Experiences of Australian professional female tennis players returning to competition from injury

Background: This study examined the experiences of professional female tennis players returning to competition from injury.

Methods: In a study commissioned by Tennis Australia, 55 Australian professional female tennis players responded anonymously to a questionnaire developed for the purposes of this study. The questionnaire consisted of open and closed questions that assessed a player’s attribution style, the occurrence and effect of minor and major injuries, frequency and type of treatment sought, attitudinal chances following injury and preventative injury factors.

Results: The quantitative and qualitative analyses of participants’ responses revealed players generally displayed an internal attribution style with the majority of minor injuries involving lower limb injuries (attributed to playing on hard surfaces). Players reported these injuries were addressed in a variety of ways including self-treatment. The majority of severe injuries were upper limb/shoulder and these were generally treated at tournament sites with some requiring surgery.

Conclusions: Players adopted a range of measures to assist recovery from severe injury including the services of health professionals. In further findings, a player’s attribution style was not a predictive variable, except in terms of the number of tournaments missed for minor injuries. Implications of the study’s results and future research directions for cross-cultural studies are highlighted.

First, create goodwill : The ten commandments of social change - the case of maternity services

Professional workers - midwives and obstetricians - within 15 caseload maternity units were interviewed to evaluate their response to collaborative care models.  The evidence shows that new discourses and models have the potential to disrupt the 'silo effect' of old professional boundaries and to facilitate a realignment between midwives and obstetricians along more egalitarian lines.  However change is not automatic. Among other conditions, a coalition of 'change champions' is necessary to build cultures of respect and recognition among all staff.

Barriers to the detection and management of depression by palliative care professional carers among their patients : perspectives from professional carers and patients' family members

Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.

Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.

Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.

Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.

Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.

Rural and regional Australian public accounting firm services : service provision, concerns and tensions

Public accounting firms provide a necessary and important service for rural and regional areas. However, the provision of high-quality services is hindered by a number of factors. This paper reports the findings from a large-scale survey of professional accounting firm practitioners located in rural and regional Australia, identifying factors causing concerns and tensions and quantifying their scope and importance. Prominent concerns and tensions identified include adverse effects arising from the employment market, communications technology developments and legislation such as the Corporate Law Economic Reform Program (Audit Reform and Corporate Disclosure) Act 2004 and the Financial Services Reform Act 2001.

The Role of TAFE as an Equity Pathway to Social Inclusion, Employment, and to University : a submission from The Deakin University Social Work/Gordon TAFE Community Services Work, Geelong Based Project Team

Executive Summary

The Deakin University Social Work/Gordon TAFE Community Services Work Geelong Based Project Team (the Project Team) was assisted by Higher Education Partnership and Participation funding made available through Deakin University Participation and Partnerships Program (DUPPP) to carry out research and project work in 2012/13.

In the following submission to the House of Representatives Inquiry into the role of Technical and Further Education (TAFE) system and its operation, this Project Team seeks to establish a case for:

1. Funding to enable TAFE to continue as:

a) an equity pathway to social inclusion, employment, and to university, particularly in regional areas.
b) an integral complement to the University education sector to deliver on the ambitious objectives of the Federal Government’s widening participation agenda, as a mechanism to deliver the skills, knowledge and workforce needed now, and in the future, in the Australian economy.
2. Increased resources for separate and joint sector development
a) Publicly funded TAFEs need funding to be restored and increased to enable them to maintain the high quality education they provide and to maintain their successful work in supporting communities, regions and disadvantaged individuals to gain skills, training and employment.
b) Universities need increased funding to increase staffing levels and therefore free up teaching staff to spend the necessary time to develop relationships with and provide support to students. This is important for the achieving the goals of the widening participation agenda of increasing access without increasing attrition at the same time.
c) TAFEs and Universities need funding to do the work required to further develop and formalise diploma-degree pathways so that disadvantaged individuals can exit into employment at the diploma level or be supported in an efficient and seamless way to undertake further study.
3. Active use of localised and nuanced partnership approaches by education institutions. This includes:
• Cross teaching by TAFEs and Universities in courses that can be articulated, such as professional practice diplomas and degrees
• Programs negotiated and designed according to the needs of students in each location. TAFEs and Universities need resources in order to do this work
• Focus on regional centres where there is a particular opportunity for government to make an impact on TAFE pathways to employment and/or further education
• Workforce development in regional areas due to new industries is a particular area of need
4. Recognise and capitalise on the complementary and symbiotic nature of each sector’s skills, strengths and capacities.
The submission responds to the second, third and fifth points of the Terms of Reference of the Inquiry and is based on the research work carried out by the Project Team in 2012/13.

