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Background/Aims: Molar pregnancy is a rare complication of pregnancy. Patients face surgery, human chorionic gonadotropin monitoring and potentially systemic treatment, resulting in unique support needs. This study's aim was to explore the impacts of gestational trophoblastic disease on embodied and emotional experience. Methods: This qualitative study considered stories of molar pregnancy from 20 women in the UK, US, Canada and Australia. These were drawn from 18 publicly available online blogs and eight semi-structured interviews, and analysed thematically. Results: Three themes were developed: 'loss', describing women's responses to their pregnancy ending; 'isolation', comprising 'rarity', 'lack of awareness' and support seeking; and 'alienation', capturing the unfamiliarity of diagnosis, 'failure' and barriers to 'moving forward'. Conclusions: Experiences are shaped by wider narratives of 'typical' pregnancy. Patient care requires an individualised and responsive approach, and non-specialist practitioners should feel confident in discussing molar pregnancy and have access to up-to-date guidance. [ABSTRACT FROM AUTHOR]

There is an urgent need to develop an international competency and capability framework to support standardization of education and roles in advanced practice physiotherapy (APP). This need arose due to the rapid growth of the APP model of care, implemented out of necessity in the absence of agreement as to the competencies and capabilities or formal education required for the roles. This study explores the views and perceptions of practitioners and key stakeholders on a draft competency and capability framework for advanced practice physiotherapists. The purpose of this study was to: 1) gather feedback from key stakeholders (advanced practice physiotherapists, researchers, and leaders) on a draft competency and capability framework and 2) use that feedback to revise and improve the draft framework. Qualitative study using a series of four multi-national online focus groups. Thematic analysis was conducted according to Braun and Clarke. Sixteen participants from the United Kingdom, Ireland, Canada, Australia, and New Zealand participated in the study. Five themes were generated after data analysis: clinical expert, experienced communicator, strong leader, collaborator, and knowledge creator). A modified competency and capability framework was developed based on feedback from the focus groups and input from subject matter experts (SMEs). This study provides a modified core competency and capability framework comprising 24 competencies grouped under six domains. This study is a step toward international standardization of advanced practice physiotherapy based on a commonly agreed framework for the education and training of advanced practice physiotherapists. [ABSTRACT FROM AUTHOR]

