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Background: Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic).Objectives: To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources.Methods: A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy.Results: Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training organization and information-seeking for management rather than diagnosis.Conclusion: Trainee information-seeking is mainly from GP colleagues and electronic sources. Human information-sources are preferentially sought for more complex problems, even by these early-career GPs who have trained in the 'internet era'. [ABSTRACT FROM AUTHOR]

South eastern Australia is a global warming hotspot, and is also home to ~70% of Australia's population and one of Australia's largest fisheries—the South East Scalefish and Shark Fishery. This fishery spans shelf to deep waters, subtropical to temperate waters, employs many gears, and interacts with over 100 species. Despite following best practice fisheries management principles, including taking an ecosystem perspective to overall fisheries interactions, management interventions have failed to arrest or recover the decline of some focal species. Using an Atlantis ecosystem model developed for the fishery over the past 20 years, this paper presents simulations that suggest climate change may be a major contributor to the trajectories seen for a number of species—such as jackass morwong (Nemadactylus macropterus), blue warehou (Seriolella brama), and gemfish (Rexea solandri). This kind of climate influence poses many challenges for fisheries management into the future, raising questions about what to do when climate change undermines or overrides fisheries management actions and objectives. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between policy compliance, the emergence of alternate epistemes and authorities in online spaces, and the decline of trust and legitimacy in democratic institutions. Drawing on insights from public policy, regulation theory, and political theory, the paper critically engages with scholarship on "policy-takers" to illuminate the tensions of compliance and legitimacy in liberal states. It proposes a compliance--legitimacy matrix that identifies the features of policy compliance--including consent, legitimacy, expertise, and trust--and their relationship to the disaggregation of policy knowledge. The article applies this framework to a case study of social media posts that respond to policy information during the management of the Covid-19 pandemic in Australia. Through analysis of these posts, the study reveals the distrust in "the science" and experts advocated by government and the calls from skeptic groups for noncompliance with public health measures. The paper argues that public policy faces an epistemic crisis of public confidence, with significant downstream consequences for compliance with public policy initiatives that has been brought on both by the failures of states to cultivate trust in science and the government. The compliance--legitimacy matrix offers a useful tool for policymakers to anticipate and address objections from policy-takers and to preempt and diffuse their fears. [ABSTRACT FROM AUTHOR]

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

The article presents information about various papers related to geophysics. Some of the papers are "The Seismic Structure of the Saurashtra Crust in Northwest India and Its Relationship With the Reunion Plume," by G.S.P. Rao and H.C. Tewari, "Maximum Horizontal Stress Orientations in the Cooper Basin, Australia: Implications for Plate-Scale Tectonics and Local Stress Sources," by S. D. Reynolds, S. D. Mildren, R. R. Hulls, J. J. Meyer and T. Flottmann, "A Magnetic Field Model With Daily Variations of the Magnetospheric Field and Its Induced Counterpart in 2001," by V. Lesur, S. Macmillan and A. Thomson.

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

Aims This paper analyses the content of news media messages on drinking during pregnancy in Australia over an 18-year period to understand whether and how the nature of messages communicated to women has changed over time. Methods Factiva was used to search Australian newspapers from 2000 to 2017, resulting in a sample of 1394 articles from the 18 major national and state-based newspapers. Content analysis of articles was undertaken, and Poisson regression analysis was used to assess changes over time. Results The largest number of articles on drinking during pregnancy was published in 2007. Themes that significantly increased over time included Harms to the Child (from 0.97% in 2008 to 29.69% in 2015) and Prevention Initiatives (from 0% in 2005 to 12.50% in 2017). Articles endorsing women not consuming alcohol during pregnancy significantly increased over time (from 20.69% in 2001 to 53.78% in 2013), matched by a decreasing trend in the proportion of articles presenting mixed advice (from 15.93% in 2009 to 0% in 2017). The largest number of articles adopted no position in relation to women's consumption. Conclusions A stronger abstinence message during pregnancy has been communicated through Australian newspaper media over time. The mixed messaging and large number of articles not endorsing a position on consumption may reflect the inconclusiveness of the evidence on harms from low to moderate levels of alcohol consumption during pregnancy. Opportunities remain for researchers to work with public health advocates to disseminate balanced messages based on evidence-based research. [ABSTRACT FROM AUTHOR]

We describe a case of a 12-year-old female with a past history of autism spectrum disorder who presented to the emergency department of a rural hospital in Australia after ingesting two nickel-metal hydride (NiMH) batteries at home. Hitherto, no literature has described any gastrointestinal complications related to NiMH battery ingestion. This paper aims to provide insight into the management of NiMH battery ingestion and to increase the awareness of the need for prompt management to prevent further damage to the gastrointestinal tract. [ABSTRACT FROM AUTHOR]

Compared with gravity data, gravity gradient data can reflect the structural features of density anomalies with higher sensitivity and resolution. Gravity gradient inversion is a common method for interpreting gravity gradient data, but the non-uniqueness of gravity gradient inversion solutions makes it difficult to quickly determine the effectiveness and reliability of the inversion results. To solve this problem, this paper combines the gravity gradient inversion and gravity gradient curvature methods and applies them to different sets of synthetic models. The gravity gradient inversion results are useful primarily for determining the spatial distributions and physical properties of density anomalies, while the gravity gradient curvature results have a prominent advantage in judging the geometric features of the density anomalies. In addition, one form of gravity gradient curvature, the contour lines of the shape index, can be compared with the top view of the inversion results to rapidly confirm the distribution of density anomalies, which is especially valuable for unexplored regions. On the basis of the respective advantages and features of these two methods, the gravity gradient curvature can be used as an important criterion to judge the results of gravity gradient inversion. The two methods are then combined to analyse airborne gravity gradient data measured in the field at the Kauring Test Site in Australia. Compared with the findings of previous gravity inversion research, this study shows that several anomalous blocks exist in the vicinity of the central anomalies, thereby demonstrating that the combination of these two methods is effective and reliable in identifying density anomalies. [ABSTRACT FROM AUTHOR]

