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Research has consistently established the positive impact of sharing books with young children. Evidence suggests several important factors when evaluating book sharing with young children, including the quality of educator practice = and the nature of groupings, as well as the frequency and duration of book sharing sessions and access to books. Other evidence suggests book sharing may be particularly important for children from low ses backgrounds attending early learning settings. This paper reports on a larger study which investigated the factors and relationships influencing the use of children's literature to support principles of diversity in kindergarten rooms of long day care centres. A mixed methods approach was adopted and a convergent design was employed to synthesise the qualitative and quantitative data and interpret significant relationships and their meanings. The quality of educator practice was measured through the Systematic Assessment of Book Reading (SABR) and Children's engagement in book sharing was assessed using the Children's Orientation to Book Reading Rating Scale. Detailed analysis of 148 video recorded book sharing sessions produced statistical representations of the frequency and duration of book sharing across the contexts and the nature of involvement of the children in the study. Twenty four educators and 110 children from four long day care centres in Western Australia participated. Data were collected through semi-structured interviews, video-based observations, field notes, document analysis and a book audit. The results showed that while the children in this study had a range of book sharing experiences, few of these were frequent or of high quality. Of great concern is the finding that the children in this study most likely to be considered at risk of educational disadvantage were those with the least exposure to book sharing in general, and, even less so, to high quality book sharing, raising concerns about equitable outcomes for them. [ABSTRACT FROM AUTHOR]

Suicide has a devasting and far-reaching effect on our communities. In developed countries, most people who die by suicide are male. Understanding men's mental health and what they experience in a suicidal state is key to preventing future attempts. Our paper explores how a group of 37 men in Australia describe the leadup to their suicidality. Underpinned by interpretive phenomenological analysis, interview transcripts were examined for phrases that the investigative team subjectively identified as profound. Our approach considered language and expression that evoke reactions to the sometimes contradictory nature of suicide. The process enabled our team to identify the emotions, rationales, and motivations for and against suicide that give rise to and arise during suicidal states. One man's source of strength may be another's cause of anguish, so any single, one-size-fits-all pathway to suicide prevention is unlikely to succeed, signaling the need for a tailored approach to suicide prevention. [ABSTRACT FROM AUTHOR]

This paper examines the links between place attachment and older persons' preferences to age in place, and factors that disrupt these preferences. We use data from the 2001–2021 Household, Income and Labour Dynamics in Australia Survey and panel-data modelling to confirm strong associations between several place attachment dimensions and aging-in-place preferences. Strong ties to children, strong social capital, residence in social housing, homeownership status, housing wealth, and home and neighborhood satisfaction are all positively linked to a stronger preference to age in place. Our findings reveal important differences between older homeowners and older non-owners. For owners, closeness to children is a strong predictor of aging-in-place preferences, although mortgage debt can trigger involuntary moves. For non-owners, tenure security achieved through longer durations at one's address of residence is linked to stronger aging-in-place preferences. However, private renters are more often exposed to involuntary moves. We discuss the policy implications of these disruptions. [ABSTRACT FROM AUTHOR]

Intersecting gender and other social inequalities are pertinent to women's mental health across the life course. Gendered violence and other forms of gender inequality in particular play a key role in the higher burden of psychological distress carried by young women. However, the context of gendered violence is often minimised or overlooked entirely when young women seek help or advice around mental health concerns. This is especially the case for young women under the age of 30 years. This paper reports on a research study exploring how young women in Australia understand their mental health, and the scope for new approaches to support that better address their needs. A qualitative survey undertaken with 52 Australian young women was used to explore the nature of their mental health experiences, sought to learn about the strategies they used when experiencing poor mental health and the scope for mental health peer support as an alternative approach to intervention. Responses from a diverse group of young women demonstrated that they understood the role that gendered violence and gender inequality played in their mental health. Findings point to the risk of slippage between young women's understandings of their lived experience and those of traditional service providers, demonstrating the risks associated with minimising or ignoring of the gendered nature of young women's mental health problems. [ABSTRACT FROM AUTHOR]

Background and aims: Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences – and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home–school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home–school partnerships study over time and (2) understand their experiences of being community partners on the home–school partnerships project. Methods: Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home–school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home–school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results: We found that parents' input fundamentally shaped the broader home–school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home–school partnership study – although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home–school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions: These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications: This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities. [ABSTRACT FROM AUTHOR]

Words and stories have the power to resonate with people. Composite narratives can be constructed using multiple participant accounts, representing their experiences while also capturing the properties and categories of qualitative research findings. The ability of composite narratives to represent the multiple facets of theory construction through a singular narrative point-of-view is unique and provides a concise and credible method to present research findings. This paper explains how composite narratives can be constructed to present the research data that findings are built upon through an illustrative example of the process. The example of a composite narrative presented in this article is one of a larger set from a grounded theory study about a substantive group of Australian students' experiences of their interactions in the classroom that communicate their teachers' expectations of them. Narratives have the power to affect change in society by enhancing the transferability of research findings, presenting research findings with impact because they are engaging and memorable for readers. Qualitative researchers who are interested in composing composite narratives to reflect multiple participants' different experiences, through interview data, will benefit from the justification and example of the technique, which provides a model for future research. [ABSTRACT FROM AUTHOR]

Children and young people's access to and engagement in education is a key determinant of future positive outcomes. Children and young people in out-of-home care disproportionally experience educational disruptions and disengagements affecting their ability to participate in schooling, further and higher education. There is increasing international interest in the participation of young people with lived experience of out-of-home (OOHC) in research projects. This paper presents the findings of a study in the Australian state of Victoria where a group of lived experience consultants (LECs) were employed to consult on the results of a broader survey of the attitudes of professionals, carers and care leavers regarding the educational experiences of children in OOHC. Two meetings were held with the LECs, one to gain their views on the survey findings, and secondly, to reflect on their experiences working on the project. The findings suggest that formalizing the engagement of lived experience voices in research, inherently a qualitative approach, promotes a more informed representation of the challenges faced by children and young people within OOHC. In this case, engaging young adults with lived experience helped identify key barriers to effective educational participation that the project design may otherwise have overlooked. They also identified key strategies for improving LEC engagement such as involving them in developing key research aims and questions, and enabling the provision of a 'safe space' for them to participate. This new approach promotes co-design at multiple levels, providing opportunities for a meaningful collaborative approach to research. [ABSTRACT FROM AUTHOR]