Professional quality of life (ProQOL) refers to workers' subjective feelings associated with work involved in helping others who have experienced trauma. It consists of positive and negative aspects, that is, subscales of compassion satisfaction, and burnout and secondary traumatic stress. Foster and kinship caring inherently involves risks associated with exposure to the trauma responses of children in their care. This exposure can lead to poor ProQOL, carer attrition, and placement instability. While limited studies specifically explore ProQOL of carers, many studies have examined factors and interventions related to ProQOL. However, there is a lack of synthesis of these studies. To fill such a research gap, we undertook a scoping review of 70 empirical studies from Australia, the United Kingdom, and the United States, published from 2012 to 2022 reporting on ProQOL, and its related factors and concepts. We applied a multilevel ecosocial construct to examine complex interrelationships between private and governance settings to better understand factors related to ProQOL of carers and interventions aimed to improve it in these dynamic systems. In our review, some studies showed positive outcomes for carers, such as reduced stress or burnout associated with training. However, there was insufficient attention to factors associated with ProQOL at relational and sociopolitical levels. It is crucial to improve carers' ProQOL or well-being to ensure their retention and placement stability. Long-term systemic improvements require interventions across different levels of the system. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on this subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Attainment inequalities exist for ethnic minority students graduating from higher education institutes (HEIs) in the UK. Previous research has investigated the outcomes and experiences of students from ethnic minority backgrounds on health and social care programmes. However, studies exploring ethnic minority speech and language therapy (SLT) students’ experiences have only focused on international students and were conducted in Australia. No known studies exploring the experiences of both home‐domiciled and international SLT students from ethnic minority backgrounds have been conducted in the UK.To explore the experiences of home‐domiciled and international ethnic minority students on a SLT training programme and to identify ways to improve these experiences.All SLT students attending a pre‐registration postgraduate course who identified as being from an ethnic minority background were invited to participate. Two focus groups, one for three international students and one for six home students, were conducted. Data were analysed using reflexive thematic analysis.Three themes were identified that illustrated students’ current experiences and how experiences could be improved: (1) feeling an outsider, explores students’ sense of belonging in SLT education; (2) finding ways to manage, describes the strategies used by students to cope with their experiences of marginalization, and how adopting these strategies impact on their well‐being; and (3) promoting inclusion, explains how the training programme could be modified to improve the experience of ethnic minority students.A better understanding of the experiences of ethnic minority SLT students can help others to support them more effectively. The findings suggest that making changes to SLT training programmes could improve ethnic minority students’ outcomes and experiences. These include: more training for staff and students, support groups for ethnic minority students, sharing lived experiences of students and experienced SLTs from ethnic minority backgrounds, and clearer ways of reporting racist incidents. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. Previous studies have investigated the experiences of ethnic minority students on a range of HEI programmes, including those for students of physiotherapy and occupational therapy. The only studies investigating the experiences of ethnic minority SLT students are those exploring how international SLT students in Australia can be supported on professional placement. This study explores the experiences of home and international SLT students in the UK who identify as being from minority ethnic backgrounds. Findings suggest that these students feel like outsiders, affecting their sense of belonging. The need to find and implement strategies to manage their feelings of marginalization impacts on their well‐being. The findings suggest measures to promote the inclusion of ethnic minority SLT students to improve their experiences and support their well‐being. These include more training for all staff and students and the creation of a ‘lived experiences library’ where students and experienced SLTs from ethnic minority backgrounds could share positive experiences as well as ways of dealing with challenges. Clearer ways of reporting racist incidents would be beneficial for all students. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. It is important that ethnic minority SLT students are involved in developments that aim to improve their experiences. [ABSTRACT FROM AUTHOR]

This study explores the representation of scientists and politicians in editorial cartoons from three countries: Australia, South Africa and the United Kingdom. Of 466 cartoons collected from six Sunday newspapers (two from each country) over an 18-month period, 226 (49%) contained some reference to COVID-19. A qualitative analysis of cartoons highlights the politicisation of science and the relative absence of scientists in the cartoon discourse. Cartoonists focus on the political aspects of the pandemic, often portraying politicians as juggling competing demands, such as health needs versus personal freedom. However, they often miss the opportunity to address the reasons for the imposition of COVID-19-related restrictions or the effectiveness of health measures, instead portraying scientists as oppositional figures. In addressing COVID-19 in this way, cartoonists subtly suggest conflicts between the values of scientists, politicians and society. Cartoonists also tie the pandemic into broader political discourses in each country, for example, states' rights, corruption and Brexit in, respectively Australia, South Africa and the UK. This work provides insights into journalistic coverage of complex, science-related issues, with a particular focus on the ways that editorial coverage reflects public sentiment, policy responses and social attitudes. [ABSTRACT FROM AUTHOR]

The aims of this integrative review included examining the intervention characteristics, religious tailoring, and behavioural outcomes of health and social care interventions with Muslim-minorities in Australia, Canada, UK, and the USA. Nineteen articles were included, and each showed some level of improved health and social care outcomes associated with interventions that were religiously tailored to Islamic teachings, and when notions of health were extended to physical, psychological, spiritual and social domains. Future studies should measure levels of religiosity to understand whether religiously tailored interventions produce a significant intervention effect when compared to non-religiously tailored interventions with Muslims. [ABSTRACT FROM AUTHOR]

Dynamic face stimuli are increasingly used in face perception research, as increasing evidence shows they are perceived differently from static photographs. One popular method for creating dynamic faces is the dynamic morph, which can animate the transition between expressions by blending two photographs together. Although morphs offer increased experimental control, their unnatural motion differs from the biological facial motion captured in video recordings. This study aimed to compare ratings of emotion intensity and genuineness in video recordings, dynamic morphs, and static photographs of happy, sad, fearful, and angry expressions. We found that video recordings were perceived to have greater emotional intensity than dynamic morphs, and video recordings of happy expressions were perceived as more genuine compared to happy dynamic morphs. Unexpectedly, static photographs and video recordings had similar ratings for genuineness and intensity. Overall, these results suggest that dynamic morphs may be an inappropriate substitute for video recordings, as they may elicit misleading dynamic effects. [ABSTRACT FROM AUTHOR]

