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This paper describes the cognitive interview phase of the development of two brief surveys, the Movement Behaviour Questionnaire-Baby (MBQ-B) and Movement Behaviour Questionnaire-Child (MBQ-C), which measure the duration of physical activity, screen time, and sleep of children aged 0–5 years. The aims were (1) review the format, content, and clarity of questionnaire items and response options, (2) understand how parents retrieve, encode, and formulate responses when asked about their child's movement behaviours, and (3) identify potential sources of response error and make appropriate modifications. Interviews with parents of children aged 0–5 years were conducted using concurrent think-aloud techniques and probing questions. Parents reviewed the MBQ-B and/or MBQ-C depending on the developmental stage of their child(ren). Twenty-nine interviews were conducted with 20 parents, over four iterative rounds. Participants recalled usual family routines and rules when estimating the duration/frequency of behaviours. To estimate active play, parents referred to the child's daily routine considering wake and bedtimes, naps, and mealtimes. Participants were influenced by the examples provided, being unable to interpret these as exemplars only. Decomposing general items into specific questions with examples was well received. Use of numeracy skills when estimating duration was evident. Interviews informed revisions to item wording, examples, and recall prompts, which will be taken forward into the MBQ-B and MBQ-C validation studies. Utilising cognitive interviewing can enhance confidence that questionnaire items are correctly interpreted and understood by participants. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to suggest how well-being messages are recontextualized into school-based contexts from an analysis of national policy and state curricular approaches to health education as reported in the findings of two selected case studies as well as community concerns about young people's well-being. Design/methodology/approach: A cross-sectional review of Australian federal and state-level student well-being policy documents was undertaken. Using two case examples of school-based in-curricular well-being programs, the paper explores how discourses from these well-being policy documents are recontextualized through progressive fields of translation and pedagogic decision making into local forms of curriculum. Findings: Pedagogic messages about well-being in Australia are often extra-curricular, in that they are rarely integrated into one or across existing subject areas. Such messages are increasingly focused on mental health, around phenomena such as bullying. Both case examples clearly demonstrate how understandings of well-being respond to various power relations and pressures emanating from stakeholders within and across official pedagogic fields and other contexts such as local communities. Originality/value: The paper focusses on presenting an adaptation of Bernstein's (1990) model of social reproduction of pedagogic discourse. The adapted model demonstrates how "top-down" knowledge production from the international disciplines shaping curriculum development and pedagogic approaches can be replaced by community context-driven political pressure and perceived community crises. It offers contemporary insight into youth-at-risk discourses, well-being approaches and student mental health. [ABSTRACT FROM AUTHOR]

The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P = 0.05) and for people living alone than living with family (80 vs 60 respectively; P = 0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P=0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93-20.03) vs 1.65 (0.79-3.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level. [ABSTRACT FROM AUTHOR]

Objective: This study examined Gold Coast staff and patient experiences with the rapid expansion of a virtual model of chronic disease management during the COVID-19 pandemic. Methods: The study undertook a survey of enrolled patients (n = 24) and focus groups with clinical and administrative staff (n = 44) delivering chronic disease programs at Gold Coast Health in Queensland. The study also examined routinely collected activity data for the chronic disease programs before COVID (January–February 2020) and for the first 3 months of the COVID-19 response (March–May 2020). Results: Chronic disease programs continued to provide similar numbers of appointments over the COVID-19 response period, but there was a marked increase in the proportion of appointments that were delivered virtually, either by telephone or video conference. Most patients were satisfied with their virtual care experiences and felt that their health care needs were met. Conclusions: The COVID-19 response provided an opportunity to learn and further develop models of virtual care. Staff and patients were generally supportive of continuing to include virtual appointments in the future. Ongoing concerns were predominantly around the support available to patients and staff to ensure they are trained and equipped to manage the technology and new mode of communicating. What is known about the topic?: Emerging evidence suggests that virtual models of health care delivery, such as telephone and video consultations and remote patient monitoring, can be safe and cost-effective alternatives to traditional face-to-face chronic disease management programs. Virtual care is associated with equal or improved clinical outcomes, as well as efficiency improvements, such as reduced failure to attend rates. What does this paper add?: The increasing burden of chronic disease across Australia, as well as the need to minimise the risk of vulnerable patient groups attending in-hospital appointments where it is safe and appropriate to do so, means that expanding the delivery of virtual chronic disease management will become increasingly necessary. The results of this study provide an opportunity to learn from a rapid rollout of virtual care for these staff and patient groups and will help inform advances in this area. What are the implications for practitioners?: Existing evidence, demographic pressures and the COVID-19 pandemic response all point to virtual care as a viable and safe alternative to traditional models of chronic disease management. The lessons presented here provide more detailed guidance on the support that staff and patients require to ensure virtual care is a seamless and safe alternative or adjunct to traditional chronic disease management programs. [ABSTRACT FROM AUTHOR]

Haemodialysis (HD) is one form of kidney replacement treatment (KRT) for patients with kidney disease. HD removes fluid and toxins through diffusion and ultrafiltration. Isolated ultrafiltration (Iso Uf) may be performed to facilitate increased fluid removal, improve a patient's tolerability, and achieve the ultrafiltration goal (UFG). Iso Uf can be performed in association with, or in addition to, standard HD and requires no additional equipment. However, although this type of treatment has been evident for decades, there is minimal current evidence in relation to clinical practice, assessment criteria and process evaluation. Current practice trends are often based on clinical judgement, experience and patient assessment. Inconsistent practices have therefore been raised as an area for investigation in order to define appropriate standards of clinical care. The aim of this paper is to understand current practices in relation to Iso Uf, including assessment criteria, treatment interventions and evaluation strategies, and compare this with currently available literature in order to scope treatment considerations. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why. Methods: The study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania. Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks. Results: Of 823 patients screened for eligibility, 698 eligible patients, 612 provided consent. Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%). Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion. Conclusions: Our study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor. Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate. [ABSTRACT FROM AUTHOR]

