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Barriers and facilitators affecting the social activities of people with congenital physical and communication disabilities are well documented. However, little is known of their experiences of developing sexual and intimate relationships. This study conducted a systematic review of the literature to address this gap in knowledge. Ten online databases were searched for relevant papers between 1990 and 2014. In addition, hand searches of Augmentative and Alternative Communication Journal and the Sexuality and Disability Journal were conducted. Fifteen papers were identified and appraised. The thematic coding approach identified six principal themes. However, the content analysis revealed that the majority of the literature focused on the social needs of people with physical and communication disabilities. Despite evidence that people with disabilities are sexually active, there is little focus on the experiences of people with disabilities developing intimacy and expressing sexuality. The few references to sexuality in the relevant literature focused on protection from abuse, though some researchers called for improved counseling on sexuality and relationships, and improved access to sexual health services. Further research is required to focus on practical and theoretical outcomes to enhance social relationships and sexuality, and offer lovers who use AAC real advice in their search for intimacy. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the long-term influence of having a child at risk of different developmental delays (communication, mobility, self-care, relating, learning, coping, or behaving) on parental labor force participation as the child grows. Method: A retrospective cohort was conducted using data from the Longitudinal Study of Australian Children survey, Waves 1–8 covering birth to 15 years of age of children. Multivariable logistic regressions were used to explore the odds ratio of mothers being out of the labor force at different children's ages. Cox proportional hazards models were utilized to identify the 'risk' of mothers returning to the workforce after leaving. All models were adjusted for the mother's age, education attainment, and employment status at time of birth, as well as marital status at the current wave. Results: There were 5,107 records of children, and 266 of them were at risk of any developmental delays at age 4–5 years. This sample represents 243, 026 children born in Australia in 2003/04. After adjusting for potential confounders, mothers of children at risk of each type of developmental delay (except mobility and self-care) had greater odds of being out of, and not returning to the labor force from children aged 2–3 to 14–15 years, when compared to mothers of children who are not at risk of developmental delays. Similar differences were found for fathers but were distinctly small and with narrower fluctuations, compared to mothers. Conclusion: Policies and programs funded by the government are greatly needed to support the mothers of children at risk of developmental delays. Significance: What is already known: Maternal labour force participation has been negatively affected by having a child with chronic health conditions, whereas paternal labour force participation is not significantly influenced. What this paper adds: Having a child at risk of developmental delays negatively influenced maternal and paternal labour force participation, where the influence on fathers was distinctly small and with narrower fluctuations during the 14 to 15 years of follow-up. [ABSTRACT FROM AUTHOR]

This paper examines how antiretroviral therapy (ART) use and fears towards the onward transmission of HIV have changed among people living with HIV (PLHIV) in Australia between 1997 and 2018. Participants were recruited as part of the HIV Futures study, a large cross-sectional survey of PLHIV in Australia, in 1997, 2003, 2012 and 2018 (total n = 3889). ART use, viral load detectability, and fear of onward HIV transmission were compared between years. Predictors of onward transmission fear were assessed among the 2018 subsample. While ART use within our sample decreased between 1997 and 2003, it subsequently increased to 97% in 2018. Self-reported viral load undetectability steadily increased over time, up to 88% in 2018. Notably, fewer PLHIV reported being fearful of transmitting HIV in 2018 compared to all other years. Being unfamiliar with the undetectable = untransmissible health movement, and having a detectable or uncertain viral load at last test, were significant predictors of being fearful of onward HIV transmission. Beyond the immediate medical considerations of HIV treatment, these results suggest that the undetectable = untransmissible movement may play a critical role in attenuating burdens experienced by PLHIV in Australia and that such messaging, in tandem with early and consistent ART use, should remain a salient feature of heath messaging among this population. [ABSTRACT FROM AUTHOR]

Aim: Owing to the COVID-19 pandemic, many companies shifted to telework, with few insights into its implementation, organisational conditions or the role of workplace health promotion and management. This study focused on a multifactorial investigation of conditions in companies which implemented and evaluated telework during the first lockdown in 2020 as well as on their future intentions to facilitate teleworking under health-promoting working conditions. Subject and methods: The research hypotheses relate to an extended technology acceptance model. In a mixed-methods design, expert interviews were fed into the development of an online questionnaire. Out of 1858 contacted companies representing a broad range of Austrian businesses, 192 responses (general management, workplace health managers, etc.) were analysed using descriptive and multivariate statistics. Results: The degree of implementation and claim to teleworking increased significantly during the first lockdown and did not return to pre-pandemic levels afterwards. Changes depended on preparation and experience: evaluation of teleworking and willingness to continue offering teleworking were conditional on preparation and the degree of implementation. Prerequisites for future intentions to implement health-promoting teleworking included readiness, general willingness and existing workplace health promotion/management structures. Conclusion: This paper demonstrates the potential of health-promoting organisational cultures for development processes – particularly in times of crisis. Anchoring health-focused structures in companies helps to create health-promoting frameworks. Health-promoting teleworking can be developed from workplace health promotion/management using established approaches. It is essential to build on in-house capacities and competencies to develop awareness for a holistic culture for health-promoting (tele)work and to encourage deliberations about potential measures. [ABSTRACT FROM AUTHOR]

This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = −.39, p <.01); positive-wellbeing (r = −.66, p <.05); and healthy activity (r = −.41, p <.001). Low positive wellbeing (β =.55, p <.001) was the strongest predictor of depressive symptoms. Family cohesion (β =.25, p <.001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes. [ABSTRACT FROM AUTHOR]

This paper explores attitudes toward dating people with disability amongst young people in Australia and Hong Kong. Data relating to disability were extracted from an e-survey that investigated young people's (n = 2208) experiences of and attitudes toward dating. Quantitative data were analysed using descriptive statistics while open ended responses were subjected to interpretive content analysis. When asked about preferred characteristics for potential dates, young people identified factors that were unlikely to be negatively influenced by disability, such as loyalty, honesty, dedication, humour, and kindness. Yet when asked whether disability would influence their dating choices, most said that it would and expressed an unwillingness to date people with disability. Young adults in Hong Kong expressed less openness to dating people with disability than those in Australia. Physical disability and mental health issues were seen as less of a barrier to dating than intellectual or developmental disability. Despite recent gains in public attitudes toward people with disability, improvements are needed in terms of young people in the general population viewing people with disability as suitable partners and thus, allowing them to enjoy equal rights to relationships and sexuality. Culture is an important determinant, indicating a potential for change. [ABSTRACT FROM AUTHOR]

Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most ( n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. [ABSTRACT FROM AUTHOR]

Social research with people living with HIV (PLHIV) rarely distinguishes between gay men and bisexual men. However, bisexual men may have unique experiences of HIV-related stigma and distinct support needs. In this paper, findings are presented from a cross-sectional survey of Australian PLHIV, which included the Berger (HIV) stigma scale. A total of 872 PLHIV completed the survey, of which 48 (6.0%) were bisexual men. Bisexual men reported higher levels of internalised HIV-related stigma, greater negative self-image and poorer emotional wellbeing than gay men. Bisexual men also reported less social support, less connection with lesbian, gay, bisexual, transgender and queer (LGBTQ) communities, and less connection with other PLHIV. Analysis of data from an open-text question revealed feelings of social isolation and fear of rejection was associated with participant's HIV diagnosis. Study findings suggest that existing social supports for PLHIV may not adequately address the unique support needs of bisexual men. [ABSTRACT FROM AUTHOR]