Introduction: A lack of patient safety research hampers capacity to improve safety in healthcare. Ultrasound is often considered 'safe' as it does not use ionising radiation, a simplistic view of patient safety. Understanding sonographers' actions towards patient safety is crucial; however, self-reported measures cannot always predict behaviour. This study is part of a PhD exploring patient safety in medical diagnostic ultrasound. The aim of this paper is to explore sonographers' responses to the patient safety concerns identified in Part one of this study. The ultimate aim of the study is to inform the final phase of the doctoral study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. The Theory of Planned Behaviour (TPB) explained how sonographers respond to perceived patient safety risks in practice. Results: Thirty-one sonographers were interviewed. Based on the seven themes identified in Part one of the study, results showed that incongruences exist between identifying patient safety risks and the actions taken in practice to manage these risks. Conclusion: The TPB showed that behavioural, normative and control beliefs impact sonographers' responses to perceived patient safety risks in practice and can lead to risk avoidance. Lack of regulation in ultrasound creates a challenge in dealing with Fitness to Practice issues. Collective actions are required to support sonographers in taking appropriate actions to enhance patient safety from multiple stakeholders including accreditation bodies, regulatory authorities, educational institutions and employers. [ABSTRACT FROM AUTHOR]

In a study on children, families and food messages in Victoria, Australia, we utilised a multi-methods approach that included visual data produced by primary-school aged children. Working with 50 families, we provided each child investigator with an iPad for 3–4 days and invited them to photograph family food events important to them. The analysis of visual data alongside child and family interviews revealed the diverse meaning-making practices children draw on to understand food practices at home and school. These research practices aspired to locate the researchers and children as co-creators. In this paper, we reflect on the challenges and (dis)comfort we faced as researchers as the implications of co-creation emerged and we engaged with children's voices, photos and families inside their homes. The multi-methods approach supported a comprehensive and rich engagement with commensality and pleasure in food practices at home for children, but illuminated the complex emotional and intellectual terrain of such research practices. [ABSTRACT FROM AUTHOR]

Annual turnover of home care workers represents a huge loss of revenue and is a key source of inefficiency in the home health care industry. In this article, we propose a data-driven approach to monitor employee churn and to capture the evolution of employee intent to leave. Unlike most papers in the literature, we use machine learning techniques to analyze over 2 million visits in the US, Canada, and Australia between 2016 and 2019. Results show that the gap between the number of hours worked and in the contract is the most important factor to predict employee intent to leave, which means an employee should be given as many hours as requested in the contract to improve retention. Secondary results show that having diverse shift lengths and continuity in services and patients seem to be associated with less turnover. [ABSTRACT FROM AUTHOR]

Introduction: Patient safety has been an undervalued component of quality healthcare but is a challenging area of research. Ultrasound is the most common imaging modality in the world. Research on patient safety in ultrasound is generally focused on bioeffects and safe operation of ultrasound equipment. However, other safety issues exist in practice that warrant consideration. This paper forms the first part of a PhD study exploring patient safety in medical diagnostic ultrasound, beyond the notion of bioeffects. The ultimate aim of the study is to inform the final phase of the research study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. A thematic analysis categorised data into codes and generated final themes. Results: A heterogeneous mix of 31 sonographers, who reflected the profile of the profession in Australia, were interviewed between September 2019 and January 2020. Seven themes emerged from the analysis. These were bioeffects, physical safety, workload, reporting, professionalism, intimate examinations and infection control. Conclusion: This study presents a comprehensive analysis of sonographers' perceptions of patient safety in ultrasound imaging, not previously available in the literature. Consistent with the literature, patient safety in ultrasound tends to be viewed in technical terms through the potential for bioeffects of tissue damage or physical harm to the patient. However, other patient safety issues have emerged, and while not as well recognised, have the potential to negatively impact on patient safety. [ABSTRACT FROM AUTHOR]

Digital maps have been taken up as a productive tool in both activism and academic research. However, there has been less consideration of their use as a research method in qualitative social sciences research. This paper aims to contribute towards scholarship on qualitative research by providing a critical reflection on the use of digital mapping as a research method in a feminist research project on street-based harassment in Australia. Drawing on practices of reflexivity, as well as comments made by participants across 46 qualitative interviews, I consider how digital mapping can be used to facilitate feminist research, arguing that it represents a generative instrument which lends itself to the development of in-depth insights from participants. Yet, mapping also delimits the epistemological possibilities of qualitative research, and I consider how this method simultaneously constrains what can be known about street harassment. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) can involve patterns of physical, sexual and emotional abuse. Women typically experience physical IPV in combination with emotional IPV, while emotional IPV is often experienced in the absence of other types of IPV. There is very little known about women's experiences of these different types of IPV over time. The primary aim of this paper is to describe patterns in women's individual experiences of physical and/or emotional IPV across the first 10 years of motherhood. Data were drawn from a prospective pregnancy cohort of 1507 first-time mothers in Melbourne, Australia. Emotional, physical, and combined physical and emotional IPV were reported in the first, fourth and tenth year of motherhood using the Composite Abuse Scale. The overall prevalence of each type of IPV remained consistent across the three time-points, with emotional IPV alone being the most prevalent. There was substantial variability in women's experiences of IPV over time and there was no common progression from one type of IPV to another. Women were more likely to report IPV at more than one time-point if they experienced combined physical and emotional IPV, while for women who reported emotional or physical IPV alone this was more likely to be at a single time-point. A number of socio-demographic characteristics in early pregnancy were associated with a higher risk of reporting IPV at all three time-points, including being unemployed (RRR = 3.6; 95% CI: 2.1, 6.2) and being aged 18–24 years (RRR = 3.1; 95% CI: 1.8, 5.4). Knowledge of the variability and persistence of IPV in the first 10 years of motherhood, and factors associated with these experiences, can help tailor effective health and social service responses. [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) is a common yet hidden form of violence. It is primarily perpetrated against women by their male partners and is associated with a range of serious mental and physical health outcomes. Despite these harms, it is chronically under-researched. In particular, the overlaps between IPSV and psychological abuse in relationships are poorly understood. Extant literature has focused primarily on the relationship between IPSV and physical violence, neglecting the fact that IPSV often involves verbal or emotional coercion, threats or blackmail rather than the use of 'force'. In this paper, we draw on reflexive thematic analysis of qualitative interviews with n = 38 victim/survivors of IPSV to explore how they understood the relationship between sexual and psychological abuse in their heterosexual relationships. Four themes were developed from this analysis: 1. I felt like I couldn't say Nno'; 2. I felt degraded and worthless; 3. Letting me know who's boss; and 4. Making me feel crazy. These themes broadly correspond to four distinct patterns or interactions between IPSV and psychological abuse. Our findings strongly suggest that the relationship between sexual and psychological abuse in relationships is far more complex than previous research would indicate. Psychological abuse is not simply a tool to obtain sex and sexual violence is not only used as a mechanism of psychological control. Instead, the two forms of abuse interact in ways that can be unidirectional, bi-directional or simultaneous to develop and maintain an environment of fear and control and erode women's self-worth. [ABSTRACT FROM AUTHOR]