The purpose of this systematical review was to appraise the clinimetric properties of measures of motivation in children aged 5-16 years with a physical disability or motor delay. Six electronic databases were searched. Studies were included if they reported measuring motivation in school-aged children across occupational performance areas. Two reviewers independently identified measures from included articles. Evaluation of measures was completed using the COSMIN ( consensus-based standards for the selection of health measurement instruments) checklist. A total of 13,529 papers were retrieved, 15 reporting measurement of motivation in this population. Two measures met criteria: Dimensions of Mastery Questionnaire (DMQ) and Pediatric Volitional Questionnaire (PVQ). There was evidence of adequate validity for DMQ, and preliminary evidence of test-retest reliability. Psychometric evidence for PVQ was poor. Both measures demonstrated good clinical utility. The large number of retrieved papers highlights the importance being attributed to motivation in clinical studies, although measurement is seldom performed. Both identified measures show promise but further psychometric research is required. [ABSTRACT FROM AUTHOR]

Although the availability of mobile device applications (apps) to support people with hearing impairment is rapidly increasing, there are few reports of the use of such apps by the target population. The aim of this paper is to describe research that has applied apps at various stages of the adult rehabilitation journey. A summary of studies utilising apps to investigate (1) the hearing difficulties and acoustic environments of adults with mild hearing impairment, (2) hearing aid benefit in this population and (3) useability of an app to guide hearing aid handling tasks. Older adults with no previous experience with hearing aids, who owned a smartphone or tablet and were confident in using apps. Participant samples ranged from 10 (hearing aid benefit pilot study, mean age = 70 years) to 30 participants (app useability study, mean age = 69 years). All studies showed that smartphone apps can provide real-world insights during the early stages of the patient journey and hearing aid management support during the latter stages. App useability was rated positively by participants. Smartphone apps may be used as a feasible complement to face-to-face interaction in audiology practice. [ABSTRACT FROM AUTHOR]

Optimal primary care sector performance is vital for ensuring the delivery of quality health services and effective clinical management of populations. The Primary Care Practice Improvement Tool (PC-PIT) incorporates subjective staff input and objective indicators to measure 13 elements of organisational performance. This study aimed to measure change in organisational performance for general practices using the PC-PIT with Primary Health Network (PHN) support. A pre-post design was used for changes in PC-PIT subjective and objective scores. Practices used results with PHN support to complete two Plan Do Study Act initiatives and were reassessed 9-months later. PC-PIT scales were dichotomised into lower and higher scores, with odds ratios used to determine effect size. Staff survey response rates were 55.4% at baseline and 50.1% at follow up. There were modest increases in the likelihood of staff rating several elements higher at follow up. When implemented with PHN support staff, the PC-PIT has the potential for effective, focussed and sustained quality improvement, with capacity to support Health Care Home model transition and implementation. Optimising primary care practice performance presents an important national challenge. This paper demonstrates the positive effect of the Primary Care Practice Improvement Tool (PC-PIT), supported by a Primary Health Network practice support team, in building practice quality and performance. [ABSTRACT FROM AUTHOR]

Indigenous Australians are disproportionally affected by hepatitis B compared with non-Indigenous Australians. The higher prevalence of hepatitis B among Indigenous Australians has been linked to an increased incidence of liver cancer in this population. There is evidence that comprehensive programs of hepatitis B virus management, which include liver cancer surveillance and appropriate antiviral therapy, offer a cost-effective approach to reduce the incidence of liver cancer in Australia. This paper reports on data from the first study investigating understandings of hepatitis B and attitudes to treatment among Torres Strait Islanders living with chronic hepatitis B. Forty-two participants completed an interview questionnaire. Participants typically had an unclear understanding of hepatitisBand reported significant gaps in monitoring and follow up. A majority of participants indicated a willingness to use treatment if required. The findings of this study suggest the need for a new service delivery model that is appropriate to remote communities such as the Torres Strait Islands, to improve hepatitis B follow up, disease monitoring and management, and where appropriate, the uptake of treatment. [ABSTRACT FROM AUTHOR]

Purpose – Support workers who provide in-home support to people with psychiatric disability are becoming a significant part of the mental health workforce. Research is needed to establish the optimum level and content of training they need to effectively carry out their role. Design/methodology/approach – This paper reports on this paper is to draw on the results of a survey of 104 support workers and interviews with 18 support workers and eight managers in Queensland, Australia, who provide in-home support for people with psychiatric disability. The authors describe the training undertaken by these workers and their perceptions of the adequacy of this training in relation to the challenges of their work. Findings – The majority of support workers felt they had adequate training, though many expressed the desire to know more about mental illness symptoms, medications and the concept of recovery. Support workers nominated motivating their clients and managing challenging behaviour as the most difficult aspect of the job. Future training offered to these workers needs to focus on increasing knowledge about mental illness and the concept of recovery, and supporting them in their work with clients who have low levels of motivation and/or challenging behaviours. Access to professional supervision may also be of benefit. Originality/value – This paper adds to knowledge about the training needs of support workers who provide in-home support to people with psychiatric disability. These findings will be useful for practitioners and decision makers who are considering the training needs of this group. [ABSTRACT FROM AUTHOR]

