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This review aims to identify healthcare providers' (HCPs) experiences with issues related to the quality use of medicines among culturally and linguistically diverse (CALD) patients, the underlying factors, and the enablers of and barriers to providing culturally safe care to promote quality use of medicines. The searched databases were Scopus, Web of Science, Academic search complete, CINHAL-Plus, Google Scholar and PubMed/Medline. The initial search returned 643 articles, of which 14 papers were included. HCPs reported that CALD patients were more likely to face challenges in accessing treatment and sufficient information about treatment. According to the theoretical domains framework, determinants such as social influences due to cultural and religious factors, lack of appropriate resources about health information and cultural needs, lack of physical and psychological capabilities such as lack of knowledge and skills, and lack of motivation could impede HCPs' abilities to provide culturally safe care. Future interventions should deploy multilevel interventions, such as education, training, and organisation structural reforms. [ABSTRACT FROM AUTHOR]

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms. [ABSTRACT FROM AUTHOR]

This study was designed to understand the interaction between Christian faith and gender incongruence. An anonymous online survey was advertised to the Australian Christian community. Individuals with first-hand experience of transgender issues were eligible to participate. There were 122 eligible responses. This paper describes the experience of the 30 participants experiencing gender incongruence. Persons in the church experiencing gender incongruence desired to hold onto faith. As a result, they experienced a tension between the desire to remain in the church, and the desire to live congruously with their gender, which could lead to expulsion. Strategies to reconcile these two factors varied. [ABSTRACT FROM AUTHOR]

Domestic/family violence (DFV) and child protection co-occurrence of risk is common, with related homicides remaining a grave public concern. Recognising and prioritising high-risk cases that pose a lethal risk remains a complex challenge for practitioners across a range of services and legal jurisdictions. There are significant gaps in practice knowledge about how to assess and respond to high-risk cases involving child protection and DFV concerns, while working safely and effectively. This paper reports on qualitative research conducted with practitioners from a range of justice and service delivery organisations in Queensland, Australia. A community of practice, supported by the U.S. based Safe & Together Institute, provided the forum for data to be collected on participants' reflections and observations. An action research framework was employed to connect practice learning into research data through an iterative cycle of reflection and review. Ethnographic note taking was used to document arising policy and practice issues. Discussions in the CoP were also recorded and transcribed verbatim. Thematic analysis was undertaken combining inductive and deductive techniques. Key findings include: learning from and partnering with women; applying a perpetrator pattern-based approach in high-risk cases; engaging with men as fathers; and improving the role of the judicial system. Practice needs to be informed by centring the victim/survivor perspective, which requires a collaborative approach while maintaining system integrity to hold the perpetrator within system responses to ensure accountability. There are important learnings for developing service sector responses and future research on high-risk cases. [ABSTRACT FROM AUTHOR]

Background: This paper investigates the content of Australian policies that address withholding or withdrawing life-sustaining treatment to analyse the guidance they provide to doctors about the allocation of resources. Methods: All publicly available non-institutional policies on withholding and withdrawing life-sustaining treatment were identified, including codes of conduct and government and professional organization guidelines. The policies that referred to resource allocation were isolated and analysed using qualitative thematic analysis. Eight Australian policies addressed both withholding and withdrawing life-sustaining treatment and resource allocation. Results: Four resource-related themes were identified: (1) doctors' ethical duties to consider resource allocation; (2) balancing ethical obligations to patient and society; (3) fair process and transparent resource allocation; and (4) legal guidance on distributive justice as a rationale to limit life-sustaining treatment. Conclusion: Of the policies that addressed resource allocation, this review found broad agreement about the existence of doctors' duties to consider the stewardship of scarce resources in decision-making. However, there was disparity in the guidance about how to reconcile competing duties to patient and society. There is a need to better address the difficult and confronting issue of the role of scarce resources in decisions about life-sustaining treatment. [ABSTRACT FROM AUTHOR]

Having children compels parents to examine their vaccine beliefs, particularly if they are vaccine-hesitant or refuse all vaccines. Presently, little is known about the specific ways in which having children influences the vaccine beliefs of parents. This research examined how having children changed the attitudes of Australian vaccine-hesitant and vaccine-refusing parents towards childhood vaccination. We asked 904 Australian parents who believed that having children changed their attitudes to vaccination to describe these changes. Parents' responses were inductively, iteratively coded and thematically analysed. Themes were compared between parents who believed all vaccines should be refused, parents with varying degrees of vaccine hesitancy, and parents who were fully vaccine-accepting. Low numbers of responses from fully vaccine-accepting parents meant that this paper focused on mostly vaccine-hesitant and vaccine-refusing vaccine parents. Five themes were identified. Having children prompted all parents to learn about vaccine choices. Hesitant and refusing parents' interpreted vaccine choices through a lens of distrust of pharmaceutical companies and regulatory bodies overseeing vaccine safety. The distrust fuelled parents' fears about vaccination risks, such as side effects. Parents became concerned about the scheduled timing of vaccinations, particularly of the Hepatitis B vaccine. Parents among the three groups that believed some or all vaccines should be refused reported that a vaccine permanently injured their child. This research contributes to understanding how having children affects the vaccine attitudes among vaccine-hesitant and vaccine-refusing parents. Greater support for parents with negative vaccination experiences may prevent hesitant attitudes. The vaccination schedule needs to be communicated to parents better. [ABSTRACT FROM AUTHOR]

