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This paper draws together critical learnings from diverse qualitative health research projects in Australia that sought to shift power and focus on the strengths and expertise of people with lived experience who are involved as co-researchers. These projects have included exploring and challenging identities, understanding experiences in treatment programs, critiquing and designing/re-designing services, and sharing experiences with the wider community in novel and innovative ways. Lived experiences included alcohol and other drug dependency, mental health, domestic, family or sexual violence, and living with HIV. This paper provides important learnings and actions about partnering with co-researchers with lived experience. In this paper we draw on a process of reflective discussions that occurred over six months with fortnightly online meetings between co-researchers, including co-authors with lived experience external to academia and university-based researchers, some of whom also have lived-experience that intersects with their research. From this, we distilled key learnings across seven themes: (1) the ethics of ethics, which highlights a need for constant reflection on the ethical issues in co-research; (2) recruiting co-researchers, which focuses on ensuring and integrating a diversity of voices; (3) creating safety for all, which must be a priority of engagement and support self-determination; (4) supporting different ways of partnering, which emphasises the need for diverse roles and ways to contribute on research teams; (5) capacity building and training, which requires ongoing evaluation of needs and tailored responses; (6) positioning, which highlights the need to transition from the idea of vulnerability to a strengths-based perspective of lived experience; and (7) power plays, reflecting the need to disrupt the dynamics and established hierarchies of privileging certain forms of knowledge and expertise. The paper includes recommendations for action against these seven themes. [ABSTRACT FROM AUTHOR]

Objectives: This paper critiques the haematological monitoring guidelines for clozapine. It describes the history of clozapine, as well as the pathophysiology and epidemiology of clozapine-induced neutropenia (CIN) and agranulocytosis (CIA). The paper appraises the extant literature on mandatory clozapine haematological monitoring. Conclusion: Contemporary Australian protocols for clozapine haematological monitoring are not consistent with the current evidence base. CIN and CIA are rare occurrences, and the associated risk of death is low. Potential modifications to existing guidelines include changing neutrophil thresholds for patients with benign ethnic neutropenia and reducing the frequency or removing haematological monitoring after two years of clozapine treatment. [ABSTRACT FROM AUTHOR]

The recent global pandemic renewed the importance of telecommunication infrastructure, as many COVID responses (e.g., working from home, home-schooling, e-commerce) were challenged by the inequity of access to broadband services and its underlying network. This paper examines the geospatial footprint of the National Broadband Network (NBN) in relation to the demographics of Australia's cities and regions. Through data made available by the NBN, which describes the technologies used in its multi-technology mix platform, and published demographic data available via the Australian Bureau of Statistics (ABS), we explore the equity of access to broadband technologies across the nation. The results show a persistent urban-regional divide in the NBN. The paper also offers a brief assessment of the complex and contradictory ways policy responses attempt to mitigate the digital divide, including updates to the national infrastructure project plans. [ABSTRACT FROM AUTHOR]

The articulation of school autonomy into practice nationally, regionally and locally is highly situated in terms of what it enables or impedes with regard to the professional autonomy of principals and teachers. Principal autonomy does not necessarily mean greater teacher professional autonomy. In this paper, we draw on a three-year qualitative study investigating the social justice implications of school autonomy reform in Australia. We present interview data from a case study of a large secondary college to present two conflicting stories of autonomy. Supported by a managerial restructure reflecting distributed leadership, we juxtapose the positive account of autonomy expressed by the leadership team with the negative one expressed by teachers. We explore the justice implications of this disjuncture and argue the importance of critically examining the complex ways in which the intentions and enactments of distributed leadership can be differently articulated and understood within the context of school autonomy reform. [ABSTRACT FROM AUTHOR]

Background: Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. Its goals are to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services and is grounded in equal partnerships between civic life, community members, patients and carers, and service providers. This takes many forms, including what we have termed the 'citizen organization'. Objectives: This paper reports on an evaluation of Little Haven's model of care and explores the organization's place as a 'citizen' of the community it services. Design: A co-designed evaluation approach utilizing mixed-method design is used. Methods: Multiple data sources obtained a broad perspective of the model of care including primary qualitative data from current patients, current carers, staff, volunteers and organizational stakeholders (interviews and focus groups); and secondary quantitative survey data from bereaved carers. Thematic analysis and descriptive statistics were generated. Results: This model of care demonstrates common service elements including early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users, with strong community engagement. These elements enable high-quality care for patients and carers who describe the support as 'over and above', enabling good quality of life and care at home. Staff and volunteers perceive the built-in flexibility of the model as critical to its outcomes; the interface between the service and the community is similarly stressed as a key service element. Organizational stakeholders observed the model as a product of local activism and accountability to the community. Conclusion: All participant groups agree the service model enables the delivery of excellent care. The construction of a community palliative care service as a citizen organization emerged as a new concept. Plain language summary: 'Citizen organization': an Australian community-based palliative care service model Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. It aims to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services in equal partnerships between civic organizations, community members, patients and carers, and service providers. We undertook an evaluation of Little Haven's model of care by speaking with current patients, current and past carers, staff, volunteers and stakeholders about their experiences of Little Haven. We found that Little Haven's model contains the essential elements of a palliative care service and provides early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users. They have strong community engagement with a strong background in community activism. We identified that Little Haven's 'being in the community' goes beyond service provision or even sentiment. We observed a symbiotic relationship between the organization and the community it supports in what we have termed the 'citizen organization'. The distinctive characteristic of the citizen organization is its inseparability from the community in which it dwells. [ABSTRACT FROM AUTHOR]