Accessible Summary: In the past 30 years, many people with (intellectual) learning disabilities have been moved out of large "institutions" and into their own home in their local communityThese people are now often between 30 and 50 years oldWe asked people with learning disabilities aged between 30 and 50 and who are living in their local community what things, including work, that they enjoyed doingWe asked people with learning disabilities aged between 30 and 50 and who are living in their local community whether they felt that they could make decisions about their lifeWe found out the things that make their life good, and also what might stop people enjoying their lifeWe learnt that people with learning disabilities should receive more support to assist them before they retireWe learnt that people with learning disabilities still need more support and choice around who they live with Background: This study investigated perceived quality of life (QoL) of community‐dwelling middle‐aged adults (30–50 years) with an intellectual disability and/or developmental disability living in rural or urban areas in New South Wales and Queensland, Australia. The specific aim of the current paper was to provide a descriptive evidence base of QoL and its specific domains by various key demographic characteristics of middle‐aged individuals. This cohort is likely to have either experienced or reached adulthood during and after large‐scale deinstitutionalisation in Australia. Methods and procedures: A cross‐sectional design was utilised, based on the QoL‐Q survey, testing domains of satisfaction; Competence/Productivity; Empowerment/Independence; and social belonging/community integration. The survey included demographic questions and was distributed to participants through disability support agencies across two states. The final sample included 291 respondents. Results: The overall QoL‐Q scores ranged from 3.0 to 29.5 (Mean = 20.4, SD, 4.1), with considerable variation in mean scores both across and within domains. The two demographic areas that showed greatest predictive value for QoL were work status and accommodation issues. The loss of agency and control in choice of co‐residents influenced perceived QoL for empowerment and independence domain of QoL‐Q. Conclusions: The findings highlight QoL issues associated with policy decisions and support programmes for middle‐aged adults. The two key recommendations arising from the project are that future planning for post‐retirement or reduced working hours needs to commence at a much younger age than currently expected, and more attention needs to focus on facilitating individual decision‐making and choice within shared accommodation options. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the effectiveness of a structured audio-visual educational session for people on asthma symptoms management during a general practitioner visit. Methods: We conducted this single-centre intervention study in a general practice clinic in Queensland, Australia. There were 78 intervention and 78 control participants in this study. We followed 1:1 randomisation to allocate study intervention between two groups of participants with asthma. The intervention group received an audio-visual demonstration of asthma, its symptoms, triggers, and how to use inhalers correctly, along with the standard asthma management by a physician on enrolment. The control group received only the standard asthma management by a physician. We assessed the 'Asthma Control Test' score on enrolment and after 90 days and compared the changes across the groups. Results: Participants were, on average, 28 years old (range: 6–60, 60% women). The intervention group showed a 1.9-unit increment, and the control group showed a −0.5-unit increment in 'Asthma Control Test' score from baseline to endline. The difference of differences between the intervention and control groups was 2.4 units (P = 0.016) after adjusting for potential confounders. In age-stratified analysis, the children (6–17 years) showed a significant difference (mean difference of 2.5 between intervention and control groups) in their asthma control score. Conclusions: Structured educational sessions involving audio-visual media along with standard management for people with asthma during general practice visits would be effective for better asthma control. However, a further multi-centre study with a larger sample is needed to see its efficacy. The effectiveness of an asthma educational adjunct to standard management during a general practice visit is not well studied. A recent study in a Queensland general practice clinic examined the impact of a structured audio-visual educational session on asthma management and showed a significant improvement in Asthma Control Test scores in the intervention group compared to controls. This suggests the potential efficacy of such interventions in enhancing asthma control during general practice visits, although further multi-centre studies are necessary for conclusive evidence. [ABSTRACT FROM AUTHOR]

Family‐focussed practice is an important component of mental health care. In Australia, service users' views about their experience of service are collected using instruments such as the Your Experience of Service (YES) survey. This study examined 10,579 Queensland (Australia) service users' experiences of mental health services during 2019–2021, with a particular focus on their perspectives of how family and carers are involved in their care. The study examined if family‐focussed practice is welcomed by service users and if it is important in terms of predicting recovery‐related outcomes (e.g., hopefulness, managing day‐to‐day life, well‐being, and experience of care) and which demographics (e.g., age, gender, and Indigenous status) and service characteristics (e.g., time in service, duration, year of service, and setting type) are associated with these outcomes and with family member involvement. A substantial majority of service users reported a positive experience of care (very good or excellent), feeling they had opportunities for family involvement and that their opinions about family involvement were respected (usually or always). Chi‐square tests and nonlinear regression models showed that family involvement predicts care outcomes. Specifically, where individuals felt that their perspectives were recognised, their outcomes were consistently rated as more positive. The results also revealed that setting, age group, time in service, and admission status were significantly correlated with all user experience outcome variables and family‐oriented variables. Future research has the potential to further strengthen this understanding of service users' preferred opportunities and opinions about family involvement and how to improve family engagement and better meet the needs of service users and their families. [ABSTRACT FROM AUTHOR]

Objective: The acuity and number of presentations being made to emergency departments (EDs) is increasing. In an effort to safely and efficiently manage this increase and optimise patient outcomes, innovative models of care (MOC) have been implemented. What is not clear is how these MOC reflect the needs of patients or relate to each other or to ED performance. The aim of this study was to describe ED MOC in Queensland, Australia. Methods: Situated within a larger mixed-methods study, the present study was a cross-sectional study. In early 2015, leaders (medical directors and nurse managers) from public hospital EDs in Queensland were invited to complete a survey detailing ED activity, staffing profiles, treatment space, MOC and National Emergency Access Target (NEAT) performance. Routinely collected ED information system data was also used. Results: Twenty of the 27 EDs invited participated in the study (response rate 74%). An extensive array of MOC were identified that were categorised into those that facilitate input, throughput and output from the ED. There was no consistent evidence as to the relative effectiveness of these MOC in achieving ED performance benchmarks, such as NEAT performance. Conclusion: There is considerable variability in the MOC used throughout EDs in Queensland. A more complete analysis of the relative effectiveness of different MOC either in isolation or as part of a comprehensive approach would help inform more consistent MOC in Queensland EDs. What is known about the topic?: MOC in any given ED are implemented in response to factors such as the geographical location of the hospital, hospital-specific characteristics and service profile, staffing profile and patient demographic profile. In the era of time-based targets, they may also serve to address a particular aspect of flow in the face of rising ED demand. Although many of the MOC attempt to deal with flow in a linear fashion, target specific phases of the ED journey or address particular patient cohorts, what is clear is that not all EDs are shaped and formed the same. What does this paper add?: The study provides a comprehensive description of the varied models of care operating within Queensland public hospital EDs and how they relate to ED performance. A basic taxonomy of contemporary ED MOC is necessary to allow comparison between departments and inform decisions regarding safety, efficiency and cost-effectiveness. What are the implications to practitioners?: A contemporary understanding of the presence and profile of ED MOC that currently exist within a network of hospitals and health services is important for managers, clinicians and patients to inform decision-making regarding the safety, clinical effectiveness and cost-effectiveness of these models. This understanding can also inform where and how further improvements in care delivery can progress. [ABSTRACT FROM AUTHOR]

