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This paper examines the reflections of a cohort of Australian children who lived through the 2020–21 COVID‐19 pandemic and experienced being in 'lockdown'; a state of largely being confined to the home for long periods daily. We report how children reflect on their experiences and illustrate how reflections draw on similar topics focused on localised child concerns regarding health, education, family, digital engagement, mealtimes and food. Further, we argue for the importance of including children's own voices of lived experience in reports regarding life during the pandemic since these perspectives may differ from those reported by adults on children's behalf. [ABSTRACT FROM AUTHOR]

An increasing focus in aged care policy is supporting older people to age at home. However, there is little recognition of the health and independence of older private renters living in a space they do not own or control. This paper draws on in-depth interviews and assessments undertaken in the homes of 27 older tenants in the Brisbane environs aiming to understand how renting privately influenced their ability to meet their basic needs. An analysis of the findings highlights the disadvantage experienced by many older private renters. Most older private renters were unable to meet their basic needs given unaffordable rent whilst reliant on the aged pension. Further, with limited access to community aged care including home modifications, the health and independence of older private renters was found to be at risk. IMPLICATIONS Community aged care is difficult for older private renters to utilise in Australia, with unaffordable services and tenancy law limiting access to community aged care services including home modifications. It is vital social workers advocate for the community aged care needs of older private renters in practice and policy settings. [ABSTRACT FROM AUTHOR]

This paper reports on findings of the Sex Ed Dads survey which sought Australian fathers' perspectives on communicating with their young children about relationships and sexuality, as informal sexuality educators. Given the majority of existing family-based sexuality education research draws on the experiences of mothers, gaining insights from fathers is a much needed first step in designing resources to support paternal engagement in sexuality education. A diverse sample of 612 Australian fathers completed an online survey about their views on sexuality education and their role within it. Participating fathers valued sexuality education for their children and believed that their own informal contribution to its provision was important. Fathers reported high levels of comfort discussing a wide range of topics with their child at the age they deemed appropriate, although a gap between what fathers believed they should discuss and what they actually discussed was found. Findings offer insights for schools, resource developers and sexuality education providers seeking to support increased engagement of fathers in the sexuality education domain. [ABSTRACT FROM AUTHOR]

Aim: To determine the extent to which evidence-based medication safety practices have been implemented in public and private mental health inpatient units across Australia. Methods: The ReducingAdverse Medication Events in Mental Health survey was piloted in Victoria,Australia, in 2015, and rolledoutnationally in 2016. In total, 235mentalhealth inpatient units fromall States andTerritories inAustraliawere invited to participate. The survey included questions about the demographics of themental health unit, evidence-based strategies to improve prescriptionwriting, the administration and dispensing ofmedicines and pharmacy-led interventions, and also questions relating to consumer engagement in medication management and shared decision-making. Results: The response rate was 45% (N=106 units). Overall, the survey found that 57% of the mental health units had fully or partially implemented evidence-based medication safety practices. High levels of implementation (80%) were reported for the use of standardized medication charts such as the National Inpatient Medication Chart as a way to improve medication prescription writing. Most (71%) of the units were using standardized forms for recording medication histories, and 56% were using designated forms for Medication Management Plans. However, less than one-fifth of the units had implemented electronic medication management systems, and the majority of units still relied on paper-based documentation systems. Interventions to improve medicine administration and dispensing were not highly utilized. Individual patientbased medication distribution systems were fully implemented in only 9% of the units, with a high reliance (81%) on ward stock or imprest systems. Tall Man lettering for labelling was implemented in only one-third of the units. Pharmacy services were well represented in mental health units, with 80% having access to onsite pharmacist services providing assessments of currentmedications and clinical review services, adverse drug reaction reporting and management services, patient and carer education and counselling, and medicines information services. However, pharmacists were involved in only half of medical reconciliations. Their involvement in post-discharge follow-up was limited to 4% of units. Conclusions: Gaps in medication safety practices included limited use of individual patient supply systems for medication distribution, a high reliance on ward stock systems and high reliance on paper-based systems for medication prescribing and administration. With regards to service provision, clinical pharmacist involvement in medical reconciliation services, therapeutic drug monitoring and interdisciplinary ward rounds should be increased. Discharge and post-discharge services were major gaps in service provision. [ABSTRACT FROM AUTHOR]

