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This paper aims to develop a sensory methodological framework to explore older user's landscape experience. Applying empirical experience in Australian aged-care facilities, it addresses a methodological gap in the current literature to help move beyond the current taken-for-granted approaches such as interviews, cognitive mapping, behavioural observation and visual methods. We propose a more holistic method which enables the exploration of older people's in situ environmental experience. The multisensory framework we propose here is based on the first author's doctoral fieldwork experience that took place in two aged-care facilities in Brisbane, Australia. Findings suggest this framework facilitates an understanding of users' olfactory, auditory and visual responses to the physical environment, and promotes a deeper engagement with the landscape. We argue that this is essential to promoting good landscape design which genuinely connects with older people's needs. [ABSTRACT FROM AUTHOR]

Engagement in health research is increasingly practised worldwide. Yet many questions remain under debate in the ethics field about its contribution to health research and these debates have largely not been informed by those who have been engaged in health research. This paper addresses the following key questions: what should the ethical goals of engagement in health research be and how should it be performed? Qualitative data were generated by interviewing 22 people with lived experience, members of the public, and engagement managers about power sharing in health research. Thematic analysis of study data identified the following five themes: the value of engagement in research, ideal engagement, tokenistic engagement, terms to describe those engaged, and engagement roles in research. The paper presents that data and then considers what insights it offers for what engagement should look like—its ethical goals and approach—according to those being engaged. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to describe the implementation and evaluation of the Growing Strong Brains® (GSB) toolkit in a remote Aboriginal community in Western Australia (WA) over a 2-year period, 2018–2019. Background: Ngala, a community service organisation in WA, developed the GSB toolkit in 2014, a culturally appropriate and interactive resource to build knowledge of early childhood development within Aboriginal communities. This was in response to evidence that a higher percentage of children in Aboriginal communities were developmentally vulnerable compared to the rest of the population. The GSB toolkit promotes awareness and understanding of early brain development pre-birth and in the early years of a child's life. Methods: The project was underpinned by participatory action research (PAR). Reflective PAR review cycles (n = 5) monitored local community engagement, navigated challenges and utilised community strengths. Fifty-nine local service providers attended a 2-day formal training. Data were collected by using various methods throughout the project, including feedback following training, focus groups, surveys, one-on-one interviews using yarning techniques and reflective feedback from the Project Lead. Findings: Establishing local Aboriginal project staff was pivotal to the success of the project. When delivering services for and with Aboriginal people, it is essential that cultural competence, safety and decision-making is carried through from planning to implementation and evaluation, and involves genuine, respectful and authentic relationships. Sufficient time allocation directed towards building relationships with other service providers and local community members needs to be considered and built into future projects. The Growing Strong Brains® project is embedded within the local community, and anticipated implementation outcomes were achieved. The support of the local people and service providers was beyond expectation, enabling the building of local capacity, and the development of a common understanding of the key messages from the GSB toolkit to allow integration throughout all levels of the community. This project has been important to build on the strategies necessary to introduce, implement and evaluate the GSB toolkit in other remote Aboriginal communities. [ABSTRACT FROM AUTHOR]

Housing wealth dominates the asset portfolios of the older population in Australia and many other countries. Given the anticipated spike in fiscal costs associated with population ageing, there is growing policy interest in housing equity withdrawal (HEW) to finance living needs in retirement. This paper sheds light on homeowners’ perceptions of the obstacles associated with two forms of HEW: mortgage equity withdrawal (where the in situ home owner increases his/her housing-related debt) and downsizing (where housing equity is released by moving to a lower-valued property). We uncover a series of age-specific barriers impeding older Australians’ use of these forms of HEW through qualitative analysis of semi-structured interviews conducted with home owners and professional service providers in related areas of policy and practice. To that end, we recommend the development of a range of safeguards that will minimise the risk exposure and other obstacles associated with HEW for older home owners. [ABSTRACT FROM AUTHOR]

The paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to 'Close the Gap' (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research. [ABSTRACT FROM AUTHOR]

Background: Many studies aggregate prescription opioid misuse (POM) and heroin use into a single phenotype, but emerging evidence suggests that their genetic and environmental influences may be partially distinct. Methods: In total, 7164 individual twins (84.12% complete pairs; 59.81% female; mean age = 30.58 years) from the Australian Twin Registry reported their lifetime misuse of prescription opioids, stimulants, and sedatives, and lifetime use of heroin, cannabis, cocaine/crack, illicit stimulants, hallucinogens, inhalants, solvents, and dissociatives via telephone interview. Independent pathway models (IPMs) and common pathway models (CPMs) partitioned the variance of drug use phenotypes into general and drug-specific genetic (a), common environmental (c), and unique environmental factors (e). Results: An IPM with one general a and one general e factor and a one-factor CPM provided comparable fit to the data. General factors accounted for 55% (a = 14%, e = 41%) and 79% (a = 64%, e = 15%) of the respective variation in POM and heroin use in the IPM, and 25% (a = 12%, c = 8%, e = 5%) and 80% (a = 38%, c = 27%, e = 15%) of the respective variation in POM and heroin use in the CPM. Across both models, POM emerged with substantial drug-specific genetic influence (26–39% of total phenotypic variance; 69–74% of genetic variance); heroin use did not (0% of total phenotypic variance; 0% of genetic variance in both models). Prescription sedative misuse also demonstrated significant drug-specific genetic variance. Conclusions: Genetic variation in POM, but not heroin use, is predominantly drug-specific. Misuse of prescription medications that reduce experiences of subjective distress may be partially influenced by sources of genetic variation separate from illicit drug use. [ABSTRACT FROM AUTHOR]

