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To effectively manage a crisis, most decisions made by governments, organizations, communities, and individuals are based on "shared situational awareness" (SSA) derived from multiple information sources. Developing SSA depends on the alignment of mental models, which "represent our shared version of truth and reality on which we can act." Social media has facilitated public sensemaking during a crisis; however, it has also encouraged mental model dissonance, resulting in the digital destruction of mental models and undermining adequate SSA. The study is concerned with the challenges of creating SSA during the COVID‐19 pandemic in Australia. This paper documents a netnography of Australian public health agencies' Facebook communication, exploring the initial impact of COVID‐19 on SSA creation. Chaos theory is used as a theoretical lens to examine information perception, meaning, and assumptions relating to SSA from pre to post‐pandemic periods. Our study highlights how the initial COVID‐19 "butterfly effect" swamped the public health communication channel, leaving little space for other important health issues. This research contributes to information systems, information science, and communications by illustrating how the emergence of a crisis impacts social media communication, the creation of SSA, and what this means for social media adoption for crisis communication purposes. [ABSTRACT FROM AUTHOR]

In Australia, like many high-income countries, food insecurity is associated with increased risks of chronic diseases, sub-optimal development outcomes in children, and mental health conditions including depression and anxiety. Food insecure households employ a range of strategies, including the use of food charity, to help alleviate hunger and meet cost of living pressures. The aim of this paper is to investigate the lived experience of food insecurity for welfare-dependent households, and to examine these experiences within a structural violence framework. Structural violence investigations seek to understand the distal causal factors that can help explain poor health patterns and inequities. Semi-structured interviews were conducted with customers (n = 78) of food pantries, soup kitchens, and community development programs (June 2018 to January 2019) in the state of Victoria, Australia. Thematic analysis established evidence of controlling, demeaning and depriving practices in the interactions between the participants and the services and staff at national welfare providers and food charities. The same providers and charities nominally set up to address the exact situations in which participants found themselves. The findings of this study suggest that food and social services are an on-the-ground setting through which structural violence is enacted and experienced. [ABSTRACT FROM AUTHOR]

Objective: To describe patterns of use of the available Government-subsidised mental health services among people living in Australian residential aged care facilities. Methods: A retrospective population-based trend analysis was conducted, including all non-Indigenous people living in an Australian facility between 2012 and 2017. Adjusted incidence proportions and trends were estimated for four groups of mental health services. Results: The use of Medicare-subsidised mental health services was very low overall. The proportion of residents who accessed primary care mental health services increased from 1.3% in 2012/2013 to 2.4% in 2016/2017, while psychiatry service use increased from 1.9 to 2.3%. Claims for clinical psychology increased from 0.18 to 0.26%, and claims for a registered psychologist, occupational therapist or social worker rose from 0.45 to 1.2%. People with dementia were less likely than people without dementia to access all services aside from psychiatry services. Conclusions: Less than 3% of residents accessed funding subsidies for mental health services and people with dementia experienced pronounced barriers to service access. Mental health care is a pillar of the publicly-funded health system in Australia, and low use of these services among aged care residents indicates a need for organisational and policy changes to improve access. What is known about the topic? People living in residential aged care facilities report very high rates of mental health conditions, including depression and anxiety. What does this paper add? We demonstrate very low use (<3%) of Government-funded mental health services among people living in residential aged care facilities in Australia, with only small increases in use over time. What are the implications for practitioners? Practitioners should routinely assess the mental health needs of people living in residential aged care and refer for in-reach mental health services where needed, noting that facility staff are usually not trained for this role. [ABSTRACT FROM AUTHOR]