Crime rates in Australia have declined or been steady over the past decade yet prison populations are at all-time highs. Similarly, unemployment rates have been low but unemployment for those ex-prisoners seeking work is very high. In this paper, we draw on the findings of an Australia-wide survey of government-funded employment service providers who support working-aged Australians including ex-prisoners in their search for work. We find that the heterogeneity of the needs of ex-prisoners coupled with the frugality and inflexibility of government policies and practices frustrates the abilities of these agencies to provide services to this target group. [ABSTRACT FROM AUTHOR]

Compared with similar research mainly focusing on the Belt and Road Initiative (BRI) in Australian mainstream media using discourse analysis, this paper explores the reasons for the narrative shift by conducting semi-structured interviews with leading and well-known Australian narrative producers. This paper takes two conditions as a given. Firstly, the BRI narratives in Australian mainstream media shifted in tone from mostly positive to highly critical. Secondly, the Australian mainstream media's increasingly negative attitudes towards the BRI are essentially not just about the BRI but the Chinese government. Based on my analysis and interviews, this paper makes contributions by filling in the gap of finding out reasons to explain this narrative shift. More concretely, this paper finds out that while mainstream media is influential in many areas of national policy making, mainstream media reporting on foreign affairs is less so. By comparison, the Australian government's BRI or China policy has a significant impact on Australian mainstream media reporting. This narrative shift has been driven by international politics and Australia's China policy, influenced by Australian audiences' preference of local news and their local position, and its democratic responsibilities. Meanwhile, the vagueness and constant changing characteristics of the BRI do not help the understanding of the BRI in Australian media. [ABSTRACT FROM AUTHOR]

Studio music teachers have always been constant in Australian society, rarely recognised beyond their immediate surrounds. Building a 'connection' of students required advertising, primarily by word-of-mouth or via local press announcements. Few teachers placed individual advertisements in local papers. This changed in 1911 with the establishment of monthly The Australian Musical News, intended to report and support musicians and music teachers. In its first edition, four studio music teachers placed advertisements, first to use this new opportunity. We unfold the stories of Mrs. Arthur Royce, Herr Franz O. Schieblich, James Ure, and J. Alfred Johnstone. By happenstance, their diverse careers capture the different ways of being a studio teacher in contemporary Australia. We note the unchanging nature of studio music teaching and suggest that, with the exception of technologies, the activities of these four teachers resonate with modern practice. [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]

Researchers have found that many post-secondary music students suffer from physical and mental health issues. However, researchers have mainly studied these problems at the individual level, with little investigation of how music students' work is shaped by the coordinating effects of policies, texts, and discourses at and beyond their local site. This paper describes a protocol for an international project that will explore the health of music students in the context of their daily work. Using an institutional ethnography approach, we will examine the social organization of music students' work at three universities: two in Canada and one in Australia. This will be the first set of studies that use institutional ethnography specifically for the purpose of understanding how the social organization of music students' work shapes their health. Data will be collected using several methods common to institutional ethnography: interviews, focus groups, observations, and collecting texts. Data analysis will begin during the data collection process and proceed in two fluid stages. The first stage will involve a detailed investigation of the pertinent work activities at each music school. The second will involve linking that work to specific social relations within and beyond the institution. After data analysis has been completed at all three sites, findings will be compared to one another to identify commonalities and differences in how students' work is organized. Findings of the entire project may inform policy-making and lead to positive change at the institutions studied, as well as others where similar social organization may occur. The novel approach described here will provide opportunities to expand current knowledge about music students' work and health beyond what has been learned through approaches that focus on students' individual behaviours and attributes. [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]

Australia has a long history of privately owned utility price regulation, one that is little known. This price control was designed to restrain the market power of several utilities (gas, rail, tramways, electricity, and water). The purpose of this paper, therefore, is to establish what types of price control that were used in Australia in the utilities sector before the First World War and to determine the degree to which this price control influenced efficiency. As price levels in this era were set in legislation, the lack of flexibility led to less-than-optimal outcomes, and eventually and led to new approaches were developed after 1912 to the utilities that remained in private ownership, and in some cases influenced the movement in Australia towards government control. [ABSTRACT FROM AUTHOR]

In Australia, racism remains a challenge to dismantle within public health institutions. This paper examines the pressures I experienced from some public health scholars and practitioners to conform to colonial and positivist approaches in knowledge production that still dominate the field. To challenge this hegemony, my research practices turned into what Mignolo calls "epistemic disobedience," an approach to delink from Western ways of producing knowledge. Based on this experiential learning process, I argue epistemic disobedience should not be overlooked in the discussion of decolonizing research and antiracist pedagogy in the context of doctoral training. [ABSTRACT FROM AUTHOR]

In the 1980s, successive Australian governments began to pursue a program of microeconomic restructuring, taking their lead from the developing 'free market' reform projects underway in the United States and the United Kingdom. One of the prominent features of the emerging liberalisation agenda was the commercialisation and privatisation of government-owned companies and assets. In keeping with this trend, over the following decades, a series of changes have been introduced to Australia's container ports aimed at improving their productivity and efficiency. Drawing on a series of interviews and analysis of governmental and non-governmental reports, the purpose of this study is to examine how port policy has unfolded 'on the ground' in Australia. The paper considers some of the 'common sense' economic maxims expounded for reform in relation to actual outcomes for industry stakeholders, concluding that principles and practice have diverged significantly and that many of the assumed benefits have failed to materialise. [ABSTRACT FROM AUTHOR]