AimThis paper explores cultural and professional dynamics of HIV general practice nursing in Australia. It highlights specific contributions that HIV general practice nurses make to HIV medicine and considers how nurses’ clinical practice has been shaped by past experiences of the AIDS crisis and subsequent developments in HIV medicine.BackgroundIn international contexts, nurses in HIV medicine commonly work as part of shared-care teams. In recent years, HIV general practice nursing has become a prioritised area for primary health care in Australia.MethodsData for this analysis were drawn from 45 in-depth, semi-structured interviews conducted with nurses and general practitioners (GPs) who provide HIV care in general practice, and key informants who work in policy, advocacy or education and training of the HIV general practice workforce.FindingsViewed through a socio-ecological framework of social capital, descriptive content analysis highlights a unique and strong HIV health professional identity, which emerged out of the adverse conditions experienced by nurses, GPs and allied health professionals during the 1980s AIDS crisis. Participants reported that today, HIV general practice nursing includes information provision, HIV treatment side-effect management, teaching patients methods to increase adherence to HIV treatments and capacity building with allied health professionals. Participants reported that HIV general practice nurses can reduce the clinical burden on GPs, ameliorate patients’ exposure to HIV health care-related stigma and discrimination and facilitate the emergence of a comprehensive and personalised model of shared primary health care based on trust and rapport, which is desired by people with HIV. This study's findings support the future expansion of the role of HIV general practice nurses in Australia and internationally. General practice nursing will become increasingly important in the scaling up of HIV testing and in caring for increasing numbers of people living with HIV. [ABSTRACT FROM AUTHOR]

The experiences of young people with disabilities of inclusive schooling are largely underresearched. This paper reports recent findings of a small-scale Australian qualitative study, in which secondary students with vision impairment spoke about their experiences of receiving paraprofessional support. Two overarching themes emerged from this study: ‘light’ and ‘heavy’ paraprofessional support. The results presented here demonstrate that participants described that support personnel upheld the strong arm of the special education tradition, which was manifestly detrimental to their inclusion. Raw data is presented to elucidate the emergent themes, and to explain the various pedagogical and general support roles of class and special educators in eliminating the need for direct paraprofessional presence in lessons. The light and heavy model of support is also examined in terms of how it fits into the complexity of the education discourse and the young people's own aspirations for full inclusion. [ABSTRACT FROM PUBLISHER]

Caring for elderly relatives has predominately been explored from the standpoint of the needs and experiences of the hegemonic culture in multicultural countries like Australia, Canada and the United States of America. Australia, in particular, has paid scant attention to cultural and linguistically diverse groups in relation to caring for the aged. In this paper we focus on Chinese-Australian families caring for elderly relatives. We explore the traditional value of filial piety which is said to underpin social norms and beliefs about caring for aged parents in Chinese cultures. Specifically we draw on four in-depth interviews with Chinese-Australian care-givers of elderly relatives to identify meanings of filial piety and practices of filial piety. Findings indicate that while filial piety is still an important value in caring for the aged, meanings about how to practise filial piety are changing and vary across families. [ABSTRACT FROM PUBLISHER]

Meetings between advisers and claimants are central to many welfare-to-work programmes. These ‘street-level’ exchanges between clients and staff are critical to the implementation of policy. When talking to welfare claimants, it becomes clear that contact with welfare bureaucrats is constitutive of their experience of policy and it is not until parent and adviser meet and negotiate that the policy is truly enacted. The policy comes into being through an exchange between advisers and parents, who interact, albeit unequally, to shape the proceedings. This paper examines the experience of parents claiming income support who faced compulsory employment measures. Drawing on research with claimants of teenage children, I examine the adviser meeting as an interpellative interaction. The state addresses mothers as workers and welfare claimants in an interpellation which is mediated by the adviser in dialogue with the mother. This analysis demonstrates how the notion of interpellation can inform research on street-level interactions. [ABSTRACT FROM PUBLISHER]

Adolescents with Asperger syndrome (AS) are increasingly being placed in academically focused high schools. These students, although academically able, may not be coping with the wider classroom and social demands of transition to, and within, the high school environment. Schools are keen to enrol these students. However, there appears to be a gap between the rhetoric and the reality relating to the varying perceptions of key stakeholders. In this paper we present the results of a study of the perceptions of key stakeholders in the transition of two students with AS into two academically focused high schools. Eight participants were involved in semistructured, one-on-one interviews. Key stakeholders included executive teachers, classroom teachers, students and their caregivers. The results indicated that there were some differences in the teacher and caregiver perspectives across physical, academic and social areas of transition. [ABSTRACT FROM AUTHOR]