Objective: Hospital utilisation research is important in pursuing cost-saving healthcare models. Tonsillectomy is one of the most common paediatric surgeries and the most frequent reason for paediatric hospital readmission. This study aimed to report the government-funded costs of paediatric tonsillectomy in the state of Victoria, Australia, extrapolate costs across Australia, and identify the cost determinants. Methods: A population-based longitudinal study was conducted with a bottom-up costing approach using linked datasets containing all paediatric tonsillectomy and tonsillectomy with adenoidectomy surgeries performed in the state of Victoria between 2010 and 2015. Results: The total average annual cost of tonsillectomy hospitalisation in Victoria was A$21 937 155 with a median admission cost of A$2224 (interquartile range (IQR) 1826–2560). Inflation-adjusted annual tonsillectomy costs increased during 2010–2015 (P < 0.001), not explained by the rising number of surgeries. Hospital readmissions resulted in a total average annual cost of A$1 427 716, with each readmission costing approximately A$2411 (IQR 1936–2732). The most common reason for readmission was haemorrhage, which was associated with the highest total cost. The estimated total annual expenditure of both tonsillectomy and resulting readmissions across Australia was A$126 705 989. Surgical cost in the upper quartile was associated with younger age, male sex, lower socioeconomic status, surgery for reasons other than infection alone, overnight vs day case surgery, public hospitals and metropolitan hospitals. Surgery for obstructed breathing during sleep had the strongest association to high surgical cost. Conclusions: This study highlights the cost of paediatric tonsillectomy and associated hospital readmissions. The study findings will inform healthcare reform and serve as a basis for strategies to optimise patient outcomes while reducing both postoperative complications and costs. What this known about the topic? Tonsillectomy is one of the most common surgeries in childhood and the most frequent reason for paediatric unplanned hospital readmissions. There is growing interest in cost containment and a value-based model of funding. What does this paper add? This is the first study to investigate the economic effect of paediatric tonsillectomy at a national level worldwide. The estimated national annual cost of tonsillectomy was A$126 705 989 and rising. What are the implications for practitioners? These findings will inform healthcare reform that aims to contain costs while optimising patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Strict patient isolation in hospital is associated with adverse health outcomes. However, there is a lack of high‐quality evidence for effective interventions to improve safety and quality of care for these patients. Aims: To identify patient reported areas for improvement in the care of patients in hospital isolation and to determine the feasibility of collecting patient reported outcomes using validated tools. Methods: Design: An exploratory mixed methods study. Setting: A major metropolitan teaching hospital in Melbourne, Australia. Participants: Patients in hospital isolation for transmissible infections. Data collection: Data were collected by (1) phone interviews with patients in isolation and (2) seven validated measurement tools to assess cognition, loneliness, nutritional status, quality of life, anxiety and depression and physical activity. Data were collected between September and December 2021. Data analysis: Interviews were transcribed and analysed using thematic analysis. Quantitative data were analysed descriptively including participant characteristics and outcome data. Results: Participants identified areas for improvement including activities to decrease boredom, more contact with staff to mitigate loneliness and increase comfort care, and formalised communication about clinical treatment and discharge plan. Patients with gastrointestinal symptoms were happier to be alone. There were operational challenges within the health service including delays and miscommunication. Only 70% of the participants completed all questionnaires. Conclusion: This study identified areas for improvement in care of patients in isolation and demonstrated that collecting patient reported outcomes using validated tools was feasible. The results of this research will inform development of an intervention to manage adverse effects. Implications for the Profession and/or Patient Care: Patients in hospital isolation require additional consideration to ensure that their needs are met to avoid adverse outcomes. The patient experience and comfort can be negatively affected when fundamental care is lacking. Reporting Method (EQUATOR): EQUATOR guidelines for Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR‐RHS). Patient or Public Contribution: Thirteen patients in hospital isolation agreed to participate in this study, sharing their experiences through interviews and assessment. [ABSTRACT FROM AUTHOR]

Prior to its introduction in Australia, many people opposed euthanasia—or voluntary assisted dying as it is known—because of its potentially detrimental impact on grief and bereavement outcomes for family members and carers. We examine the novel experiences of grief and bereavement of VAD for family members and carers who were going through, had gone through, or were contemplating VAD, juxtaposing the international literature on grief and bereavement. As such, 42 semistructured interviews with family members and carers were undertaken in the state of Victoria, which was the first jurisdiction to legislate in favour of VAD. Interviews explored many themes around end‐of‐life decision‐making in order to ascertain the ways in which VAD helped or hindered grief and bereavement processes. A thematic analysis of the interview data was undertaken using QSR NVivo software. Four key themes were identified: values and meaning‐making, expression of a continuing bond, anticipatory grief, and the burden of care associated with supporting loved ones going through VAD. These themes were juxtaposed with the key literature on grief and bereavement to demonstrate how VAD presents novel challenges for carers. We argue that while VAD deaths share similar characteristics to other deaths; in some respects, grief and bereavement outcomes for family members and carers are unique. For family members and carers helping a loved one go through VAD, they were able to derive a sense of meaning from fulfilling their wishes and striving for them to have a "good death"; they were able to maintain a bond with them through advocacy of VAD and unique rituals; and they were able to plan and prepare effectively by knowing the exact time of death. Family members and carers also noted that VAD presents some significant challenges for grief and bereavement, especially in terms of the impact of VAD on familial relationships and burdens associated with moral predicaments. Nonetheless, VAD was generally viewed positively by family members and carers, who expressed gratitude for mitigating their loved one's suffering. [ABSTRACT FROM AUTHOR]

