Exploring non-cancer pain conditions in a community sample : critiquing a current conceptual model of the acute to chronic pain transition and examining predictors of chronicity

This program of research examines the experience of chronic pain in a community sample. While, it is clear that like patient samples, chronic pain in non-patient samples is also associated with psychological distress and physical disability, the experience of pain across the total spectrum of pain conditions (including acute and episodic pain conditions) and during the early course of chronic pain is less clear. Information about these aspects of the pain experience is important because effective early intervention for chronic pain relies on identification of people who are likely to progress to chronicity post-injury. A conceptual model of the transition from acute to chronic pain was proposed by Gatchel (1991a). In brief, Gatchel’s model describes three stages that individuals who have a serious pain experience move through, each with worsening psychological dysfunction and physical disability. The aims of this program of research were to describe the experience of pain in a community sample in order to obtain pain-specific data on the problem of pain in Queensland, and to explore the usefulness of Gatchel’s Model in a non-clinical sample. Additionally, five risk factors and six protective factors were proposed as possible extensions to Gatchel’s Model. To address these aims, a prospective longitudinal mixed-method research design was used. Quantitative data was collected in Phase 1 via a comprehensive postal questionnaire. Phase 2 consisted of a follow-up questionnaire 3 months post-baseline. Phase 3 consisted of semi-structured interviews with a subset of the original sample 12 months post follow-up, which used qualitative data to provide a further in-depth examination of the experience and process of chronic pain from respondents’ point of view. The results indicate chronic pain is associated with high levels of anxiety and depressive symptoms. However, the levels of disability reported by this Queensland sample were generally lower than those reported by clinical samples and consistent with disability data reported in a New South Wales population-based study. With regard to the second aim of this program of research, while some elements of the pain experience of this sample were consistent with that described by Gatchel’s Model, overall the model was not a good fit with the experience of this non-clinical sample. The findings indicate that passive coping strategies (minimising activity), catastrophising, self efficacy, optimism, social support, active strategies (use of distraction) and the belief that emotions affect pain may be important to consider in understanding the processes that underlie the transition to and continuation of chronic pain.

Enriching relationships : community engagment toward sustainable coastal futures

Coastal communities face the social, cultural and environmental challenges of managing rapid urban and industrial development, expanding tourism, and sensitive ecological environments. Enriching relationships between communities and universities through a structured engagement process can deliver integrated options towards sustainable coastal futures. This process draws on the embedded knowledge and values of all participants in the relationship, and offers a wide and affordable range of options for the future. This paper reviews lessons learnt from two projects with coastal communities, and discusses their application in a third. Queensland University of Technology has formed collaborative partnerships with industry in Queensland's Wide Bay-Burnett region to undertake a series of planning and design projects with community engagement as a central process. Senior students worked with community and produced design and planning drawings and reports outlining future options for project areas. A reflective approach has been adopted by the authors to assess the engagement process and outcomes of each project to learn lessons to apply in the next. Methods include surveying community and student participants regarding the value they place on process and outcomes respectively in planning for a sustainable future. All project participants surveyed have placed high importance on the process of engagement, emphasising the value of developing relationships between all project partners. The quality of these relationships is central to planning for sustainable futures, and while the outcomes the students deliver are valued, it is as much for their catalytic role as for their contents. Design and planning projects through community engagement have been found to develop innovative responses to the challenges faced by coastal communities seeking direction toward sustainable futures. The enrichment of engagement relationships and processes has an important influence on the quality of these design and planning responses.

Empowerment games : empathic design probes for user participation in community housing

This paper documents the empowering process of a group of public housing residents through different design probing exercises. These exercises worked along with existing social processes without any involvement of designers. This paper shows how a design researcher devised a series of probing tools called "empowerment games" with a group of active users. These games are self-learning tools for making the abstract language of design legible to users. The main purpose of this intitiative was to change the preconception of govenmental bodies and professional designers of the passivity of the users with regard to their designed environment. This was the first case of the application of a participatory design process in Hong Kong subsidized housing. Design empathy is a central skill when working with users throughout the whole design research project.

