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Background: Although exclusive breastfeeding is recommended for the first six months of life, research suggests that breastfeeding initiation rates and duration among Indigenous communities differ from this recommendation. Qualitative studies point to a variety of factors influencing infant feeding decisions; however, there has been no collective review of this literature published to date. Therefore, the objective of this scoping review was to identify and summarize the qualitative literature regarding Indigenous infant feeding experiences within Canada, the United States, Australia, and Aotearoa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews and the Joanna Briggs Institute Guidelines, in October 2020, Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for relevant papers focusing on Indigenous infant feeding experiences. Screening and full-text review was completed by two independent reviewers. A grey literature search was also conducted using country-specific Google searches and targeted website searching. The protocol is registered with the Open Science Framework and published in BMJ Open. Results: Forty-six papers from the five databases and grey literature searches were included in the final review and extraction. There were 18 papers from Canada, 11 papers in the US, 9 studies in Australia and 8 studies conducted in Aotearoa. We identified the following themes describing infant feeding experiences through qualitative analysis: colonization, culture and traditionality, social perceptions, family, professional influences, environment, cultural safety, survivance, establishing breastfeeding, autonomy, infant feeding knowledge, and milk substitutes, with family and culture having the most influence on infant feeding experiences based on frequency of themes. Conclusions: This review highlights key influencers of Indigenous caregivers' infant feeding experiences, which are often situated within complex social and environmental contexts with the role of family and culture as essential in supporting caregivers. There is a need for long-term follow-up studies that partner with communities to support sustainable policy and program changes that support infant and maternal health. [ABSTRACT FROM AUTHOR]

Community-based primary care, such as general practice (GP) or urgent care, serves as the primary point of access to healthcare for most Australians and New Zealanders. Coronavirus disease 2019 (COVID-19) has created significant and ongoing disruptions to primary care. Traditional research methods have contributed to gaps in understanding the experiences of primary care workers during the pandemic. This paper describes a novel research design and method that intended to capture the evolving impact of the COVID-19 pandemic on primary care workers in Australia and New Zealand. Recurrent, rapid cycle surveys were fielded from May 2020 through December 2021 in Australia, and May 2020 through February 2021 in New Zealand. Rapid survey development, fielding, triangulated analysis and dissemination of results allowed close to real-time communication of relevant issues among general practice workers, researchers and policy-makers. A conceptual model is presented to support longitudinal analysis of primary care worker experiences during the COVID-19 pandemic in Australia and New Zealand, and key learnings from applying this novel method are discussed. This paper will assist future research teams in development and execution of policy-relevant research in times of change and may inform further areas of interest for COVID-19 research in primary care. [ABSTRACT FROM AUTHOR]

Simple Summary: The dairy industry in Australia and New Zealand is pasture-based, therefore, monitoring failed transfer of passive immunity (FTPI) is challenging. This study involved a systematic literature search and meta-analysis of papers reporting FTPI data from dairy calves within eight days of birth in Australia and New Zealand, until the end of 2022. An overall prevalence of 33% of FTPI in dairy calves in Australasia and a prevalence of 38% at the farm level were calculated from the meta-analysis, comparable to rates observed elsewhere. Factors, such as the frequency of calf removal from the calving area, time of the first colostrum feed after birth, colostrum volume and quality, and other management practices, were found to play a significant role in FTPI in Australasia. Monitoring and minimizing the prevalence of failed transfer of passive immunity (FTPI) in dairy replacement calves within the first week of life is crucial for calf health and farm profitability. In this study, a systematic literature search and meta-analysis were conducted on papers reporting the prevalence of FTPI in calves from pasture-based dairy farms in Australia and New Zealand. Two search methods, a "traditional method" and a "search engine method", were conducted to identify published studies on FTPI in Australia and New Zealand. Data from a total of 13,430 calves from eight studies in Australasia were included in the analysis for FTPI within 8 days of birth. The meta-analysis revealed that the average prevalence of FTPI was 33% across the two countries, with the lowest FTPI (9%) in Western Australia and the highest FTPI (59%) in New Zealand. Using farm data from three studies, the average prevalence of FTPI at the farm level in Australasia was 38%, with the lowest prevalence found in a farm in South Australia (6%). In conclusion, the meta-analysis confirmed the need for good management of cows and newborn calves after birth in pasture-based systems to reduce FTPI in calves. Collecting newborn calves from pasture at least twice per day after birth and providing colostrum of sufficient quantity and quality as soon as possible were the best practices for preventing FTPI in Australasian dairy systems. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