This paper uses secondary analysis to understand how COVID-19 shaped people's experiences with psychosocial support services in Australia. Data are drawn from questionnaires (n = 66) and semi-structured interviews (n = 62), conducted for a national service evaluation, with 121 people living with enduring mental health conditions and using psychosocial support services. Data relating to COVID-19 were inductively coded and analysed using constant comparative analysis. Most people's experiences included tele-support. While some people described minimal disruption to their support, many reported reduced engagement. People's wellbeing and engagement were influenced by: their location, living situation and pre-COVID lifestyles; physical health conditions; access to, comfort with, and support worker facilitation of technology; pre-COVID relationships with support workers; and communication from the organisation. The findings can help services prepare for future pandemics, adjust their services for a 'COVID-normal' world, and consider how learnings from COVID-19 could be incorporated into a flexible suite of service delivery options. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been a large expansion in literature pertaining to the game of Australian football (AF). Furthermore, there have been a number of rule changes that are likely to have changed the demands of the game. Based on these advances and changes, it seemed important to conduct a review assessing the scientific literature surrounding the sport.Objective: The review evaluates the match demands of AF, the qualities required for success, and the impact training and competition have on adaptation, injury and fatigue.Methods: A systematic search of PubMed, CINAHL, SPORTDiscus, Web of Science and Scopus for AF literature was conducted; studies investigating match demands, physical qualities, training practices and injury were included. Weighted means and standard deviations were calculated for match demands and physical and anthropometric profiles across playing standards.Results: A total of 1830 articles were retrieved in the initial search, with 888 removed as duplicates, 626 removed for being non-relevant and a further 152 removed for being AF papers but not relevant to the review. As such, 164 AF papers were included in the review. Due to the intermittent high-intensity nature of match-play, players need a wide range of physical and technical qualities to excel, with speed, aerobic fitness, reactive agility and well-developed lean mass being central to success. Training for AF at the elite level is associated with high workloads, with players engaging in numerous training modalities; even altitude and heat training camps have been utilised by Australian Football League (AFL) teams to further augment fitness improvements. While high chronic workloads can be tolerated and are needed for improving physical qualities, careful planning and monitoring of internal and external workloads is required to minimise sharp spikes in load that are associated with injury.Conclusions: There is a complex interaction between numerous contextual factors that influence the match demands that are discussed in this review. Whilst players must have the physical capacities to cope with the intense physical demands of AF matches, the successful execution of technical skills during match-play is central to success. To develop these skills and attributes, specific and carefully planned and monitored training must be performed over a number of years. [ABSTRACT FROM AUTHOR]

Background: Adolescents diagnosed with cancer experience unique psychosocial concerns that persist beyond treatment completion into longer-term survivorship. Camp-based, group Acceptance and Commitment Therapy (ACT) programs are a potential model for providing evidence-informed psychological and peer support to adolescent cancer survivors. Objective: This paper describes the development and exploration of the feasibility and acceptability of such a program, Places You'll Go. This manualised program incorporates five 90-min group ACT sessions within a 3-day camp, teaching ACT strategies in the context of psychosocial impacts of cancer. Method: Eight facilitators and twenty-eight Australian adolescent cancer survivors (68% female; age range 12–17 years, M = 15.4 years) participated in the program and evaluation. Feasibility was assessed using facilitator-reported session duration, attendance, quality and content fidelity; facilitators also completed interviews after program completion. Young people completed surveys on program acceptability at the end of each session and at program completion. Results: All planned sessions were delivered, with 97% attendance and high fidelity in manualised program delivery. All young people were mostly or very satisfied and would recommend the program to another cancer survivor. Opportunities for peer connection and skill development contributed to perceived program acceptability. Conclusions: The Places You'll Go program was acceptable and feasible to deliver. It is a promising community-based model for promoting peer support and well-being in adolescent cancer survivors, indicating the potential of ACT-based approaches for this population. Further work is underway to evaluate whether the program improves psychosocial wellbeing among participants, and if this is linked to the therapeutic mechanisms underpinning ACT. [ABSTRACT FROM AUTHOR]

Recent increases in the availability of pre-exposure prophylaxis (PrEP) internationally have widened the range of HIV prevention strategies available to gay and bisexual men. This paper aimed to quantify the use of different risk reduction strategies and compare characteristics of men who rarely use any strategies with those who regularly use condoms or PrEP. Using national cross-sectional data from the Gay Community Periodic Surveys in Australia, comparisons were made between regular condom users (37.1% of participants), PrEP users (50.1%), and men who infrequently used any risk reduction strategies (12.8%). The proportion of gay and bisexual men reporting infrequent use of HIV risk reduction strategies has decreased in recent years. These men reported less frequent high-risk sexual practices than PrEP users and also reported less recent HIV testing than either PrEP or condom users. Men who infrequently use HIV risk reduction strategies should be encouraged to test for HIV more regularly and to utilise prevention strategies that align with their infrequent high-risk behaviour. [ABSTRACT FROM AUTHOR]

The main objective of this paper is to present a systematic analysis and review of the state of the art regarding the prediction of absenteeism and temporary incapacity using machine learning techniques. Moreover, the main contribution of this research is to reveal the most successful prediction models available in the literature. A systematic review of research papers published from 2010 to the present, related to the prediction of temporary disability and absenteeism in available in different research databases, is presented in this paper. The review focuses primarily on scientific databases such as Google Scholar, Science Direct, IEEE Xplore, Web of Science, and ResearchGate. A total of 58 articles were obtained from which, after removing duplicates and applying the search criteria, 18 have been included in the review. In total, 44% of the articles were published in 2019, representing a significant growth in scientific work regarding these indicators. This study also evidenced the interest of several countries. In addition, 56% of the articles were found to base their study on regression methods, 33% in classification, and 11% in grouping. After this systematic review, the efficiency and usefulness of artificial neural networks in predicting absenteeism and temporary incapacity are demonstrated. The studies regarding absenteeism and temporary disability at work are mainly conducted in Brazil and India, which are responsible for 44% of the analyzed papers followed by Saudi Arabia, and Australia which represented 22%. ANNs are the most used method in both classification and regression models representing 83% and 80% of the analyzed works, respectively. Only 10% of the literature use SVM, which is the less used method in regression models. Moreover, Naïve Bayes is the less used method in classification models representing 17%. [ABSTRACT FROM AUTHOR]