Objective. To quantify the introduction of new, temporary telehealth Medicare Benefits Schedule (MBS) items delivered by allied mental health professionals (AMHPs) through the Better Access initiative during the COVID-19 pandemic in Australia. Methods. MBS-item service data for clinical psychologists, registered psychologists, social workers, and occupational therapists were extracted for existing face-to-face, remote videoconferencing and new, temporary telehealth items for the study period April-December 2020. The total number of services in Australia were compared with the baseline period of 2019. Given the second wave of increased COVID-19 infections and prolonged lockdowns in the state of Victoria, we compared the per capita rate of services for Victoria versus other states and territories. Results. During the study period, there was an overall 11% increase in all allied mental health consultations. Telehealth use was substantial with 37% of all sessions conducted by videoconferencing or telephone consultations. The peak month was April 2020, during the first wave of increasing COVID-19 cases, when 53% of consultations were via telehealth. In terms of Victoria, there was an overall 15% increase in all consultations compared with the same period in 2019. Conclusions. Allied mental health services via MBS-subsidised telehealth items greatly increased during 2020. Telehealth is an effective, flexible option for receiving psychological care which should be made available beyond the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method: A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results: Seventy-nine mentors were recruited to support two groups of nurses (N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being "witness to mentee growth," "having facilitated access to learning" and receiving "unexpected benefits" including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion: The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health. [ABSTRACT FROM AUTHOR]

Purpose: Schools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary school parents regarding school food and nutrition, including education, practices and policy. Design/methodology/approach: An online survey was conducted among 787 parents in March 2021, which included closed and open-ended questions. Findings: The results indicated the inconsistent implementation of policies and/or varying practices among different schools. Parents' views were slightly associated with some demographic and personal measures including their SES levels, education, age, the main language spoken at home and universalism values. Parents viewed healthy food provision through canteens, policies and informing parents, fruit and vegetable breaks and kitchen and garden programs as the main contributors to the promotion of healthy eating. They believed unhealthy options in canteens, school fairs, events and birthdays are the major contributors to the formation of unhealthy eating habits among children at schools. Results revealed the efforts to establish health promoting school food environments in Australian primary schools; however, inconsistencies and discrepancies among schools should be addressed to ensure equity among all children. Practical implications: The findings may provide directions for policymakers and school managers and can inform future reforms and initiatives in Australian primary schools and elsewhere. Originality/value: This is the first study that has examined Australian parents' views of school food policy, practices and environments using a mixed-methods design. [ABSTRACT FROM AUTHOR]