Objectives: Differentiating schizophrenia from mania in acutely psychotic patients can be difficult, but is important in determining immediate and subsequent management. Such differentiation is generally addressed by clinical interviews, but an observational approach may assist. This paper therefore describes the development of a relevant observational measure. Methods: We developed a provisional list of 49 items (weighting features with suggested specificity to schizophrenia and mania) for independent completion by two nurses and judged its ability to predict diagnosis provided by consultant psychiatrists. Results: Eighty-seven psychotic patients were recruited, and 173 completed data sets were analysed. We refined the item set to two sets of 10 items that best-differentiated schizophrenia from mania and vice versa. Optimal differentiation was achieved with a score of at least 7 on both the schizophrenia and mania item sets. Difference scores (i.e. schizophrenia items affirmed minus mania items affirmed) were also generated, with a difference score of +1 (i.e. one or more schizophrenia items being affirmed than mania items) showing optimal differentiation (sensitivity 0.67, specificity 0.82) between the two conditions. Evaluating all potential difference scores, we demonstrated that, as difference scores increased, diagnostic accuracy in identifying each condition was very high. Conclusion: Analyses allow the properties of an observational measure (the 20-item Sydney Psychosis Observation Tool) to be described. While a single cut-off difference score was derived with acceptable discriminatory ability, we also established the capacity of varying difference scores to assign both schizophrenia and mania diagnoses with high accuracy. [ABSTRACT FROM AUTHOR]

Summary: Social workers are expected to challenge the exclusion and oppression of marginalised populations which requires the critical interrogation of prejudicial views, discriminatory attitudes, and oppressive practices. In this regard, social work practitioners need to be vigilant of their own attitudes toward the people they serve. This is relevant to social work practice with sexual minorities. This paper presents the results of a mixed-methods study informed by a critical theoretical frame that explored Vietnamese social work practitioners' attitudes toward sexual minorities. The findings presented in this article were drawn from a survey of 292 social work practitioners based in Hanoi, Vietnam and 12 semi-structured interviews with volunteers recruited from the pool of survey participants. Findings: The findings suggest that practitioners who participated in this study held relatively positive attitudes toward people who identify as lesbian or gay. However, those who had what could be considered moderate to positive attitudes were not necessarily free from prejudicial and discriminatory views, particularly when it came to certain matters such as those relating to their own families and work with young children. Applications: The discussion of the findings illustrate the relevance of the broader social context to Vietnamese social work practitioners' attitudes toward sexual minorities. It highlights the potent influence of dominant ideologies in shaping prejudicial views and attitudes and points to the need for practice at a broader level targeting Vietnamese society and culture as a whole. [ABSTRACT FROM AUTHOR]

Forecasts predict a growing shortage of skilled nursing staff in countries worldwide. Nurse migration is already a common strategy used to address nursing workforce needs. Germany, the UK, and Australia are reviewed here as examples of destination countries for nurse migrants. Agreements exist between countries to facilitate nurse migration; however, it is not evident how nurse migrants have contributed to data on which these arrangements are based. We examined existing primary research on nurse migration, including educational needs and initiatives to support policymakers', stakeholders', and health professions educators' decisions on measures for ethical and sustainable nurse migration. We conducted a rapid evidence assessment to review available empirical research data which involved, was developed with, or considered migrant nurses to address the research question: what are the findings of research that directly involves migrant nurses in producing primary research data? A total of 56 papers were included. Four main themes were identified in this research data: Research does not clearly define what is meant by the term migrant nurses; discrimination is often reported by migrant nurses; language and communication competencies are important; and structured integration programs are highly valued by migrant nurses and destination healthcare employers. Migrant nurses continue to experience discrimination and reduced career opportunities and therefore should be included in research about them to better inform policy. Structured integration programs can improve the experience of migrant nurses by providing language support (if necessary), a country-specific bridging program and help with organisational hurdles. Not only researching migrant nurses but making them active partners in research is of great importance for successful, ethical, and sustainable migration policies. A broader evidence base, especially with regard to the views and experiences of migrant nurses and their educational support needs, should be promoted to make future immigration policy more needs-based, sustainable and ethically acceptable. [ABSTRACT FROM AUTHOR]

Objective: The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment. Background: Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region. Methods: Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs. Results: Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a "benefits realization" process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur. Conclusions: The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design. [ABSTRACT FROM AUTHOR]

Background: Coal miners have been reported to have higher rates of risky/harmful alcohol misuse; however, it is not known if metalliferous mining employees whose working conditions differ in workplace practices, also have increased rates of risky/harmful alcohol misuse. This study aimed to examine alcohol consumption in a sample of Australian metalliferous mining workers and to examine the demographic and workplace factors associated with risky/harmful alcohol use. Methods: All employees from a convenience sample of four Australian mine sites were invited to complete a paper-based cross-sectional survey between June 2015 and May 2017. The survey contained questions relating to social networks, health behaviors, psychological distress, demographic characteristics, and risky/harmful drinking. Current alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated measure of risky and/or harmful drinking. Factors associated with risky/harmful drinking were investigated using univariate and multivariable logistic regression. Findings: A total of 1,799 participants completed the survey (average site response rate 95%). Overall, 94.8% of males and 92.1% of females reported using alcohol in the preceding 12 months. The odds of risky/harmful alcohol use were significantly higher in those who were male, younger, and reported higher psychological distress. Conclusions/Application to Practice: This study identified that metalliferous mining employees engage in at-risk levels of alcohol consumption significantly higher than the national average despite workplace policies and practices that restrict alcohol use. Personal and workplace risk factors that may help target specific employee groups and inform the development of tailored, integrated multicomponent intervention strategies for the industry were identified. [ABSTRACT FROM AUTHOR]

