Academic literature on the topic 'Personal injuries – New South Wales'

AbstractPsychologists’ adherence with evidence-based guidelines based on the biopsychosocial premise in the management of musculoskeletal injuries is influenced by the actions by General Practitioners (GPs), insurers, and injured patients’ actions. For data collection, we interviewed GPs (n = 6), insurers (n = 6), and injured people (n = 15) from the two personal injury compensation schemes in New South Wales. Thematic analysis yielded the following: GPs were reticent to access psychological services that represented a poor fit between their practice and treatment guidelines, insurers lacked trust in the validity of “secondary psychological injury” claims’. Injured peoples’ willingness to engage with treatment was impaired by a poor fit between the treatment guidelines and their experience of insurers’ and psychologists’ practices.

This study aimed to measure the subsequent health and health service cost burden of a cohort of workers hospitalised after sustaining work-related traumatic spinal injuries (TSI) across New South Wales, Australia. A record-linkage study (June 2013–June 2016) of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Of the 824 individuals injured during this time, 740 had sufficient follow-up data to analyse readmissions ≤90 days post-acute hospital discharge. Individuals with TSI were predominantly male (86.2%), mean age 46.6 years. Around 8% (n = 61) experienced 119 unplanned readmission episodes within 28 days from discharge, over half with the primary diagnosis being for care involving rehabilitation. Other readmissions involved device complications/infections (7.5%), genitourinary or respiratory infections (10%) or mental health needs (4.3%). The mean ± SD readmission cost was $6946 ± $14,532 per patient. Unplanned readmissions shortly post-discharge for TSI indicate unresolved issues within acute-care, or poor support services organisation in discharge planning. This study offers evidence of unmet needs after acute TSI and can assist trauma care-coordinators’ comprehensive assessments of these patients prior to discharge. Improved quantification of the ongoing personal and health service after work-related injury is a vital part of the information needed to improve recovery after major work-related trauma.