Introduction: Access to after‐hours care (AHC) is an important aspect of general practice service provision. Objective: To establish the prevalence and associations of early‐career GPs' provision of AHC. Design: An analysis of data from the New alumni Experiences of Training and independent Unsupervised Practice (NEXT‐UP) cross‐sectional questionnaire‐based study. Participants were early‐career GPs (6‐month to 2‐year post‐Fellowship) following the completion of GP vocational training in NSW, the ACT, Victoria or Tasmania. The outcome factor was 'current provision of after‐hours care'. Associations of the outcome were established using multivariable logistic regression. Findings: Three hundred and fifty‐four early‐career GPs participated (response rate 28%). Of these, 322 had responses available for analysis of currently performing AHC. Of these observations, 128 (40%) reported current provision of AHC (55% of rural participants and 32% of urban participants). On multivariable analysis, participants who provided any AHC during training were more likely to be providing AHC (odds ratio (OR) 5.51, [95% confidence interval (CI) 2.80–10.80], p < 0.001). Current rural location and in‐training rural experience were strongly associated with currently providing AHC in univariable but not multivariable analysis. Discussion: Early‐career GPs who provided AHC during training, compared with those who did not, were more than five times more likely to provide after‐hours care in their first 2 years after gaining Fellowship, suggesting participation in AHC during training may have a role in preparing registrars to provide AHC as independent practitioners. Conclusion: These findings may inform future GP vocational training policy and practice concerning registrars' provision of AHC during training. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to map the geographic distribution of tertiary hospitals in Australia’s most populous cities. Good access to hospital facilities improves the health and welfare of a community. The use of geographic information system (GIS) technology can assist in understanding spacial accessibility to services. Methods. Using Quantum GIS, a geodatabase was constructed to incorporate hospital locations and demographic distribution data throughout Australia’s 20 most populous cities. Data on the population’s age groups were integrated into the geodatabase to investigate the distribution of age groups and their utilisation of access to emergency departments in tertiary public health care. Overall this study reported the geospatial distribution of 89 tertiary hospitals and the demographics of the population in areas around these hospitals. Results. The majority of hospitals were located in the three most populated cities of New South Wales (NSW), Sydney, Wollongong and Newcastle, which contain a total of 32 hospitals, with 23 (72%) of the hospitals in Sydney. There were 7.8, 24.0, 53.4 and 81.0% of the population in NSW within 1.5, 3, 6 and 50 km of the hospitals, respectively. The second-highest number of hospitals was in Victoria (n = 22), with 18 (82%) hospitals located in Melbourne. This was followed by Queensland (n = 14), with eight (57%) hospitals located in Brisbane. Conclusions. The results indicate that 82.2% of the Australian population lives within a 50 km radius of a tertiary hospital, with NSW having higher age distribution percentages than the other states. The results of this study could be used to locate and improve areas of need with a high burden of disease and low accessibility to healthcare services. [ABSTRACT FROM AUTHOR]

Introduction: The Cardiff model is a data sharing approach that aims to reduce the volume of intoxicated patients in emergency departments (EDs). This approach has not been tested in a rural setting. Objective: This study assessed whether this approach would reduce the number of alcohol‐associated presentations during high‐alcohol hours (HAH) in a regional ED. Design: From July 2017, people over the age of 18 attending the ED were asked by the triage nurse (1) whether they had consumed alcohol in the past 12 h, (2) their typical alcohol consumption level, (3) the location where most alcohol was purchased and (4) the location of the last drink. From April 2018, quarterly letters were sent to the top five venues reported within the ED. Deidentified, aggregated data were shared with local police, licensing authorities and local government, identifying the top five venues reported in the ED and providing a summary of alcohol‐related attendances to the ED. Interrupted time series analyses were used to estimate the influence of the intervention on monthly injury and alcohol‐related ED presentations. Findings: ITS models found that there was a significant gradual decrease in the monthly rate of injury attendances during HAH (Coefficient = −0.004, p = 0.044). No other significant results were found. Discussion: Our study found that sharing last drinks data collected in the ED with a local violence prevention committee was associated with a small, but significant reduction in the rate of injury presentations compared with all ED presentations. Conclusion: This intervention continues to have promise for reducing alcohol‐related harm. [ABSTRACT FROM AUTHOR]

Aims: To identify the origin of fresh and minimally processed foods served to hospital patients, and explore the challenges and enablers to local food procurement in hospitals. Methods: A mixed methods study was conducted in a healthcare network in Victoria, Australia. Packaging labels and product information were used to audit fresh and minimally processed foods purchased in 1 week. Processed food items and meals made offsite were not audited. Interviews were conducted with patients, staff and suppliers to explore their perspectives towards local food in hospitals. Framework analysis was used to identify themes. Results: Of 105 food products audited, 32% were imported, 25% were 'local' from Victoria and the remaining 43% were from within Australia (excluding Victoria). Qualitative interviews revealed several challenges including: increased cost of local food items, inconsistent supply and variable quality of local produce, difficulty accessing origin information, and lack of autonomy for hospitals to make food procurement choices. Enablers included: conducting a food origin audit to increase awareness, group purchasing organisation prioritising local food suppliers, and suppliers valuing local produce. Conclusion: A food origin audit and interviews with stakeholders provided a rich understanding of current practices and how to increase local food procurement. [ABSTRACT FROM AUTHOR]

