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Objective: To evaluate the suitability and acceptability of virtual training post accreditation visits conducted online for medical specialist training in ophthalmology in Australia and New Zealand. Methods: A two-phase study (pilot and implementation) was conducted. In the pilot phase, an open-ended observation proforma was used by the authors to independently record their observations, which were later compared and discussed until consensus was achieved. All participants were asked to complete an online survey. A document analysis of accreditation documents was conducted. Observation data were broken down into themes and triangulated with online survey and document analysis results. In the implementation phase, the inspections were observed by one of the authors (SK) and the observation notes were discussed with other authors to obtain a contextual and consensual view. A document analysis of all accreditation-related documentation was undertaken. The documents included in the document analysis were planning and scheduling records, interview and inspection notes, training post inspection fact and document notices and accreditation reports. Finally, a post-inspection focus group of all inspectors was conducted. Results: The accreditation interviews adequately addressed all relevant issues with high levels of robustness and reliability. Participants found it more difficult to discuss complex issues virtually compared with onsite visits. The virtual accreditation reports were not any different to what would be expected if a face-to-face accreditation visit had been conducted; however, it was not possible using the virtual inspection to determine the appropriateness of facilities and clinic layout to support and facilitate trainee learning and supervision. Conclusions: Virtual accreditation of training posts in medical specialist training is viable in limited circumstances where there are no known complex training post-related issues and the site has not made substantial changes to clinic and theatre layout, equipment and facilities since the previous accreditation. What is known about the topic? All medical specialist colleges in Australia and New Zealand accredit the sites where training is delivered, usually by conducting periodic face‐to‐face visits. What does this paper add? This paper provides evidence that in limited circumstances, it is possible to accredit training posts virtually. What are the implications for practitioners? This paper provides an outline of issues to consider when planning virtual accreditation of training posts in medical specialist education. [ABSTRACT FROM AUTHOR]

Heart failure is a chronic condition with various implications for individuals and families. Although the importance of implementing palliative care is recommended in best practice guidelines, implementation strategies are less clear. This study sought to; (1) determine Australian and New Zealand cardiovascular nurses and physicians' end of life care attitudes and specialist palliative care referral in heart failure and; (2) determine self-reported delivery of supportive care and attitudes towards service names. An electronic survey was emailed to members of four peak bodies and professional networks. Participants were also recruited through social media. Paper-based versions of the survey were completed by attendees of the 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, August 2018. There were 113 completed responses included in the analyses. Participants were nurses (n = 75), physicians (n = 32) and allied health professionals (n = 4). Most (67%) reported they were comfortable with providing end of life care; however, fewer respondents agreed they received support for their dying patients and one-third experienced a sense of failure when heart failure progressed. Most (84–100%) participants agreed they would refer a heart failure patient later in the illness trajectory. There was a more favourable attitude towards the service name 'supportive care' than to 'palliative care'. Comfort with end of life discussions is encouraging as it may lead to a greater likelihood of planning future care and identifying palliative care needs. Peer support and supervision may be useful for addressing feelings of failure. The use of needs-based assessment tools, adopting the service name 'supportive care' and further research focusing on primary palliative team-based approach is required to improve palliative care access. Cardiovascular nurses and physicians are comfortable providing end of life care, but referrals to palliative care in the later stages of heart failure persists. [ABSTRACT FROM AUTHOR]

Background: Global health (GH) training aims to equip clinicians with the skills and knowledge to practise in international and cross‐cultural environments. Interest among obstetrics and gynaecology trainees is unknown. Aims: The Trainee Interest in Global Health Training (TIGHT) study aimed to assess demand for GH training among specialty trainees in Australia and New Zealand. The primary objective was to quantify the number of trainees interested in undertaking a rotation in a resource‐limited environment (RLE) in a low‐ or middle‐income country during specialty training. This paper reports the results of a planned sub‐group analysis of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees. Materials and Methods: A cross‐sectional study was conducted between August and October 2018. Data were collected using an anonymous, self‐reporting, web‐based survey. Results: There were 210 respondents among 698 RANZCOG trainees, equating to a response rate of 30.1%. Overall, 77% (157/204) of respondents were keen to undertake a rotation in a RLE, with the vast majority (166/203, 81.8%) interested or very interested in having their GH accredited for training. Sixty‐four percent (125/195) expressed interest in undertaking an integrated GH training or fellowship program as an adjunct to specialty training, and a majority (177/201, 88.1%) were keen to continue GH work as a specialist obstetrician and gynaecologist. Conclusion: There is significant demand for GH training among RANZCOG trainees. These findings should inform the development of accredited rotations in RLEs and the cultivation of safe and effective global women's health training pathways. Ideally, these arrangements should be underpinned by mutually beneficial partnerships with both educational and development objectives. [ABSTRACT FROM AUTHOR]