Objectives: This paper compares the evolution of the psychosocial sector in two Australian regions pre and post introduction of the National Disability Insurance Scheme – a major reform to the financing, planning and provision of disability services in Australia, intended to create greater competition and efficiency in the market, and more choice for service users. Methods: We used a standardised service classification instrument based on a health ecosystems approach to assess service availability and diversity of psychosocial services provided by non-government organisations in two Primary Health Network regions. Results: We identified very different evolutionary pathways in the two regions. Service availability increased in Western Sydney but decreased in the Australian Capital Territory. The diversity of services available did not increase in either Primary Health Network 4 years after the reform. Many services were experiencing ongoing funding uncertainty. Conclusion: Assumptions of increased efficiency through organisational scaling up, and a greater diversity in range of service availability were not borne out. Implications: This study shows the urgent need for evaluation of the effects of the NDIS on the provision of psychosocial care in Australia. Four years after the implementation of the NDIS at vast expense key objectives not been met for consumers or for the system as a whole, and an environment of uncertainty has been created for providers. It demonstrates the importance of standardised service mapping to monitor the effects of major reforms on mental health care as well as the need for a focus at the local level. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy are associated with longer term cardiovascular risk. Understanding if depression or antidepressant use in pregnancy is associated with HDP is important in identifying those potentially vulnerable to poorer health in later life. This study examines if depression and antidepressants are associated with HDP. Methods: In all, 815 pregnant women were recruited within an Australian pregnancy cohort study at less than 20 weeks of pregnancy, all undertook the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and were assigned to four groups for this paper: those with unmedicated depression meeting criteria for current depression (n = 97), those taking selective serotonin reuptake inhibitors in early pregnancy (n = 101), those taking serotonin and noradrenaline reuptake inhibitors in early pregnancy (n = 31), and those without depression or taking antidepressant medication (control; n = 586). Women were then assessed again following birth. Hypertensive disorders of pregnancy were diagnosed according to the Society of Obstetric Medicine in Australia and New Zealand Guidelines. Results: Use of serotonin and noradrenaline reuptake inhibitors (SNRIs) (adjusted risk ratio = 9.10, 95% confidence interval = [3.82, 21.67]) and unmedicated depression (adjusted risk ratio = 3.11, 95% confidence interval = [1.32, 7.35]) were independently associated with significantly higher risk for developing hypertensive disorders of pregnancy compared to controls. Selective serotonin reuptake inhibitors (SSRIs) use did not confer any increased risk. Higher doses of SNRIs, but not selective serotonin reuptake inhibitors, were associated with significantly higher risk for developing HDP (adjusted risk ratio = 4.83, 95% confidence interval = [1.50, 15.58]). Conclusions: Our findings suggest that those with depression in pregnancy and/or on an serotonin and noradrenaline reuptake inhibitor should have closer surveillance for the development of hypertensive disorders of pregnancy. These findings support treatment of depression in pregnancy, however, also the consideration of class of antidepressant. [ABSTRACT FROM AUTHOR]

Globally, significant numbers of women report obstetric violence (OV) during childbirth. The United Nations has identified OV as gendered violence. OV can be perpetrated by any healthcare professional (HCP) and is impacted by systemic issues such as HCP education, staffing ratios, and lack of access to continuity of care. The current study explored the experiences of OV reported in a national survey in 2021 by Australian women who had a baby in the previous 5 years. A content analysis of 626 open text comments found three main categories: "I felt dehumanised," "I felt violated," and "I felt powerless." Women reported bullying, coercion, non-empathic care, and physical and sexual assault. Disrespect and abuse and non-consented vaginal examinations were the subcategories with the most comments. [ABSTRACT FROM AUTHOR]

Objective: To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion. Design: We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study. Setting: Economically disadvantaged areas in rural Australia. Participants: Patients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. Main measures: A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28). Results: Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57–0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00–1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02–2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14–2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18–0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion. Conclusions: Cardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, trans, queer, and asexual (LGBTQA+) young people with disability are known to experience higher rates of harassment or abuse than LGBTQA+ young people without disability. This study focused on participants in Australia and identified factors associated with harassment or abuse among LGBTQA+ adolescents and young adults who reported a disability as well as associations with mental health outcomes. Analyses were conducted from a national survey that included 2,500 LGBTQA+ people who reported a disability and were aged 14 to 21 years. Measures included experiences in the past 12 months of verbal and physical harassment or abuse due to one's sexual orientation or gender identity, sexual harassment or abuse, mental health, suicidality, and sociodemographic traits. Overall, 48.4% of participants with disability reported experiencing verbal harassment or abuse, 12.4% physical harassment or abuse, and 29.7% sexual assault or harassment. In multivariable regression analyses, verbal harassment or abuse was significantly more likely among trans men, participants with an intellectual disability, and those who were "out" to most or all of their family. Physical harassment or abuse was significantly more likely among participants with a physical or sensory disability. Sexual harassment or abuse was significantly more likely among trans women and participants with a physical or sensory disability. Participants who experienced harassment or abuse were also significantly more likely to have attempted suicide in the past 12 months. These findings will assist policymakers and practitioners in identifying contexts linked to a heightened risk of abuse among LGBTQA+ young people with disability and further underscore an immediate need to address and prevent harm in this population. [ABSTRACT FROM AUTHOR]

Many autistic adults are likely to experience poor financial wellbeing and hardship due to unemployment and under-employment. Research in the general population demonstrates that subjective financial wellbeing—how people perceive their financial situation—influences quality of life. There is no research, however, examining the subjective financial wellbeing of autistic people. This study therefore aimed to (1) understand the subjective financial wellbeing of a sample of autistic adults living in Australia compared to a general Australian population sample and (2) identify the predictors of subjective financial wellbeing in this sample of autistic adults. To this end, 191 autistic adults aged 18–83 years (mean = 39.28, standard deviation = 11.74) completed an online survey about their economic status, financial wellbeing, financial behaviors, confidence in money management skills, and anxiety and depression symptoms. Almost half of our sample felt it was a struggle to make ends meet, whereas only one-third of the general Australian population felt this way. Similar to the general population, autistic people's income and their financial behaviors (specifically, saving and not borrowing for everyday expenses) predicted their sense of financial wellbeing. Our findings have implications for both research and practice. Researchers have found the way people feel about their financial situation is related to their quality of life. We know that many autistic people find it hard to find a job. And for those autistic people who have a job, they are often underpaid. Not having a job or being underpaid often means having low income. Having low income is likely to influence how autistic people feel about their financial situation. However, no research has looked at these issues for autistic people. This is the first study that helps us learn more about what autistic adults think about their financial situation. We looked at autistic people's thoughts on this issue compared to people from the general Australian population. We also looked at what things might impact how autistic people feel about their financial situation—which might be how much money they earn, what they do with that money, and their mental health. Many autistic adults felt they were struggling with financial wellbeing and this was connected both to the level of their income and how they said they managed their money. Those who were able to save and not borrow for everyday expenses reported feeling a greater sense of financial wellbeing. Concrete changes might help to improve autistic people's financial wellbeing. We need to investigate how we can help autistic people find and keep well-paying jobs. And we need to work out the best ways of equipping autistic people with the skills they need in financial matters. [ABSTRACT FROM AUTHOR]

Ongoing health issues influence the postseparation lives of survivors of intimate partner violence (IPV). This study identified associations between health following IPV and demographic, housing, employment, and social participation factors. Survivors of IPV in Australia were surveyed. Logistic regression assessed factors of interest with physical and mental health conditions. Six hundred and fifty-eight women participated. Physical health issues were associated with reduced skills and confidence in employment. A mental health diagnosis was associated with women not working as desired and lower incomes. Screening for health impacts and longer-term responses to women could reduce the long shadow of IPV impacts. [ABSTRACT FROM AUTHOR]

