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This paper is the first of a two-part report on a mixed methods study that examined the job satisfaction of teachers who worked in faith-based schools. Five aspects of the work of teaching (colleagues, working conditions, responsibility, work itself, and recognition) and two transcendent factors (spirituality and religiosity) were examined to see how they impacted overall job satisfaction. In this mixed methods project, both quantitative and qualitative data were collected from a sample that consisted of nine schools in two Australian faith-based educational systems: Lutheran and Seventh-day Adventist. This paper reports on the findings from regression analysis of the quantitative data (N = 221), which indicated that overall job satisfaction was influenced by a combination of direct and indirect relationships that centred around working conditions, work itself, religiosity, and the age of the respondent. It also was found that religiosity impacted overall job satisfaction directly and indirectly via the mediating element of spirituality. A partial discussion of the results is presented in this report, but the complete discussion will be found in Part Two (2024). [ABSTRACT FROM AUTHOR]

The introduction of long‐acting injectable buprenorphine preparations for opioid use disorder has been widely heralded as a breakthrough treatment, with several studies indicating positive results when using these medications. In many locations, nurse practitioners prescribe, administer, and monitor long‐acting injectable preparations. The objective of this paper is to explore whether a reduction in dispensed needles and syringes is attributable to increased nurse practitioner prescribing of LAIB. We used a retrospective audit of needles dispensed through the health service needle and syringe program vending machine, and individuals treated with long‐acting injectable buprenorphine by the nurse practitioner led model. In addition, we examined potential factors that may influence changes in the number of needles dispensed. Linear regression found that each individual with opioid dependence treated with long‐acting injectable buprenorphine was associated with 90 fewer needles dispensed each month (p < 0.001). The nurse practitioner led model of care for individuals with opioid dependence appears to have influenced the number of needles dispensed at the needle and syringe program. Although all confounding factors could not be discounted entirely, such as substance availability, affordability, and individuals obtaining injecting equipment elsewhere, our research indicates that a nurse practitioner led model of treating individuals with opioid use disorder influenced needle and syringe dispensing in the study setting. [ABSTRACT FROM AUTHOR]

Background: A wealth of evidence supports the important role high‐quality parent–child interactions play in children's early language acquisition. However, the impact on later language outcomes remains unclear. Aims: To examine the associations between responsive parental behaviours across the early years and child language outcomes at age 7 years with families from an Australian longitudinal cohort study (N = 1148, 50% female). Methods & Procedures: At child ages 12, 24 and 36 months, parents completed a self‐report measure of responsive parental behaviours. Child language was directly assessed at age 7 using the Clinical Evaluation of Language Fundamentals, 4th edition (CELF‐4), Australian Standardisation. Linear regression was used to examine associations between responsive parental behaviours from 12 to 36 months (consistently high, inconsistent and consistently low responsive parental behaviours at the three time points) and language scores at age 7 years. Adjusted models were run, including the following potential confounders: child sex; birth weight; birth order; maternal education; socio‐economic disadvantage; non‐English‐speaking background; family history of speech–language problems; mother's vocabulary score; maternal mental health score; and mother's age at birth of child. A final adjusted model was run, including the potential confounder variables as well as adjusting for children's earlier language skills. Outcomes & Results: Linear regression results showed children with parents who rated high on responsive parental behaviours at all three time points had higher mean language scores at age 7 than children whose parents reported low responsive parental behaviours across early childhood. This association attenuated after adjusting for earlier child language skills. Conclusions & Implications: Findings support the consistent use of responsive parental behaviours across the very early years of childhood to support long‐term language outcomes. Findings also suggest that models of surveillance and support which monitor and assist families at multiple time‐points over the early years are likely to be most effective for preventing ongoing language difficulties. WHAT THIS PAPER ADDS: What is already known on this subject: There is extensive evidence consistently demonstrating the important contribution of aspects of parent–child interaction, specifically responsive parental behaviours, to children's language development. What this paper adds to the existing knowledge: Understanding the cumulative benefit of responsive parent–child interactions across the very early years may help to inform preventive interventions and service delivery models for supporting young children's language development. This study demonstrates in a large, population‐based cohort the contribution of consistency of responsive parental behaviours during infancy and toddlerhood to school‐age language outcomes, accounting for other child, family and environmental factors. Capturing regular parent behaviours via self‐report during the early years may be a more efficient and less costly method than parent–child interaction observations to monitor the home language‐learning environment during routine developmental checks. What are the potential or actual clinical implications of this work?: Findings support the need for surveillance of children and families in the early years, ensuring that intervention occurs when families need it most, that is, support is responsive to changing needs and that nuanced advice and support strategies are provided to activate positive developmental cascades. Capturing both parent behaviours and child language may assist clinicians to identify those families who may benefit from parent–child interaction intervention. [ABSTRACT FROM AUTHOR]

Background: Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD. Aims: To test the predictive relationship between parent‐reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population‐based sample. Methods: Data were leveraged from the prospective Raine Study (n = 1626 second‐generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well‐established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years. Results: No single parent‐reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85–1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59–1.32, p = 0.563) were also non‐significant. Conclusions: Parent reports of early indicators of DLD are well‐intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed. WHAT THIS PAPER ADDS: What is already known on the subject: DLD is a relatively common childhood condition; however, children with DLD are under‐identified and under‐served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge: No one parent‐reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work?: The broad dissemination and use of 'red flags' is well‐intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation‐based interventions. [ABSTRACT FROM AUTHOR]

Background: Early intervention is essential healthcare for stuttering, and the translation of research findings to community settings is a potential roadblock to it. Aims: This study was designed to replicate and extend the Lidcombe Program community translation findings of O'Brian et al. (2013) but with larger participant numbers, incorporating clinicians (speech pathologists/speech anlanguage therapists) and their clients from Australia and England. Methods & Procedures: Participants were 51 clinicians working in public and private clinics across Australia (n = 36) and England (n = 15), and 121 of their young stuttering clients and their families. Outcome measures were percentage of syllables stuttered (%SS), parent severity ratings at 9 months post‐recruitment, number of clinic visits to complete Stage 1 of the Lidcombe Program, and therapist drift. Outcomes & Results: Community clinicians in both countries achieved similar outcomes to those from randomized controlled trials. Therapist drift emerged as an issue with community translation. Speech and language therapists in England attained outcomes 1.0%SS above the speech pathologists in Australia, although their scores were within the range attained in randomized trials. Conclusions & Implications: Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice. The long‐term impact of therapist drift in community clinical practice with the Lidcombe Program has yet to be determined. WHAT THIS PAPER ADDS: What is already known on the subject: The Lidcombe Program is an efficacious early stuttering intervention. Translation to clinical communities has been studied with one Australian cohort. What this paper adds to existing knowledge: A larger translation cohort is studied, comprising community clinicians and children in Australia and England. What are the potential or actual clinical implications of this work?: Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice. [ABSTRACT FROM AUTHOR]

Community mobilisation is essential to prevent further biodiversity loss and protect the natural environment. This includes engaging in public- and private-sphere behaviours, and community support of relevant government policies. This purpose of this paper is to explore and compare the factors associated with public- and private-sphere nature conservation behaviour and policy support. We utilised data from a survey of 4,048 Australians, representative for age, gender, and geographic location, which measured engagement in nature conservation behaviours and support for diverse conservation policies. Hierarchical Multiple Regressions were conducted to assess relationships between behaviour and policy support with the key independent variables of awareness (of biodiversity issues), connection (to nature), and concern (about biodiversity issues), and socio-demographic covariates. Overall, community support for nature conservation policies was high, not just for incentive measures but for regulations and penalties. Regression models explained 22.9% of the variance in public-sphere behaviour, 30.2% of the variance in private-sphere behaviour, and 43.5% of the variance in policy support. Concern made one of the strongest contributions for all outcomes, and was substantially stronger for policy support compared to behaviour. Awareness and connection also made independent contributions to all outcomes. Socio-demographic variables explained a smaller proportion of unique variance for policy support (1.0%) compared to behaviour (public-sphere: 9.6%, private-sphere: 6.3%). Notably, for public-sphere behaviour, younger age explained almost as much variance as concern. Implications for practitioners and policymakers seeking to engage the general population in conservation support are discussed. [ABSTRACT FROM AUTHOR]

