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Staphylococcus argenteus and Staphylococcus schweitzeri, previously known as divergent Staphylococcus aureus clonal lineages, have been recently established as novel, difficult-to-delimit, coagulase-positive species within the S. aureus complex. Methicillin-resistant strains of S. argenteus are known from Australia and the UK. Knowledge of their epidemiology, medical significance and transmission risk is limited and partly contradictory, hampering definitive recommendations. There is mounting evidence that the pathogenicity of S. argenteus is similar to that of 'classical' S. aureus , while as yet no S. schweitzeri infections have been reported. To provide decision support on whether and how to distinguish and report both species. PubMed, searched for S. argenteus and S. schweitzeri. This position paper reviews the main characteristics of both species and draws conclusions for microbiological diagnostics and surveillance as well as infection prevention and control measures. We propose not distinguishing within the S. aureus complex for routine reporting purposes until there is evidence that pathogenicity or clinical outcome differ markedly between the different species. Primarily for research purposes, suitably equipped laboratories are encouraged to differentiate between S. argenteus and S. schweitzeri. Caution is urged if these novel species are explicitly reported. In such cases, a specific comment should be added (i.e. 'member of the S.aureus complex') to prevent confusion with less- or non-pathogenic staphylococci. Prioritizing aspects of patient safety, methicillin-resistant isolates should be handled as recommended for methicillin-resistant Staphylococcus aureus (MRSA). In these cases, the clinician responsible should be directly contacted and informed by the diagnosing microbiological laboratory, as they would be for MRSA. Research is warranted to clarify the epidemiology, clinical impact and implications for infection control of such isolates. [ABSTRACT FROM AUTHOR]

When researching with or about families in home-based research, there are numerous unexpected ethical issues that can emerge, particularly in qualitative research. This paper is based on reflective accounts of four homed-based research projects, two in the UK and two Australia, which examined ethical dilemmas identified when engaged in home-based research with young children. Using a synergy of ecocultural theory and Foucauldian ideas of Heterotopia as theoretical conceptualisations, the authors employed reflective lenses to guide their approach, and examine dilemmas and complexities when conducting research in the home. We argue that, to address ethical dilemmas, researchers need to problematise and reflect upon the nature of respectful approaches and the ethical implications of their behaviours. We conclude that, although ethical codes are valuable when researching families at home, researchers should plan for and forefront their methodological approaches in ways that are family-centred, whilst also framed by practices that are ethical, respectful and reflective to the situated contexts of family's ecologies and heterotopias. [ABSTRACT FROM AUTHOR]

This paper involves an examination of skilled manual work in the modern paper industry. The data were collected at five mills in three countries -- the UK, Australia and the USA. The questions were formulated in order to probe four theories of skilled work. The results suggest that the distinction between skilled and nonskilled work is a fundamental feature of occupational differentiation in all five plants. They also reveal that there are intra-skilled conflicts over relative pay and demarcation lines and that these are affected by the wider socio-political environment. [ABSTRACT FROM AUTHOR]

Background: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. Methods: Aim: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020–21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. Results: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. Conclusion: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media. [ABSTRACT FROM AUTHOR]

Background: Dysarthria after stroke is when speech intelligibility is impaired, and this occurs in half of all stroke survivors. Dysarthria often leads to social isolation, poor psychological well-being and can prevent return to work and social lives. Currently, a variety of outcome measures are used in clinical research and practice when monitoring recovery for people who have dysarthria. When research studies use different measures, it is impossible to compare results from trials and delays our understanding of effective clinical treatments. The aim of this study is to develop a core outcome set (COS) to agree what aspects of speech recovery should be measured for dysarthria after stroke (COS-Speech) in research and clinical practice. Methods: The COS-Speech study will include five steps: (1) development of a long list of possible outcome domains of speech that should be measured to guide the survey; (2) recruitment to the COS-Speech study of three key stakeholder groups in the UK and Australia: stroke survivors, communication researchers and speech and language therapists/pathologists; (3) two rounds of the Delphi survey process; (4) a consensus meeting to agree the speech outcomes to be measured and a follow-up consensus meeting to match existing instruments/measures (from parallel systematic review) to the agreed COS-Speech; (5) dissemination of COS-Speech. Discussion: There is currently no COS for dysarthria after stroke for research trials or clinical practice. The findings from this research study will be a minimum COS, for use in all dysarthria research studies and clinical practice looking at post-stroke recovery of speech. These findings will be widely disseminated using professional and patient networks, research and clinical forums as well as using a variety of academic papers, videos, accessible writing such as blogs and links on social media. Trial registration: COS-Speech is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database, October 2021 https://www.comet-initiative.org/Studies/Details/1959. In addition, "A systematic review of the psychometric properties and clinical utility of instruments measuring dysarthria after stroke" will inform the consensus meeting to match measures to COS-Speech. The protocol for the systematic reviews registered with the International Prospective Register of Systematic Reviews. PROSPERO registration number: CRD42022302998. [ABSTRACT FROM AUTHOR]

Securitization of the critical infrastructure as an important factor of national security has been among the aspects of wider changes in the security discourse since the end of the Cold War. The concept of critical infrastructure protection, initially focused on countering the terrorism threat, has been changing and expanding, from adopting the ‘all-hazard approach’, until the recent prevalence of the strategy of resilience in managing strategic security and operational risks. The sources of those risks are found mainly in climate-change induced natural hazards, as well as in global challenges of interconnection and interdependencies of critical infrastructure. The paper discusses the concepts of resilience and critical infrastructure, and then analyses the approaches to critical infrastructure protection and resilience in the United States, the United Kingdom and Australia. Analyzed are the official documents – strategies, laws and by-laws, reviews and guidelines produced by the governmental bodies of the mentioned countries, with the aim of clarification of the concept, as well as the countryspecific variations in its operationalization. [ABSTRACT FROM AUTHOR]

The article presents the reflections on coordinating a multi-country paper which emphasizes a means to an end. It offers information about a research to inform policy making in multi-country comparative health systems. The research involves the International Medical Workforce Collaborative (IMWC) member countries including Australia, U.S., and Great Britain.

