The role of the health surveillance program in the Queensland coal mining industry

The Queensland Coal Industry Employees Health Scheme was implemented in 1993 to provide health surveillance for all Queensland coal industry workers. Tt1e government, mining employers and mining unions agreed that the scheme should operate for seven years. At the expiry of the scheme, an assessment of the contribution of health surveillance to meet coal industry needs would be an essential part of determining a future health surveillance program. This research project has analysed the data made available between 1993 and 1998. All current coal industry employees have had at least one health assessment. The project examined how the centralised nature of the Health Scheme benefits industry by identi~)jng key health issues and exploring their dimensions on a scale not possible by corporate based health surveillance programs. There is a body of evidence that indicates that health awareness - on the scale of the individual, the work group and the industry is not a part of the mining industry culture. There is also growing evidence that there is a need for this culture to change and that some change is in progress. One element of this changing culture is a growth in the interest by the individual and the community in information on health status and benchmarks that are reasonably attainable. This interest opens the way for health education which contains personal, community and occupational elements. An important element of such education is the data on mine site health status. This project examined the role of health surveillance in the coal mining industry as a tool for generating the necessary information to promote an interest in health awareness. The Health Scheme Database provides the material for the bulk of the analysis of this project. After a preliminary scan of the data set, more detailed analysis was undertaken on key health and related safety issues that include respiratory disorders, hearing loss and high blood pressure. The data set facilitates control for confounding factors such as age and smoking status. Mines can be benchmarked to identify those mines with effective health management and those with particular challenges. While the study has confirmed the very low prevalence of restrictive airway disease such as pneu"moconiosis, it has demonstrated a need to examine in detail the emergence of obstructive airway disease such as bronchitis and emphysema which may be a consequence of the increasing use of high dust longwall technology. The power of the Health Database's electronic data management is demonstrated by linking the health data to other data sets such as injury data that is collected by the Department of l\1mes and Energy. The analysis examines serious strain -sprain injuries and has identified a marked difference between the underground and open cut sectors of the industry. The analysis also considers productivity and OHS data to examine the extent to which there is correlation between any pairs ofJpese and previously analysed health parameters. This project has demonstrated that the current structure of the Coal Industry Employees Health Scheme has largely delivered to mines and effective health screening process. At the same time, the centralised nature of data collection and analysis has provided to the mines, the unions and the government substantial statistical cross-sectional data upon which strategies to more effectively manage health and relates safety issues can be based.

Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

NAPLAN, a high priority or . . . ? Statements about its purpose in Queensland schools

This paper reports on statements from Professional Development participants who were asked to comment on NAPLAN. The participants were involved in a project designed by the YuMi Deadly Centre (YDC) for implementation into 25 Queensland School to enhance the teaching and learning of mathematics to Aboriginal and Torres Strait Islander students and low SES students. Using an action research framework and a survey questionnaire, the preliminary data obtained from participating principals is mixed, with statements indicating that NAPLAN is a high priority for some schools while others indicated that it does not “tell” the whole story of student learning.

What factors are associated with cyclists getting injured? Correlates of cyclist injuries in Queensland

Pedal cyclists are over-represented in traffic crash injuries in Australia. This study examined correlates of cycling injuries in a sample of Queensland cyclists. Members of Bicycle Queensland (n=1976) were asked about cycling injuries as part of an online survey. They also reported demographic characteristics, reasons for cycling, years of cycling as an adult, and cycling frequency. Multivariate logistic regression modelling was used to examine the association between these variables and experiencing cycling injuries last year (yes/no). Thirty-one percent of respondents (n=617) reported at least one cycling injury. Respondents had greater likelihood of injury if they cycled more frequently, had cycled <5 years, or cycled for recreation or competition. These findings suggest that injuries are mostly likely to occur among less experienced cyclists, those cycling the most, and those cycling for sport and recreation. Injury prevention interventions should include cycle skills training along with fostering safer cycling environments.

A preliminary examination of the effects of changes in motorcycle licensing in Queensland

Several sets of changes have been made to motorcycle licensing in Queensland since 2007, with the aim of improving the safety of novice riders. These include a requirement that a motorcycle learner licence applicant must have held a provisional or open car licence for 12 months, and imposing a 3 year limit for learner licence renewal. Additionally, a requirement to hold an RE (250 cc limited) class licence for a period of 12 months prior to progressing to an R class licence was introduced for Q-RIDE. This paper presents analyses of licensing transaction data that examine the effects of the licensing changes on the duration that the learner licence was held, factors affecting this duration and the extent to which the demographic characteristics of learner licence holders changed. The likely safety implications of the observed changes are discussed.

Service learning in teacher education

If the student wellbeing pedagogy characterised by the troika metaphor is to become more widely adopted, beginning teachers need to be inducted into service learning. In this chapter, we discuss the implementation and outcomes of a service learning program in a Bachelor of Education course in Australia. The program provides pre-service teachers with insights into service learning practice. Pre-service teachers are given supported opportunities to examine and challenge traditional beliefs and values about student diversity and the role of schools in developing a more inclusive society. They are supported in developing ethics of care and concern for inclusive and equitable practices – characteristics necessary for quality teaching. Thus, the Queensland University of Technology (QUT) service learning program is an ideal example of the troika effect in practice, in that the pedagogy fuses values education, quality teaching and service learning to develop within each student an inclusive ethical framework that will inform their classroom practice as beginning quality teachers.