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A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Summary: This paper proposes the use of a hybrid 5 MW power generation system combining concentrated solar thermal and solar photovoltaic technology where the efficiency of the power block is increased by taking advantage of hot water from a low‐temperature geothermal source. Aiming at a case study for Winton in Queensland the pertinent meteorological data are used for our simulations. In addition, the paper analyzes the feasibility of including a thermal desalination technology that uses the waste heat from the power block for producing clean water from wastewater. Our design replaces the traditional dry cooling system with a water‐cooled heat exchanger to remove the waste heat from the power block. Finally, this work explores the ratio of concentrated solar thermal and photovoltaic electricity production that optimizes the levelized cost of electricity and water production. the results indicate that the incorporation of the desalination system does not produce a significant increase in this value, and the optimal ratio of electricity production is obtained when the photovoltaic system contributes to 27.5% of the total electricity generation. Our water production cost can be as low as 40 ₵/m3 while for the combined system our minimum levelized cost of electricity figures out at 12.4 ₵/kWh to generate the base load with thermal storage. [ABSTRACT FROM AUTHOR]

Patients who miss scheduled appointments reduce clinical productivity and delay access to care for other patients. Reminders have improved attendance for healthcare appointments previously, but it is not known if short message service (SMS) implementation reduces incidence of patients unable to attend (UTA) or who fail to attend (FTA) appointments in the public dental service. This paper studied the effectiveness of SMS reminders in increasing appointment attendance at outpatient public dental services in Queensland. Data were sourced from the adult service and the children and adolescent oral health service (CAOHS) at West Moreton Hospital and Health Service, a public dental service in Queensland. A total of 63,238 appointments pre‐implementation of SMS reminders and 55,028 appointments post‐implementation over a period of 2 years were analysed for rates of attendance, UTA and FTA. Characteristics of UTA and FTA appointments were analysed to identify factors that hindered improvement after implementation of reminders. For the CAOHS, the attendance rate decreased 4% (95% CI: 2%, 6%) following SMS implementation. The UTA rate also increased by 20% (95% CI: 15%, 25%). Following SMS implementation in the adult service, the attendance rate increased from 73.5 (95% CI: 72.6, 74.4) to 77.7 (95% CI: 76.6–78.8) per 100 appointments. The FTA rate post‐implementation was 1.08 (95% CI: 1.00, 1.16) times that from pre‐intervention, and the UTA rate decreased from 21.7 (95% CI: 21.2, 22.2) to 17.1 (95% CI: 16.6, 17.7) per 100 appointments. The SMS reminders had a mixed effect on the attendance, UTA and FTA rates for the CAOHS and adult services. Reminders reduced the rates of UTA for the CAOHS service and increased the rate of attendance for the adult service. There was an increase in the FTA rate for both services. [ABSTRACT FROM AUTHOR]

The redefining of human immunodeficiency virus (HIV) from an acute disease to a manageable chronic illness has reshaped the focus of care, emphasising clinical outcomes and sidelining the complex social barriers many people living with HIV (PLHIV) still face. This parallels changes in the location of HIV care in Australia, with many PLHIV seeking care from private general practitioners whose ability to address complex social issues is constrained by limitations of time and resources. In response, peer navigation has emerged as a model of care implemented by some HIV‐based community health organisations seeking to support PLHIV's biomedical and psychosocial needs. However, there is limited understanding of how peer navigation operates in community settings or of the way these programmes integrate with primary care. This paper is the first to explore peer navigation from the perspective of general practitioners (GPs), with experience in treating PLHIV, to understand the role they see for peer navigators (PNs) in supporting PLHIV. Semi‐structured in‐depth interviews were conducted with six GPs (11.5% of specialty HIV GPs in Queensland, Australia) to examine their views and experiences of peer navigation in the context of HIV care. GPs highlighted the complexities of care for PLHIV and the need for additional resources and supports for psychosocial care. GPs valued peer navigation as part of a patient support network and bridge to health and social care systems. PNs normalised HIV, alleviating fear and stigma, educating and translating clinical information for patients. However, a key challenge was the absence of direct communication pathways with PNs. Peer navigation has clear potential in supporting the care of PLHIV, to alleviate constraints in GP settings and expand HIV care beyond the clinic. [ABSTRACT FROM AUTHOR]