Aims: To describe clinic management and referral pathways among adults with type 1 diabetes (T1D) aged > 25 years attending a public outpatient diabetes service. Methods: Retrospective cohort study of people with T1D aged > 25 years seen by endocrinologists in one Australian urban public outpatient in 2017. Electronic and paper medical records were reviewed using a dataset adapted from the UK National Institute for Health and Care Excellence 2015 guidelines. Results: Among the 111 people with T1D (mean age 41 ± 13 years, 55% men, mean body mass index 27.1 ± 5.6 kg/m2), mean HbA1c was 8.1 ± 1.9% (66 ± 19 mmol/mol) (lower than the Australian National Diabetes Audit: 8.5%/69 mmol/mol) with 25.5% meeting the guideline target of < 53 mmol/mol (7.0%). Most people had seen a diabetes educator (80.2%) or dietitian (73.0%) and had complication screening. Complication rates were high (nephropathy 20.4%, retinopathy 27.4%, peripheral neuropathy 30.1%, ischaemic heart disease/acute infarction 10.5%). Overall, 27% of referrals occurred following an acute inpatient admission or emergency department presentation and 13% for management of diabetes in pregnancy. Conclusions: A high proportion of people with T1D accessed public specialist care either during pregnancy or after a largely avoidable acute glycaemia-related hospital presentation. Subsequent care was in line with national specialist standards. This area has a "wait for acute event" rather than "complication prevention" model of care, associated with under-referral to the local multidisciplinary specialist service. Understanding how widespread this model of care is, and ways to reduce its prevalence, are urgently required. [ABSTRACT FROM AUTHOR]

This paper presents the spatial variation of area‐orientated annual maximum daily rainfall (AMDR), represented by well‐fitted generalized extreme value (GEV) distributions, over the last century in Great Britain (GB) and Australia (AU) with respect to three spatial properties: geographic locations, sizes, and shapes of the region‐of‐interest (ROI). The results show that the spatial variation of GEV location‐scale parameters is dominated by geographic locations and area sizes. In GB, there is an eastward‐decreasing banded pattern compared with a concentrically increasing pattern from the middle to coasts in AU. The parameters tend to decrease with increased area sizes in both studied regions. Although the impact of the ROI shapes is insignificant, the round‐shaped regions usually have higher‐valued parameters than the elongated ones. These findings provide a new perspective to understand the heterogeneity of extreme rainfall distribution over space driven by the complex interactions between climate, geographical features, and the practical sampling approaches. Key Points: Rainfall series are extracted and processed from more than 11,000 regions of interest over the last 100 years in Great Britain and Australia.Spatial distribution of extreme rainfall modeled qualitatively and quantitatively shows impact from location, size, and shape of regions.Methods and findings provide new perspectives for understanding the heterogeneous nature of climate variability and climatic change impact. [ABSTRACT FROM AUTHOR]

Academic, policy, and public concerns are intensifying around how to respond to increasing mental health problems amongst young people in OECD countries such as the UK and Australia. In this paper we make the case that public knowledge about mental health promotion, help-seeking, support and recovery can be understood as an enactment of public pedagogy--as knowledge practices and processes that are produced within and beyond formal spaces of learning. We explore the question of how new pedagogic modes of address are produced through digital technologies--social media, gamified therapies, e-mental health literacy, wearable technology--as they invite particular ways of knowing embodied distress as "mental illness or ill health." The rapid growth of formal and informal pedagogical sites for learning about youth mental health raises questions about the affective arrangements that produce new kinds of (ab)normal in the digital era. Through a posthumanist perspective that connects critical mental health studies and public pedagogy, this paper offers an original contribution that theorises pedagogic sites within the cultural formation of public-personal knowledge about mental (ill) health. [ABSTRACT FROM AUTHOR]

This paper examines recent social security policies in Australia and the UK for workless disabled people. The paper outlines developments in both countries over the past two decades and points to the fact that while there may be differences in the detail, the trends in such policies in the two countries are similar. This involves moves towards stricter eligibility criteria, greater expectation of workless disabled people to make efforts to (re)enter paid employment and, through such processes, a redrawing of the ‘disability category’ that denotes the ‘truly’ disabled from those who are deemed capable of doing at least some paid work. The paper goes on to consider explanations of such change, arguing that liberal explanations in the social administration tradition are problematic and that they, therefore, need to be placed within the neoliberal project, in particular its concern with putting people to work. The paper concludes that this has essentially involved a redrawing of the disability category to ensure a smaller number of people of working age in both countries can legitimately claim an existence outside of paid work. The paper also argues that more comparative research is required to understand the impacts of such trends on disabled people and provide insights for those resisting the influence of neoliberalism on welfare regimes. [ABSTRACT FROM AUTHOR]