We provide evidence of Gordon TAFE in Geelong working as an equity mechanism in the particular case of the welfare/ community services diploma to social work degree pathway. The project team considers that there is a strong case for additional resourcing of TAFE to enable it to continue what it does well. TAFE is the key training and education sectorthe ‘education and social hub’that can successfully attract, retain, and graduate people who may not otherwise access education due to one or more combinations of:

1. having a low SES current or past background;
2. living in regional areas;
3. receiving interrupted primary and secondary education;
4. having disabilities;
5. being sole parents;
6. being from refugee backgrounds;
7. having English as an additional language/culture;
8. retrenchment from employment in dying industries;
9. short, medium and long term unemployment;
10. past and/or current caring roles;
11. marriage/relationship breakdowns;
12. domestic violence;
13. gender, class, age, race/ethnicity and dis/ability discriminations; and
14. socialised expectations and fears.

The recommendations in this submission are based on research findings about important similarities and differences between Gordon TAFE welfare and Deakin University social work students in Geelong, and their respective institutional organisations and contexts. The two institutions employ a repertoire of diverse administrative, teaching, learning and support approaches to meet different mission goals, requirements and needs.

Thinking about practice in integrated children’s services: considering transdisciplinarity

Integrated service delivery in the early childhood education and care sector is burgeoning as a direct result of government agendas in Australia that privilege services for young children and families, especially those considered most vulnerable and at risk. In many cases this means reviewing and revising current practice to work more collaboratively with other professionals. This paper reports the findings of one aspect of a larger Australian study entitled: ‘Developing and sustaining pedagogical leadership in early childhood education and care professionals’. The focus of this paper is the understandings and practices of professionals in both Queensland and Victoria working in integrated Children's Services across the education, care, community and health sectors. The notion of transdisciplinary practice is also explored as a way to sustain practice. Qualitative data collection methods, including the ‘Circles of Change’ process, the ‘Significant Change’ method and semi-structured interviews were used. The findings indicate concerns around professional identity, feeling valued, role confusion and the boundaries imposed by funding regulations. Working in a transdisciplinary way was generally considered a useful way to move practice forward in these settings, although the ramifications for leadership that this approach brings requires further consideration.

"The university didn't actually tell us this is what you have to do": Social inclusion through embedding of academic skills in first year professional courses

This paper presents findings from a mixed methods project investigating first year social work students' perceived role in academic skills and thier development.  Students expressed the perception that academic skill requirements and how they would be assessed should be made explicit, and idenfied a stigma associated with accessing study support services.  The aper concluses that an intentional design strategy, such as embedding academic skills into the curriculum, helps bridge the different expectations between academics and students and hence constitutes a socially inclusive strategy to teaching professional courses sucha s social work, within higher education.  Recommendations to enhance the succes and sustainability of such an initiative in the current higher educacion environment are offered.

Professional views on the management of sex offenders in the community

Sex offender registration and community notification schemes form an increasingly important part of public policy relevant to the management of known sex offenders in the community. Critics of these policies not only point to the lack of empirical evidence that is currently available to support their impact on reoffending, but also the disproportionate and potentially iatrogenic effects that they have on offenders. However, there have been few attempts to understand these issues from the perspective of those practitioners who work on a daily basis with sex offenders in the community. These professionals are uniquely placed to contribute to an understanding of effective risk management and, as such, this article presents an analysis of the perspectives of a group of experienced practitioners and how this practice-based wisdom might inform the development of sex offender public policy.