Down the aisle : the effects of technological change on retail workers skills

Reconfiguration of corporate structures and the retailer-supplier interface in the retail industry have restructured product markets and supply chains, as well as supermarket employment, over the past decade or so (Baret, Lehndorff & Sparks 2000; du Gay 1996). Various studies have examined the consequent changes in labour usage practices within supermarkets or superstores (Baret et al. 2000; Marchington 1995; Penn & Wirth 1993; Sparks 1992; Dawson, Findlay & Sparks 1987, 1986). Commonly, this literature explores the interplay between shifts in the structure of the labour market, broader societal trends and retailers’ employment strategies. One study found that domestic and gender dimensions, accompanied by industrial relations regimes, exert considerable influence on patterns of labour usage (Baret et al. 2000). However, while the types of labour usage and the drivers of changes to labour usage patterns have attracted significant academic attention, research has largely overlooked the ways in which the nature of supermarket work has evolved as a result of changing technology, which effectively bolsters managerial prerogative, and which has affected the skill levels of workers in the industry (Marchington 1995).

Union strategies in representing ‘new workers’ : the case of UK retail union

The purpose of this paper is to explore the changing nature of employee voice through trade union representation in the retail industry. The retail industry is a major employer in the UK and is one of the few private sector service industries with union representation (Griffin et al 2003). The requisite union: the Distributive and Allied Workers (USDAW) union is one of the biggest unions in the country. However, the characteristics of the industry provide unique challenges for employee voice and representation including: high labour turnover; high use of casual, female and student labour; and, variable levels of union recognition (Reynolds et al 2005). Irrespective of these challenges, any extension of representation and organisation by unions in the retail sector is inherently valuable, socially and politically, given that retail workers are often categorised as vulnerable, due to the fact that they are among the lowest paid in the economy, sourced from disadvantages labour markets and increasingly subject to atypical employment arrangements (Broadbridge 2002; Henley 2006; Lynch 2005; Roan 2003).

Looking through the haze of discontent : smokers as a data source

In the case of industrial relations research, particularly that which sets out to examine practices within workplaces, the best way to study this real-life context is to work for the organisation. Studies conducted by researchers working within the organisation comprise some of the (broad) field’s classic research (cf. Roy, 1954; Burawoy, 1979). Participant and non-participant ethnographic research provides an opportunity to investigate workplace behaviour beyond the scope of questionnaires and interviews. However, we suggest that the data collected outside a workplace can be just as important as the data collected inside the organisation’s walls. In recent years the introduction of anti-smoking legislation in Australia has meant that people who smoke cigarettes are no longer allowed to do so inside buildings. Not only are smokers forced outside to engage in their habit, but they have to smoke prescribed distances from doorways, or in some workplaces outside the property line. This chapter considers the importance of cigarette-smoking employees in ethnographic research. Through data collected across three separate research projects, the chapter argues that smokers, as social outcasts in the workplace, can provide a wealth of important research data. We suggest that smokers also appear more likely to provide stories that contradict the ‘management’ or ‘organisational’ position. Thus, within the haze of smoke, researchers can uncover a level of discontent with the ‘corporate line’ presented inside the workplace. There are several aspects to the increased propensity of smokers to provide a contradictory or discontented story. It may be that the researcher is better able to establish a rapport with smokers, as there is a removal of the artificial wall a researcher presents as an outsider. It may also be that a research location physically outside the boundaries of the organisation provides workers with the freedom to express their discontent. The authors offer no definitive answers; rather, this chapter is intended to extend our knowledge of workplace research through highlighting the methodological value in using smokers as research subjects. We present the experience of three separate case studies where interactions with cigarette smokers have provided either important organisational data or alternatively a means of entering what Cunnison (1966) referred to as the ‘gossip circle’. The final section of the chapter draws on the evidence to demonstrate how the community of smokers, as social outcasts, are valuable in investigating workplace issues. For researchers and practitioners, these social outcasts may very well prove to be an important barometer of employee attitudes; attitudes that perhaps cannot be measured through traditional staff surveys.