Objective The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers. Design Cross-sectional study. Setting Electronic survey of participants from Australia, New Zealand and the United Kingdom. Subjects A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement. Main outcome measure Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or ≥15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC. Results No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years. Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p<0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p<0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p<0.001) increased odds of being diagnosed with CRC. Conclusion No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC. [ABSTRACT FROM AUTHOR]

Background Heuristic inquiry is a research approach that improves understanding of the essence of an experience. This qualitative method relies on researchers' ability to discover and interpret their own experience while exploring those of others. Aim To present a discussion of heuristic inquiry's methodology and its application to the experience of nurse migration. Discussion The researcher's commitment to the research is central to heuristic inquiry. It is immersive, reflective, reiterative and a personally-affecting method of gathering knowledge. Researchers are acknowledged as the only people who can validate the findings of the research by exploring their own experiences while also examining those of others with the same experiences to truly understand the phenomena being researched. This paper presents the ways in which the heuristic process guides this discovery in relation to traditional research steps. Conclusion Heuristic inquiry is an appropriate method for exploring nurses' experiences of migration because nurse researchers can tell their own stories and it brings understanding of themselves and the phenomenon as experienced by others. Implications for practice Although not a popular method in nursing research, heuristic inquiry offers a depth of exploration and understanding that may not be revealed by other methods. [ABSTRACT FROM AUTHOR]

As Arbo and Benneworth (2007) have alerted us, higher education institutions are now expected not only to conduct education and research, but also to play an active role in the development of their economic, social and cultural surroundings. They call this the ‘regional mission’ of HEIs. This paper is concerned with cultural engagement. Research on universities’ cultural engagement in their regions and the impact of that engagement is still in its infancy, partly because there are different understandings of ‘culture’ and of what ‘engagement’ entails. In this paper, qualitative data from the reports of mixed teams of academics and regional administrators involved in a large international project designed to improve universities’ regional engagement are analysed and discussed. The on-going study — PASCAL Universities' Regional Engagement (PURE) — investigates the role of HEIs in their regions across in a variety of fields such as the economy, community development, the environment and others. This article analyses the data from the study to identify the different perspectives universities and regions have of cultural engagement. The aim here is to demonstrate the value of PURE in facilitating the development of mutual understanding both between universities through a common language and between universities and their regions in respect of mutual expectations. For example, particularly difficult to de-construct is universities’ engagement with disadvantaged communities (Doyle, 2007) but Powell's (2009) work suggests that universities might engage more broadly and effectively ‘through better knowledge sharing and co-creation with business and community partners’ to become ‘real drivers of creative change in developing socially inclusive projects’. Others have written about the educational role of universities in developing a ‘lifelong learning culture’ in their region (European Universities’ Charter on Lifelong Learning, 2008). [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to outline some of the key issues related to migrant workers, work, public policy and HRM while introducing the five articles included in the special issue. Design/methodology/approach - The paper reports on the issue which is made up of articles that present research based on surveys, interviews and longitudinal census data. Findings - It is evident that high-performing economies attract migrants from lower-performing economies. However, with influxes of migrant labour there are a number of challenges that need to be met at the organisational and policy levels. Research limitations/implications - The indications are that some economies are beginning to slow and this means that migrant flows will also slow or reverse. The implications for migrant-dependent sectors and countries are not clear, although all five papers indicate areas for further research. Practical implications - Each article includes practical implications depending on the sector, skill and country being examined. Practical implications include the role of day labour centres as HR mediators between organisations and employees, the need for culturally sensitive and tailored training programs to assist professional migrants and the need for policies geared towards the assimilation of migrants and return migrants in order to assist their integration into the labour market. Originality/value - The five articles presented here represent a wide range of approaches, skill levels and sectors within the five counties examined: the USA, UK, Australia, Canada, and Finland. Some, such as the US paper which includes the first national survey of day labour worker centres, present findings from a highly under-represented area. [ABSTRACT FROM AUTHOR]

It is common to find final or near final year undergraduate Information Technology students undertaking a substantial development project; a project where the students have the opportunity to be fully involved in the analysis, design, and development of an information technology service or product. This involvement has been catalyzed and prepared for during their previous studies where the students have been told and shown how to develop similar systems. It is the belief that only through this 'real' project do they get the chance to experience something similar to what is expected of them when they embark on their chosen profession; that is, as an information technology professional. The high value of 'near real life' educational experience is recognized by many universities across the globe. The aim of this paper is to present examples from three countries - Australia, United Kingdom and South Africa, of the delivery of these team, capstone or industrial experience projects; their curricula and management processes. Academics from institutions in each of the countries share experiences, challenges and pitfalls encountered during the delivery of these information technology projects within their institutions. An overview of each institution's strategies is provided and highlights specific issues such as the selection of projects, allocation of teams to projects, legal requirements, assessment methods, challenges and benefits. The pedagogies presented here are not exhaustive; however, the three institutions do have in common the implementation of a combination of constructivism with a community of practice approach in delivering the project unit. The three universities recognize the need for industrial experience and learning of applied skills, and therefore make these projects a compulsory part of the curriculum. The projects tend to be real life business problems which are solved over a period of two semesters, and in the case of Cape Town it could be two consecutive years of two semesters each. These projects tend to involve practical development (for example databases and web sites). The process of project-to-team allocation is generally similar in all cases. Despite their differences, team work related problems are quite similar in all three cases presented, and seem to appear as a result of team work complexity, and the number of stakeholders involved. The intention of this paper is not to propose solutions to these problems (as these would be context dependent), but to draw the attention to the main problem categories for similar schemes, these are; • project selection, • management of students, • management of academic staff, • student team motivation, • equality and diversity, • passengers, and • assessment. Furthermore, it is not the intention of the authors to portray one approach as better than another, however, the approaches are representative of how team projects are being delivered across the globe, and in particular, in the contributing institutions. It is hoped that the assimilation and dissemination of information regarding the various approaches presented will nurture further discussion, and open communication across the globe with the view to enhancing the teaching and learning experience of such projects. [ABSTRACT FROM PUBLISHER]

