Search

The article discusses the approaches for gluteal tendinopathy which includes education plus exercise and corticosteroid injection.

This aim of this paper is to set the scene for the need for impact assessment and return on investment in funded cardiovascular research in Australia, starting with the historical perspective on waste in health and medical research. Recently there has been a substantial move from discussion and policy about the need for research translation, into practice and application via the evolution of funding streams like the Australian Medical Research Future Fund (MRFF). Health and medical research funders play a critical role in both setting the expectations for research translation and impact and helping researchers to meet these expectations. As a leading cause of death, cardiovascular disease is a national health priority, recognised as such with a AUD$220 million MRFF allocation to the Cardiovascular Health Mission. Focussing on cardiovascular research, we address some of the barriers researchers face in prospectively planning for research translation and impact assessment, and call for an ecosystem that supports a return on investment for all stakeholders, especially the community and patient end-users. [ABSTRACT FROM AUTHOR]

This paper considers the role of the teacher in relation to moral education in Catholic schools in Australia and Ireland. Literature pertaining to faith-based schooling, the moral role of the teacher and moral education across the curriculum in both countries is outlined. The paper draws on a small-scale study involving a survey with 154 respondents and individual interviews with nine teachers. Some interesting country differences emerged that are indicative of cultural settings. These include pedagogical practices, the nature of teacher–student relationships and levels of awareness of schools' founding charisms. Some implications for moral education in faith-based schools are identified. [ABSTRACT FROM AUTHOR]

Purposes: This study aimed to compare between electronic medication administration records and paper-based records in the nursing time spent on various activities in a medication round and the medication administration processes followed by nurses in an Australian residential aged care home. It also aimed to identify the benefits and unintended adverse consequences of using the electronic medication administration records.Methods: Time-motion observation, taking of field notes, informal conversation and document review were used to collect data in two units of a residential aged care home. Each unit had one nurse administer medication. Seven nurses were observed over 12 morning shifts. Unit 1 used electronic medication administration records and Unit 2 used paper-based records.Results: No significant difference between the two units was found in the nursing time spent on various activities in a medication round, including documentation, verbal communication, medication administration, infection control and transit. Comparison of the medication administration processes between the electronic and paper-based medication administration records identified a procedural problem which violated the organization's documentation requirement. This problem was documenting before providing medication to a resident when using the paper-based records. It was not observed with the electronic medication administration records. Benefits of introducing the electronic medication administration records included improving nurses' compliance with documentation requirements, freedom from the error of signing twice, reducing the possibility of forgetting to medicate a resident, facilitating nurses to record the time of medication administration to a resident and increasing documentation space. Unintended adverse consequences of introducing the electronic medication administration records included inadequate information about residents, late addition of a new resident's medication profile in the records and nurses' forgetting to medicate a resident due to power outage of the portable device.Conclusions: The electronic medication administration records may not change nursing time spent on various activities in a medication round or substantially alter the medication administration processes, but can generate both benefits and unintended adverse consequences. Future research may investigate whether and how the adverse consequences can be prevented. [ABSTRACT FROM AUTHOR]

Background: Minimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes.Methods: This paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8-15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding.Results: Compared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms.Limitations: The observational data provide insight into real-world practice but require statistical methods to account for selection into treatment.Conclusions: While clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice. [ABSTRACT FROM AUTHOR]

Introduction: The availability and implementation of evidence-based care is essential to achieving safe, quality trauma patient outcomes. Little is documented, however, about the challenges trauma clinicians face in their day-to day practice, or their views on the availability of evidence. This paper presents the most significant clinical practice challenges reported by multidisciplinary trauma care professionals in Australia and New Zealand, in particular those that may be resolved with focussed research or enhanced implementation activity.Methods: An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted between September 2018 and February 2019 using the Snowballing Method. Participants were recruited via a non-random sampling technique to complete an online survey. Thematic analyses were conducted.Results: There were nine significant clinical practice challenge themes in trauma care, arising from 287 individual clinical practice challenges reported. The most reported being clinical management (bleeding, spinal, older patients) and operationalisation of the trauma system. There was no consensus as to the availability of evidence to guide each theme.Conclusion: Future research should seek to address the clinical practice challenge of Australian and New Zealand trauma community to enable safe, quality trauma patient outcomes. [ABSTRACT FROM AUTHOR]

This paper explores the impact of acculturation conditions, orientations and outcomes on international students in Australia's tertiary education sector. Specifically, we investigate the factors that facilitate or hinder acculturation of international students within a multidimensional acculturation context (Arends-Tóth & van de Vijver, 2006). We used a sequential exploratory mixed-methods design in two studies to investigate acculturation of international students at an Australian university and test how these factors are related to psychological and sociocultural outcomes. In Study 1, we conducted a generic qualitative study using semi-structured interviews with a conventional content analyses approach,which compared the experiences of international students who on average had high numbers of positive experiences versus those who had high numbers of negative experiences. We found that a support network of mixed-nationals, and especially host locals, facilitates positive psychological and sociocultural adjustment, and buffers acculturative stress. Study 2 quantitatively tested the association of factors found in Study 1 (perceived stereotypes, intercultural and ethnic network/resources) with psychological and sociocultural acculturation outcomes. Study 2, shows that perceived negative stereotypes loosen ties with the dominant (host) culture and reinforces ties with the ethnic (non-host) culture. The social resources associated with either culture was found to be useful for acculturation, with both independently contributing to participant well-being. Contact with host locals played a particularly crucial role in developing these resources. Our findings provide foundations for pragmatic policy implications, suggesting value in the development of formally organized contact programs in the early sojourn experience of international students. [ABSTRACT FROM AUTHOR]