Using panel data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, this paper examines to what extent informal care provided by couples and single individuals affects their household savings. This paper is one of the first attempts to examine the relationship between informal care and savings. There are both negative and positive effects of informal care on wealth accumulation, but we do not know which of these effects dominate. We estimate quantile regression models and find that informal care provision has limited negative impacts on changes in household wealth formation. There was no effect of caring on wealth formation for the lower quantile and the negative effects are limited to the mid to high quantile groups. [ABSTRACT FROM AUTHOR]

Purpose: There is a growing concern over the need for greater transparency of quality information by companies about modern slavery to contribute toward elimination of the practice. Hence, this paper aims to examine factors behind the quality of voluntary modern slavery disclosures and major sources of pressure on Australian company disclosures in a premodern slavery legislated environment. Design/methodology/approach: Content analysis and cross- sectional regression modeling are conducted to analyze factors determining the quality of voluntary modern slavery disclosures of the top 100 firms listed on the Australian Stock Exchange and their implications for institutional pressures. Findings: Results indicate that size, assurance by Big-4 firms and publication of stand-alone modern slavery statements are significant drivers of disclosure quality in the sample. Profitability, listing status and the degree of internationalization are found to be unrelated to the quality of voluntary modern slavery disclosures. Industry classification is significant but only partly supports the prediction, and further investigation is recommended. Practical implications: This paper provides a foundation for regulators and companies toward improving the quality of their modern slavery risk disclosures with a particular focus on prior experience, assurance and size. In practice, contrary to suggestions in the literature, results indicate that monetary penalties are unlikely to be an effective means for improving the quality of modern slavery disclosure. Results of the study provide evidence of poor quality of disclosures and the need for improvement, prior to introduction of modern slavery legislation in Australia in 2018. It also confirms that regulation to improve transparency, through the required publication of a modern slavery statement, is significant but not enough on its own to increase disclosure quality. Originality/value: To the best of the authors' knowledge, this is the first research examining company level factors with an impact on voluntary modern slavery disclosure quality and the links to institutional pressures, prior to the introduction of the Commonwealth Modern Slavery Act 2018. [ABSTRACT FROM AUTHOR]

Access to valid and reliable neuropsychological measures for use with culturally diverse groups in Australia is limited. The aim of this study was to adapt and translate a selection of English language neuropsychological tests, employ several existing standardised Greek language tests, and provide specific reference group normative data for Greek Australian older adults. A convenience sample of 90 healthy older Greek Australians (M = 77.14 ± 4.46; range = 70–85), with a primary school level of education (M = 5.60 ± 0.68; Range = 4–6), was recruited throughout the Melbourne metropolitan area. Several neuropsychological measures were administered which assessed domains such as verbal and visual memory, confrontational naming, and executive functions. Regression modelling revealed that age, education and sex predicted between 5% and 35% of the variance of test scores, with age being the most significant predictor of performance across a majority of measures. Therefore, the normative data for all tests were stratified according to three age bands (70–74, 75–79, 80–85). The use of culture-specific tests and norms for assessment of older Greek-Australians with limited education may facilitate accuracy of assessment findings, improve diagnostic outcomes, and reduce misclassification. What is already known about this topic: The use of English language tests with migrant populations and tests developed in nations of origin can lead to misclassification when applied to long-term immigrant peers. The use of test content derived from English language tests has been found to be inappropriate for use with culturally diverse groups. Access to norms and tests for assessment of culturally diverse groups in Australia are limited. What this topic adds: This paper provides a template for translating and adapting existing English language tests for use with culturally diverse groups. This is the first study to provide a set of comprehensive norms for Greek Australian older adults. Utilising culturally appropriate and specific reference group norms for Greek-Australians may improve the accuracy of assessment findings and reduce misclassification. [ABSTRACT FROM AUTHOR]

This paper estimates the difference in academic performance of the oldest (treated) and youngest (control) students in a given grade. We employ Queensland Department of Education school administration panel data for the population of 2008–2016 state school students. Academic performance is measured using standardised test scores (National Assessments Program in Numeracy and Literacy) and teacher‐assessed measures of performance and effort for individuals in grades 3, 5 and 7. The empirical analysis employs a regression discontinuity design based on birth date relative to administrative rules on age of school enrolment. The class‐assigning mechanism operates via a known cut‐off date and results in the oldest child in the grade being almost a year older than the youngest. However, lack of enrolment compliance implies the regression discontinuity design is fuzzy rather than sharp, identifying the local average treatment effect rather than the average treatment effect. In particular, given the one‐sided nature of non‐compliance, we employ the partially fuzzy estimator of Battistin and Rettore (Journal of Econometrics, 142, 715–30, 2008). Exploiting a 2008 enrolment cut‐off date reform, which delayed school starting age by 6 months, we find a large increase in enrolment compliance. This exogenous change in the enrolment age enables one to gauge the importance of enrolment non‐compliance in estimating the treatment effect of being older versus younger in cohort. We find that pre‐reform the treatment effect is small and generally statistically insignificant and post‐reform it is sizeable and statistically significant. [ABSTRACT FROM AUTHOR]

Reported in this paper is an evaluation of structural and functional performance of heavy duty and light duty pavements by addressing the effects of several factors on the rate of pavement deterioration. The sample used herein is a network of freeways and arterials from Victoria/Australia covering four road classes, namely M, A, B and C. The first two road classes represent heavy duty pavement and the last two road classes represent light duty pavements. These road classes differ in qualities, functions, duties, geometric standards, and traffic volumes and loadings. This paper aims to assess the performance of the four road classes by comparing their pavement conditions and environmental factors affecting the rate of pavement deterioration. More than 2300 kilometers of road length was selected from 40 highway sections to reflect Victoria's network conditions. The parameters considered for assessing road performance were traffic loading, pavement strength, and environmental factors. Hierarchical linear regression analysis was used to explore the significance of different predictor variables for all road classes. The study confirms that the rate of roughness and rutting progression per year for all road classes is very close, and the environmental factors affect roughness and rutting progressions for light duty pavements only. [ABSTRACT FROM AUTHOR]

Objective: Farmers are prone to poor well‐being and are at higher risks of suicide than the general population. The aim of this study was to understand whether the negative impact of daily stressors on Australian farmers' well‐being could be buffered through a strong internal locus of control – a strong sense of control over what happens in life. Methods: Australian farmers self‐reported their well‐being, daily stress, and locus of control. Design: Cross‐sectional via pen‐and‐paper survey. Setting: Participants completed the surveys at the beginning of agricultural management training courses. Participants: Australian farmers (N = 129, M age = 39 ± 12 years, 54.7% male). Main Outcome Measures Internal and external locus of control, daily stress, and subjective well‐being. Results: More daily stressors were associated to poorer well‐being, regardless of external locus of control; however, farmers with a stronger internal locus of control were buffered from the negative impacts of daily stressors. That is, daily stressors were not significantly associated with well‐being for farmers with a strong internal locus of control. Conclusions: Internal locus of control may be a significant factor in supporting good well‐being for farmers. Further research should investigate how to enhance internal locus of control amongst this population. It may be that interventions to enhance internal locus of control in farmers could improve their well‐being and productivity, good outcomes for the individual farmers, and global society overall. [ABSTRACT FROM AUTHOR]