This article questions the assumption that increasing competition among higher education institutions is the best method of achieving a strong higher education sector in developing countries. It notes that there has been increasing emphasis on the importance of higher education institutions for sustainable development, particularly because of their importance to the global knowledge economy. For the same reason, the appropriate management of the relationship between the state and higher education institutions is vital to a strong and dynamic future for these institutions. This paper proposes a menu of options for higher education governance, grouped around ‘state-centric’ and ‘neo-liberal’ models of development. The ‘state-centric’ model proposed is based on a variety of examples of high performing Asian economies, in particular, while the ‘neo-liberal’ model is based on emerging trends in higher education management in countries such as Australia, the United States and the United Kingdom. The paper suggests that despite pressure across the globe to encourage a market among universities, this may not always be the most efficient use of resources, or the best way to integrate universities in a country’s drive for economic growth. [ABSTRACT FROM AUTHOR]

The paper explores the dynamics of competition in higher education. National competition and global competition are distinct, but feed into each other. Higher education produces ‘positional goods’ (Hirsch 1976) that provide access to social prestige and income-earning. Research universities aim to maximise their status as producers of positional goods. This status is a function of student selectivity plus research performance. At system-level competition bifurcates between exclusivist elite institutions that produce highly value positional goods, where demand always exceeds supply and expansion is constrained to maximise status; and mass institutions (profit and non-profit) characterised by place-filling and expansion. Intermediate universities are differentiated between these poles. In global competition, the networked open information environment has facilitated (1) the emergence of a world-wide positional market of elite US/UK universities; and (2) the rapid development of a commercial mass market led by UK and Australian universities. Global competition is vectored by research capacity. This is dominated by English language, especially US universities, contributing to the pattern of asymmetrical resources and one-way global flows. The paper uses Australia as its example of system segmentation and global/national interface. It closes by reflecting on a more balanced global distribution of capacity. [ABSTRACT FROM AUTHOR]

Abstract As institutions established to administer the penal exile of British imperial subjects, the historic gaols of Australia and Ireland are linked by a painful legacy of involuntary transportation. Today, outstanding examples of these prisons are conserved and publicly presented as monuments of national significance. This paper considers material meanings associated with these unusual heritage places. Given their explicit historic association with British imperial power, what role do heritage prisons play in the formation of a postcolonial affiliation or consciousness? This paper will consider how heritage prisons have come to embody the emotive links of longing and belonging forged between the modern nations of Ireland and Australia. [ABSTRACT FROM AUTHOR]

The thesis of this paper is that governments of some otherwise enlightened states are increasingly fearful of acknowledging the restraints imposed on them by existing international law. They are also reluctant to enter into new commitments by way of international conventions that would expand the reach of international law. The paper asks whether these fears are based on a true understanding of international law or on some distorted view of it. It will draw comparisons and some contrasts between Australia and the United States in their reactions to a number of recent events as well as to some enduring situations of contemporary relevance. Had time (and the limits of my research) permitted, one might also have examined public attitudes toward international law in China, Japan, and Russia in this context, where similar fears appear to be entertained. France, Germany, Italy, and the United Kingdom, also enlightened states, appear by contrast to belong to a group more dedicated to international law. As Robert Kagan has recently remarked, the experience of two world wars at close quarters, and the formation of the European Union, have made the European countries more dedicated to process, where the United States is more interested in results. [ABSTRACT FROM AUTHOR]

This paper reports on a self-reported survey of performance in international construction joint ventures formed and operated by Australian and British contracting organizations. Based on previous studies, a questionnaire survey was developed to investigate the relationships between reported risk and success factors, and the performance of ventures. Through structural equation modeling, the paper empirically examines the effect of key processes such as partner selection, venture formation, and operation on venture performance. The results provide evidence that local partner attributes influence venture formation which, in turn, is strongly and positively related to its operation. These results also suggest that the negative impact of host government-related risks on venture formation is direct, while their impact on venture performance is indirect, through creating a “less certain” operating environment. Project-related risks appear to have strong and negative dual “direct and indirect” effects on venture performance. Based on these empirical results, the paper advocates that selecting a suitable complementary local partner and adopting a proactive risk management strategy are vital antecedents to successful venture performance. [ABSTRACT FROM AUTHOR]

