuals and appeared to be unrelated to size. Cod established home ranges of between 70 and 820 m in length. Five of the tagged cod returned to a previous home range after moving more than 10 km, whereas three did not move more than 2 km from their capture location for the duration of the study. Cod used large woody debris complexes more than any other type of habitat, and rarely used areas of open water. Managers should give high priority to maintenance of fish passage and protection/rehabilitation of large woody debris habitats if cod populations are to recover. [ABSTRACT FROM AUTHOR]

This paper summarizes trends in Australian wetland rehabilitation onthe basis of responses to a questionnaire from sixty-nine rehabilitation projects and a literature review. Project sizes ranged from 0.4 to 110,000 ha. Costs ranged from A $6 to 70,000 ha-1 yr-1, with most projects costing less than A$1,000 ha-1 yr-1 and with larger projects generally costing less per area than smaller projects. The oldest project began in 1963, but most projects began between 1990 and 1996. The most commonly cited dominant plant genera in rehabilitation projects were Eucalyptus, Melaleuca, Muehlenbeckia, Juncus, Avicennia, and Typha. Filling and draining and altered hydrology were the most commonly cited impacts that led to a need for rehabilitation, while excavation and planting were the most commonly cited rehabilitation methods. About 65% of projects undertake rehabilitation methods that address the causes of impacts. Habitat improvement was the most commonly stated objective in wetland rehabilitation. Of the projects that supported monitoring programs, fewer than 25% appeared to monitor variables that were closely linked to project goals. Thirty-six projects reported involvement in research other than monitoring, with vegetation research most frequently cited. Most projects encouraged some level of community involvement. Wetland rehabilitation in Australia could benefit from a centralized register of projects and a library of rehabilitation literature, including government and in-house reports. [ABSTRACT FROM AUTHOR]

The existence of laws and policies in Australia that affect wetland protection and rehabilitation has been ascertained. There is a diverse range of environmental legislation, primarily at the state level, that potentially affects wetlands. There are environmental planning instruments made under legislation in New South Wales and Western Australia, which are specifically directed to the protection of wetlands. These are legislative-backed mechanisms providing legal protection towetlands. Whilst there is no national policy on wetlands, a draft Commonwealth policy has been circulated and is expected to be released in final form in February 1997. New South Wales is the only state with a current wetlands policy, whilst some other states have draft policies. These policies do refer to wetland rehabilitation. The present federal government indicated it wished to finalize a national wetlands policy in the lead up to its election in March 1996. This is not likely to happen soon and any national policy will probably be an implementation framework for the policies of individual governments. It issuggested that a commonwealth policy, whilst useful in providing consistency in commonwealth government decision making affecting wetlands, does not go far enough. Given that only one state in Australia hasa wetland policy, it may take the formulation of a national policy to get the remaining states and territories in Australia to finalize their own policies. [ABSTRACT FROM AUTHOR]