DORA Health Service:

Assessing Cognitive Communication Disorders for Return to Work Following Acquired Brain Injury: A Mixed Methods Investigation of Clinical Experiences and Perspectives

Thu, 01 Jan 2026 00:00:00 GMT

Title: Assessing Cognitive Communication Disorders for Return to Work Following Acquired Brain Injury: A Mixed Methods Investigation of Clinical Experiences and Perspectives Authors: Cameron, Kate; Cornwell, Petrea; Watter, Kerrin; McLennan, Vanette; Wegener, Nina; Hewetson, Ronelle Abstract: Cognitive communication changes are common after acquired brain injury (ABI) and can impact a person's ability to return to and sustain work. To understand the practices and experiences of speech-language pathologists (SLPs) involved in assessing cognitive communication skills for return to work (RTW) after ABI. An explanatory sequential mixed methods design was used, involving sequential data collection points of a benchmarking survey followed by expert opinion focus groups. Descriptive statistics and content analysis were used to analyse the data. Thirty-four SLPs completed an online survey. Six participants took part in focus groups. Findings suggest SLPs are currently involved in assessing the communication skills of individuals aiming to RTW after an ABI, and that they use a variety of approaches, including standardised and informal or dynamic assessments. They may benefit from training resources, and support to integrate into interprofessional teams. This study emphasises the need to prioritise assessing cognitive communication skills for individuals aiming to RTW post injury. While SLPs provide assessment for this population, improving their integration in interprofessional teams, training and detailed clinical resources will be valuable. SLPs have specialised expertise that can be applied to assessing cognitive communication skills for return to work (RTW). Practice guidelines that are specific to cognitive-communication assessment for RTW are needed to support decision-making and ensure greater practice consistency and confidence. Interdisciplinary collaboration and involvement of SLPs in the RTW process can ensure communication skills are appropriately assessed. What is already known on the subject It is known that cognitive and social communication changes following ABI can impact a person's ability to return to and maintain work. Existing guidelines, such as the International Cognitive Rehabilitation Guidelines for Cognitive Rehabilitation following Traumatic Brain Injury, models such as the Model of Cognitive Communication Competence and professional associations such as Speech Pathology Australia (SPA) and the American Speech Language Hearing Association (ASHA) support the role of SLPs in assessing cognitive communication disorders that impact return to work (RTW) after ABI. These however, provide general advice rather than specific clinical practice information or training resources. There are a variety of cognitive communication assessments but there is a limited understanding of how these are applied in practice. What this paper adds to the existing knowledge This study identifies current RTW cognitive communication assessment practice challenges and opportunities for improvement. What are the potential or actual implications of this work? Findings provide additional support for the role of SLPs in RTW teams. It provides an overview of what is currently occurring in clinical practice and offers guidance on areas for development including functional assessment approaches and interprofessional collaboration. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Petrea Cornwell

Improving primary care management and referral practices for paediatric allergic rhinitis: A quality improvement study

Thu, 01 Jan 2026 00:00:00 GMT

Title: Improving primary care management and referral practices for paediatric allergic rhinitis: A quality improvement study Authors: Vemula, Mounavi; Kapoor, Vishal; Bourke, Peter Abstract: Background and Objectives Paediatric allergic rhinitis (AR) is often referred for specialist input despite effective primary care strategies. This study evaluates AR referrals to the Cairns Hospital Paediatric Allergy Clinic against local guidelines and assesses the impact of a quality improvement project on referral patterns. Method A 12-month retrospective audit reviewed paediatric AR referrals and management. Interventions included updated guidelines, educational initiatives, and a streamlined referral process. Post-intervention referrals were analysed to assess impact on community management. Results Pre-intervention, 10% (40/417) of referrals received were for AR, with 68% (27/40) discharged after primary management optimisation and only 20% (8/40) commencing allergen immunotherapy. Post-intervention, 22% (32/144) of referrals received were for AR, with 81% (26/32) on guideline recommended medical therapy at referral (vs 53% [21/40] pre- intervention, P = 0.01) and 50% of these (16/32) had specified the treatment duration (vs 23% [9/40] pre-intervention, P = 0.02). Discussion Our streamlined referral process with referrer-focused educational initiatives, improved referral appropriateness and enhanced pre-hospital management of AR before specialist referral. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Mounavi Vemula, Peter Bourke

A Preventive Social Media Intervention for Perinatal Depression and Anxiety in Regional, Rural, and Remote Communities: Participatory Co-Design Study