Purpose: To compare the frequency of General Practitioner (GP) services and the time between first and last GP services (service duration) provided to workers with low back pain (LBP) between four Australian workers' compensation jurisdictions. Methods: Retrospective cohort study using service level data collated from the Australian states of Western Australia, South Australia, Victoria and Queensland. Negative binomial regression was used to compare GP service volume between jurisdictions in workers with accepted LBP compensation claims. Quantile regression was used to compare GP service duration. Models were adjusted for sociodemographic factors and occupation. Analyses were repeated in four cohorts with progressively more restrictive cohort definitions to account for the influence of jurisdictional policy variation in employer excess, service delivery and maximum time-loss benefit duration. Results: The study sample included 47,185 time-loss claims accepted between July 2010 and June 2015, that were linked with 452,391 GP services. Workers with LBP in Queensland recorded significantly fewer GP services funded and recorded significantly shorter average service duration than in other states. This pattern of jurisdictional variation was evident in all four cohorts, but was attenuated when cohorts excluded short- and long duration claims. In the final, most restricted cohort statistically significant adjusted incidence rate ratios of 1.47–1.60 were observed in Victoria, South Australia and Western Australia, while these states recorded additional service duration of 4.3–20.7 weeks at the median. Conclusion: There is significant variation in provision of GP services to injured workers with LBP between four Australian workers' compensation jurisdictions. Administrative requirements for time-based provision of work capacity certificates by medical practitioners may be contributing to service variation. [ABSTRACT FROM AUTHOR]

In this article, the use of sport as a coping strategy by South Sudanese youth who have suffered the trauma of forced migration is examined. This article explores the relationship that has emerged between the young people and sport, in particular basketball, and how they use their participation in basketball and sports to cope with the stressors of their lives. The research intended to explore to what degree sport can play in improving mental health and what mental health interventions, in general, were being sought by this marginalized demographic. This qualitative study was underpinned by the psychosocial conceptual framework. We undertook semi-structured interviews with 23 South Sudanese youth aged 14–21 years, we also conducted focus groups of 11 South Sudanese elders and parents. The results of this research were feed back to the wider South Sudanese community through two forums. The data collected were analyzed using thematic analysis. The results of the study identified sport as an important coping strategy for the participants, both as a diversion from drug and alcohol misuse, potential criminal activity and as a way to self-manage the symptoms of anxiety and depression they were experiencing, and a mechanism to enhance self-worth. The study also indicated there was a lack of mental health interventions for these young people and that they had shown a great deal of resilience to develop their own ways to deal with the trauma they had experienced. The research reported positive associations of wellbeing and participation in sport, however more research needs to be conducted to ascertain the extent to which sport impacts mental health and how this can be incorporated into interventions for Sudanese youth and young people from similar forced migration and resettlement backgrounds. This study suggested that sport can be a driving force of good for many of the young people's lives, worthy of further research. [ABSTRACT FROM AUTHOR]

In 2020 Coronavirus disease (COVID-19) was identified in Australia. During the pandemic, as essential workers, hospital-based social workers have been on the frontline. This cross-sectional study examines the resilience of social workers during the COVID-19 pandemic, how the pandemic impacted on social work and lessons learnt. Hospital social workers working in three states, namely Victoria, Queensland, and New South Wales were invited to participate in an online web-based survey, providing non-identifiable demographic details and information a) relating to their proximity to COVID-19, b) their degree of resilience (CD-RISC-2), c) professional quality of life, d) perceived social support, e) physical health, f) professional and personal growth during the pandemic, and g) impacts of COVID-19 on their practice. Basic descriptive statistics were computed for variables of interest. Within group, comparisons were made using paired t-tests or one-way ANOVAs for continuous variables as appropriate to investigate possible interstate differences. Regression analyses were conducted to determine which factors contribute to resilience. Social workers, during the pandemic, whether working under the constraints of lockdown or not, demonstrated high levels of resilience. These levels were similar across the three states, unaffected by the degree of infection in the community, indicating that as a group, social workers have high innate levels of resilience. This study provides an in-depth understanding of the impact of COVID-19 on hospital social workers, the long-term impact of the pandemic on social work practice, and potentially useful lessons learnt for the future. [ABSTRACT FROM AUTHOR]