BACKGROUND: An exploratory baseline study was conducted to ascertain the state of play in the field of spinal cord injury, vocational rehabilitation and employment in Queensland, Australia. OBJECTIVE: The aim of this study was to establish the rate of return to work and better understanding of vocational expectations and the vocational rehabilitation culture in the Queensland Spinal Injuries Unit, prior to the introduction of an early vocational rehabilitation intervention for people with spinal cord injury. METHODS: A mixed methods approach was utilised, involving administration of either an online survey tool or paper questionnaire to people who had sustained a spinal cord injury within the preceding three years. Statistical analysis of the quantitative data and thematic analysis of the qualitative free-text data was undertaken with the 34 eligible responses. RESULTS: The findings demonstrate a dramatic change in the rate of employment following spinal cord injury, and a lack of vocationally focused support whilst participants were undergoing in-patient rehabilitation. CONCLUSIONS: The study indicates a return to work rate of approximately 35%, and provides support for an individualised vocational rehabilitation intervention, fully integrated into the multidisciplinary spinal injuries unit rehabilitation program. [ABSTRACT FROM AUTHOR]

With international and national policies requiring teachers to adopt inclusive practices worldwide, this paper examines the impact of transformational learning in a critical service-learning program on final-year pre-service teachers’ approaches to inclusive teaching. Data from emailed questionnaires and focus group interviews are analysed through a social, critical framework. The results indicate that the critical service-learning program provided the students with an opportunity to consider diversity and inclusion in selecting teaching strategies, and to enact values suitable to inclusive practices and appreciation of diversity in schools. In this paper we argue that transformative learning experiences about inclusivity and diversity are needed if pre-service teachers are to be challenged to adopt inclusive values and practice in schools. A critical service-learning program for pre-service teachers provides a solid foundation on which to develop or build on the ability to think and teach inclusively. [ABSTRACT FROM PUBLISHER]

Background: The established nurse transition-to- practice program offered at one Australian health service underwent significant changes in 2017. This study aimed to gain feedback from the participants in the 2016 and 2017 programs. Method: A four-page paper survey was given to participants in the 2016 and 2017 programs. Results: Both cohorts were positive about the content, organization, and support provided to them throughout the program. Conclusion: The program will continue to undergo incremental improvements to meet the needs of the organization and the graduates. The need to tailor future programs to meet the needs of nurses working in rural and remote facilities has been identified. It has been suggested that options for more dynamic presentations of content also need to be explored. [ABSTRACT FROM AUTHOR]

The focus of this paper is on an Australian research project that evaluated the effectiveness of a resource called the Ask Health Diary, which is used in the school curriculum to promote self-determination for better health and wellbeing for adolescents who have an intellectual disability. Education and health researchers used questionnaires and interviews to gather data from adolescents attending special schools and special education units located in secondary schools in south-east Queensland, their teachers and their parents/carers. This paper reports on two research questions: First, ‘How did the teachers use the Ask Health Diary to promote self-determination in health?’, and second, ‘How did teachers, parents/carers and students perceive the benefits and value of the Ask Health Diary?’ The findings indicate that the Ask Health Diary provides a sound curriculum framework for teachers, adolescents and parents/carers to work together to promote self-determination and better health outcomes for young people who have an intellectual disability. [ABSTRACT FROM PUBLISHER]

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Purpose The implementation of mental health promotion is a core part of the role for all mental health professionals. This involves working with individuals and groups to facilitate the uptake and application of new knowledge, skills and personal attributes. Recently, an Australian intervention that included teaching nurses and educators the skills of mental health promotion was implemented and evaluated. The purpose of this paper is to report the findings of the qualitative evaluation and explore specific attributes of this facilitation, which helps to clarify and articulate a hidden, and taken-for-granted practice.Design/methodology/approach A qualitative mixed-methods study was designed to evaluate the perceived skills and attributes necessary for effective facilitation of a mental health promotion program in schools.Findings This evaluation revealed that facilitation is more than simply allowing free-flowing discussion amongst participants. For mental health promotion to be effective, the leader needs to be able to balance content delivery with flexibility, to use interpersonal behaviors that support and empower, and be willing to see the self as always learning and growing.Practical implications Without explicit training or discussion of facilitation, it is possible that mental health professionals may slip into teaching didactically. Didactic teaching may not empower learners to articulate their own views, or internalize and demonstrate new skills. A facilitative approach is more fitting to the values of twenty-first-century health promotion. Facilitation is a skill that deserves to be taught explicitly within all mental health promotion courses, so that mental health professionals are inspired to teach in ways that are transactional, and empowering.Originality/value A facilitative approach is more fitting to the values of twenty-first-century health promotion. This study confirms that facilitation is a skill that deserves to be taught explicitly to all mental health professionals so they are inspired to implement effec"tive mental health promotion. [ABSTRACT FROM AUTHOR]

Parental substance misuse has a pervasive impact on family functioning, parenting, and, ultimately, child wellbeing and development. Subsequently, linkages with informal and formal support networks are crucial for ameliorating risk. To facilitate engagement with these families prior to identification in child protection systems, it is vital to understand the factors inhibiting and promoting engagement with informal and formal support. This paper examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns. Parents reporting alcohol problems in a clinical range (n = 322) were drawn from a representative parent sample (n = 1991). Alcohol‐misusing parents reported low help‐seeking for parenting‐focused support services. The findings particularly highlight the role of age, education, socioeconomic status, ethnicity, parenting stress, empowerment and trust in support services for predicting parents' help‐seeking. 'Examines how different factors influence informal and formal help‐seeking by alcohol‐misusing parents with regard to parenting and family concerns' Key Practitioner Messages: The role of practitioners working in family welfare and child protection services in identifying and facilitating support for alcohol-misusing families is described.Parenting‐focused support services need to be promoted, especially for vulnerable parent populations.Education of service providers along with the wider community is required to foster and increase trust and support uptake before alcohol-misusing families become involved with statutory systems. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