This paper reports part of a doctoral study which investigated the resettlement experiences of African migrants in Australia (N= 115), and focuses upon the findings of those who participated in individual face-to-face interviews (N= 30). It examines the resettlement challenges facing African migrants in Western Australia (WA), such migration having increased in recent years. Although migrating to relatively wealthy countries such as Australia may be a cause for optimism among African migrants, the challenges associated with resettlement may have a negative effect on their well-being. The findings indicate that participants experienced a variety of resettlement challenges including separation experiences, language difficulties, parenting and cultural issues, under-employment and unemployment, financial problems, and racial discrimination. The study confirms the limited existing research, contributes to a better understanding of the major challenges affecting African migrants in Australia, and has implications for the formulation of effective policies and practices aimed at mitigating resettlement challenges. [ABSTRACT FROM AUTHOR]

The games industry has seen a burst of new interest in the prospect of unionization. The efforts of organizations like Game Workers Unite have attracted much favorable coverage in the enthusiast and trade industry press, increasing awareness amongst videogame audiences of the difficult working conditions facing professional game developers. However, often missing from these discussions is an articulation of what unionization would look like for the significant number of game developers working in precarious conditions in small, often informal teams. The fragmented nature of contemporary gamework presents challenges in aggregating worker power similar to those found in other fields of creative or precarious work and entrepreneurial careers, where contingent work is typically organized around piecemeal, project–based funding arrangements. In this paper we draw from empirical research with Australian game developers to identify a number of barriers to unionization posed by small-scale game production. We also identify how within these same circumstances, novel and alternative forms of solidarity and collective action are beginning to emerge. The article ultimately argues that any successful attempt to unionize videogame workers will need to both account for, and take advantage of, the complex situation of small-scale videogame production in local contexts. [ABSTRACT FROM AUTHOR]

Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This paper reviews the literature assessing the risk of ketamine misuse and dependence in patients with a history of illicit drug use, abuse or dependence and presents recommendations for psychiatrists who prescribe ketamine in such patients with treatment-resistant depression. [ABSTRACT FROM AUTHOR]

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly. [ABSTRACT FROM AUTHOR]

Many common law jurisdictions recognise that directors have an obligation to consider the interests of company creditors when the company is experiencing financial distress. Despite numerous cases attempting to crystalise legal principles related to this obligation and significant academic commentary on the topic, the parameters of the obligation remain uncertain. This paper provides an analytical comparison of the latest case law in Australia and the UK concerning the two most important issues that exist in relation to this obligation, namely when is the obligation triggered and what do directors have to do to ensure that they comply with the obligation. We found that the UK courts appear to be adopting a much more restrictive approach regarding the trigger for the obligation, whereas the obligation may arise much earlier in Australia, due to the liberal framing of the trigger. An analysis of case law also revealed that the weight attached to the interests of creditors once the obligation is triggered seems to be much more significant in the UK, compared to Australia. This analysis is important as there is no doubt that courts in other common law jurisdictions, and particularly in the Commonwealth, will examine the Australian and UK jurisprudence in making their decisions in relation to any claim that directors have failed to comply with the obligation to consider the interests of creditors. [ABSTRACT FROM AUTHOR]

This study considers cultural adaptation through tourism, focusing on language-travelers: hybrid education-tourism consumers whose voices remain relatively silent in tourism studies. Qualitative, semi-structured interviews were undertaken with students, teachers, and managers in Australian English language schools to understand what language-travelers expect from their Australian experiences and the implications for language schools. The findings propose that sojourners' experiences are framed by pre-visit imaginaries of object authenticity, wherein the "object" is both Australian culture and the wider Anglophone "West." Such imaginaries are found to be validated by language schools, which face pressure to balance letting students glimpse the "backstage" and staging out-group imagined "authenticities," such as by hiring fun, approachable, and above all White teachers. We identify opportunities for language centers to understand their role within tourism as cultural mediators and suggest ways forward in promoting and inculcating critical intercultural competence among language-traveler sojourners. [ABSTRACT FROM AUTHOR]

The aim of this paper is to explore what aspects create experiential value for wine tourists. We synthesize the extant literature into four dimensions for wine tourism value creation, namely, product-related aspects; sensory and affective experiential aspects; cognitive, educational experiential aspects; and social-relational experiential value-creating aspects. So far, most studies merely discuss product-related aspects whilst insights on experiential value are less known. Using online review data from wine tourists in Australia, we develop a novel deep neural network-based framework using an innovative AI-based exploratory design. Results of the case study reveal that in addition to product-related aspects, sensory-and education-related experiential aspects are also highly important for value creation in wine tourism. Theoretical and practical implications, as well as ideas for future research are discussed. [ABSTRACT FROM AUTHOR]