Doctor of Philosophy (PhD)
Injuries to people living and working on farms in New South Wales continue to be a significant burden on the health system, Workers’ Compensation system, agricultural industries and farming families. Strategies to reduce the number and severity of injuries suffered by farmers and people working on farms rely on accurate information. Unfortunately there is no one dataset available to describe the circumstances surrounding farm injuries and the size of this burden in Australia. Hence, a number of different data sources are required to provide a picture of farm injuries. To date, there has been very little critical examination of what value each of these datasets provides to describing farm injuries. This Thesis aimed to: • Undertake surveillance of injuries occurring to people on farms or during agricultural production in NSW using data from an Emergency Department, NSW Hospital Separations information, NSW Workers’ Compensation Claims, and ABS Deaths data. • Critically examine the utility of Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths Data for the surveillance of farm injuries in NSW. • Critically examine data classification systems used in Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths data collections to describe the breadth of farm injuries in NSW. • Define the priority areas for farm injury prevention initiatives in NSW based on the information obtained from the examination of the data from Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths. • Evaluate the effectiveness of the NSW Rollover Protective Structure (ROPS) rebate scheme and examine the utility of the data currently available in NSW to measure the performance of the program. Four datasets, Tamworth Emergency Department, Hospital Separations, Workers’ Compensation and the Australian Bureau of Statistics (ABS) Deaths data were used to provide information on the surveillance of farm injuries, describe the breadth of classifications used to describe farm injuries, and define priorities for the prevention of farm injuries. There were 384 farm-related injuries which presented to the Emergency Department at the Tamworth Base Hospital between 1 September 1997 and 31 August 1998. Emergency Department data collected in this study used the Farm Injury Optimal Dataset (FIOD) for classification, which allowed for a comprehensive picture of the circumstances surrounding the injury event. The three most common external causes of injury were related to horses, motorcycles, and animals. Commonly people were working at the time of injury. Children represented 21% of the people injured. The average number of injuries per 100 farms per annum was 34.7. An examination of hospital discharge data for NSW was undertaken for the period 1 July 1992 to 30 June 2000 where the location of the injury was a farm. Classification of cases in this dataset conformed to the International Classification of Disease (ICD) versions 9 and 10. There were 14,490 people who were injured on a farm during the study period. The three most common external causes of injury were motorcycles, animals being ridden and agricultural machinery. Children represented 17% of all farm injury cases. The rate per 1,000 farms ranged from 19 to 42 per annum. An examination of Workers’ Compensation claims for agricultural industries in NSW between 1 July 1992 and 30 June 2001 was undertaken. The ‘Type of Occurrence’ classification system was used to code the claims. There were 24,332 claims of which the majority were males (82%). The incidence of injury / disease in agriculture per annum varied from 37 per 1,000 workers to 73 per 1,000 workers. The rate per 1,000 agricultural establishments varied from 54 to 76. The average cost of a claim was $10,880 and the average time lost per claims was 9.2 weeks. There were 81 deaths and 3,158 permanent disabilities. The three most common agents were sheep / goats (5%), ferrous and non-ferrous metals (5%), crates / cartons / boxes / etc (5%). Using ABS deaths data to examine the deaths of people working and living on farms was limited to males whose occupation was recorded as ‘farmer and farm manager’ and ‘agricultural labourer and related worker’. There were 952 deaths over the period 1 January 1991 and 31 December 2000. The information provided a consistent series of cases over time. Areas where prevention should be directed included motor vehicle accidents; falls; agricultural machinery; other machinery; firearms; poisoning; and drowning. Using any one of the datasets alone to examine people injured on farms not only underestimates the number of people injured, but also misses particular types of agents involved in farm injuries. Each of the datasets used in this Thesis provides a different perspective of farm injury in NSW. By examining the information together, there are a number of areas which are consistently represented in each dataset such as falls and agricultural machinery. While no one dataset provided all the information that would be useful for the prevention of injuries, the available information does provide direction for the development of prevention strategies. The overall weakness of the information provided is that it misses a number of risk factors that contribute to farm injuries such as fatigue and training. The lack of appropriate denominator information also makes it difficult to directly compare the datasets and estimate the size of the problem. There are a number of additional coding categories that could be included in each dataset that would provide a better understanding of the different groups at risk of sustaining an injury on a farm or during agricultural work. These coding categories include activity at time of injury, admission to hospital, and occupation. An example of the use of data to determine the effectiveness of a farm injury prevention program is the ‘NSW Rollover Protective Structure (ROPS) Rebate Scheme’ evaluation. Tractor rollover deaths have been identified as an issue for prevention by Farmsafe Australia; however, such deaths were not identified in any of the datasets used in this Thesis due to coding limitations in the ABS data. In this Thesis information about the evaluation of the ‘NSW ROPS Rebate Scheme’ is presented. The scheme was successful in fitting 10,449 ROPS to tractors and the following lessons were learnt: when providing a rebate, the administration (i.e. sending the cheque) needs to be done well; advertising is important and should be co-ordinated, increase the awareness of the risk(s) the intervention is aiming to prevent and effectiveness of subsequent solution (s); the program should ensure there is an increased awareness of the outcome the intervention is aiming to prevent; if regulation is part of the program, enforcement needs to undertaken; and should address any barriers to uptake. The information provided in this Thesis highlights the substantial burden that farm injury places on the agricultural and rural sector of NSW. While there is no one data source that can describe the circumstances and the burden of farm injuries, the currently available datasets do provide an insight into the circumstances of farm injuries and the burden these injuries place on health, Workers’ Compensation, agricultural industries and farming families.