Purpose: This paper responds to the call for more research to fully understand out of pocket (OOP) costs for cancer patients by providing a detailed discussion of such costs for adult haematology patients from Queensland, Australia.Methods: The descriptive qualitative research was based on in-depth interviews with 45 (n = 45) haematology patients from regional, rural and remote areas.Results: The discussion itemises the OOP costs under four categories including the costs associated with travel and accommodation, the costs associated with family and friends during relocation, the costs associated with diagnosis and treatment, and the costs of parking.Conclusions: The paper provides evidence of the categories of financial burden experienced by haematology patients who have to relocate for specialist treatment by detailing the extensive range of OOP costs. The expectation is that the itemisation of OOP cost variables will contribute to future efforts of quantification. [ABSTRACT FROM AUTHOR]

This paper reports and analyses findings from a qualitative study that explored the impact of organizational policy, cultures and support structures on the research pathways of early career researchers within one Australian university. The author captured the perspectives and experiences of six early and six senior researchers and examined the degree to which respondents perceived their university was effective in supporting the early career researcher to sustain and progress their research. As this paper explores, giving voice to academics’ lived experiences of research raised questions as to the efficacy of existing institutional support structures as significant gaps between internal research policy and the lived research experience on the ground were revealed. Ultimately, understanding academics’ lived experiences of research may not only build institutional knowledge to inform and enhance institutional capacity to more effectively sustain and grow quality research, but also strengthen advocacy for much-needed and targeted external research funding. [ABSTRACT FROM AUTHOR]

Purpose: The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population.Methods: Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology.Results: The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position.Conclusions: This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential. [ABSTRACT FROM AUTHOR]

This paper summarizes an exploratory study undertaken to consider the work of Australian chaplaincy personnel ministering to people proceeding through emotionally challenging judicial court proceedings. This qualitative research (a first among Australian court chaplains) was not concerned with specific court procedures per se, but predominantly about the perspectives of chaplains concerning their professional contribution and issues they experienced while trying to assist people struggling with court processes. Data from a single focus group indicated that court chaplains were striving to fulfill religious and spiritual duties according to national and international standards. Given various frustrations identified by chaplain participants, which either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of court chaplaincy and thus maximize the benefits of spiritual and pastoral care to people in court. Implications of this exploratory study relate not only to court chaplaincy but also to ecclesiastical organizations, governments and the need of support for further research to be conducted. [ABSTRACT FROM AUTHOR]

The birth of an extremely premature baby is a tragedy, and it is only natural that the parents will rely on the spiritual and religious beliefs that guide the rest of their lives. At this difficult time, parents with strong religious beliefs will hope for divine intervention and pray for a miracle. This paper outlines the difficulties experienced by neonatal nurses when caring for an extremely premature baby whose parents hold on to hope and their belief in divine intervention and a miracle. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in NSW, Australia. A qualitative approach was used to analyse the data. The theme of 'hoping for a miracle' was captured by two sub-themes 'praying for a miracle' and 'oscillating between hope and despair'. For some families, the hope of divine intervention seemed all consuming, and the nurses were witness to the desperation and disappointment of families when a miracle was not forthcoming. [ABSTRACT FROM AUTHOR]

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

This paper reports on a qualitative study exploring the role and functionality of emotions in feedback. In-depth interview data from students and lecturers at an Australian university are analysed using cognitive appraisal and prototype theory. Results suggest that students experience a range of positive and negative emotions in feedback contexts which function to address both achievement and relational concerns. Practical implications are identified. [ABSTRACT FROM AUTHOR]

Under pressure from crowded immigration detention centres and an election commitment to remove children from detention, in 2010 the Australian government opened a low security immigration detention facility for families and children in the Adelaide Hills. Children from this alternative place of detention (APOD) attend nine local schools. However, many local residents feared their enrolment would create conflict, reduce educational outcomes for local students, and overburden teachers and school resources. To answer these concerns we conducted an ethnography of the schools and interviewed school teachers, principals, parents, the education managers in the Department of Immigration and Citizenship (DIAC) and the Department of Education and Children's Services (DECS). This paper reports our findings on the impacts of the new arrivals on school finances, teacher time and resources, the local children, and the broader Hills community. As did previous quantitative studies, we found no negative effects. Rather, the new arrivals created a newly enriched learning environment and social experiences. The schools also played an integral role in changing the initially hostile community attitudes towards asylum seekers. Our qualitative research approach allowed us to explore factors that created this outcome. We found that the absence of negative impacts was the result of the funding for specialised support staff, the social justice orientation of the school's leaders and staff, and a school-wide commitment to values of inclusivity and diversity. This research provides further empirical evidence on the impacts of immigration on education, increases our understanding of the factors that mediate these impacts, and provides a useful case study for schools that teach asylum seeker children. [ABSTRACT FROM AUTHOR]