Background: Recent rapid growth in urban areas and the desire to create liveable neighbourhoods has brought about a renewed interest in planning for compact cities, with concepts like the 20-minute neighbourhood (20MN) becoming more popular. A 20MN broadly reflects a neighbourhood that allows residents to meet their daily (non-work) needs within a short, non-motorised, trip from home. The 20MN concept underpins the key planning strategy of Australia's second largest city, Melbourne, however the 20MN definition has not been operationalised. This study aimed to develop and operationalise a practical definition of the 20MN and apply this to two Australian state capital cities: Melbourne (Victoria) and Adelaide (South Australia). Methods: Using the metropolitan boundaries for Melbourne and Adelaide, data were sourced for several layers related to five domains: 1) healthy food; 2) recreational resources; 3) community resources; 4) public open space; and 5) public transport. The number of layers and the access measures required for each domain differed. For example, the recreational resources domain only required a sport and fitness centre (gym) within a 1.5-km network path distance, whereas the public open space domain required a public open space within a 400-m distance along a pedestrian network and 8 ha of public open space area within a 1-km radius. Locations that met the access requirements for each of the five domains were defined as 20MNs. Results: In Melbourne 5.5% and in Adelaide 7.6% of the population were considered to reside in a 20MN. Within areas classified as residential, the median number of people per square kilometre with a 20MN in Melbourne was 6429 and the median number of dwellings per square kilometre was 3211. In Adelaide's 20MNs, both population density (3062) and dwelling density (1440) were lower than in Melbourne. Conclusions: The challenge of operationalising a practical definition of the 20MN has been addressed by this study and applied to two Australian cities. The approach can be adapted to other contexts as a first step to assessing the presence of existing 20MNs and monitoring further implementation of this concept. [ABSTRACT FROM AUTHOR]

Background: P2Y12 inhibitor therapy is recommended for 12 months in patients hospitalised for acute myocardial infarction (AMI) unless the bleeding risk is high. Aims: To describe real‐world use of P2Y12 inhibitor therapy following AMI hospitalisation. Methods: We used population‐level linked hospital data to identify all patients discharged from a public hospital with a primary diagnosis of AMI between July 2011 and June 2013 in New South Wales and Victoria, Australia. We used dispensing claims to examine dispensing of a P2Y12 inhibitor (clopidogrel, prasugrel or ticagrelor) within 30 days of discharge and multilevel models to identify predictors of post‐discharge dispensing and persistence of therapy to 1 year. Results: We identified 31 848 patients hospitalised for AMI, of whom 56.8% were dispensed a P2Y12 inhibitor within 30 days of discharge. The proportion of patients with post‐discharge dispensing varied between hospitals (interquartile range: 25.0–56.5%), and significant between‐hospital variation remained after adjusting for patient characteristics. Patient factors associated with the lowest likelihood of post‐discharge dispensing were: having undergone coronary artery bypass grafting (odds ratio (OR): 0.17; 95% confidence intervals (CI): 0.15–0.20); having oral anticoagulants dispensed 180 days before or 30 days after discharge (OR: 0.39, 95% CI: 0.35–0.44); major bleeding (OR: 0.68, 95% CI: 0.61–0.76); or being aged ≥85 years (OR: 0.68, 95% CI: 0.62–0.75). A total of 26.8% of patients who were dispensed a P2Y12 inhibitor post‐discharge discontinued therapy within 1 year. Conclusion: Post‐hospitalisation use of P2Y12 inhibitor therapy in AMI patients is low and varies substantially by hospital of discharge. Our findings suggest strategies addressing both health system (hospital and physician) and patient factors are needed to close this evidence‐practice gap. [ABSTRACT FROM AUTHOR]