In this paper the authors examine the perceptions of mothers about the schooling transitions, including transitions to postschool options, made by their adult child with an intellectual disability (ID). Twenty mothers of an adult child with an ID living in New South Wales, Australia, and the Czech Republic, aged 48 years or older, were recruited to participate in this study. Mothers were interviewed following a semistructured protocol. The audiotaped interviews were transcribed verbatim, and analysed using a constant comparison analytic approach.The experiences and issues faced by mothers at differing transitions of their adult child with an ID will be discussed, including issues of school selection, lifelong planning, and engaging with professionals. Common and unique themes within and between each country will be drawn, along with a comparison of findings from recent research reporting on transition experiences of mothers with young children with ID. The concluding discussion will focus on lessons learned about lifelong transition experiences, and pose future directions for enhancing the quality of transitions for persons with special needs and their families. [ABSTRACT FROM AUTHOR]

BackgroundAlthough numerous studies have examined the latent structure of major depression, less attention has focused on mania. This paper presents the first investigation outside the USA to evaluate the psychometric properties of the DSM-IV criterion B mania symptoms using item response theory (IRT).MethodData were drawn from the Australian 2007 National Survey of Mental Health and Well-Being (NSMHWB, n = 8841). The psychometric performance of the mania symptoms was evaluated using a two-parameter logistic model. Because substance use disorders (SUDs) frequently co-occur with mania and can influence manic symptom expression, differential item functioning (DIF) between mania respondents with/without a SUD diagnosis was also assessed.ResultsFactor analysis supported a unidimensional trait underlying mania. The grandiosity symptom displayed the highest discrimination whereas discrimination was lowest for decreased need for sleep. Relatively speaking, grandiosity tapped the severe end and increased goal-oriented activities tapped the mild end of the mania severity continuum. The symptoms generally performed equivalently between those with/without a SUD diagnosis, with one exception; the activities with painful consequences symptom was endorsed at lower levels of severity, and hence more frequently, by those with a SUD diagnosis versus those without a SUD diagnosis.ConclusionsAccurate conceptualization of latent structure has crucial theoretical, statistical and clinical implications. The symptoms generally performed well in distinguishing between respondents with differing levels of liability, but others did not, suggesting modification is warranted to ensure optimal use in epidemiological samples. Given the dearth of psychometric evaluation studies of mania, further research replicating these results is necessary. [ABSTRACT FROM PUBLISHER]

This study sought to explore qualitatively experiences of existential loneliness (EL) in 80 older people living in retirement communities across the United Kingdom and Australia. Qualitative semi-structured interviews permitted in-depth exploration of issues such as biographical narrative, close relationships, loss, feelings of loneliness and retirement living. It was our intention to conduct a large-scale, deep-listening exercise that would provide further clues about EL in older people and the circumstances that give rise to such feelings. Data provided rich insight into older people's inner lives. Core themes identified loss of close attachments, lack of physical touch and intimacy, deterioration of health and body, and lack of an emotional language through which to express EL as central to older people's experiences. Furthermore, there was a suggestion that the move to retirement living was for many people inextricably connected to their experience of EL. Our data further support and extend the notion that EL can be thought of as a gradual sense of separation from the world and that ageing intensifies a myriad of social, emotional and physical circumstances that prompt its emergence. This sense of existential isolation need not be thought of as exclusive to those experiencing extreme frailty or who face death imminently – our data pointed to a clear and gradual emergence of EL throughout later life. [ABSTRACT FROM AUTHOR]

Global awareness about an increase of chronic diseases and premature mortality due to 'unhealthy eating' and 'sedentary lifestyles' is embedded in various discourses shaped by relationships and power. In this article, I investigate the role of physical activity in the lives of middle-aged women in Australia and how their experiences with exercise influence the way they position themselves within the context of inter-discursivity regarding fitness and 'healthy ageing'. Results reveal how 'knowledge' about 'healthy lifestyles' is created and accessed, and how women make sense of the healthism discourse, the obesity crisis, and discourses around menopause and ageing. The participants for this study are nine women in their forties to sixties who volunteered to participate in semi-structured interviews after completing an online survey about physical activity that was part of a larger project. Their accounts of health and fitness, healthy eating, weight management, mental wellbeing and ageing are categorised and interpreted in a post-structuralist framework through the lens of feminist relational discourse analysis. Results show that all women are influenced by healthism discourses as well as being affected by assumptions and recommendations for ageing, menopausal women. They shape female identity by adopting, but also by resisting, discourses around their bodies and minds. [ABSTRACT FROM AUTHOR]

Background: Vulnerability to depression can be measured in different ways. We here examine how genetic risk factors are inter-related for lifetime major depression (MD), self-report current depressive symptoms and the personality trait Neuroticism. Method: We obtained data from three population-based adult twin samples (Virginia n = 4672, Australia #1 n = 3598 and Australia #2 n = 1878) to which we fitted a common factor model where risk for 'broadly defined depression' was indexed by (i) lifetime MD assessed at personal interview, (ii) depressive symptoms, and (iii) neuroticism. We examined the proportion of genetic risk for MD deriving from the common factor v. specific to MD in each sample and then analyzed them jointly. Structural equation modeling was conducted in Mx. Results: The best fit models in all samples included additive genetic and unique environmental effects. The proportion of genetic effects unique to lifetime MD and not shared with the broad depression common factor in the three samples were estimated as 77, 61, and 65%, respectively. A cross-sample mega-analysis model fit well and estimated that 65% of the genetic risk for MD was unique. Conclusion: A large proportion of genetic risk factors for lifetime MD was not, in the samples studied, captured by a common factor for broadly defined depression utilizing MD and self-report measures of current depressive symptoms and Neuroticism. The genetic substrate for MD may reflect neurobiological processes underlying the episodic nature of its cognitive, motor and neurovegetative manifestations, which are not well indexed by current depressive symptom and neuroticism. [ABSTRACT FROM AUTHOR]