Objective: This study reports on the characteristics of individuals conducting health service research (HSR) in Australia and New Zealand, the perceived accessibility of resources for HSR, the self-reported impact of HSR projects and perceived barriers to conducting HSR. Methods: A sampling frame was compiled from funding announcements, trial registers and HSR organisation membership. Listed researchers were invited to complete online surveys. Close-ended survey items were analysed using basic descriptive statistics. Goodness of fit tests determined potential associations between researcher affiliation and access to resources for HSR. Open-ended survey items were analysed using thematic analysis. Results: In all, 424 researchers participated in the study (22% response rate). Respondents held roles as health service researchers (76%), educators (34%) and health professionals (19%). Most were employed by a university (64%), and 57% held a permanent contract. Although 63% reported network support for HSR, smaller proportions reported executive (48%) or financial (26%) support. The least accessible resources were economists (52%), consumers (49%) and practice change experts (34%); researchers affiliated with health services were less likely to report access to statisticians (P < 0.001), economists (P < 0.001), librarians (P = 0.02) and practice change experts (P = 0.02) than university-affiliated researchers. Common impacts included conference presentations (94%), publication of peer-reviewed articles (87%) and health professional benefits (77%). Qualitative data emphasised barriers such as embedding research culture within services and engaging with policy makers. Conclusions: The data highlight opportunities to sustain the HSR community through dedicated funding, improved access to methodological expertise and greater engagement with end-users. What is known about the topic?: HSR faces several challenges, such as inequitable funding allocation and difficulties in quantifying the effects of HSR on changing health policy or practice. What does this paper add?: Despite a vibrant and experienced HSR community, this study highlights some key barriers to realising a greater effect on the health and well-being of Australian and New Zealand communities through HSR. These barriers include limited financial resources, methodological expertise, organisational support and opportunities to engage with potential collaborators. What are the implications for practitioners?: Funding is required to develop HSR infrastructure, support collaboration between health services and universities and combine knowledge of the system with research experience and expertise. Formal training programs for health service staff and researchers, from short courses to PhD programs, will support broader interest and involvement in HSR. [ABSTRACT FROM AUTHOR]

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

Introduction: This paper reports the key findings of the first survey of Australian, New Zealand (ANZ) and Singaporean radiation oncology trainees on contouring and planning.Methods: The survey was conducted from May to July 2018 using a 35-question instrument. It was emailed to all ANZ and Singaporean trainees on the Royal Australian and New Zealand College of Radiologists (RANZCR) database with at least 6 months experience. The questions related to demographics, time spent on contouring, most difficult sites to contour, most useful atlas, feedback on contouring, interaction with radiation therapists, plan reviews, stereotactic radiation therapy (SBRT), brachytherapy and suggested areas of improvement. Respondents were assured that their responses were anonymous.Results: The response rate was 50% (54/108). Most respondents were from New South Wales (31%) with nearly all working full time (96%) and a large majority in public practice (89%). All respondents had at least one other accredited trainee at their site. The large majority (75%) spent at least two hours per week contouring, but nearly 80% had to spend some time out of hours contouring with 10% performing all their contouring out of hours. Two-thirds of respondents indicated there was insufficient time for contouring with over half having no allocated time for this activity. All respondents were allowed to independently contour by their consultants and were allowed to do radical and palliative cases. The most difficult cases to contour were head and neck and the upper gastrointestinal sites with the RTOG atlas the most useful guide. All trainee respondents received feedback on their contouring which was most often face to face. Interaction with radiation therapists was valuable and more interaction was desired. Two-thirds (67%) of respondents had the opportunity to review treatment plans with consultants with one to two cases per week being the most common numbers reviewed, but this was usually not done (87%) on an allocated time in the roster. The large majority (90%) had the opportunity to be involved in brachytherapy, but this dropped to 60% for SBRT. Three quarters (73%) of respondents felt that there was not enough time spent on contouring, planning and evaluation of plans.Conclusions: This initial detailed survey of ANZ and Singaporean trainees on contouring and planning indicates that dedicated protected time without interruption is required for this integral activity with current hours spent on this activity inadequate. Optimisation and improvement in a number of areas is required. Feedback from this study should be adopted by sites and networks. Feedback could also be considered as the Faculty of Radiation Oncology transitions into programmatic assessment. [ABSTRACT FROM AUTHOR]

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

This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms. [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/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