This article concerns the principles by which courts determine the quantum of equitable compensation that a trustee must pay following a breach of trust. Traditional equitable principles focused on the trustee's obligation to account for his or her stewardship of the trust property, and to restore the assets of which he or she deprived it. The Supreme Court of the United Kingdom has recently confirmed that the earlier decision in Target Holdings Ltd v Redferns marked a shift in thinking about monetary remedies for breach of trust in England. This article addresses the question to what degree that shift towards a causal analysis represents the law in Australia, and to what degree it should do so. The argument advanced in this paper is that the underlying rationale of equity's traditional principles continues to hold good, and that the traditional principles represent the law in Australia and should continue to do so for the future. [ABSTRACT FROM AUTHOR]

Background: Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children.Methods: We conducted a systematic review of qualitative studies reporting lone parents' accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies.Results: Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts.Conclusion: WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW. [ABSTRACT FROM AUTHOR]

Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of "identity of pain," "recognition of pain," and "response to pain." The metaphor of "normalizing suffering" was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society--among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain--must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain. [ABSTRACT FROM AUTHOR]

This paper describes a new tool called 'Day-of-Care Survey', developed to assess inpatient delays in acute hospitals. Using literature review, iterative testing and feedback from professional groups, a national multidisciplinary team developed the survey criteria and methodology. Review teams working in pairs visited wards and used case records and bedside charts to assess the patient's status against severity of illness and service intensity criteria. Patients who did not meet the survey criteria for acute care were identified and delays were categorised. From March 2012 to December 2013, nine acute hospitals across Scotland, Australia and England were surveyed. A total of 3,846 adult general inpatient beds (excluding intensive care and maternity) were reviewed. There were 145 empty beds at the time of surveys across the nine sites, with 270 definite discharges planned on the day of the survey. The total number of patients not meeting criteria for acute care was 798/3,431 (23%, range 18-28%). Six factors accounted for 61% (490/798) of the reasons why patients not meeting acute care criteria remained in hospital. This survey gives important insights into the challenges of managing inpatient flow using system level information as a method to target interventions designed to address delay. [ABSTRACT FROM AUTHOR]

Abstract: The UK consumes almost 5% of world's wine production, drinking 12.9 million hectolitres annually or 21 l per capita per year. Australian wines are most popular with the UK consumer, accounting for around 17% of total take-home purchases. This paper focuses on Australian red wine and presents the life cycle environmental impacts of its consumption in the UK. The results indicate that a 0.75 l bottle of wine requires, for example, 21 MJ of primary energy, 363 l of water and generates 1.25 kg of CO2 eq. For the annual consumption of Australian red wine, this translates to around 3.5 PJ of energy, 600 million hectolitres of water and 210,000 t CO2 eq. Viticulture and wine distribution are the main hot spots contributing over 70% to the environmental impacts considered. Shipping in bulk rather than bottled wine would reduce the global warming potential (GWP) by 13%, equivalent to 27,000 t CO2 eq. annually. For every 10% increase in recycled glass content in bottles, the GWP would be reduced by 2% or 3600 t CO2 eq./yr; the savings in other environmental impacts are smaller (0.7–1.5%). A 10% decrease in bottle weight would reduce the impacts by 3–7%; for the GWP, the saving would be 4% or 7000 t CO2 eq./yr. If only 10% of the wine was packaged in cartons instead of glass bottles, the GWP savings would be 5% or 10,600 t CO2 eq./yr; the other impacts would also be reduced by 2–7%. These measures could together save at least 48,000 t CO2 eq./yr, almost a quarter of the current emissions from the UK consumption of Australian red wine. [Copyright &y& Elsevier]

The decision of the Malaysian government to make it compulsory for students to pass History at the Sijil Pelajaran Malaysia level in 2012 has attracted a positive response from Malaysian people. General public opinion on making history compulsory seems favourable on all sides of the social and political spectrum, but there remain many questions to be answered regarding the content of the history syllabus. Certain quarters have pushed for a re-evaluation of the syllabus that includes, amongst other things, the history of each Malaysian race and its leaders. This paper provides a comparison of the successes and failures of history education in developed countries including Britain, Australia and Canada, to consider whether Malaysia can learn from their experiences. It also provides an evaluation of Malaysia's history syllabus at Form Five level, particularly in terms of what, should properly constitute Malaysian history, as well as exploring the relevance of history teaching to the country's educational objectives. Finally, it explores problems of teaching history at school level. [ABSTRACT FROM AUTHOR]

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing. [ABSTRACT FROM AUTHOR]

Abstract: A small corpus of student e-mail requests to academic staff in a British and an Australian university was collected in order to investigate the cross-cultural nature of Englishes in these requesting events. The notions of account and but-justification, together with the concepts of equity and equilibrium are used to explicate the distribution of various features associated with these requests. Results indicate that the British data orient to deferential dependence whereas the Australian data exhibit interdependent egalitarianism. Finally, the process of our analysis brings to light the fact that we ought to refine theory of obligation and this, we do. The overall claims of this paper are that the situated nature of student e-mail requests can have a great bearing on the discursive construction of student identities, that this has a bearing on how things get done, and that how things get done in different varieties of English merits further investigation. [Copyright &y& Elsevier]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Joint geriatric/psychiatric wards are a potential solution to improving care of older patients with both psychiatric and medical illnesses in acute hospitals. A literature search using Medline, PsycINFO, Embase and CINAHL between 1980 and 2010 was carried out for information about joint wards for older people. Thirteen relevant papers were identified. These wards share common characteristics and there is evidence that they may reduce length of stay and be cost-effective, but there are no high-quality randomised controlled trials. Further research is needed, particularly regarding cost-effectiveness. [ABSTRACT FROM AUTHOR]