The population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeed more likely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful. [ABSTRACT FROM AUTHOR]

Objective: The present qualitative study aimed to gain an in-depth understanding of participants' attitudes, knowledge, perceived effectiveness (a person's belief that his/her behaviour can contribute to environmental preservation) and behaviours relating to a sustainable eating pattern.Design: One-to-one interviews (either face-to-face or by telephone) were conducted following a structured interview schedule, audio-recorded, transcribed verbatim and analysed using inductive thematic analysis in NVivo 10.Setting: Victorian (Australia) adult participants recruited via online advertisements, flyers on community advertisement boards and letterbox drops.Subjects: Twenty-four participants (mean age 40 years, range 19-69 years; thirteen female, eleven male) were interviewed.Results: Participants reported that environmental impact was not an important influence on their food choice. Participants displayed limited knowledge about a sustainable eating pattern, with most unaware of the environmental impact of food-related behaviours. Most participants believed sustainable eating would be only slightly beneficial to the environment. Participants reported undertaking limited sustainable food behaviours currently and were more willing to undertake a food behaviour if they perceived additional benefits, such as promoting health or supporting the local community.Conclusions: The study suggests consumers need further information about a sustainable eating pattern and the environmental impact of food choice. The findings highlight some of the barriers that will need to be addressed when promoting this kind of eating pattern and that a range of interventions will be necessary. [ABSTRACT FROM AUTHOR]

The combination of population ageing and climate change is creating a new threat for many Australian coastal hamlets vulnerable to the impact of tropical cyclones. Increasingly, elderly people are facing future tropical cyclones alone, without support from family and friends, relying instead on already stretched government and authority resources, despite Emergency Management Australia's (EMA) policy expectation that all citizens must be self-reliant. This research explored the future self-reliance and disaster resilience of coastal hamlets through the lens of the Social Cognitive Theory by outlining the findings from focus groups, personal interviews and questionnaires involving participants over 65 years of age, residing in townships previously impacted by Cyclone Larry (in 2006) and Cyclone Yasi (in 2011). Participants recalled a lack of social support following the cyclones, a fear of evacuating their homes, as well as the trauma of recovering from such intense destruction. Respondents were also concerned about the physical, cognitive and financial impacts of ageing on their ability to prepare and recover from future cyclones, frightened that experiences from the past might be repeated in the future, contributing to feelings of isolation, frustration and the loss of community, and a rethinking of ageing in the place of their choice. These considerations impact on the dependence EMA has that all citizens will remain self-reliant when faced with a natural hazard and should be considered when making future policy decisions in relation to more isolated coastal townships. [ABSTRACT FROM AUTHOR]

We explored 3 general classroom teachers’ experiences of including a child with Down syndrome in their early years classrooms. Located at 3 different Australian school settings, 1 teacher was the head of a Preparatory class, 1 was a Year 3 teacher, and the third was a teacher of a split Preparatory/Year 1 class. Interview data were drawn from a larger study, in which data were gathered over a 5-month period through class observations and teacher interviews. The findings indicate that although there were highly inclusive experiences identified in the school sites, the school context played an important role in the inclusion of the child. Teachers indicated that receiving targeted information about Down syndrome and collaborative support from parents, teaching colleagues, and their wider school enabled them to work more inclusively with their student with Down syndrome in their classroom. [ABSTRACT FROM PUBLISHER]

Against the background of population ageing and increasing cultural diversity in many Western countries, the study examined differences and similarities between Australian-born people and Chinese immigrants in their relationships with adult children. The specific research questions were: (a) are there differences between these groups in the nature of parent–child relationships; and (b) if there were differences, did these differences reflect the Confucian concept of filial piety among older Chinese immigrants. The solidarity–conflict model and the concept of ambivalence were used to quantify parent–child relationships. Data from 122 community-dwelling people aged 65 and over (60 Australian-born and 62 Chinese-born people) were collected using standardised interviews. There were significant differences between the two groups for all relationship dimensions except associative solidarity. Compared to Australian participants, Chinese participants were more likely to live with their children. However, when they did not live with their children, they lived further away. They were also more likely to receive, but less likely to provide, instrumental help. Finally, they reported higher levels of normative solidarity, conflict and ambivalence, and lower levels of affectual and consensual solidarity. The differences in solidarity dimensions persisted when socio-demographic variables were controlled for. The study revealed complex differences in the nature of older parent–child relationships between Australian-born people and Chinese immigrants. Some of these differences, such as more prevalent multigenerational living among older Chinese immigrants, likely reflect the strong influence of filial piety among this group. However, differences in other dimensions, such as lower levels of consensual solidarity, might be associated with the Chinese participants’ experience as immigrants. This study also highlights the usefulness of the solidarity–conflict model as a theoretical framework to understand the nature of parent–child relationships among older Chinese immigrants. [ABSTRACT FROM PUBLISHER]