This paper outlines an evaluation of reflective practice groups ( RPG) involving nurses and midwives from three clinical nursing specialties at Redcliffe and Caboolture Hospitals, Queensland, Australia. The groups were facilitated by the consultation liaison psychiatry nurse and author using a process-focused, whole-of-group approach to explore clinical narrative in a supportive group setting. This was a preliminary evaluation utilizing a recently-developed tool, the Clinical Supervision Evaluation Questionnaire, along with externally-facilitated focus groups. Nurses and midwives responded favourably to RPG, reporting a positive impact on clinical practice, self-awareness, and resilience. The majority of participants considered RPG had positive implications for team functioning. The focus groups identified the importance of facilitation style and the need to address aspects of workplace culture to enable group development and enhance the capacity for reflection. Evaluation of the data indicates this style of RPG can improve reflective thinking, promote team cohesion, and provide support for nurses and midwives working in clinical settings. Following on from this study, a second phase of research has commenced, providing more detailed, longitudinal evaluation across a larger, more diverse group of nurses. [ABSTRACT FROM AUTHOR]

chang a.m., gardner g.e., duffield c. & ramis m.-a. (2010) A Delphi study to validate an Advanced Practice Nursing tool. Journal of Advanced Nursing 66(10), 2320–2330. Aim. This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background. Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method. An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results. After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion. The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce. [ABSTRACT FROM AUTHOR]

Problem The continuity of care for people with neurological conditions in a remote northwest Queensland town as services are currently only available intermittently. Design Mixed methods design using questionnaires and staff review of the program and processes. Setting Intermittent community rehabilitation service for clients with neurological conditions has been offered in Mount Isa and is supported by a similar fulltime service in Townsville. Both services use a unique client-centred, student-assisted, interprofessional model of care. Key measures for improvement Understanding participant experiences by obtaining feedback from clients, students and allied health professionals ( AHPs) regarding their experiences of using telehealth in this setting. Strategy for change Previous clients of the North West Community Rehabilitation service were offered a review assessment using telehealth by an interprofessional team. Effects of change Using telehealth enabled the client, remote AHP and students in Mount Isa to be connected to expert assistance in Townsville. Lessons learnt The findings suggest that telehealth was useful in a community rehabilitation setting to provide review services for clients. This improved continuity of care for these clients because without this telehealth assessment, the clients would have had to wait up to 12 months for the next service period in Mount Isa or travel to a major urban centre to access a similar service. Feedback from clients, students and AHPs was positive; however, some challenges were identified. Recommendations for future service delivery using telehealth are outlined in the paper. [ABSTRACT FROM AUTHOR]

Objectives: To explore experiences and attitudes of frail older persons to using bathing wipes as a hygiene option at home. Methods: A descriptive, exploratory study was conducted with older clients who required hygiene assistance post hospital discharge and consented to trial bath wipes. Client participants or their carer completed a verbal questionnaire administered via telephone. Descriptive statistics summarised the quantitative data and closed-ended questions were analysed using content analysis. Results: Thirty-seven of the 49 consented participants used the bathing wipes at home. There was high level of agreement that bathing wipes were fit for purpose and participants indicated that they were suitable to use to supplement assisted showers. Conclusion: The use of bathing wipes provides an acceptable hygiene option and can support autonomy of frail, older persons, while reducing the risk of falls from wet floors. Bathing wipes are of use to persons who have not yet regained independence with showering and/or are awaiting bathroom modifications installed. What is already known about the topic? • Wet floors associated with showering unassisted, can be a falls hazard to elderly persons attempting to regain independence. • Transition care programs offered for elderly clients returning to their own home post hospital discharge are limited in scope and duration. • Falls in frail, older people are common, with adverse consequences for the individual and the health system. What this paper adds • Bath wipes were well accepted by elderly clients as an alternative to showering without assistance. • Bath wipes can be used by the individual on a short-term basis while they regain independence with hygiene, while they wait for bathroom modifications, or they can be used longer term. [ABSTRACT FROM AUTHOR]

Objective To examine urban-rural differences and individual risk factors for a late stage of breast cancer at diagnosis in Australian women. Design Individual-level longitudinal data were linked with cancer registry data from New South Wales (New South Wales Cancer Registry linked by the Centre for Health Record Linkage (CHeReL)), Queensland (Queensland Cancer Registry) and Victoria (The Cancer Council Victoria). Setting Participants were drawn from the Australian Longitudinal Study on Women's Health 1946-1951 cohort (n = 13 715). Participants The sample included 195 women identified from the linked cancer registry data with a breast cancer diagnosis. Interventions Rural or urban residence was measured using Accessibility/Remoteness Index of Australia Plus (ARIA+). Individual characteristics and socio-demographic variables examined included survey year, menopausal status, country of birth, education and marital status. Main outcome measures A late stage of breast cancer at diagnosis was defined based on the TNM Classification of Malignant Tumours. Results A late stage of breast cancer diagnosis was observed in 36% of women residing in urban areas and 40% of women residing in rural areas. After adjusting for individual characteristics, we found that obesity was the strongest risk factor for a late stage of breast cancer at diagnosis. Conclusions Given that women are becoming increasingly obese, and that the rate of obesity is higher in the Australian rural population, this paper provides further evidence for targeting interventions for obesity, particularly in rural Australia, as a public health priority. [ABSTRACT FROM AUTHOR]