Previous research has indicated that healthcare support for sexuality after spinal cord injury appears to be neglected or inadequately provided. The perspectives of people living with spinal cord injuries regarding what is lacking and what support they would like to be provided, and why, has yet to be explored. This paper uses critical theory to explore how societal constructs of sexuality and disability shape how sexuality is supported after a spinal cord injury. To do this, we conducted in-depth semi-structured interviews with 11 people with a spinal cord injury from Australia, the United Kingdom, and the United States. We drew from the works of various critical disability theorists to analyze what discourses underpinned the experiences people with spinal cord injuries had when receiving sexuality support. Analysis suggested that the following discourses were apparent: (1) broken bodies require repair, (2) sex is penetration, ejaculation then reproduction, and (3) sexual autonomy is required. Findings indicated healthcare professionals need to recognize people with spinal cord injuries as sexual beings with a diverse range of desires, lives, relations, and bodies. Provision of individualized comprehensive high-quality sexuality support is therefore warranted. To achieve this, healthcare professionals should aim to be aware of, and mitigate, ableist and normative assumptions. [ABSTRACT FROM AUTHOR]

Background: Economic evaluations are being conducted with increasing frequency in the maternity care setting, with more randomized controlled trials containing a health economic component. Key emerging criticisms of economic evaluation in maternity care are lack of robust data collection and measurement, inconsistencies in methodology, and lack of adherence to reporting guidelines. Methods: This article provides a guide to the design of economic evaluations alongside clinical trials in maternal health. We include economic concepts and considerations for the maternity setting and provide examples from the UK and Australia. Results: There are many important considerations for the design of economic evaluations alongside clinical trials. To be effective, researchers must select types of economic evaluation, which align with their study objectives; choose an appropriate evaluation perspective, time horizon, and discount rate; and identify accurate ways to measure and evaluate health outcomes and costs. Discussion: This guide is written for noneconomists and can be used for designing economic evaluations to be conducted as a part of clinical trials. We seek to improve the quality, consistency, and transparency of economic evaluations in maternal health. [ABSTRACT FROM AUTHOR]

Despite advances in the field of augmentative and alternative communication (AAC), outcomes among children who require AAC remain discouraging. Practitioners may benefit from guidelines to aid decision-making in relation to supporting pre-linguistic communicators. We conducted an open-ended questionnaire of 30 AAC professionals from six countries—Australia, Denmark, the Netherlands, New Zealand, the United Kingdom, and the United States—to determine if consensus existed regarding the assessment information needed, the communication skills to teach, and the instructional strategies to employ to support AAC learning for pre-linguistic communicators. We analyzed the responses using qualitative content analysis in four iterative phases. We provide five statements that reflect areas of consensus and divergence among the participating AAC professionals. These findings provide important insights related to assessment, communicative competence, instructional strategies, decision-making, and communication partner instruction. Findings of this preliminary exploration indicate the need for ongoing and targeted research related to AAC decision-making guidance that attends to context (e.g., languages spoken, service structures) and pre- and in-service training in AAC decision-making. [ABSTRACT FROM AUTHOR]

Background: Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences. Methods: Based on the conceptual framework developed by Arksey and O'Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding. Results: Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis. Discussion: While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures. [ABSTRACT FROM AUTHOR]

Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault. [ABSTRACT FROM AUTHOR]