AimConsumer health organisations (CHOs) are non-profit or voluntary sector organisations that promote and represent the interests of patients and carers affected by particular conditions. The purpose of this study was to examine, among patients with chronic disease, what differentiates those who contact CHOs from those who do not and what stops people from making contact.BackgroundCHOs can enhance people’s capacity to manage chronic disease by providing information, education and psychosocial support, but are under-utilised. Little is known about barriers to access.MethodsData were from a baseline telephone survey conducted as part of a randomised trial of an intervention to improve access to CHOs. Participants constituted a consecutive sample of 276 adults with diagnosed chronic disease recruited via 18 general practitioners in Brisbane, Australia. Quantitative survey items examined participants’ use and perceptions of CHOs and a single open-ended question explored barriers to CHO use. Multiple logistic regression and thematic analysis were used.FindingsOverall, 39% of participants had ever contacted a CHO for their health and 28% had contacted a CHO specifically focussed on their diagnosed chronic condition. Diabetes, poorer self-reported physical health and greater health system contact were significantly associated with CHO contact. The view that ‘my doctor does it all’ was prevalent and, together with a belief that their health problems were ‘not serious enough’, was the primary reason patients did not make contact.ConclusionAttitudinal and system-related barriers limit use of CHOs by those for whom they are designed. Developing referral pathways to CHOs and promoting awareness about what they offer is needed to improve access. [ABSTRACT FROM AUTHOR]

Long-term unemployment can negatively impact health and well-being, and is a central focus of governments seeking to address poverty and social exclusion. Little is known about how individuals experience programmes aimed at addressing long-term unemployment and consequently the client-centred indicators of 'success'. In-depth interviewswere carried outwith 31 long-termunemployed individuals engaged in a 'life-first' programme integrating vocational assistance with intensive personal strengths-based support. The participants in this programme faced multiple disadvantages including employment and educational barriers as well as a range of significant personal issues. They equated successful outcomes in the programme with receiving awealth of psychosocial and practical assistance in addition to vocational support, and having a casemanagerwho approached these issues as awhole. Findings suggest that, in order to provide the best chance of gaining and maintaining employment, programmes should address, in tandem, personal and vocational barriers facing those who are long-term unemployed. [ABSTRACT FROM AUTHOR]

By 2050, the number of people in Australia aged over 85 is expected to quadruple. Yet, from a socio-psychological research perspective, little is known about the experiences of people who continue to live at home during late old age (85 years and over), a period when challenging problems associated with ageing escalate and threaten to compromise independence. Utilising a qualitative methodology, the subjective lived experience of 23 very old adults (19 women, four men, with a mean age of 90.7 years, range 85–101 years) who live independently in rural Australia were elicited. The aims of the research were to understand their thoughts and feelings about ageing in place at home, and what psychological, social and practical adaptive strategies they employ to cope with difficulties encountered during very old age. In-depth interviews were analysed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases and interpretation of exemplars. Participants described how historical, cultural and environmental contexts shaped their everyday thoughts, activities and what was meaningful for them. The findings add to our understanding of the largely unnarrated lives of the very old, suggest a need for person-centred home-care assessment processes and aid significant others (family, friends and neighbours) to understand better what very old adults need to live independently. [ABSTRACT FROM PUBLISHER]

Convincing evidence has identified inflammation as an initiator of atherosclerosis, underpinning CVD. We investigated (i) whether dietary inflammation, as measured by the ‘dietary inflammatory index (DII)’, was predictive of 5-year CVD in men and (ii) its predictive ability compared with that of SFA intake alone. The sample consisted of 1363 men enrolled in the Geelong Osteoporosis Study who completed an FFQ at baseline (2001–2006) (excluding participants who were identified as having previous CVD). DII scores were computed from participants’ reported intakes of carbohydrate, micronutrients and glycaemic load. DII scores were dichotomised into a pro-inflammatory diet (positive values) or an anti-inflammatory diet (negative values). The primary outcome was a formal diagnosis of CVD resulting in hospitalisation over the 5-year study period. In total, seventy-six events were observed during the 5-year follow-up period. Men with a pro-inflammatory diet at baseline were twice as likely to experience a CVD event over the study period (OR 2·07; 95 % CI 1·20, 3·55). This association held following adjustment for traditional CVD risk factors and total energy intake (adjusted OR 2·00; 95 % CI 1·03, 3·96). This effect appeared to be stronger with the inclusion of an age-by-DII score interaction. In contrast, SFA intake alone did not predict 5-year CVD events after adjustment for covariates (adjusted OR 1·40; 95 % CI 0·73, 2·70). We conclude that an association exists between a pro-inflammatory diet and CVD in Australian men. CVD clinical guidelines and public health recommendations may have to expand to include dietary patterns in the context of vascular inflammation. [ABSTRACT FROM AUTHOR]