Objectives: To examine in a sample of nurses working in acute-care wards, self-reported perceptions of the: 1) patient; family; nurse; doctor; and health system-related barriers to the provision of optimal end-of-life care to people who are dying in hospital; and 2) five barriers which, if removed, would lead to the greatest improvements in hospital-based end-of-life care. Background: Nurses play a central role in caring for dying patients and can offer a unique perspective about the factors that impact the quality of end-oflife care delivered in hospitals. Study design and methods: Two hundred and fifteen registered and enrolled nurses from three metropolitan and three rural hospitals across three health services completed a questionnaire-based, cross-sectional study between April 2016 and June 2017. Results: Nurses perceive that doctors continue to treat for too long (79% ranked as a large barrier); families have unrealistic expectations about a patient's prognosis (73%); junior doctors are unwilling to alter the decision of senior doctors (67%); doctors do not adequately explain the dying process (66%); and doctors have inadequate training in end-of-life care (66%). Nurses indicated that doctors reducing the length of active treatment and families having a more realistic expectation about life-expectancy would lead to the greatest improvement in end-oflife care in hospitals. Discussion: In this study of nurses working in a wide range of acute care settings across rural and metropolitan locations, substantial barriers to the provision of high-quality end-of-life care were perceived across all facets of healthcare provision. Important barriers included the continuation of potentially futile treatment, inadequacy of symptom control, and poor communication between doctors, patients and their families. Conclusion: Nurses perceive a range of patient; family; provider; and health system-related challenges to the provision of optimal end-of-life care in hospital. Findings highlight potential areas for improvement as part of a coordinated approach to optimising the provision of end-of-life care in hospitals. Future goals should include larger-scale, longitudinal studies across various states and territories to inform the development of interventions that can help to address the identified gaps in service provision. Implications for research, policy, and practice: This study has highlighted the need to involve all stakeholders when designing interventions to improve end-of-life care. Nurses can provide valuable insight into the factors that can make the greatest impact in improving care provision. It suggests that the provision of high-quality end-oflife care in hospitals is complex, and that there is substantial overlap between items nurses perceive to be barriers in each of the five domains of care provision. To achieve sustainable improvement in the quality of end-of-life care provided in hospitals, a multi-factorial, and collegial, approach to designing interventions will be needed. What is already known about the topic? • End-of-life care is increasingly being provided in hospital settings. • Nurses are an important source of information and support for dying patients and their families. • Few studies have explored nurses' perceptions of the barriers to the provision of high-quality end-oflife care across all domains of healthcare provision. What this paper adds: • Important barriers include continuation of potentially futile treatment, adequacy of symptom control, and poor communication between doctors, patients, and their families. • Findings can support the design of more effective intervention strategies to mitigate identified barriers and achieve improvements in the quality of end-of-life care delivered in hospital. [ABSTRACT FROM AUTHOR]

Current international targets aim for 90% of people diagnosed with HIV to be on antiretroviral treatment (ART). This paper aims to identify sociodemographic and attitudinal factors associated with ART non-use over time in three samples of Australian people living with HIV (PLHIV). Data for this paper were derived from an Australian cross-sectional survey of PLHIV that was repeated at three different time points: 1997, 2003, and 2012. There were approximately 1000 respondents to each survey (n = 3042 in total). The survey included approximately 250 items related broadly to health and well-being, ART use, and attitudes towards ART use. Univariate and multivariate logistic regression analyses were used. While the proportion of participants using ART increased between 1997 and 2012 (78.8–87.6%,p < .001), there was a decrease between 1997 and 2003 to 70.6% (p < .001). Factors linked to ART non-use remained steady over those 15 years. In all cohorts, people less likely to be using ART were younger and had a more recent diagnosis of HIV. In 2003 and 2012, people in full-time employment were less likely to be using ART, while those whose main source of income was a pension or social security were more likely to be using ART. Multivariate models showed that, at each time point, a belief in the health benefits of delayed ART uptake was associated with non-use. These findings suggest that there may be barriers to ART uptake that have persisted over time despite changes to clinical guidelines that now encourage early uptake. [ABSTRACT FROM PUBLISHER]