Child road trauma poses a preventable public health burden to the community. This PhD research aimed to: 1) quantify the magnitude of child passenger injuries in New South Wales (NSW), Australia; 2) evaluate the effectiveness of different restraint use to prevent fatalities among child passengers; and 3) estimate the benefit in the general child population from different intervention targets relating to restraint use. It comprised two studies to validate methodology and four independent epidemiological studies. The first study to validate methodology assessed the data item availability and categorization across different road traffic injury surveillance data collections in NSW in relation to World Health Organization recommended data item lists and necessary data item lists for road traffic injury research. Exclusion of, or insufficient categorization of, crucial data items such as restraint use and injurious outcome existed for each data collection. The other study to validate methodology assessed the performance (in terms of incidence estimates, sensitivity, and specificity) of several methods for removing multiple counting when conducting analyses on hospital separation data for child passenger injuries under either primary-diagnosis or all-diagnoses based injury definition, using linkage methods as a comparison. The "readmission"-based criterion consistently best approximated the linkage-method-derived incidence rate. Two epidemiological studies used NSW hospital separation datasets and quantified the magnitude of child road trauma in NSW in terms of hospitalisation rates. One study examined the trend in hospitalised injury incidence rates during the period of July 1998 to June 2005 using a non-parametric estimation method, and reported a non-significant decline of hospitalised injuries to child passengers over time. The second study used Poisson regression to demonstrate that rural NSW children were two times more likely to suffer hospitalised injuries compared with their urban counterparts. The third epidemiological study used the Fatality Analysis Reporting Systems (FARS) from the United States (US) and estimated the association between different restraint uses and child passenger fatality using a matched cohort method. Improperly using restraints significantly elevated the risk of death for child passengers involved in a crash compared to any other restraint use. The advantage of child restraints over seat belts in terms of fatality reduction was not statistically significant, although previous studies have shown an advantage for serious injury reduction. The last study was performed to quantify the relative public health benefit in terms of reduction in child passenger deaths and injuries for different interventions relating to restraint use in the general population using a case-based population attributable risk fraction method. Results support the ongoing child restraint legislation change in Australia to require compulsory child restraint uses for children up to their 7th birthday, and an increasing proper use of age-appropriate restraints would provide the greatest reduction in fatalities and injuries among child passengers assuming equal population uptake for all interventions. In conclusion, this thesis demonstrates that child road trauma remains a public health burden to the Australian community; and highlights the importance of properly using age-appropriate restraints in preventing injuries to child passengers.

Aim The purpose of the study was to formally identify trauma care delivery problems at the study institution, implement a solution in the form of trauma case management (TCM), and measure the effect of TCM on staff satisfaction, clinical coding accuracy and patient outcomes, using practice-specific outcome variables such as in-hospital complication rates, length of stay, resource use and allied health service intervention rates. This research also aimed to make a unique contribution to the international trauma literature by addressing the lack of any evidence specifically measuring the impact of trauma case management intervention. Methods St George Hospital is a 600 bed urban Teaching Hospital of the University of NSW. It is a designated Trauma Centre, seeing around 200 severely injured patients and around 2500 injury admissions per year. A series of focus groups and a staff satisfaction survey identified perceived problems associated with trauma care, and a trauma case management program was implemented. A preliminary study was conducted with positive results and funding was obtained to provide TCM seven days a week to all trauma patient admissions. A larger clinical trial was conducted and data from 754 patients were collected over fourteen months after TCM was introduced at the study hospital. These data were compared with 777 matched patients from the previous 14 months as a control group. An audit was conducted on trauma patient clinical coding using the daily progress record kept by the trauma case manager. The data were analysed with SPSS. The statistical tests used were Mann-Whitney U, chi-squared (2) logistic regression and generalised linear models. Results Focus groups and the staff satisfaction survey identified communication and coordination as the main problems associated with trauma care delivery. Following the initial implementation of the program, staff support for TCM was overwhelming. TCM greatly improved the rate of and time to Allied Health intervention (p<0.0001). Results demonstrated a decrease in the occurrence of deep vein thrombosis (p<0.038), coagulopathy (p=0.041) and respiratory failure. A reduced hospital length of stay (LOS), particularly in the paediatric (p<0.05) and 45 - 64 years age group was noted. There were 6621 fewer pathology tests performed (p<0.0001) and the total number of bed days was 483 days less than predicted from the control group. Many hospital clinical coding errors and omissions were highlighted by the TCM record comparison. The use of TCM records resulted in Twenty eight percent of recoded records having their Australian national diagnostic related group (AN-DRG) changed, which resulted in the identification over $39,000 in unidentified funding. Conclusion TCM improves staff satisfaction, communication and clinical coding accuracy. The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution. This initiative demonstrates that TCM results in improvements to quality of care, trauma patient morbidity, financial performance and resource use. This research makes an important and original contribution to the international trauma literature by providing the results of a clinical trial formally measuring the impact of trauma nursing case management intervention.