Many GPs undertake postpartum care for women and their infants. GP follow-up enables early identification and management of problems, education and support for parenting, and reconnection with general practice following the birth. However, there is little information about GPs' understanding of their role in postpartum care and how it is undertaken. This cross-sectional survey of GPs in Southern Queensland, conducted between February and July 2013, describes the involvement of GPs in postpartum care. GPs were posted a 52-item questionnaire adapted from a previous Victorian GP study and were telephoned 2 weeks later. GPs completed the survey on paper or online. The response rate was 17.4% (163 GPs). Approximately 39% were uncertain whether women were happy with the GP-provided postpartum care. GPs' recommendations for the timing of postpartum reviews were inconsistent within and across birthing sectors and consultations took longer than anticipated. Developing guidelines around the timing and appropriate length of postpartum consultations could assist GPs in providing appropriate care for mothers and infants. [ABSTRACT FROM AUTHOR]

Aims:The aim of this study was to present preliminary normative data for the Jebsen Taylor Test of Hand Function test (JTTHF) in Australian children. Normative data provide reference values for comparison of upper limb capacity when evaluating and planning treatment.Methods:The JTTHF administration procedures and materials were standardized. One hundred and two typically developing children aged 5 to 10 years in Brisbane, Australia, were then assessed using the JTTHF.Results:Five-year-old children were significantly different to all other groups (one year age bands), and 6-year-old children were significantly different from 9-year-old children in the dominant hand. Regression modeling showed improvements of 0.9 and 0.89 s in JTTHF total time for the dominant and nondominant hands, respectively, for every 12 months of maturation in 6- to 10-year-old children.Conclusions:This paper presents preliminary JTTHF norms for Australian typically developing children 5 years, 6 to 7 years, 8 to 9 years, and 10 years of age. [ABSTRACT FROM PUBLISHER]

Meat/meat alternatives (M/MA) are key sources of Fe, Zn and protein, but intake tends to be low in young children. Australian recommendations state that Fe-rich foods, including M/MA, should be the first complementary foods offered to infants. The present paper reports M/MA consumption of Australian infants and toddlers, compares intake with guidelines, and suggests strategies to enhance adherence to those guidelines. Mother–infant dyads recruited as part of the NOURISH and South Australian Infants Dietary Intake studies provided 3 d of intake data at three time points: Time 1 (T1) (n 482, mean age 5·5 (sd 1·1) months), Time 2 (T2) (n 600, mean age 14·0 (sd 1·2) months) and Time 3 (T3) (n 533, mean age 24 (sd 0·7) months). Of 170 infants consuming solids and aged greater than 6 months at T1, 50 (29 %) consumed beef, lamb, veal (BLV) or pork on at least one of 3 d. Commercial infant foods containing BLV or poultry were the most common form of M/MA consumed at T1, whilst by T2 BLV mixed dishes (including pasta bolognaise) became more popular and remained so at T3. The processed M/MA increased in popularity over time, led by pork (including ham). The present study shows that M/MA are not being eaten by Australian infants or toddlers regularly enough; or in adequate quantities to meet recommendations; and that the form in which these foods are eaten can lead to smaller M/MA serve sizes and greater Na intake. Parents should be encouraged to offer M/MA in a recognisable form, as one of the first complementary foods, in order to increase acceptance at a later age. [ABSTRACT FROM PUBLISHER]

Aim This study aimed to demonstrate how supervisors and students use their time during the three domains of nutrition and dietetic clinical placement and to what extent patient-care and non-patient activities change during placement compared with pre- and post-placement. Methods A cohort survey design was used with students from two Queensland universities, and their supervisors in 2010. Participants recorded their time use in either a paper-based or an electronic survey. Supervisors' and students' time use was calculated as independent daily means according to time-use categories reported over the length of the placement. Mean daily number of occasions of service, length of occasions of service, project activities and other time use in minutes was reported as productivity output indicators and the data imputed. A linear mixed modelling approach was used to describe the relationship between the stage of placement and time use in minutes. Results Combined students' (n = 21) and supervisors' (n = 29) time use as occasions of service or length of occasions of service in patient-care activities were significantly different pre, during and post placement. On project-based placements in food-service management and community public health nutrition, supervisors' project activity time significantly decreased during placements with students undertaking more time in project activities. Conclusions This study showed students do not reduce occasions of service in patient care, and they enhance project activities in food service and community public health nutrition while on placement. A larger study is required to confirm these results. [ABSTRACT FROM AUTHOR]

Background and purpose Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD. Methods A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples. Results Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p < 0.001). Conclusion The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: The continuing decline in clinician scientists is a global concern. This paper reports on a two-fold rationale to address this decline by increasing the number of students on a formal pathway to an academic research career, and building a 'teaching-research nexus' using the research intensive environment at our University. Methods: The University of Queensland has implemented a research intensive program, the Clinician Scientist Track (CST), for a select cohort of students to pursue a part time research Masters degree alongside their full time medical degree. To this end, the support of clinical academics and the research community was vital to achieve a 'teaching-research-clinical nexus' - most appropriate for nurturing future Clinician Scientists. Results: In three years, the CST has 42 enrolled research Masters' students with the majority (90%) upgrading to a PhD. Research represents 33 different areas and over 25 research groups/centres across this University and internationally. Conclusions: Other research intensive institutions may similarly build their 'teaching-research nexus' by purposeful engagement between their medical school and research community. The CST offers a feasible opportunity for outstanding students to build their own 'field of dreams' through an early start to their research career while achieving a common goal of rejuvenating the ethos of the clinician scientist. [ABSTRACT FROM AUTHOR]

Students of nursing enter their programmes of study with preconceived ideas of what a career in their chosen profession will entail. The literature suggests that images from the media and past experiences contribute to these perceptions. Although it is positive images of the profession that will usually attract an individual to a career in nursing, often more negative perceptions will direct students away from potentially rewarding areas of specialization. This paper describes career projections of nursing students enrolled in the first year of four preservice nursing programmes at the rural campus of one Australian university. Part of a larger study, the data reported here indicate that most respondents intend to practice in the areas of midwifery, paediatrics and emergency nursing. Oncology, community nursing, aged care and mental health nursing all ranked poorly across three rounds of surveys. These findings have implications for practicing nurses and nurse educators who seek to dispel inaccurate images of these important specializations. [ABSTRACT FROM AUTHOR]