Introduction: The Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities.Methods: An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted using the Snowballing Method between September 2018 and February 2019. Participants were recruited via a non-random sampling technique to complete an online survey. Descriptive statistical and content analyses were conducted.Results: The data use priorities identified by 102 trauma professionals from a range of locations participated were clinical improvement and system/process improvement (86.3%). Participants reported that access to trauma data should primarily be for clinicians (93.1%) and researchers (87.3%). Having a standardised approach to review trauma cases across hospitals was a priority in trauma quality improvement.Conclusion: Trauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Since 2005, radiation oncology trainees in Australia and New Zealand have had to undertake a piece of original research during training, and submit a manuscript, as first author, for senior peer-review. Satisfactory completion of this requirement is one component of eligibility to sit the Royal Australian and New Zealand College of Radiologists Fellowship examinations. The purpose of this study was to examine the value of this curriculum requirement, including the publication rates and potential barriers to trainee research. Materials and methods: An online survey was sent to 116 radiation oncologists/trainees who trained since the mandatory research requirement was introduced (2005–2011). Questions concerned research topics, publications, subsequent research activity, perceptions on barriers to research and aids to conducting research during training. A web-based search of PubMed by author name was carried out to complete and verify publication statistics. Results: In total, 108 (93.1%) of the 116 trainees across 20 centres who submitted their research papers to the Radiation Oncology Faculty Research Committee were successful in meeting the required standard first time. Half of these trainees ultimately published their paper in a peer-reviewed journal. Of trainees responding to the survey, 62% presented their research at a scientific meeting. Most of the studies were either retrospective (62.3%) or dosimetry/physics projects (10.1%). The main problems encountered in conducting projects were competing clinical commitments and lack of dedicated research time. Notably, long ethics approval processes, lack of supervision and statistical support for projects were not considered barriers. Conclusion: This mandatory research requirement ensures trainees initiate and complete at least one project during their training. Since the introduction of this curriculum component, half of the research projects have resulted in publication in a peer-reviewed journal. Increased ‘protected time’ and training in scientific writing and methods may improve publication rates and quality. This first review of the Australian and New Zealand radiation oncology trainee research requirement highlights areas that need to be addressed to further support and foster a research culture among junior radiation oncologists. [Copyright &y& Elsevier]

Summary: Sports scientists require a thorough understanding of the energy demands of sports and physical activities so that optimal training strategies and game simulations can be constructed. A range of techniques has been used to both directly assess and estimate the physiological and biochemical changes during competition. A fundamental approach to understanding the contribution of the energy systems in physical activity has involved the use of time–motion studies. A number of tools have been used from simple pen and paper methods, the use of video recordings, to sophisticated electronic tracking devices. Depending on the sport, there may be difficulties in using electronic tracking devices because of concerns of player safety. This paper assesses two methods currently used to measure player movement patterns during competition: (1) global positioning technology (GPS) and (2) a computer-based tracking (CBT) system that relies on a calibrated miniaturised playing field and mechanical movements of the tracker. A range of ways was used to determine the validity and reliability of these methods for tracking Australian footballers for distance covered during games. Comparisons were also made between these methods. The results indicate distances measured using CBT overestimated the actual values (measured with a calibrated trundle wheel) by an average of about 5.8%. The GPS system overestimated the actual values by about 4.8%. Distances measured using CBT in experienced hands were as accurate as the GPS technology. Both systems showed relatively small errors in true distances. [Copyright &y& Elsevier]

This paper explores governance and control in operating room nurses' clinical practice. Traditionally, operating room nurses have been portrayed as 'handmaidens' to the surgeons, a position which implies that nurses' bodies and the knowledge they use in practice are sites of discursive control by others. This paper unsettles this understanding by showing how operating room nurses studied ethnographically in an Australian setting are both disciplined by and actively shape practice through knowing surgeons' technical requirements for surgery, through inscribing them in discourses of time, and through having deep knowledge of the surgeons' 'soul'. We argue that as a form of governance, nurses' knowledge of surgeons is a subjugated form of knowledge, located low down on a hierarchy of knowledges. Furthermore, as a form of governance that has previously been unarticulated in the literature, it transcends the traditional lines of authority and control in the nurse-doctor relationship. The data in this paper are drawn from an ethnographic study that explored a range of nurse-nurse and nurse-doctor communication practices in operating room nursing. [ABSTRACT FROM AUTHOR]

Abstract: Introducing reclaimed water as an alternative to the traditional mains water supply involves change in practices as well as technology. Therefore, the social effects of innovative solutions to sustainable water management need to be carefully considered. This paper will present findings from research undertaken in California and Florida, USA, and Australia. What is the community response to recycling reclaimed water? Are there ways of involving the public so that the change involved in introducing reclaimed water achieves sustainable outcomes? Results from a series of case studies where indirect potable reuse has been planned will be considered along with the findings from a range of industry surveys, mainly conducted in the USA. In relation to non potable reuse, this paper will cover acceptance of some of the main uses, and householder''s experience of recycling water for residential use. The resulting analysis suggests that the shift from traditional, centrally controlled water supplies to innovative alternatives, requires a corresponding shift in resources to support what is essentially a social transformation in water service delivery and management. [Copyright &y& Elsevier]

