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Introduction: There is a dire paucity of research into the burden, correlates and motives of substance use among trans young people in Australia. Method: Using data from a national survey of Australian trans young people (N = 859, Mage = 19.4), we estimated prevalence of past 6‐month substance use (tobacco, alcohol, cannabis, other drugs) and lifetime substance use disorder diagnoses. Covariate‐adjusted multivariate logistic regression models tested associations between substance use types with 18 interpersonal factors. Open‐ended responses regarding substance use motives (n = 489) were qualitatively analysed using thematic analysis with an interpretative phenomenological approach. Results: Prevalence of lifetime substance use disorder diagnosis was 13.5% (95% confidence interval [CI] 11.1, 16.1). Alcohol use was most reported (72.4%; 95% CI 68.9, 75.6) followed by tobacco (31.1%; 95% CI 27.7, 34.6) and cannabis (30.6%; 95% CI 27.2, 34.2). Trans women reported highest rates of alcohol and cannabis use; use of other drugs was highest among trans men. Highest risk of substance use was observed among trans youth who experienced discrimination, intimate partner abuse, peer rejection and lack of family support (adjusted odds ratios ranging 1.5 to 3.0). Four multi‐levelled themes of substance use motives were identified: circumstantial use, somatic use, feeling better about oneself and one's life, and harm reduction. Discussion and Conclusions: While substance use among trans young is largely circumstantial, hedonistic and altruistic, facilitating self‐exploration, friendship and community connectedness, substance use among trans young people is highly prevalent and may be used to cope with sleep difficulties, depression/anxiety and cisnormativity, including delays and waitlists for accessing gender‐affirming care. [ABSTRACT FROM AUTHOR]

Young people who are lesbian, gay, bisexual, trans, queer or questioning, asexual and other diverse genders and sexualities (LGBTQA+) are at greater risk of adverse mental health outcomes and suicide, with additional barriers to accessing safe and affirming physical and mental health services in comparison to the general population. Parents of LGBTQA+ young people who are supportive and accepting can take on additional responsibilities and an active role in supporting young people, and more information is needed to understand how parents support LGBTQA+ young people in times of acute mental health difficulties (including suicide risk) and what parents experience while navigating support systems. It is imperative these experiences are better understood to inform other parents, clinicians and service providers alike. We aimed to develop a nuanced understanding of the experiences of Australian parents of LGBTQA+ young people in providing support during times of acute distress and suicidal crisis. We utilized an exploratory qualitative design using semi-structured one-on-one interviews with 11 parents. We provide clinically useful recommendations, with the aim of aiding enhanced parental support for LGBTQA+ young people, given this population's unique needs. [ABSTRACT FROM AUTHOR]

The existing literature exploring the experiences of parenting a trans child tends toward reporting the challenging aspects of the parental journey. Studies also reference positive experiences such as enhanced parent-child connectedness and affirmation of personal values. Limited dedicated research focused on the positive aspects of parenting a trans child exists. We aimed to better understand positive parental experiences accordingly. Using data from a large cross-sectional survey, we explored parental responses (N = 134) to a single open-text question asking what parents had experienced as positive about parenting their trans child. We used the general inductive approach (GIA) to analyze data and report on common themes. Almost all parents identified at least one positive aspect; most cited multiple benefits. Five major themes emerged from the data: 1) Personal growth; 2) experiencing the strengths of the child; 3) improved aspects of the parent-child relationship; 4) positive change in the child; 5) experiencing social connection and support. Findings provide a nuanced addition to the literature on parental experiences and have clinical implications for those working with parents of trans children. A better understanding of positive parental experiences can aid clinicians in increasing parental support and acceptance for young people within an affirmative framework. [ABSTRACT FROM AUTHOR]

