Search

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]

People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Student‐led clinics can provide health services to marginalised groups where service offerings are sparse or difficult to access, such as rural areas. Offering these services to children and young people can promote health and well‐being by addressing the individual challenges and the social determinants of health. There is uncertainty, however, as to whether student‐led clinics can meet Australian accreditation standards for health professionals completing degree programs. Objective: This study aims to determine the capacity for health student placements in school‐based student‐led clinics to meet accreditation standards. Design: A systematic scoping review was conducted based on Arksey and O'Malley's framework and the PRISMA‐ScR statement. Setting: Several databases were examined, including Ebsco (Academic Source and CINAHL), ProQuest (PsycINFO, ERIC) and grey literature sources along with a desktop review of accreditation standards across seven health disciplines. Two independent reviewers screened eligible studies. Findings: The search retrieved 1037 records with 65 full‐text papers assessed for eligibility. Eleven papers met the inclusion criteria. Based on the evidence, both nursing and exercise and sports science accreditation standards were best suited to student‐led clinics. Discussion: Although broad categories of work‐integrated learning activities were applied, it appears feasible to expect accreditation standards for health disciplines at an Australian university to be a good fit for health student‐led school‐based clinics. Conclusion: Increasing health student placement opportunities within student‐led clinics can improve the health and well‐being of children and young people in regional, rural and remote (RRR) areas of Australia who may otherwise have limited access to allied health services. [ABSTRACT FROM AUTHOR]

Barriers and facilitators affecting the social activities of people with congenital physical and communication disabilities are well documented. However, little is known of their experiences of developing sexual and intimate relationships. This study conducted a systematic review of the literature to address this gap in knowledge. Ten online databases were searched for relevant papers between 1990 and 2014. In addition, hand searches of Augmentative and Alternative Communication Journal and the Sexuality and Disability Journal were conducted. Fifteen papers were identified and appraised. The thematic coding approach identified six principal themes. However, the content analysis revealed that the majority of the literature focused on the social needs of people with physical and communication disabilities. Despite evidence that people with disabilities are sexually active, there is little focus on the experiences of people with disabilities developing intimacy and expressing sexuality. The few references to sexuality in the relevant literature focused on protection from abuse, though some researchers called for improved counseling on sexuality and relationships, and improved access to sexual health services. Further research is required to focus on practical and theoretical outcomes to enhance social relationships and sexuality, and offer lovers who use AAC real advice in their search for intimacy. [ABSTRACT FROM AUTHOR]

Objectives. To review the prevalence of loneliness (during/after COVID-19) in older people. Design. Scoping review using Medline and PsycInfo for worldwide prevalence estimates (white published literature search) and Google for prevalence data inside the Euregio Meuse-Rhine (grey literature). Setting. Worldwide prevalence estimates and a focus on the Euregio Meuse-Rhine. Participants. Papers published between 2016 and 2022 and a mean age of minimum of 65 years. Measurements. Prevalence estimates for older people. Results. The white literature search yielded 37 articles. Before the onset of the COVID-19 pandemic, loneliness estimates were the highest in Nigeria (46%) and the lowest in Australia (5%) (mean prevalence was 25.6%). Loneliness was reported to be higher in specific populations, for example, people living in specific communities such as senior housing communities or with impairments, than in the general population, with a mean prevalence estimate of 47.8%. During COVID-19, the prevalence of loneliness was higher than that before the pandemic: we observed a mean prevalence of 39.4%, in comparison to 25.6 before COVID-19. The grey literature search showed that, compared to Belgium and the Netherlands (13.5% and 36.5%, respectively), loneliness estimates were the lowest in Germany, with a mean prevalence of 7.7%. Conclusion. Large international differences in the prevalence of loneliness were observed between countries and populations studied. Several hypotheses could explain such differences, including sociocultural or historical-political characteristics. Without surprise, the pandemic and associated measures were linked to a higher level of loneliness. Furthermore, recommendations for addressing loneliness, including interventions, are discussed. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Little is known about adolescent inpatient units, key features which define them, and how these essential services operate and deliver care. What the paper adds to existing knowledge?: Adolescent inpatient unit studies are limited in their descriptions of settings in terms of how they operate and key features.The proposed preliminary checklist is a practical tool to assist clinicians, policy makers, and researchers when reporting to ensure comprehensive descriptions of adolescent inpatient settings. What are the implications for practice?: This could be used to inform service design processes for inpatient and other mental health service models which is of critical importance in the context of reforms and implementation of these in Australia currently.Greater attention to operational models, services, and philosophies of practice will improve reporting and allow for the advancement of knowledge, comparison of study results, and a clearer direction for mental health nursing clinicians and researchers. Introduction: Adolescent inpatient units care for vulnerable population groups; however, little is known about how these essential services operate and deliver care. Aims: To examine the descriptions of adolescent mental health inpatient units in Australian and international research publications and to identify key features which were used to define them. A secondary aim was to develop a checklist to improve consistency when reporting on the operations and services delivered within adolescent mental health inpatient units (both public and private). Methods: Five electronic databases (CINAHL, MEDLINE, ERIC, EMBASE, and PsycINFO) were systematically searched. We included studies that provided descriptions of operations and services within adolescent inpatient units where participants had a mean age between 12 and 25. Narrative synthesis was used to explore the similarities and differences between descriptions of settings. Results: Twenty‐eight studies were identified, which varied in their descriptions of adolescent inpatient units, providing inconsistent information to inform best practice. Discussion: Studies lack consistency and comprehensive detail when describing the operational models within inpatient units, making interpretation challenging. Consequently, a preliminary checklist is proposed to improve reporting of adolescent inpatient units. [ABSTRACT FROM AUTHOR]