Management and organisational barriers in the acquisition of computer usage skills by mature age workers

Aim: To investigate workplace cultures in the acquisition of computer usage skills by mature age workers. Methods: Data were gathered through focus groups conducted at job network centres in the Greater Brisbane metropolitan region. Participants who took part were a mixture of workers and job-seekers. Results: The results suggest that mature age workers can be exposed to inappropriate computer training practices and age-insensitive attitudes towards those with low base computer skills. Conclusions: There is a need for managers to be observant of ageist attitudes in the work place and to develop age-sensitive strategies to help mature age workers learn computer usage skills. Mature age workers also need to develop skills in ways which are practical and meaningful to their work.

Understanding rural and remote schools, and facilitating school-community relationships

Rural and remote schools make up a significant portion of Australian schools. Although there are rural schools that exceed 500 students, the Australian Bureau of Statistics (ABS) (2008) reports that 2,188 Australian primary schools have enrolment numbers less than 100. Rural schools need a supply of good teachers; however many universities involved in teacher education are located in city areas. For example, Queensland University of Technology is city-based, generating the highest number of early career teachers for Queensland including teachers for rural schools. Given the number of graduates and the number of rural schools, it seems likely that early career teachers will have opportunities for teaching in these settings, which also means living within a rural community. This chapter will discuss the nature of teaching in rural and remote schools, the challenges, the rewards and the importance of working closely with the local community. It is hoped that by understanding rural and remote schools, early career teachers can make informed decisions that will influence their future career prospects.

Being and Living in an Australian Urban Community

There is a limited evidence base which highlights the plight of Australian Aboriginal and Torres Strait Islander populations living in urban areas and the issues that impact on Indigenous achievements in education, health status, housing needs, rates of incarceration and the struggle for cultural recognition. This is despite over 70 % of all Aboriginal and Torres Strait Islander people in Australia now living in urban or regional urban areas (ABS 2008). The statistics demonstrate that living in urban centres is as much part of reality for Australian Aboriginal and Torres Strait Islander people as living in a remote discrete community. Using the capital city of Brisbane, Queensland as a case study, this paper will explore some of the issues that Aboriginal and Torres Strait Islander peoples face against a backdrop of the statistics and some of the current literature. It will additionally explore why there has been limited research with Aboriginal and Torres Strait Islander populations in urban areas and highlight some of the innovative research taking place which will begin to redress this gap. The research issues presented within this paper will resonate with some of the Native American and Indigenous movement patterns and associated issues additionally occurring in the United States of America, Canada and New Zealand.

Union strategies in representing ‘new’ workers : the comparative case of UK and Australian retail unions

This paper is a comparative exploratory study of the changing nature of employee voice through trade union representation in the retail industry in the UK and Australia. In both countries, the retail industry is a major employer and is one of the few private sector service industries with significant union membership (Griffin et al 2003). The relevant unions, the Distributive and Allied Workers Union (USDAW) and the Shop, Distributive and Allied Union (SDA), are the fourth largest and largest unions in the UK and Australia respectively. However, despite this seeming numerical strength in membership, the characteristics of the industry provide unique challenges for employee voice and representation. The significance of the study is that any extension of representation and organisation by unions in the retail sector is valuable socially and politically, given that retail workers are often categorised a s vulnerable, due to their low pay, the predominance of disadvantaged labour market groups such a s women and young people, workers’ atypical employment arrangements and, in the case of the UK, variable levels of union recognition which inhibit representation (Broadbridge 2002; Henley 2006; Lynch 2005; Roan & Diamond 2003; Reynolds et al 2005). In addition, specifically comparative projects have value in that they allow some variables relating to the ‘industry’ to be held constant, thus reducing the range of potential explanations of differences in union strategy. They also have value in that the research partners may be more likely to notice and problematise taken-for-granted aspects of practices in another country, thus bringing to the fore key features and potentially leading to theoretical innovation. Finally, such projects may assist in transnational diffusion of union strategy.