Aims and objectives: To investigate the epidemiology, risk factors, and preventive strategies for serious head and spinal injuries related to rugby league and union football in New South Wales (NSW). Methods: The three main components of this study included. 1. A retrospective analysis of clinical and compensation case file records during the 16-year period, 1984-1999. 2. A review of game rules, weights and heights of players, over the past 100 years. 3. A review of film and video footage of rugby football games spanning most of the 20th century. A method was developed to allow valid comparisons in style of play over a 70-year period. Results: The estimated annual incidence rate of SCI for rugby league players was 1.9 (95%CI 1.3 - 2.8) per 100,000 estimated players per year, and 3.3 (95%CI 2.2 - 4.8) per 100,000 estimated rugby union players per year over the study period 1984 to 1999. There was no significant change in the incidence of rugby league related serious spinal cord injuries (1984-1999), fatalities (1984-1999) or serious head injuries (1984-1999). There was a small but significant decline in rugby union related serious spinal cord injuries (1984-1999, P<0.05). However, the relative risk of spinal cord injury was 1.34 times greater for rugby union compared to rugby league over the entire study period (95%CI 1.01 - 1.67, P<0.05). For rugby football, the evidence suggested that the force of impact between participants was a key causal risk factor for serious injury. Elite rugby league and union players from 1999-2000 teams were significantly heavier (P<0.05) and taller (P<0.05) than players pre 1950. Players in modern elite games post 1989 were more likely to be tackled by multiple opponents (P = 0.000), tackled head on (P<0.05), at chest level (P<0.05) and at greater speeds than their earlier counterparts pre 1958. However, modern players appear to be no more aggressive or perpetrate greater foul play than their predecessors. Conclusions: There was a continued annual occurrence of catastrophically serious injuries leading to permanent brain damage and quadriplegia associated with rugby league and union in NSW. The critical risk factors found to be associated with serious injury in rugby football suggest relatively novel approaches to the development of preventive strategies.

Australia is a common law country. Australia is a federation of five states and two territories. Laws affecting adults in need of protection whether in terms of financial or personal Private Mandates, Statutory Wills, or state appointed financial managers or enduring guardians are generally made at state level. Other areas of law, such as family law, bankruptcy, and corporations are at a federal level.

The English Bankruptcy Act of 1542 and subsequent 17th century legislation served as the model for early personal insolvency laws upon white settlement in Australia. In 1840 the colony of New South Wales, Australia’s first colony, passed an Absent Debtors Act and the following year an Act for Giving Relief of Insolvent Debtors. A number of the colonies passed insolvency legislation in the period leading up to Federation in 1901. Under the Australian Constitution from 1901 the Federal Parliament has had power to ‘make laws for the peace, order and good government’ with respect to bankruptcy and insolvency. The Federal Parliament used this power in 1914 to create its first Bankruptcy Act and there were new Acts in 1924 and 1966. The present legislation is the Bankruptcy Act 1966 (Cth) which had major amendments in 2002 and 2004.

Allambie Heights Public School is located on the Northern Beaches of Sydney, New South Wales, Australia. It is a Kindergarten to Year 6 school for students aged five to twelve years. The school is “committed to the pursuit of high academic achievement in a safe, secure, and caring learning environment. The programs offered are diverse, and challenge and inspire our students. Students, parents and staff work in partnership to create a vibrant learning community. Literacy, numeracy and technology are emphasized within learning programs”. The school motto, ‘Ever Aim High’, “underpins the school’s strong belief that each child needs to be recognized for their own achievements, celebrating success [both at] a school and personal level”. As a Positive Behavior for Learning school, the school values of respect, responsibility, and resilience are key to the success of our school community. We currently have 514 students and 51 staff in our school. Four students identify as Aboriginal and Torres Strait Islander and 14% of students come from a language background other than English. The school is in a high socio-economic area with a Family Occupation and Education Index (FOEI) of 17. The school Index of Community and Socio-Educational Advantage is 1,112.