Australia is currently undergoing fundamental and far-reaching reforms in water management that have been prompted by wide-spread environmental degradation caused by past water management practices. This paper is an extract of a wider study that explores how governments incorporate social justice into water reform policies and how that effort is perceived by non-government stakeholders. Using a comprehensive Social Justice Framework, we used a mixed methods approach that combines a quantitative content analysis of key water reform documents with a qualitative semistructured interview process to identify and analyse three principles of social justice that apply to the environment as a water stakeholder: need as a distributive justice principle, representativeness and accuracy as procedural justice principles. We found that the environment is identified as a legitimate water stakeholder whose needs are meant to be assured through the water reform process. However, the environment suffers from a crisis of identity. Other water stakeholders claim to speak for the environment but say different things. Thus, due to a diversity of voices, strong government intention to satisfy environmental needs is diluted in practice. Furthermore, the prerogative to define and measure environmental needs through science, while deemed to be fair and objective, leads to unintended consequences that complicate management and disenfranchise less scientifically capable stakeholders. Overall, we believe that the formal recognition of the environment as a stakeholder in water reform is a significant forward step but its crisis of identity must be resolved before the environment can fully utilise its new role as a stakeholder. [ABSTRACT FROM AUTHOR]

Purpose: Despite the personal and economic importance of the issue of returning to work after cancer treatment, there are major limitations in the research literature on the topic. Indeed, in relation to the focus of the present article, the experience of return to work for Australian haematology patients, there is little research available. Methods: The return-to-work findings are a sub-set from a study examining survivorship issues conducted through in-depth, qualitative interviews with a state-wide sample ( n = 50) of individuals who were at least 1 year post-treatment for haematological malignancy. Results: There were three groups identified in relation to employment: (1) those who were retired and work was not an issue, (2) those who had successfully re-entered the workforce and (3) those who wanted to work but were finding the process of return-to-work difficult. It is the third group that is the major focus for this paper. Conclusions: The clear indications are that group 3 requires assistance with return-to-work and were vulnerable to a range of psychosocial distress caused by inability to return to employment. Supportive care strategies to assist return to employment are provided. Relevance of manuscript to inform research, policies and/or programs Current improvements in cancer treatments have not only increased the number of cancer survivors but also peoples' ability to work during and following treatment. Maximising opportunities for cancer patients to return to work is a significant concern not only for individuals and employers but also economically for society. The findings reported in this article explored the individual story of a range of individuals with haematological malignancies in relation to their desire and efforts to return to work. Importantly, the findings not only provide insights on the work re-entry challenges faced by such individuals but also posit supportive care service delivery solutions to assist those who are vulnerable and frustrated in their efforts to find employment. [ABSTRACT FROM AUTHOR]

Umbilical cord blood banking is one of many biomedical innovations that confront pregnant women with new choices about what they should do to secure their own and their child's best interests. Many mothers can now choose to donate their baby's umbilical cord blood (UCB) to a public cord blood bank or pay to store it in a private cord blood bank. Donation to a public bank is widely regarded as an altruistic act of civic responsibility. Paying to store UCB may be regarded as a 'unique opportunity' to provide 'insurance' for the child's future. This paper reports findings from a survey of Australian women that investigated the decision to either donate or store UCB. We conclude that mothers are faced with competing discourses that force them to choose between being a 'good mother' and fulfilling their role as a 'good citizen.' We discuss this finding with reference to the concept of value pluralism. [ABSTRACT FROM AUTHOR]

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries' identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants' care are discussed with suggestions for further research. [ABSTRACT FROM AUTHOR]

There has been considerable interest in generic attributes in higher education for over a decade and yet while generic skills or attributes are an important aspect of policy, there is often a lack of consistency between beliefs about the importance of these skills and attributes and the degree to which exist in teaching practice. There has been an assumption that these attributes exist outside of the disciplinary context, yet the findings of this study suggest that they are strongly influenced by the disciplinary culture in which they are taught. The study reported in this paper examines the apparent gap between ideal notions of generic attributes and their enactment in teaching practice. This qualitative study examined the teaching of generic attributes in five disciplines (physics, history, economics, medicine and law) in two Australian universities. It found that the notion of generic attributes is highly complex and while attributes such as critical thinking, problem solving and communication are valued by teaching staff they are often implicit in teaching. This gap between what is valued and what is actually taught is a result of variation in interpretation of generic attributes, the difficulties of reducing complex attributes to definable learning outcomes and practical constraints on teaching caused by factors such as large classes. Furthermore, it can be explained by the finding that generic attributes are part of the epistemic culture of the disciplines and often remain tacit. The findings of this study have significant implications for scholarship, policy and pedagogy. [ABSTRACT FROM AUTHOR]