Objectives: We set out to examine the volume, scope and quality of research related to First Nations peoples' perceptions of, and experiences with, child rearing and/or parenting programs. Methods: We systematically reviewed the literature published between 2000 and 2020. Sixty-eight studies identified through electronic databases and references lists met inclusion criteria. Results: The study found an 8% increase in publications in the field each year (P -value = 0.002), mostly conducted in Australia with Aboriginal and Torres Strait Islander people (n = 29, 41%). Scope included positive and negative experiences relating to: parenting from adult (n = 19 studies) and teenager (n = 4) perspectives; and pregnancy, antenatal and postnatal care from the perspective of adults (n = 23) and teenagers (n = 2). Descriptive studies included qualitative (n = 40; 58%), quantitative (n = 8, 12%) or mixed methods (n = 7, 10%). Thirteen experimental studies reported the development, acceptability and/or effectiveness of programs (19%), of which three met the Cochrane Effective Practice and Organisation of Care design criteria. Conclusions: Despite an overall increase in volume, research efforts do not demonstrate a clear scientific progression. Further methodologically rigorous studies examining child rearing and/or parenting programs developed in collaboration with First Nations populations are needed. What is known about the topic? Examining research output, effectiveness and acceptability of existing existing parenting and child rearing programs for First Nations parents can inform research priorities and service development.. What does this paper add? Rigorous research to inform the development and evaluation of parenting programs is limited. Strengths-based, community-wide approaches should integrate community identities, expertise and resources, encourage ownership and engagement, and build capacity.. What are the implications for practitioners? Continued efforts are necessary to develop programs uniquely informed by, and tailored to, First Nations parents. [ABSTRACT FROM AUTHOR]

Introduction: The number of occupational therapy degree programs in Australia has increased substantially over the last decade. During this time, Australian academics have produced a significant amount of scholarship focussed on entry‐level education; however, the landscape of this scholarship has not been examined. The aim of this study was to review the literature on the scholarship of entry‐level Australian occupational therapy education programs, specifically the topics explored and methods employed. Methods: An extensive search of nine databases produced 1,002 papers related to occupational therapy education. Two researchers screened each paper using inclusion and exclusion criteria. Seventy‐six articles, published between 2000 and September 2019, were included. Data were extracted using a coding tool, and entered into NVivo, where data were analysed using queries and tallies of the characteristics of the articles. Results: Sixty‐eight articles were research and eight were other peer reviewed literature. Articles primarily focussed on student characteristics and perceptions. Quantitative research designs were predominant with surveys the most frequently used method. There were few articles that addressed the topic of teaching methods and approaches, and of these none addressed occupation‐centred teaching. No articles addressed the learning environment. Four articles reported on an educational intervention that targeted participation, and attitudes/perceptions or knowledge/skills of students and/or academics. These findings inform understanding about what has been completed so far in the scholarship; and what topic focus and research designs could address gaps in existing knowledge. Conclusions: This review elucidated topics that have been well researched (student focus), as well as gaps in the scholarship (teaching methods and approaches including occupation‐centred teaching, and the learning environment). It showed that quantitative designs were predominant, with qualitative approaches less frequently adopted. The results of this review could assist academics and researchers to focus their scholarship on topics that require further investigation and diversify research methods. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to quantify the use of linked data for health and human services research in Australia since the establishment of the Population Health Research Network (PHRN) in 2009. Methods: A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist to search for all publications involving the use of Australian linked data between 2009–10 and 2016–17. Publications were categorised by subject, data linked and data linkage unit involved. Results: In all, 7153 articles were identified from the initial search, and 1208 were included in the final analysis. An increase in the number of publications involving linked data was observed from 2009–10 through to 2015–16. Most articles (82%) featured data linked by at least one PHRN-funded data linkage unit. The research areas of 86% of publications were able to be classified according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification (ICD-10-AM). The number of publications involving cross-sectoral linked data also increased. Conclusions: Investment in Australian data linkage infrastructure has seen an increase in the number of research publications involving the use of linked health and human services data. This study identified areas where linked data is commonly used and those where use could be improved. What is known about the topic?: Data linkage is a method of bringing together information about individual people, places and events from different sources in a way that protects individual privacy. Individual jurisdictions have reported benefits from research conducted using linked data, including the generation of new knowledge and supporting improvements in the delivery of a wide range of health and human services. There has been significant investment in national data linkage infrastructure in Australia over the past 8 years. To date, there has been no systematic investigation of the effect of this investment on the use of linked population data by the research community. What does this paper add?: This paper provides evidence of the increased use of high-quality population-based linked data in research over the 8-year period studied. It demonstrates the application of data linkage across a wide range of health areas and highlights the small but growing number of studies using cross-sectoral data to investigate complex conditions. What are the implications for practitioners?: It is important to demonstrate to funders, policy makers, data custodians and researchers the value of robust data linkage capacity as an important national resource. Its use by researchers can bring enormous social and economic benefits by providing a more complete picture of the health and well-being of the community. The range of data collections routinely linked is increasing, as is the pool of researchers experienced in handling and analysing the data. Continued investment in Australia's data linkage infrastructure and the inclusion of other collections including general practice data will augment the use of this infrastructure in expanding the evidence base for policy makers and practitioners. [ABSTRACT FROM AUTHOR]