This paper evaluates the processes and mechanisms available for integrating different types of knowledge for environmental management. Following a review of the challenges associated with knowledge integration, we present a series of questions for identifying, engaging, evaluating and applying different knowledges during project design and delivery. These questions are used as a basis to compare three environmental management projects that aimed to integrate knowledge from different sources in the United Kingdom, Solomon Islands and Australia. Comparative results indicate that integrating different types of knowledge is inherently complex – classification of knowledge is arbitrary and knowledge integration perspectives are qualitatively very different. We argue that there is no single optimum approach for integrating local and scientific knowledge and encourage a shift in science from the development of knowledge integration products to the development of problem-focussed, knowledge integration processes. These processes need to be systematic, reflexive and cyclic so that multiple views and multiple methods are considered in relation to an environmental management problem. The results have implications for the way in which researchers and environmental managers undertake and evaluate knowledge integration projects. [Copyright &y& Elsevier]

Working from recently declassified Australian and British government files, this paper examines the archival evidence on policy thinking in London and Canberra towards the Five Power Defence Arrangements (FPDA) during the period 1970-75. The article argues that one of the main reasons for the Heath government's decision to deploy a token military force in Southeast Asia as part of a multilateral defence arrangement with Australia, New Zealand, Malaysia and Singapore was the desire to uphold these Commonwealth connections. By contrast, Canberra was beginning to question the value of such arrangements in a rapidly changing Southeast Asian strategic environment. [ABSTRACT FROM AUTHOR]

This paper builds on earlier work by the author to explore the international dimensions of a study of the changing roles and identities of professional staff in higher education (Whitchurch , ). It further develops the concept of the blended professional, characterising individuals with identities drawn from both professional and academic domains, and examines the institutional spaces, knowledges, relationships and legitimacies that they construct. Comparisons between the United Kingdom, Australia and the United States are used to provide indicators of possible futures for this group of staff, including their positioning in the university community, the challenges they face, and the potentials that they offer to their institutions. [ABSTRACT FROM AUTHOR]

As a result of a rise in divorce rates coupled with an increased prevalence of cohabitation, a growing percentage of the population has experienced or will experience the breakdown of a relationship and also the possibility of forming another new relationship. This paper explores the impact of previous relationship and fertility histories on repartnering. Using a longitudinal approach we compare the nature of repartnering behaviour in the United Kingdom and Australia, countries with similar policy and legislative frameworks. Using prospective panels surveys (British Household Panel Survey and the Household, Income and Labour Dynamic in Australia), we find that within five years of becoming single, an estimated 49 per cent of the United Kingdom sample and 43 per cent of the Australian sample had entered a new relationship, most commonly cohabitation. Event history analysis reveals strong repartnering patterns by age, and residency of children. The effect of previous relationship type suggests that people who have previously cohabited are more likely to repartner that those who did not. [ABSTRACT FROM AUTHOR]

Using recently declassified archival material pertaining to the Chartered Bank of India Australia and China, this article foregrounds quantitative evidence that sheds new light on the history of British banks in Asia. It shows that Hong Kong came to play a critical role in the bank's note issue strategy after the Straits Settlements had moved off the silver standard in 1906. Locally denominated notes issued on mainland China complemented the Hong Kong issue. However, their circulation volume dropped dramatically during the anti-British boycott that followed the May Thirtieth Incident (1925). [ABSTRACT FROM AUTHOR]

Background: In Australia and internationally, there is concern about the growing proportion of women giving birth by caesarean section. There is evidence of increased risk of placenta accreta and percreta in subsequent pregnancies as well as decreased fertility; and significant resource implications. Randomised controlled trials (RCTs) of continuity of midwifery care have reported reduced caesareans and other interventions in labour, as well as increased maternal satisfaction, with no statistically significant differences in perinatal morbidity or mortality. RCTs conducted in the UK and in Australia have largely measured the effect of teams of care providers (commonly 6-12 midwives) with very few testing caseload (one-to-one) midwifery care. This study aims to determine whether caseload (one-to-one) midwifery care for women at low risk of medical complications decreases the proportion of women delivering by caesarean section compared with women receiving 'standard' care. This paper presents the trial protocol in detail. Methods/design: A two-arm RCT design will be used. Women who are identified at low medical risk will be recruited from the antenatal booking clinics of a tertiary women's hospital in Melbourne, Australia. Baseline data will be collected, then women randomised to caseload midwifery or standard low risk care. Women allocated to the caseload intervention will receive antenatal, intrapartum and postpartum care from a designated primary midwife with one or two antenatal visits conducted by a 'back-up' midwife. The midwives will collaborate with obstetricians and other health professionals as necessary. If the woman has an extended labour, or if the primary midwife is unavailable, care will be provided by the back-up midwife. For women allocated to standard care, options include midwifery-led care with varying levels of continuity, junior obstetric care and community based general medical practitioner care. Data will be collected at recruitment (self administered survey) and at 2 and 6 months postpartum by postal survey. Medical/obstetric outcomes will be abstracted from the medical record. The sample size of 2008 was calculated to identify a decrease in caesarean birth from 19 to 14% and detect a range of other significant clinical differences. Comprehensive process and economic evaluations will be conducted. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN012607000073404. [ABSTRACT FROM AUTHOR]