This paper seeks to extend existing conceptualisations of risky and harmful consumption. Our work draws on a qualitative, rhizomatic study of Australian consumers' sports betting practices. We utilise Deleuze and Guattari's related concepts of molar and molecular lines and lines of flight to draw attention to sports betting's mutually affecting discursive, socio-material and emotional intensities. We examine the ongoing tensions between how people understand themselves as gamblers, the social normalisation of gambling and the parameters of risky betting behaviour. We argue that conceiving gambling consumption through molar and molecular lines challenges the binaries inherent in current framings of risky and harmful consumption. We also consider the possibilities for lines of flight and implications for gambling harm. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) carries the potential for unprecedented disruption in radiology, with possible positive and negative consequences. The integration of AI in radiology holds the potential to revolutionize healthcare practices by advancing diagnosis, quantification, and management of multiple medical conditions. Nevertheless, the ever‑growing availability of AI tools in radiology highlights an increasing need to critically evaluate claims for its utility and to differentiate safe product offerings from potentially harmful, or fundamentally unhelpful ones. This multi‑society paper, presenting the views of Radiology Societies in the USA, Canada, Europe, Australia, and New Zealand, defines the potential practical problems and ethical issues surrounding the incorporation of AI into radiological practice. In addition to delineating the main points of concern that developers, regulators, and purchasers of AI tools should consider prior to their introduction into clinical practice, this statement also suggests methods to monitor their stability and safety in clinical use, and their suitability for possible autonomous function. This statement is intended to serve as a useful summary of the practical issues which should be considered by all parties involved in the development of radiology AI resources, and their implementation as clinical tools. [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]

Families of choice is an important framework used to think about non-heterosexual people's attachments. This means the family of origin has received limited attention when theorising their relationships. This group has often been considered in relation to coming out, which centralises the importance of sexuality for understanding kinship ties. This paper extends the limited, but growing scholarship on non-heterosexual people, and their families of origin. It does this by drawing on a larger project on the lives of gay men of South Asian descent, in Australia. Results demonstrate that attachment through blood, shared history, emotions, and obligations, firmly embed gay South Asian men in their families of origin, even when there is disapproval of their sexuality. More broadly, the study resists framing the respondents and findings in culturally essentialist terms, premised on an 'East' versus 'West' binary. It argues that by resisting such orientalism we can see similarities pertaining to families of origin across different contexts, and in doing so, produce queer scholarship able to speak across divides. [ABSTRACT FROM AUTHOR]

In this paper, the case study of ketamine as a new treatment for severe depression is used to outline the challenges of repurposing established medicines and we suggest potential solutions. The antidepressant effects of generic racemic ketamine were identified over 20 years ago, but there were insufficient incentives for commercial entities to pursue its registration, or support for non-commercial entities to fill this gap. As a result, the evaluation of generic ketamine was delayed, piecemeal, uncoordinated, and insufficient to gain approval. Meanwhile, substantial commercial investment enabled the widespread registration of a patented, intranasal s-enantiomeric ketamine formulation (Spravato®) for depression. However, Spravato is priced at $600–$900/dose compared to ~$5/dose for generic ketamine, and the ~AUD$100 million annual government investment requested in Australia (to cover drug costs alone) has been rejected twice, leaving this treatment largely inaccessible for Australian patients 2 years after Therapeutic Goods Administration approval. Moreover, emerging evidence indicates that generic racemic ketamine is at least as effective as Spravato, but no comparative trials were required for regulatory approval and have not been conducted. Without action, this story will repeat regularly in the next decade with a new wave of psychedelic-assisted psychotherapy treatments, for which the original off-patent molecules could be available at low-cost and reduce the overall cost of treatment. Several systemic reforms are required to ensure that affordable, effective options become accessible; these include commercial incentives, public and public–private funding schemes, reduced regulatory barriers and more coordinated international public funding schemes to support translational research. [ABSTRACT FROM AUTHOR]

A stand-alone strangulation offence was introduced in Queensland, Australia in 2016. One of the elements of the Queensland strangulation offence is that the victim did not consent to the strangulation. This paper reviews the harms and dangers associated with strangulation before overviewing the debates about the use of strangulation during sex. Drawing on focus group discussions conducted with domestic violence support workers and men's behaviour change workers, we discuss four overlapping themes identified in the discussions. These were perceptions that: strangulation during sex is normalised; consent is not informed; it happens in the context of coercive control; and the requirement of consent opens a loophole in the strangulation offence. Considering the issues raised, and the clear risks and harms, we suggest that consideration should be given to whether it is ever possible to consent to strangulation and we consider possible reforms such as following the two-tiered approaches to consent used in the England and Wales law and elsewhere in Australia. We also conclude that law reforms such as these are partial solutions and there is significant need for more community education about the risks and harms of strangulation. [ABSTRACT FROM AUTHOR]

Young women in Australia experience serious risks from intimate partner violence (IPV) as a form of family violence. However, there has been a lack of attention to the impact of this on young women and, as a result, these risks are not well understood. This article critically examines existing literature, policy and research and in doing so, specifically explores the ways in which young women aged between 10 and 20 years old are represented and positioned in contemporary family violence discourses. Framed by a review of socio-political and cultural history, the paper highlights the early colonial, patriarchal foundations of Australia, which have specific implications for the challenges that contemporary young women experience in situations of IPV. With a particular emphasis on the Australian context, this article employs both an intersectional and critical feminist lens, with a key focus on the dimensions of adolescent development and youth social geographies. Focusing specifically on these dimensions, including development, gender and age, highlights the important role that feminist social work perspectives and practices can contribute to uncovering, understanding and responding to young women's experiences of intimate partner violence through policy and advocacy. [ABSTRACT FROM AUTHOR]