Globally, foodborne illness is a significant public health challenge. Food safety inspection plays a crucial role in the regulation of food businesses to prevent foodborne illnesses. To be an effective health protection measure, however, food safety inspections must facilitate the thorough evaluation of food safety risks. Our research examined how food safety inspectors from Australia, Ireland, New Zealand, the UK, and the U.S. assessed food contamination control during food premise inspections. Data were collected via an online survey of environmental health practitioners who routinely conduct food safety inspections. The findings indicated that inspectors are generally aware of food safety hazards that can be present at food businesses and have deployed a variety of relevant data-gathering methods to inform their examination of the extent of contamination control. The findings also indicated a prevailing methodological incongruence stemming from the absence of a robust inspection methodology. We propose that these shortcomings be addressed by solutions that are formulated based on established hazard analysis critical control point (HACCP) principles and qualitative field research. The development of a clear and appropriate methodology will support food safety inspections to provide a robust and reliable means for evaluating food safety risk and ultimately reduce the incidence and burden of foodborne illness. [ABSTRACT FROM AUTHOR]

The VIA-Youth (Park & Peterson, 2006) is perhaps the most commonly administered youth measure of the Peterson and Seligman (2004) character strengths. This article is the first in a series describing revision of the VIA-Youth, with the goals of making the development process more transparent, targeting scale unidimensionality, achieving measurement invariance, and extending the age range to 8–17. A sample of 286 youth in three countries completed 198 candidate items, from which a 98-item inventory was developed. Ratings of strengths were provided for 250 of the youth by 202 parents and 164 teachers. The relative size of relationships between informants was related to youth age, and to ratings of the observability and evaluativeness of the strengths, in the expected direction. The findings suggest youth self-report of character strengths and ratings by significant others are not highly related, but are consistent with prior studies of informant convergence in youth ratings. [ABSTRACT FROM AUTHOR]

Background: Only one pilot value set (UK) is currently available for the EQ Health and Wellbeing Instrument short version (EQ-HWB-S). As an alternative to preference-weighted scoring, we examined whether a level summary score (LSS) is appropriate for the EQ-HWB-S using Mokken scaling analyses. Methods: Data from patients, carers and the general population collected during the developmental phase of the EQ-HWB-S in Australia, US and UK were used, noting 3 of 9 items have since undergone revision. EQ-HWB-S data fit was examined using R package Mokken scaling's monotone homogeneity model, utilizing the automated item selection procedure (AISP) as well as Loevinger's scaling coefficients for items and the scale (HS). Manifest monotonicity was assessed by examining whether the cumulative probability for responses at or above each response level did not decrease across the summary score. Results: EQ-HWB-S data were available for 3340 respondents: US = 903, Australia = 514 and UK = 1923. Mean age was 50 ± 18 and 1841 (55%) were female. AISP placed all 9 items of the EQ-HWB-S on a single scale when the lower bound was set to < 0.448. Strong scalability (HS = 0.561) was found for the EQ-HWB-S as a single scale. Stronger scales were formed by separating the psychosocial items (n = 6, HS = 0.683) and physical sensation items (n = 3, HS = 0.713). No violations of monotonicity were found except for the items mobility and daily activities for the subgroups with long-term conditions and UK subjects, respectively. Discussion: As EQ-HWB-S items formed a strong scale and subscales based on Mokken analysis, LSS is a promising weighting-free approach to scoring. [ABSTRACT FROM AUTHOR]

The article highlights the transformative journey of a nurse-turned-activist who founded a not-for-profit organization, Her Heart, dedicated to addressing the alarming statistics and barriers faced by women in heart health. Topics include her diverse career trajectory, challenges in setting up the organization, and innovative solutions such as an online directory to connect women with female cardiologists and Australia's first online risk assessment tool tailored for women.