Objective. This paper describes the effects of a maternity consumer representative training program on participants' confidence to fulfil this role and engagement in representative activities. Methods. The present study was a descriptive, pre-post evaluation design with a 3-month follow-up. Fifty-eight people completed the program and 55 agreed to participate in the evaluation. Participants completed questionnaires to assess confidence to undertake consumer representative roles and reported on their engagement with consumer activities. Results. Participants' perceived confidence to function in the role of consumer representative differed significantly before and after the workshop (F(2,18) = 7.057, P < 0.001), as did confidence in decision making (F (2,16) = 7.615, P = 0.005), confidence in negotiating outcomes and liaising with key people (F(2,18) = 7.154, P = 0.005), and confidence in making use of relevant networks (F (2,18) = 4.319, P = 0.029). There was a decline in confidence at 3 months, with confidence at this time no longer significantly different from that at the time of recruitment. Engagement with consumer organisations increased by 45% compared with rates at commencement of the project. Conclusions. The program enhanced participants' confidence to fulfil a maternity consumer representative role but was not sustained. Further research is needed as to how to best support maternity consumer representatives and assess their contribution to promoting woman-centred care. [ABSTRACT FROM AUTHOR]

This paper explores the feasibility of a brief Mindfulness with Metta Training Program (MMTP), targeting the enhancement of mindfulness and self-compassion in a retreat format, as a means of increasing resilience in human services professionals. In this randomised control trial, 44 human services professionals were randomly allocated either to a MMTP retreat group or to a control group. Following the MMTP intervention, no significant differences between the retreat and control groups were found on resilience, mindfulness and self-compassion variables. However, significant improvements were observed over time for the retreat group for mindfulness and self-compassion at one and four months and for resilience at four-months post MMTP intervention. The results of this pilot study show that MMTP in a retreat format is a promising method of increasing resilience, mindfulness and self-compassion in human services professionals. [ABSTRACT FROM AUTHOR]

Objective. Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Methods. Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. Results. The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. Conclusions. This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. [ABSTRACT FROM AUTHOR]

From an organisational point of view, professional support is an important aspect of clinical governance and a tool for maximising service delivery quality. As a key factor in staff retention and recruitment, access to professional support is also regarded as an important tool for facilitating workforce growth in a competitive health workforce market. While some work units provide appropriate professional support such as in-service, professional supervision is a key challenge for a large organisation employing many health professionals to ensure equitable and relevant access to finite professional support resources. The goal of this paper is to describe the Professional Support Program designed and implemented by Queensland Health. This program seeks to support professionals who may not previously have had optimal engagement in professional support and to enhance the quality of professional support activities available. Evaluation indicates that the Professional Support Program has been successful in facilitating participation in, and quality of professional support activities. [ABSTRACT FROM AUTHOR]

Background/aim Evidence-based practice and research are beginning and endpoints on a research continuum. Progression along the continuum builds research capacity. Occupational Therapy has a low evidence base, thus, clinicians are not implementing evidence-based practice or publishing research. Barriers to implementing evidence-based practice and engaging in research include a lack of confidence. This research gauged Occupational Therapists' research experience, support needs and barriers, and compared levels of research anxiety between allied health disciplines. Methods A cross-sectional survey was sent to Health Practitioners in northern Queensland in May- June 2011. Responses about experience, support needs and barriers, between Occupational Therapists, were analysed using Chi-square 'goodness of fit' tests. Multivariate analysis compared responses between disciplines about research anxiety. This paper reports results for the subset of Occupational Therapists. Results The whole population, consisting of 152 Occupational Therapists, was sent a questionnaire, from which 86 responded. More Occupational Therapists than not had experience of evidence-based practice and less support was required, but they had little experience of producing research and required more support. The amount of support required for activities along the research continuum was inversely related to the level of experience in these tasks. Barriers included lack of staff and time. Occupational Therapists were more anxious about research (53 of 79, 67%) than all other Health Practitioner disciplines combined (170 of 438, 39%, P < 0.0001). Conclusion A cohesive strategy should focus on consolidating Occupational Therapists' evidence-based practice skills and building confidence. Clinicians wishing to engage in research need access to academic support. Academics and clinicians should work closely to produce clinically relevant research. [ABSTRACT FROM AUTHOR]

Training for health services staff often focuses on improving individual practitioner's knowledge and skills, with less emphasis given to the broader organizational context, in particular those elements that support successful implementation of changes post-training. This paper compares the effectiveness of a standard training model for suicide prevention to an enhanced training model. The training involved the public mental health workforce throughout the State of Queensland, Australia and was developed in collaboration with the State health department and as such took place within a policy and practice context. The standard training involved participation in a one-day training workshop, which provided information on evidence-based suicide prevention strategies. The enhanced model took an organizational development approach and incorporated a focus on creating and strengthening networks to enhance the capacity of mental health service staff to undertake preventive strategies. Findings suggest that multi-component organizational approaches for suicide prevention produces benefits that should now be trialled through experimental approaches. [ABSTRACT FROM AUTHOR]

Computer-based therapy has the potential to increase the intensity of therapy for individuals with aphasia. The aim of our project was to investigate the effectiveness of providing computer-based aphasia therapy as an adjunct to standard speech pathology treatment approaches in the inpatient rehabilitation ward setting. Secondary aims were to 1) investigate the frequency and length of usage of the self-directed computer therapy exercises by participants, and 2) investigate participants' attitudes towards computer-based therapy, and whether these attitudes changed following a block of self-directed computer-based therapy. Two participant cases will be presented. Both participants displayed improved naming of treated items, and a non-significant change in general language function. The benefits and challenges encountered implementing computer-based therapy research in a hospital rehabilitation setting will also be discussed. The current paper suggests that computer-based aphasia therapy delivered by a tablet computer may have potential as a useful adjunct to standard clinical practice; however, a number of factors need to be considered before embarking on the implementation process. [ABSTRACT FROM AUTHOR]