Addressing clients' demands, designers have become increasingly concerned about the operation phases of buildings and, more specifically, energy consumption. This issue has become more prominent as people realize that the Earth's resources are limited and depleted, and buildings are major energy consumers. Building Information Modelling (BIM) has gained popularity in recent years and is now widely used by architects, engineers, and construction teams to collaborate and provide a comprehensive design that follows a sustainable strategy. The objective of this research is to examine how building variables are linked to energy consumption in various building shapes, achieved by building prototypes. The accuracy of the regression models is evaluated by undergoing a validation process. Consequently, this study created building information models of selected education facility office rooms and used Autodesk Insight 360 and Green Building Studio (GBS) to perform energy simulations. A 6 Green Star education building in Australia is chosen as the case study of this paper. Thirteen variables related to building internal design were examined, and five were found to endure a substantial effect on building energy consumption. The study also looked at the window-to-wall ratio (WWR), which was analyzed by multi-linear regression; however, the results showed that the model did not fit well, and the error obtained during the validation process ranged from 1.0% to 26.0%, which is unacceptable for this research. These findings highlight some limitations in using BIM tools and linear regression methods and discuss some potential improvements that can be achieved in future studies. [ABSTRACT FROM AUTHOR]

Objectives: This study explored publicly funded health system and patient expenditure in the post-acute phase following discharge from inpatient acquired brain injury (ABI) or spinal cord injury (SCI) rehabilitation. The secondary aim was to explore sociodemographic and injury characteristics associated with high costs. Methods: This was a prospective cohort study. 153 patients (ABI: n = 85; SCI: n = 68) who consented to the use of their Medicare data were recruited between March 2017 and March 2018, at the point of discharge from ABI or SCI specialist rehabilitation units. The main outcome measure involved linkage of the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data for the 12 months following discharge from rehabilitation. Bayesian penalised regression was used to determine characteristics associated with high costs. Results: The median number of MBS items used in the 12 months after discharge was 33 (IQR: 21–52). General practitioners and allied health services were accessed by 100% and 41% of the cohort, respectively. The median MBS system cost (in Australian dollars) was $2006 (IQR: $162–$3090). Almost half (46%) of the participants had no MBS patient expenditure. The median PBS system cost was $541 (IQR: $62–$1574). For people with ABI, having a traumatic injury or one comorbidity was associated with lower PBS system costs by on average $119 and $134, respectively. We also found that hospitalisation in ABI was associated with higher PBS system costs, by on average $669. Conclusion: There was evidence of high and variable MBS and PBS costs, raising concerns about financial hardship. Future research should focus on identifying any unmet service and prescription needs in the post-acute rehabilitation phase for these populations. What is known about the topic? Acquired brain injury and spinal cord injury incur high long-term health costs, yet little is known about Medicare service use and costs in the early post-acute phase. What does this paper add? This study provides insight into service use and the burden of injury on Medicare Benefits Schedule and Pharmaceutical Benefits Scheme systems in the 12 months after hospital discharge. High and variable system and patient expenditure are most notable. What are the implications? Highly variable patient costs raise concerns about the access and affordability of sufficient healthcare services in the post-acute rehabilitation period. [ABSTRACT FROM AUTHOR]

Where earlier conceptions of problem neighbors saw them as contributing to neighborhood level forms of disorder, neighbor problems, in contrast, occur in the everyday domestic setting of residential life and challenge conceptual boundaries between public/private and civility/incivility. As a result, there is a need to better understand the phenomenon of problems between neighbors beyond conceptions of public disorder and to understand the processes that influence how and why neighbor problems arise. In this study, we examine neighbor problems as manifest in reported complaints to a local municipality in Australia to understand how neighborhood features affect the likelihood of neighbors experiencing problems with each other. We propose five hypotheses to examine the social-interactive, environmental, and geographical mechanisms of neighborhood effects and test these hypotheses through logistic regression models on the way certain neighborhood features relate to the prevalence of neighbor problems. The findings reveal the sources of neighbor problems that typically reside in a combination of the social-interactive dynamics of the neighborhood itself—including the composition of the resident population—and the environmental features of the neighborhood in terms of the condition, density and use of dwellings, but not in the location of the neighborhood relative to larger-scale political and economic forces of the city. The paper concludes with a discussion of the significance of these findings for research, policy, and practice. [ABSTRACT FROM AUTHOR]

This paper investigated the characteristics of mothers of children with a disability who registered for a mental health and wellbeing workshop. The questionnaire measured mental health, health-related behaviours, empowerment, family cohesion, wellbeing and child-related variables. Regression analysis identified factors associated with depressive symptoms and positive wellbeing. Fifty-seven percent of participants (N = 171) had depressive symptoms within the clinical range. Higher symptoms were associated with reduced: empowerment (r = −.39, p <.01); positive-wellbeing (r = −.66, p <.05); and healthy activity (r = −.41, p <.001). Low positive wellbeing (β =.55, p <.001) was the strongest predictor of depressive symptoms. Family cohesion (β =.25, p <.001), was the strongest predictor of positive-wellbeing. Future health and wellbeing interventions that support mothers with high care responsibilities should include psycho-education and strategies to address healthy maternal and family-related behaviour changes. [ABSTRACT FROM AUTHOR]

Objective: To describe the change in telemental health service volume that resulted from the introduction of the Medicare Benefits Schedule (MBS) item numbers in 2020 for services provided by psychologists and psychiatrists in Australia for a 3-year period, from January 2019 to December 2021. Methods: Quarterly MBS activity and cost data for mental health services provided by consultant psychiatrists, clinical psychologists, and psychologists between January 2019 and December 2021 were extracted from the MBS statistics website. Data were grouped by profession and delivery mode (in-person, telephone or videoconference) and reported using activity counts. Descriptive analysis and interrupted time-series regression analysis were conducted. Specific descriptive explorations were also conducted for psychiatrists, including: new client consultations, review or general consultations, and group consultations. Results: The delivery of mental health services by telehealth (telemental health) during the pandemic has increased (P < 0.0001). When the pandemic started in March 2020, telemental health services provided by psychiatrists and psychologists increased from a combined 1–2% per quarter to 29% videoconference and 20% telephone in quarter two 2020. After the onset of the pandemic, videoconference remained the primary form of telehealth for these professions. However, the telephone accounted for approximately a third of the telehealth activity after the new item numbers were introduced. Conclusion: Telemental health services are more likely to be conducted by videoconference than by telephone. The observed increase in telehealth service activity confirms how crucial appropriate funding models are to the sustainability of telehealth services in Australia. The growth in telehealth was used to support people with mental health conditions in Australia. What is known about the topic? Psychologists and psychiatrists were among the earliest adopters and were assigned some of the first telehealth item numbers on the Medicare Benefits Schedule. What does this paper add? The delivery of mental health services by telehealth during the pandemic has increased. Telemental health services are more likely to be done by videoconference in psychiatry and psychology than by other professions. What are the implications for practitioners? The observed increase in telehealth service activity confirms how crucial appropriate funding models are to the sustainability of telehealth services in Australia. [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]