Using length frequency distribution data (LFD) is cost-effective for estimating somatic growth in fish or invertebrates as length data are relatively easy to obtain. The recently developed R packages TropFishR and fishboot extend classic ELEFAN (Electronic LEngth Frequency ANalysis) programs and include more powerful optimization procedures and a bootstrap method for estimating uncertainties. Yet, the fundamental functions require users to provide search conditions (e.g. upper and lower limits for each parameter, length-class size, number of length-classes for the calculation of moving average), which can significantly affect the results. In this paper, we compare the ELEFAN approach with a Bayesian approach in analysing LFD, employing both standard and seasonal von Bertalanffy growth functions. We apply both approaches to a commercially valuable but poorly studied red endeavour prawn (Metapenaeus ensis) harvested in Australia's Northern Prawn Fishery. Sensitivity tests on ELEFAN confirm that any change in search settings would affect the results. Simulation studies on Bayesian growth models show that Linf and K can be accurately obtained even with modal progression of only one year-class and using non-informative priors. However, age information, including the theoretical age at length zero (t0), is difficult to estimate and requires LFD from multiple age classes and informative priors. The Bayesian models yield mean parameters of: Linf = 36.56 mm (carapace length), K = 2.74 yr–1, and t0 = -0.02 yr for the males, and Linf = 51.81 mm, K = 1.94 yr–1, and t0 = -0.02 yr for the females. Seasonal oscillation models fit the LFD better, but the improvement is small and the estimated season-related parameters have large variances. [ABSTRACT FROM AUTHOR]

While research in social and affective neuroscience has a long history, it is only in the last few decades that it has been truly established as an independent field of investigation. In the Australian region, despite having an even shorter history, this field of research is experiencing a dramatic rise. In this review, we present recent findings from a survey conducted on behalf of the Australasian Society for Social and Affective Neuroscience (AS4SAN) and from an analysis of the field to highlight contributions and strengths from our region (with a focus on Australia). Our results demonstrate that researchers in this field draw on a broad range of techniques, with the most common being behavioural experiments and neuropsychological assessment, as well as structural and functional magnetic resonance imaging. The Australian region has a particular strength in clinically driven research, evidenced by the types of populations under investigation, top cited papers from the region, and funding sources. We propose that the Australian region has potential to contribute to cross-cultural research and facilitating data sharing, and that improved links with international leaders will continue to strengthen this burgeoning field. [ABSTRACT FROM AUTHOR]

This paper estimates the effect of a major skilled visa programme in Australia on the wages and occupation-specific skills performed by native workers. We combine data from the full population of approved Temporary Work Visa applications with the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) longitudinal survey from 2005–2015. Our findings indicate that skilled international workers increase the wages of natives, and induce native workers to specialize in occupations associated with a high intensity of communication and cognitive skills. We find no evidence of negative effects of the visa programme on the wages of high-skilled or low-skilled native workers, or on previous migrants who may be close substitutes to the skilled visa holders. [ABSTRACT FROM AUTHOR]

With this paper, we initiate the Supplement on Deepening our Understanding of Quality in Australia (DUQuA). DUQuA is an at-scale, cross-sectional research programme examining the quality activities in 32 large hospitals across Australia. It is based on, with suitable modifications and extensions, the Deepening our Understanding of Quality improvement in Europe (DUQuE) research programme, also published as a Supplement in this Journal, in 2014. First, we briefly discuss key data about Australia, the health of its population and its health system. Then, to provide context for the work, we discuss previous activities on the quality of care and improvement leading up to the DUQuA studies. Next, we present a selection of key interventional studies and policy and institutional initiatives to date. Finally, we conclude by outlining, in brief, the aims and scope of the articles that follow in the Supplement. This first article acts as a framing vehicle for the DUQuA studies as a whole. Aggregated, the series of papers collectively attempts an answer to the questions: what is the relationship between quality strategies, both hospital-wide and at department level? and what are the relationships between the way care is organised, and the actual quality of care as delivered? Papers in the Supplement deal with a multiplicity of issues including: how the DUQuA investigators made progress over time, what the results mean in context, the scales designed or modified along the way for measuring the quality of care, methodological considerations and provision of lessons learnt for the benefit of future researchers. [ABSTRACT FROM AUTHOR]

Background Compared to national averages, the Gold Coast, Australia, has a proportionately higher number of children entering their first year of primary school with 'at risk' or 'vulnerable' language skills. This paper investigates the distribution of paediatric speech-language pathology (SLP) services on the Gold Coast, relative to children's language and cognitive skills, and socioeconomic status (SES). Methods SLP service locations were identified through national association data and a manual search and mapped against SES and Australian Early Development Census data, for language and cognitive skills. Results Data for 7595 children was included, with 943 (12.4%) at risk and 780 (12.6%) vulnerable for language and cognitive skills. A total of 75 SLPs were identified (85.3% private, 14.6% public), which is 1 SLP to every 23 children who might have current or impending speech, language and communication needs. Fewer services were available in areas where vulnerable children were located and most were private providers, leading to further potential barriers to service access. Conclusions The number of SLP services located on the Gold Coast is inadequate to meet the needs of children with language and cognitive skill vulnerabilities. Consideration of how services might be distributed is explored and warrants further consideration. [ABSTRACT FROM AUTHOR]