Summary: This paper presents an interlink inverter control method for providing a constant tie‐line smoothing service in a grid‐connected residential microgrid (MG) to mitigate the fluctuating nature of renewable power generation and load demand. A grid power controller is designed for an MG to keep a constant grid power on typical days of the year by maintaining the charging/discharging of the battery. To achieve this objective, the MG controller sends the reference to the interlink inverter controller based on load dynamics, average PV generation and battery capacity. Moreover, a state‐space model is developed from the dynamic model of the MG system, and an eigenvalue‐based stability analysis is performed for different system parameters. The proposed control method is verified through extensive case studies by using real irradiance and typical residential customer load data in Queensland, Australia. In addition, a comparison with a dynamic energy management‐based method that aims to achieve the same objective is presented to demonstrate the performance of the proposed control method. Results show that the proposed method provides a constant tie‐line power for a grid‐connected residential MG for typical days of the year. [ABSTRACT FROM AUTHOR]

Background: Patients with complex chronic conditions experience fragmentation of care, unnecessary hospitalization and reduced quality of life, with an increased incidence of poor health outcomes. Aim(s): The aim of this paper was to explore how nurse navigators manage client care. This was achieved through an examination of narratives provided by the nurse navigator that evaluated their scope of practice. Method(s): All nurse navigators employed by Queensland Health were invited to participate in a study evaluating the effectiveness of the service. Eighty‐four self‐reported vignettes were thematically analysed to understand the work from the nurses' perspectives. Results: Two themes emerged from the vignettes. Theme 1, the layers of complexity, is comprised of three sub‐themes: the complex patient, the complex system and patient outcomes. Theme 2, professional attributes, has two sub‐themes: person‐centred care and clinical excellence. Conclusion: Navigators innovatively integrate services and address the fragmented nature of the health system. They apply expert clinical and social skills, through consistent and robust communication, to meet the needs of those with multiple chronic conditions. Implications for nursing management: Results provide insight into the new role, illuminating the work they achieve, despite system complexities. [ABSTRACT FROM AUTHOR]

Aim This paper aims to identify and explore key obstacles preventing ward managers from effectively performing the human resource management (HRM) responsibilities required in their role. Background In the context of increasing costs and the decentralisation of responsibility to ward level, the relevance of the ward manager role within the 'black box' between human resource management and firm performance is becoming increasingly pertinent. Methods This paper presents an intensive case study including 37 interviews across all levels of a hospital where senior management attempted to shift to a high performance model of human resource management. Results The findings indicated that ward managers played a critical role in maintaining and improving employee performance, although they were restricted from effectively performing their responsibilities due to budget pressure and limited managerial skill development. Conclusions Our findings support the contention that hospitals would benefit from focusing on the critical role of the ward manager as the central locus of influence in high performance human resource management (HPHRM) systems. Implications for nursing management Investment into high performance human resource management is discouraged if the hospital cannot adequately enable ward managers who are responsible for implementation. Introduction of managerial skills training to potential and existing ward managers is critical. [ABSTRACT FROM AUTHOR]

Indigenous patient navigator (IPN) programmes show promise in addressing barriers to cancer care and facilitation of patient self‐efficacy. The purpose of this paper is to describe and reflect upon the experience of training an IPN and implementation of the intervention in the Australian context with Indigenous cancer patients. Randomised clinical trial might provide the best available evaluation measure of an intervention but caution should be taken in the implementation process. Socio‐cultural aspects and training can affect the conduct of this type of intervention. We report here five issues needing consideration prior to implementing such intervention. Specifically: (1) recognition of the collective bonds within Indigenous community and understanding by IPN of the degree of personal assistance perceived as not intrusive by the patient; (2) conduct ongoing evaluation of the different role of an IPN involved in this intervention care provider vs. researcher. (3) meaningful engagement develops from a trusting/collaborative relationship between research team and study site staff which may not occur in the study time frame; (4) existing skills as well as training provided may not translate in the IPN understanding and aligning with the study objectives/research values; (5) recruitment of participants requires innovative and highly flexible strategies to be successful. [ABSTRACT FROM AUTHOR]