Soil scientists used to speak of soil quality, a concept expressing a soil’s “fitness for purpose.” The prime purpose was for agriculture and the production of food and fiber. However, to the general public soil quality is a rather abstract con­cept and in recent years the term has been replaced by soil health. A significant reason for this change is that health is a concept that resonates with people in a personal sense. This change is epitomized in the motto “healthy soil = healthy food = healthy people” on the website of the Rodale Institute in Pennsylvania (http://rodaleinstitute.org/). One consequence of this change is an increasing focus on the state of the soil’s biology, or life in the soil, an emphasis that is expressed through the promotion of organic and biodynamic systems of farming. Viticulture and winemaking are at the forefront of this trend. For example, Jane Wilson (2008), a vigneron in the Mudgee region of New South Wales, is quoted as saying, “the only way to build soil and release a lot of the available minerals is by looking after the biology,” and Steve Wratten (2009), professor of ecology at Lincoln University in New Zealand has said, “Organic viticulture rocks! It’s the future, it really is.” This exuberance has been taken up by Organic Winegrowers New Zealand, founded only in 2007, who have set a goal of “20 by 2020,” that is, 20% of the country’s vineyards under certified organic management by the year 2020. The Cornell Soil Health Assessment provides a more balanced assessment of soil health (Gugino et al., 2009). The underlying concept is that soil health is an integral expression of a soil’s chemical, physical, and biological attributes, which determine how well a soil provides various ecosystem functions, including nutrient cycling, supporting biodiversity, storing and filtering water, and maintaining resilience in the face of disturbance, both natural and anthropogenic. Although originally developed for crop land in the northeast United States, the Cornell soil health approach is readily adapted to viticulture, as explained by Schindelbeck and van Es (2011), and which is currently being attempted in Australia (Oliver et al., 2013; Riches et al., 2013).

The construction industry faces many challenges, one of which is the difficult to define psychosocial influences. The construction sector has highly demanding employment conditions, long working hours and sometimes unfeasible terms of project execution. Psychosocial influences represent emotional as well as physiological characteristics which impact the immediate environment. Some construction personnel face psychosocial problems that can lead to depression or suicide. The research conducted in this paper focuses on the psychosocial status of personnel working in construction companies, in New South Wales (NSW), Australia. A questionnaire survey was conducted to investigate the psychosocial hazards observed in the construction industry in NSW. Practitioners in two private construction companies and one government department having construction project management experience in NSW were involved in the survey. The data analysis indicates that most workers experienced being pressured to stay back and work long hours. This led to workers being ‘very frequently’ tired. Regarding bullying, Respondents reported that the frequency of they experienced ‘exclusion or isolation from workplace activities’ was ‘monthly’. Being ‘Subjects of gossip or false, malicious rumours’ was reported as happening ‘weekly’ and ‘Humiliation through gestures, sarcasm, criticism or insults’ was said to happen ‘almost daily’. This study's findings indicate that construction projects could have unaddressed psychosocial hazards and risks, each of which may be a potential factor for accidents and occupational and psychological injuries. The data displayed from this research could help understand psychosocial hazards. Spreading awareness on the issue can hopefully be a step towards improving the mental health of construction workers while decreasing the overall suicide rate.

A challenge for greyhound racing is optimizing the tracks to minimize the risk of injuries. The effects of different track design variables on greyhound injury rates has not been explored sufficiently. The purpose of this paper is to present some preliminary findings on the effect of greyhound racetrack design variables such as the track curvature and lure alignment. An analysis was carried out of two years of greyhound racing injury data from three different tracks in New South Wales, Australia. The data from before and after an intervention was introduced were compared. Variables in the study, which may affect\ the analysis were investigated to minimize the errors. The analysis showed that there is a reduction in injury rates for a longer lure arm in the tracks with short or no straight section. To verify the effect of track design variables on the greyhound dynamics a kinematic simulation of greyhound center of gravity was created. The simulation considered fundamental variables correlating directly with kinematics between the greyhound and the track. The simulation data showed that the rate of change in the rotation of the greyhound heading direction decreases when the track running path has a more gradual curvature. The result of the simulation showed excellent agreement with that of injury data analysis.