Objective: Clarifying the distinctions between art-based creative activities in the domains of occupational therapy and art therapy in the context of stroke rehabilitation, while also describing the effects of art-based creative activities on stroke rehabilitation. Design: Scoping review. Data source: A systematic search was performed in nine databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL and four Chinese database) from their inception to December 2023. Review methods: The study included randomized and non-randomized controlled trials involving art-based creative activities, as well as qualitative research providing detailed intervention measures. The study focused on stroke patients, with primary outcomes related to patients' physiological recovery, psychological well-being, ADL, etc. Data extraction included information on intervention strategies and study results. Results: Seventeen studies were included, extracting six similarities and differences in creative activity between two domains. Creative activities were observed to have positive impacts on daily living activities, limb motor function, fine motor ability, and emotional well-being in stroke patients. Conclusion: Creative activities, whether in occupational therapy or art therapy, involve providing participants with tangible crafting materials for the creation of artistic works. Future stroke rehabilitation practices should tailor activities and intervention focus based on patients' rehabilitation needs, preferences, and cultural background. The current comprehensive analysis provides initial support for the potential positive role of creative activities in stroke rehabilitation, but further in-depth research is needed to confirm their effectiveness. [ABSTRACT FROM AUTHOR]

Background: Over the past two decades, there has been an increase of immigrants in Australia. Despite this, the availability of culturally responsive resources and services that cater to their needs remains insufficient. Objective: The aim of this study was to explore the resources used and trusted by Mongolian- and Arabic-speaking migrant mothers in Australia for child health information and examine how they navigate and overcome challenges they encounter accessing this information. Design: Semi-structured telephone interview Methods: A theory informed semi-structured 60-min telephone interview was conducted in Arabic and Mongolian with 20 Arabic- and 20 Mongolian-speaking migrant mothers of children younger than 2 years or currently pregnant and living in Australia. Data were analysed thematically using the framework method. Results: The reliance on digital platforms such as google emerged as a common trend among both groups of mothers when seeking child health information. Notably, there were differences in resources selection, with Mongolian mothers showing a preference for Australian-based websites, while Arabic-speaking mothers tended to opt for culturally familiar resources. There were various barriers that hindered their access to health services and resources, including language barriers, cost, and limited knowledge or familiarity with their existence. Negative encounters with healthcare professionals contributed to a perception among many mothers that they were unhelpful. Both groups of mothers employed a cross-checking approach across multiple websites to verify trustworthiness of information. Acculturation was shown only among the Mongolian-speaking mothers who adapted their cultural practices in line with their country of residence. Conclusion: The findings of this study highlight the importance of addressing the needs of migrant mothers in accessing child health information. Health professionals, government agencies, and researchers have an opportunity to provide culturally responsive support by fostering a culturally inclusive approach to developing and promoting equitable access to services and resources, ultimately enhancing the wellbeing of migrant families. Plain language summary: Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in Australia Mothers may experience barriers accessing resources and services related to child health behaviours after migration to Australia. Studies have found that parents actively seek health information and have a significant impact on their child's health behaviours, which can have long-term effects. Various factors influence parental decision-making regarding child health, including the socio-cultural environment, life experiences, and access to services and resources. This study reveals that both Arabic- and Mongolian-speaking migrant mothers heavily depend on online sources for accessing health information, primarily due to various barriers they face when accessing in person services, such as language constraints, financial limitations, and challenges in accessing healthcare services. This article also provides recommendations for future research and initiatives to be considered addressing the challenges faced by migrant mothers in accessing healthcare resources and services. [ABSTRACT FROM AUTHOR]

Family values operate in both immediate (i.e., familial) and broader social contexts. This study used a mixed methods approach to examine both forms of family values in the Australian context. A convenience sample of 856 people completed a measure of family values about both their own values and their perceived values of one of their parents, and a measure of familism. Using a story completion approach, a majority of the sample also responded to three story stems focused on the perceived values held by fictional families. Quantitative findings identified relationships between participant and perceived parent values in terms of gender. Participants reported high levels of familism, predicted by religiosity, age, and being a parent. Qualitative findings suggested that some participants were mindful of discrimination faced by the fictional families, but many participants also provided deficit accounts. [ABSTRACT FROM AUTHOR]

Introduction: Effective primary healthcare services have been identified by the World Health Organization as the most equitable approach to enhancing universal healthcare. Robust models of mentoring for registered nurses (RNs) transitioning to primary healthcare roles have yet to be described in the Australian context. A robust mentoring model can support RNs to fulfill their potential, bridging the gap between theory and practice. In 2015, the peak body for nurses in primary health care (PHC) began developing a transition to practice program, including embedded mentoring to support newly graduated and more experienced registered and enrolled nurses. This quality improvement study reports the experiences and perspectives of nurses participating as mentors in two separate offerings of the program delivered between 2019 and 2021. Method: A two-phase concurrent mixed methods evaluation utilized data from pre- and post online surveys and post program meetings. Quantitative items underwent descriptive analyses. Thematic analysis of free-text responses and comments was conducted independently by two researchers. Mentors voluntarily provided self-report data and were informed that data is routinely collected to support continuous quality improvement processes for all programs. An Information Sheet informed mentors of data usage, confidentiality, and options to withdraw without penalty from the program at any time. Results: Seventy-nine mentors were recruited to support two groups of nurses (N = 111). Mentor self-rated overall satisfaction with program participation was 86.67% (very or extremely satisfied). Mentors described being "witness to mentee growth," "having facilitated access to learning" and receiving "unexpected benefits" including personal and professional growth and enhanced enthusiasm for their role in PHC. Conclusion: The embedded mentoring reported in this article combined a focus on skills acquisition and professional identity with the provision of a range of resources and support activities. Sustainable mentoring programs will be an important mechanism for supporting the expanding roles required of nurses working in primary health. [ABSTRACT FROM AUTHOR]

This study involved examining the psychometric properties of the Tripartite Occupational Well-Being Scale (TOWBS) among a sample of 502 Australian teachers. The TOWBS (12 items) comprises three factors of subjective vitality, behavioral engagement, and professional growth. The TOWBS – Short (3 items) assesses a broad factor of occupational well-being. Results confirmed the reliability, factor structure, and longitudinal measurement invariance of the scale scores for both scales. In addition, the two forms of the scale functioned similarly across different teacher characteristics, and the well-being factors were demonstrated to be associated with four external correlates in plausible ways (workplace buoyancy, psychological detachment, somatic burden, emotional exhaustion). Combined, findings offer support for the scale as an assessment of teacher well-being. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Barriers to healthcare experienced by Australian autistic adults have not been previously explored. We conducted a cross-sectional investigation of barriers to healthcare and associated factors from a subtle realism perspective. Perceived barriers to healthcare were obtained from the Barriers to Healthcare Checklist Short-Form (BHC). A total of 263 autistic and 70 non-autistic individuals completed the BHC. On average, autistic adults reported more barriers to healthcare (4.58) than non-autistic adults (0.76). Gender diversity, higher levels of generalised anxiety, greater global disability and less satisfaction with social support contributed to the experience of barriers to healthcare in autistic participants in regression modelling. Australian autistic adults face substantial barriers to healthcare. Understanding these barriers provides an opportunity to develop approaches to improve access; such as co-designing a healthcare access roadmap for autistic adults, with co-designed policies and practices which advocate for the needs of autistic adults. This study looked at how Australian autistic and non-autistic adults experience barriers to healthcare. We asked autistic and non-autistic adults to complete the Barriers to Healthcare Checklist Short-Form (BHC). We analysed data from 263 autistic adults and 70 non-autistic adults. We found that autistic adults experienced more barriers to healthcare than non-autistic adults. Gender diversity, feeling more anxious, having greater disability and feeling unsatisfied with social support contributed to barriers to healthcare in autistic participants. We recommend interventions such as developing and implementing a national action plan, similar to the National Roadmap for Improving the Health of People with Intellectual Disability (2021) to reduce barriers and address unmet healthcare needs of Australian autistic adults. We also recommend working with autistic adults to develop new policies and strategies, implementing environmental adaptations to health care facilities, and increasing Autism education opportunities for health professionals to address gaps in knowledge. [ABSTRACT FROM AUTHOR]