This article reflects on and progresses Australian and international debates about the urban–rural digital divide. In commentary style, I draw on my own experience of living in rural Australia and six years of scholarship devoted to understanding digital inclusion in geographically remote communities. The paper is anchored theoretically in global scholarly debates around rural digital inclusion, but also deeply contextualised in the current state of digital infrastructure and capability investment and the lived experiences of people in rural Australia. In tacking stock of the geographical digital divide, I combine findings and vignettes from my published research with the insights of other authors and data from the Australian Digital Inclusion Index. I make observations about the evolution of geographical digital inclusion in Australia focused on three themes: incremental digital development; the complexity and cost of getting connected; and compounding factors of disadvantage. These insights culminate in articulation of an emerging digital divide within rural cohorts. [ABSTRACT FROM AUTHOR]

A concept of visibility frames much scholarship and public writing on LGBTQ+ representation in film and television, and underpins diversity reporting and inclusivity measurement. Although visibility is often depicted as a social good, there is a growing critical interest in asking if there are different kinds of visibility, and how these might be differentially valued. This paper reports insights gained from interviews with Australian stakeholders involved in the production of screen entertainment with LGBTQ+ content. The study found that stakeholders are motivated by to create texts that make LGBTQ+ stories and characters visible. The range of approaches to visibility was, however, nuanced and diverse: some understood any LGBTQ+ representation as valuable, while others discussed visibility in contexts of character depth, anti-stereotyping, and visibility tempered by concepts of human dignity. Although visibility is perceived diversely, it remains a significant lens by which creative artists involved in LGBTQ+ texts understand their work. [ABSTRACT FROM AUTHOR]

Objectives: Hospital in the Home models are rapidly expanding in response to increasing bed pressures. This study examined patient and multidisciplinary health professional perceptions of a new geriatric evaluation and management and rehabilitation hospital in the home service in Australia. The service was unique, as adults of all ages with a variety of rehabilitation or geriatric evaluation and management needs were within scope. Methods: A qualitative descriptive approach was used with a consumer co-researcher and a consumer advisor being integral to decision-making. Patient feedback was collected via a paper-based patient satisfaction survey between August 2020 and February 2022. Additionally, interviews with current and past staff were conducted from July to November 2021. Reflexive thematic analysis was conducted for qualitative data and descriptive statistics used for quantitative data. Results: Patient surveys were analysed (n = 199, 42.2% response rate) with 60.8% of participants aged 75 years or over and 26.6% speaking a language other than English. High satisfaction was expressed. Feelings of comfort, familiarity, convenience, and reassurance were voiced. A person-centred approach enhanced involvement in care. Challenges included carer burden and clear communication. Sixteen staff (33% response rate) were interviewed. In general, staff said the service was inclusive and responsive, and the home environment beneficial, particularly for patients from culturally diverse backgrounds. A strong hospital partnership and comprehensive multidisciplinary approach were vital. Challenges included fragmentation due to part-time roles and combining with a pre-existing acute hospital in the home service. Conclusions: This qualitative exploration of staff and patients' perceptions of a geriatrician-led, multidisciplinary geriatric evaluation and management and rehabilitation hospital in the home service demonstrated that it was person-centred and optimised patients' control and ownership of care. The inclusive service parameters ensured responsiveness to diverse needs whilst allowing earlier return home from hospital, both of which are vital for quality patient care. [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]

Chronic low back pain is characterised by multiple and overlapping biological, psychological, social and broader dimensions, affecting individuals' lives. Multidisciplinary pain services have been considered optimal settings to account for the multidimensionality of chronic low back pain but have largely focused on cognitive and behavioural aspects of individuals' pain. Social dimensions are usually underexplored, considered outside or beyond healthcare professionals' scope of practice. Employing Actor Network Theorist Mol's concept multiplicity, our aim in this paper is to explore how a pain service's practices bring to the fore the social dimensions of individuals living with low back pain. Drawing on 32 ethnographic observations and four group exchanges with the service's clinicians, findings suggest that practices produced multiple enactments of an individual with low back pain. Although individuals' social context was present and manifested during consultations at the pain service (first enactment: 'the person'), it was often disconnected from care and overlooked in 'treatment/management' (second enactment: 'the patient'). In contrast, certain practices at the pain service not only provided acknowledgement of, but actions towards enhancing, individuals' social contexts by adapting rules and habits, providing assistance outside the service and shifting power relations during consultations (third enactment: 'the patient-person'). We therefore argue that different practices enact different versions of an individual with low back pain in pain services, and that engagement with individuals' social contexts can be part of a service's agenda. [ABSTRACT FROM AUTHOR]

Australia's National Disability Insurance Scheme (NDIS) is a substantial policy reform aiming to radically transform the design and delivery of disability services. Choice and control are key tenets of the scheme, however challenges and limitations exist with respect to inequities and difficulties posed by boundaries between the NDIS and mainstream services. People with disability who have been incarcerated are particularly at risk of experiencing these limitations. However there has been little academic exploration of these issues for this group. This paper explores whether NDIS services are readily accessible for people with disability who were formerly incarcerated, outlining some of the challenges this group encounters. The research is based on interviews with 28 stakeholders from government and non-government organisations that interact with and provide support or services to people with disability within the criminal justice system. Our findings confirm the importance of a functioning NDIS plan to help prevent some individuals encountering the criminal justice system, outlining several challenges that formerly incarcerated people with disability experience with the scheme. We conclude that ideas of choice and control are inhibited for some formerly incarcerated people with disability and highlight actions that can be taken regarding specialist support coordination, advocacy services and market stewardship to address these issues. [ABSTRACT FROM AUTHOR]