Objective: Clarifying the distinctions between art-based creative activities in the domains of occupational therapy and art therapy in the context of stroke rehabilitation, while also describing the effects of art-based creative activities on stroke rehabilitation. Design: Scoping review. Data source: A systematic search was performed in nine databases (Web of Science, PubMed, EMBASE, Cochrane Library, CINAHL and four Chinese database) from their inception to December 2023. Review methods: The study included randomized and non-randomized controlled trials involving art-based creative activities, as well as qualitative research providing detailed intervention measures. The study focused on stroke patients, with primary outcomes related to patients' physiological recovery, psychological well-being, ADL, etc. Data extraction included information on intervention strategies and study results. Results: Seventeen studies were included, extracting six similarities and differences in creative activity between two domains. Creative activities were observed to have positive impacts on daily living activities, limb motor function, fine motor ability, and emotional well-being in stroke patients. Conclusion: Creative activities, whether in occupational therapy or art therapy, involve providing participants with tangible crafting materials for the creation of artistic works. Future stroke rehabilitation practices should tailor activities and intervention focus based on patients' rehabilitation needs, preferences, and cultural background. The current comprehensive analysis provides initial support for the potential positive role of creative activities in stroke rehabilitation, but further in-depth research is needed to confirm their effectiveness. [ABSTRACT FROM AUTHOR]

Scholars have detailed the range of skills required for conservation and voiced concerns that training is not fit for purpose. Still, we have little understanding of what skills conservation education aims to teach. This study uses survey data and content analysis of online module descriptions to examine skills and methods teaching in conservation higher education across the United Kingdom and Australia. We found most conservation‐specific modules aimed to develop disciplinary and communication skills, but fewer than half aimed to develop interpersonal or project management skills. Social science methods training was absent from the core offering of over half of the conservation degrees reviewed. To prepare students for conservation careers and the complex problems they will encounter, the conservation education sector should further focus on building essential nonacademic skills and provide training on the breadth of methods that contribute to effective conservation science. This analysis can help educators to reflect on teaching aims and forge a curriculum that will best prepare students for contemporary conservation challenges. [ABSTRACT FROM AUTHOR]

Purpose: Foresight J's journey started in 1999, and in 2022, it marked the conclusion of its 24 years of publication. This paper aims to provide an overall overview of important research trends published in Foresight J between 1999 and 2022 by conducting a quantitative analysis of the journal's literature. The overarching goal is to provide valuable insights into the dynamics of scholarly communication, aiding researchers, institutions and policymakers in assessing the significance and influence of academic work, guiding future research directions and academic evaluation. Design/methodology/approach: The two bibliometrics methodologies that make up the methodology of this article are scientific mapping and performance analysis. Authors have explained the development and composition of the Foresight J using these methods. The SCOPUS database is being used in current research to analyse several dimensions, such as the evolution of publications by year, the most cited papers, core authors and researchers, leading countries and prolific institutions. Moreover, the conceptual structure, scope, burst detection and co-occurrence analysis of the journal are mapped using network visualization software such as VOSviewer, CiteSpace and RStudio. Findings: With a strong track record of output over the years, Foresight J has continued to develop in terms of publications. It is determined that "Saritas" is the author with the greatest overall impact. However, according to SCOPUS bibliometric data, "Blackman" and "Richardson" are the authors with the greatest relevance in terms of the quantity of articles. In addition, it becomes apparent that the USA, Australia and the UK are very productive nations in terms of publications. The most popular fields of the journal have always been forecasting, foresight, scenario planning, strategic planning, decision-making, technology and sustainable development. These are also the author keywords that appear the most frequently. In contrast, new study themes in the Foresight J include digital technologies, innovation, sustainability, blockchain, artificial intelligence and sustainability. Research limitations/implications: Several noteworthy research implications are provided by the bibliometric study of Foresight J. "Saritas" is the author with the most overall impact, indicating that the precise contributions and influence of this researcher in the fields of forecasting, foresight and related fields. Given that "Blackman" and "Richardson" are well-known writers, it is also critical to examine the scope and complexity of their contributions to potentially identify recurring themes or patterns in their writing. The geographic productivity results, which show that the USA, Australia and the UK are the top three countries for Foresight J publications, may encourage more research into regional differences, patterns of collaboration and the worldwide distribution of research endeavours in the context of forecasting and foresight. Popular fields including scenario planning, forecasting, foresight and sustainable development are consistent, indicating persistent research interests. Examining the causes of these subjects' ongoing relevance can reveal information about the consistency and development of scholarly interests over time. Practical implications: Foresight J's bibliometric analysis has real-world applications for many stakeholders. It helps editors and publishers make strategic decisions about outreach and content by providing insights regarding the journal's influence. Assessing organizational and author productivity helps institutions allocate resources more effectively. Policymakers acquire an instrument to evaluate research patterns and distribute funds efficiently. In general, bibliometric study of a journal helps decisionmakers in academic publishing make well-informed choices that maximize the potential of options for authors, editors, institutions and policymakers. Social implications: The societal ramifications of bibliometrically analysing Foresight J from 1999 and 2022 are substantial. This analysis highlights, over the past 24 years, research trends, technological developments and societal priorities have changed by methodically looking through the journal's articles. Gaining knowledge about the academic environment covered by the journal can help raise public awareness of important topics and promote critical thinking. In addition, the analysis can support evidence-based decision-making by alerting decision makers to the influential research that was published in Foresight J. This could have an impact on the course of policies pertaining to innovation, technology and societal development. Originality/value: This study presents a first comprehensive article that provides a general overview of the main trends and patterns of the research over the Foresight J's history since its inception. Also, the paper will help the scientific community to know the value and impact of Foresight J. [ABSTRACT FROM AUTHOR]