Sexual violence (SV) against women is common in higher education settings, causing serious harm to the health, well-being, and academic outcomes of victim/survivors. There have been numerous systematic reviews of the quantitative evidence on this topic, highlighting the prevalence, health impacts, and barriers and facilitators to help-seeking after SV. To date, however, qualitative research exploring the lived experience of women higher education students has not been synthesized. This scoping review and thematic synthesis of qualitative studies aims to map the global evidence on women higher education students' experiences of SV and explore how they understand and make sense of their experiences. We searched five databases (CinAHL, Academic Search Complete, Medline, PsychInfo, and SocIndex) in January 2023 for relevant articles. Eligible articles needed to be published in English and describe qualitative or mixed-methods primary research on the lived experiences of women higher education students who were victim/survivors of SV. In all, 34 articles describing 32 studies met these inclusion criteria. Thematic analysis of data extracted from the included studies suggests that, for women higher education students, the experience of SV is characterized by profound shame, with often-irreversible impacts on hopes and plans for the future. Yet, at the same time, SV is normalized and expected as a part of the "student experience." Furthermore, an imagined "specter" of "real violence" is held up as a constant comparison that serves to minimize and trivialize their experiences. These findings have important implications for higher education providers seeking to improve programs to address SV. [ABSTRACT FROM AUTHOR]

Substance use is a risk factor for being both a perpetrator and a victim of violence. The aim of this systematic review was to report the prevalence of acute pre-injury substance use in patients with violence-related injuries. Systematic searches were used to identify observational studies that included patients aged ≥15 years presenting to hospital after violence-related injuries and used objective toxicology measures to report prevalence of acute pre-injury substance use. Studies were grouped based on injury cause (any violence-related, assault, firearm, and other penetrating injuries including stab and incised wounds) and substance type (any substance, alcohol only, drugs other than alcohol only), and they were summarized using narrative synthesis and meta-analyses. This review included 28 studies. Alcohol was detected in 13%–66% of any violence-related injuries (five studies), 4%–71% of assaults (13 studies), 21%–45% of firearm injuries (six studies; pooled estimate = 41%, 95% CI: 40%–42%, n = 9,190), and 9%–66% of other penetrating injuries (nine studies; pooled estimate = 60%, 95% CI: 56%–64%, n = 6,950). Drugs other than alcohol were detected in 37% of any violence-related injuries (one study), 39% of firearm injuries (one study), 7%–49% of assaults (five studies), and 5%–66% of penetrating injuries (three studies). The prevalence of any substance varied across injury categories: any violence-related injuries = 76%–77% (three studies), assaults = 40%–73% (six studies), firearms = n/a, other penetrating injuries = 26%–45% (four studies; pooled estimate = 30%, 95% CI: 24%–37%, n = 319).Overall, substance use was frequently detected in patients presenting to hospital for violence-related injuries. Quantification of substance use in violence-related injuries provides a benchmark for harm reduction and injury prevention strategies. [ABSTRACT FROM AUTHOR]

Feminist researchers have diversified understandings of family violence by examining how women's experiences are influenced by gender and its intersections with other social inequalities. This article seeks to contribute to intersectional and transnational feminist scholarship on violence that examines the influence of structural factors such as insecure migration status on the nature of women's lived experiences in Western industrialized countries. It reports on findings from a study with migrant women who experienced family violence in Victoria, Australia when their migration status was "insecure," and examines similarities and differences in the forms and patterns of violence and abuse women described. [ABSTRACT FROM AUTHOR]

Background: Globally there are high numbers of patients with palliative care needs receiving care in hospitals. Patient reported experience measures (PREMs) provide useful data to guide improvement work. How to implement PREMs within palliative care populations is unclear. Aim: To explore the perspectives of inpatients with palliative care needs, their family members, and the clinical team regarding the use of a generic PREM as compared with a PREM designed for people with palliative care needs and related implementation factors. Design: A qualitative study was undertaken using semi-structured interviews and focus groups and integrated thematic analysis. Setting/participants: Inpatients with palliative care needs, their family members, and clinical team members were recruited from three wards in an Australian metropolitan hospital. Results: Twenty-seven interviews and three focus groups were conducted. Six themes emerged: (1) PREMs for people with palliative care needs ought to be tailored to the needs of this population; (2) PREMs should appraise whether the needs of families have been met in addition to those of patients; (3) PREMs for inpatients with palliative care needs ought to be easy to use, brief and incorporate space for free text alongside each question; (4) Implementation of PREMs for people with palliative care needs ought to consider who administers these, when and how often; (5) PREM data need to be specific enough to inform process change and/or care provision; (6) Patients and families require meaningful feedback to encourage PREM completion. Conclusions: This study provides practical guidance for PREM selection and implementation to inform improvements to care for inpatients with palliative care needs. [ABSTRACT FROM AUTHOR]

Sexual violence is a public health issue that can be experienced across the life course. Public transport is a key site of sexual violence and harassment experienced by women and gender-diverse people in Australia, although victim-survivor voices have rarely been sought in addressing this issue. Through in-depth qualitative interviews with 41 diverse female and gender-diverse victim-survivors who were staff or students at two Australian universities, we sought to understand their experiences of sexual violence and harassment on public transport. We found that women and gender-diverse people, while often reporting on a significant experience of sexual violence or harassment on public transport, also had other, "everyday" experiences across their life course that impacted how they traveled and their confidence in the world. Overall, we argue that the significant impact of sexual violence and harassment on public transport should be addressed through targeting public transport as a key site for primary prevention of sexual violence and harassment. [ABSTRACT FROM AUTHOR]