Objective: In Australia, 2.7 million surgical procedures were performed in the year 2016–17. This number is ever increasing and requires effective management of operating theatre (OT) time. Preoperative prediction of theatre time is one of the main constituents of OT scheduling, and anecdotal evidence suggests that surgeons grossly underestimate predicted surgical time. The aim of this study is to assess surgeons' accuracy at predicting OT times across different specialties and effective theatre scheduling. Methods: A database was created with de-identified patient information from a 3-month period (late 2016). The collected data included variables such as the predicted time, actual surgery time, and type of procedure (i.e. Emergency or Elective). These data were used to make quantifiable comparisons. Results: Data were categorised into a 'Theatre list' and 'Scopes list'. This was further compared as 'Actual–Predicted' time, which ranged from an average underestimation of each procedure by 19 min (Ear Nose and Throat surgeons) to an average overprediction of 13.5 min (Plastic Surgery). Urgency of procedures (i.e. Emergency and Elective procedures) did not influence prediction time for the 'Theatre list', but did so for the 'Scopes list' (P < 0.001). Surgeons were poor at predicting OT times for complex operations and patients with high American Society of Anaesthesiologists grades. Overall, surgeons were fairly accurate with their OT prediction times across 1450 procedures, with an average underestimation of only 2.3 min. Conclusions: In terms of global performance at The Queen Elizabeth Hospital institution, surgeons are fairly accurate at predicting OT times. Surgeons' estimates should be used in planning theatre lists to avoid unnecessary over or underutilisation of resources. What is known about the topic?: It is known that variables such as theatre changeover times and anaesthesia time are some of the factors that delay the scheduled start time of an OT. Furthermore, operating time depends on the personnel within the operating rooms such as the nursing staff, anaesthesiologists, team setup and day of time. Studies outside of Australia have shown that prediction models for OT times using individual characteristics and the surgeon's estimate are effective. What does this paper add?: This paper advocates for surgeons' predicted OT time to be included in the process of theatre scheduling, which currently does not take place. It also provides analysis of a wide range of surgical specialties and assesses each professions' ability to accurately predict the surgical time. This study encompasses a substantial number of procedures. Moreover, it compares endoscopic procedures separately to laparoscopic/open procedures. It contributes how different variables such as the urgency of procedure (Emergency/Elective), estimated length of procedure and patient comorbidities affect the prediction of OT time. What are the implications for practitioners?: This will encourage hospital administrators to use surgeons' predicted OT time in calculations for scheduling theatre lists. This will facilitate more accurate predictions of OT time and ensure that theatre lists are not over or underutilised. Moreover, surgeons will be encouraged to make OT time predictions with serious consideration, after understanding its effect on theatre scheduling and associated costs. Hence, the aim is to try to make an estimation of OT time, which is closer to the actual time required. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence has the potential to innovate current practices used to detect the imminent risk of suicide and to address shortcomings in traditional assessment methods. Objective: In this paper, we sought to automatically classify short segments (40 milliseconds) of speech according to low versus imminent risk of suicide in a large number (n=281) of telephone calls made to 2 telehealth counselling services in Australia. Methods: A total of 281 help line telephone call recordings sourced from On The Line, Australia (n=266, 94.7%) and 000 Emergency services, Canberra (n=15, 5.3%) were included in this study. Imminent risk of suicide was coded for when callers affirmed intent, plan, and the availability of means; level of risk was assessed by the responding counsellor and reassessed by a team of clinical researchers using the Columbia Suicide Severity Rating Scale (=5/6). Low risk of suicide was coded for in an absence of intent, plan, and means and via Columbia suicide Severity Scale Ratings (=1/2). Preprocessing involved normalization and pre-emphasis of voice signals, while voice biometrics were extracted using the statistical language r. Candidate predictors were identified using Lasso regression. Each voice biomarker was assessed as a predictor of suicide risk using a generalized additive mixed effects model with splines to account for nonlinearity. Finally, a component-wise gradient boosting model was used to classify each call recording based on precoded suicide risk ratings. Results: A total of 77 imminent-risk calls were compared with 204 low-risk calls. Moreover, 36 voice biomarkers were extracted from each speech frame. Caller sex was a significant moderating factor (β=-.84, 95% CI -0.85, -0.84; t=6.59, P<.001). Candidate biomarkers were reduced to 11 primary markers, with distinct models developed for men and women. Using leave-one-out cross-validation, ensuring that the speech frames of no single caller featured in both training and test data sets simultaneously, an area under the precision or recall curve of 0.985 was achieved (95% CI 0.97, 1.0). The gamboost classification model correctly classified 469,332/470,032 (99.85%) speech frames. Conclusions: This study demonstrates an objective, efficient, and economical assessment of imminent suicide risk in an ecologically valid setting with potential applications to real-time assessment and response. [ABSTRACT FROM AUTHOR]

All papers in this special edition ofMental Health, Religion & Cultureutilise data sets from the 2011 round of the Australian National Church Life Survey (NCLS). This paper presents a methodological overview of the NCLS, including data collection methods, survey instruments and demographic descriptions of church attender and leader data sets. The data sets have good national coverage and denominational diversity, although Pentecostals are under-represented. The data sets may be further affected by self-selection by participating churches; however, the content of the surveys is unlikely to have triggered self-selection biases at the level of individuals. The paper also provides details concerning the measurement of quality of life in the present collection, concentrating on the Personal Wellbeing Index (PWI) which is featured in four of the five empirical papers. Mean PWI scores for churchgoers and leaders were similar to the Australian populace at large, although there was greater variability among churchgoers. The domain of spirituality/religion makes a significant contribution to well-being in these Australian Christian sub-populations. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to profile the most common complaints and to examine whether any demographic factors are associated with receiving a complaint for five health professions in Australia. Methods: A national cohort study was conducted for all complaints received for medicine, nursing/midwifery, dentistry, pharmacy and psychology from 1 July 2012 to 31 December 2013 (18 months). Data were collected from the Australian Health Practitioner Regulation Agency (AHPRA), the New South Wales (NSW) Health Professional Councils' Authority and the NSW Health Care Complaints Commission. The frequency and risk of complaints were summarised for the five professions and by demographic information. Results: There were 545 283 practitioners registered with AHPRA between 1 July 2012 and 31 December 2013, consisting of 20 935 dentists, 101 066 medical practitioners, 363 040 nurses/midwives, 28 370 pharmacists and 31 872 psychologists. During the study period there were 12 616 complaints, corresponding to an annual rate of 1.5 per 100 practitioners. Complaints were most common for doctors and dentists (5% per annum per practitioner) and least common for nurses/midwives (0.5% per annum per practitioner). Sex (P < 0.01), age (P < 0.01) and country of birth (P < 0.01) were all associated with risk of complaint. The most common complaints were clinical care (44% of all complaints), medication (10%) and health impairment of the practitioner (8%). Types of complaints varied by profession, sex and age. Conclusions: The risk of a complaint is low, but varies by profession and demographics. The types of complaints also vary by profession and demographics. Differences between professions is most likely driven by their different work tasks and work environments. What is already known on this subject?: Although complaints are summarised annually from state and national health regulators, no overall national summary of complaints across professions exists. Thus, it is difficult to examine which complaints are most common, how professions differ from each other or what factors may be associated with risk and type of complaint. Previous studies have primarily focused on a single profession, such as medicine, where, for example, the number of prior complaints, sex, doctor speciality and age have been found to be associated with recurrent complaints. What does this paper add?: This paper is the first of this kind to provide a national summary of all complaints from five of the most common health professions in Australia. We found that regardless of profession, men were at least twice as likely to have a complaint made against them than women. We also found that the types of complaint differed between men and women. There were similarities across professions for the most common types of complaints, but clear differences between professions were also noted. Not surprising, clinical care was typically the most common type of complaint for the five professions, but somewhat surprising was the inclusion of health impairment as one of the most common types of complaints. What are the implications for practitioners?: Identifying the most common complaints, and the factors associated with these, may assist practitioners to understand their risk(s) of complaint and could potentially assist educators and regulators develop education programs that help reduce complaints. [ABSTRACT FROM AUTHOR]