Many countries embarked on reforms of mental health law in the wake of the Convention on the Rights of Persons with Disabilities. These reforms have had varying levels of success. This paper considers the experience of consumers in the Victorian mental health system, drawing on an evaluation that asked consumers and clinicians about their knowledge and experience of rights under the Victorian Mental Health Act, 2014. The data show that consumers were not informed of their rights, were not involved in decisions about treatment, were not able to access safeguards, and could not exercise their rights. The explanations for this include limited staff time, unclear delegations of responsibility, a lack of knowledge, training, and support for rights, and a preference for 'best interests' approaches. The paper identifies tangible reforms that would maintain rights for consumers, including competent refusal of treatment, legislative and regulatory reforms, and training and resourcing. Consumers in this study found that the rights-based framework in the Mental Health Act, 2014 had such an insignificant effect on clinical mental health practice in Victoria that their rights appeared to be illusory. [ABSTRACT FROM AUTHOR]

The high prevalence of post traumatic stress disorder (PTSD) among people with heroin dependence and its impact on short term outcomes has been well established. The impact of PTSD on long-term recovery is, however, unknown. This paper examines the impact of current and lifetime PTSD on long-term recovery from heroin dependence among participants who took part in the 11-year follow-up of the Australian Treatment Outcome Study (ATOS), a prospective naturalistic longitudinal study of 615 people with heroin dependence recruited from Sydney, Australia, in 2001-2002. Seventy-one percent of the cohort (n = 431) were re-interviewed 11-years post study entry. Outcomes examined included heroin and other drug use, dependence, general physical and mental health, depression, PTSD, employment, and the incidence of trauma exposure, overdose, imprisonment, and attempted suicide over the 11- year follow-up. Despite having a poorer profile at baseline, individuals with current PTSD or a history of PTSD at baseline demonstrated similar levels of improvement to those without a history of PTSD in all outcome domains across the 11-year follow-up, PTSD was associated with consistently higher levels of major depression, and attempted suicide, subsequent trauma exposure, and poorer occupational functioning across the 11-year follow-up. These findings highlight the importance of interventions aimed at occupational rehabilitation, reducing the likelihood of retraumatisation, and addressing PTSD and associated comorbidities among people with heroin dependence. [ABSTRACT FROM AUTHOR]

Background: Compared to the general population, among gay and bisexual men (GBM) prevalence rates of anxiety and depression, and of drug use, are high.Objective: This paper explores the relationship between mental health, sexual risk behavior, and drug use among Australian GBM. We identify factors associated with indicators of poor mental health.Methods: Between September 2014 and July 2017, 3017 GBM responded to measures of anxiety and depression in an online cohort study of drug use.Results: Mean age was 35.3 years (SD 12.8). 17.9% screened positive for current moderate-severe anxiety and 28.3% for moderate-severe depression. The majority (52.2%) reported use of illicit drugs in the previous six months, including 11.2% who had used methamphetamine. One third had high (20.4%) or severe (10.6%) risk levels of alcohol consumption, and 18.3% who were current daily smokers. Most illicit drug use in general was not associated with either anxiety or depression, but men who used cannabis were more likely to show evidence of depression (p = 0.005). Among recent methamphetamine users, 28.0% were assessed as dependent: dependent users were more likely to show evidence of both depression and anxiety than were non-dependent users. High or severe risk drinking was associated with depression and daily tobacco use was associated with both anxiety and depression. Depression and anxiety was associated with: less personal support, viewing oneself as 'feminine', and being less socially engaged with gay men. Sexual risk behavior was not associated with either depression or anxiety.Conclusion: Prevalence of anxiety and depression was high, as was prevalence of licit and illicit drug use. Substance use was associated with anxiety and depression only when the use was considered problematic or dependent. Social isolation and marginalization are strong drivers of poor mental health, even within this population for whom anxiety and depression are common. [ABSTRACT FROM AUTHOR]

Much research concerning drug use in the context of sexual activity among gay and bisexual men derives from public health scholarship. In this paper, we critically examine how the relationship between methamphetamine use and sexual risk practice is treated and understood in this body of research. While public health has made important contributions to establishing the link between methamphetamine use and sexual risk-taking, the precise nature of the relationship is not well defined. This creates space for ungrounded assumptions about methamphetamine use to take hold. We outline what appear to be two dominant interpretations of the methamphetamine/sexual practice relationship: the first proposes that methamphetamine has specific pharmacological properties which lead to sexual disinhibition, risky behaviour and poor health outcomes; the second proposes that methamphetamine attracts men who are already inclined toward highly sexualised interactions and risky practice, and that such men are likely to engage in these practices with or without drugs. We suggest that both interpretations are problematic in that they individualise and cast drug and sex practices as inherently risky and biopsychologically determined. We outline a more historically, socially and politically engaged way to understand methamphetamine use in the context of sexual activity by drawing on the concept of sex-based sociality and the ways in which gay and bisexual men may use methamphetamine and sex as social resources around which to build identities, establish relationships, participate in gay communities, and maximise pleasure while protecting themselves and others from harm. [ABSTRACT FROM AUTHOR]