Improving child protection services: Australian parents' and grandparents' perspectives on what needs to change

This exploratory, small-scale research aimed to understand parents’ and grandparents’ experiences and expectations of child protection investigations. Semi-structured, in-depth interviews were conducted with nine participants. The central theme, captured as ‘a domino effect’, crystallises the participants’ views of why it is important to improve child protection services; that there were significant practical relationship repercussions in families’ lives beyond the immediate investigation. The sub-themes that emerged – support within systemic complexity, policies in practice, intervention processes and practices, and ‘it’s just a job to them’ –suggested how child protection services contributed to ‘the domino effect’ in their lives. A final sub-theme indicated participants’ awareness of the complexity and difficulty of child protection as a job, notwithstanding their expressed frustrations. We have made practical recommendations based on participants’ perspectives about ‘what needs to change?’, and suggestions for improvements to practise that centralise social work as a profession which values the professional relationship with services users. We also suggest that the professional relationship should extend beyond the interpersonal to guiding services users within the legal complexities in contemporary child protection. Being exploratory, this study and its recommendations guide future research to contribute improving child protection services.

Evaluating health services with point of service feedback: perspectives and experiences of patients, staff and community volunteers in an inpatient rehabilitation facility

PURPOSE: To determine patient, staff and community volunteer opinions and experiences of point of service feedback (POSF) in an inpatient rehabilitation facility. METHOD: Participants were recruited by purposeful sampling. Two researchers conducted in-depth semi-scripted interviews with patients, staff or volunteers until no new issues emerged. Manually transcribed interview data underwent thematic analysis that grouped information into categories of related information. RESULTS: Twenty patients, 26 staff from 10 different professional groups, and 2 community volunteers were interviewed. Patient and volunteer data were grouped into five main categories: patients wanted their voice heard and acted on; patients could be positively and negatively affected by POSF; patients could be reluctant to evaluate staff; patients preferred POSF to post-discharge mailed questionnaires; and patients' feedback was influenced by the data collector. Staff wanted: feedback to help them improve the patient experience; and feedback that was trustworthy, usable and used. Staff believed that the feedback-collector influenced patients' feedback and affected how feedback could be used. CONCLUSIONS: Patients, staff and community volunteers identified issues that determine the appropriateness and usefulness of POSF. Policy and practise should address the preferences, needs and experiences of health service users and providers so that POSF produces maximum benefits for both patients and health services. Implications for Rehabilitation POSF can enhance patients' experiences of inpatient rehabilitation by providing a mechanism to be heard and communicating that patients are valued; care must be exercised with patients who find giving feedback stressful. Collecting POSF is most beneficial when coupled with methods to efficiently and effectively respond to feedback. POSF requires interpretation in light of its limitations including patients' ability to accurately and unreservedly communicate their experiences. Who collects POSF requires careful consideration; community volunteers have both advantages and disadvantages.

Professional attitudes to sex offenders: implications for multiagency and collaborative working

Recent years have seen the development and implementation of a range of multi-disciplinary and partnership approaches to managing risk in known sex offenders, involving collaboration between justice and human services agencies. Potential barriers to the development of effective multidisciplinary practices arise when participating professionals hold different attitudes about those they are responsible for managing. This paper examines differences in attitudes towards sex offenders in two professional groups – police officers and allied health workers. The results suggest that police officers tend to hold more negative views than those who deliver treatment and support services. They are more likely to believe that offenders cannot change their behaviour and should be subject to more punitive sanctions. These findings are discussed in relation to judgements of both risk and dangerousness and associated decisions about the appropriate management of sex offenders in multi-agency and multi-disciplinary working forums.

