Development, reliability and validity of the queensland evaluation of wheelchair skills (QEWS)

- Objectives To develop and test a valid and reliable assessment of wheelchair skills for individuals with spinal cord injuries (SCI); the Queensland Evaluation of Wheelchair Skills (QEWS). - Setting Hospital, Australia. - Methods Phase 1: Four Delphi panel rounds with clinical experts were used to develop the QEWS. Phase 2: Intra-rater and inter-rater reliability of the QEWS items were examined in 100 people with SCI. Phase 3a: Concurrent validity was investigated by examining the association between QEWS total scores and physiotherapists’ global ratings of wheelchair skill performance. Phase 3b: Construct validity was tested in 20 people with recent SCI by examining change in QEWS total scores between when they first mobilised in a wheelchair and scores obtained 10 weeks later. - Results Phase 1: The QEWS was developed. Phase 2: The intra-class correlation coefficients reflecting the intra-rater reliability and the inter-rater reliability for the QEWS total score were 1.00 and 0.98, with scores being within one point of each other 96 and 91% of the time, respectively. Phase 3a: The QEWS total scores were comparable with the global rating of wheelchair skill performance (r2=0.93). Phase 3b: The QEWS scores changed by a median (interquartile range (IQR)) of 4 (1 to 6) points over the 10-week period following first wheelchair mobilisation. - Conclusion The QEWS is a valid and reliable tool for measuring wheelchair skills in individuals with SCI. The QEWS is efficient and practical to administer and does not require specialised equipment.

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: A quasi-experimental study

Background There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). Methods A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Results Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196). Conclusions Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

Who does nutrition prevention work in Queensland? An investigation of structural and political workforce reforms

- Aim This study aimed (i) to determine the change in the number of government-funded nutrition positions following structural and political reforms and (ii) to describe the remaining workforce available to do nutrition prevention work, including student placements, in Queensland. - Methods Positions funded by the Queensland government were counted using departmental human resource data and compared with data collected 4 years earlier. Positions not funded by the government were identified using formal professional networks and governance group lists. Both groups were sent an online survey that explored their position name, funding source, employer, qualifications, years of experience, work in prevention and ability to supervise students. - Results There was a 90% reduction in the number of nutrition prevention positions funded by the government between 2009 (137 full time equivalents (FTE)) and 2013 (14 FTE). In 2013, 313 specialist (n = 92) and generalist (n = 221) practitioners were identified as potentially working in nutrition prevention throughout Queensland. A total of 30 permanent FTEs indicated over 75% of their work focused on prevention. This included the 14 FTE funded by the Queensland government and an additional 16 FTE from other sectors. Generalists did not consider themselves part of the nutrition workforce. - Conclusions Queensland experienced an extreme reduction in its nutrition prevention workforce as a result of political and structural reforms. This disinvestment by the Queensland government was not compensated for by other sectors, and has left marked deficits in public health nutrition capacity, including student placements.

Brace yourself for a fatter, unhealthier Queensland after health promotion cuts

Queensland appears intent on dismantling its public and preventive health services. Health Minister Lawrence Springborg last week outlined the rationale for getting rid of more than 150 jobs in nutrition, health promotion and Indigenous health, arguing previous “campaigns” and “messaging” around obesity were “piecemeal” and had “grossly failed”. The plan now, the minister argued, is to focus on a new centrally-driven and high-profile approach...

Effect of temperature and precipitation on salmonellosis cases in South-East Queensland, Australia: An observational study

Objective Foodborne illnesses in Australia, including salmonellosis, are estimated to cost over $A1.25 billion annually. The weather has been identified as being influential on salmonellosis incidence, as cases increase during summer, however time series modelling of salmonellosis is challenging because outbreaks cause strong autocorrelation. This study assesses whether switching models is an improved method of estimating weather–salmonellosis associations. Design We analysed weather and salmonellosis in South-East Queensland between 2004 and 2013 using 2 common regression models and a switching model, each with 21-day lags for temperature and precipitation. Results The switching model best fit the data, as judged by its substantial improvement in deviance information criterion over the regression models, less autocorrelated residuals and control of seasonality. The switching model estimated a 5°C increase in mean temperature and 10 mm precipitation were associated with increases in salmonellosis cases of 45.4% (95% CrI 40.4%, 50.5%) and 24.1% (95% CrI 17.0%, 31.6%), respectively. Conclusions Switching models improve on traditional time series models in quantifying weather–salmonellosis associations. A better understanding of how temperature and precipitation influence salmonellosis may identify where interventions can be made to lower the health and economic costs of salmonellosis.