Objective: Bullying is common in medical specialist training in Australia. To understand bullying rates across medical specialist training programs, we analyse the recent Medical Training Survey, administered by the Medical Board of Australia to all registered medical practitioners. Methods: Medical Training Survey data were extracted and averaged from 2020 to 2023. Results: Many speciality trainees reported personally experiencing or witnessing bullying. This was lowest in general practice (13% personally experienced and 15% witnessed) and highest in obstetrics and gynaecology (27% and 41%). The highest rate of bullying by supervisors was in surgery: 60% of surgical trainees stated that when they were bullied it was by their supervisor. Within psychiatry, 22% of trainees had personally experienced bullying and 32% of trainees had witnessed bullying. When they were bullied, the perpetrator was less commonly a supervisor (40%). In all specialities, there was a very low percentage of bullying which was reported, and was identified as having a satisfactory outcome: the most satisfactory outcomes (13%) were in general practice. Conclusion: Current rates of bullying for medical specialist trainees, the reluctance to report, as well as the lack of satisfactory outcomes, is of grave concern for Australian healthcare. This requires urgent attention at a systems level. [ABSTRACT FROM AUTHOR]

Purpose: Problematic alcohol and drug use (AOD) is a contributing factor to escalate domestic violence (DV). Yet, combined DV and AOD interventions remain limited. This article examines a combined pilot intervention for men with comorbid AOD and DV use. Methods: Mixed methods with concurrent triangulation design. Data comprises victim-survivors' reports of abuse at intake and exit, interviews with men and victim-survivors at exit and 6-month followup, and 12-month follow-up court data. Study participants included 30 male program participants and 14 female victim-survivors. Results: Findings suggest reduced AOD and DV use at program exit, that appears maintained for most men at 6-month followup. The victim-survivor data suggests more positive outcomes among men who maintained or resumed their relationship with the victim-survivor than separated men. Conclusions: Findings indicate benefits of combined early interventions addressing comorbid AOD and DV use and highlight the importance of victim-survivor voices in program reviews. [ABSTRACT FROM AUTHOR]

Domestic violence against women increased during COVID-19 lockdowns. This inaugural study examined the content of Australian government online portals, for women seeking support and help for domestic violence, during the 2021 COVID-19 pandemic. This mixed methods study incorporated four phases: a search; measurement of portal quality standard using DISCERN; enumeration of portal items; and a qualitative exploration of portal text. Australian governments must continue to work alongside domestic violence services as we found some portals were better than others. Continued review, revision, and funding are needed to meet the demands associated with this evolving public health emergency. [ABSTRACT FROM AUTHOR]

In Australia, at least one in every five women has experienced sexual violence since age 15. Research consistently links sexual violence with poor mental health, persisting long after the crisis period. Trauma-informed mental health support is therefore critical. This article draws on interviews with 29 women who had experienced sexual violence to understand their experiences accessing mental health services in Australia. Our findings suggest that, constrained by a biomedical model of care, mental health practitioners' understanding of trauma generally, and sexual violence particularly, may be lacking. Further, women struggle to navigate a "maze" of services. [ABSTRACT FROM AUTHOR]

The community sector performs an important function in providing emergency food relief, yet food insecurity is often a chronic issue due to poverty and social exclusion. Progressive food provision models present opportunities to improve voluntary food relief services that are dominant in many countries. Informed by research with clients indicating a preference for blended service models that go beyond food provision, two government agencies partnered with a social enterprise and academics to pilot a social supermarket model. This research article (a) briefly summarizes international evidence on social supermarkets' characteristics and offerings, (b) describes a process used to collaboratively develop a social supermarket incorporating universal access and social supports, and (c) presents a rubric defining elements of a social supermarket. Applicable to other community sector settings, the rubric emphasizes dignified access and service, plus opportunities for social support and connection, which are important elements in pathways out of food insecurity. [ABSTRACT FROM AUTHOR]

Introduction/Objective: The objective of the study was to develop an understanding of the perceptions of people with Parkinson's disease and clinical academics on the implementation of a regional interdisciplinary model of care. Methods: A qualitative descriptive study was undertaken. A PD interdisciplinary clinic was conducted in an Australian regional location. As a novel variation, in this clinic, 4 clinical academics consulted simultaneously offering a long, 3-h appointment. Following the clinic, we conducted 2 focus groups with all clinical academics and 6 semi-structured interviews with people with PD and carers. Data were analyzed using Elo & Kyngäs' inductive content analysis approach. Results: An overarching main category namely, "interdisciplinary care proved valuable to regional people with PD and clinical academics," and 3 generic-categories including "identifying interdisciplinary care as a viable option in regional locations," "current care provision is disempowering and burdensome," and "regional residing people with PD and their carers seek locally accessible healthcare with PD skilled clinicians" were identified. Conclusion: Our findings suggest the implementation of interdisciplinary care to regional healthcare systems is valued by clinical academics and people with PD and carers. Further research is required to establish how interdisciplinary care can be implemented in regional Australia and its effects on practice changes, patient outcomes, and quality of life. [ABSTRACT FROM AUTHOR]

Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives, when hormonal and physical changes are often accompanied by psychological and social evolution. Access to sexual health and sexual well-being (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high-income countries. A systematic review of the enablers and barriers to women (including trans-gender and non-binary people) aged 40–65 years accessing SHSW services in high-income countries was undertaken. Four databases (PubMed, PsycINFO, Web of Science and Google Scholar) were searched for peer-reviewed publications. Findings were thematically extracted and reported in a narrative synthesis. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their healthcare professionals (HCPs), and the over-arching effect of stigma, social connections and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities and financial incentives to access services for under-served groups. Efforts are needed to enhance education about SHSW and related services among midlife women and their healthcare providers. This increased education should be leveraged to improve research, public health messaging, interventions, policy development and access to comprehensive services, especially for midlife women from underserved groups. Plain language summary: Sexual health and sexual wellbeing services for midlife women in high income countries Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives. Access to Sexual Health and Sexual Wellbeing (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective of this systematic review was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high income countries. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their HealthCare Professionals (HCPs), and the over-arching effect of stigma, social connections, and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities, and financial incentives for under-served groups to access services. The appetite for education about SHSW and SHSW services among midlife women and their HCPs should be capitalised upon, and utilised to improve research, public health messaging, interventions and access to holistic services, particularly for midlife women from under-served groups. [ABSTRACT FROM AUTHOR]

This article contributes to the sociology of relationships by exploring the moral imperatives that shaped perceptions and negotiations of family life during lockdowns in Australia during the COVID-19 pandemic. We identified dominant discourses from an online qualitative story completion task and situate these in relation to emerging literature on the impact of pandemic-related restrictions on domestic relationships, gender relations, and labour division. We argue that discourses of family connection, clean and tidy homes, and the commodity of time operated as moral imperatives. These imperatives simultaneously offered opportunities for enrichment and agency, as well as operating as unobtainable benchmarks that constrained people's sense of wellbeing. In this analysis we explore how COVID-19 lockdown stories offer new ways of understanding the interplay between displaying and doing 'family life' where gender and labour relations are performed, reinforced and challenged. [ABSTRACT FROM AUTHOR]

While understanding the diversity of women's lived experiences is a key focus area in the international feminist literature on family violence, research with migrant women in Australia remains limited. This article seeks to contribute to the growing body of intersectional feminist scholarship that examines how immigration or "migration status" impacts the dynamics of migrant women's experiences of family violence. The article examines precarity in relation to migrant women's lives in Australia and focuses on the ways that their specific circumstances contribute to and are compounded by the experience of family violence. It also considers how precarity functions as a structural condition that has implications in terms of various forms or patterns of inequality that can heighten women's vulnerability to violence and undermine their efforts to ensure their safety and survival. [ABSTRACT FROM AUTHOR]

Interest in voluntary assisted death (VAD) has been growing among researchers, policy makers and the public. This study aimed to explore older adults' perspectives on VAD in Australia. Using purposive sampling, 15 adults ≥65 years participated in in-depth semi-structured interviews. Interpretative phenomenological analysis identified four themes: cultural reflections; beliefs and worldviews; health aspects; and fabric of life. Participants expressed a desire to have control over end-of-life options, challenged by religious beliefs. Participants expressed concern that VAD legislation could leave people vulnerable to coercion and saw a need for safeguards. Reasons for and against supporting and utilising VAD were discussed. Physical illness was seen a more compelling reason for VAD than mental ill-health. Finally, connections to life and other were discussed, and being able to do the things one loved were named aspects of what it meant to live a good life. Implications are discussed along with future research directions. [ABSTRACT FROM AUTHOR]

Funeral workers (FWs) work within increasingly medicalized and commodified death-management systems. This study explored Worker Health and Safety (WHS) impacts in contemporary death management on Australian and Irish FWs. Mixed methods combined a survey and interviews. Survey data were descriptively summarized, interviews thematically analyzed, and a schematic systems model developed of the combined results. Survey participants (n = 45) reported psychosocial hazards from work pressures, competition, and fatigue. Psychosocial hazards were more frequently reported than physical hazards by Australian FWs. Physical hazards were of greater concern to Irish FWs. Themes from 11 interviews were: Personal Attributes, Work Demands, and Socio-Cultural Context. All FWs reported conflicts between individual capacities, work demands, and resources, resulting in hazardous personal states including difficulty sleeping and stress. Respectfully manually handling human remains and "event management" demands for increasingly elaborate funerals created negative WHS impacts. This research informs risk management for FWs and other workers in the increasingly complex death-care industry. [ABSTRACT FROM AUTHOR]