The new world of work and employment: fitness workers and what they want from the employment relationship

This paper reports on an empirically based study of the Queensland (Australia) health and fitness industry over 15 years (1993 -2008). This study traces the development of the new occupation of fitness instructor in a service industry which has evolved si nce the 1980s and is embedded in values of consumption and individualism. It is the new world of work. The data from the 1993 study was historically significant, capturing the conditions o f employment in an unregulated setting prior to the introduction of the first industrial a ward in that industry in 1994. Fitness workers bargained directly with employers over all a spects of the employment relationship without the constraints of industrial regulation or the presence of trade unions. The substantive outcomes of the employment relationship were a direct reflection of m anagerial prerogative and worker orientation and preference, and did not reflect the rewards and outcomes traditionally found in Australian workplaces. While the focus of the 1993 research was on exploring the employment relationship in a deregulated environment, an unusual phenomenon was identified: fitness workers happily trading-off what would be considere d standard working conditions for the opportunity to work (‘take the stage’). Since then, several streams of literature have evolved providing a new context for understanding this phenomenon in the fitness industry, including: the sociology of the body (Shilling 1993; Turner 1996); emotional (Hochschild 1984) and aesthetic labour (Warhurst et al 2000); the so cial relations of production and space (Lefebvre 1991; Moss 1995); body history (Helps 2007); the sociology of consumption (Saunders 1988; Baudrillard 1998; Ritzer 2004); and work identity (Du Gay 1996; Strangleman 2004). The 2008 survey instrument replicated the 1993 study but was additionally informed b y the new literature. Surveys were sent to 310 commercial fitness centres and 4,800 fitness workers across Queensland. Worker orientation appears unchanged, and industry working conditions still seem atypical despite regulation si nce 1994. We argue that for many fitness workers the goal is to gain access to the fitness centre economy. For this they are willing to trade-off standard conditions of employment, and exchange traditional employm ent rewards for m ore intrinsic psycho-social rewards gained the through e xp o sure of their physical capital (Bourdieu 1984) o r bo dily prowess to the adoration o f their gazing clients. Building on the tradition of emotional labour and aesthetic labour, this study introduces the concept of ocularcentric labour: a state in which labour’s quest for the psychosocial rewards gained from their own body image shapes the employment relationship. With ocularcentric labour the p sycho-social rewards have greater value for the worker than ‘hard’, core conditions of employment, and are a significant factor in bargaining and outcomes, often substituting fo r direct earnings. The wo rkforce profile (young, female, casual) and their expectations (psycho-social rewards of ado ration and celebrity) challenge traditional trade unions in terms of what they can deliver, given the fitness workers’ willingness to trade-off minimum conditions, hard-won by unions.

The impact of pain on the quality of life of people with multiple sclerosis: A community survey

The purpose of this study was to examine the impact of pain on functioning across multiple quality of life (QOL) domains among individuals with multiple sclerosis (MS). A total of 219 people were recruited from a regional MS society membership database to serve as the community-based study sample. All participants completed a questionnaire containing items about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the preceding 2 weeks. Respondents who reported pain then completed an in-person structured pain interview assessing pain characteristics (intensity, quality, location, extent, and duration). Comparisons between participants with and without MS-related pain demonstrated that pain prevalence and intensity were strongly correlated with QOL: physical health, psychological health, level of independence, and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. These findings suggest that for people with MS, pain is an important source of distress and disability beyond that caused by neurologic impairments.

Suicide and community psychiatric care

A preliminary survey of 34 suicides among patients attending community services for the chronically mentally ill revealed a rate of 520 per 100,000 admitted. In contrast to earlier hospital surveys, no risk variables were identified for patients dying by suicide. Thirty-four percent of suicides occurred within one week of the last treatment and 59% within 3 months of service entry. It appears that early and intensive follow-up may be necessary to prevent suicide among patients receiving community psychiatric care.