Use of antiseptic hand rubs in the health and community services industry: an Australian population-based survey

BACKGROUND: The use of antiseptic hand rubs (AHRs), rather than washing with soap and water, is considered to be the gold standard for reducing the frequency of nosocomial infections, as well as being less damaging to the hands than washing with soap and water, but little is known at a population level about usage patterns for AHRs. OBJECTIVES: To describe AHR use patterns among workers in the health and community services industry in Australia. METHODS: Using data from a population-based survey of Australian workers, we focused on health and community services workers' exposure to chemicals at work, including the use of AHRs. Data regarding the frequency of hand-washing were also collected. RESULTS: Nine hundred and fifty-six health and community service workers participated in the Australian National Hazard Exposure Worker Surveillance survey. Of these, 11% reported using AHRs, and 31% reported hand-washing >20 times per shift. According to an adjusted logistic regression model, professional workers [adjusted odds ratio (aOR) 2.29, 95% confidence interval (CI): 1.40-3.72] and frequent hand washers (aOR 3.08, 95%CI: 1.92-4.93) were more likely to use AHRs. CONCLUSIONS: AHR use by health and community service workers was generally lower than expected. AHR use was most likely to be reported by professionals and frequent hand washers, suggesting that AHRs are used as an adjunct to conventional hand-washing.

The establishment and development of neurosurgery services in Papua New Guinea

BACKGROUND: Papua New Guinea (PNG) is a developing Pacific Nation of 7.3 million people. Although neurosurgery training was introduced to PNG in the year 2000, it was in 2003 that a neurosurgery service was established. Prior to this time, neurosurgery in PNG was performed by general surgeons, with some assistance from visiting Australian neurosurgeons. Neurosurgical training was introduced to PNG in 2000. The model involved a further 3 years of training for a surgeon who had already completed 4 years of general surgical training. We aim to review the output, outcomes and impact achieved by training the first national neurosurgeon. METHODS: The data on activity (output) and outcomes were collected prospectively from 2003-2012. Ongoing mentoring and continuing professional development were provided through annual neurosurgical visits from Australia. There were serious limitations in the provision of equipment, with a lack of computerized tomographic or MR imaging, and adjuvant oncological services. RESULTS: There were 1618 neurosurgery admissions, 1020 neurosurgical procedures with a 5.74 % overall mortality. Seventy percent of cases presented as emergencies. There were improved outcomes, particularly for head injuries, whilst hydrocephalus was managed with an acceptable morbidity and revision rate. CONCLUSIONS: The training of a neurosurgeon resulted in PNG patients receiving a better range of surgical services, with a lower mortality. The outcomes able to be delivered were limited by late presentations of patients and lack of resources including imaging. These themes are familiar to all low- and middle-income countries (LMICs) and this may serve as a model for other LMIC neurosurgical services to adopt as they consider whether to establish and develop neurosurgical and other sub-specialist surgical services.

A suite of visual languages for model-driven development of statistical surveys and services

Objective: To provide statistician end users with a visual language environment for complex statistical survey design and implementation. Methods: We have developed, in conjunction with professional statisticians, the Statistical Design Language (SDL), an integrated suite of visual languages aimed at supporting the process of designing statistical surveys, and its support environment, SDLTool. SDL comprises five diagrammatic notations: survey diagrams, data diagrams, technique diagrams, task diagrams and process diagrams. SDLTool provides an integrated environment supporting design, coordination, execution, sharing and publication of complex statistical survey techniques as web services. SDLTool allows association of model components with survey artefacts, including data sets, metadata, and statistical package analysis scripts, with the ability to execute elements of the survey design model to implement survey analysis. Results: We describe three evaluations of SDL and SDLTool: use of the notation by expert statistician to design and execute surveys; useability evaluation of the environment; and assessment of several generated statistical analysis web services. Conclusion: We have shown the effectiveness of SDLTool for supporting statistical survey design and implementation. Practice implications: We have developed a more effective approach to supporting statisticians in their survey design work.

Comparison of medication policies to guide nursing practice across seven Victorian health services

Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.