Background.Genetic influences contribute significantly to co-morbidity between conduct disorder and substance use disorders. Estimating the extent of overlap can assist in the development of phenotypes for genomic analyses.Method.Multivariate quantitative genetic analyses were conducted using data from 9577 individuals, including 3982 complete twin pairs and 1613 individuals whose co-twin was not interviewed (aged 24–37 years) from two Australian twin samples. Analyses examined the genetic correlation between alcohol dependence, nicotine dependence and cannabis abuse/dependence and the extent to which the correlations were attributable to genetic influences shared with conduct disorder.Results.Additive genetic (a2 = 0.48–0.65) and non-shared environmental factors explained variance in substance use disorders. Familial effects on conduct disorder were due to additive genetic (a2 = 0.39) and shared environmental (c2 = 0.15) factors. All substance use disorders were influenced by shared genetic factors (rg = 0.38–0.56), with all genetic overlap between substances attributable to genetic influences shared with conduct disorder. Genes influencing individual substance use disorders were also significant, explaining 40–73% of the genetic variance per substance.Conclusions.Among substance users in this sample, the well-documented clinical co-morbidity between conduct disorder and substance use disorders is primarily attributable to shared genetic liability. Interventions targeted at generally reducing deviant behaviors may address the risk posed by this shared genetic liability. However, there is also evidence for genetic and environmental influences specific to each substance. The identification of these substance-specific risk factors (as well as potential protective factors) is critical to the future development of targeted treatment protocols. [ABSTRACT FROM PUBLISHER]

The article discusses the research regarding the perspective of parents regarding the sources of information autism spectrum disorder (ASD) in Australia. The research conducted a qualitative analysis of the interviews participated by 12 parents of children with autism spectrum disorder. Results show that among the 26 types of sources, internet are the frequently type utilized by the parents.

Over the last two decades, the concept of resilience has become the focus of a growing body of gerontological research. However, there is a dearth of qualitative research that explores how socio-economic and socio-cultural factors shape older people's resilience. This study addresses this gap and explores the concept of resilience through the lens of 25 Australians from a variety of backgrounds, investigating the resilience strategies they employed in the face of different challenging life events. A qualitative narrative methodology involving one focus group and semi-structured interviews was employed. A stratified convenience sample of 34 people aged 60 and over participated in semi-structured interviews between 2009 and 2011. The study describes the meaning participants assigned to the term resilience, and focuses on the range of resilience responses and strategies they employed, bringing to light some key commonalities and differences. The study's findings suggest that access to economic and cultural resources and the nature of the adversity older people face can shape and limit their resilience strategies. The article outlines how the concept of resilience could be incorporated into aged care practice and argues that resilience-focused interventions that potentially broaden the resilience repertoire of older people should be explored within an aged care context. [ABSTRACT FROM AUTHOR]

Increasing numbers of people with dementia reside in single-person households, yet little is known of their experiences and priorities. This exploratory Australian study elicited perceptions of seven people with dementia living alone, regarding their domestic environment and its surroundings. The general aim was to identify unmet service needs in this vulnerable population. Drawing upon the theoretical concepts of ‘the will to mobility’ and ‘life-space’, we identified four factors of particular salience to our respondents. These were access to public space, social distance and proximity, changing meanings of space and objects, and imaginative co-presence. Participants provided useful insights into a soon-to-be-common scenario in which increased numbers of people with dementia will be living without a resident carer. The findings have implications for the development of more personalised and targeted dementia care in the domestic setting, more inclusive public planning and more extensive public education programmes. [ABSTRACT FROM PUBLISHER]

Although home–school collaborations are important for inclusive education, most studies have identified the problems experienced by parents whose children have additional special needs. The aim of this study was to present the views of Australian parents, with children diagnosed with autism spectrum disorder, regarding what they considered to be the enablers for inclusion, within the context of their experiences of a program of support in inclusive schools (a Victorian State Government initiative called the Inclusion Support Program). Four focus group interviews were conducted, within a phenomenological, qualitative paradigm, with 14 mothers, in rural and urban primary and secondary public schools. Parents identified various innovations including the provision of a safe space, structured school and free time, flexibility around timetable, curriculum and staffing and the provision of socially attractive activities. Another theme was the potential for schools to be a ‘catalyst point’ to bring together parents, teachers and community agencies. The importance of eliciting parental expertise is highlighted here. [ABSTRACT FROM PUBLISHER]

Older men from ethnic minority communities living in a regional town in Australia were identified by a government-funded peak advocacy body as failing to access local health and support services and, more broadly, being at risk of not ageing well. A qualitative study was undertaken to explore the health and wellbeing of ethnic minority men growing older in a rural community, and to identify the barriers they faced in accessing appropriate services from a range of different perspectives. Individual interviews were conducted with key informants (service providers and community leaders), followed by focus groups with older men from four ethnic minority communities. The men in this study showed signs that they were at risk of poor mental and physical health, and experienced significant barriers to accessing health and support services. Furthermore, environmental, technological, social and economic changes have brought challenges for the older men as they age. Despite these challenges, this study demonstrated how work, family and ethnic identity was integral to the lives of these older men, and was, in many ways, a resource. Key informants' perspectives mostly confirmed the experiences of the older men in this study. The discrepancies in their views about the extent of health-promoting behaviour indicate some key areas for future health intervention, services and research. [ABSTRACT FROM PUBLISHER]