Introduction: Rural doctors typically work in low resource settings and with limited professional support. They are sometimes pushed to the limits of their usual scope of practice to provide the medical care needed by their community. In a previous phenomenological study, we described the concept of clinical courage as underpinning rural doctors' work in this context. In this paper, we draw on rural doctors' experiences during the unfolding COVID pandemic to re examine our understanding of the attributes of clinical courage. Methods: Semi structured interviews were conducted with rural doctors from 11 countries who had experience preparing for or managing patients with COVID 19. Interviews were transcribed verbatim and coded using NVivo. A deductive thematic analysis was undertaken to identify common ideas and responses related to the features of clinical courage. Results: Thirteen interviews from rural doctors during the unfolding COVID 19 pandemic affirmed and enriched our understanding of the attributes of clinical courage, particularly the leadership role rural doctors can have within their communities. Conclusion: This study extended our understanding that rural doctors' experience of clinical courage is consistent amongst participants in many parts of the world, including developing countries. [ABSTRACT FROM AUTHOR]

Simple Summary: Crofton weed toxicity, caused by Ageratina adenophora, has been recognized as a cause of fatal lung disease in horses for over a century. Despite its impact on horse health in many areas of the world, the toxic syndrome is poorly understood and understudied. This paper looks at the prior research on weed biology, the potential toxicology mechanisms, and the pathology in horses and other species, as well as the future directions to improve our understanding of this fatal toxic weed affecting horses. Crofton weed (Ageratina adenophora) is a global and highly invasive weed, with ingestion causing severe respiratory disease in horses, leading to irreversible and untreatable pulmonary fibrosis and oedema. While reports of equine pneumotoxicity remain common in Australia and New Zealand, equine pneumotoxicity may be underdiagnosed in other countries where Crofton weed is endemic but poorly differentiated. The pathogenesis of Crofton weed toxicity following ingestion has been well described in a number of different animal models, including rodents, rabbits, and goats. However, induced toxicity is organ-selective across different animal species, and these vastly differ from the pathogenesis described in horses, both clinically and after experimental exposure. Sources of variation may include species-specific susceptibility to different toxins present in the plant, different mechanistic processes of toxicity, and species differences in toxin biotransformation and bioactivation across different organs. Considering disease severity and Crofton weed's invasiveness globally, assessing published toxicological and exposure data is necessary to advance research, identify specific toxins for horses, and possible prophylactic and therapeutic strategies. This review presents an overview of the available literature on equine toxicity, parallels between toxicity in horses and other animal species, and important aspects to be included in the future research agenda. [ABSTRACT FROM AUTHOR]

Background: There is limited research into how midwives use social media within their professional role. Small pilot studies have explored the introduction of social media into maternity practice and teaching but there is little evidence around how midwives use social media professionally. This is important as 89% of pregnant women turn to social media for advice during pregnancy, and how midwives use social media could be influencing women, their perception of birth and their decision making. Methods: Aim: To analyse how popular midwives portray birth on the social media platform Instagram. This is an observational mixed methods study using content analysis. Five 'popular' midwives from each country (UK, New Zealand, USA and Australia) were identified and their posts about birth collated from a one-year period (2020–21). Images/videos were then coded. Descriptive statistics enabled comparison of the posts by country. Categorisation was used to analyse and understand the content. Results: The study identified 917 posts from the 20 midwives' accounts, containing 1216 images/videos, with most coming from USA (n = 466), and UK (n = 239), Australia (n = 205) and New Zealand (n = 7) respectively. Images/videos were categorised into 'Birth Positivity', 'Humour', 'Education', 'Birth Story' and 'Advertisement'. Midwives' portrayals of birth represented a greater proportion of vaginal births, waterbirths and homebirths than known national birth statistics. The most popular midwives identified mainly had private businesses (n = 17). Both the midwives and women portrayed in images were primarily white, demonstrating a disproportionate representation. Conclusion: There is a small midwifery presence on Instagram that is not representative of the broader profession, or the current picture of midwifery care. This paper is the first study to explore how midwives are using the popular social media platform Instagram to portray birth. It provides insight into how midwives post an un-medicalised, low risk representation of birth. Further research is recommended to explore midwives' motivation behind their posts, and how pregnant and postnatal women engage with social media. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Background: Cultural differences between health professionals and Indigenous peoples contribute to health inequalities, and effective cross-cultural communication and person-centred healthcare are critical remedial elements. Community pharmacists can play a significant role by reducing medication-related problems through medication reviews, yet barriers to access include cultural and linguistic challenges. The Indigenous Medication Review Service (IMeRSe) aimed to address these barriers via a culturally responsive intervention. The aim of this paper is to present the cross-cultural training framework developed as a component of this intervention and the feasibility evaluation of the first stage of the training framework. Methods: A training framework was developed, emphasising pharmacists' skills and confidence in effective cross-cultural communication and relationship-building with Indigenous Australians (Please note that the use of the term 'Indigenous' in this manuscript includes all Aboriginal and Torres Strait Islander people and acknowledges their rich traditions and heterogenous cultures) across three stages: (1) online and workshop-based, covering Indigenous history and health, cross-cultural communication and a holistic, strengths-based approach to intervention delivery; (2) orientation to local Aboriginal Health Services, community and cultural protocols; and (3) ongoing mentoring. The feasibility evaluation of the first stage included the following: self-reported levels of cultural capability, cultural confidence and skills, motivators and barriers to working with Indigenous Australians, assessed pre- and post-training. Participants completed self-administered questionnaires including a 22-item validated Cultural Capability Measurement Tool. Paired t tests assessed change in mean scores of Likert scale data. Results: Stage 1 development resulted in an 8.5-h standardised cross-cultural training programme tested with 39 pharmacists working across urban and rural/remote Australia. Thirty-six pharmacists completed the feasibility evaluation (75.7% female, all non-Indigenous, 75.7% never attended prior cross-cultural training). Participants reported overall acceptability with training; the majority perceived it added value to their practice. Improved cultural capability post-training was reflected in increased scores for 21/22 items, nine reaching statistical significance. There were significant improvements for all 26 confidence and skills statements, and selected motivational and barrier statements, particularly participants role in improving Indigenous health outcomes and cross-cultural communication. Conclusions: This study provides preliminary evidence that the training programme was feasible to deliver and prepared pharmacists to deliver a culturally responsive medication review intervention. The online knowledge-based modules and face-to-face workshops provide a standardised framework for larger-scale implementation of the intervention training. Trial registration: Australia and New Zealand Clinical Trials Registry ACTRN12618000188235.Prospectively registered 22 January 2018. [ABSTRACT FROM AUTHOR]