As the prevalence of type 2 diabetes continues to escalate, health system reform is seeking better patient outcomes through new models of care that aim to provide the most appropriate care when needed. Patients' experiences of service innovations can shed light on the successes and challenges of implementing change. This paper explores patients' views of a new model of integrated care for patients with type 2 diabetes. A mixed-methods, randomised control trial evaluated a beacon clinic model of care for complex type 2 diabetes led by specialist general practitioners ( GPs) in primary care settings in Brisbane, Australia. In this qualitative sub-study conducted between May 2014 and January 2015, 25 consenting participants were re-interviewed after 12 months using semi-structured questions, to explore their experiences of the new model of care. Interview transcripts were analysed thematically. In the first theme, Organised for patient-centred care, patients appraised the structural elements of the clinic. For most, it was an enabling experience which included convenience, flexibility and prompt communication back to the referring GPs. The preferences of a minority were partly realised, as they tried to understand the clinical purpose in comparison with traditional care. The second theme, Positioned as partners in care, revealed the pivotal role of patient-clinician relationships in patients' engagement with advice and self-care. Most found clinicians' collaborative approach engaging and motivating. A small minority with contextual concerns were disappointed with the focus on diabetes and struggled to engage fully with the model. Most participants valued this model of care, which reflects a capacity to manage the variable and complex needs of most patients referred for care. However, multi-level strategies are also needed to enhance patients' engagement with care and the sustainability of integrated diabetes care. [ABSTRACT FROM AUTHOR]

Aim This paper reports on the outcomes of a locally designed educational programme to support leadership capability of junior registered nurses. Background The Developing Leader Programme is an in-house programme delivered in three face-to-face workshops, comprising self-directed reflective and application activities. Method Surveys were used to evaluate self-perceived leadership capability over a 9-month period. The survey comprised a Leadership Capability Instrument adapted from two existing tools. Participants completed surveys at the commencement of the programme, after the third and final workshop and approximately 6 months afterwards. In addition, examples of descriptive accounts of programme activities submitted by individual participants were included to enrich data. Results Of 124 participants, 79 completed surveys at the first workshop, 28 at the final workshop and 31 were returned 6 months after completion of the programme. Mean scores for each area of leadership capability significantly improved throughout the duration of the programme ( P < 0.001). Participants also indicated a willingness to enact leadership behaviours through reported activities. Conclusions Survey responses indicated that participants perceived improved leadership capability after completing the Developing Leader Programme. Implications for nursing management Early educational intervention to facilitate the development of leadership skills as well as clinical skills in junior registered nurses can assist with how they interact with the team. Participation of junior registered nurses in a locally designed leadership programme can assist them to develop leadership behaviours for everyday practice. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the findings from an exit interview with a cardiometabolic health nurse (CHN) following a 26‐week trial. Design and Methods: The CHN participated in a semi‐structured exit interview following completion of the 26‐week trial. Applied thematic analysis was used to identify themes contained in the resultant transcript. Findings: Contrary to the literature, the CHN did not consider additional training necessary to undertake the role. The CHN felt additional information regarding the research implications of the trial and greater organizational support would contribute to better consumer and health service outcomes. Practice Implications: While personally rewarding, more can be done to help the CHN role reach its potential. [ABSTRACT FROM AUTHOR]

Dementia is one of the major causes of disability and dependence amongst older people and previous research has highlighted how the well-being of people with dementia is inherently connected to the quality of their relationships with their informal carers. In turn, these carers can experience significant levels of emotional stress and physical burden from the demands of caring for a family member with dementia, yet their uptake of formal services tends to be lower than in other conditions related to ageing. This paper is based on a qualitative study undertaken in the Australian state of Queensland and explores issues of access to and use of formal services in dementia care from the perspective of the informal family carers. It identifies three critical points at which changes in policy and practice in the formal care system could improve the capability of informal carers to continue to care for their family member with dementia: when symptoms first become apparent and a diagnosis is sought; when the condition of the person with dementia changes resulting in a change to their support needs; and when the burden of informal care being experienced by the carer is so great that some form of transition appears to be immanent in the care arrangement [ABSTRACT FROM AUTHOR]