Thu, 01 Jan 2026 00:00:00 GMT

Title: A Preventive Social Media Intervention for Perinatal Depression and Anxiety in Regional, Rural, and Remote Communities: Participatory Co-Design Study Authors: Lynch, Kacey Jane; Shatte, Adrian Brian Royce; Muller, Jessica; George, Kendall; Rossini, Gisele; Anson, Angela; Hala, Courtney; Dimmock, James; Hutchinson, Delyse; Teague, Samantha Abstract: Background Perinatal depression and anxiety are significant public health concerns, affecting up to 1 in 5 women globally, with disproportionate burden carried by women in regional, rural, and remote communities where structural and social inequities amplify vulnerability. Access to perinatal mental health support in these settings is severely constrained by geographical isolation, workforce shortages, financial barriers, and a lack of culturally safe services. Prevention is recognized as critical to reducing this burden, with evidence suggesting that effective preventive approaches can reduce population-level illness by up to 40% and alleviate downstream demand on overstretched services. Digital mental health interventions hold promise for improving access to support, yet few are co-designed with underserved perinatal populations. Objective This study aimed to identify the mental health needs of perinatal women in regional, rural, and remote communities and to co-design a framework for a preventive social media-based intervention informed by platform-specific affordances and constraints, using Northern Queensland, Australia, as an exemplar. Methods Using a participatory co-design approach, 26 perinatal women (21 postnatal and 5 antenatal) and 8 mental health care professionals from regional, rural, and remote Northern Queensland participated in focus groups or interviews, supplemented by ongoing consultation with a community advisory group comprising lived experience representatives, clinicians, and local community leaders. Qualitative data were analyzed using reflexive thematic analysis to identify core community mental health needs. Identified needs were then examined through a needs-affordances framework to determine how specific platform features could address, enable, or constrain those needs in the context of a preventive intervention. Results Five core mental health needs were identified: (1) social connection and support; (2) personalized and respectful health care; (3) information that empowers; (4) place-based and culturally safe support; and (5) accessible, low-burden digital formats. Participants viewed social media as a potentially useful platform for fostering peer connection, normalizing perinatal experiences, and providing timely psychoeducation. However, both mothers and professionals expressed concerns about misinformation, harmful social comparison, and privacy risks that must be proactively addressed in program design. These insights were synthesized into a set of prototype design guidelines specifying recommended content, features, tone, and delivery formats to inform subsequent intervention development. Conclusions This study provides a place-based, co-designed needs-affordances framework to guide the development of a preventive social media-based intervention for perinatal mental health support in regional, rural, and remote communities. The findings demonstrate that social media is an acceptable and promising platform for preventive perinatal mental health support in these settings, provided that design is driven by community need, platform affordances are systematically analyzed, and known risks are explicitly mitigated. These findings address a significant gap in the literature and offer a replicable methodological approach for co-designing contextually relevant digital mental health interventions with underserved populations. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Angela Anson

Persistent malnutrition in a remote Australian hospital—Insights from a 10‐year cross‐sectional study

Thu, 01 Jan 2026 00:00:00 GMT

Title: Persistent malnutrition in a remote Australian hospital—Insights from a 10‐year cross‐sectional study Authors: Smalley, Rachael; Nichols, Elisabeth; Lauren Caruana; Scott, Megan; Jochinke, Elise; Tregea, Tiffany; Franklin, Natasha Abstract: Aim: To describe the burden of malnutrition in an at‐risk population and validate a screening tool. Methods: A 10‐year cross‐sectional study was conducted in a remote hospital. Dietitians screened participants using the Malnutrition Screening Tool or the Adult Nutrition Tool. Participants scoring ≥2 utilising the Malnutrition Screening Tool or ≥4 utilising the Adult Nutrition Tool, or already under the care of a dietitian, were assessed for malnutrition using a Subjective Global Assessment. The validity of the Adult Nutrition Tool was compared to the Malnutrition Screening Tool in participants undergoing a Subjective Global Assessment. Results: Of 980 study participants, 70.1% identified as Aboriginal Australian and 42.6% were at risk of malnutrition. Three‐hundred and seventy‐four (58.8%) participants were malnourished. The Adult Nutrition Tool showed superior area under the curve (0.74, 95% confidence interval [0.67, 0.81], p < 0.001) than the Malnutrition Screening Tool (0.64, 95% confidence interval [0.56–0.73], p 0.001). An Adult Nutrition Tool score ≥2 demonstrated superior sensitivity (98.2%) and specificity (16.7%) compared to a Malnutrition Screening Tool score ≥2 (sensitivity 97.2% and specificity 14.3%). An Adult Nutrition Tool score of ≥3 demonstrated reduced sensitivity (92.0%) but superior specificity (20.2%) than screening scores ≥2 for both tools. Conclusion: Malnutrition risk is high in a remote Australian hospital. This study confirms the Adult Nutrition Tool and the Malnutrition Screening Tool are valid tools to predict malnutrition in a unique remote hospital, recommending an 'at‐risk' threshold of ≥2 for the Adult Nutrition Tool to aid in the early detection of malnutrition. Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Lauren Caruana