Background: Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees. Aims: This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills. We hypothesised that knowledge of swallow anatomy and physiology, visual perceptual skills, self‐efficacy and interest, and prior clinical exposure would all influence VFSS novice analysts' skill development. Methods & Procedures: Participants were undergraduate speech pathology students recruited from an Australian university, who had completed the required theoretical units in dysphagia. Data assessing the factors of interest were collected—the participants identified anatomical structures on a still radiographic image, completed a physiology questionnaire, completed subsections of the Developmental Test of Visual Processing—Adults, self‐reported the number of dysphagia cases they managed on placement, and self‐rated their confidence and interest. Data for 64 participants relating to the factors of interest were compared with their ability to accurately identify swallowing impairments following 15 h of VFSS analytical training, using correlation and regression analysis. Outcomes & Results: Success in VFSS analytical training was best predicted by clinical exposure to dysphagia cases and the ability to identify anatomical landmarks on still radiographic images. Conclusions & Implications: Novice analysts vary in the acquisition of beginner‐level VFSS analytical skill. Our findings suggest that speech pathologists who are new to VFSS may benefit from clinical exposure to dysphagia cases, sound foundational knowledge of anatomy relevant to swallowing and the ability to see the anatomical landmarks on still radiographic images. Further research is required to equip VFSS trainers and trainees for training, to understand differences between learners during skill development. WHAT THIS PAPER ADDS: What is already known on the subject: The existing literature suggests that no vice Video fluoroscopic Swallowing Study (VFSS) analysts training may be influenced by their personal characteristics and experience. What this study adds: This study found that student clinicians, clinical exposure to dysphagia cases and their ability to identify anatomical landmarks relevant to swallowing on still radiographic images prior to training best predicted their ability to identify swallowing impairments after training. What are the clinical implications of this work?: Given the expense of training health professionals, further research is required into the factors that successfully prepare clinicians for VFSS training, including clinical exposure, foundational knowledge of anatomy relevant to swallowing and the ability to identify the anatomical landmarks on still radiographic images. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the relationship between education and health amongst Australian women. Design/methodology/approach: This study uses the Household, Income and Labour Dynamics in Australia data set. Spouse's education is employed as an instrument to solve the potential endogeneity of educational attainment. Findings: The results indicate that an additional year of schooling can lead to an increase in self-reported health, physical health, mental health and a reduced likelihood of having long-term health conditions. Women who are not in the labour force are likely to enjoy higher benefits of education compared to their employed counterparts. The findings also suggest that the relationship between education and health can be explained by the extent of positive health behaviours and social capital as mediators. Research limitations/implications: The conclusion from the results might be different in the case of men, reducing the generalisability of the results. Several objective health variables should be used to provide further aspects of health on which education has an impact. Practical implications: As the positive effect of education on women's health is empirically found, investment in women's education should be seriously considered and reevaluated. Originality/value: This paper focuses on Australian women which not only reduces the heterogeneity between genders but also adds to the rare number of studies on this topic in Australia. This paper also employs a formal mediation analysis to examine what are the mechanisms explaining the relationship between education and health. [ABSTRACT FROM AUTHOR]

Financial illiteracy is widespread amongst the elderly. Financially illiterate people are more likely to experience asset loss and outlive their savings after retirement. This paper measures financial literacy of elderly Australians using Item Responses Theory. Using a Lasso regression, we find that younger, married males with higher income and greater net wealth are more likely to be financially literate. Better financial literacy is also associated with good health, higher educational attainment, better occupation and outright home ownership. Our findings suggest policy‐makers take action and we make informed and practicable policy recommendations. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health's Hospital Admission Risk Program (HARP). Methods: A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results: The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P = 0.037) and complex needs (P < 0.001) received more post-discharge contacts by HARP staff than those suffering from diabetes, renal conditions and psychosocial needs when they lived alone. Similarly, respiratory (P < 0.001), heart disease (P = 0.015) and complex needs (P = 0.050) patients had more contacts, with an increased number of episodes than those suffering from diabetes, renal conditions and psychosocial needs. Conclusion: The Flinders Program appeared to have significant positive impacts on HARP patients that could be more effective if high-risk groups, such as respiratory patients with no carers and respiratory and heart disease patients aged 0–65, had received more targeted care. What is known about the topic?: Chronic conditions are common causes of premature death and disability in Australia. Besides mental and physical impacts at the individual level, chronic conditions are strongly linked to high costs and health service utilisation. Hospital avoidance programs such as HARP can better manage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help individuals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add?: This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia's health system. What are the implications for practitioners?: Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management support achieve significant reductions in potentially avoidable hospitalisation and emergency department presentation rates, though sex, type of chronic condition and living situation appear to matter. Benefits might also accrue from the combination of contextual factors (such as the Flinders Program, supportive service management, clinical champions in the team) that work synergistically. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to investigate the relationship between board diversity, as represented by the percentage of female, minority or female and minority directors on the boards of directors, and firm financial performance, and to explore the potential determinants of board diversity, using data from the Australian corporate sector. Design/methodology/approach - The paper uses the top 500 Australian companies as the initial data-set. Firm performance measures include return on assets, return on equity and shareholder return. Several control variables are introduced in the regression analysis. Findings - The results indicate that gender and racial diversity do not have significant influence on performance. It is reported that larger firms tend to have relatively more female members, and smaller firms or firms with larger boards may have more minority directors. Research limitations/implications - The findings should not be extrapolated to all firms as the sample is restricted to listed companies. To examine the complete impact of board diversity future research could consider non-financial performance indicators. Practical implications - The analysis shows that greater diversity does not lead to poor performance, which suggests that gender and racial diversity could be achieved without a negative effect on shareholder wealth. Originality/value - In addition to giving improved evidence on the effect of gender diversity on performance; the paper may be the first study which ascertains whether there is a "business case" for greater minority participation in boardrooms in the Australian context. [ABSTRACT FROM AUTHOR]

This paper draws upon the 2001 census to examine the impact of national economic reform on the growth of regional cities. The paper argues that regional cities in Australia have taken on new roles within both their region and the national economy. It argues that deregulation of the economy has contributed to the growth of some regional cities and especially those that have been able to deepen their economies. Through the use of regression analysis, the paper suggests that regional centres that have witnessed an increase in the level of specialisation within their economy have, on average, grown more quickly than other cities. The paper concludes with a discussion of the implications for our understanding of the evolution of urban systems. [ABSTRACT FROM AUTHOR]

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Purpose Type 2 diabetes mellitus has become a major concern of Australian healthcare providers. From rates of barely more than 1 percent in the mid-90s, diabetes is now the leading cause of morbidity in the country. To combat the growing diabetes epidemic, Western Sydney Local Health District created the Western Sydney Diabetes (WSD) initiative. One of the key components of the WSD initiative since 2014 has been joint specialist case conferencing (JSCC). The purpose of this paper is to evaluate the JSCC service including both individual- and practice-based changes.Design/methodology/approach The authors evaluated the JSCC program by conducting an analysis of patient-level data in addition to a discrete practice-level study. The study aim was to examine both the effect on individual patients and the practice, as well as acceptability of the program for both doctors and their patients. The evaluation included data collection and analysis of primary patient outcomes, as well as a survey of GPs and patients. Patient data on primary outcomes were obtained by accessing and downloading them through GP practice management software by GP practice staff.Findings The authors found significant improvements at both the patient levels, with reductions in BMI, HbA1c and blood pressure sustained at three years, and at the practice level with improvements in markers of patient management. The authors also found high acceptability of the program from both patients and GPs.Originality/value This paper provides good evidence for the use of a JSCC program to improve diabetes management in primary care through capacity building with GPs. [ABSTRACT FROM AUTHOR]

Accurate rainfall prediction is a challenging task. It is especially challenging in Australia where the climate is highly variable. Australia’s climatic zones range from high rainfall tropical regions in the north to the driest desert region in the interior. The performance of prediction models may vary depending on climatic conditions. It is, therefore, important to assess and compare the performance of these models in different climatic zones. This paper examines the performance of data driven models such as the support vector machines for regression, the multiple linear regression, the k-nearest neighbors and the artificial neural networks for monthly rainfall prediction in Australia depending on climatic conditions. Rainfall data with five meteorological variables over the period of 1970–2014 from 24 geographically diverse weather stations are used for this purpose. The prediction performance of each model was evaluated by comparing observed and predicted rainfall using various measures for prediction accuracy. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the relationships between clinicians’ and managers’ risk aversion and a range of variables related to the implementation of the Collaborative Recovery Model (CRM). Positive risk taking is an integral component of the recovery process. Clinicians’ risk aversion has the potential to negatively impact on their implementation of recovery-oriented practices. The CRM provides an evidence-based framework to assist consumers to participate in the recovery process. However, there is a need for research to clarify the factors related to recovery that have impact on managers’ and clinicians’ risk aversion, and ultimately on implementation of recovery practices.Design/methodology/approach A cross-sectional survey assessed clinicians’ (n=174) and managers’ (n=48) risk aversion and their self-reported learning experiences, commitment to using CRM, goal setting attitudes and CRM implementation behaviour.Findings Clinicians who reported more risk aversion were significantly more likely to report positive attitudes towards goal setting. Stepwise regression revealed that training experiences, goal setting attitudes and commitment to CRM significantly predicted an increase in CRM implementation. Over and above this, risk aversion predicted a small but significant increase in the self-reported use of CRM. Managers experienced significantly less risk aversion than clinicians, with a negative relationship between risk aversion and commitment to CRM principles.Originality/value This paper suggests that clinicians’ risk aversion impacts upon their implementation of the CRM, with managers less risk averse than clinicians. [ABSTRACT FROM AUTHOR]

