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It has been claimed that effective responses to child sexual abuse (CSA) must engage with the specific cultural, social, and religious contexts of the target communities. For Jewish communities in Australia, the program J-Safe was established to raise awareness, create cultural change, and empower the Jewish community to be able to prevent, recognize, and address child sexual assault within the school setting. This paper reports on the experiences of teachers in two Jewish-day schools who had participated in the J-Safe Project’s protective behaviors teacher training program. Participants’ accounts of the training indicate the Project builds teachers’ knowledge and supports teachers’ skill development in the areas of incidence, behavioral indicators and responding to disclosure suggest the training has relevance for the Jewish teaching context. However, the extent to which the training was successful at engaging with culturally specific norms within the Jewish community seems to have been limited, although it may be that the participants were not atypical from the wider group who participated in the J-Safe Project training. [ABSTRACT FROM AUTHOR]

This paper reports on a study of Australian early childhood teachers' pedagogical practices with young children experiencing parental separation and divorce. Twenty-one semi-structured interviews and a focus group were conducted to explore the actions of teachers to support young children experiencing parental separation and divorce. A grounded theory approach was used to analyse data. Teachers reported actions that were focussed on constructing emotional, behavioural, and academic support for young children, as well as forming partnerships with parents, school personnel, and community members to assist. Results are discussed in terms of the implications for professional practice. [ABSTRACT FROM AUTHOR]

Introduction: Voluntary assisted dying (VAD) is increasingly being legalised internationally. In Australia, all six states have now passed such laws, with Victoria being the first in 2019. However, early research in Victoria on the patient experience of seeking VAD shows that finding a connection to the VAD system is challenging. This study analyses the causes of this 'point of access' barrier. Methods: We conducted semi‐structured qualitative interviews with family caregivers and a person seeking VAD, with participants recruited via social media and patient interest groups. Data were thematically analysed. We also undertook documentary analysis (content and thematic) of publicly available reports from the oversight body, the Voluntary Assisted Dying Review Board. Results: We interviewed 32 family caregivers and one patient across 28 interviews and analysed six Board reports. Finding a point of access to the VAD system was reported as challenging in both interviews and reports. Four specific barriers to connecting with the system were identified: (1) not knowing VAD exists as a legal option; (2) not recognising a person is potentially eligible for VAD; (3) not knowing next steps or not being able to achieve them in practice; and (4) challenges with patients being required to raise the topic of VAD because doctors are legally prohibited from doing so. Conclusion: Legal, policy and practice changes are needed to facilitate patients being able to find a connection to the VAD system. The legal prohibition on doctors raising the topic of VAD should be repealed, and doctors and institutions who do not wish to be involved in VAD should be required to connect patients with appropriate contacts within the system. Community awareness initiatives are needed to enhance awareness of VAD, especially given it is relatively new in Victoria. Patient or Public Contribution: Families and a patient were the focus of this research and interviews with them about the experience of seeking VAD were the primary source of data analysed. This article includes their solutions to address the identified point of access barriers. Patient interest groups also supported the recruitment of participants. [ABSTRACT FROM AUTHOR]

Background: Like many countries where voluntary assisted dying (VAD) is legal, eligible doctors in Victoria, Australia, have sole legal authority to provide it. Doctors' attitudes towards legalised VAD have direct bearing on their willingness to participate in VAD and consequently, on whether permissive laws can effectively facilitate access to VAD. The study aimed to explore how some Victorian doctors are perceiving and experiencing the provision of legalised VAD under a recently commenced law. Methods: Semi-structured interviews with 25 Victorian doctors with no in-principle objection to legalised VAD were conducted between July 2019-February 2020. Interviews were recorded, transcribed, and analysed using thematic analysis. Ethical approval from the relevant institution was obtained. Results: Doctors perceive or experience VAD to fundamentally challenge traditional medical practice. Barriers to access to VAD derive from applicant, communication, and doctor-related factors. Doctors' willingness to participate in VAD is situation specific. [ABSTRACT FROM AUTHOR]

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

The impact of Australian disability policy reform, known as the National Disability Insurance Scheme, on the capacity of rural health and human service organizations to facilitate higher education has been poorly investigated. This study explored how health professionals perceive the impact of the National Disability Insurance Scheme on nursing and allied health work-integrated learning (WIL) in rural host organizations during the scheme's implementation in Victoria, Australia. Data collected from 20 health professionals across rural Victoria were thematically analyzed and mapped onto WIL dimensions. This process revealed themes relating to shifts in WIL purpose, context, nature and responsibilities. The findings suggest the National Disability Insurance Scheme may have limited rural organizational capacity to host students undertaking WIL, and in turn, contributed to a decline in rural health education during the implementation phase. Thus, WIL partners may need to pay greater attention to the policy framework surrounding rural WIL opportunities. [ABSTRACT FROM AUTHOR]