Background Short food questions are appealing to measure dietary intakes. Methods A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. Results Most questions assessed foods or food groups ( n = 29), with the most commonly assessed being fruit ( n = 22) or vegetable intake ( n = 23), dairy foods and discretionary foods ( n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency ( n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. Conclusions The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development. [ABSTRACT FROM AUTHOR]

Purpose: There is a growing recognition of the urgency to enhance health outcomes for children and young people residing in out-of-home care (OOHC). Research underscores the need to establish effective pathways to quality health care for children and young people who have been exposed to trauma. Child protection (CP) practitioners should play a vital role in proactively improving health outcomes and navigating the intricacies of healthcare systems. Their involvement in initiating and collaborating on healthcare interventions is pivotal for the well-being of these vulnerable children and young people. However, challenges associated with poor health literacy and the complexities of healthcare systems hinder collaborative service delivery in the Australian context. This review explores how CP practitioners support the health care of children and young people in their care. Design/methodology/approach: A scoping review followed Arksey and O'Malley's framework, employing a narrative synthesis to assess the selected studies. Findings: Health outcomes for children and young people in OOHC remain under-researched and potentially under-resourced within the realm of CP practice. There is room for enhanced practices and system integration in CP service delivery to better address health needs and prevent further health and well-being disparities. Originality/value: Through this scoping review and involving industry experts in the discussion of findings, this study contributes valuable insights to the existing knowledge base regarding the active participation of CP practitioners in addressing the healthcare needs of vulnerable children. [ABSTRACT FROM AUTHOR]

Objective: The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods: Anintegrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results: There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion: In recognition of the importance of peer support fornewparents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parentswhoare in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteerhomevisiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological limitations, pointing to a need for further rigorous research. [ABSTRACT FROM AUTHOR]

Rural medical education is known as one of the most effective strategies in improving rural recruitment and retention. The aim was to identify modes of delivery to improve access to rural postgraduate medical education. Arksey and O'Malley's methodological framework was used for conducting scoping reviews. CINAHL, Google Scholar, ERIC, PsycINFO, Medline and PubMed were searched to identify peer‐reviewed English‐language literature published between 2000 and 2019 focusing on postgraduate rural and regional medical education. A total of 102 articles were identified, with 51 included in the final analysis after applying inclusion and exclusion criteria. Outcome measures included: article type; research methodology; date of publication; country of origin; and study population. Through iterative reading, common themes were identified. A typology of 6 content themes emerged as follows: rural curriculum; procedural skills; rurally based learning; service delivery; workforce; and distance learning. The majority of articles focused on rural curriculum, and rurally based learning, with half originating from Australia or New Zealand. Although results strongly emphasised context and curriculum in rural environments, lack of specific and pragmatic approaches was noted. Surprisingly, few articles focused on rural distance learning utilising information and communication technology. Pathways to improve rural education access include recognition of the unique rural context in curriculums; development of rural educational faculty; and creation of opportunities for rural specialist training. Emphasis should be given for education provided through rural centres rather than urban facilities. Use of information technology could be increased, for example in remote trainee supervision programs. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to identify mental health interventions within male-dominated industries. Design/methodology/approach -- A systematic literature review was undertaken, examining mental health interventions within male-dominated industries. Major electronic databases, grey literature and reference lists for English language studies published January 1990-June 2012 were searched. Independent extraction of the studies was completed by two reviewers using predefined data fields including study quality measures. Findings -- Five studies met inclusion criteria. The available evidence suggests that effective interventions to address anxiety and depression in male-dominated industries include: improving mental health literacy and knowledge, increasing social support, improving access to treatment, providing education for managers and addressing workload issues. Practical implications -- Working conditions and the workplace can have a significant impact on a worker's mental health. Work-related factors including working conditions, job demands and social support in the workplace are particularly important for the mental health workers. Indeed, poor work conditions have been associated with poorer mental health outcomes in particular anxiety and depression, however, little work has been conducted on mental health interventions in the workplace and further the impact on male-dominated industries. Originality/value -- Overall, the body of evidence supporting effective interventions for mental health problems among workers in male-dominated industries is limited. Nonetheless, the evidence does suggest that mental health interventions in male-dominated industries is logistically feasible and can have some positive impact on the mental health of workers, particularly for high prevalence low severity disorders such as anxiety and depression. [ABSTRACT FROM AUTHOR]