Anterior knee pain is a chronic condition that presents frequently to sport medicine clinics, and can have a long-term impact on participation in physica activity. Conceivably, effective early management may prevent chronicit and facilitate physical activity. Although a variety of nonsurgical interven' tions have been advocated, previous systematic reviews have consistenty been unable to reach conclusions to support their use. Considering a decade has lapsed since publication of the most recent data in these reviews, it is timely to provide an updated synthesis of the literature to assist sports medicine practitioners in making informed, evidence-based decisions. A systematic review and meta-analysis was conducted to evaluate the evidence for non- surgical interventions for anterior knee pain. A comprehensive search strategy was used to search MEDLINE, EM- BASE, CINAHL® and Pre-CINAHL®, PEDro, PubMed, SportDiscus®, Web of Science®, BIOSIS Previews®, and the full Cochrane Library, while reference lists of included papers and previous systematic reviews were hand searched. Studies were eligible for inclusion if they were randomized clinical trials that used a measure of pain to evaluate at least one nonsurgical inter- vention over at least 2 weeks in participants with anterior knee pain. A modified version of the PEDro scale was used to rate methodological quality and risk of bias. Effect size calculation and meta-analyses were based on random effects models. Of 48 suitable studies, 27 studies with low-to-moderate risk of bias were included. There was minimal opportunity for meta-analysis because of heterogeneity of interventions, comparators and follow-up times. Meta- analysis of high-quality clinical trials supports the use of a 6-week multimodal physiotherapy programme (standardized mean difference [SMD] 1.08, 95% CI 0.73, 1.43), but does not support the addition of electromyography bio- feedback to an exercise programme in the short-term (4 weeks: SMD -0.21, 95% CI -0.64,0.21; 8-12 weeks: SMD -0.22,95% CI -0.65, 0.20). Individual study data showed beneficial effects for foot orthoses with and without multimodal physiotherapy (vs flat inserts), exercise (vs control), closed chain exercises (vs open chain exercises), patella taping in conjunction with exercise (vs exercise alone) and acupuncture (vs control). Findings suggest that, in implementing evidence-based practice for the nonsurgical management of anterior knee pain, sports medicine practitioners should prescribe local, proximal and distal components of multimodal physiotherapy in the first instance for suitable patients, and then consider foot orthoses or acupuncture as required. [ABSTRACT FROM AUTHOR]

Recruiting adults with autism spectrum disorders (ASD) into research poses particular difficulties; longitudinal studies face additional challenges. This paper reports on a mixed methods study to identify factors influencing the participation in longitudinal autism research of adults with ASD, including those with an intellectual disability, and their carers. Common and differentiating factors influencing the research participation of participants are identified and discussed. Factors influencing participation were found to differ both between and within participant categories. We propose a dichotomy whereby factors influencing research participation can be classified as those arising from a participant's values, which act as either a motivator or a deterrent; and those based on convenience, which act as either an enabler or inhibitor. These findings are applicable to research studies that seek to recruit adults with ASD as participants. [ABSTRACT FROM AUTHOR]

Purpose: LGBTQ people are less likely to seek support and face significant barriers in accessing affirmative family violence support services. Efforts to improve family violence service access must be grounded in the preferences of LGBTQ people themselves. Method: Data from a large nationwide Australian survey of the health and wellbeing of LGBTQ adults were analysed. 4,148 participants expressed a preference for family violence service provision. Multivariable logistic regressions were used to identify factors associated with preferences for family violence service provision, comparing mainstream services that are not known to be inclusive, mainstream services that are known to be LGBTQ-inclusive, and LGBTQ-specific services. Results: In total, 8.8% (n = 363) of participants indicated a preference for mainstream services, 57.5% (n = 2,383) for mainstream services that are known to be LGBTQ-inclusive and 33.8% (n = 1,402) for LGBTQ-specific services. Trans and non-binary identified people were more likely to prefer LGBTQ-specific services than cisgender participants, while bisexual, pansexual and asexual people were more likely to prefer mainstream LGBTQ-inclusive services. Participants with a regular general practitioner were more likely to prefer LGBTQ-inclusive services. Participants who had not felt supported the most recent time they reported an experience of family violence were more likely to prefer LGBTQ-specific services. Conclusion: Family violence and healthcare services require training in LGBTQ issues to provide inclusive and affirming care. The findings have implications for policy and practice in family violence care and illustrate an urgent need to reform the current narrative of family violence, which frequently excludes LGBTQ communities. [ABSTRACT FROM AUTHOR]

Parents of gender variant children currently receive conflicting information concerning how to respond to their child's gender variance. This conflict arises from divisions within the academic literature between what are referred to as either reparative or affirmative approaches to working with gender variant children. The current paper reports on a scoping study designed to understand the support experiences of Australian parents of gender variant children, together with their attitudes towards gender variance. The study was mixed methods in design, including both quantitative and qualitative information gained from 61 parents of gender variant children. The major findings of the project indicate that a formal diagnosis of gender variance appears to facilitate support towards gender variant children and their parents. The study also found conflicting experiences of contact with healthcare professionals, with some participants reporting positive and supportive experiences and others reporting negative interactions with professionals. Finally, the study found that there were gender differences in relation to parental responses, namely that fathers were less supportive of their child's gender variance. As such, the paper indicates room for improvement in relation to healthcare professionals working with gender variant children and their families, together with insight into the experiences of parents for this group of young people. [ABSTRACT FROM AUTHOR]

Caregivers of children with neurodiverse needs are known to experience challenges and hardship due to the increased needs of the child and the lack of support available. This study aimed to explore the support needs and well-being of caregivers of children with neurodiverse needs in Australia. Sixty-six caregivers participated in an online survey asking questions about support needs. The results highlighted five main themes that caregivers commonly experienced including: barriers to community engagement, impact on close relationships, negative impact on mental health and identity, financial hardship, and identified support needs. Findings identified multiple unmet needs existing amongst caregivers and further emphasises the importance of addressing these needs to improve the quality of life of caregivers of children with neurodiverse needs. [ABSTRACT FROM AUTHOR]

Background: The benefits of physical activity to maintain optimal health and well-being in children and adolescents are undisputed. The school environment offers opportunities for children to be physically active. Objective: The aim of this review is to systematically examine the effects of recess-based interventions on the physical activity (PA) levels of school-aged children and adolescents. Data Sources: A systematic literature search was conducted to identify papers reporting interventions to promote PA during school recess and/or lunchtime periods. The search was conducted in six databases (PubMed, SPORTDiscus™, Web of Science, Proquest, Cochrane and Scopus) for papers published between January 2000 and April 2011. Study Selection: Articles were included in the review if (i) they reported the findings of an intervention targeting PA levels of children and/or adolescents during school recess and/or lunchtime; (ii) have a measure of PA as an outcome variable; (iii) participants were aged between 5 and 18 years; and (iv) were published in English. Methods: Two authors independently searched the literature using the same search strategies to identify papers reporting interventions that promote PA during school recess and lunchtime periods. Methodological quality was assessed using an adapted eight item assessment scale. The effects of the interventions were assessed with a rating system used in a recent review of interventions in youth. Results: The search originally retrieved 2,265 articles. Nine published peer-reviewed journal articles met the inclusion criteria for this review. Eight studies used randomized controlled trials and one was a controlled trial. Three studies demonstrated high methodological quality (33%). None of the studies adequately reported the randomization procedure or used power calculations. Few studies reported potential confounders and three studies had less than a 6 week follow-up. Five studies demonstrated a positive intervention effect on children's PA levels, with four reporting statistically significant increases and two reporting significant decreases in recess PA. The summary of the levels of evidence for intervention effects found inconclusive results for all intervention types, though promising strategies that require further investigation were identified. Limitations: Whilst every effort was made to ensure that this review was as encompassing as possible, it may be limited by its search terms especially if there were studies with unclear titles or abstracts. In addition, only manuscripts published in English were considered, eliminating any possible studies published in other languages. Conclusions: All of the studies used an objective measure to assess PA outcomes, although several criteria were consistently absent from the studies. The levels of evidence were not sufficient to establish conclusive intervention effects on children's recess PA. This could be due to the small number of published studies. There is a need for higher-quality intervention research to strengthen published findings to inform recess PA interventions. Intervention research is needed in adolescents due to the absence of school recess intervention research in this population. [ABSTRACT FROM AUTHOR]