This study explores if and how migrating social workers' gender, country of origin and time living in the United Kingdom relate to their job and life satisfaction, and to building a new social network post-migration. Online questionnaires and semi-structured interviews were carried out with participants from Australia, Canada, India, Romania, South Africa, the United States and Zimbabwe. We found a statistically significant connection between the length of time in the United Kingdom and satisfaction from working as social workers and living in the United Kingdom. All our participating groups were generally only mildly satisfied professionally, but satisfied with living in the United Kingdom. [ABSTRACT FROM AUTHOR]

Objective: To compare cost‐effectiveness of oral sildenafil citrate, administered after onset of labor, with standard care to health system funders in the UK and Australia. Methods: We conducted a modeled cost‐effectiveness analysis, measuring costs and quality adjusted life years (QALYs), using a decision‐analytic model covering onset of labor to 1 month post‐birth. The relative risk of emergency cesarean section and operative vaginal birth was taken from a Phase 2 placebo controlled double blinded randomized control trial. Results: Both options of care resulted in the same QALYs gained over the model time period (0.08). Sildenafil citrate was cost‐saving compared with standard care, saving £92 per birth in the UK (AU$303 per birth in Australia). Sensitivity analyses did not identify any areas of uncertainty that stopped sildenafil citrate being cost saving compared with standard care. Threshold analysis revealed that sildenafil citrate would be cost saving up to a per birth drug or administration cost of £152.32 in the UK (AU$333.61 in Australia). Conclusion: Oral sildenafil citrate may be cost saving compared with standard care; however, the effects on neonatal outcomes still need to be demonstrated in large randomized trials. Synopsis: Oral sildenafil‐citrate may be cost saving compared with standard care; however, the effects on neonatal outcomes still need to be demonstrated in large randomized trials. [ABSTRACT FROM AUTHOR]

The article focuses on evaluating the quality of reporting in palliative and end-of-life care intervention studies regarding social characteristics like socioeconomic position, race, religion, and main language of participants. Topics include the findings that a significant proportion of studies do not report these characteristics adequately, with a tendency to use broad categories that may not capture the diversity of participants, hindering efforts to address inequalities in palliative care.