Background: Children and adolescents with intellectual disability are at risk of developing psychiatric symptoms and disorders; yet, the estimates reported in the literature have been inconsistent, presenting a potential barrier for service planning and delivery. Sources of variability could arise from differences in measurement instruments as well as subgroup membership by severity of intellectual disability, gender and age. This systematic review aimed to address these gaps. Method: MEDLINE and PsycINFO databases were searched from inception to 2018 and selected studies were reviewed. Studies were included if they reported point prevalence estimates of mental health symptomology or diagnoses in a general population of 6- to 21-year-old individuals with intellectual disability. The Joanna Briggs Institute Prevalence Critical Appraisal Checklist was applied to eligible papers to appraise their scientific strength. Pooled prevalence for mental health symptomology was determined using a random-effects meta-analysis. Results: A total of 19 studies were included, including 6151 children and adolescents. The pooled prevalence estimate captured by the Developmental Behaviour Checklist was 38% (95% confidence interval = [31, 46]), contrasting with 49% (95% confidence interval = [46, 51]) captured by the Child Behaviour Checklist; both rates were higher than a non-intellectual disability population. Severity of intellectual disability did not significantly influence the Developmental Behaviour Checklist risks. Insufficient data were available to conduct statistical analyses on the effects of age, gender and socioeconomic status. Of diagnosed psychiatric disorders, attention deficit/hyperactivity disorder (30%), conduct disorder (3–21%) and anxiety disorders (7–34%) were the most prevalent conditions. Conclusion: This review consists of the largest sample hitherto evaluated. In the intellectual disability population, mental health comorbidities could be better detected by a symptom phenotype than a psychiatric diagnostic phenotype. Crucially, future research needs to address the effect of measurement validity in the intellectual disability population. Estimated prevalence rates were high compared to the general population, indicating the importance of systematic screening, case detection and appropriate management. [ABSTRACT FROM AUTHOR]

Suicide is a major public health issue globally. The World Health Organization has called for nations to create comprehensive national suicide prevention strategies including multisectoral collaboration, awareness raising, advocacy and capacity building. The workplace provides opportunity and structure for suicide prevention programs. However, many of these programs are poorly documented and evaluated. The MATES in Construction (MATES) program is a multimodal workplace-based suicide prevention program designed for and by the construction industry. This systematic review examined the available evidence for the effectiveness of the MATES program and is reported according to PRISMA guidelines. A literature search resulted in the inclusion of 12 peer-reviewed articles published between January 2010 and February 2023 containing primary data of evaluations of MATES. There was evidence of the effectiveness of the MATES program in improving mental health and suicide prevention literacy, helping intentions and reducing stigma. The results highlighted the importance of worker-to-worker peer approaches with workers consistently stating that supervisors were the least trusted resources for mental health and suicide concerns. Favourable results were found in relation to reduced suicide risk in the construction industry. The evidence base for MATES is limited in terms of causal inference with very few controlled evaluations and no experimental studies having been conducted to date. Improved understanding of how the program motivates volunteers, their experiences and research on the longer-term impacts of the program on the industry is required. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to examine non‐pharmacological interventions for helping people with dementia who experience feeding difficulties in order to improve their nutritional status. Methods: The articles were searched using PsycINFO, Medline, PubMed, CINAHL and Cochrane. Two independent investigators critically appraised eligible studies. The PRISMA guidelines and checklist were used. The possibility of risk of bias was assessed using a tool to assess the quality of randomised control trials (RCT) and non‐RCT studies. A narrative synthesis was conducted as a method of synthesis. The Cochrane Review Manager (RevMan 5.4) was used for meta‐analysis. Results: The systematic review and meta‐analysis included seven publications. Six interventions were identified and categorised as: eating ability training for people with dementia, staff training and feeding assistance and support. The meta‐analysis found evidence of the effect of eating ability training on feeding difficulty, quantified by the Edinburgh Feeding Evaluation in Dementia scale (EdFED) with a weighted mean difference of −1.36 (95% confidence interval: −1.84 to −0.89, p < 0.001) and on self‐feeding time. A spaced retrieval intervention showed a positive effect on EdFED. The systematic review discovered that while feeding assistance had a positive effect on feeding difficulty, staff training had no effect. According to the meta‐analysis, these interventions had no effect on improving the nutritional status of people with dementia. Conclusions: None of the included RCTs met the Cochrane risk‐of‐bias criteria for randomised trials. This review found that direct training for people with dementia and indirect feeding support from care staff resulted in fewer mealtime difficulties. More RCT studies are needed to determine the efficacy of such interventions. [ABSTRACT FROM AUTHOR]