This paper aims to describe delivery and birth outcomes of Aboriginal infants and their mothers in an urban setting on the east coast of Australia. The paper uses a causal pathway approach to consider the role of risk and protective factors for low birthweight. All mothers who delivered at Campbelltown Hospital between October 2005 and May 2007 were eligible. The study included 1,869 non-Aboriginal infants and 178 Aboriginal infants and their mothers. Information on delivery and birthweight was extracted from electronic medical records. Risk factors for poor outcomes were explored using regression and causal pathway analysis. Mothers of Aboriginal infants were younger than mothers of non-Aboriginal infants, and were more likely to be single, less educated, unemployed prior to pregnancy, and live in a disadvantaged neighbourhood. Health and service use was similar. They were significantly more likely to have a vaginal delivery than mothers of non-Aboriginal infants (77% cf 62.5%; χ = 14.6, P < 0.001) and less likely to receive intervention during delivery. Aboriginal infants (3,281.1 g) weighed 137.5 g (95%CI: 54-221 g; P = 0.001) less then non-Aboriginal infants (3,418.7 g). Gestational age, and single mother with incomplete education, prior unemployment, smoking, and living in a disadvantaged neighbourhood were associated with lower birthweight. Maternal vulnerability had a cumulative impact on birthweight. A causal pathway analysis demonstrated the associations between risk factors. [ABSTRACT FROM AUTHOR]

The social difficulties of autism spectrum disorder (ASD) are typically explained as a disruption in the Shared Attention Mechanism (SAM) sub-component of the theory of mind (ToM) system. In the current paper, we explore the hypothesis that SAM's capacity to construct the self-other-object relations necessary for shared-attention arises from a self-categorization process, which is weaker among those with more autistic-like traits. We present participants with self-categorization and shared-attention tasks, and measure their autism-spectrum quotient (AQ). Results reveal a negative relationship between AQ and shared-attention, via self-categorization, suggesting a role for self-categorization in the disruption in SAM seen in ASD. Implications for intervention, and for a ToM model in which weak central coherence plays a role are discussed. [ABSTRACT FROM AUTHOR]

This paper charted the cognitive and behavioural profiles from toddlerhood to middle childhood in 48 children diagnosed with ASD at 24-months. The Mullen Scales of Early Learning (MSEL) was administered at 24- and 48-months and the Wechsler Abbreviated Scale of Intelligence (WASI) at school age. Autism severity was derived using The Autism Diagnostic Observation Schedule (ADOS) Results: Developmental Disability/Intellectual Disability (DD/ID; Developmental Quotient <70) reduced from 64% at 24-months to 8% at outcome. Seventy-three percent of children continued to meet ADOS cut-off at school age. Conclusion: Diagnoses at 24-months, appear to be reliable and stable. Further research is needed to investigate whether early identification, which provides more opportunity to access early intervention, may in turn facilitate cognitive development over time. [ABSTRACT FROM AUTHOR]

Background: Quality of life is an important quality indicator for health and aged care sectors. However, self-reporting of quality of life is not always possible given the relatively high prevalence of cognitive impairment amongst older people, hence proxy reporting is often utilised as the default option. Internationally, there is little evidence on the impact of proxy perspective on interrater agreement between self and proxy report. Objectives: To assess the impacts of (i) cognition level and (ii) proxy perspective on interrater agreement using a utility instrument, the Quality of Life-Aged Care Consumers (QOL-ACC). Methods: A cross-sectional study was undertaken with aged care residents and family member proxies. Residents completed the self-report QOL-ACC, while proxies completed two proxy versions: proxy-proxy perspective (their own opinion), and proxy-person perspective (how they believe the resident would respond). Interrater agreement was assessed using quadratic weighted kappas for dimension-level data and concordance correlation coefficients and Bland-Altman plots for utility scores. Results: Sixty-three residents (22, no cognitive impairment; 41, mild-to-moderate cognitive impairment) and proxies participated. In the full sample and in the mild-to-moderate impairment group, the mean self-reported QOL-ACC utility score was significantly higher than the means reported by proxies, regardless of perspective (p < 0.01). Agreement with self-reported QOL-ACC utility scores was higher when proxies adopted a proxy-person perspective. Conclusion: Regardless of cognition level and proxy perspective, proxies tend to rate quality of life lower than residents. Further research is needed to explore the impact of such divergences for quality assessment and economic evaluation in aged care. [ABSTRACT FROM AUTHOR]

This study investigates the nature of the social interaction profiles observed among youth with intellectual disabilities (ID), defined while considering their relationships with their parents, peers, and teachers, as well as the implication of these profiles for self-esteem, aggressive behaviors, and prosocial behaviors. A sample of 393 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged between 11 and 22 (M = 15.70), was recruited in Canada (n = 141) and Australia (n = 253). Our results revealed four profiles, corresponding to Socially Isolated (23.24%), Socially Integrated (39.83%), Socially Rejected (28.37%) and Socially Connected (8.57%) youth with ID. The socially integrated and connected profiles both presented higher self-esteem, more prosocial behaviors, and less aggressive behaviors than the socially isolated and rejected profiles. [ABSTRACT FROM AUTHOR]

Recovery-orientated practice is crucial to mental health care services—consistently identified in policy, service delivery guidelines and national mental health action plans. An essential component to systems reform and the adoption of recovery-orientated practice is the inclusion of peer support workers as practice leaders to support shifting culture in mental health service delivery. Designated peer support roles operate as healthcare professionals who utilise their lived and living experience of mental health difficulty to support those on their recovery journey through mutual understanding of shared experience. This research sought to explore the experiences of peer support workers integrating into mental health teams and identify organisational actions to facilitate successful recognition, integration and acceptance by colleagues; therefore, promoting sustainability of the peer support role. Qualitative interviews were undertaken with 18 peer support workers employed across four Australian states within 12 different government and non-government organisations. Study findings reveal three key areas for organisational change with seven main themes to assist organisations to better facilitate the successful integration of peer support workers into mental health service teams. These included robust induction, training for existing staff, clear referral pathways into the service, consistent supervision and debriefing, leadership support, professional development pathways and involving peer workers through change processes. These themes were grouped into three key areas for change including preparation, process and structural changes, and cultural change actions for sustainability. This article makes recommendations for organisations to consider when implementing peer support roles into mental health services. [ABSTRACT FROM AUTHOR]

The aim of this paper was to evaluate the effectiveness of an online self-management program in improving health outcomes and well-being for gay men living with HIV in Australia. The online Positive Outlook Program was based on self-efficacy theory and used a self-management approach to enhance HIV-positive gay men's skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. The 7-week program was delivered in closed groups and comprised information modules, action-planning activities, moderated discussion boards, and weekly peer-facilitated 'live chats'. A randomised controlled trial was conducted to establish the effectiveness of the Positive Outlook program compared to a 'usual care' control. Participants were HIV-positive gay men 18 years or older living in Australia. Primary outcomes were evaluated at three time-points (baseline, post-intervention and 12-week's post-intervention follow-up) and included HIV-related quality of life (PROQOL-HIV), outcomes of health education (HeiQ) and HIV specific self-efficacy (Positive Outlook Self-Efficacy Scale). A total of 132 gay men with HIV in Australia were randomly allocated to the intervention (n = 68) or usual care control (n = 64) groups. Maximum likelihood marginal-linear modelling indicated significant improvement in the intervention group on the PROQOL-HIV subscales of body change ( p = 0.036), social relationships ( p = 0.035) and emotional distress ( p = 0.031); the HeiQ subscales of health-directed activity ( p = 0.048); constructive attitudes and approaches ( p = 0.015); skill and technique acquisition ( p = 0.046) and health service navigation ( p = 0.008); and the Positive Outlook Self-Efficacy Scale on the subscales of relationships ( p = 0.019); social participation ( p = 0.006); and emotions ( p = 0.041). Online delivery of self-management programs is feasible and has the potential to improve quality of life, self-management skills and domain specific self-efficacy for gay men with HIV. [ABSTRACT FROM AUTHOR]