Governments are challenged by the need to ensure that ageing populations stay active and engaged as they age. Therefore, it is critical to investigate the role of mobility in older people's engagement in out-of-home activities, and to identify the experiences they have within their communities. This research investigates the use of transportation by older people and its implications for their out-of-home activities within suburban environments. The qualitative, mixed-method approach employs data collection methods which include a daily travel diary (including a questionnaire), Global Positioning System (GPS) tracking and semi-structured interviews with older people living in suburban environments in Brisbane, Australia. Results show that older people are mobile throughout the city, and their car provides them with that opportunity to access desired destinations. This ability to drive allows older people to live independently and to assist others who do not drive, particularly where transport alternatives are not as accessible. The ability to transport goods and other people is a significant advantage of the private car over other transport options. People with no access to private transportation who live in low-density environments are disadvantaged when it comes to participation within the community. Further research is needed to better understand the relationship between transportation and participation within the community environment, to assist policy makers and city and transportation planners to develop strategies for age-friendly environments within the community. [ABSTRACT FROM AUTHOR]

Workplaces, managers and employers who are seeking to maintain the standing, capacities and productivity of their workplaces are now facing two crucial facts: (a) an ageing workforce and (b) all workers, regardless of age, need to adapt to the changing requirements for workplace performance. These facts mean that managers and supervisors need to confront issues found in the changing demographics of their own workforce. That is, as the portion of workforces aged over 45 years (i.e. older workers) increases, it is these workers who are available to be employed, and supported in sustaining their ongoing employability. To address these issues requires understanding of particular workers' capacities and aspirations and then acting to develop further their capacities based on new understanding, and rebutting social sentiments about these workers that are often value-laden, contradictory and biased. The case here is made through drawing on literature and analyses of interview data of Australian managers of older workers, that the current logic of management relies upon deeply held and widely shared beliefs of age-blind meritocracy and equal opportunity rather than informed views. [ABSTRACT FROM PUBLISHER]

This study explores how interactions between frontline welfare service delivery employees and recipients are seen to affect welfare recipients’ capabilities. Seventeen employees and fifty-two welfare recipients from the Australian Department of Human Services were interviewed regarding their service delivery experiences. Interviews were transcribed and participants’ descriptions of the outcomes achieved from welfare service delivery interactions were analysed to determine the major themes. Burchardt and Vizard's (2007) capability list captured many of the effects described by participants, particularly the capability domains labelled ‘Individual, family and social life’, ‘Education and learning’, ‘Standard of living’, ‘Health’ and ‘Productive and valued activities’. Other outcomes were described by participants that might represent early indicators of positive or negative impact. Our findings suggest that welfare service delivery can both promote and impair capability development for welfare recipients. [ABSTRACT FROM PUBLISHER]

This qualitative study investigated the ageing and aged care experiences in Australia of two cohorts of older survivors of genocide: Jewish Holocaust survivors and older Cambodian genocide survivors. It was carried out in response to an identified need to better train aged care workers who are in contact with these groups. In-depth interviews were conducted with 21 community-dwelling survivors aged 65 and over. Credibility was ensured by methodological triangulation and peer debriefing. The study highlighted the importance of understanding older survivors’ ageing and aged care experiences in the context of their entire lifecourse and in terms of both vulnerability and resilience. It showed that trauma history can heighten older survivors’ sensitivity to many aspects of the social and physical environments in residential, community and home-based aged care settings. The study also uncovered the potential for aged care services to help older survivors cope with the psycho-social and emotional effects of resurfacing post-traumatic stress symptoms. The implications of the study findings for care practice include the importance of recognising older survivors of genocide as a distinct group of clients and the need to distinguish staff training for caring for this client group from general cultural awareness training. [ABSTRACT FROM PUBLISHER]

This article reports on a study into university preservice teachers’ perceptions of online video-recorded interviews as an alternative to the traditional lecture format in a course on inclusive education. With the aim of assisting preservice teachers to link theory and practice, the series of video-recorded interviews focused on key concepts around educating students with diverse needs and abilities. The interviews were conducted between the course coordinator and a number of professionals with relevant field experience in special education and inclusion, and were then made available to preservice teachers online. Survey data indicated that this type of delivery model was perceived as effective in promoting engagement and learning, and in facilitating an understanding of the connection between theory and practice. Implications for teacher education are discussed. [ABSTRACT FROM PUBLISHER]