Child Abuse and Neglect: A Socio-legal Study of Mandatory Reporting in Australia - Report for the Queensland Government

This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Queensland. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., teachers, doctors, nurses, and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

Reduced incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland, Australia

Objective To determine trends in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland (Australia) between 2005 and 2010 that coincided with changes in state-wide ambulatory diabetic foot-related complication management. Methods All data from cases admitted for the principal reason of diabetes foot-related hospitalisation or amputation in Queensland from 2005–2010 were obtained from the Queensland Hospital Admitted Patient Data Collection dataset. Incidence rates for foot-related hospitalisation (admissions, bed days used) and amputation (total, minor, major) cases amongst persons with diabetes were calculated per 1,000 person-years with diabetes (diabetes population) and per 100,000 person-years (general population). Age-sex standardised incidence and age-sex adjusted Poisson regression models were also calculated for the general population. Results There were 4,443 amputations, 24,917 hospital admissions and 260,085 bed days used for diabetes foot-related complications in Queensland. Incidence per 1,000 person-years with diabetes decreased from 2005 to 2010: 43.0% for hospital admissions (36.6 to 20.9), 40.1% bed days (391 to 234), 40.0% total amputations (6.47 to 3.88), 45.0% major amputations (2.18 to 1.20), 37.5% minor amputations (4.29 to 2.68) (p < 0.01 respectively). Age-sex standardised incidence per 100,000 person-years in the general population also decreased from 2005 to 2010: 23.3% hospital admissions (105.1 to 80.6), 19.5% bed days (1,122 to 903), 19.3% total amputations (18.57 to 14.99), 26.4% major amputations (6.26 to 4.61), 15.7% minor amputations (12.32 to 10.38) (p < 0.01 respectively). The age-sex adjusted incidence rates per calendar year decreased in the general population (rate ratio (95% CI)); hospital admissions 0.949 (0.942–0.956), bed days 0.964 (0.962–0.966), total amputations 0.962 (0.946–0.979), major amputations 0.945 (0.917–0.974), minor amputations 0.970 (0.950–0.991) (p < 0.05 respectively). Conclusions There were significant reductions in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in the population of Queensland over a recent six-year period.

Re-imagining public journalism for community radio news-gathering

This paper explores the use of public journalism within a community radio news context. It argues that, the central tenets of the public journalism movement can help to frame, more adequately, a news gathering and production approach Tailored to the needs of community media. . Community radio stations generally enjoy strong relationships with their listeners and play an important role in the formation of the community itself (Lowrey et al., 2008). This paper argues that such strong community ties, in conjunction with public journalism news gathering approaches give community radio stations a strong opportunity to produce relevant, local news sourced driven by their listeners. In this regard ,this paper examines a particular case of public journalism used within the The Wire, a national, daily current affairs program broadcast on community radio. In the case study examined here ,public journalism informed story production that were designed to better meet the needs of community radio stations and their audiences.

Evaluation of the Queensland Minimum Passing Distance Road Rule

The two-year trial of the Queensland minimum passing distance (MPD) road rule began on 7 April 2014. The rule requires motor vehicles to provide cyclists a minimum lateral passing distance of one metre when overtaking cyclists in a speed zone of 60 km/h or less, and 1.5 metres when the speed limit is greater than 60 km/h. This document summarises the evaluation of the effectiveness of the new rule in terms of its: 1. practical implementation; 2. impact on road users’ attitudes and perceptions; and 3. road safety benefits. The Centre for Accident Research and Road Safety – Queensland (CARRS-Q) developed the evaluation framework (Haworth, Schramm, Kiata-Holland, Vallmuur, Watson & Debnath; 2014) for the Queensland Department of Transport and Main Roads (TMR) and was later commissioned to undertake the evaluation. The evaluation included the following components: • Review of correspondence received by TMR; • Interviews and focus groups with Queensland Police Service (QPS) officers; • Road user survey; • Observational study; and • Crash, injury and infringement data analysis.

The impact of the public library as a creative place in the community: A contextual review

This review examines recent literature on the public library as a creative place and the ways in which socio-cultural impact is being measured in assessments of cultural value. Inputs such as funding and staffing are frequently measured against outputs such as visitor numbers and lending frequencies, but qualitative measures (outcomes and impacts) are minimal in the literature because of the lack of persuasive evaluative frameworks and the difficulty of designing and facilitating the evaluations at local and national levels. Nevertheless, when combined with data about outputs and outcomes, the impact on individuals and their communities can be measured effectively and reported persuasively (Poll 2012, p.124). This contextual review provides an overview of current thinking about public libraries and creative spaces with particular attention paid to the rise of so-called makerspaces and Fab Labs. This includes discussion on the types of creative activities that are occurring in the public library context, and an outline of the rhetoric and reality of the public library as a community space. These outlines are reconsidered in a discussion of the evaluative frameworks that have been employed by libraries in the past, followed by an account of some prominent creative spaces that have been formally evaluated. The existence of creative spaces in public libraries is in a state of constant flux, and the development and redevelopment of evaluative frameworks will ensure that published reports will continue to appear throughout 2015 and beyond. This review provides a brief snapshot of the state of the field as it is in the first quarter of 2015.