Peer support groups have been an increasingly popular way of limiting the adverse effects of life with a chronic illness for adolescents although few groups have been rigorously evaluated. This paper reports the findings of a realistic evaluation of a hospital based peer support program Chronic Illness Peer Support (ChIPS), in Sydney, Australia. We collected qualitative interview and focus group data from four participant groups; new ChIPS members, their parents, older members who had been in ChIPS for two or more years, and ChIPS co-ordinators past and present. Results of qualitative data have been aggregated and organised into three categories; program attendance: getting in and staying in; program outcomes for young people: personal growth and development; and social connection. Questionnaires were also administered to fourteen new ChIPS members but no significant changes in distress or self-esteem were recorded between the beginning and the end of the short study period. The ChIPS Introductory Program fulfilled its aim, entering young people with chronic illness into the peer support program. There was evidence of initial personal growth and development in those young people, with potential for enhanced social connection from ongoing participation in ChIPS activities. [ABSTRACT FROM AUTHOR]

Depressive and fatigue symptoms are common health concerns for women in the postnatal period. Few studies have sought to investigate the role of fatigue in the development and maintenance of depressive symptoms. The aim of this paper was to examine the relationship between depressive symptoms and fatigue over the course of the first 4 years postpartum, in particular focusing on the extent to which fatigue at earlier time points predicted later depressive symptoms and vice versa. Data from over 1000 women participating in a longitudinal study of Australian women's physical and psychological health and recovery after childbirth were used. An autoregressive cross-lagged panel model was tested to assess the mutual influences of fatigue and depressive symptoms across five time points at 3, 6, 12 and 18 months postpartum, and at 4 years postpartum. A complex bidirectional relationship between fatigue and depressive symptoms from 3 months to 4 years postpartum was observed, where fatigue at earlier time points predicted depressive symptoms at later time points, and vice versa. The findings of this study suggest interventions targeting the prevention and management of fatigue may also confer some benefit in improving or preventing the development of depression symptoms in the early parenting period. [ABSTRACT FROM AUTHOR]

This paper reports on leadership program participants' experience of, and readiness for, stage transition (when one adult developmental stage gives way to another-as in Loevinger's (Ego development. Jossey-Bass, San Francisco, ) stage theory of consciousness, or ego, development). This appears to be the first study reporting the subjective experience of recent shifts in consciousness specifically within the context of leadership development programs. Using qualitative thematic methods to analyse survey responses from 84 individuals graduating from three Australian community leadership programs, we compared the accounts of those who had shifted a stage of consciousness ('shifters'), those who had changed but not transitioned ('movers'), and those who had not experienced change ('non-shifters'). We found support for theoretical predictions concerning the types of changes shifters noticed in themselves, consistent with the small but growing body of research showing positive associations between consciousness development and better leadership performance and organisational outcomes. The data additionally provide support for the conceptual framework of consciousness development articulated by Manners and Durkin (Dev Rev 20:475-513, . doi:), and contextual information which may help explain and predict the differing responses to leadership training of people with Myers Briggs Type Indicator Sensing and Intuition preferences-thus contributing to program selection and design. An important, if preliminary, finding was that when selecting candidates for developmental training programs, people who are experiencing significant work or other life changes and challenges should arguably be prioritised rather than sidelined: our shifters cited such challenges as influences promoting readiness for change. Although these conclusions are based on an analysis of survey data, they provide direction for future in-depth qualitative and quantitative research. [ABSTRACT FROM AUTHOR]

This paper summarizes an exploratory study undertaken to consider the work of Australian chaplaincy personnel ministering to prisoners within correctional facilities. This qualitative research was not concerned with specific correctional institutions per se, but predominantly about the perspectives of chaplains concerning their professional contribution and issues they experienced while trying to provide pastoral care to prisoners. Data from a single-focus group indicated that prison chaplains were striving to fulfill religious and spiritual duties according to national and international standards for the treatment of prisoners. Given various frustrations identified by participants, that either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of chaplaincy and thus maximize the benefits of pastoral care to prisoners. Implications of this exploratory study relate not only to prison chaplaincy but also to ecclesiastical organizations, correctional facilities, governments and the need of support for further research to be conducted. [ABSTRACT FROM AUTHOR]

Despite suicide ideation being one of the most frequently reported health issues impacting tertiary students, there is a paucity of research evaluating the efficacy of preventive interventions aimed at improving mental health outcomes for students studying at two tertiary institutes. The current study evaluated the efficacy of the "Talk-to-Me" Mass Open Online Course (MOOC) in improving tertiary students' abilities to support the mental health of themselves and their peers via a randomised controlled trial design, comparing them to a waitlist control group. Overall, 129 tertiary students (M = 25.22 years, SD = 7.43; 80% female) undertaking a health science or education course at two Western Australian universities were randomly allocated to either "Talk-to-Me" (n = 66) or waitlist control (n = 63) groups. The participants' responses to suicidal statements (primary outcome), knowledge of mental health, generalised self-efficacy, coping skills, and overall utility of the program (secondary outcomes) were collected at three timepoints (baseline 10-weeks and 24-weeks from baseline). Assessment time and group interaction were explored using a random-effects regression model, examining changes in the primary and secondary outcomes. Intention-to-treat analysis (N = 129) at 10-weeks demonstrated a significant improvement in generalised self-efficacy for "Talk-to-Me" compared to the control group (ES = 0.36, p =.04), with only the "Talk-to-Me" participants reporting increased knowledge in responding to suicidal ideation (primary outcome). This change was sustained for 24 weeks. Findings provide preliminary evidence suggesting that the "Talk-to-Me" MOOC can effectively improve tertiary students' mental health and knowledge of how to support themselves and others in distress. ACTRN12619000630112, registered 18-03-2019, anzctr.org.au. [ABSTRACT FROM AUTHOR]

HIV self-testing allows people to collect samples and test themselves at home, addressing known barriers to facility-based testing. We aimed to measure the uptake of home HIV testing among Australian gay and bisexual men (GBM). Using national cross-sectional data from the Australian Gay Community Periodic Surveys, we assessed trends in home HIV testing among non-HIV positive GBM between 2018 and 2020. Overall, the use of home HIV testing was low, but slightly increased during 2018–2020 (from 0.3 to 0.8%, RR = 1.54, 95%CI = 1.23–1.92, p-trend < 0.001). Testing at home was more likely among non-HIV-positive GBM who were born overseas and recently arrived in Australia, at higher risk of HIV, and infrequent HIV testers. Given the greater use of home testing by men at higher risk of HIV, recent migrants and infrequent testers, all priority groups in Australia's HIV epidemic, we recommend increasing access to HIV self-testing to enhance uptake in these and other groups of GBM. [ABSTRACT FROM AUTHOR]

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (Mage = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention. [ABSTRACT FROM AUTHOR]