This paper compares climate change campaigns conducted by environmental nongovernment organizations (NGOs) in the United Kingdom (UK) and Australia. The NGOs represent a diversity of political access, financial resources, and international connections. Three campaign activities common to both countries undertaken between 2004 and 2006 are analyzed for their effectiveness via interviews and document review. This examination is embedded within an analysis of the political, economic, policy, and social contexts of each country. It is shown that in the UK climate change has been used as a pivotal leadership issue, that the fossil fuel industry’s influence is not predominant, and that NGOs enjoy political legitimacy. Whereas, in Australia climate change has only recently emerged as a political priority, the fossil fuel industry has had significant political and financial influence, and NGO advocacy has been marginalized. It is argued that NGOs are embedded in the political and policy contexts of their country, and the greatest campaign traction and NGO influence can only be achieved when these contexts provide favorable conditions. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper is to contribute to pertinent discussions regarding advanced practice nursing roles. In particular discussion will focus on the potential implications for the developing nurse ractitioner (NP) role on the existing clinical nurse specialist (CNS) roles. Setting: The literature presented originates primarily from the United States of America (USA), United Kingdom and Australia. Specific emphasis is placed on the psychiatric/mental health nursing context. Primary argument: Amidst the confusion in terminology to describe and explain advanced, expanded or extended nursing roles, and to distinguish between the clinical nurse specialist and the nurse practitioner, there is a need to establish clarity. The need for both clinical nurse specialist and nurse practitioner roles has been hotly debated in the USA. Conclusions: The roles of clinical nurse specialist and nurse practitioner may be complementary but fulfil different functions. It is therefore important that both roles be maintained and implemented in response to consumer and health service needs. [ABSTRACT FROM AUTHOR]

While some forms of public-private partnerships are a feature of hospital construction and operation in all countries with mixed economies, there is increasing interest in a model in which a public authority contracts with a private company to design, build and operate an entire hospital. Drawing on the experience of countries such as Australia, Spain, and the United Kingdom, this paper reviews the experience with variants of this model. Although experience is still very limited and rigorous evaluations lacking, four issues have emerged: cost, quality, flexibility and complexity. New facilities have, in general, been more expensive than they would have been if procured using traditional methods. Compared with the traditional system, new facilities are more likely to be built on time and within budget, but this seems often to be at the expense of compromises on quality. The need to minimize the risk to the parties means that it is very difficult to "future-proof" facilities in a rapidly changing world. Finally, such projects are extremely, and in some cases prohibitively, complex. While it is premature to say whether the problems experienced relate to the underlying model or to their implementation, it does seem that a public-private partnership further complicates the already difficult task of building and operating a hospital. [ABSTRACT FROM AUTHOR]

This paper describes the process of review, design, and delivery of a course in modern embedded systems, an international collaborative teaching project involving the University of New South Wales (Australia), Manchester University, and Imperial College, London University (United Kingdom). This project, being the first of its kind anywhere in the world, provides a learning environment that replicates the current industrial practice in embedded systems design in an easy and comprehensible setting, an environment where the processor, dedicated coprocessors, and software are all integrated to create a functional system such as used in sophisticated electronic devices, including mobile phones, Web phones, televisions, digital cameras, and personal digital assistants. Such collaborations are important in both reducing development costs in developing up-to-date, and increasingly sophisticated, courses and in addressing pedagogical issues that are common between computer and electrical engineering programs in all academic institutions. To assist students' learning experience, the course is supported with purpose built state-of-the-art programmable hardware and software development platforms, carefully planned laboratory experiments, lecture notes, weekly online quizzes, tutorials, and a companion CD-ROM as a learning tool. Since the introduction of this complete package, students' satisfaction, assessment results, and skills obtained through evaluation and assessment methods have improved markedly. [ABSTRACT FROM AUTHOR]

Public interest in assisted reproduction (AR) has remained high since the birth of the first 'test tube baby' in the United Kingdom in 1978. Australian scientists have been frontrunners in the development and implementation of reproductive technology and recently, there has been renewed debate about government funding and access to AR. This paper provides a timely overview of reproductive technology services in Australia and examines the body of social research on the impacts of this technology, particularly previous research on how women and their partners experience assisted reproduction procedures. The popular expectations of success are compared to the latest success rates. It is argued that there is a need for more social research to counterbalance the dominance of the biomedical aspects of AR, in particular, for more research into people's actual experiences of AR, expectations of the likelihood of success, access issues and on the general impact of involuntary childlessness. [ABSTRACT FROM AUTHOR]

The global expansion of access to higher education has increased demand for information on academic quality and has led to the development of university ranking systems or league tables in many countries of the world. A recent UNESCO/CEPES conference on higher education indicators concluded that cross-national research on these ranking systems could make an important contribution to improving the international market for higher education. The comparison and analysis of national university ranking systems can help address a number of important policy questions. First, is there an emerging international consensus on the measurement of academic quality as reflected in these ranking systems? Second, what impact are the different ranking systems having on university and academic behavior in their respective countries? Finally, are there important public interests that are thus far not reflected in these rankings? If so, is there a needed and appropriate role for public policy in the development and distribution of university ranking systems and what might that role be? This paper explores these questions through a comparative analysis of university rankings in Australia, Canada, the UK, and the US. [ABSTRACT FROM AUTHOR]