This paper presents experimental and numerical investigations into the post-fire cross-section compressive behaviour and resistances of circular recycled aggregate concrete-filled stainless steel tube (RACFSST) stub columns. Twelve stub column specimens, fabricated from concretes with three recycled coarse aggregate replacement ratios (0%, 35% and 70%), were tested after exposure to the ISO-834 standard fire for 0 min (i.e. at ambient temperature), 15 min, 30 min and 45 min. The experimental investigation included heating and cooling of specimens, cylinder tests and post-fire tensile coupon tests and stub column tests. The test results, including load–end shortening curves, failure loads and failure modes, were fully reported and the initial compressive stiffnesses and confinement effect were discussed. The numerical investigation was subsequently conducted, where thermal and mechanical finite element models were developed and validated against the test results and then used to perform parametric studies to generate further numerical data. Given the absence of design codes for stainless steel–recycled aggregate concrete composite structures after exposure to fire, the relevant design rules for circular natural aggregate concrete-filled carbon steel tube stub columns at ambient temperature, as set out in the European code, Australia/New Zealand standard and American specification, were assessed, using post-fire material properties, for their applicability to circular RACFSST stub columns after exposure to fire, based on the test and numerical data. The assessment results generally revealed that the European code and the Australian/New Zealand standard led to an acceptable level of design accuracy and consistency, while the American specification resulted in rather conservative and scattered post-fire cross-section compression resistance predictions. • The compressive behaviour of circular RACFSST stub columns after exposure to fire is investigated. • Post-fire compression tests on twelve circular RACFSST stub column specimens are conducted. • The influences of heating durations and RCA replacement ratios are analysed. • Thermal and mechanical FE models are validated against test results and then used to conduct parametric studies. • The relevant design codes are assessed against the test and FE data. [ABSTRACT FROM AUTHOR]

Cold-formed steel (CFS) Tab connections are popular due to their rapid fastening and ease of installation, and their applications have increased recently in Pacific countries, including Australia and New Zealand. This type of connection consists of a Tab plate formed from the web of the supporting beam and is screwed to the joist web, providing a dependable load path from the joist to the galvanized C-section supporting beam. However, no studies have been reported in the literature for the shear capacity of such connections. This paper presents a shear test program designed to determine the shear capacity of CFS Tab connections and to identify their failure mechanism. The experimental program included three different beam sizes, C-150, C-190 and C-240. Each test was repeated three times, resulting in nine tests in total. All the specimens failed in plate yielding and plate tearing, which occurred on the tension side of the plate (top region). Nonlinear finite element (FE) models were then developed and verified against the test results. The FE results showed good agreement with the test results in terms of connection stiffness, connection strength and failure modes. Finally, it was shown that the design equations given in the Australia/New Zealand standard (AS/NZS 4600) and American Iron and Steel Institute (AISI S100) for predicting the combined bending and shear capacity could predict the ultimate shear capacity of CFS Tab connections investigated in this study. • The results of monotonic shear tests of a novel CFS Tab connection are reported. • CFS Tab connections failed in plate yeailding and tearing. • A nonlinear FE model is developed. Results showed good agreement with the test results. • A design procedure is proposed for predicting the shear capacity of CFS Tab connections. [ABSTRACT FROM AUTHOR]