Objective: This cost-analysis study explored Pharmaceutical Benefits Scheme (PBS) data to determine the financial patient contribution (PC) towards dispensed medications prescribed by dentists and temporal trends in cost contributions. Methods: For this study we used the PBS online dataset and only included concessional data in the analysis. Data on dental medications dispensed under the PBS from 2006 to 2018 were accessed. For all medicines aggregated to different pharmacological categories (antibiotics, analgesics and opiates, anti-inflammatories, antifungals, benzodiazepines, anticonvulsants and anti-emetics, and emergency medications), a temporal trend was generated using annual PC data. Cumulative patient and mean annual PC data were also generated in a similar manner. Results: Cumulative PC over the study period for dental PBS prescriptions was A$28 783 361 (A$5.55 per dispensing). The mean annual PC for dental PBS was A$2 214 105 (for the entire concessional population from 2006 to 2018), with a statistically significant and strong correlation between year and PC (Dental PBS, A$59 756 per year; r = 0.98: P < 0.0001). Antibiotics represented the highest proportion of PC (87.8%), whereas the lowest proportion of PC was for emergency medications (e.g. adrenaline, atropine, glucagon, naloxone), which amounted to 0.003%. Conclusions: This study highlights the increasing contributions made by patients towards antibiotic prescriptions. What is known about the topic?: Australian dentists can independently prescribe subsidised medications as per a set scope for general and specialist dentists, regulated under the PBS with requisite adherence to specific legal requirements. What does this paper add?: This is the first study highlighting the increased level of patient financial contributions towards dental medicines, according to different pharmacological categories, dispensed by pharmacists in Australia. What are the implications for practitioners?: This study creates a base for future research assessing the appropriateness of the PBS subsidy and the PBS Safety Net threshold, possibly reassessing the out-of-pocket pricing on brand substitution and appropriately reassessing the current dental PBS schedule. [ABSTRACT FROM AUTHOR]

Objective: This study determined the economic impact of 16 'high-priority' hospital-acquired complications (HACs), as defined by the Australian Commission on Safety and Quality in Health Care, from the perspective of an individual Australian health service. Methods: A retrospective cohort study was performed using a deidentified patient dataset containing 93 056 in-patient separations in Northern Health (Victoria, Australia) from 1 July 2016 to 30 June 2017. Two log-linked generalised linear regression models were used to obtain additional costs and additional length of stay (LOS) for 16 different HACs, with the main outcome measures being the additional cost and LOS for all 16 HACs. Results: In all, 1700 separations involving HACs (1.83%) were identified. The most common HAC was health care-associated infections. Most HACs were associated with a statistically significant risk of increased cost (15/16 HACs) and LOS (11/16 HACs). HACs involving falls resulting in fracture or other intracranial injury were associated with the highest additional cost (A$17 173). The biggest increase in additional LOS was unplanned admissions to the intensive care unit (5.42 days). Conclusions: This study shows the economic impact of HACs from the perspective of an individual health service. The methodology used demonstrates how other health services could determine safety priorities corresponding to their own casemix. What is known about the topic?: HACs are a major issue in Australian health care; however, their effect on cost and LOS at the individual health service level is not well quantified. What does this paper add?: Additional cost and LOS implications for 16 high-priority HACs have been quantified within an Australian health service. There is substantial variation in terms of the number of HACs and the economic impact of each HAC. What are the implications for practitioners?: This study provides a template for other health services to assess the economic impact of HACs corresponding to their own casemix and to inform targeted patient safety programs. [ABSTRACT FROM AUTHOR]

Background: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity. Methods: A cross-sectional postal survey of the seven specialties most likely to be involved in end-of-life care in the acute setting was conducted between 18 July 2012 and 31 January 2013. The sample comprised all medical specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in those three Australian states. The survey measured medical specialists' level of legal compliance, and reasons for their decisions, concerning the withholding or withdrawal of lifesustaining treatment. Multivariable logistic regression was used to examine predictors of legal compliance. Linear regression was used to examine associations between the decision about life-sustaining treatment and the relevance of factors involved in making these decisions, as well as state differences in these associations. Results: Response rate was 32% (867/2702). A majority of respondents in each state said that they would provide treatment in a hypothetical scenario, despite an advance directive refusing it: 72% in NSW and Queensland; 63% in Victoria. After applying differences in state law, 72% of Queensland doctors answered in accordance with local law, compared with 37% in Victoria and 28% in NSW (p < 0.001). Doctors reported broadly the same decision-making approach despite differences in local law. Conclusions: Law appears to play a limited role in medical decision-making at the end of life with doctors prioritising patient-related clinical and ethical considerations. Different legal frameworks in the three states examined did not lead to different decisions about providing treatment. More education is needed about law and its role in this area, particularly where law is inconsistent with traditional practice. [ABSTRACT FROM AUTHOR]

Despite anecdotal evidence of a COVID-19 induced decline in the intensity of interstate migration in Australia, population-level evidence is limited. The recent release of the 2020 wave of the Household, Income and Labour Dynamics in Australia (HILDA) Survey provides a unique opportunity to robustly assess the effect of the COVID-19 pandemic on the level, direction, determinants, and reasons for migration in Australia. By applying a series of regression models to individual-level longitudinal microdata, and measuring migration at a range of spatial scales, this paper shows that COVID-19 has somewhat accelerated the long-term decline in the intensity of internal migration--particularly for residential mobility, short-distance migration, and migration due to employment and involuntary reasons. The sociodemographic determinants of migration have remained broadly stable, despite a slight increase in the deterring effect of duration of residence and a reduction in the impact of education. Finally, we show that the increase in net migration gains in regional areas is underpinned by a decrease in outflows. Juxtaposing these results with aggregate-level migration statistics from the Australian Bureau of Statistics from 2021, we conclude that the effect of COVID-19 on internal migration to date has been minimal and is likely to be short-lived. However, it may still be too soon to make a definitive judgement, as shifts in work patterns stemming from the pandemic may further transform the level, direction, and composition of internal migration. [ABSTRACT FROM AUTHOR]

Summary: This paper discusses several modern approaches to regression analysis involving time series data where some of the predictor variables are also indexed by time. We discuss classical statistical approaches as well as methods that have been proposed recently in the machine learning literature. The approaches are compared and contrasted, and it will be seen that there are advantages and disadvantages to most currently available approaches. There is ample room for methodological developments in this area. The work is motivated by an application involving the prediction of water levels as a function of rainfall and other climate variables in an aquifer in eastern Australia. [ABSTRACT FROM AUTHOR]

Tweedie's compound Poisson regression models have been introduced in recent years to model and predict daily, monthly and seasonal precipitation data. Tweedie's compound Poisson regression analysis of precipitation data captures the relationship between the mean structure of precipitation and covariates while accounting for its right‐skewness and zero‐inflation appropriately, and thus extends trend analysis stage of classical time series techniques to handle right‐skewed time series data with possible zero‐inflation. A distinctive advantage of Tweedie's compound Poisson modelling of precipitation data is that the occurrence and quantity of precipitation can be simultaneously modelled using a single distribution; however, this approach ignores serial correlation between precipitation data observed over time. In this study, we propose to accommodate complex correlation structures of time series precipitation data using the Autoregressive Integrated Moving Average (ARIMA) models at the next stage as done in the classical time series analysis. Our analyses of monthly precipitation data in Australia demonstrated the usefulness of our two‐stage approach to prediction of precipitation. [ABSTRACT FROM AUTHOR]

This article introduces research on mean-variance efficiency of equity market portfolios that used Australian data. Two factors have motivated this research. First, existing Australian evidence on this topic employ data from the industrial sector of the market due to the lack of suitable resource sector data at the time. Second, research on mean-variance efficiency led to the development of multivariate tests that have more power than the two stage tests of efficiency conducted in the 1970's. The researchers undertake multivariate regression tests in their papers.