Summary: We estimated the short-term impact of fragility fractures on community-dwelling women in five countries. Women with fragility fractures reported significantly more difficulties performing activities of daily living and significantly higher levels of lost productivity and caregiver support than those without fractures; results highlight the multi-country indirect burden of fragility fractures. Introduction: To estimate the impact of fragility fractures on activities of daily living (ADL), productivity loss and caregiver support in women with a recent fragility fracture. Methods: This multi-centre cross-sectional study enrolled community-dwelling women aged ≥ 50 years in South Korea, Spain, Germany, Australia and the United States. The fragility fracture cohort consisted of women with an index fragility fracture in the past 12 months; the fracture free cohort consisted of women with no fracture in the 18 months prior to study enrolment. Study participants completed three validated questionnaires: Lawton Instrumental ADL (IADL), Physical Self-Maintenance Scale (PSMS) and iMTA Productivity Cost Questionnaire (iPCQ). Results: In total, 1,253 participants from 41 sites across the five countries were included. Compared with the fracture free cohorts, fragility fracture cohorts had significantly lower function and were more dependent on support (p < 0.05 in all countries for Lawton IADL, and in South Korea, Spain, Australia and the United States for PSMS), significantly higher hours of paid absenteeism (p < 0.05, Spain, Germany, Australia), significantly higher unpaid lost productivity (p < 0.05, South Korea, Spain, Germany), significantly more days of paid help received in the home (p < 0.05 South Korea, Spain and the United States), and significantly more days of unpaid help from family members or friends (p < 0.05, all countries). Conclusion: In this multi-national study, fragility fractures in community-dwelling ≥ 50 years women were associated with several outcomes indicating higher indirect burden and lower quality of life, including more difficulties performing ADL and higher levels of lost productivity and caregiver support. [ABSTRACT FROM AUTHOR]

Millions of people cross political borders yearly without having the proper documents. This has led to increased detention and deportation practices in destination countries for reasons related to security and sovereignty. The objective of the current study was to analyze and visualize research publications on the detention and deportation of migrants to identify current research hotspots, research gaps, and potential future research in the field. Relevant research articles were obtained from the Scopus database for the study period from 1900 to December 31, 2022. The analysis included presentations of key contributors to the field and visualization of topics, themes, and international collaboration. In total, 906 articles were found. The earliest was in 1982. The majority of articles were published in journals within the subject areas of social sciences and humanities. The number of publications showed a steep rise from 2011 to 2022. The Journal of Ethnic and Migration Studies was the most prolific, but publications in the Citizenship Studies journal received the highest number of citations per article. Researchers from the United States contributed the most. Mexico ranked fifth in the number of publications. Oxford University was the most prolific institution, followed by three universities in Australia. The majority of articles were single-authored, indicative of limited author-author collaboration. Research hotspots in the field were "human rights" and "mental health". The detention and deportation of Mexican and other Latino migrants in the United States constituted a distinct research theme in the field. International research collaboration was limited by geographical proximity (e.g., the United States and Mexico) or common language (e.g., the United Kingdom and Australia). Future research topics should focus on alternatives to detention, family separation, and healthcare services for detained migrants. Research activity on detention and deportation is required from all world regions, including the source countries of migrants. Future research should promote alternatives to traditional detentions. The contribution of countries in Africa, the Middle East, and South-Eastern Asian regions needs to be encouraged. Future research on the detention and deportation of non-Latino migrants is highly required. [ABSTRACT FROM AUTHOR]

Purpose: Health and social care professionals are ideally placed to identify and address gender-based violence (GBV), yet research continues to demonstrate that the subject is being poorly covered at undergraduate level. This qualitative study explored health and social care students' and educators' views on GBV education, with a view to identifying 'best practice'. We aimed to capture students' and educators' experiences and perceptions of GBV education across participating countries; how participants thought GBV should be taught/learned within their curricula; and their views on how GBV education might be 'optimized'. Methods: We conducted nine focus group discussions and one semi-structured interview with 23 students and 21 academic staff across the UK, Australia and Chile. Results: Thematic analysis yielded three themes: (1) GBV addressed in all but name, (2) Introduce sooner, explore later and (3) A qualitative approach to learning. Educators and students indicated that GBV is largely being overlooked or incompletely addressed within curricula. Many participants expressed a wish for the subject to be introduced early and revisited throughout their study, with content evolving as cohorts mature. Lastly, our findings indicate that GBV education could benefit from adopting a 'qualitative' approach, prioritizing survivor narratives and incorporating dialogue to facilitate student engagement. Conclusion: Though time constraints and competing demands within undergraduate curricula are frequently cited as barriers to moving away from traditional didactic methods, our findings suggest that teacher-centered strategies are insufficient and, in some regards, inappropriate for GBV education. The need for a paradigm shift in GBV education is discussed. [ABSTRACT FROM AUTHOR]

Purpose: Corporal punishment (CP) and physical abuse (PA) in childhood are associated with increased risk of child-to-parent violence (CPV). Without context of discipline (i.e., the intention of behavior change, and use of reasonable force), both CP and PA represent the use of physical force against a child. It is still unclear if their associations with CPV are similar when they co-occur, or when they occur in isolation. The current study examined the differential and cumulative association of different types of physical force in childhood with rates of CPV. Method: The sample consisted of 1,132 participants, between 18 to 87-years-old (M = 50.95, SD = 14.24) and included 59.5% female and 39.2% male participants who completed an online survey measuring CP, PA and CPV. Participants formed three groups: low CP or PA (group low), high CP only (group HCP), or high PA and CP (group PA + CP). Results: Two one-way ANOVAs with planned contrasts were conducted separately for CPV against mothers and fathers. The group HCP reported significantly higher CPV against both the mother and the father than group low and there was no significant difference between group HCP and group PA + CP. Conclusions: Higher rates of CP are associated with higher rates of CPV; however, this rate does not increase further when there is concurrent PA. This suggests that there may be a low sensitivity for retaliation from a young person, or coercive training (through high parent–child conflict), in environments where there is physical force from a parent. [ABSTRACT FROM AUTHOR]