Background: Public health approaches to palliative and end-of-life care focus on enhancing the integration of services and providing a comprehensive approach that engages the assets of local communities. However, few studies have evaluated the relative costs and benefits of providing care using these service models. Objectives: To assess the effect on healthcare usage of a community-based palliative care program ('Compassionate Communities Connectors') where practical and social support was delivered by community volunteers to people living with advanced life-limiting illnesses in regional Western Australia. Design: Controlled before-and-after study/Cost-consequence analysis. Methods: A total of 43 community-based patients participated in the program during the period 2020–2022. A comparator population of 172 individuals with advanced life-limiting illnesses was randomly selected from usage data from the same set of health services. Results: Relative to controls, the intervention group had lower hospitalizations per month [Incidence rate ratio (IRR): 0.37; 95% CI: 0.18–0.77, p = 0.007], less hospital days per month (IRR: 0.23; 95% CI: 0.11–0.49, p < 0.001) and less emergency presentations (IRR: 0.56; 95% CI: 0.34–0.94, p = 0.028. The frequency of outpatient contacts overall was two times higher for the intervention group (IRR: 2.07; 95% CI: 1.11–3.86, p = 0.022), indicating the Connector program may have shifted individuals away from the hospital system and toward community-based care. Estimated net savings of $AUD 518,701 would be achieved from adopting the Connector program, assuming enrollment of 100 patients over an average 6-month participation period. Conclusion: This combined healthcare usage and economic analysis of the 'Compassionate Communities Connectors' program demonstrates the benefits of optimizing palliative care services using home-based and community-centered interventions, with gains for the health system through improved patient outcomes and reduced total healthcare costs (including fewer hospitalizations and readmissions). These findings, coupled with the other published results, suggest that investment in the Connectors program has the capacity to reduce net health sector expenditure while also improving outcomes for people with life-limiting illnesses. Trial Registration: Australian and New Zealand Clinical Trial Registry: ACTRN12620000326998. [ABSTRACT FROM AUTHOR]

Telehealth has been widely adopted during the COVID-19 pandemic, and this article examines challenges faced by telephone interpreters in working with healthcare providers in the context of the Australian healthcare system. Based on one-on-one interviews with 67 healthcare interpreters in Australia, it explores various elements which affect communication processes in telephone interpreting and interpreters' views on healthcare providers' abilities to collaborate with interpreters. Data analysis indicates that telephone interpreting is often affected by a lack of briefing, poor acoustics and the absence of visual cues. While these factors pose significant challenges to telephone interpreters, a provider's tendency to see interpreters as 'translation machines' was perceived as a deeper underlying problem by the interpreters. The mechanistic approaches to interpreting among healthcare providers pose barriers to interpreter–provider collaboration and exacerbate communication problems caused by the external elements in telephone-interpreted encounters. The article calls for urgent need to raise awareness of interpreting among healthcare providers as a key to ensuring desirable health outcomes for patients from minority backgrounds. [ABSTRACT FROM AUTHOR]

Technology-facilitated abuse (TFA) is a significant, harmful phenomenon and emerging trend in intimate partner violence. TFA encompasses a range of behaviours and is facilitated in online spaces (on social media and networking platforms) and through the misuse of everyday technology (e.g. mobile phone misuse, surveillance apps, spyware, surveillance via video cameras and so on). The body of work on TFA in intimate relationships is emerging, and so this scoping review set out to establish what types of abuse, impacts and forms of resistance are reported in current studies. The scoping review examined studies between 2000 and 2020 that focused on TFA within intimate partnerships (adults aged 18+) within the setting of any of these countries: the UK and Ireland, USA, Canada, New Zealand and Australia. The databases MEDLINE, CINAHL and Scopus were searched in December 2020. A total of 22 studies were included in the review. The main findings were that TFA is diverse in its presentation and tactics, but can be typed according to the eight domains of the Duluth Power & Control Wheel. Impacts are not routinely reported across studies but broadly fall into the categories of social, mental health and financial impacts and omnipresence. Similarly, modes of resistance are infrequently reported in studies. In the few studies that described victim/survivor resistance, this was in the context of direct action, access to legal or professional support or in the identification of barriers to resistance. [ABSTRACT FROM AUTHOR]

Within a context of increasingly ubiquitous pornography consumption among men, little is known about men who reject pornography, their motivations to stop consuming it, and their concerns about the treatment of women. In this article, we explore the stated motivations of 124 men who have decided to stop consuming pornography, in order to understand what role—if any—concerns about violence against women and gender equality played in their decision. Specifically, we focus on the implications of these findings for future research on the role of men in preventing or addressing harmful attitudes about women through their everyday practices. [ABSTRACT FROM AUTHOR]

Background: Paramedic practice is diversifying to accommodate evolving global health trends, including community paramedicine models and growing expertise in palliative and end-of-life care. However, despite palliative care specific clinical practice guidelines and existing training, paramedics still lack the skills, confidence and clinical support to provide this type of care. Aim: To elicit paramedics', palliative care doctors and nurses', general practitioners', residential aged care nurses' and bereaved families and carers' experiences, perspectives, and attitudes on the role, barriers and enablers of paramedics delivering palliative and end-of-life care in community-based settings. Design: A qualitative study employing reflexive thematic analysis of data collected from semi-structured online interviews was utilised. Setting/participants: A purposive sample of 50 stakeholders from all Australian jurisdictions participated. Results: Five themes were identified: positioning the paramedic (a dichotomy between the life saver and community responder); creating an identity (the trusted clinician in a crisis), fear and threat (feeling afraid of caring for the dying), permission to care (seeking consent to take a palliative approach) and the harsh reality (navigating the role in a limiting and siloed environment). Conclusion: Paramedics were perceived to have a revered public identity, shaped by their ability to fix a crisis. However, paramedics and other health professionals also expressed fear and vulnerability when taking a palliative approach to care. Paramedics may require consent to move beyond a culture of curative care, yet all participant groups recognised their important adjunct role to support community-based palliative care. [ABSTRACT FROM AUTHOR]

Objective: To explore how stakeholders in rehabilitation conceptualise 'successful rehabilitation', to inform the development of a minimum dataset and core outcomes for sub-acute rehabilitation. Design: Qualitative consensus study using the nominal group technique. Setting: Online focus groups. Participants: Consumer representatives (n = 7), clinicians (n = 15), and health service managers (n = 9) from Australia. Intervention: Participants responded to the question, 'What does successful rehabilitation look like?'. Following item generation, they prioritised their top five responses, allocating 100 points across items to denote relative importance. Main measures: Prioritised responses were analysed across stakeholder groups using qualitative content analysis. Results: Ten themes were identified. 'Successful rehabilitation' is: (1) person and family centred; (2) effective; (3) inter-professional; (4) accessible; (5) goal oriented with meaningful outcomes; (6) connected to the continuum of care; (7) evidence-based and supportive of innovation and research; (8) appropriately funded and skilled; (9) satisfying and engaging; and (10) safe. Conclusions: Stakeholder-defined 'successful rehabilitation' aligned with principles of value-based care and evidence-based rehabilitation. Provision and receipt of person and family centred care was the most important indicator of successful rehabilitation. Measures of success should include indicators of structure, process, outcome, and experience, and be conducted at multiple time-points. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy. Study Design: Randomised crossover trial. Setting: Biomechanics laboratory. Subjects: 27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration. Interventions: Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions. Main measures: Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions. Results: There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F2,52 = 0.02, p = 0.98; extended position: F2,52 = 2.26, p = 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F1,26 = 0.94, p = 0.34; extended position: F1,26 = 0.79, p = 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F1.51,39.17 = 0.54, p = 0.54) or across timepoints (affected lateral epicondyle: F1,26 = 0.94, p = 0.34). Conclusion: Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist. [ABSTRACT FROM AUTHOR]