shacklock k. & brunetto y. (2012) The intention to continue nursing: work variables affecting three nurse generations in Australia. Journal of Advanced Nursing 68(1), 36-46. Abstract Aims. The aims of the study were to examine how seven variables impacted upon the intention of hospital nurses to continue working as nurses and to investigate whether there are generational differences in these impacts. Background. There is a critical shortage of trained nurses working as nurses in Australia, as in many other Organisation for Economic Co-operation and Development member countries. The retention of nurses has been examined from the traditional management perspectives; however, this paper presents a different approach (Meaning of Working theory). Methods. A self-report survey of 900 nurses employed across four states of Australia was completed in 2008. The sample was hospital nurses in Australia from three generational cohorts - Baby Boomers (born in Australia between 1946 and 1964), Generation X (1965-1979) and Generation Y (1980-2000). Results. Six variables were found to influence the combined nurses' intentions to continue working as nurses: work-family conflict, perceptions of autonomy, attachment to work, importance of working to the individual, supervisor-subordinate relationship and interpersonal relationships at work. There were differences in the variables affecting the three generations, but attachment to work was the only common variable across all generations, affecting GenYs the strongest. Conclusion. The shortage of nurses is conceptualized differently in this paper to assist in finding solutions. However, the results varied for the three generations, suggesting the need to tailor different retention strategies to each age group. Implications for management and policy planning are discussed. [ABSTRACT FROM AUTHOR]

The World Health Organization has drawn up a set of strategies to encourage health workers to live and work in remote and rural areas. A comprehensive instrument designed to evaluate the effectiveness of such programs has not yet been tested. Factors such as Stated rural intention, Optional rural training, Medical sub-specialization, Ease (or self-efficacy) and Rural Status have been used individually or in limited combinations. This paper examines the development, validity, structure and reliability of the easily-administered SOMERS Index. Limited literature review and cross-sectional cohort study. Australian medical school. A total of 345 Australian undergraduate-entry medical students in years 1 to 4 of the 5-year course. Validity of the factors as predictors of rural career choice was sought in the international literature. Structure of the index was investigated through Principal Components Analysis and regression modelling. Cronbach's alpha was the test for reliability. The international literature strongly supported the validity of the components of the index. Factor analysis revealed a single, strong factor (eigenvalue: 2.78) explaining 56% of the variance. Multiple regression modelling revealed that each of the other variables contributed independently and strongly to Stated Rural Intent (semi-partial correlation coefficients range: 0.20-0.25). Cronbach's alpha was high at 0.78. This paper presents the reliability and validity of an index, which seeks to estimate the likelihood of rural career choice. The index might be useful in student selection, the allocation of rural undergraduate and postgraduate resources and the evaluation of programs designed to increase rural career choice. [ABSTRACT FROM AUTHOR]

This paper points out that equating the rate of exceedance over threshold to the probability of exceedance in the generalized Pareto distribution, as is often applied in practice, leads to erroneous model parameter estimation, under- or overestimation of hazard, and impairs the duality between the generalized Pareto (GPD) and the generalized extreme-value (GEV) distributions. The problem stems from the fundamental difference in the domain of definition: the rate of exceedance ∈ 0 , ∞ and the probability of exceedance ∈ 0 , 1 . The erroneous parameter estimation is a result of practice in model parameter estimation that uses the concept of 'return period' (the inverse of exceedance probability) for both the GEV and the GPD. By using the concept of 'average recurrence interval' (the inverse of exceedance rate) of extremes in stochastic processes, we illustrate that the erroneous hazard estimation of the GPD is resolved. The use of average recurrence interval along with the duality allows the use of either the GEV or GPD for extreme hazard analysis, regardless of whether the data are collected via block maxima or peaks over a threshold. Some recommendations with regard to the practice of distribution parameter estimation are given. We demonstrate the duality of the two distributions and the impact of using average recurrence interval instead of return period by analysis of wind gust data collected by an automatic weather station at Woomera, South Australia, Australia. [ABSTRACT FROM AUTHOR]

Objective: Older people represent a large proportion of emergency department (ED) presentations, with multiple comorbidities a strong predictor of frequent attendance. This study examined associations between the general practice management received by older patients with chronic disease and ED attendance. Methods: This retrospective study examined linked data from general practice and ED for patients aged ≥65 years who presented to a general practitioner (GP) between 2010 and 2014. Data from the computerised medical records of patients attending 50 general practice clinics in the inner east Melbourne region ere linked with ED attendance data from the same region. Patients with chronic disease were identified and characteristics of ED versus non-ED attendees were compared. Poisson regression was used to explore factors associated with ED usage. Results: During the study period, 67 474 patients aged ≥65 years visited a GP, with 63.3% identified as having at least one chronic condition and 21.4% of these having at least one ED presentation. Over 70% of the ED presentations in this group resulted in hospital admissions. The most common diagnoses for ED presentation were cardiovascular disorders, pain and injuries. ED attendance was associated with being aged ≥85 years (incidence rate ratio (IRR) 2.09; 95% confidence interval (CI) 1.96–2.11), higher socioeconomic status (IRR 1.49; 95% CI 1.45–1.53), having a GP management plan (IRR 1.47; 95% CI 1.43–1.52), multimorbidity (IRR 1.53; 95% CI 1.46–1.60), more frequent GP visits (IRR 1.10; 95% CI 1.05–1.15) and having a higher numbers of prescriptions (IRR 1.51; 95% CI 1.44–1.57). Conclusion: This study suggests that ED presentation is associated with greater frailty and multimorbidity in patients. Further research is necessary to determine why higher rates of chronic disease management through GP management plans and more frequent visits did not mediate higher rates of presentation and the reasons behind the socioeconomic differences in ED presentation for patients in this age group. What is known about the topic?: Increases in the volume and rate of ED presentations by older people will markedly affect emergency and acute hospital care and patient flow as the proportion of older Australians increases. What does this paper add?: We used a novel and highly transferable data linkage between data collected from the clinical records of general practice patients and their associated data from ED and hospital settings and examined the relationship between GP management received by older patients with chronic disease and ED attendance. What are the implications for practitioners?: Increasing utilisation of GP services may not have an effect on reducing ED attendance, particularly for older patients who may experience poorer overall health. [ABSTRACT FROM AUTHOR]

Objective: Risk factors and clinical outcomes of non-index hospital readmissions (readmissions to a hospital different from the previous admission) have not been studied in Australia. The present study compared characteristics and clinical outcomes between index and non-index hospital readmissions in the Australian healthcare setting. Methods: This retrospective cohort study included medical admissions from 2012 to 2016 across all major public hospitals in South Australia. Readmissions within 30 day to all public hospitals were captured using electronic health information system. In-hospital mortality and readmission length of hospital stay (LOS) were compared, along with 30-day mortality and subsequent readmissions among patients readmitted to index or non-index hospitals. Results: Of 114 105 index admissions, there were 20 539 (18.0%) readmissions. Of these, 17 519 (85.3%) were index readmissions and 3020 (14.7%) were non-index readmissions. Compared with index readmissions, patients in the non-index readmissions group had a lower Charlson comorbidity index, shorter LOS and fewer complications during the index admission and were more likely to be readmitted with a different diagnosis to the index admission. No difference in in-hospital mortality was observed, but readmission LOS was shorter and 30-day mortality was higher among patients with non-index readmissions. Conclusion: A substantial proportion of patients experienced non-index hospital readmissions. Non-index hospital readmitted patients had no immediate adverse outcomes, but experienced worse 30-day outcomes. What is known about the topic?: A significant proportion of unplanned hospital readmissions occur to non-index hospitals. North American studies suggest that non-index hospital readmissions are associated with worse outcomes for patients due to discontinuity of care, medical reconciliation and delayed treatment. Limited studies have determined factors associated with non-index hospital readmissions in Australia, but whether such readmissions lead to adverse clinical outcomes is unknown. What does this paper add?: In the Australian healthcare setting, 14.7% of patients were readmitted to non-index hospitals. Compared with index hospital readmissions, patients admitted to non-index hospitals had a lower Charlson comorbidity index, a shorter index LOS and fewer complications during the index admission. At the time of readmission there was no differences in discharge summary completion rates between the two groups. Unlike other studies, the present study found no immediate adverse outcomes for patients readmitted to non-index hospitals, but 30-day outcomes were worse than for patients who had an index hospital readmission. What are the implications for practitioners?: Non-index hospital readmissions may not be totally preventable due to factors such as ambulance diversions stemming from emergency department overcrowding and prolonged emergency department waiting times. Patients should be advised to re-present to hospital in case they experience recurrence or relapse of a medical condition, and preferably should be readmitted to the same hospital to prevent discontinuity of care. [ABSTRACT FROM AUTHOR]