Methods for calculating health indicators profoundly influence understanding of and action on population health and inequities. Age-standardization can be useful and is commonly applied to account for differences in age structures when comparing health indicators across groups. Age-standardized rates have well-acknowledged limitations, including that they are relative indices for comparison, and not accurate measures of actual rates where the age structures of groups diverge. This paper explores these limitations, and demonstrates alternative approaches through a case study quantifying mortality rates within the Aboriginal and Torres Strait Islander (Indigenous) population of Australia and inequities compared with the non-Indigenous population, over 2001-16. Applying the Australian Standard Population, the Aboriginal and Torres Strait Islander age-standardized mortality rate was more than double the crude mortality rate in 2001 and 2016, inflated through high weighting of older age groups. Despite divergent population age structures, age-standardized mortality rates remain a key policy metric for measuring progress in reducing Indigenous-non-Indigenous inequities in Australia. Focusing on outcomes age-standardized to the total population can obscure inequities, and denies Aboriginal and Torres Strait Islander peoples and communities valid, actionable information about their health and well-being. Age-specific statistics convey the true magnitude of health risks and highlight high-risk subgroups. When requiring standardization, standardizing to a population-specific standard (here, an Indigenous standard) generates metrics centred around and reflective of reality for the population of focus, supporting communities' self-determination to identify priorities and informing resource allocation and service delivery. The principles outlined here apply across populations, including Indigenous and other populations internationally. [ABSTRACT FROM AUTHOR]

Appendiceal diverticulitis is known as a rare pathology and its etiology remains largely unknown. We describe a case of a 41-year-old woman with a past history of inflammatory bowel disease (IBD) who was admitted to the Emergency Department at a rural hospital in Australia with right iliac fossa pain (RIF) and later was found to have acute appendiceal diverticulitis on histopathologic studies. Thus far, no literature has described IBD as one of the possible contributing factors of appendiceal diverticulitis. This paper aims to shed light on the possible causative relation between appendiceal diverticulitis and IBD. [ABSTRACT FROM AUTHOR]

Study Question: What is the likelihood of having a child within 4 years for men and women with strong short-term reproductive intentions, and how is it affected by age?Summary Answer: For women, the likelihood of realising reproductive intentions decreased steeply from age 35: the effect of age was weak and not significant for men.What Is Known Already: Men and women are postponing childbearing until later ages. For women, this trend is associated with a higher risk that childbearing plans will not be realised due to increased levels of infertility and pregnancy complications.Study Design, Size, Duration: This study analyses two waves of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey. The analytical sample interviewed in 2011 included 447 men aged 18-45 and 528 women aged 18-41. These respondents expressed a strong intention to have a child in the next 3 years. We followed them up in 2015 to track whether their reproductive intention was achieved or revised.Participants/materials, Settings, Methods: Multinomial logistic regression is used to account for the three possible outcomes: (i) having a child, (ii) not having a child but still intending to have one in the future and (iii) not having a child and no longer intending to have one. We analyse how age, parity, partnership status, education, perceived ability to conceive, self-rated health, BMI and smoking status are related to realising or changing reproductive intentions.Main Results and the Role Of Chance: Almost two-thirds of men and women realised their strong short-term fertility plans within 4 years. There was a steep age-related decline in realising reproductive intentions for women in their mid- and late-30s, whereas men maintained a relatively high probability of having the child they intended until age 45. Women aged 38-41 who planned to have a child were the most likely to change their plan within 4 years. The probability of realising reproductive intention was highest for married and highly educated men and women and for those with one child.Limitations, Reasons For Caution: Our study cannot separate biological, social and cultural reasons for not realising reproductive intentions. Men and women adjust their intentions in response to their actual circumstances, but also in line with their perceived ability to have a child or under the influence of broader social norms on reproductive age.Wider Implications Of the Findings: Our results give a new perspective on the ability of men and women to realise their reproductive plans in the context of childbearing postponement. They confirm the inequality in the individual consequences of delayed reproduction between men and women. They inform medical practitioners and counsellors about the complex biological, social and normative barriers to reproduction among women at higher childbearing ages.Study Funding/competing Interest(s): This research was partly supported by a Research School of Social Sciences Visiting Fellowship at the Australian National University and an Australian Research Council Discovery Project (DP150104248). Éva Beaujouan's work was partly funded by the Austrian Science Fund (FWF) project 'Later Fertility in Europe' (Grant agreement no. P31171-G29). This paper uses unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the authors and should not be attributed to either DSS or the Melbourne Institute. The authors have no conflicts of interest. [ABSTRACT FROM AUTHOR]

This paper examines the evolution of Australian fiscal policy and the fiscal policy framework over the past quarter-century. Following the early 1980s recession, a sustained fiscal consolidation saw the general government budget balance (for all levels of government) move from a deficit of 3 1/2 per cent of GDP in 1983/4 to a surplus of 1 3/4 per cent 5 years later in 1988/9. A severe recession in the early 1990s interrupted this process, and the budget returned to sizeable deficits which peaked at 4 3/4 per cent of GDP in 1992/3. The second half of the 1990s saw a repeat of the experience a decade earlier, with the budget returning to surplus in 1997/8. In contrast to the 1980s experience, however, the general government sector (for all levels of government) has recorded surpluses for the subsequent 8 years to the present. The paper outlines Australia's macroeconomic experience over this time and argues that there have been two significant medium-term factors motivating the extended periods of fiscal consolidation. The first factor, relevant since the mid-1980s. has been the large Australian current-account deficits since that time, and the associated build-up of net foreign liabilities. The second factor, which entered the public debate more recently, is a desire to provide fiscal policy flexibility to respond to the ageing of the population and the projected rising public cost of health services--both influences that are likely to be of increasing importance over the next generation or so. The paper discusses the introduction and evolution of Australia's medium-term fiscal framework which has been put in place to respond to these challenges. [ABSTRACT FROM AUTHOR]