This article examines the results of the world's largest ever survey of international relations (IR) scholars with an eye to establishing the particularities of the discipline in Australia and New Zealand. The survey covered the areas of teaching, research, the structure of the profession and scholars' views on foreign policy. From these results, this paper compares IR in New Zealand and Australia, and discusses the extent to which the discipline in these two countries is distinctive from its overseas counterparts, especially in the United States and the United Kingdom. The particular areas of focus include the degree to which the field in Australasia conforms to or differs from US or Commonwealth identities; epistemological and gender divides; the distinctive foci of what IR scholars in both countries teach and research; which publications are favoured and disfavoured; and the contrasting linkages between academia and the world of government and policy. We conclude with some suggestions about how the field in both countries might be improved. [ABSTRACT FROM AUTHOR]

Healthcare systems have a vested interest in employing work-ready graduates. The challenge for universities is to find ways to provide workplace learning that incorporates student education and high quality patient care. Inland areas of Australia, similar to other rural locations globally, experience additional challenges including a relatively high incidence of ill health, increasing demand for health services, chronic workforce shortages and ageing of the existing rural health workforce. In this paper, we conceptualise and describe the research findings related to context from a consultative enquiry into university clinics conducted in 2008. Interview participants were drawn from twenty university clinics in Australia and New Zealand. A consistent theme throughout the interviews was tensions that arose between the role of education and healthcare provision within university clinics. Many interview participants described ways they managed these tensions to meet the expectations of students, educators and the community. The patient supply is the most critical factor in the context of university clinic operations. It is vital to both the educator and the healthcare provider roles. In inland areas with sparse populations a number of strategies, such as outreach clinics, hospital or health centre- based clinics and multi-disciplinary sites, will have to be developed if university clinics are to operate effectively for students and patients. [ABSTRACT FROM AUTHOR]

Because the nature, tempo and trajectories of biological changes that follow the cessation of trawling are unknown for seamounts, it is unclear whether closing them to trawling will lead to a recovery of the fauna and, if so, over what time scales. This paper reports on a ‘test of recovery’ from repeated towed camera surveys on three seamounts off New Zealand in 2001 and 2006 (5 years apart) and three off Australia in 1997 and 2006 (10 years apart). In each region, seamounts where trawling had ceased were compared to adjacent seamounts where trawling was still active, and to seamounts that had never been trawled. If recovery signals existed, the likelihood of detecting them was high because the seamounts were relatively small and topographically simple, and because quantitative survey methods were employed. Multivariate patterns showed no change in the megafaunal assemblage consistent with recovery over a 5–10 year timeframe on seamounts where trawling had ceased. Results based on the number of species and diversity were equivocal, with some cases of increase and decrease on seamounts where trawling had ceased. A few individual taxa were found at significantly higher abundance in the later surveys where trawling had occurred. We suggest this may have resulted from their resistance to the direct impacts of trawling (two chrysogorgid corals and solitary scleractinians), or from protection in natural refuges inaccessible to trawls (unstalked crinoids, two chrysogorgid corals, gorgonians, and urchins). Alternatively, these taxa may represent the earliest stages of seamount recolonisation. They have potential to be dominant for long periods because the pre-trawling composition of benthic assemblages on seamounts includes taxa that grow slowly and/or have an association with ‘thickets’ of a single keystone stony coral ( Solenosmilia variabilis) that has generated biogenic habitat over millennia. Resilience of seamount ecosystems dominated by corals is low compared to most other marine systems subject to disturbance by bottom trawling because there are no alternative habitats of the same value for supporting associated species, and because trawling typically removes coral habitat from large areas of individual seamounts. Management to conserve seamount ecosystems needs to account for changing oceanographic conditions (ocean acidification), as well as the direct impacts of human activities such as bottom trawling. Networks of spatial closures that include intact habitats over a range of depths, especially <1500 m, and on clusters and isolated seamounts, may be effective by maintaining the resilience of seamount benthic communities. [ABSTRACT FROM AUTHOR]

International volunteering is increasingly recognised as a form of alternative tourism. However, the nature of the ‘alternative’ experience gained, and the ensuing narrative between host and volunteer, remains under-explored in published research, especially in volunteer tourism research within a cultural context in a developed nation. This paper examines the nexus between volunteer tourism and cultural tourism in the search for alternative and sustainable experiences through tourism. Qualitative research using in-depth interviews, diaries and participant observation was conducted to examine the pre-, during and post-trip experiences of 12 Australian visitors undertaking organised volunteer activities in an indigenous Maori community in the North Island of New Zealand during January 2005. Members of the indigenous Maori community were also interviewed to provide an important host perspective. Findings suggest that the nature of the interaction and cultural experiences gained were perceived as mutually beneficial and seemingly different from those gained from traditional cultural products. In particular, the volunteers experienced an alternative Maori cultural product and engaged in a different narrative with their Maori hosts through their volunteer work, one rich in authentic cultural content, genuine and reflective of modern Maori life in New Zealand society. [ABSTRACT FROM AUTHOR]