This systematic review synthesized current knowledge about the prevalence of adverse childhood experiences (ACEs) among young people known to have offended and examined evidence of associations between ACEs, trauma symptoms, and offending behavior. A systematic search of English-language, peer-reviewed studies published from the year 2000 onwards was conducted. A final pool of 124 studies that reported quantitative data were included in the review. The Cambridge Quality Checklist for the assessment of studies on offending was used to assess methodological quality of included studies. Pooled data indicated that almost 87% of justice-involved young people across 13 countries experienced at least one traumatic event. The odds of experiencing at least one ACE were over 12 times greater for justice-involved young people compared with nonjustice-involved young people. Prevalence of individual ACEs ranged from 12.2% for childhood sexual abuse to 80.4% for parental separation among justice-involved young people. Those who reported both a higher number and multiple types of ACEs were more likely to be diagnosed with post-traumatic stress symptoms. However, when considering only high-quality studies, there was minimal evidence to suggest that a higher incidence of ACEs predicted trauma symptoms or that trauma symptoms mediated the association between ACEs and offending behavior. Further research is needed to elucidate factors that differentiate young people exposed to ACEs who go on to offend from those who do not. This research is essential to understanding whether ACEs and trauma are drivers of offending behavior and for informing prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Employment is frequently desired by persons who experience homelessness yet is often elusive. Little is known about the range and effectiveness of employment‐based interventions evaluated in existing literature on key psychosocial outcomes including employment participation, mental well‐being, housing tenure, community integration and substance use. To identify and synthesise existing studies, we conducted a systematic review of effectiveness using the methodology proposed by the Joanna Briggs Institute (JBI) following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Following the removal of duplicates, we screened 13,398 titles and abstracts, and reviewed 79 studies at the full‐text review stage using two independent raters. A total of 16 studies met criteria for inclusion in a narrative synthesis and were subjected to critical appraisal. The majority of studies were conducted in the US (n = 14; 87.5%) with other studies published in Canada (n = 1; 6.3%) and Australia (n = 1; 6.3%). Interventions evaluated in existing studies included combined substance use and vocational skills interventions (n = 7; 43.8%), supported employment (n = 6; 37.5%), and integrated supports including an employment component (n = 3; 18.8%). The effectiveness of these interventions on employment, mental well‐being, housing tenure, community integration, and substance use is presented. Findings suggest that research evaluating employment interventions for persons who experience homelessness is in an early stage of development. Researchers and practitioners may consider collaborating with persons with lived experiences of homelessness and practitioners in co‐designing and modifying existing approaches to target key outcomes more effectively. Policymakers may consider allocating resources to such initiatives to further the development of practice and research aimed at supporting persons who experience homelessness to secure and sustain employment during and following homelessness. [ABSTRACT FROM AUTHOR]

Background: Poor health outcomes amongst marginalized groups result in part from health inequities related to social and structural determinants of health. Marginalized people report higher incidences of comorbidities, chronic disease and adverse health behaviours than their nondisadvantaged peers. The objective of this review is to examine marginalized Australians' experiences of and access to community‐based primary health services in urban locations. Methods: A systematic search incorporating related MeSH terms and synonyms pertaining to marginalized Australian populations and their health‐seeking was conducted across seven databases. We included qualitative studies that reported experiences of health‐seeking within community‐based primary health care in metropolitan Australia. Participant populations experiencing marginalization due to social stigma and isolation, early‐life disadvantage, poor health and/or financial hardship were included. A meta‐ethnographic framework was used to synthesize themes across selected studies and researcher triangulation was employed to develop higher‐order themes. Results: Search results revealed 26 studies included for critical appraisal and synthesis. Seven higher‐order themes were developed describing experiences of health service engagement amongst marginalized groups: (1) Understanding the patient within the context of family and community, (2) Health and cultural beliefs influence health‐seeking, (3) Lack of information and poor cultural competence limit utilization of services, (4) Motivation for treatment influences health service engagement, (5) Accessing services, a spectrum of experience—from discrimination to validation, (6) Navigating a complex system in a complex society, (7) Preferences for health care and expectations for systemic change. Conclusion: Marginalized Australians experience health disadvantage across micro, meso and macro levels of health system navigation and commonalities in health‐seeking were identified across each of the distinct marginalized groups in our analysis. This review outlines important areas of consideration for health care provision and policy development essential to helping address health inequities for a diversity of marginalized populations. Patient or Public Contribution: Whilst patient voices were reported across all studies included within this review, no further patient or public contribution applies to this study. [ABSTRACT FROM AUTHOR]