This paper reviews application of the Daily Egg Production Method (DEPM) to sardine (Sardinops sagax) off southern Australia between 1995 and 2019. Coefficients of variation (CVs) of estimates of spawning biomass (SB) were reduced from 23–59% to 8–12% by: (i) estimating mean daily egg production (P 0), spawning fraction (S), and sex ratio (R) from all historical data rather than annually; and (ii) combining batch fecundity (F) and female weight (W) into a single parameter, relative fecundity (F ′ =  F ^ / W). Total daily egg production was estimated most precisely from annual estimates of spawning area (A) and estimates of P 0 obtained from historical data. Both S and R were estimated most precisely from historical data. Estimating W and F from historical data did not increase precision. F ′ had lower CVs than both W and F , and was stable across years and a wide range of W. Findings demonstrate that A can be converted into a precise estimates of SB using estimates of P 0, S , R , and F ′ obtained from historical data. However, the possibility that DEPM parameters may change in the future cannot be discounted. Future monitoring should include annual estimation of P 0 and periodic (e.g. 3–5 years) re-estimation of adult parameters. [ABSTRACT FROM AUTHOR]

Background: There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Methods: Using Health & WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the individuals had no chronic health conditions. Results: There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth; however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets; under the counterfactual, the average would have been $78 000. Conclusion: This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth. [ABSTRACT FROM AUTHOR]

Performance measurement (PM) in the public sector has progressively broadened to cover the operation of professionals traditionally framed as independent and autonomous. How PM reconstitutes the role and conduct of professionals is critical for understanding contemporary dynamics of policy and governance, and service provider-service user relationships. Building on Lipsky's classic Street-level Bureaucracy, this paper examines the ways in which street-level professionals are reconfigured in their roles as evidenced by the operation of Australia's schooling PM, NAPLAN. The paper reports findings from a project examining the effects of PM in social policy. Attention is given to the ambiguous and conflicting goals arising from measuring literacy and numeracy performance and the varied ways performance numbers are used by management for teacher governance at the street-level. These considerations have implications for the effectiveness of PM in delivering service improvements, the experience of service users, and the achievement of policy objectives. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this paper is to investigate the utilisation of general practice Medicare Benefit Schedule (MBS) services aligned to Comprehensive Geriatric Assessment (CGA) within 6 months of an aged care eligibility assessment and its effects on mortality and transition to permanent residential aged care (PRAC). Design Retrospective cohort study from the Historical Cohort of the Registry of Senior Australians. Setting Community. Participants In total, 69,171 Individuals (aged 75+) receiving home care packages (HCPs) between 2011 and 2015. Outcome measures Mortality and transition to PRAC. Results The claims for a management plan with team care arrangement (TCA) within 3 months of the health assessment (i.e. CGA) was present in 5% and associated with 14% lower mortality (adjusted hazard ratio [aHR], 95%CI = 0.86, 0.80–0.93) compared to no claims, lower than that seen with partial CGA which was either health assessment claims only 7.0% (aHR, 95%CI = 0.93, 0.89–0.97) or management plan coupled with TCA claims only 9.0% (aHR, 95%CI = 0.91, 0.89–0.97). This pattern was seen in those frailer but not in those where the frailty index score was <0.21. Claims for management plans coupled with TCAs alone were associated with a 10% lower transition to PRAC (asHR, 95%CI = 0.90, 0.85–0.96) in those with FI score < 0.21 while this estimate was not significant in individuals with FI score ≥ 0.21. Conclusion It appears the conduct of a combination of interventions considered to be components of the CGA by GPs was associated with a lower risk of mortality that no claims or partial conduct of CGA. [ABSTRACT FROM AUTHOR]

Robots are increasingly appearing as a potential answer to the 'care crisis' facing a number of countries. Although it is anticipated that many positives will flow from the application of these technologies, they are also likely to generate unexpected consequences and risks. This paper explores the use of robots within disability and aged care settings in the Australian and New Zealand contexts. Informed by thirty-five semi-structured interviews with a range of stakeholders, the paper explores why this area is so difficult to govern examining areas identified as generating tensions around the use of robots in care settings. In each of these areas some respondents saw the introduction of robots to be relatively straightforward applications that do not require extensive structures of governance. Others, however, viewed these applications as having potentially greater implications and the need to govern for these over the longer term. The three areas of tension that we explore in this paper relate to independence and surveillance, the re-shaping of human interaction and who can care. These tensions illustrate some of the problems involved in governing robots in a care service context and some of the potentially difficult issues that governments will need to resolve if these technologies are to be effective. We conclude the paper arguing what is needed is a responsive regulation approach to help resolve some of the complexities and tensions in overseeing these technologies. [ABSTRACT FROM AUTHOR]

Focal Ratio Degradation (FRD) in optical fibres can result in light loss. In astronomical instrumentation, FRD must be controlled because light levels are low. A new Integral Field Spectrograph (IFS) instrument called Hector, was recently completed and was installed on the Anglo-Australian Telescope (AAT) in Australia in 2021 December. The integral field units (IFUs) for Hector made with hexagonally packed multi-mode fibres are called hexabundles. In this paper, we introduce a cone-beam measurement method to measure FRD at optical wavelengths. We present the FRD and throughput performance of the hexabundles for Hector and show that the process for making hexabundles introduced no additional significant FRD beyond that of the bare fibre. [ABSTRACT FROM AUTHOR]