Background: Pre-drinking is often defined as an economically-minded set of drinking practices engaged in prior to attending public entertainment areas, such as licensed venues. This paper explores motivations and practical considerations that a sample of teenagers describes as significant to 'pre-drinking', despite not attending licensed premises during their most recent risky drinking session.Methods: Data were derived from the mixed-methods Young Australians Alcohol Reporting System (YAARS) project. 16 participants aged 16-19 were identified as pre-drinking on their most recent risky drinking session, followed by subsequent alcohol consumption in non-licensed venues. 4 members of this subsample also undertook qualitative interviews.Results: These data expand on existing understandings of pre-drinking by emphasising the breadth of motivations and practical considerations understood to shape both pre-drinking practices, and subsequent drinking in other public entertainment areas. These primarily included desires for personal enhancement and experiencing freedom over restriction, the dynamics of accessing alcohol and private space, the necessity of opportunism, and concerns regarding parents and other authority figures.Conclusions: Analyses of groups obscured by dominant definitions of what constitutes 'pre-drinking' illuminate a broader range of motivations and concerns facing young people who drink. Such findings enhance our understanding of young people's drinking practices, the terminology used to describe them, and the development of relevant policies and interventions. [ABSTRACT FROM AUTHOR]

Expensive simulation equipment continues to sit idle in nursing learning and teaching environments. To identify factors that influence nursing educator comfort in the use of simulation at an Australian university an explorative qualitative research project was undertaken using an interpretative constructivist methodology. The Goodwin et al. (2007) adapted Comfort Theory for nursing education has been used. The aim of the study was to identify factors that influence nurse educator's comfort in the use of simulation. Research question asked was: What are the barriers and enhancers to using simulation as a learning and teaching modality. Thematic analysis of data from focus groups on four different campus sites was undertaken. Four themes identified that affected participants' comfort in this study were: 1) Personal barriers; 2) Human resource barriers; 3) Structural barriers and 4) Suggestions to address barriers. Further understanding of the themes and how they relate to educator comfort with simulation are shared with the reader. The paper also outlines emerging recommendations to improve educator comfort. [ABSTRACT FROM AUTHOR]

Preparing a person-centred nursing workforce to work in diverse settings is a global health priority. Nursing students' first placement experience is a key transitional moment that shapes professional understanding and motivation to become a nurse. This paper reports the outcomes of combining flipped and simulated learning to enhance nursing students' understanding of person-centred care, the professional nursing role and preparation for placement. The study design was exploratory, the setting, an undergraduate nursing program in an Australian University. Participants included first year nursing students, academic tutors and clinical facilitators. Data collected via survey, semistructured interviews and focus group discussion were analysed descriptively and thematically. Over 90% of students surveyed considered the unit structure, content and resources prepared them well for placement. Pre-class preparation and simulated tutorial activities facilitated student engagement and knowledge translation. Students, tutors and clinical facilitators valued the person-centred approach. Tutors considered the unit materials and focus enhanced students' professional understanding. Clinical facilitators deemed students well-prepared for placement. These results from multiple perspectives, though limited, support combining the flipped classroom and person-centred simulation in nursing education as a strategy to prepare students for clinical placement, translate person-centred values into practice and promote professional understanding and role socialisation. [ABSTRACT FROM AUTHOR]

Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF ) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative sample of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-sample of respondents aged 55–65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment. [ABSTRACT FROM AUTHOR]

Background: Between 1992 and 2012 dispensing episodes for pharmaceutical opioids (PO) in Australia increased from 500000 to 7500000. In the US, increases in the prescription of PO have been linked to increases in opioid-related morbidity and mortality and transitions to heroin injection. However, Australian data indicate that morbidity and mortality related to PO are relatively low, particularly when compared to heroin and other drugs. This paper explores the characteristics and patterns of non-medical pharmaceutical opioid (NMPO) use among a sample of young people in Sydney, Australia.Methods: During 2015, we conducted in-depth qualitative interviews with 34 young people who use PO non-medically by oral (n=22) and intravenous (n=12) routes of administration.Results: Oral NMPO users were a more affluent group who clustered around the Northern, Inner and Eastern suburbs of Sydney, while the intravenous users came from a range of locations including rural/regional areas of NSW and socioeconomically disadvantaged suburbs of South Western Sydney. Oral users were characterised by intermittent and largely self-limiting NMPO use and reported few health and social consequences. Intravenous users reported heavy and frequent drug, including NMPO, use and a range of adverse health and social consequences including overdose, injecting risk behaviour, hepatitis C virus (HCV) infection and residential instability.Conclusion: Results highlight the significance of social and structural factors in trajectories of opioid use and related harms. Factors such as stable housing and family relationships, disposable income and close social networks observed in young oral NMPO users may help to explain differences in patterns of NMPO use and related outcomes between the two groups. [ABSTRACT FROM AUTHOR]

Introduction: Physical injury is a leading cause of death and disability among children worldwide and the largest cause of paediatric hospital admission. Parents of critically injured children are at increased risk of developing mental and emotional distress in the aftermath of child injury. In the Australian context, there is limited evidence on parent experiences of child injury and hospitalisation, and minimal understanding of their support needs. The aim of this investigation was to explore parents' experiences of having a critically injured child during the acute hospitalisation phase of injury, and to determine their support needs during this time.Methods: This multi-centre study forms part of a larger longitudinal mixed methods study investigating the experiences, unmet needs and well-being of parents of critically injured children over the two-year period following injury. This paper describes parents' experiences of having a child 0-13 years hospitalised with critical injury in one of four Australian paediatric hospitals. Semi-structured interviews were conducted with forty parents and transcribed verbatim. The data were managed using NVIVO 10 software and thematically analysed.Findings: Forty parents (26 mothers and 14 fathers) of 30 children (14 girls and 16 boys aged 1-13 years) from three Australian States participated. The majority of children were Australian born. Three main themes with sub-themes were identified: navigating the crisis of child injury; coming to terms with the complexity of child injury; and finding ways to meet the family's needs.Conclusions: There is a need for targeted psychological care provision for parents of critically injured children in the acute hospital phase, including psychological first aid and addressing parental blame attribution. Parents and children would benefit from the implementation of anticipatory guidance frameworks informed by a family-centred social ecological approach to prepare them for the trauma journey and for discharge. This approach could inform care delivery throughout the child injury recovery trajectory. The development and implementation of a major trauma family support coordinator in paediatric trauma centres would make a tangible difference to the care of critically injured children and their families. [ABSTRACT FROM AUTHOR]