Introduction: The slow pace of change in respect of increasing the diversity of medical students suggests powerful actors are reproducing practices to support the status quo. Opening up medicine to embrace diversity thus requires the deconstruction of entrenched processes and practices. The first step in doing so is to understand how the actor‐network of widening participation and access to medicine (WP/WA) is constructed. Thus, here we examine how the connections among actors in WP/WA in two different networks are assembled. Methods: A comparative case study using documents (n = 7) and interviews with staff and students (n = 45) from two medical schools, one United Kingdom and one Australian, was used. We used Callon's moments of translation (problematisation, interessement/operationalisation, enrolment, mobilisation) to map the network of actors as they are assembled in relation to one another. Our main actant was institutional WP to medicine policy (actor‐as‐policy). Results: Our actor‐as‐policy introduced five other actors: the medical school, medical profession, high schools, applicants and medical school staff. In terms of problematisation, academic excellence holds firm as the obligatory passage point and focal challenge for all actors in both countries. The networks are operationalised via activities such as outreach and admissions policy (e.g., affirmative action is apparent in Australia but not the UK). High schools play (at best) a passive role, but directed by the policy, the medical schools and applicants work hard to achieve WP/WA to medicine. In both contexts, staff are key mobilisers of WP/WA, but with little guidance in how to enact policy. In Australia, policy drivers plus associated entry structures mean the medical profession exerts significant influence. Conclusions: Keeping academic excellence as the obligatory passage point to medical school shapes the whole network of WP/WA and perpetuates inequality. Only by addressing this can the network reconfigure. Treating policy as an actor in UK and Australian medical schools, Coyle et al. were enabled to conduct unique comparisons between Widening Practice networks that shine light on how staff, students and policies navigate equity and excellence in medicine. [ABSTRACT FROM AUTHOR]

Background: Spoken discourse impairments post‐traumatic brain injury (TBI) are well‐documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech–language pathologist (SLP) is recommended for adults with discourse impairments post‐TBI, with an emphasis on context‐sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice. Aims: To explore the under‐researched area of clinical practice for spoken discourse interventions with adults post‐TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base. Methods & Procedures: Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi‐structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach. Outcomes & Results: :Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development/utilization and insight‐building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client‐specific factors and rationales prioritized tailored, context‐sensitive and goal‐directed treatment. Conclusions & Implications: This study provided insight into a previously under‐researched area. It highlighted a wide range of treatment activities and factors informing current SLPs' treatment of spoken discourse impairment post‐TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post‐TBI, from initial assessment to outcome measurement, may help inform clinical decision‐making and the transfer of research to practice. WHAT THIS PAPER ADDS: What is already known on the subject: Spoken discourse impairments occur in dialogic and monologic productions post‐TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision‐making for discourse interventions post‐TBI are limited. What this paper adds to existing knowledge: This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post‐TBI. It details the factors that influence clinical decision‐making for this caseload and identifies an emphasis on client priorities and the value of clinician experience. What are the potential or actual clinical implications of this work?: This study identifies the broad and complex considerations required to deliver context‐sensitive discourse intervention post‐TBI. It indicates the need for an in‐depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience. [ABSTRACT FROM AUTHOR]

Historians of the late British empire often cite the 1960s and 1970s as a turning point in Commonwealth nationalisms, when British sentiment abroad was in major decline. This article investigates one exception to that phenomenon: Australians' continued appreciation for British television, especially British comedy television. While other historians have seen this as a symptom of 'cultural imperialism', this article argues that Australian stations purchased British comedies for complex commercial reasons that extended beyond imperial sentiment. Australian and British television stations worked together to bring British television programmes to Australia. Public and private British stations sold Australians programmes to finance their domestic activities, claiming their products were uniquely 'high quality'. Australian stations borrowed British language of 'high quality' to describe these programmes, a rhetoric which filtered through to how Australian viewers described their television preferences. Combining international business records with viewers' opinions, this article demonstrates the role media firms could play in positively framing consumers' attitudes to Britain even in the post-imperial era. [ABSTRACT FROM AUTHOR]

Many if not most sperm donors in the early years of IVF donated under conditions of anonymity. There is, however, a growing awareness of the ethical cost of withholding identifying parental information from donor children. Today, anonymous donation is illegal in many jurisdictions, and some jurisdictions have gone as far as retrospectively invalidating contracts whereby donors were guaranteed anonymity. This article provides a critical evaluation of the ethics and legality of anonymous donation. We defend Australian and British legislation that has outlawed donor anonymity, and we argue for the establishment of a central registry that provides donor children with the ability to easily and reliably access identifying information about their donor parents. [ABSTRACT FROM AUTHOR]