A postcolonial perspective in the history of economic thought reveals the ways in which racial theory was built into the foundations of neoclassical economics. Neoclassical economics emerged within the context of nineteenth-century European colonisation and this paper connects the material practices of colonisation in Australia to this emerging body of theory. In particular, the paper focuses on the Western breadwinner/dependent family ideal that was deeply embedded within economic visions of development, prosperity and progress. I argue that neoclassical economics naturalised and justified colonial practices that sought to impose the homogeneity of culture, desires and needs used to justify the displacement and subordination of the colonised Aborigines. [ABSTRACT FROM AUTHOR]

People with disability are an at-risk group in the COVID-19 pandemic for a range of clinical and socioeconomic reasons. In recognition of this, Australians with disability and those who work with them were prioritized in access to vaccination, but the vaccination targets were not met. In this paper, we analyze qualitative data generated from a survey with 368 disability support workers to identify drivers of COVID-19 vaccination hesitancy and why the implementation of this policy may have experienced challenges. We identify a range of themes within these data but ultimately argue that a major driver of vaccine hesitancy in this group is a mistrust of government and an erosion of employment terms and conditions. Drawing on the policy capacity literature, we argue that the "Achilles' heel" for the Australian government in this case is the critical policy capacity of political legitimacy. This finding has important implications for where the government needs to increase/build policy capacity, strengthening its efforts and better relating to organizations that can be helpful in terms of developing public health messaging for disability support workers. [ABSTRACT FROM AUTHOR]

Statistical agencies make changes to the data collection methodology of their surveys to improve the quality of the data collected or to improve the efficiency with which they are collected. For reasons of cost it may not be possible to estimate the effect of such a change on survey estimates or response rates reliably, without conducting an experiment that is embedded in the survey which involves enumerating some respondents by using the new method and some under the existing method. Embedded experiments are often designed for repeated and overlapping surveys; however, previous methods use sample data from only one occasion. The paper focuses on estimating the effect of a methodological change on estimates in the case of repeated surveys with overlapping samples from several occasions. Efficient design of an embedded experiment that covers more than one time point is also mentioned. All inference is unbiased over an assumed measurement model, the experimental design and the complex sample design. Other benefits of the approach proposed include the following: it exploits the correlation between the samples on each occasion to improve estimates of treatment effects; treatment effects are allowed to vary over time; it is robust against incorrectly rejecting the null hypothesis of no treatment effect; it allows a wide set of alternative experimental designs. This paper applies the methodology proposed to the Australian Labour Force Survey to measure the effect of replacing pen-and-paper interviewing with computer-assisted interviewing. This application considered alternative experimental designs in terms of their statistical efficiency and their risks to maintaining a consistent series. The approach proposed is significantly more efficient than using only 1 month of sample data in estimation. [ABSTRACT FROM AUTHOR]

Background The hospital intensive care unit (ICU) environment encompasses sick patients who present for care in health crisis. Healthcare in this setting is complex, often involving the co-ordination of multiple professional teams, all under significant time pressures. The sequelae for staff interacting in this dynamic and often volatile setting are variable, depending upon their coping skillset and their familiarity with the stressors. Aims The primary aim of this study was to describe and in doing so, normalize the behavioural responses expressed by ICU doctors (Intensivists) in response to stressful workplace events. The secondary aim was to identify those responses that contributed to resilience. Methods A prospective qualitative study of senior Intensivists using a semi-scripted iterative interview. Data were transcribed and thematically analysed with verbatim quotations selected to support coding choices. Results Nineteen experienced Intensivists from three sites in Australia and Israel participated. Clinicians described conscious, physiological and professional responses to stressors, including sense-making and taking time to process information with appropriate support. Two of the most important mitigation processes revealed were the use of reflective learning and preventative practice changes to prevent future errors. These were overlaid with the importance of disclosure and transparency in clinical work. Conclusions Repeated exposure to stressful events potentiates burnout, wherein staff no longer experience satisfaction and enjoyment in what they do. This paper presents the behavioural responses that experienced Intensivists described in relation to stressful events in the ICU, including steps taken to mitigate the effects of these events on their personal well-being. [ABSTRACT FROM AUTHOR]

In the long history of monopolies, business method patents are a novel and recent edition. In the Digital Age, where time is money and speed is everything, innovative methods for undertaking business are as important to a business as the products or services it provides to its clients. In recent years several reviews, conducted in both Australia and internationally,4 have questioned the appropriateness of patenting business methods. This paper reviews the availability of business method patents in Australia in light of the 2006 decision of the Full Court of the Federal Court in Grant v Commissioner of Patents,5 which confirmed the need in Australia for a `useful product' to issue from the working of a method (business or otherwise) in order for the method to be patentable. This paper will review arguments both criticising and defending business method patents and consider whether business methods warrant special treatment. [ABSTRACT FROM AUTHOR]

The standard Blanchard-Quah (BQ) decomposition forces aggregate demand and supply shocks to be orthogonal. However, this assumption is problematic for a nation with an inflation target. The very notion of inflation targeting means that monetary policy reacts to changes in aggregate supply. This paper employs a modification of the BQ procedure that allows for correlated shifts in aggregate supply and demand. It is found that shocks to Australian aggregate demand and supply are highly correlated. The estimated shifts in the aggregate demand and supply curves are then used to measure the effects of inflation targeting on the Australian inflation rate and level of GDP. [ABSTRACT FROM AUTHOR]