The Australian Nursing and Midwifery Accreditation Council (ANMAC) has set regulatory standards, that require midwifery students to verify how they have met ANMAC standard 8.11 requirements prior to registration as a midwife. The most common formats for recording achievement of the ANMAC requirements are paper-based or electronic portfolios. Research was conducted to compare student's experiences of completing their university portfolio format. Focus group interviews were held at two south east Queensland universities. This study has found that there is disparity between universities in the level of detail documenting evidence of midwifery experiences. The paper-based portfolio was criticised for not having sufficient space for the students to explain the extent of their experiences, in contrast students completing the ePortfolio felt their reflective entries were excessive. Some students felt the portfolio was not being used to its full potential with suggestions that all experiences that fall within the midwife scope of practice should be recorded as evidence of practice experiences. Students felt the current ANMAC Standard 8.11 requirements limit the range of experiences and are repetitive in requiring up to 100 recordings for some experiences. No nationally agreed format exists of how students are required to document their required ANMAC experiences. • The depth of detail recorded as evidence for ANMAC differs between universities. • No national consistency exists in students' documentation of ANMAC standards. • Student's thoughts on their learning from normal experiences were unexpected. • Cognitive dissonance was experienced by students in this study. [ABSTRACT FROM AUTHOR]

Many businesses have commenced using social media for crisis communication with stakeholders. However there is little guidance in literature to assist organisational crisis managers with the selection of an appropriate crisis response strategy. Traditional theories on crisis communication may not adequately represent the social media context. This study took a qualitative approach and explored organisational use of social media for crisis communication at seventeen large Australian organisations. An analysis of 15,650 Facebook and Twitter messages was conducted, drawing on the lens of Situational Crisis Communication Theory (SCCT) (Coombs & Holladay, 2002). Findings suggested that when large Australian organisations responded to crises via social media, they lacked an awareness of the potential of social media for crisis communication. Organisations often did not respond to stakeholder messages or selected crisis response strategies that may increase reputational risk. The paper contributes important understandings of organisational social media use for crisis communication. It also assists crisis managers by providing six crisis response positions and a taxonomy of social media crisis messages that stakeholders may send to organisations. Key implications are discussed. [ABSTRACT FROM AUTHOR]

Background: International drug law enforcement agencies have identified an apparent rise in high level drug traffickers choosing to deal in multiple different drugs. It is hypothesised that this may be a "deliberate modus operandi" and that the formation of "portfolios of trades" may make such traffickers more profitable, harmful and resilient to changes in drug supply and policing. In this paper we provide the first exploration of the extent, nature and harms of poly-drug trafficking at Australian borders.Methods: Two different methods were used. First, we used Australian Federal Police (AFP) data on all commercial level seizures at the Australian border from 1999 to 2012 to identify the proportion of seizures that were poly-drug and trends over time. Second, we used unit-record data on a sub-set of 20 drug trafficking cases and linked-cases (defined as the original drug trafficking case and all other criminal cases that were connected via common offenders and/or suspects) to compare the profiles of poly-drug and mono-drug traffickers, including: the total weight and type of drug seized, the value of assets seized, and the level of involvement in other crime (such as money laundering and corruption).Results: Between 5% and 35% of commercial importations at the Australian border involved poly-drug trafficking. Poly-drug trafficking occurred in almost every year of analysis (1999-2012), but it increased only slightly over time. Compared to mono-drug traffickers poly-drug traffickers were characterised by: larger quantities of drugs seized, larger networks, longer criminal histories and more involvement in other types of serious crime.Conclusion: Some fears about poly-drug traffickers may have been overstated particularly about the inherent escalation of this form of trafficking. Nevertheless, this suggests poly-drug traffickers are likely to pose added risks to governments and law enforcement than mono-drug traffickers. They may necessitate different types of policy responses. [ABSTRACT FROM AUTHOR]

Abstract: The notion of developing resilience is becoming increasingly important as a way of responding to the social determinants of poor health, particularly in disadvantaged groups. It is hypothesized that resilient individuals and communities are able to ‘bounce back’ from the adversities they face. This paper explores the processes involved in building resilience as an outcome in relation to both quitting smoking and never smoking. The study involved 93 qualitative, oral-history interviews with participants from population groups with high and enduring smoking rates in Adelaide, Australia, and was essentially interested in how some people in these groups managed to quit or never start smoking in the face of adversities, in comparison to a group of smokers. Our key findings relate to what we call additive and subtractive resilience strategies, which focus on the practices, roles and activities that individuals either ‘took on’ or ‘left behind’ in order to quit smoking or remain abstinent. The theoretical lenses we use to understand these resilience strategies relate to biographical reinforcement and biographical reinvention, which situate the resilience strategies in a broader ‘project of the self’, often in relation to attempting to develop ‘healthy bodies’ and ‘healthy biographies’. [Copyright &y& Elsevier]