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States. We also examine the policy challenges for workforce planning and the design of health systems infrastructure. Data are derived from registries of professional nurses, censuses, interviews with key informants, case studies in source and destination countries, focus groups, and empirical modelling to examine the patterns and implications of the movement of nurses across borders. The flow of nurses to these destination countries has risen, in some cases quite substantially. Recruitment from lower-middle income countries and low-income countries, as defined by The World Bank, dominate trends in nurse migration to the United Kingdom, Ireland, and the United States, while Norway and Australia, primarily register nurses from other high-income countries. Inadequate data systems in many countries prevent effective monitoring of these workforce flows. Policy options to manage nurse migration include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Recommendations for enhancements to workforce data systems are provided. [ABSTRACT FROM AUTHOR]

The differences in internal mobility between national populations are large and complex in origin. In studying them we must use comparable indicators. This paper discusses how measures of migration intensity at the national level should be constructed, drawing on analyses of residential mobility in Australia and Britain. We argue for the tailoring of intensity measures to observation plan and to age-time plan, and for removing the effects of mortality and external migration on census-based measures. We propose simple estimation of infant migrants, a standard stopping-age in calculating gross measures of migration, and argue for the use of a common population for computing age-standardized measures of migration and a common mortality schedule for computing migration expectancies. We conclude with recommendations for developing comparable cross-national measures of migration intensity. [ABSTRACT FROM AUTHOR]

One of the most familiar theories about politics in Australia, as in Britain, is that the political parties are divided fundamentally on class lines. But the strength and nature of the link between class and party remains both controversial and unclear. This paper brings new evidence to bear by applying powerful multivariate techniques to national sample survey data from Australia, Britain and the USA. We distinguish three separate aspects of class: the categorical distinction between blue- and white-collar workers which informs the standard definition of class in political science; an occupational status aspect which ranks jobs on a continuum running from low to high; and conflict aspects, based on 'ownership of the means of production', on the 'exercise of authority in the workplace', and the cleavage between public and private employees. We show, first, that these quite distract aspects of class have different effects. In Australia occupational status has important effects on income and class self-image but is politically irrelevant. The much maligned blue-collar/white-collar distinction is, indeed, financially irrelevant but, none the less, has appreciable effects on class self-image and political preferences, while the conflict aspects have modest but dear effects on income, class self-image and politics. Whether or not an individual is a public employee is consistently important in all three countries. Second, the impact of class on party is relatively modest, albeit cler. Finally, these patterns are quite similar in Australia, Britain and the USA. [ABSTRACT FROM AUTHOR]

Debate on teacher quality and quality in teaching and teacher education has been as vigorous in Australia as it has been in the UK and the USA In Australia, however, reform in teacher education has been subsumed within a national metapolicy of corporate federalism which is an amalgam of beliefs or discourses including neo-corporatism, economic rationalism, corporate managerialism and human capital The paper analyses the most recent document on reform of teacher education in Australia (the Ebbeck Report) and shows how its policy formulation is influenced by the discourse of corporate federalism It also shows how micro-economic reform in this sector is related to reforms in other sectors of education. [ABSTRACT FROM AUTHOR]

Background: Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. Methods: A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care. Results: The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East. Conclusions: This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran. [ABSTRACT FROM AUTHOR]

Background: In 2006, the British government launched 'Improving Access to Psychological Therapies' (IAPT), a low intensity cognitive behaviour therapy intervention (LiCBT) designed to manage people with symptoms of anxiety and depression in the community. The evidence of the effectiveness of IAPT has been demonstrated in multiple studies from the UK, USA, Australia and other countries. MindStep™ is the first adaptation of IAPT in Australia, delivered completely by telephone, targeting people with a recent history of a hospital admission for mental illnesses within the private health system. This paper reports on the outcome of the first 17 months of MindStep™ implemented across Australia from March 2016. Methods: This prospective observational study investigated the MindStep™ program in a cohort of clients with a recent hospitalisation for mental illnesses. The study used quantitative methods to compare pre-post treatment clinical measures (N = 680) using Patient Health Questionnaire (PHQ-9) and the Generalised Anxiety Disorder (GAD-7). This study also included in-depth interviews with participants (N = 14) and coaches (N = 4) to determine the feasibility and acceptability of the program. Results: Of the 867 clients referred to MindStep™, 757 had initial assessments by phone making an enrolment rate of 87.3%. Following assessment, 680 commenced treatment and of them, 427 (62.7%) completed treatment. According to 'per-protocol' analysis (N = 427), there was a large effect size for post-treatment PHQ-9 (d = 1.03) and GAD-7 (d = 0.99) scores; reliable recovery rate was 62% (95% CI: 57–68%). For intent-to-treat analysis using multiple imputation (N = 680), effect sizes were also large for pre-post treatment change: PHQ-9 (d = 0.78) and GAD-7 (d = 0.76). The reliable recovery rate was 49% (95% CI: 45–54%). Qualitative findings supported these claims where participants were positive about MindStep™ and found the telephone delivery and use of mental health coaches highly acceptable. Conclusions: MindStep™ has demonstrated encouraging outcomes that suggest LiCBT can be successfully delivered to people with a history of hospital admissions for anxiety and depressive disorders and achieve target recovery rates of > 50%. Other promising evaluation findings indicate the MindStep™ option is acceptable, feasible and safe within the stepped models of mental health care delivery in Australia. [ABSTRACT FROM AUTHOR]