To illustrate the potential use of plural research methods, two studies of Australian women's retirement incomes are examined. The first study employed quantitative microsimulation techniques. Its outcomes emphasised low lifetime earnings as a cause of women's lower retirement incomes. The second study used an inductive approach known as grounded theory, and its conclusions emphasised household decision-making processes as a cause of both women's low lifetime earnings and lower retirement incomes. Using Runde's criteria for assessing causal explanations, a comparison is made of the outcomes of the two studies. The conclusion is that, rather than being seen as competing accounts, the outcomes of the two varying research methods can be viewed as complementary. By demonstrating the different insights afforded by contrasting research methods, this paper provides some support for pluralism of research methods within the discipline of economics. [ABSTRACT FROM AUTHOR]

In a series of papers, Blackburn et al. claim to solve the conceptual and measurement issues associated with vertical gender segregation by occupation. In this paper it is argued that the authors misinterpret the conventional index measures of segregation, which leads them to a misspecification of their vertical and horizontal components of segregation which are alleged to be orthogonal. As a consequence, the two components are conflated, so that neither component of segregation is correctly calculated. There are also conceptual and measurement difficulties with the cross-national empirical work of Charles (2003). The absence of hierarchical employment data by occupation from the typical Labour Force Survey precludes the estimation of country wide vertical segregation. Data from sources such as the Australian Workplace Industrial Relations Survey will enable the calculation of vertical gender segregation, in addition to the generation of insights about the factors contributing to vertical gender segregation. Case studies too will enable a greater understanding of the extent and causes of vertical gender segregation. [ABSTRACT FROM AUTHOR]

In this, the eightieth year of the formalisation of the Australian economics profession, a survey of it seems appropriate. While the profession's beginnings were marked by an idiosyncratic, heterodox tradition, the paper finds that those attributes have by now been largely dissolved by internationalisation. To demonstrate this, two periods in Australian economic history, and the role of economic opinion within each, are examined. One concerns the mobilisation of native economics expertise in developing policies to deal with the Great Depression, while the latter episode covers the rise of neo-liberal policy or economic rationalism in Australia. Unlike the interwar period and the post-war era, contemporary Australian economics, despite its policy success in reforming the economy has problems in attracting young minds to its fold. [ABSTRACT FROM AUTHOR]

Labour immigration contributed strongly to Europe's post-war economic development. In contrast to migration to North America or Australia, these movements of labour were always seen as temporary by sending and receiving countries, and, at least initially, also by most migrants. Although many migrants stayed more permanently, return migration is a highly relevant feature in practice. Its significant role and the underlying behavioural mechanisms are not well understood, however. it is therefore not too surprising that most policy measures taken in the 1970s and 1980s to encourage return migration failed. The paper takes the view that much can be learned from recent European history. Temporary immigration schemes may be helpful to moderate illegal migration and to foster East-West economic relationships. Given the tight policies in the European Union, short-term migration seems to be the only channel to open the door slightly. The paper reviews the European history of return migration and the policy regimes in important European labour migration-receiving countries. it also provides new empirical evidence on the determinants of return behaviour anti successful return. Return propensities of migrants increase with the age at entry, but decrease with the number of years of residence. Conditional on having decided to return, however, the remaining years in the country decrease with years of residence and, keeping years of residence constant, with entry age. Return incentives may cause dissatisfaction and reintegration problems in the home country. The results support the view that economic benefits are the larger, the earlier it is clear whether migration is temporary or permanent. [ABSTRACT FROM AUTHOR]

We present a method for measuring the dispersion of higher mode surface wave phase velocities from a single seismogram using a hierarchical transdimensional Bayesian approach. The 1-D shear velocity profiles down to 800 km depth between sources and seismic stations are regarded as the controlling parameters to tune the phase velocities of fundamental and higher modes. The misfits between synthetics and real waveforms indicate whether the phase velocities are recovered well from the data. We use Monte Carlo Markov chains to approximate the posterior distribution of each model parameters and assess the uncertainties from these probability density functions. These techniques can test models of varying dimensions while being parsimonious, thereby letting the data themselves control the complexity of the solution. Another advantage is that the algorithm can decide how much data noise is needed in order to explain the data without overfitting them. The data noise can be treated as an unknown and different noise levels can be applied to the different time windows considered. The posterior noise distributions can then be used as an indicator of the quality of the waveform fit within each frequency–time window. We considered phase velocities between 50 and 200 s for each mode and performed a reliability analysis to determine which modes and periods are reliably constrained. In this paper, we first present the method and demonstrate its feasibility with synthetic tests, which show that the technique is robust. We then illustrate it with applications to real data. We applied the method to two paths sampling Australia using earthquakes at regional distances and obtained results that agree well with previous studies. The new method can be used in regional and global tomographic studies to obtain phase velocity maps and 3-D models of seismic velocities and anisotropy at depths that are not well resolved by fundamental mode surface waves or body waves. [ABSTRACT FROM AUTHOR]