Background and Objective: Hypoxic training techniques are increasingly used by athletes in an attempt to improve performance in normoxic environments. The 'live low-train high (LLTH)' model of hypoxic training may be of particular interest to athletes because LLTH protocols generally involve shorter hypoxic exposures (approximately two to five sessions per week of <3 h) than other traditional hypoxic training techniques (e.g. live high-train high or live high-train low). However, the methods employed in LLTH studies to date vary greatly with respect to exposure times, training intensities, training modalities, degrees of hypoxia and performance outcomes assessed. Whilst recent reviews provide some insight into how LLTH may be applied to enhance performance, little attention has been given to how training intensity/modality may specifically influence subsequent performance in normoxia. Therefore, this systematic review aims to evaluate the normoxic performance outcomes of the available LLTH literature, with a particular focus on training intensity and modality. Data Sources and Study Selection: A systematic search was conducted to capture all LLTH studies with a matched normoxic (control) training group and the assessment of performance under normoxic conditions. Studies were excluded if no training was completed during the hypoxic exposures, or if these exposures exceeded 3 h per day. Four electronic databases were searched (PubMed, SPORTDiscus™, EMBASE and Web of Science) during August 2013, and these searches were supplemented by additional manual searches until December 2013. Results: After the electronic and manual searches, 40 papers were deemed to meet the inclusion criteria, representing 31 separate studies. Within these 31 studies, four types of LLTH were identified: (1) continuous low-intensity training in hypoxia (CHT, n = 16), (2) interval hypoxic training (IHT, n = 4), (3) repeated sprint training in hypoxia (RSH, n = 3) and (4) resistance training in hypoxia (RTH, n = 4). Four studies also used a combination of CHT and IHT. The majority of studies reported no difference in normoxic performance between the hypoxic and normoxic training groups ( n = 19), while nine reported greater improvements in the hypoxic group and three reported poorer outcomes compared with the control group. Selection of training intensity (including matching relative or absolute intensity between normoxic and hypoxic groups) was identified as a key factor in mediating the subsequent normoxic performance outcomes. Five studies included some form of normoxic training for the hypoxic group and 14 studies assessed performance outcomes not specific to the training intensity/modality completed during the training intervention. Conclusion: Four modes of LLTH are identified in the current literature (CHT, IHT, RSH and RTH), with training mode and intensity appearing to be key factors in mediating subsequent performance responses in normoxia. Improvements in normoxic performance appear most likely following high-intensity, short-term and intermittent training (e.g. IHT, RSH). LLTH programmes should carefully apply the principles of training and testing specificity and include some high-intensity training in normoxia. For RTH, it is unclear whether the associated adaptations are greater than those of traditional (maximal) resistance training programmes. [ABSTRACT FROM AUTHOR]

Mathematical models predict higher rates of HIV and sexually transmitted infections (STIs) in populations with higher rates of concurrent sexual partnerships. Although gay men and other men who have sex with men (MSM) have disproportionately high rates of HIV/STIs, little is known about the prevalence and correlates of sexual concurrency in these populations. This paper reports findings from a national community-based survey of 1,034 Australian gay-identified men aged 18-39 years, who gave detailed information about their sexual partners over the past 12 months. In all, 237 (23 %) reported two or more concurrent sexual partners. For their most recent period of concurrency, 44 % reported three or more partners and 66 % reported unprotected sex with one or more of their partners. A multivariate logistic regression found sexual concurrency was significantly more likely among men on higher incomes ( P = 0.02), who first had anal sex at a relatively young age ( P = 0.03), and who reported a large number of partners in the past 12 months ( P < 0.001). Age, education, HIV status, and other sociodemographic and sexual behavior variables were not significant correlates. However, men who reported sexual concurrency were significantly more likely to have been diagnosed with an STI in the past 12 months ( P = 0.04). Findings from this study suggest sexual concurrency is common among younger Australian gay men. With many of these men not always using condoms, health agencies should consider the potential impact of concurrency on HIV/STI epidemics among gay men and other MSM. [ABSTRACT FROM AUTHOR]

Drowning, a largely preventable problem, continues to be a serious issue worldwide, with young men particularly at risk. Alcohol and drugs are often present among young males and, particularly for males aged 18-34 years, alcohol is considered to be a significant risk factor for drowning. The current study aimed to understand the motivations guiding the intentions of young Australian men to engage in drinking and swimming, a behaviour not yet examined systematically. A cross-sectional correlational design was adopted to investigate the ability of the theory of planned behaviour (TPB) and additional variables to predict males' intentions to drink and swim. Males ( N = 211) aged 18-34 years ( Mage = 23.93, SD = 4.01) completed a survey either on-line or paper-based. The survey assessed the TPB constructs of attitude, subjective norm, and perceived behavioural control (PBC); and additional variables of group norms, anticipated regret, objective (i.e. swimming ability) and perceived (i.e. perceived severity and perceived susceptibility) risk perceptions, and past behaviour. Support was found for the TPB constructs of attitude and subjective norm, but not PBC, as well as the additional constructs of group norm, anticipated regret, objective risk, and past behaviour in predicting males' intentions to drink and swim; explaining an overall 76 % of variance. Knowledge gained from this study will help to inform resultant interventions designed to discourage alcohol use in, on, or around water and, thus, prevent drownings in this at risk group. [ABSTRACT FROM AUTHOR]

Summary: The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. Introduction: The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. Methods: ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. Results: The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. Conclusions: The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries. [ABSTRACT FROM AUTHOR]

This paper examines the upper-limb movement kinematics of young children (3-7 years) with high-functioning autism using a point-to-point movement paradigm. Consistent with prior findings in older children, a difference in movement preparation was found in the autism group (n = 11) relative to typically developing children. In contrast to typically developing children, the presence of a visual distractor in the movement task did not appear to impact on early movement planning or execution in children with autism, suggesting that this group were not considering all available environmental cues to modulate movement. The findings from this study are consistent with the possibility that autism is associated with a difficulty using visual information to prime alternative movements in a responsive way to environmental demands. [ABSTRACT FROM AUTHOR]

Little is known about positive development across the transition from adolescence to young adulthood. The purpose of this paper was to use longitudinal data from a large community sample, the Australian Temperament Project, to investigate prospective associations between positive development at age 19-20 years and changes in social, health, and behavioral outcomes at 23-24 years. Data from 890 young adults (61.7% women) were analyzed using path analysis. Emotional health, physical well-being, friendship quality, reduced antisocial behavior, and positive development in young adulthood were predicted by higher levels of positive development in late adolescence, after controlling for baseline levels of respective outcomes, gender, and family socioeconomic status. Parent relationship quality and alcohol use were not significantly predicted. Based on these findings, interventions promoting positive development during adolescence should be investigated as a potential means of yielding positive social, health, and behavioral consequences well into young adulthood. [ABSTRACT FROM AUTHOR]

Purpose: To investigate trends in SGLT2i and GLP-1RA use in Australia in the era of increased evidence of their cardiovascular benefits. Methods: We used national dispensing claims for a 10% random sample of Australians to estimate the number of prevalent and new users (no dispensing in the prior year) of SGLT2i or GLP-1RA per month from January 2014 to July 2022. We assessed prescriber specialty and prior use of other antidiabetic and cardiovascular medicines as a proxy for evidence of type 2 diabetes (T2D) and cardiovascular conditions, respectively. Results: We found a large increase in the number of prevalent users (216-fold for SGLT2i; 11-fold for GLP-1RA); in July 2022 approximately 250,000 Australians were dispensed SGLT2i and 120,000 GLP-1RA. Most new users of SGLT2i or GLP-1RA had evidence of both T2D and cardiovascular conditions, although from 2022 onwards, approximately one in five new users of SGLT2i did not have T2D. The proportion of new users initiating SGLT2i by cardiologists increased after 2021, reaching 10.0% of initiations in July 2022. Among new users with evidence of cardiovascular conditions, empagliflozin was the most commonly prescribed SGLT2i, while dulaglutide or semaglutide was the most common GLP-1RA. Conclusion: SGLT2i and GLP-1RA use is increasing in Australia, particularly in populations with higher cardiovascular risk. The increased use of SGLT2i among people without evidence of T2D suggests that best-evidence medicines are adopted in Australia across specialties, aligning with new evidence and expanding indications. [ABSTRACT FROM AUTHOR]