Objectives: The literature describing the oral health of people with Multiple Sclerosis (MS) is scant and the findings equivocal. The aim of this study was to describe the oral health and oral self‐care behaviours of people living with MS and compare it to the Australian population. Methods: Participants enrolled with the Australian MS Longitudinal Study (AMSLS) were invited to participate in the survey using an online or paper‐based questionnaire. Data were collected on level of disability, oral health, oral self‐care and factors influencing attendance for oral health care. Results: Completed questionnaires were received for 1523 respondents. Over one‐fifth (n = 320; 22%) rated their oral health as fair or poor, and more than half (n = 840; 57%) reported toothache in the last 12 months. These proportions were higher than those for the general Australian adult population (oral health prevalence ratio (PR) = 1.25 [1.12, 1.40]; toothache PR = 3.63 [3.39, 3.88]), and this is despite comparable or better self‐maintenance habits and dental attendance reported by respondents. People with MS reported high rates of mouth dryness (68.4%), teeth sensitivity (64.7%), change of taste (40.5%) and orofacial pain (39.0%); fewer than 10% experienced none of these. There was a lower prevalence of self‐reported need for treatment (extraction or filling) than in the Australian adult population (15.8% vs 32.9%). Conclusions: People with MS have a greater oral health burden, demonstrated by their poorer self‐reported oral health than the Australian adult population. Furthermore, they experience high rates of toothache, mouth dryness, teeth sensitivity, change of taste and orofacial pain. These findings are contrary to their self‐reported good oral self‐care and dental attendance habits and suggest some of the oral health impacts are due to MS rather than dental behaviours. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether differences in access to specialist disability services by people from culturally and linguistically diverse (CALD) backgrounds when compared with those born in Australia represent a service gap or the healthy migrant effect.Method: To use the latest disability statistics to measure the different rates of people with disability, and the rates of people with profound and severe disability, of people born in Australia and those born abroad; to compare the difference between those who mainly speak English with those who primarily speak a language other than English at home (LOTE); and examine the age-specific and standardised disability rates of these subgroups.Results: The rate of access of specialist disability services by people with disability who were from CALD backgrounds is highly disproportionate to their presence in the community. As a whole, people from CALD backgrounds have a similar level of disability as Australia-born people. They have a greater rate of profound and severe disability and a higher level of need for assistance in undertaking core activities. For younger age cohorts targeted by specialist disability services, there is little difference in the level of need for assistance between people from CALD backgrounds and the rest of community. Those people who mainly speak LOTE at home have a relatively higher level of need for assistance than those who speak mainly English at home.Conclusions: The paper reveals a substantial gap in specialist disability services between people from CALD and the broader community. This cannot be explained by the difference in the level of need for assistance between Australia-born and overseas-born populations, therefore raises some policy questions as to the barriers to the use of such services and how to effectively narrow the service access gap and improve utilisation rates.Implications for RehabilitationThe paper reveals a substantial accessibility gap in specialist disability services between people from culturally and linguistically diverse (CALD) backgrounds and the broader community in Australia.Rehabilitation is a large component of disability services. Therefore, understanding the gap, promoting the awareness of the services, developing appropriate and effective services to respond the need of people with disability from CALD backgrounds, are critically important to rehabilitation services and related research. [ABSTRACT FROM PUBLISHER]

While rural background has consistently been the strongest predictor of rural practice, the Australian medical schools have a vital role to play in changing rural intention. Research on rural exposure during medical training has to date resulted in inconsistent findings. The purpose of this paper is to examine what occurs during a short conscripted rural exposure. A post-test self-report questionnaire evaluating the University of Queensland Rural Medicine Rotation eight-week clinical rotation was completed by 1609 domestic medical students from 2007 to 2011. The most effective single learning outcome was students who strongly agree that the rural rotation experience had increased their appreciation of the greater depth of clinical responsibility inherent in rural practice. These students were more likely to indicate that their intention to practise rurally had been positively rather than negatively influenced and more like to indicate they were very encouraged by the experience rather than merely encouraged to practise rurally. The most powerful group of learning outcomes, in positively changing rural intention from a short mandated exposure were aligned with developing an understanding of the context of rural medical practise. These contribute to our understanding of the role rural exposure. [ABSTRACT FROM AUTHOR]

Extensive evidence has shown that working nonstandard hours, such as evening or night shifts, impacts negatively on workers' own health, and a growing literature suggests such impacts extend to the health of workers’ children. Using matched parent and child data from a large Australian panel survey this paper explores the effects of parental work schedules on the mental and physical health of adolescents aged 15–20 in sole-parent families. Random-effects models indicate adolescents have marginally worse emotional and physical health when their parent works nonstandard hours, based on SF-36 component summary scores, associated primarily with emotional or physical role limitations. Parental weekend schedules are particularly detrimental to adolescent physical health. Evidence is found that the effects of nonstandard work schedules on adolescent wellbeing are transmitted through increased work-family conflict and exacerbated where parents have low job control. [ABSTRACT FROM AUTHOR]