Abstract: Knowledge of erosion rates and sediment yields from gullies is critical for the effective prioritisation of management efforts aimed at reducing the impact of gully-derived sediments on water quality. This paper describes a rapid assessment method for estimating sidewall gully erosion rates for already established gully networks. It combines a conceptual-empirical model of the cycle of gully initiation and stabilisation with an easy-to-apply technique for assessing gully extent and dimensions. The method is illustrated using a case study of the Avon-Richardson Catchment of north-central Victoria, Australia. It is estimated that a total of 4.6×106 tonnes of sediment have been generated in that catchment from gully erosion since the latest major phase of gullying in the mid 1800s. This is equivalent to 8.9tha−1 y−1 if sediment generation was evenly distributed spatially and temporally across the 3300km2 catchment over 160years prior to 2010. Current rates of gully erosion are estimated to be 4700ty−1 (equivalent to 1.4tha−1 y−1). The results are comparable with observed rates of sidewall erosion in the Avon-Richardson Catchment. Further testing is required to build confidence in its applicability to assess sediment yields and for assisting regional authorities to plan remediation efforts. [Copyright &y& Elsevier]

Introduction: The absence of a clear model of care for services supporting pregnant women and mothers with substance use disorders has impeded opportunities to build an evidence base for the effectiveness of these services. Previous research has typically focused on the needs of pregnant women or mothers, as two distinct groups. This paper explores service providers' perceptions of key components of a model of care, extending from perinatal care to community-based support for up to 17 years post-delivery. A model of care is outlined and feasibility factors affecting implementation are highlighted.Methods: Qualitative methods were adopted as a first step to informing development of the model of care. Semi-structured in-depth interviews were conducted with thirty-eight staff providing a range of substance use in pregnancy and parenting services (SUPPS) in hospital and community-based agencies, in a metropolitan health district in Sydney, Australia. Interview data was entered into NVivo and analysed using constant comparative methods.Results: Guiding principles for the model of care included integrated care, harm reduction and person-centredness. Practice approaches integral to the model of care were promoting engagement with women, flexible service provision, trauma-informed care, and continuity of care. Feasibility factors influencing implementation of the model of care included fragmentation or siloing of the service network and workforce sustainability.Conclusions: A harm reduction approach was crucial for promoting engagement of women with SUPPS, particularly child protection services. A greater focus on providing ongoing community-based support for mothers also has the potential to achieve sustainable positive outcomes for women and children. Implementation of the SUPPS model of care could be undermined by threats to integration of service delivery and continuity of care. Further research is needed to explore consumer perspectives and inform the model of care as a framework for evaluation. [ABSTRACT FROM AUTHOR]

Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings. [ABSTRACT FROM AUTHOR]

This paper presents the initial findings of a survey of research from 1995 to 2004 into initial teacher education in Australia. Teacher education research has grown rapidly over the last decade and it is timely to critically evaluate directions within the field. An overview of the research is presented in terms of number and type of research projects, key research themes and topics, range of methodologies, general strengths and weaknesses, and key trends. The insights provided by this survey will be of value in establishing a context for future research, policy, and practice. [Copyright &y& Elsevier]

Abstract: The article draws on findings from the PhD Examination Project at the SORTI Research Centre of The University of Newcastle, Australia. It focuses on an analysis of the roles of examiner and supervisor, in relation to the candidate, as seen through the lens of Habermas''s ‘Ways of Knowing’ theory. On the basis of this, it has been postulated that the dominant text in the PhD examination process may work to constrain the generation of new knowledge rather than encourage it. The paper explores practical implications for research training and questions the current well being of the doctoral regime. [Copyright &y& Elsevier]

Abstract: This paper reports on research that investigated and implemented benchmarking as a trigger for cleaner production in the drycleaning industry in Western Australia and applies this knowledge to the small business sector. The critical success factors for environmental benchmarking are: identifying cleaner production gaps in areas important to the long-term future of the businesses, promoting the drivers to close the performance gaps, and ensuring managers possess the correct skills to close these gaps. The participants accepted the benchmarks as suitable targets and committed their businesses to achieving these targets in their action plans. Economic benefits and maintaining their licence to operate were found to be the important drivers. Program participants on average reduced hazardous waste generation by 48%, perchlorethylene consumption by 30% and improved their energy efficiency by 9%. Furthermore, managers involved in the program had a significantly higher uptake of cleaner production than the general small business community in Western Australia. [Copyright &y& Elsevier]

Unlabelled: Focused assessment with sonography for trauma (FAST) is a method for detecting haemoperitoneum in trauma patients on initial assessment in the Emergency Department. The aim of this paper is to present an Australian trauma centre's experience with FAST as a tool to screen for intraabdominal free fluid in patient's sustaining blunt truncal trauma. Method: Over a 63-month period, FAST scans were prospectively studied and compared with findings from a gold-standard investigation, either computed tomography (CT) or laparotomy. Results: 463 FAST results were collected prospectively from 463 patients. 53 scans were excluded due to lack of a corresponding confirmatory gold-standard test. Overall sensitivity, specificity, positive and negative predictive values for FAST in detecting free fluid were 78%, 97%, 91%, 93%, respectively. Analysis of the credentialed operators demonstrated an improvement in accuracy (sensitivity 80%, specificity 100%, positive predictive value 100%, negative predictive value 94%). These findings are comparable with documented international experience. Conclusion: The study demonstrates that the use of non-radiologist performed FAST in the detection of free fluid is safe and accurate within an Australian Trauma Centre. [ABSTRACT FROM AUTHOR]