Background: delivering appropriate care for patients with multimorbidity and polypharmacy is increasingly challenging. Challenges for individual healthcare professions are known, but only little is known about overall healthcare team implementation of best practice for these patients. Objective: to explore current approaches to multimorbidity management, and perceived barriers and enablers to deliver appropriate medications management for community-dwelling patients with multimorbidity and polypharmacy, from a broad range of healthcare professional (HCP) perspectives in Australia. Methods: this qualitative study used semi-structured interviews to gain in-depth understanding of HCPs' perspectives on the management of multimorbidity and polypharmacy. The interview guide was based on established principles for the management of multimorbidity in older patients. HCPs in rural and metropolitan Victoria and South Australia were purposefully selected to obtain a maximum variation sample. Twenty-six HCPs, from relevant medical, dentistry, nursing, pharmacy and allied health backgrounds, were interviewed between October 2013 and February 2014. Fourteen were prescribers and 12 practiced in primary care. Interviews were digitally audio-taped, transcribed verbatim and analysed using a constant comparison approach. Results: most participants did not routinely use structured approaches to incorporate patients' preferences in clinical decision-making, address conflicting prescriber advice, assess patients' adherence to treatment plans or seek to optimise care plans. Most HCPs were either unaware of medical decision aids and measurements tools to support these processes or disregarded them as not being user-friendly. Challenges with coordination and continuity of care, pressures of workload and poorly defined individual responsibilities for care, all contributed to participants' avoiding ownership of multimorbidity management. Potential facilitators of improved care related to improved culture, implementation of electronic health records, greater engagement of pharmacists, nurses and patients, families in care provision, and the use of care coordinators. Conclusion: extensive shortcomings exist in team-based care for the management of multimorbidity. Delegating coordination and review responsibilities to specified HCPs may support improved overall care. [ABSTRACT FROM AUTHOR]

Background: Death anxiety is a known phenomenon in older people of culturally and linguistically diverse backgrounds (CALD) hospitalised for end-of-life (EOL) care. Little is known about how nurses assuage death anxiety in this population. Aims: To investigate strategies used by nurses to assuage death anxiety and facilitate a good death in older CALD Australians hospitalised for EOL care. Methods: Advanced as a qualitative descriptive inquiry, a purposeful sample of 22 nurses was recruited from four Victorian healthcare services. Interviews were transcribed verbatim and analysed using thematic analysis processes. Findings: Nurses used three key strategies: recognising death anxiety; delineating its dimensions; and initiating conventional nursingcaring behaviours to help contain it. Contrary to expectations, cultural similarities rather than differences were found in the strategies used. Conclusions: Nursing strategies for recognising, delineating, and managing death anxiety in older CALD people hospitalised at the EOL is an important component of quality EOL care. [ABSTRACT FROM AUTHOR]

Background Fathers of refugee background are dealing with multiple, interrelated stressors associated with forced migration and establishing their lives in a new country. This has implications for the role of men in promoting the health and well-being of their families. Methods Afghan community researchers conducted interviews with 30 Afghan women and men who had recently had a baby in Australia. Interviews and focus groups were conducted with health professionals working with families of refugee background. Results Fourteen men, 16 women, and 34 health professionals participated. Afghan men reported playing a major role in supporting their wives during pregnancy and postnatal care, accompanying their wives to appointments, and providing language and transport support. Although men embraced these roles, they were rarely asked by health professionals about their own concerns related to their wife's pregnancy, or about their social circumstances. Perinatal health professionals queried whether it was their role to meet the needs of men. Conclusion There are many challenges for families of refugee background navigating maternity services while dealing with the challenges of settlement. There is a need to move beyond a narrow conceptualization of antenatal and postnatal care to encompass a broader preventive and primary care approach to supporting refugee families through the period of pregnancy and early years of parenting. Pregnancy and postnatal care needs to be tailored to the social and psychological needs of families of refugee background, including men, and incorporate appropriate language support, in order to improve child and family health outcomes. [ABSTRACT FROM AUTHOR]