In silico experimental modeling of cancer involves combining findings from biological literature with computer-based models of biological systems in order to conduct investigations of hypotheses entirely in the computer laboratory. In this paper, we discuss the use of in silico modeling as a precursor to traditional clinical and laboratory research, allowing researchers to refine their experimental programs with an aim to reducing costs and increasing research efficiency. We explain the methodology of in silico experimental trials before providing an example of in silico modeling from the biomathematical literature with a view to promoting more widespread use and understanding of this research strategy. [ABSTRACT FROM AUTHOR]

As health systems worldwide confront a growing prevalence of chronic disease, attention has focused on self-management as a strategy for delivering better outcomes for individuals and the health system. Consumer health organisations (CHOs) offer an existing, but under-utilised, resource for supporting self-management. This paper reports on a study designed to investigate the use of CHOs among people with diabetes and arthritis. A cross-sectional computer-assisted telephone interview survey was completed by 279 people who had made contact with one of four CHOs in Queensland, Australia, between July and August 2006. Self-reported data were collected on the participants’ socio-demographic and health-related characteristics, pathways to, use and benefits of CHO contact and subsequent health actions. People contacted CHOs primarily to obtain further information about their condition or to access services or products. Most believed CHOs offered useful information relevant to their health and better ways to manage health problems. Almost half reported that they had started exercising or changed diet following contact. More than two-thirds of diabetes contacts had been directed to the organisation by a health professional, compared with less than one-third of those with arthritis. Correspondingly, people with diabetes reported shorter periods between diagnosis and contact and more prior contact with the organisation and were less likely to wish they had made contact earlier. The study concludes that people who contact CHOs report benefits and health actions conducive to better self-management. The integration of CHOs within the wider health system, as in the case of the diabetes CHO in this study, is likely to facilitate contact. Further attention to the role of these organisations as part of a comprehensive approach to chronic illness care is warranted. [ABSTRACT FROM AUTHOR]

This paper describes the experiences of volunteers who have been trained to deliver the Stanford Chronic Disease Self-Management Program course. In Queensland, Australia, Leaders usually work in pairs (a Health Professional Leader (HPL) and a Peer Leader (PL)). Qualitative data were collected to explore volunteers’ experiences as Leaders and their opinions about working together to deliver self-management courses. The data were collected from September 2005 to December 2005. In-depth, semistructured telephone interviews were conducted with a purposive sample of 34 Leaders (17 PL, 17 HPLs). Thematic analysis revealed two core themes that described Leaders’ perceptions and experiences of working relationships between HPLs and PLs: (i) The Value of Working Together and (2) Relationship Tensions. Both HPLs and PLs believed that working together represented ‘the best of both worlds’ and that the combination of peers and health professionals enhanced the sustainability of the approach. However, a number of tensions were revealed that undermined the development and sustainability of these working relationships. From HPLs’ perspective, the benefits of working with volunteer PLs did not always justify the ‘burden’. Finding the ‘right person’ for the PL role was difficult and a higher value was often placed on the contribution of professionals. The tensions that were most prominent for PLs were grounded in the disparity between their status and that of HPLs, their lack of ownership over courses coupled with lack of a strong voice in the co-Leader relationship, and the absence of connection and engagement among Leaders. Working relationships between HPLs and PLs have potential to deliver positive outcomes for people with chronic disease, but the current study has highlighted the necessity of developing a culture of mutual respect and a system that values both forms of knowledge and expertise (i.e. experiential and professional). [ABSTRACT FROM AUTHOR]

HEGNEY D., PEARCE S., ROGERS-CLARK C., MARTIN-MCDONALD K.&BUIKSTRA E. (2005)European Journal of Cancer Care14, 75–82Close, but still too far. The experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatmentThis paper reports the findings of a study undertaken in November 2001 on the experiences of 17 rural people from the regional city of Toowoomba who had been diagnosed with cancer and were required to travel to the capital city of Queensland (Brisbane) for radiotherapy. The interviews were tape recorded; the recordings were transcribed verbatim and analysed for emergent themes and subthemes, following verification by the participants that the transcription was a true record of their experience. The major themes that arose from the study were (1) the burden of travel; (2) the difficulties of living in accommodation that is not one's own home; (3) the financial burden caused by the need to relocate or travel to and from Brisbane; (4) the lack of closeness to family and friends; (5) and feelings of being a burden on others. The findings suggest that at a time of stress, an increasing burden is placed on cancer clients and their families if they are required to travel for radiotherapy. Health professionals who read the results of this study should be aware of the isolation of rural people who have to live in an unfamiliar environment at a time of great stress. Support mechanisms should be put into place in these referral centres to deal with these stressors. [ABSTRACT FROM AUTHOR]