Philosophers and historians of biology have argued that genes are conceptualized differently in different fields of biology and that these differences influence both the conduct of research and the interpretation of research by audiences outside the field in which the research was conducted. In this paper we report the results of a questionnaire study of how genes are conceptualized by biological scientists at the University of Sydney, Australia. The results provide tentative support for some hypotheses about conceptual differences between different fields of biological research. [Copyright &y& Elsevier]

Objectives: To review governmental guidelines on amalgam use worldwide and to assess trends in the usage of amalgam and composite materials in restoration of posterior teeth. Methods: A letter was sent to 24 government health agencies or representative organisations requesting details of regulations pertaining to amalgam use. A literature search was carried out in order to identify papers in which the incidence of amalgam and composite restorations was stated. Results: Ten replies were received, indicating few restrictions on the use of amalgam. Results obtained from published work appear to indicate that amalgam use is declining, but at rates which are unclear in many countries because of the paucity of published data. Amalgam use has been found to be decreasing in the USA, Australia and Scandinavia, with lesser decreases being apparent in the UK. Conclusions: There are few restrictions to the use of amalgam worldwide. In countries where data are available, such as USA, Australia and Scandinavia, amalgam use has been found to be decreasing, with smaller decreases being apparent in the UK. [ABSTRACT FROM AUTHOR]

Abstract: Earlier research by Mullins and Kiley (2002) [Studies in higher education, 27(4), 369–386] reported on the processes that experienced examiners go through when they assess research theses. Since that study two further studies have been undertaken, interviews with novice Australian examiners, reported here, and the analysis of approximately 100 examiners’ reports (Kiley, 2004). These studies now allow us to address the comment made by many of the experienced examiners who were interviewed that it was not wise to send a research thesis, particularly one which is not strong, to inexperienced examiners. We also wanted to determine the extent to which less experienced examiners follow the same processes and use the same criteria as their more experienced colleagues, and whether there was any basis for the experienced examiners’ comments. This paper draws particularly on the results of the interviews with 26 examiners and supervisors which indicated that by comparison with experienced examiners, less experienced examiners paid more attention to institutional criteria and the summative dimension of assessment; were unsure of the boundary conditions relating to very good or poor theses; and were more likely to refer back to their own postgraduate experience when reflecting on their approach to both supervision and examination. [Copyright &y& Elsevier]

There is growing evidence of spillover effects to developed countries from the plant genetic improvement work of international agricultural research centers (IARCs) that nevertheless benefit the targeted developing countries. This paper examines the modes in which such spillover effects from IARCs to developed countries have an impact on the overall benefits from the IARC system. A case study of production spillovers in Australia from ICARDA’s work indicates a shift of benefits for the rest of the world from producers to consumers, with overall benefits to the rest of the world marginally higher in the presence of spillovers. These findings suggest spillovers to developed countries can enhance the impacts of the IARCs on developing countries though they can affect the distribution of benefits received. [Copyright &y& Elsevier]

Clinical trials for the treatment of schizophrenia now often include cognitive assessments in addition to clinical ratings of symptoms. Recently, these trials have included cross-national assessments. It is not clear if translated psychological tests produce consistent results across different languages. This paper presents the results of a study of the comparability of the results of cognitive assessments in different English-speaking countries and a number of countries where tests were translated into other languages. Performance on tests of executive functioning, verbal and visuo-spatial learning and memory, language skills, psychomotor speed, and vigilance was compared across the first episode patients with schizophrenia (n=301) assessed in six different languages (English, French, Finnish, German, Hebrew, and Afrikaans), including two different countries where patients were assessed in English and other languages: Canada (French) and South Africa (Afrikaans). The variance in performance across the sites tested in English was as large as the variance between English and non-English speakers when all tests were considered. Performance differences across English and other languages were found only for executive functions, vigilance, and psychomotor speed, with executive functioning differences nonsignificant when education was considered. No differences were found between English and non-English speakers in Canada. These results suggest that the translation of tests of memory and verbal skills can lead to consistent results across translated versions of the tests. Differences between countries were greater than differences between languages, suggesting the need to consider representativeness of patient samples in terms of local educational attainment. In general, these data support the validity of cross-national neuropsychological assessments. [Copyright &y& Elsevier]

Background: Healthcare professionals (HCPs) provide an important point of contact through which people who use performance and image enhancing drugs (PIEDs) could access reliable information, advice, and interventions on a range of PIEDs, their use and related harms. However, HCPs often report difficulties engaging and building rapport with people who use PIEDs, and research suggests that they often lack specialist knowledge on these substances. Providing credible evidence-based resources to support HCPs is thus important. However, educational materials in this area are generally absent and the ones that exist have not been assessed for their utility in the HCP workforce. This paper examines the acceptability and usability of a PIED e-learning module (the Dopinglinkki e-module) targeted at HCPs in three EU Member States and Australia.Methods: A standardised two stage, mixed methodology was implemented. Stage 1 involved HCPs completing the e-module and completing an online survey (N = 77). Stage 2 involved conducting individual structured interviews with a subset of survey respondents (N = 37). Normalisation Process Theory and the Theoretical Framework of Acceptability were used as conceptual lenses.Findings: The e-module provided information that was perceived as useful for HCPs' current and future practice. However, several individual, organisational and societal level barriers were reported as preventing the e-module becoming an accepted and normalised aspect of the HCP workforce, including the need for up to date evidence, the time-consuming nature of completing the e-module, lack of organisational support, the use of over-complex language, and the module's potential to reinforce the stigmatisation of PIEDs.Conclusion: Providing credible evidence-based resources to support HCPs' knowledge development is important. Evidence-based and theory informed interventions are needed to equip HCPs with knowledge that can aid culturally sensitive interactions and effective engagement with people who use PIEDs. Reflecting on our study findings, it is important that the development of interventions should include the voices of both HCP and those using PIEDs, and that careful consideration is given to the various factors that may act as a barrier to effective implementation. [ABSTRACT FROM AUTHOR]