Fly-in/fly-out (FIFO) work practices have become common place in Australia over the past two decades. Research has documented the personal impact of these work practices, but little peer-reviewed research is available on the family impact of this work. The study aimed to better understand (1) the impact of FIFO work arrangements on children, parents and relationships; (2) strategies parents use to manage the home-away cycle; and (3) preferences for parenting support. Interviews were conducted with six FIFO workers and 15 partners of FIFO workers with at least one child aged 2–12 years. Inductive thematic analysis revealed six themes: effects on children; effects on family relationships; effects on parenting; managing transitions; managing separations; and the need for flexible, tailored parenting support. The findings provided important insight into the experiences of working FIFO with a family and can inform the development of parenting support targeted at FIFO families. [ABSTRACT FROM AUTHOR]

We present a cost-benefit analysis of an Australian Government sponsored 3-year supported employment program for autistic adults—the DXC Dandelion Program—in the information and communications technology sector. We explored the range of direct costs associated with running the program, benefits to participants, and avoided costs to the government. Estimates were based on data from 56 (86% men; M age = 25.28, standard deviation [SD] = 8.36 years) autistic participants in the program. The program generated a high benefit ratio for government, mainly driven by increases in wage rates and hours worked and avoiding welfare and unemployment benefit payments. Participants received the largest benefit through wages and access to the labor market, with most participants transitioning into productive, open employment following program completion. The results from the model are robust; the benefit ratio remained above 1.0 even when higher discount rates were applied. In sum, our analysis identifies potential economic savings associated with supported employment programs that provide pathways for otherwise unemployed or under-employed autistic adults to enter the workforce. Relative to the size of the population, there are fewer autistic people than non-autistic people in the workforce. Employment programs that provide extra support to autistic people may help them to gain and keep jobs that are suited to their skills and expertise. In this study, we reviewed the DXC Dandelion Program. This is a supported autism employment program run in partnership with the Australian Government. The program provided jobs to autistic people who worked in information and communications technology roles, such as software testing and cyber security. In this study, we examined some of the benefits of the program for the autistic people who participated in it. We also examined the benefits of the program to the government. We found that there are many savings to government when autistic people are employed in jobs that are matched to their skills and abilities, compared to being unemployed or working in jobs that are below their level of education, training, or skills. [ABSTRACT FROM AUTHOR]

While animals have long been a focus in therapeutic spaces for young people via approaches such as animal-assisted therapies, there is a sense in which such approaches overlook the broader contribution that animals play by being present in young people's lives. In this article, we explore how the presence of animals (both physical and psychological) in interactions with healthcare professionals may hold specific meaning for trans young people living in Australia. Participants were recruited through Parents of Gender Diverse Children. Interviews were conducted in November 2021 with 17 trans young people and one of each of their parents living in Australia. All interviews were audio recorded, transcribed, and analyzed using thematic analysis. Two main themes were developed: (1) how healthcare professionals respond to conversations about animals and (2) the beneficial role of the presence of animals. The article concludes by discussing the importance of thinking about the presence of animals beyond existing frameworks and recognizing the value placed on the presence of animals by trans young people. [ABSTRACT FROM AUTHOR]

Objective : To describe trends, age, and sex-specific patterns of population hospital admissions with a diagnosis of craniosynostosis (CS) in Australia. Data Source : Population data for hospital separations (in-patient) from public and private hospitals (July 1996-June 2018) were obtained from the publicly available Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database. Main outcome measures : The outcome variables were hospital separation rates (HSR) (number of hospital separations divided by the estimated resident population [ERP] per year) and average length of stay (aLOS) (patient days divided by the number of hospital separations) with a diagnosis of CS. Trends in HSR and aLOS adjusted for age, sex, and type of CS were investigated by negative binomial regression presented as annual percent change (APC). Results : In 8057 admissions identified, we observed no significant change in the annual trend for HSR for the 22-year period. However, a marginal annual decrease of 1.6% (95% CI: -0.7, -2.4) in the aLOS was identified for the same time period. HSR were higher for males, infants, and single suture synostosis. aLOS was 3.8 days (95% CI: 3.8, 3.9) per visit, longer for syndromic conditions. Conclusion : There was a minor reduction in the average length of hospital stay for CS over the 22-year period potentially indicative of improved care. Population-level information on hospitalisations for rare craniofacial conditions can inform research, clinical, and surgical practice. [ABSTRACT FROM AUTHOR]

Background: Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness. Aim: To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease. Design: Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach. Setting/participants: A purposive sample (n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia. Results: Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures – Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care. Conclusions: For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs. [ABSTRACT FROM AUTHOR]

Background: The constraining prison culture is not, for the most part, conducive to the provision of palliative care for people in prison. Aim: This study aimed to explore patterns of palliative and end-of-life care provision for hospitalised prison patients. Design: A retrospective qualitative review of hospital medical records to explore the quality of end-of-life care provision for patients experiencing incarceration who died within hospital. Qualitative inductive analysis of record extracts of each patients final 3-months of life was undertaken. Setting/participants: An Australian metropolitan hospital responsible for providing secondary and tertiary health services for people experiencing incarceration. This study included a systematic sample of male patients experiencing incarceration who died in hospital between 2009 and 2019. Results: Medical record extracts of 15 male patients revealed two broad themes: (1) barriers to equitable access to palliative care for incarcerated hospitalised patients; and (2) factors that facilitated quality end-of-life care for patients and families. Barriers included: tensions between balancing risk and humanity; and limited agency over place and death. Conversely, early recognition of deterioration and anticipated dying provided patients and families opportunity to focus on end-of-life goals. Conclusions: Institutional influences of security and control challenged the provision of equitable end-of-life care for people experiencing incarceration. Further research is required to inform, and incorporate, best approaches to identifying patient wishes and advance planning into care within, or despite, the constrains of incarceration. Policy reform and a coordinated, best practice approach to the management of end-of-life care for people experiencing incarceration is needed. [ABSTRACT FROM AUTHOR]