The research project described in the present paper aimed to explore the types of self-reported management which families in relatively ‘high’, ‘moderate’ and ‘low’ medically resourced areas use for episodes of incapacity and the length of time from an initial symptom to the management behaviours. A telephone survey was conducted in rural and remote Queensland, Australia, to explore one or more types of management for the most recent incapacity episode of family members. A respondent indicated at least one type of management for any one episode. These included using a home remedy, self-treatment and an ambulatory doctor's visit. Data were analysed descriptively and analytically. Log transformations were used for all outcomes prior to using bivariate analyses which incorporated the correlation between observations to compare the time from initial symptom to management between groups. Among 394 households contacted, 270 provided information about 697 household members, 269 (38.5%) of whom had had at least one episode of incapacity in the previous 12 months. Among people in each of the three resourced areas, there was a significant difference in the length of time taken to visit accident and emergency (A&E) units. Men visited the units and consulted books earlier than women. Although age was not quite significantly related to the use of A&E units ( P = 0.06), data suggested that people 35 years or older tended to take a longer time to use the services than the younger age groups. After taking into account that the members of the same household might take the same time from initial symptoms to management, people who were incapacitated and lived in areas with different levels of medical resources and gender were likely to be different in the time taken to use services at the A&E units. [ABSTRACT FROM AUTHOR]

Abstract This paper provides a review and summary of strain comparison and selective breeding work carried out on redclaw crayfish Cherax quadricarinatus (von Martens) at the Queensland Department of Primary Industries, Freshwater Fisheries and Aquaculture Centre, Walkamin. Redclaw crayfish are a highly marketable, environmentally tolerant, freshwater crayfish with a moderately fast, but variable, growth rate. Five strains of the species were assessed morphologically and in terms of age at maturity. A non-replicated production trial was also carried out before two strains, from the Gilbert and Flinders rivers in North Queensland, were chosen to be part of an experimental selective breeding programme for improved growth. Initially, 14 families of each strain were randomly mated and grown out. At this point, a size-related selection took place, with the largest animals from each family forming a selected line, and individuals from around the mean forming a control line. Within-family selection and reciprocal mating between families was performed. Data were collected after each of two generations of growout and analysed by analysis of variance. Significant differences (P < 0.05) were measured between strains, sexes and between selected and control lines. Selected individuals grew 9.5% faster than the controls. Recommendations for selective breeding research involving freshwater crayfish are presented. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of research on interventions that address the specific psychosocial needs of people with brain tumour and their families. This paper describes the protocol for a pragmatic randomised control trial (RCT) evaluating the clinical efficacy and cost‐effectiveness of the Making Sense of Brain Tumour program delivered via telehealth (Tele‐MAST) relative to standard care. Methods: The 148 adults with primary brain tumour will be randomly allocated to the 10‐session Tele‐MAST videoconferencing program or standard care from a cancer counselling service. The primary outcome is level of depression and secondary outcomes are quality of life, mental health and incremental cost per quality‐adjusted life year. The mental health and quality of life of family members will also be assessed. Assessments will be conducted at pre‐intervention, post‐intervention (primary endpoint), 6‐weeks post‐intervention and 6‐months post‐intervention. The main analysis will determine whether the Tele‐MAST intervention is more effective than standard care at post‐intervention, and whether these effects are sustained at follow‐up. Conclusion: Results will indicate whether the Tele‐MAST program is associated with better clinical outcomes and is more cost‐effective than existing cancer support services. Such outcomes will contribute to effective and accessible psychosocial care for the brain tumour population. [ABSTRACT FROM AUTHOR]