The ways in which new public management ideas impact upon the administrative culture of 'street-level' bureaucrats and professionals working within Irish social policy

The conventional meaning of culture is ‘widely shared and strongly held values’ of a particular group or society (Bradley and Parker, 2006: 89). Culture is not a rigid concept; it can be influenced or altered by new ideas or forces. This research examines the ways in which one set of ideas in particular, that is, those associated with New Public Management, have impacted upon the administrative culture of 'street-level' bureaucrats and professionals within Irish social policy. Lipsky (1980: 3) defined 'street-level' bureaucrats as ‘public service workers who interact directly with citizens in the course of their jobs, and who have substantial discretion in the execution of their work’. Utilising the Competing Values Framework (CVF) in the analysis of eighty three semi-structured interviews with 'street-level' bureaucrats and professionals, an evaluation is made as to the impact of NPM ideas on both visible and invisible aspects of administrative culture. Overall, the influence of NPM is confined to superficial aspects of administrative culture such as; increased flexibility in working hours and to some degree job contracts; increased time commitment; and a customer service focus. However, the extent of these changes varies depending on policy sector and occupational group. Aspects of consensual and hierarchical cultures remain firmly in place. These coincide with features of developmental and market cultures. Contrary to the view that members of hierarchical and consensual culture would pose resistance to change, this research clearly illustrates that a very large appetite for change exists in the attitudes of 'street-level' bureaucrats and professionals within Irish social policy, with many of them suggesting changes that correspond to NPM ideas. This study demonstrates the relevance of employing the CVF model as it is clear that administrative culture is very much a dynamic system of competing and co-existing cultures.

Replacing failed private water contracts

Failed private water concessions have been terminated and replaced with public sector operations in many countries. The paper reviews the negotiating processes involved in these terminations.

Costs, outputs and outcomes in school PFI contracts and the significance of project size

This article examines operational Private Finance Initiative (PFI) school projects and reports the experiences of UK headteachers. It considers the impact of project size on value for money (VFM). Headteachers involved in small projects are more satisfied with costs than those involved in large projects, but headteachers involved in larger projects are more satisfied with affordability. Generally, heads are more satisfied with the buildings than with the services. The authors question the government’s recent policy changes to increase the size of PFI projects.

Accountability and Value for Money in Private Finance Initiative Contracts

Within the context of New Public Management (NPM), successive UK governments have claimed that PFI projects provide more accountability, and arguably, more value for money (VFM) than conventional procurement for the public (HM Treasury 1995, 2000, 2003a and 2003b). However, recent empirical research in the UK on PFI has indicated its potential limitations for accountability and VFM (Broadbent, Gill and Laughlin, 2004; Edwards, Shaoul, Stafford and Arblaster, 2004; Shaoul, 2005; and Ismail and Pendlebury, 2006) albeit these are based on either published accounts or a limited number of key stakeholders. This paper attempts to partially redress this gap in the literature by presenting an interesting case of the impact of PFI on accountability and VFM in Northern Ireland's education sector. The findings of this research, based on forty two interviews with a wide range of key stakeholders, suggest that stakeholders have different and often conflicting expectations and the actual PFI accountability and VFM benefits are much more obfuscated than those claimed in Government publications.

Using public procurement to achieve social outcomes

The use of public procurement to achieve social outcomes is widespread, but detailed information about how it operates is often sketchy and difficult to find. This article is essentially a mapping exercise, describing the history and current use Of government contracting as a tool of social regulation, what the author calls the issue of 'linkage'. The article considers the popularity of linkage in the I 9,h century in Europe and North America, particularly in dealing with issues of labour standards and unemployment. The use of linkage expanded during the 20(th) century, initially to include the provision of employment opportunities to disabled workers. During and after World War 11, the use of linkage became particularly important in the United States in addressing racial equality, in the requirements for non-discrimination in contracts, and in affirmative action and set-asides for minority businesses. Subsequently, the role of procurement spread both in its geographical coverage and in the subject areas of social policy that it was used to promote. The article considers examples of the use of procurement to promote equality on the basis of ethnicity and gender drawn from Malaysia, South Africa, Canada, and the European Community. More recently, procurement has been used as an instrument to promote human rights transnationally, also by international organizations such as the International Labour Organisation. The article includes some reflections on the relationship between 'green' procurement, 'social' procurement, and sustainable development, and recent attempts to develop the concept of 'sustainable procurement.