This study aimed to assess differences in emotion and elaboration quality between clinical and community child cohorts in both past reminiscing and future worry conversations. We analyzed 54 Australian parents (46 mothers, 8 fathers) and their 8- to 12-year-old children (M = 9.63, SD = 1.29; 28 boys, 26 girls) in reminiscing interactions. Dyads were recruited from local schools (community cohort, n = 26) or a children's psychology clinic waitlist (clinical cohort, n = 28). Clinical cohort children engaged in less emotion exploration in both past and future conversations, as did parents for future conversations. Elaboration quality did not differ. Parent-son dyads differed in the clinical cohort, exhibiting significantly lower emotion resolution than the community cohort, or parent-daughter dyads when discussing past events. These findings suggest that discussing anticipated negative events may be a relevant point of family-based intervention for anxious children. Additionally, this study highlights the importance of parent-son emotional discussion. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B infection has been associated with the development of gestational diabetes but the underlying mechanism is not known. Objective: To examine associations between viral activity, gestational diabetes mellitus (GDM), and insulin resistance in pregnant people with chronic hepatitis B infection (HBV). Design: Prospective cohort study across three tertiary maternity centres in Melbourne, Australia, between May 2021 and April 2023. Methods: Participants were followed prospectively through pregnancy to evaluate subsequent GDM diagnosis. Demographics, pregnancy outcomes, and markers of viral activity were compared between those with GDM versus those without. Logistic regression analysis was performed pre- and post-adjustment for known confounders. Sub-group analysis of participants from South East Asia (SEA) was performed. Outcome measures included GDM diagnosis, insulin resistance (Homeostatic Model Assessment Insulin Resistance score (HOMA-IR) score), HBV activity as measured by liver function tests, HBV viral load, hepatitis B e antigen, and quantitative hepatitis B surface antigen (quantHBsAg). Results: A total of 113 women were recruited. One third (38/112, 33.9%) developed GDM, mostly diagnosed on isolated postprandial hyperglycaemia (25/38, 65.8%). Over half were born in SEA (66/113, 58.4%). Mean quantHBsAg was significantly lower in those with GDM (p = 0.044). No other associations were identified between GDM or HOMA-IR and markers of hepatic activity on multivariate logistic regression analysis and on sub-group analysis of those born in SEA. Conclusions: QuantHBsAg was significantly lower in those with GDM; otherwise, no association between GDM and measures of HBV viral activity was found. QuantHBsAg may be useful as an early pregnancy marker for GDM risk and warrants further research. [ABSTRACT FROM AUTHOR]

Introduction: Workplace violence is endemic, destructive, and escalating in frequency and severity in healthcare. There is a paucity of research on workplace violence in regional and remote hospital emergency departments (EDs). Objective: The aim of this study was to identify the perpetrator and situational characteristics associated with violent incidents in the ED across five regional and remote Australian sites. Method: This study audited hospital summary data, incident reports, and medical records for a 12-month period in 2018 to examine the perpetrator and situational characteristics of workplace violence incidents in five regional and remote Australian EDs. Results: Violent incidents were evenly spread throughout the week and across shifts. Most incidents were triaged as urgent, occurred within the first 4 hr, and had multidisciplinary involvement. Almost one in every six incidents resulted in an injury. Perpetrators of violence were predominantly young and middle-aged males and almost always patients, with most presenting with mental and behavioral disorders, or psychoactive substance use. Conclusions: Understanding the characteristics of perpetrators of violence can help in seeking to tailor interventions to reduce further violent behaviors. These findings carry implications for optimizing patient care, staff safety and resource management. [ABSTRACT FROM AUTHOR]

Background: Siblings of children with cancer have been shown to experience disruption in multiple domains including family, school, and friendships. Existing literature on siblings' experiences focuses on older children or on a broad range of ages. Aim: To explore the experience of siblings aged 8–12 years when their brother or sister is diagnosed with cancer. Method: A qualitative design incorporating phenomenology as the theoretical framework was used. Participants were recruited from across Australia via notices on social media sites and by the distribution of flyers. We used thematic analysis to analyze the data. Data were collected via semistructured interviews conducted either in person or online. Findings: A total of 13 siblings (7 boys and 6 girls) aged between 8 and 12 years (M = 9.8, SD = 1.6) were interviewed. Seven main themes were identified. These were "It was really hard": Reactions to the cancer diagnosis; "I'm really angry": Emotional and Physical Responses to siblings' treatment; "I pretend teddy is real": Play as an outlet; "It was very lonely": Missing their siblings; "I missed out on a lot of fun": Disruption of activities: School, sports, playdates, and parties; Change and Transition and "Making a difficult situation worse": COVID-19 Pandemic. Discussion: Findings extend the current understanding showing that younger siblings' developmental and cognitive skills impact their experiences of childhood cancer. Younger siblings outlined the many losses they experienced which demonstrated a need for a comprehensive and tailored program to support young siblings aged under 12 of children with cancer. [ABSTRACT FROM AUTHOR]

Argentina and Australia endured among the most severe COVID-19 lockdowns globally. This study examined which artistic creative activities (ACAs) Argentinians in the Buenos Aries region used to support their mental health and wellbeing and compared these findings with existing data for Australians (primarily from Victoria) across a similar period. Adult Argentinians (N = 86) responded to an online survey regarding 27 listed ACAs, as well as ratings of anxiety, depression, and loneliness. While "watching films and television" was the most commonly reported ACA, it was not rated as effective in supporting mental health and wellbeing. Conversely, musical ACAs were ranked highest. We consider evidence from Australia, North America, and South America that musical ACAs (especially music listening) have been most effective at supporting mental health and wellbeing during the COVID-19 pandemic by way of avoidance-based emotion regulation. We also conclude from the data that Argentinians tended to place greater importance on music-based ACAs than Australians. [ABSTRACT FROM AUTHOR]