The majority of people living with Alzheimer disease (AD) and related dementias are women. Longer life expectancy is one factor thought to contribute to this observation, but possible sex-specific biological mechanisms have received considerable attention from the research community. In the current issue of the Journal , Buckley et al. (Am J Epidemiol. 2019;188(7):1213–1223) use death certificate information on all deaths occurring among adults aged ≥60 years in Australia between 2006 and 2014 to evaluate sex/gender differences in rates of death with dementia (all types), AD dementia, and vascular dementia listed on the death certificate. The paper by Buckley et al. highlights several important methodological challenges for research examining sex/gender differences in risk of AD and related dementias, including challenges in measurement, survival bias and competing risks, and selection bias arising from sample selection. The current evidence on possible sex-specific biological risk factors for AD is intriguing, but there are numerous alternative explanations for differences in AD dementia and AD biomarkers between women and men. Triangulation of evidence from study designs with different strengths and weaknesses and transdisciplinary collaboration will be vital to generating conclusive evidence about sex/gender differences in risk of AD and related dementias. [ABSTRACT FROM AUTHOR]

In the absence of quantitative relationships, a cross-gradient function can be used to correlate unknown physical properties in a joint inversion of geophysical data sets. It introduces a structural correlation between properties. A commonly used, inexact approach adds a weighted cross-gradient term as a penalty to the cost function being minimized during inversion. This weighting factor needs to be tuned to balance the regularization and cross-gradient terms. In this paper we propose nonlinear weighting for the cross-gradient function which addresses the very different magnitudes of the cross-gradient and regularization terms. This approach also couples the weighting factors for the regularization and correlation terms reducing the number of tuning parameters. The approach is investigated for a synthetic case. Results are also shown for the 3-D joint inversion of high-resolution magnetic and gravity anomaly data from Southern Queensland in Australia with over 30 million cells. [ABSTRACT FROM AUTHOR]

Aims This paper examines: (a) change over time (2001–2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. Short summary Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons; older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. Methods Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. Results Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. Conclusion Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people. [ABSTRACT FROM AUTHOR]

Studying range expansions is central for understanding genetic variation through space and time as well as for identifying refugia and biological invasions. Range expansions are characterized by serial founder events causing clines of decreasing genetic diversity away from the center of origin and asymmetries in the two-dimensional allele frequency spectra. These asymmetries, summarized by the directionality index (ψ), are sensitive to range expansions and persist for longer than clines in genetic diversity. In continuous and finite meta-populations, genetic drift tends to be stronger at the edges of the species distribution in equilibrium populations and populations undergoing range expansions alike. Such boundary effects are expected to affect geographic patterns in genetic diversity and ψ. Here we demonstrate that boundary effects cause high false positive rates in equilibrium meta-populations when testing for range expansions. In the simulations, the absolute value of ψ (| ψ |) in equilibrium data sets was proportional to the fixation index (F ST). By fitting signatures of range expansions as a function of ɛ | ψ |/ F ST and geographic clines in ψ , strong evidence for range expansions could be detected in data from a recent rapid invasion of the cane toad, Rhinella marina , in Australia, but not in 28 previously published empirical data sets from Australian scincid lizards that were significant for the standard range expansion tests. Thus, while clinal variation in ψ is still the most sensitive statistic to range expansions, to detect true signatures of range expansions in natural populations, its magnitude needs to be considered in relation to the overall levels of genetic structuring in the data. [ABSTRACT FROM AUTHOR]

This paper explores the interrelationship between two contemporary policy debates: one focused on the social determinants of health and the other on social (inclusion) policy within contemporary welfare regimes. In both debates, academics and policy makers alike are grappling with the balance between universal and targeted policy initiatives and the role of local ‘delivery’ organizations in promoting health and social equality. In this paper, we discuss these debates in the context of a recent social policy initiative in Australia: the Social Inclusion Agenda. We examine two proposed models of engagement between the government and the not-for-profit welfare sector for the delivery of social services. We conclude that the two models of engagement currently under consideration by the Australian government have substantially different outcomes for the health of disadvantaged communities and the creation of a more socially inclusive Australia. [ABSTRACT FROM PUBLISHER]

Extensive research has shown that few robust results regarding the optimal tax structure are available. Moreover, the stylized models used in optimal tax analyses are not appropriate for practical policy advice. This paper proposes a method of examining income tax reforms designed to move towards an optimal structure. It uses a behavioural microsimulation model in which the full extent of population heterogeneity is represented along with all the details of highly complex tax and transfer systems. The approach is illustrated using the Australian microsimulation model MITTS. The results show that welfare changes for the Australian income tax structure are not symmetric with respect to increases and decreases in tax rates. In addition, the extent of inequality aversion was found to play a much larger role in the determination of the direction of tax rate changes than the form of the welfare metric or the specification of adult equivalence scales. [ABSTRACT FROM AUTHOR]

Summary. The paper describes a method of small area estimation which uses a reweighting algorithm to reweight survey data to a number of known totals (benchmarks) for small areas. The method has so far been used to estimate small area poverty rates and housing stress. The method gives poverty rates for small areas that are similar to those available from the 2006 Australian census, when the same definition of poverty was used. Various methods of validating the poverty rates have been used, including aggregating the poverty rates to a larger area and comparing them with official Australian Bureau of Statistics estimates from a survey, and applying the spatial microsimulation to larger areas and comparing with official Australian Bureau of Statistics survey results. Both these tests show that the estimates are comparable and fairly robust for most states in Australia. [ABSTRACT FROM AUTHOR]