Aim: This scoping review aimed to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Methods: Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Scopus) were searched to October 2020 for cost‐analysis studies of interventions aiming to improve dietary intake in people with mental disorders. No restriction was placed on participant age, mental disorder type or intervention design. Results are presented narratively. Results: Of 2753 articles identified, 13 articles reporting on eight studies were included. Studies were RCTs (n = 5), cluster RCT (n = 1), cluster preference RCT (n = 1), and pre‐post test (n = 1). Seven studies were in community settings (eg, outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants, and one included only females. Defined mental disorder diagnoses included serious/severe mental disorders (n = 3), major depression (n = 2), schizophrenia, schizoaffective disorder or first‐episode psychosis (n = 1), any mental disorder (n = 1), and bulimia nervosa (n = 1). Five interventions were multi‐behaviour, two were diet only and one was eating disorder treatment. Cost analyses included cost‐utility (n = 3), cost‐effectiveness (n = 1), cost‐utility and cost‐effectiveness (n = 3), and a costing study (n = 1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results. Conclusions: There is limited evidence evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Additional studies in various settings are needed to confirm cost effectiveness of different interventions. [ABSTRACT FROM AUTHOR]

In promoting positive cardiovascular health for Aboriginal and Torres Strait Islander peoples, there is a need to ensure provision of high-quality risk assessment and management in primary healthcare settings. There is some evidence of gender gaps for Australian women in the provision of cardiovascular risk assessment and management; however, there is little understanding of whether these gaps are also present for Aboriginal and Torres Strait Islander women. A mixedmethod systematic review was utilised to synthesise existing evidence on the provision of assessment and management against guideline-recommended care for Aboriginal and Torres Strait Islander women, and determine whether gender disparities in provision of care exist for this population. Sixteen studies that report gender-specific data indicate there are significant gaps in the provision of assessment and management for Aboriginal and Torres Strait Islander women and men alike. There is no evidence of incorporation of social and emotional wellbeing into cardiovascular care and limited studies outlining the assessment and management of behaviours and factors that may be protective of cardiovascular health. Furthermore, little is known about the provision of care in mainstream primary health services for Aboriginal and Torres Strait Islander peoples. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 pandemic has disrupted the Australian food supply with potential ramifications on food security. This scoping review aimed to synthesise current evidence on the prevalence of food insecurity and changes to factors related to food insecurity during the COVID‐19 pandemic in Australia. Methods: A comprehensive search strategy was used to search seven databases (MEDLINE, CINAHL, Embase, Global Health, Cochrane Database of Systematic Reviews, PsycINFO, Informit Online) and Google Scholar. Included studies were written in English, published in 2020–2021 and examined food security status in Australia during the COVID‐19 pandemic and/or factors associated with food insecurity in free‐living Australian residents. Articles with participants residing in institutional settings, where meals were supplied, were excluded. Results: A total of 700 records were identified from database, grey literature and hand searching, and nine articles were included. All studies indicated that the prevalence of food insecurity had increased due to negative changes to food availability, accessibility, usability and stability. The downturn in employment and economic circumstances following the onset of the COVID‐19 pandemic appeared to create a new group of food‐insecure Australians consisting of newly unemployed, and international students. Conclusion: COVID‐19 has exacerbated vulnerabilities in the Australian food supply and food security. Suggested actions include ongoing data collection on the long‐term impact of COVID‐19 on food supply and security in addition to coordinated national and community responses that improve the stability of the local food supply and address underlying determinants of food insecurity. [ABSTRACT FROM AUTHOR]

Introduction: Inaccessibility of mental health services in rural Australia is widely reported. Community co‐produced mental health and well‐being initiatives could fill gaps and complement other services. Objective: This scoping review summarises findings from peer‐reviewed articles to identify the key features of co‐produced Australian rural mental health initiatives that engage communities in their design, delivery or evaluation processes. Design: Between 2009 and 2019 inclusive, 14 articles met inclusion criteria and were reviewed using Arksey and O'Malley's review methodology. Findings: Communities co‐produced initiatives through informing, collaborating and instigating them. Some initiatives operated in specific places, for example an art gallery, while others operated across regions. Only two initiatives involved community members in multiple activities targeting prevention, early intervention, education and service accessibility; other initiatives were more focused, for example designing a new service. Over half of initiatives found were targeted at Aboriginal and Torres Strait Islander Peoples. Most articles discussed evaluation approaches, though methods were diverse. Discussion: Published peer‐reviewed evidence about Australian rural community co‐produced mental health initiatives appears scant. Evidence found suggests they generate a range of supports that could complement or mitigate for lack of, public health services. The overall lack of evidence, diversity of initiatives and inconsistent evaluation makes it difficult to assess effectiveness and which activities might be scaled‐up for wider benefit. Conclusion: Rural communities have limited resources, and evidence of what constitutes best practice in co‐producing mental health services would help to avoid 'reinventing the wheel.' Greater efforts in evaluating and publishing about initiatives would be helpful. [ABSTRACT FROM AUTHOR]