Objectives: Though several studies have focused on risk factors associated with excess weight gain, little is known about the extent to which socio-cultural beliefs about body sizes may contribute to risk of excess weight gain, especially in non-Western migrant communities. Drawing on socio-cultural and attribution theories, this study mainly explored socio-cultural beliefs about an ideal body size among Australian residents who were born in sub-Saharan Africa (SSA). Implications of body size beliefs for risk of excess weight gain after immigration have also been discussed. Design: Employing a qualitative design, 24 in-depth interviews were conducted with Australian residents who were born in SSA. Thematic content analysis was undertaken to ensure that participants' experiences and views were clearly captured. Results: According to the participants, a moderately large body size is idealised in the SSA community and post-migration weight gain is commonly regarded as evidence of well-being. While desirability of a moderately large body size was noted by some participants, others were concerned about health risks (e.g. high blood pressure) associated with excess weight gain. Moreover, body size ideals seemed to be different for men and women in the SSA community and these ideals were mainly promoted by family and friends. Participants reported that women with very slim (skinny) body sizes are often regarded as persons suffering from health problems, whereas those with 'plumpy' body types are often considered beautiful. Participants also noted that men are expected to look well-built and muscular while those with big bellies are often seen as financially rich. Conclusions: Participants' interpretation of post-migration weight gain as evidence of well-being calls for urgent intervention as risk of excess weight gain appear to be high in this immigrant group. [ABSTRACT FROM AUTHOR]

Objective. The COVID-19 pandemic in Australia coincided with an early trend of reduced visits to the emergency department (ED), but to determine which patients presented less requires closer evaluation. Identifying which patient groups are presenting less frequently will provide a better understanding of health care utilisation behaviours during a pandemic and inform healthcare providers of the potential challenges in managing these groups. Methods. This single-centre retrospective study examined trends in presentations in 2020 to a private, mixed paediatric and adult ED in an inner city suburb within the state of Victoria that treats both COVID-19 and non-COVID-19 patients. The 2019 dataset was used as a reference baseline for comparison. All analyses were performed using baseline characteristics and triage data. Results. The total number of visits to the ED dropped from 24 775 in 2019 to 22 754 in 2020, representing an overall reduction of 8%. Significant reductions in daily presentations and admissions from the ED were observed in the months immediately following the peak of the two COVID-19 waves in the state of Victoria. Visits by those in the 0- to 17-year age group, triage categories 4 and 5 and musculoskeletal presentations were also reduced for most of 2020. Gastrointestinal/abdominal and urological/renal presentations were reduced immediately after the first COVID-19 wave, whereas infectious diseases visits were reduced during and after the second COVID-19 wave. Conclusions. These findings add to the growing body of evidence regarding emergency care underutilisation during the COVID-19 pandemic. Reduced private ED presentations were observed overall and in paediatric patients, lower acuity triage categories, musculoskeletal, abdominal/gastrointestinal and urological/renal presentations during the first wave, whereas infectious disease cases were reduced during the second wave. [ABSTRACT FROM AUTHOR]

Objectives: To assess sociodemographic differences in postpartum women screened for intimate partner violence and who disclosed to their Maternal and Child Health nurses. Methods: Secondary analyses of survey data from women participating in a cluster randomised trial. The trial tested a nurse-designed, enhanced violence screening model-versus routine screening among eight community nurse clinics in Melbourne, Australia. Self-completion anonymous surveys were sent to all clinic attendees who had given birth in the previous eight months. We measured intimate partner violence with the Composite Abuse Scale and other sociodemographic variables. Multivariable logistic regression was used to analyse characteristics of screened versus unscreened women and those who did or did not disclose. Results: 91 clinics (163 nurses) participated in the trial. 2621/10,472 (25%) women responded to the survey. Notable characteristics, such as level of intimate partner violence (AdjOR 1.14, CI 0.94–1.40), parity (AdjOR 1.13, CI 0.94–1.35), education (AdjOR 1.20 CI 0.91–1.58) and being born in Australia (AdjOR 0.94, CI 0.86–1.03) made no significant difference to screening. However, nurses were significantly less likely to screen women with a lower income than those with a higher one (AdjOR 0.59, CI 0.40–0.87) with a dose response relationship. Women on the lowest levels of income were significantly more likely to disclose abuse (AdjOR 3.06, CI 1.02–9.17), indicating missed opportunities for nurses to provide timely care. Conclusions for practice: Despite being required to screen all women, nurses are almost twice as likely to screen more affluent women, who would be less likely to be experiencing or disclose intimate partner violence. [ABSTRACT FROM AUTHOR]