We mapped gay and bisexual men's (GBM) patterns of using pre-exposure prophylaxis (PrEP) over time and explored sexual behavior as PrEP use changed. We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBM living in Australia who had changed their PrEP use since initiating. There was considerable diversity in patterns of discontinuation, suspension, and recommencement of PrEP. Reasons for changing PrEP use mostly centered on accurate perceived changes to HIV risk. Twelve participants reported condomless anal intercourse with casual or fuckbuddy partners after discontinuing PrEP. These sex events were unanticipated, condoms were not a preferred option, and other risk reduction strategies were applied inconsistently. Service delivery and health promotion can support safer sex among GBM when PrEP use fluctuates by promoting event-driven PrEP and/or non-condom-based risk reduction methods during periods off daily PrEP, and guiding GBM to better recognize changing circumstances of risk and when to recommence PrEP. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) provide a measure of self-perceived health status or health-related quality of life. They have been used to support provider-patient decisions, healthcare delivery, and value-based healthcare models. A barrier to routine collection of PROMs is the perception that PROMs lack clinical utility. As such, it is important to establish clinicians' acceptability of the PROM prior to large-scale implementation. This study explored the acceptability of the routine use and collection of a generic PROM in healthcare services from the perspective of healthcare staff. Methods: Individual semi-structured interviews were completed from September 2020 to March 2021 with 26 staff from two multi-disciplinary community healthcare services in Melbourne, Australia. Interviews explored their experiences of using the EQ-5D-5L in their routine care. Interviews were recorded and transcribed verbatim. Data were analysed according to a framework approach, using inductive and deductive techniques. Results: Participants discussed the acceptability of the EQ-5D-5L with reference to four themes: practicalities of use; holistic nature; influence on client care; and influence on health service. Participants found the EQ-5D-5L quick and easy to administer, and appreciated that it measured multiple domains of health that were relevant to their clients' care. They believed the EQ-5D-5L helped to identify client problems, and inform service delivery. They also reported features that were less acceptable, including a lack of item specificity to some healthcare disciplines. Participants reported the challenge of managing conflict between their assessment of the client's health and the client's perspective of their own health, leading some to question whether the client could provide an accurate reflection of their own health. Conclusions: The EQ-5D-5L has several features that healthcare staff viewed as acceptable for routine collection and use in healthcare. Training on the validity of the patient reported perspective and broadening the scope of PROMs collection beyond the EQ-5D-5L should be considered to facilitate large-scale implementation. [ABSTRACT FROM AUTHOR]

Background: In recent years, the length of elite sporting competitions has raised concerns regarding player well-being, highlighting a need to review current match calendars. Therefore, this study aimed to explore the perceptions of elite National Rugby League (NRL) players and staff on the annual training and competition calendar from a player workload and well-being perspective. Methods: This study adopted a mixed-methods approach, using a sequential explanatory design. Phase one implemented a cross-sectional survey, and phase two utilised semi-structured interviews. Four hundred and thirty-nine elite rugby league players and 46 staff completed the survey. Eighteen elite professional NRL players and six football staff were interviewed, and verbal data were analysed into pre-defined topic summaries using qualitative coding reliability methods. Topics included in-season, off-season, pre-season and well-being. Results: Data analysis suggests that elite NRL players and staff believe players appear particularly comfortable with the current number of games; however, they are at their maximum capacity. Importantly, this study identified several minority groups that may require support to enhance player well-being. Players believe reducing the pre-season would negate fatigue experienced later in the subsequent season. Players and staff believe this timeframe still provides sufficient time to prepare for the upcoming season. Further, players were open to extending the off-season to 8–10 weeks and believed that extra time would allow for greater recovery from the previous season. Mid-season congested scheduling affects players following the intensified period and requires attention to alleviate fatigue. Conclusion: The results of this study convey important implications for the NRL, emphasising a need to review their annual training and competitive calendar, or to implement specific strategies to enhance the well-being of minority groups. The findings from this study should be considered when discussing the ideal length and structure of the match calendar to support players' physical and mental welfare. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether consumption of lean red meat on three exercise training days per week can promote greater improvements than exercise alone in health-related quality of life (HR-QoL) in community-dwelling older adults. Design: This study is a secondary analysis from a 6 month, two-arm, parallel randomized controlled trial conducted in 2014 and 2015. Setting: Community-dwelling older adults living in metropolitan Melbourne, Australia. Participants: One hundred and fifty-four men and women aged ≥65 years. Intervention: All participants were enrolled in a multi-component, resistance-based exercise program (3 d/week) and randomly allocated to either a group asked to consume lean red meat (2x80g cooked servings/day) on each of the three training days (Ex+Meat, n=77) or a control group asked to consume one serving of carbohydrates (1/2 cup rice/pasta or 1 medium potato; Ex+C, n=77). Measurements: HR-QoL was assessed using the Short-Form (SF)-36 health survey. Results: Overall 62% of the participants were female, the mean age was 70.7 years (range 65 to 84 years), approximately 67% of participants were classified as either overweight or obese, and the average number of chronic conditions was two. A total of 145 participants (94%) completed the study. Mean baseline HR-QoL scores were comparable to the mean for the Australian population [Global HR-QoL (mean ± SD): Ex+Meat, 49.99 ± 6.57; Ex+C, 50.49 ± 5.27]. General Linear Mixed Models examining within and between group changes over time revealed that after 6 months, there were no within-group changes in either Ex+Meat or Ex+C nor any between-group differences for any measure of HR-QoL, with the exception that the mental health subscale improved in Ex+C versus Ex+Meat [net difference for change, −2.32 (95% CI), −4.73, 0.09, P=0.048] after adjusting for relevant covariates and the physical function subscale improved in Ex+Meat relative to baseline [mean change (95% CI), 1.88 (0.37, 3.39), P=0.011]. Conclusion: A multi-component resistance-based training program performed with and without the provision of lean red meat in line with current Australian dietary guidelines on each of the three training days, did not improve HR-QoL in healthy community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Obesity and chronic disease are increasing problems in refugee populations. Afghani refugees undergoing hepatitis B vaccination between January 2015 and December 2017 at a general practice clinic received dietary counselling sessions in Dari by native speaking clinicians. Anthropometry, blood pressure, fasting lipids and liver function tests were measured at both visits with results compared over time. 110/119 refugees requiring hepatitis B vaccination were recruited into the study. Mean BMI was lower at follow up visits (25.4 vs 26.1 by wilcoxon signed rank test p 0.04) with 72 of 110 participants losing a median of 2 kg between visits (range 0.5–14 kg) a mean of 206 days after the initial consultation. Median triglyceride levels were lower at the second visit than the first (1.4 vs 1.3 mmol/L Wilcoxon signed rank test Z = 3.5, p 0.0004). This cohort of refugees lost weight and showed a small improvement in triglyceride levels between visits. [ABSTRACT FROM AUTHOR]

Suicide is a global concern with rates in Australia continuing to increase. Effective post-suicidal care is critical for reducing persistent suicidal behaviour. One model of care is that adopted by Alfred Health, delivering a multidisciplinary, hybrid clinical and non-clinical (psycho-social support), assertive outreach approach. This study measured improvements in resilience and wellbeing, changes to distress and suicidal ideation at least 6-months post-discharge from care. Thirty-one consumers participated including a one-on-one interview to gather qualitative feedback. There was a significant change on all outcome measures with large effect sizes. Participants had significantly reduced suicidal ideation and distress and increased coping self-efficacy, hope and well-being. The qualitative findings indicated that a key component to recovery was the staff. Limitations included a low sample size, and broad time range of follow-up data collection. Providing assertive, multidisciplinary, collaborative and outreach-focused post-suicidal care can increase and sustain protective psychological factors and reduced suicidal ideation in most individuals. [ABSTRACT FROM AUTHOR]