Background: Physical literacy (PL) in childhood is essential for a healthy active lifestyle, with teachers playing a critical role in guiding its development. Teachers can assist children to acquire the skills, confidence, and creativity required to perform diverse movements and physical activities. However, to detect and directly intervene on the aspects of children's PL that are suboptimal, teachers require valid and reliable measures. This systematic review critically evaluates the psychometric properties of teacher proxy-report instruments for assessing one or more of the 30 elements within the four domains (physical, psychological, cognitive, social) of the Australian Physical Literacy Framework (APLF), in children aged 5–12 years. Secondary aims were to: examine alignment of each measure (and relevant items) with the APLF and provide recommendations for teachers in assessing PL. Methods: Seven electronic databases (Academic Search Complete, CINAHL Complete, Education Source, Global Health, MEDLINE Complete, PsycINFO, and SPORTDiscus) were systematically searched originally in October 2019, with an updated search in April 2021. Eligible studies were peer-reviewed English language publications that sampled a population of children with mean age between 5 and 12 years and focused on developing and evaluating at least one psychometric property of a teacher proxy-report instrument for assessing one or more of the 30 APLF elements. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance was followed for the conduct and reporting of this review. The methodological quality of included studies and quality of psychometric properties of identified tools were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Alignment of each measure (and relevant items) with the APLF domains and 30 elements was appraised. Results: Database searches generated 61,412 citations; reduced to 41 studies that evaluated the psychometric properties of 24 teacher proxy-report tools. Six tools were classified as single domain measures (i.e. assessing a single domain of the APLF), eleven as dual-domain measures, and seven as tri-domain measures. No single tool captured all four domains and 30 elements of the APLF. Tools contained items that aligned with all physical, psychological, and social elements; however, four cognitive elements were not addressed by any measure. No tool was assessed for all nine psychometric properties outlined by COSMIN. Included studies reported a median of 3 out of nine psychometric properties. Most reported psychometric properties were construct validity (n = 32; 78% of studies), structural validity (n = 26; 63% of studies), and internal consistency (n = 25; 61% of studies). There was underreporting of content validity, cross-cultural validity, measurement error, and responsiveness. Psychometric data across tools were mostly indeterminate for construct validity, structural validity, and internal consistency. Conclusions: There is limited evidence to fully support the use of a specific teacher proxy-report tool in practice. Further psychometric testing and detailed reporting of methodological aspects in future validity and reliability studies is needed. Tools have been designed to assess some elements of the framework. However, no comprehensive teacher proxy-report tool exists to assess all 30 elements of the APLF, demonstrating the need for a new tool. It is our recommendation that such tools be developed and psychometrically tested. Trial registration: This systematic review was registered in the PROSPERO international prospective register of systematic reviews, with registration number CRD42019130936. [ABSTRACT FROM AUTHOR]

Purpose: Integrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care. Design/methodology/approach: The scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes. Findings: Overall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used. Research limitations/implications: Despite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended. Originality/value: The originality of this study is to provide evidence on integrated oral healthcare during pregnancy. [ABSTRACT FROM AUTHOR]

With the increase in our older adult population, there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study is to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL and Web of Science with tailored database search terms. The search yielded 8101 results, with 35 studies meeting inclusion. Studies were conducted in eight countries, had varying study designs (randomized controlled trials [RCTs] = 9, non‐RCTs = 6, one‐group study design = 20) and utilized previously published (19) and author developed (16) instruments. Furthermore, the studies were internationally diverse, conducted in the United States (n = 18), Australia (n = 7), UK (n = 3), China (n = 2), Canada (n = 2), Taiwan (n = 1), Brazil (n = 1) and multi‐country (n = 1). Only two studies focused on minority populations. While author‐developed instruments may be more relevant and timesaving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and understand better the effects of educational programs on caregiver knowledge. Geriatr Gerontol Int 2020; 20: 397–413. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand the challenges that people may experience when presenting to the emergency department (ED) with mental health issues • To familiarise yourself with the principles of trauma-informed care and the high prevalence of exposure to childhood trauma among people with mental health issues • To develop an awareness of the risk of re-traumatising patients during their care in the ED, and how this may be avoided There is a high prevalence of exposure to traumatic events in childhood among people who have mental health issues. Presentation to the emergency department (ED) can be challenging for these patients because the environment and their experience of care can trigger traumatic memories. Trauma-informed care is an approach to practice that is guided by knowledge of how trauma affects people's lives and their healthcare needs. Despite the increasing prevalence of mental health care delivery in EDs, the level of translation of trauma-informed care into nursing practice in this setting is largely unknown. Therefore, the authors undertook a narrative literature review, the aim of which was to gather evidence relevant to trauma-informed care in the ED and provide guidance on this practice for emergency nurses. Several databases were searched, and the relevant articles found were thematically analysed. Three emergent themes were identified from the literature: an access point for mental health care; staff attitudes; and the ED experience. Emergency nurses need to be aware of the effects of childhood trauma on people presenting with mental health issues and plan their approach to care to avoid potentially re-traumatising patients. [ABSTRACT FROM AUTHOR]