BackgroundIndividuals at ultra-high risk (UHR) for psychosis show reduced neurocognitive performance across domains but it is unclear which reductions are associated with transition to frank psychosis. The aim of this study was to investigate differences in baseline neurocognitive performance between UHR participants with (UHR-P) and without transition to psychosis (UHR-NP) and a healthy control (HC) group and examine neurocognitive predictors of transition over the medium to long term.MethodA sample of 325 UHR participants recruited consecutively from the Personal Assessment and Crisis Evaluation (PACE) Clinic in Melbourne and 66 HCs completed a neurocognitive assessment at baseline. The UHR group was followed up between 2.39 and 14.86 (median = 6.45) years later. Cox regression was used to investigate candidate neurocognitive predictors of psychosis onset.ResultsThe UHR group performed more poorly than the HC group across a range of neurocognitive domains but only performance on digit symbol coding and picture completion differed between the groups. The risk of transition was only significantly associated with poorer performance on visual reproduction [hazard ratio (HR) 0.919, 95% confidence interval (CI) 0.876–0.965, p = 0.001] and matrix reasoning (HR 0.938, 95% CI 0.883–0.996, p = 0.037). These remained significant even after controlling for psychopathology at baseline.ConclusionsThis study is the longest follow-up of an UHR sample to date. UHR status was associated with poorer neurocognitive performance compared to HCs on some tasks. Cognition at identification as UHR was not a strong predictor of risk for transition to psychosis. The results suggests the need to include more experimental paradigms that isolate discrete cognitive processes to better understand neurocognition at this early stage of illness. [ABSTRACT FROM PUBLISHER]

Workforce ageing is considered in the context of four Australian employing organisations which are each in the process of change. In these organisations, perceptions regarding the relationship between the declining body and productivity led to a depreciation of the value of older workers and their consignment to less productive edges of organisations. While this was viewed as benefiting older workers, it was also acknowledged that workforce ageing will place severe constraints on the use of such practices, already regarded with suspicion by operational managers responsible for cost containment. Policies which aim to restrain biological and psychological decline, by supporting individual functional capacity and health, workplace design and ergonomics and developing the work community are advocated. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to examine how older people make sense of their capacity to maintain sports performance. Performance maintenance is predominantly examined from a quantitative perspective, with little attention given to how people themselves account for it. We interviewed 44 competitors (23 females, 21 males) from the 2009 Sydney World Masters Games (aged 56–90 years; mean = 72 years). The major themes were: ‘Use it or lose it’ (performance preservation required specific ‘training’ and the continuation of general physical activity); ‘Adapt’/‘modify’ (participants compensated for their decline in speed, strength and endurance so they could continue competing in sport); ‘It's in my genes’ (participants attributed their ‘family history’ and/or innate ‘determination’ to performance maintenance); and ‘I like to push myself’ (participants valued improved performance, pushing their bodies and winning which motivated them to continually train and compete). The findings are discussed within a framework of three key performance maintenance theories: (a) preserved differentiation, (b) selective maintenance and (c) compensation. Although compensation and continued training are effective ways to counter decline in later life, this study extends past research by showing how older athletes tend to combine and/or generalise stable and unstable attributes of performance preservation. In particular, this research highlights the importance individuals and Western society place on self-responsibility for health, competition and performance maintenance, which act as key motivating factors. [ABSTRACT FROM PUBLISHER]

BackgroundSubclinical psychotic experiences during adolescence may represent liability for developing psychotic disorder. Both coping style and the degree of persistence of psychotic experiences may play a role in the progression to clinical psychotic disorder, but little is known about the causal relationship between the two.MethodPath modelling was used to examine longitudinal relationships between subclinical positive psychotic experiences and three styles of coping (task-, emotion- and avoidance-oriented) in an adolescent general population sample (n=813) assessed three times in 3 years. Distinct developmental trajectories of psychotic experiences, identified with growth mixture modelling, were compared on the use of these coping styles.ResultsOver time, emotion-oriented coping in general was bi-directionally related to psychotic experiences. No meaningful results were found for task- or avoidance-oriented coping. Females reported using a wider range of coping styles than males, but the paths between coping and psychotic experiences did not differ by gender. Persistence of psychotic experiences was associated with a greater use of emotion-oriented coping, whereas a decrease in experiences over time was associated with an increased use of task-orientated coping.ConclusionsEmotion-oriented coping is the most important coping style in relation to psychotic experiences, as it may contribute to a ‘vicious cycle’ and is associated with persistence of experiences. In addition, more task-oriented coping may result in a decrease in psychotic experiences. Results suggest that opportunities for intervention may already be present at the level of subclinical psychosis. [ABSTRACT FROM PUBLISHER]

Objective:Coblation tonsillectomy can be controversial. This study assessed post-tonsillectomy haemorrhage outcomes for patients operated on by a single experienced coblation-trained ENT surgeon.Study design:A retrospective audit of coblation tonsillectomies was performed using the Flinders modification of Stammberger criteria for post-tonsillectomy haemorrhage.Method:Case note review, interview and database interrogation were utilised to obtain the dataset. Haemorrhage results were compared to reports in the current literature.Results:Of those who underwent coblation tonsillectomy, 3.4 per cent were readmitted to hospital with haemorrhage and 1.3 per cent returned to the operating theatre (0.4 per cent primary haemorrhage and 0.9 per cent secondary haemorrhage). Younger children had a lower risk of returning to the operating theatre than older children or adults (0.3 per cent under the age of 12 years vs 2.0 per cent aged 12 years or older).Conclusion:Coblation can be a safe method for tonsillectomy with low complication rates when performed by an experienced ENT surgeon. The Flinders modification of the Stammberger criteria for post-tonsillectomy haemorrhage provides a simple system for data comparison. [ABSTRACT FROM PUBLISHER]