Since the mid-1990s, the Australian immigration programme has undergone a ‘paradigm’ shift to encourage skilled migrants to settle in regional Australia. The success of this programme is dependent on not just attracting increasing numbers of settlers but more importantly on retaining them in the long run in regional Australia. In this paper, we argue the importance of social connectedness for long-term stay in a particular place and empirically examine the determinants of social connectedness in regional Australia. We use the data from a national survey of 500 randomly selected principal applicants who migrated under the regional sponsored migration scheme. We derived a composite measure of social connectedness from responses to five questions about regular participation in various community activities. Logistic regression models were employed to examine the factors that contribute to social connectedness. Of all the covariates included in the model, five were critical for strong social connectedness. The families with young children, those who have lived in Australia longer, those living in small towns and those who were born in the USA/Canada, South Africa and Zimbabwe showed much stronger social connectedness than others. Another interesting finding was that those who found the assistance they received from their employer sponsor upon arrival helpful were also more likely to have strong social connectedness. The paper concludes with the policy implications and future research directions on this very important social issue. [ABSTRACT FROM AUTHOR]

Background. Down-scheduling one or more triptans to Schedule 3 (Pharmacist Only Medicine) from Schedule 4 (Prescription Only Medicine) has been debated in Australia for a decade. This study aimed to evaluate the perspectives and readiness of Western Australian (WA) community pharmacists to manage migraine including over-the-counter (OTC) provision of triptans. Methods. Data were collected using a self-administered paper-based questionnaire, posted to a random sample of 178 metropolitan and 97 regional pharmacies in WA. Respondent pharmacists were surveyed regarding: knowledge of optimal migraine treatment as per current guidelines, resources required to appropriately recommend triptans and attitudes and perspective toward down-scheduling. Data were analysed using descriptive statistics and multivariate regression analysis. Pharmacist/pharmacy characteristics influencing readiness were evaluated by assigning respondents a score based on responses to Likert scale questions. These questions were assigned to five domains based on an implementation model and these scores were used in a general linear model to identify demographic characteristics associated with readiness across each domain. Results. A total of 114 of the 275 pharmacies returned useable questionnaires (response rate: 41.5%). The two most commonly recommended first line OTC agents were a combined paracetamol/non-steroidal anti-inflammatory drugs and aspirin (44/104; 42.3% and 22/104; 21.2%, respectively) which provided context to the respondents’ knowledge of optimal migraine treatment. Responses to questions in relation to triptans and the warning signs requiring referral were in line with current guidelines, demonstrating respondents’ knowledge in these areas. Nevertheless, most respondents demonstrated uncertainty in relation to the pathogenesis of migraine. If triptans were available OTC, 66/107 (61.7%) would recommend them first-line. The majority (107/113; 94.7%) agreed that down-scheduling would improve timely access to effective migraine medication and 105/113 (92.9%) agreed that if triptans were down-scheduled, pharmacists may be better able to assist people in the treatment of migraine. Most respondents agreed that additional training and resources, including a guideline for OTC supply of triptans and the management of first-time and repeat migraine would be necessary if triptans were down-scheduled. No single demographic characteristic influenced readiness across all five domains. Discussion. Pharmacists were knowledgeable regarding triptans and recognised symptoms requiring referral; migraine knowledge could be improved. Pharmacists supported down-scheduling of one or more triptans in Australia, however they highlighted a need for further training and resources to support migraine diagnosis and provision of OTC triptans. Professional pharmacy bodies should consider these findings when recommending drugs suitable for down-scheduling for pharmacist recommendation. [ABSTRACT FROM AUTHOR]

Global ensemble prediction systems have considerable ability to predict tropical cyclone (TC) formation and subsequent evolution. However, because of their relatively coarse resolution, their predictions of intensity and structure are biased. The biases arise mainly from underestimated intensities and enlarged radii, in particular the radius of maximum winds. This paper describes a method to reduce this limitation by bias correcting TCs in the ECMWF Ensemble Prediction System (ECMWF-EPS) for a region northwest of Australia. A bias-corrected TC system will provide more accurate forecasts of TC-generated wind and waves to the oil and gas industry, which operates a large number of offshore facilities in the region. It will also enable improvements in response decisions for weather sensitive operations that affect downtime and safety risks. The bias-correction technique uses a multivariate linear regression method to bias correct storm intensity and structure. Special strategies are used to maintain ensemble spread after bias correction and to predict the radius of maximum winds using a climatological relationship based on wind intensity and storm latitude. The system was trained on the Australian best track TC data and the ECMWF-EPS TC data from two cyclone seasons. The system inserts corrected vortices into the original surface wind and pressure fields, which are then used to estimate wind exceedance probabilities, and to drive a wave model. The bias-corrected system has shown an overall skill improvement over the uncorrected ECMWF-EPS for all TC intensity and structure parameters with the most significant gains for the maximum wind speed prediction. The system has been operational at the Australian Bureau of Meteorology since November 2016. [ABSTRACT FROM AUTHOR]

The present study adds to the existing knowledge about adult children of parents with mental illness. The aim was to explore differences between adult children of parents with mental illness and parents in the general population on a range of adult relationship and parenting variables. Utilizing a cross‐sectional design, 86 adults across Australia participated in this study (47 general population; 39 adult children of parents with mental illness). Data were analysed using descriptive statistics and parametric tests. Adult children of parents with mental illness were found to be more permissive in their parenting compared with parents in the general population. However, between‐group differences were not found on measures of parenting competence, adult attachment, and relationship satisfaction. These findings suggest that adult children of parents with mental illness are able to thrive just as well as individuals in the general population but may require some support in the form of parental skills training. The paper concludes by highlighting the role of mental health professionals in the empowerment and resilience building of adult children of parents with mental illness. [ABSTRACT FROM AUTHOR]

Learning is an important aspect of active ageing, yet older people are not often included in discussions of the issue. Older people vary in their need, desire, and ability to learn, and this is evident in the context of technology. The focus of the data analysis for this paper was on determining the place of learning and technology in active ageing. The paper describes results from 2,645 respondents aged from 50 to 74 + years, in Australia, to a 178-item variable postal survey. The survey measured aspects of learning;, work; social, spiritual and emotional status; health; vision; home; life events; and demographics. There was also an open-ended question about being actively engaged in life. Ordinal regression analysis showed that interest in learning, keeping up to date, valuing communication, being younger, and being male are predictors of learning about technology. The results are at variance with an earlier analysis of our data which showed that women are generally more interested in learning. The open statements contained mentions of learning about technology for the purposes of communication, learning, family links, keeping up to date, enjoyment, staying mentally alert, and just using the computer. These results are discussed in terms of the subtle but important differences between needing and wanting to learn about technology and the opportunities for such learning by older people. [ABSTRACT FROM AUTHOR]

In this paper we examine how the stresses associated with the transition to a new country combined with additional stress arising from a period of unemployment affect the mental health of immigrants. Australian immigrants are found to have poorer mental health at 6 months after arrival in Australia compared with 18 and 42 months. Furthermore, unemployment, and especially a long duration of unemployment, is found to be associated with poor mental health. We found that although immigrant women appear unaffected by their spouses’ labour force status, there is evidence that immigrant men's mental health is affected by spouse labour force status. [ABSTRACT FROM AUTHOR]