Background: Nurses' recognition of their own level of skills and abilities (that is, perceived competence) is a prerequisite for ensuring they can practise in a safe manner. The demand for competence in the operating room (OR) may vary between clinical environments. It is,however, unclear what competency levels migrating nurses need in order to be deemed safe.Aim: This paper describes Canadian and Australian nurses' levels of perceived perioperative competence and discusses these results in the context of nurse migration.Method: A survey was distributed to OR nurses in six hospital sites (three in Canada and three in Australia). Perioperative competence was measured with a 40-item self-report survey which consisted of six domain subscales: foundational knowledge and skills; leadership; collaboration; proficiency; empathy; and professional development. Non-parametric tests were used to describe differences between groups based on country of origin, years of experience, and speciality qualifications.Results: Canadian and Australian nurses reported their overall competency levels as high across all domains. Significant differences were found, between countries, in three of the six competency domains: foundational knowledge and skills (p<.001); collegiality (p=.023); andempathy (p<.0001).Conclusions: Describing perioperative competence cross-nationally represents the first step in generating international dialogue around educational preparation for migrating nurses. The increasing global mobility of nurses makes it imperative to further standardise, with an international perspective, knowledge and practice expectations in perioperative settings. [ABSTRACT FROM AUTHOR]

The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations. [ABSTRACT FROM AUTHOR]

How to stimulate student interest in social policy, while reinforcing its professional significance for social work, remains an understudied topic. This paper reports an evaluation of a teaching intervention that sought to enhance student interest in social policy by: more explicitly connecting social policy with professional social work practice; introducing an assessment exercise that involved visiting Parliament House; and undertaking weekly “hot policy topic” small group discussions. Social work students were found to be quite aware of the importance of social policy to professional practice. The intervention did not measurably increase interest in social policy, but heightened student awareness of their capacity to contribute to policy processes. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Nurses guide and support learning of students and new graduates in the workplace. A plethora of literature exists about learners needs in the workplace however nursing leadership teams also need to support experienced nurses who facilitate others’ learning. Aim: This study sought to develop a tool for Registered Nurses’ to report on the support they receive when they facilitate the learning of others. Scale development: An extensive literature review identified 28 papers about support RNs need to facilitate learning. Five re-occuring themes pertaining to workload, communication, acknowledgement, teamwork and preparation for role emerged from analysis of these papers. These were verified independently through focus groups. A 30-item instrument was generated based on the themes; further RN focus groups were conducted to ensure clarity of items. Testing of instrument: Data were collected from RNs working in medical and surgical areas across three acute care hospitals (ranging from 300 to 750 beds). A total of 372 registered nurses responded. Principle component analysis identified 5 distinct sub scales represented by 17 items with good reliability: workload 0.953; communication 0.847; acknowledgement 0.858; teamwork 0.852; preparation 0.942. Conclusion: This newly developed tool measures Registered Nurses perceptions of support they receive to fulfil their role in supporting the learning of others. The data generated from use of this tool can inform nursing leadership about the effectiveness of existing infrastructure and resources to support RNs. [Copyright &y& Elsevier]

Young novice drivers are significantly more likely to be killed or injured in car crashes than older, experienced drivers. Graduated driver licensing (GDL), which allows the novice to gain driving experience under less-risky circumstances, has resulted in reduced crash incidence; however, the driver's psychological traits are ignored. This paper explores the relationships between gender, age, anxiety, depression, sensitivity to reward and punishment, sensation-seeking propensity, and risky driving. Participants were 761 young drivers aged 17-24 ( M= 19.00, SD= 1.56) with a Provisional (intermediate) driver's licence who completed an online survey comprising socio-demographic questions, the Impulsive Sensation Seeking Scale, Kessler's Psychological Distress Scale, the Sensitivity to Punishment and Sensitivity to Reward Questionnaire, and the Behaviour of Young Novice Drivers Scale. Path analysis revealed depression, reward sensitivity, and sensation-seeking propensity predicted the self-reported risky behaviour of the young novice drivers. Gender was a moderator; and the anxiety level of female drivers also influenced their risky driving. Interventions do not directly consider the role of rewards and sensation seeking, or the young person's mental health. An approach that does take these variables into account may contribute to improved road safety outcomes for both young and older road users. [ABSTRACT FROM AUTHOR]

Due to their complex and fluctuating needs requiring multiple transitions of care through different services and systems, the early postdischarge period is one of the vulnerabilities for people with acquired neurological disability. This study aimed to (1) map and examine system-level care transitions, including change in transition patterns and service use among people with acquired neurological disability during the first 12 months postdischarge and (2) explore the relationship between early perceptions (3 months postdischarge) of obstacles and difficulty with health service access to the pattern of care transitions. From July 2019 to March 2020, this study recruited 93 participants with acquired neurological disability resulting from acquired brain (44%) or spinal cord injury (56%) from a tertiary hospital in Queensland, Australia. Data linkage methods were used to capture system-level care transitions as movements between three levels of health care: primary, specialist, and emergency care. Health service use during care transitions was also characterised. Standardised questionnaires were used to measure obstacles and difficulty accessing health services in relation to transportation, finance, and resource availability at 3 months postdischarge. The median number of care transitions was 8 (range: 0–47), and the most frequent category of care transition pattern was where participants transit between all levels of care: primary, specialist, and emergency (n = 51/93, 54.8%). However, the frequency, direction, and sequence of transitions between different levels of care were diverse amongst participants. Most participants used primary (96%) and specialist (97%) services, while 59% used emergency services. Overall, postdischarge care transitions were common and highly variable for people with acquired neurological disability. Early perceptions of transportation being an obstacle to service access was a marginally significant contributor (p = 0.051) to more care transitions. Further research to delineate the characteristics and complications of care transitions and service use will aid in developing more personalised, coordinated postdischarge trajectories. [ABSTRACT FROM AUTHOR]