Many trans young people seek mental health support and gender-affirming medical interventions including puberty suppression, gender-affirming hormones and/or surgeries. Trans young people and their parents face multiple barriers in accessing gender-affirming care and mental health support, however little is known about the parent perspective on accessing services for their trans child. This study aimed to understand the experiences of parents accessing medical and mental health services with and for their trans children within Australia. Using data from Trans Pathways, a large mixed-methods cross-sectional study, we examined the experiences of parents (N = 194) in Australia accessing primary care, psychiatry, therapy/counseling, mental health inpatient, and gender-affirming medical services with/for their trans children (aged 25 years or younger). Qualitative data on service experiences were thematically analyzed. Quantitative analyses included frequency of access to services, wait times, service satisfaction, and mental health diagnoses of the parents' trans child. Services were mostly first accessed when the young person was between 12 and 17 years of age, with primary care physicians being the most accessed service. Parents reported that some practitioners were respectful and knowledgeable about gender-affirming care, and others lacked experience in trans health. Across all services, common barriers included long wait times, complicated pathways to navigate to access support, as well as systemic barriers such as sparsity of gender speciality services. Across services, parents reported feeling as though they do not have the necessary tools to best support their child in their gender affirmation. This study highlights the crucial need for systemic changes in the processes of accessing gender-affirming care and mental health support to enable access to appropriate and timely care. These findings also indicate the importance of improving individual practitioner knowledge around trans health, to enhance the support provided to trans young people and their parents. [ABSTRACT FROM AUTHOR]

Musicians have been described as a 'high-risk' group for experiencing musculoskeletal symptoms (MSSs), yet few studies have tested this assumption. We aimed to determine whether the prevalence and profile of MSS outcomes differed between university music students and a reference group (science students). A survey was conducted of university music and science students. Reported MSS outcomes among the two groups were compared using regression analyses. The majority of participants in both groups reported experiencing MSSs in the last 12 months and 7 days. Music students reported a higher prevalence of wrist/hand MSSs compared with science students. Compared with symptomatic science students, music students reported a higher emotional impact of MSSs. We recommend prioritizing research into interventions for music students that address MSSs in the wrist/hand region, and the emotional impact of MSSs. Addressing these MSS outcomes could reduce the MSS burden for musicians during and beyond their studies. [ABSTRACT FROM AUTHOR]

Although the progressive clinical trajectory of motor neurone disease (MND) is widely understood, multiple challenges remain preventing optimal end-of-life care for this population with unique needs from the patient, carer and service provider perspectives. This paper reports on the experiences, gaps in service and unmet needs of MND patients and family carers and explores public health palliative care approaches that would facilitate coordinated and integrated care to respond to their changing needs. This is a qualitative study of responses to questions in an online consumer survey (353 respondents) in Western Australia (2020), focusing on a subset of 29 current and bereaved carers of people with MND who have used health services in the last five years. The analysis identified themes, highlighting the insufficient integration of services across health and social care; poor and unequal access to coordinated palliative care; significant gaps in the knowledge base of the workforce and a failure to meet the consumer expectations of person-centred care. For palliative care to be accessible to those living with MND and other under-served conditions, there needs to be a shift to more comprehensive, inclusive and sustainable options, such as the public health approach to palliative/end-of-life care that engages the assets of local communities in partnership with health services, one example being the "Compassionate Communities Connectors" model of care. Further considerations include advocacy for policy changes, fostering partnerships and developing indicators for evaluating the impact of the proposed models of care. The end result is not only better care but substantial savings for the health system. [ABSTRACT FROM AUTHOR]

We aimed to evaluate and compare the prevalence and profile of musculoskeletal symptom (MSS) outcomes across cohorts of university music students with different 'majors': (i) performance and nonperformance students, and (ii) classical and non-classical performance students. Data were collected using a cross-sectional questionnaire survey, and regression analyses were used to compare the groups. Of the 166 participating students, 92.5% reported experiencing MSSs in the last 12 months, and 72.6% in the last 7 days. Few significant differences were identified between groups. Musculoskeletal symptoms are a problem for all types of university music students, and all should have access to support to prevent and manage their MSSs, regardless of their majors. [ABSTRACT FROM AUTHOR]