To date, people with intersex variations have been mainly studied via small-scale clinical research, with only a small amount of reflective commentary contributed by sociocultural scholars. This paper reports on findings from a 2015 online Australian survey of 272 people with intersex variations, which aimed to redress the gap in research on this groups’ experiences and perspectives concerning education. Participants ranged in age from 16 to 87 years, and represented all Australian states and territories. Most had experienced two medical treatment interventions related to their intersex variation: commonly reported interventions included hormonal treatment and genital surgery delivered to participants when they were aged under 18 years of age. Participants reported various physical and psychological impacts from these treatments. Well-being risks were high; most of the group had engaged in suicidal ideation, particularly when individuals first found out about their variation. This impacted on their schooling – almost one-fifth of survey respondents had received no high school certification due to their early dropout and the overwhelming majority did not attend schools with inclusive puberty/sex education provision or counselling. Most survey participants had not disclosed their intersex variation to staff, although more than half had done so to their classmates. Many had experienced bullying. Only one-quarter of participants rated their overall education experiences positively. Participants suggested improvements to schools’ information provision and support features. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to examine the growth in quality assurance maturity within the six Australian and New Zealand university libraries which make up the Libraries of the Australian Technology Network (LATN). Design/methodology/approach – The paper is based on benchmarking surveys of library quality assurance commissioned by LATN in 2005/2006, with a follow up study in 2010. The author led the conduct and analysis of both surveys. The 2005/2006 study reviewed quality assurance practices at the member libraries, to draw out examples of best practice and identify gaps and possible areas for improvement within the libraries. It was based on a review of member libraries' websites, a questionnaire completed by a nominee from each member library, and follow-up in-person interviews with each nominee and the University Librarian of each institution. In 2009/2010 the same questionnaire was re-administered to investigate whether changes had occurred in the intervening period, including what improvements had been made and where there were still gaps. Had the conduct of quality audits by the Australian Universities Quality Agency had an impact? Had members made improvements to their quality assurance processes based on the findings of the first study or for other reasons? To elicit additional information, follow-up interviews are being carried out in 2011. Findings – In 2005/2006 the reviewers found three models of responsibility for quality assurance: centralised, within a manager's portfolio and devolved. Each was appropriate to a different level of quality maturity, with a centralised model considered to be most appropriate at the early stages of development. Whereas in 2005/2006 only one library had a centralised model, by 2010 three libraries had adopted this model and one had moved on from it. The paper compares applications of these models in the libraries and looks at the extent to which growth in quality assurance in the libraries is associated with adoption of the centralised model. It distinguishes the formal creation and appointment of a quality officer position from the ad hoc individual efforts in quality which can and do occur in many libraries. In 2005/2006 only two libraries had a functioning and well-maintained quality framework which the LATN reviewers considered to be a hallmark of best practice in quality assurance. By 2010 this number had doubled to four. The paper looks at the quality, planning and/or performance frameworks in place and whether they were selected or developed by the library or imposed by their parent university. The impact of the adoption of a framework on the development of quality policies, procedures and documentation to achieve comprehensiveness, standardisation and repeatability in quality assurance are considered. A notable change between the 2005/2006 and the 2010 surveys was the growth in individual work planning and performance review, which was identified by the LATN reviewers as a sector-wide gap in 2005/2006. Ideally, use of such plans and assessments should assist in the taking quality beyond library management, to develop amongst the library staff a culture of continuous improvement.Originality/value – The paper provides real examples of how quality assurance can and has been improved in libraries, within a five year timeframe. While it is based on the experience of Australian and New Zealand libraries, it addresses concerns and provides solutions which are appropriate internationally. It provides a range of options which an individual library could adopt depending on its own context. [ABSTRACT FROM AUTHOR]

In contrast to the recent proliferation of studies incorporating ordinal methods to generate health state values from adults, to date relatively few studies have utilised ordinal methods to generate health state values from adolescents. This paper reports upon a study to apply profile case best worst scaling methods to derive a new adolescent specific scoring algorithm for the Child Health Utility 9D (CHU9D), a generic preference based instrument that has been specifically designed for the estimation of quality adjusted life years for the economic evaluation of health care treatment and preventive programs targeted at young people. A survey was developed for administration in an on-line format in which consenting community based Australian adolescents aged 11–17 years (N = 1982) indicated the best and worst features of a series of 10 health states derived from the CHU9D descriptive system. The data were analyzed using latent class conditional logit models to estimate values (part worth utilities) for each level of the nine attributes relating to the CHU9D. A marginal utility matrix was then estimated to generate an adolescent-specific scoring algorithm on the full health = 1 and dead = 0 scale required for the calculation of QALYs. It was evident that different decision processes were being used in the best and worst choices. Whilst respondents appeared readily able to choose ‘best’ attribute levels for the CHU9D health states, a large amount of random variability and indeed different decision rules were evident for the choice of ‘worst’ attribute levels, to the extent that the best and worst data should not be pooled from the statistical perspective. The optimal adolescent-specific scoring algorithm was therefore derived using data obtained from the best choices only. The study provides important insights into the use of profile case best worst scaling methods to generate health state values with adolescent populations. [ABSTRACT FROM AUTHOR]

Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and 'usual' drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop ( n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities. [ABSTRACT FROM AUTHOR]

Recognition of human rights on the basis of sexual orientation, gender identity and intersex status by the United Nations has led to the development of new policies concerning homophobia and transphobia in educational contexts. This paper examines new Australian education policies impacting gay, lesbian, bisexual, transgender, intersex and queer (GLBTIQ) teachers. A policy review uncovered a range of protections for GLBTIQ teachers in contexts such as the State of Victoria, alongside restrictions. Experiences of policy discussed in pilot study data from surveys of 63 Victorian GLBTIQ teachers, and in-depth interviews with nine Victorian GLBTIQ teachers, revealed that GLBTIQ teachers were relatively unaware of the protections available to them, compared to their awareness of protections for students. Many teachers were out as lesbian or gay to some staff members but fewer had come out to students. Teachers in religious schools had more difficulties, causing some to leave the sector. Further promotion of protections and more research are recommended. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To explore the influences on accessibility of compounded progesterone therapy for Australian women. Study design: A cross-sectional survey of a stratified sample of Australian women who use progesterone only products using the ‘Perspectives on Progesterone’ questionnaire. Main outcome measures: Principle components analysis (PCA) to determine components of access to progesterone treatment and multi-way analysis of variance to compare groups. Results: Women using compounded progesterone were likely to have made at least one lifestyle adaptation (73%), and to have tried and stopped using at least one complementary and alternative medicine therapy (63%) or conventional hormone therapy (41%). PCA revealed six components of access to progesterone treatment: affordable, values natural treatments and is concerned about other treatments, conventionally available, perceived knowledge, values information gathered from a variety of sources, and rural & disadvantaged. The multifaceted nature of progesterone use illustrates that there are multiple aspects to use of non-conventional medicines. Women looking for non-conventional treatment are neither stupid nor uninformed, their understandings, based on experience and research, need to be addressed by health professionals while assessing their condition prior to discussing the risks and benefits of non-conventional medicines. Conclusion: Access to compounded progesterone is multifaceted, and many of the women who use it have tried other treatments first. Despite the clinical ambivalence towards progesterone as an alternative for women who may have tried and rejected other treatments, including conventional hormone therapy, the women described in this paper are using it. [Copyright &y& Elsevier]

This paper examines how the relationships between the factors (predisposing, enabling and illness) of the 1973 Andersen framework and service use are influenced by changes in the caring role in older women of the 1921–26 cohort of the Australian Longitudinal Study on Women's Health. Outcome variables were the use of three formal community support services: (a) nursing or community health services, (b) home-making services and (c) home maintenance services. Predictor variables were survey wave and the following carer characteristics: level of education, country of birth, age, area of residence, ability to manage on income, need for care, sleep difficulty and changes in caring role. Carer changes were a significant predictor of formal service use. Their inclusion did not attenuate the relationship between the Andersen framework factors and service use, but instead provided a more complete representation of carers' situations. Women were more likely to have used support services if they had changed into or out of co-resident caring or continued to provide co-resident care for a frail, ill or disabled person, needed care themselves, and reported sleep difficulties compared with women who did not provide care. These findings are important because they indicate that support services are particularly relevant to women who are changing their caring role and who are themselves in need of care. [ABSTRACT FROM AUTHOR]

Drawing on the classic model of balanced affect, the Francis Burnout Inventory conceptualises good work-related psychological health among clergy in terms of negative affect being balanced by positive affect. This paper sets out to explore the relationship between work-related psychological health and psychological type (as assessed by the Francis Psychological-Type Scales) among a sample of 212 Australian clergywomen who completed the National Church Life Survey Form L in 2006. The data supported the internal consistency reliability of the Francis Burnout Inventory and Francis Psychological-Type Scales and found that work-related psychological health was positively related to extraversion and sensing. [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]