Background: Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support.Methods: The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies.Results: Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support.Conclusion: Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing. [ABSTRACT FROM AUTHOR]

Aims: To compare the policy positions of health and medical organisations across Australia, New Zealand, and the UK as they relate to sale and supply of nicotine vaping products (NVPs) and evaluate factors that have informed the differences in policy recommendations among these countries.Methods: We used mixed methods to analyse data from position or policy statements published by health and medical organisations regarding NVPs (n = 30) and consultation documents submitted to government committees regarding policy options for the regulation of NVPs (n = 26). Quality assessment of included documents was conducted using the six-item Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers, and findings were presented narratively. Qualitative data were coded using NVivo 12 software and analysed using thematic analysis.Results: An overwhelming majority of health bodies, charities and government agencies in the UK and New Zealand portrayed NVPs as a life-saving harm reduction tool. In contrast, concerns about addicting non-smoking youth to nicotine, a perceived lack of clear and convincing evidence of safety and efficacy and the potential to undermine tobacco control progress continues to define attitudes and recommendations towards NVPs among Australian health and medical organisations. Although the profoundly divided views among stakeholders seem to arise from empirical uncertainties and disagreements over the level and credibility of evidence, the source of most of these disagreements can be traced back to the fundamental and irreconcilable differences in the framing of the NVP debate, and varied tolerability of risk trade-offs associated with NVPs.Conclusion: Progress in resolving the controversy surrounding NVP policy requires stakeholders to be frame-reflective and engage in a meaningful dialogue of risk trade-offs, as well as both intended and unintended consequences of proposed policies. [ABSTRACT FROM AUTHOR]

Background: Residential rehabilitation treatment (including both Therapeutic Communities (TC) and non-TC rehabs) is a key component of service delivery for people seeking treatment for substance use disorders in Australia and globally. While mutual aid is often associated with better long-term outcomes, there is little evidence about whether inconsistencies between residential rehabilitation philosophies and particular types of mutual aid influence subsequent engagement and treatment outcomes.Objective: To assess the uptake of mutual aid groups (12-step and other) on individuals leaving TC (n = 58) or non-TC (n = 78) residential treatment, and measure its impact on substance use outcomes.Methods: Using secondary analysis of existing data, the current paper reports on 12-month outcomes from a prospective cohort study of 230 individuals entering specialist alcohol and other drug residential rehabilitation treatment in two Australian states.Results: Participants who attended TC settings were more likely to attend non-spiritual mutual aid groups (i.e., SMART Recovery) than non-TC residents. Engaging in mutual aid groups was associated with significantly improved outcomes for the non-TC residents only, where it significantly predicted abstinence (OR = 5.8, CI = 1.5-18.46) and reduced frequency of use of participants' primary drug of concern (OR = 8.6, CI = 2.6-28.6).Conclusions/importance: Although 12-step is the most readily available and accessible form of mutual aid in Australia and benefited those attending non-TC residential rehabilitation, individuals exiting a TC program (whether they have completed treatment or not) may benefit from other forms of post-treatment recovery support, including alternative forms of peer-based support. The findings suggest treatment outcomes may be enhanced when the philosophies of residential treatment and post-discharge mutual aid are more compatible. [ABSTRACT FROM AUTHOR]

Nursing research teaching is seen as central to nurse education and practice, but the impact of exposure to research teaching on students' attitudes towards research remains unclear. The aims of this study were to explore the attitudes towards research of undergraduate nursing students, before and after exposure to research teaching online. A further aim of this study was to better understand students' attitudes towards research, to inform future teaching strategies. This descriptive quasi-experimental study used pre-semester and post-semester data collected by means of an online questionnaire. The Attitudes Towards Nursing Research Scale measured student attitudes via 18 Likert items that assessed four domains: Research Abilities, Usefulness of Research, Personal Interest in Research and Using Research in Clinical Practice. There were no statistically significant changes in the overall Attitude Towards Research Scale. Individual item analysis did show statistically significant changes in two items: Understanding of research terminology increased (p = 0.001), but Intention to conduct research decreased (p = 0.035). This study generated evidence on attitudes of nursing students toward research before and after their exposure to a research subject. Research teaching online may be insufficient to effect a change in student nurses' attitudes towards research. Issue: Research is a foundational topic in undergraduate nursing curricula, but students often find the topic to be challenging to learn, while academics find it challenging to engage students in learning about research.What is Already Known: A validated instrument, Attitudes Towards Research, can be used to ascertain if teaching affects attitudes.What this Paper Adds: Overall attitudes of first year, second semester students did not change after experiencing a semester long introductory research subject. However, two item statements did show a statistically significant change, in disparate directions. Understanding of Research Terminology increased, while Intention to Conduct Research decreased. • Teaching research online did not improve attitudes towards research. • Undergraduate nursing students see value in being taught about research. • Undergraduate nursing students appreciate the relevance of research to practice. • Nursing students reported improvements in understanding of research terminology. • Students reported feeling less inclined to conduct research in the future. [ABSTRACT FROM AUTHOR]