There is growing interest in the role that apex predators play in shaping terrestrial ecosystems and maintaining trophic cascades. In line with the mesopredator release hypothesis, Australian dingoes (Canis lupus dingo and hybrids) are assumed by many to regulate the abundance of invasive mesopredators, such as red foxes Vulpes vulpes and feral cats Felis catus, thereby providing indirect benefits to various threatened vertebrates. Several recent papers have claimed to provide evidence for the biodiversity benefits of dingoes in this way. Nevertheless, in this paper we highlight several critical weaknesses in the methodological approaches used in many of these reports, including lack of consideration for seasonal and habitat differences in activity, the complication of simple track-based indices by incorporating difficult-to-meet assumptions, and a reduction in sensitivity for assessing populations by using binary measures rather than potentially continuous measures. Of the 20 studies reviewed, 15 of them (75%) contained serious methodological flaws, which may partly explain the inconclusive nature of the literature investigating interactions between invasive Australian predators. We therefore assert that most of the “growing body of evidence” for mesopredator release is merely an inconclusive growing body of literature only. We encourage those interested in studying the ecological roles of dingoes relative to invasive mesopredators and native prey species to account for the factors we identify, and caution the value of studies that have not done so [Current Zoology 57 (5): 568–583, 2011]. [ABSTRACT FROM AUTHOR]

Joint geriatric/psychiatric wards are a potential solution to improving care of older patients with both psychiatric and medical illnesses in acute hospitals. A literature search using Medline, PsycINFO, Embase and CINAHL between 1980 and 2010 was carried out for information about joint wards for older people. Thirteen relevant papers were identified. These wards share common characteristics and there is evidence that they may reduce length of stay and be cost-effective, but there are no high-quality randomised controlled trials. Further research is needed, particularly regarding cost-effectiveness. [ABSTRACT FROM AUTHOR]

In this paper, we focus on the effects of macroeconomic conditions on commercialisation. Using survey data on the activities of Australian inventors who attempted to commercialise 3,736 inventions over the period 1986–2005, we find evidence that macroeconomic conditions have a pro-cyclical effect on commercialisation activities. Such a finding has important policy implications since it suggests that recessions have both short-term effects (on employment, income) and long-term effects (on productivity). However, the magnitude of the supply-side effects—the cost of finance and level of public sector research—are estimated to be larger than the growth in aggregate or industry demand. [ABSTRACT FROM AUTHOR]

Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health promotion. Drawing on a review of literature on health promotion for marginalized and out-of-school adolescents, this paper highlights some urgent areas of focus for researchers and policy makers addressing adolescent health. Social determinants of health affecting marginalized adolescents identified by the review were education, gender, identity, homelessness, poverty, family structure, culture, religion and perceived racism, yet there is little solid evidence as to how to best address these factors. More systematic research, evaluation and global debate about long-term solutions to chronic poverty, lack of education and social marginalization are needed to break the cycle of ill health among vulnerable adolescents. [ABSTRACT FROM PUBLISHER]

This paper aims to present what is currently known about Indigenous Australians and their engagement in physical activity and to then challenge some of the ‘taken-for-granted’ ways of thinking about promoting or researching physical activity with Indigenous Australians. Major health, education and sport databases, as well as government websites were searched using the key terms of physical activity, sport, leisure, recreation, Indigenous and Aboriginal/Aborigine. A social–ecological model of health was adapted and used as an organizing framework to synthesize the literature. It is concluded that socioecological models can be valuable tools for understanding and promoting issues related to physical activity engagement for a range of populations but they may require complementary critical insights, including those from Indigenous perspectives. Productive theoretical spaces where Western and Indigenous knowledges come together can assist health educators to consider the complexity and diversity of Indigenous people's lived experiences when planning and implementing programs. [ABSTRACT FROM PUBLISHER]

The evidence-based policy (EBP) movement has often focused on relatively stable policy issues and service programs where rigorous analysis has been able to enhance policy-makers' consideration of improvement options. However, EBP has taken different turns in policy fields marked by value-conflict, rapid change, high risk or radical uncertainty. One such area in recent years has been water policy, in the context of water scarcity. There have been urgent new challenges for water policy, planning and delivery in many cities and regions around the world. This paper examines an Australian case-study, the urban water crisis in Southeast Queensland (SEQ), taking a policy governance perspective. The State government became increasingly alarmed by the deteriorating water-supply outlook, and undertook a number of policy changes including substantial re-structuring of urban water governance. The paper raises issues about the evidence base for decision-making, and for policy learning, where policy governance is shaped under conditions of uncertainty and crisis. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study examining the out-of-home care (OOHC) experiences of children aged less than one year (infants), based on data collected by the NSW Department of Community Services (DoCS), Australia. The purpose of the study is to develop a profile of infant children in OOHC and to better understand why so many young children require OOHC services and their experiences with the child welfare system. Using administrative data, we employ both descriptive and multivariate analysis to explore how child, child maltreatment history and system factors are related to the placement of infants in care. Our results are in line with research conducted in the USA and UK. The most notable finding is the high child protection reporting rate and high entry rate by infants and by Indigenous infants in particular. The tendency for infants to stay in care longer than other children, coupled with a high entry rate to care, has and will continue to have a significant impact on the child welfare system and its consequences. The implications for development of policy and early intervention programmes are discussed. [ABSTRACT FROM PUBLISHER]

In response to the new 'outcomes movement' in health care settings internationally, social workers are increasingly expected to communicate their practice using the language of outcomes. Yet, little research has focused on the language that social workers use to describe their practice and how they identify appropriate interventions and link them to clearly defined evaluative outcomes. This paper is part of a large programme of research exploring and identifying issues associated with social work practice in the Australian health context. Specifically, the paper draws on qualitative data from the first stage of the project that explores issues associated with customary social work practice. Findings from the paper suggest clear evidence of tensions and difficulties experienced by social workers in attempting to communicate the critical expertise behind their practice and that practitioners have only rudimentary understanding of the concepts of outcomes and evaluation. A key challenge for social work research concerns how to encourage the profession actively to engage with the outcomes movement whilst maintaining the core principles and values of social work. [ABSTRACT FROM AUTHOR]