Primary Health Networks (PHNs) are a new institution for health systems management in the Australian healthcare system. PHNs will play a key role in mental health reform through planning and commissioning primary mental health services at a regional level, specifically adopting a stepped care approach. Selected PHNs are also trialling a healthcare homes approach. Little isknown about the systems levers that could be applied byPHNsto achieve these aims. Arapid review of academic and grey literature published between 2006 and 2016 was undertaken to describe the use of systems levers in commissioning primary care services. Fifty-six documents met the inclusion criteria, including twelve specific to primary mental healthcare. Twenty-six levers were identified. Referral management, contracts and tendering processes, and health information systems were identified as useful levers for implementing stepped care approaches. Location, enrolment, capitation and health information systems were identified as useful in implementing a healthcare homes approach. Other levers were relevant to overall health system functioning. Further work is needed to develop a robust evidence-base for systems levers. PHNs can facilitate this by documenting and evaluating the levers that they deploy, and making their findings available to researchers and other commissioning bodies. [ABSTRACT FROM AUTHOR]

Context: Given its potential effect on nutrient and energy density, the sugar content of the diet is a subject of controversy. Objective: The aim of this review was to examine the cross-sectional or prospective evidence for associations between the intake of total sugar or added sugar (high vs low intakes) and diet quality or nutrient intakes in the general population. Data Sources: The following databases were searched for English-language articles published between 1972 and 2012: CINAHL Plus, EBM Reviews, ERIC, MEDLINE, PREMEDLINE, PsycINFO, PubMed, and ScienceDirect. Study Selection: The search identified studies that examined the association between intake of total sugar and/or added sugar and diet quality (n = 22) or nutrient intakes (n = 30). Data Extraction: The following data were extracted: sample size and population, dietary assessment method, source of added sugar data, source of funding, comparator, association between total sugar or added sugar and diet quality, and the direction and magnitude of the association. Data Synthesis: Of 22 studies, all except 1 found a higher intake of added sugar to be associated with poorer diet quality, and the exceptional study did not adjust for total energy intake. Twenty-one of 30 studies found a negative association between added sugar and micronutrient intakes. The same association was not found for total sugar intake. Conclusion: Any negative association between dietary sugar and diet quality is better exposed by referring to added sugar rather than total sugar. There was substantial variation in features of study quality, including sample size, so the magnitude of the observed effect was generally small and may not be of clinical significance. Furthermore, the positive influence that core foods such as fruit and milk exert on total sugar values may bias the association between total sugar and diet quality. [ABSTRACT FROM AUTHOR]

Psychotherapy services are limited in remote and rural areas in Australia and across the globe. Videoconferencing has become well established as a feasible and acceptable mode of psychological treatment delivery. Therapeutic alliance ( TA) is an essential factor underlying successful therapy across therapeutic models. In order to determine the state of knowledge regarding TA in psychotherapy via videoconferencing, a literature review was conducted on research studies that formally measured TA as primary, secondary or tertiary outcome measures over the past 23 years. The databases searched were Medline, PsycArticles, PsycINFO, PsycEXTRA and EMBASE. Searching identified 9915 articles that measured satisfaction, acceptability or therapeutic rapport, of which 23 met criteria for the review. Three studies were carried out in Australia, 11 in USA, 4 in Canada, 3 in Scotland and 2 in England. Studies overwhelmingly supported the notion that TA can be developed in psychotherapy by videoconference, with clients rating bond and presence at least equally as strongly as in-person settings across a range of diagnostic groups. Therapists also rated high levels of TA, but often not quite as high as that of their clients early in treatment. The evidence was examined in the context of important aspects of TA, including bond, presence, therapist attitudes and abilities, and client attitudes and beliefs. Barriers and facilitators of alliance were identified. Future studies should include observational measures of bond and presence to supplement self-report. [ABSTRACT FROM AUTHOR]