Mental illness-related stigma does not only emanate from the public but also within families of persons with mental illnesses. Familial mental illness stigma implies family members perpetuating stigma against their loved ones with mental illnesses. The aim of this review was to analyze the empirical literature on experiences of familial mental illness stigma in four countries. Using seven databases, we reviewed 133 empirical studies with 26 meeting the inclusion criteria. Each of the 26 studies spoke to various forms of familial mental illness stigma that potentially impact the self-esteem and self-worth of the affected person. Findings from this review show the existence of familial mental illness stigma in high-income countries, highlighting the need for evidence-based policies to safeguard affected persons at the family level. Close relatives stigmatizing their loved ones due to mental illnesses have contributed to the concealment of mental illness diagnoses within families, which often results in poor prognoses. Family members' understanding of mental illnesses is key in confronting the stigma associated with mental disorders in our communities, but this is contingent on continuous comprehensive familial program and education. Constant social support from community services and family members is essential in the recovery of persons with mental illnesses. This underscores the need for a stigma-free environment at all levels of society to ensure all-inclusiveness which calls for a comprehensive strategy that targets policy changes, public education, and media representations of mental health-related problems. [ABSTRACT FROM AUTHOR]

Background and Objectives The increasing number of people with dementia requires transparency and quality dementia education, training, and care. This scoping review aimed to determine the key elements of national or state-wide standards on dementia education and training that could underpin the development of international standards for dementia workforce training and education. Research Design and Methods The English-language peer-reviewed and gray literature were searched (2010–20). Key search domains were training, workforce, standards/frameworks, and dementia. Results Thirteen standards were identified from the United Kingdom (n = 5), the United States (n = 4), Australia (n = 3), and Ireland (n = 1). Most standards focused on training health care professionals with some including people in customer-centric settings, people living with dementia, and informal carers or the general community. Seventeen training topics were identified in 10 or more of the 13 standards. Cultural safety, rural issues, health care professional self-care, digital literacy, and health promotion topics were less commonly reported. The barriers to standards implementation were lack of organizational support, lack of access to relevant training, low staff literacy, lack of funding, high staff turnover, ineffective past program cycles, and inconsistent service delivery. Enablers included a strong implementation plan, funding, strength of partnerships, and building on previous work. Discussion and Implications The U.K. Dementia Skills and Core Training Standard, the Irish Department of Health Dementia Together, and the National Health Services Scotland Standard are the recommended strongest standards for underpinning the development of international standards. It is essential that training standards are tailored to the needs of the consumer, worker, and regions. [ABSTRACT FROM AUTHOR]

Summary: Mantle cell lymphoma (MCL) is a B‐cell non‐Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T‐cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma‐related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10‐year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second‐line treatment. This limitation of sequential treatment by lymphoma‐related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high‐risk patient populations. [ABSTRACT FROM AUTHOR]

Background/Aim: This retrospective study investigated the effect of lockdowns for Covid‐19 on the rates of oro‐facial trauma hospitalisations in children in Australia and the United Kingdom (UK). Materials and Methods: Hospitalisation data for children up to 19 years old for oro‐facial trauma injuries (according to ICD‐10‐AM principal diagnosis codes) over 5 years were collected for Australian and UK children. The age‐standard rate (ASR) for each age group was calculated per 100,000 population. Results: In the younger Australian children, there was no statistically significant change in the ASR of oro‐facial trauma hospitalisations during the 'Covid year', compared to the average rate over the 3 years preceding. However, there was a significant decrease in the ASR of oro‐facial trauma hospitalisations during the 'Covid year' in older Australian children (aged 10–19), and for all UK children, except for infants under one‐year‐old. Conclusions: Reduction of the ASR of hospitalisations due to oro‐facial trauma during the 'Covid year', and the implementation of lockdown measures in the two countries provides further evidence of the impact of physical activities and travel as contributing factors to oro‐facial injuries in children. In addition to its role in reducing the spread of virus infections during the pandemic, the lockdown measures also resulted in a simultaneous decrease in trauma injuries. [ABSTRACT FROM AUTHOR]

An insight into fellowship pathways for surgical trainees in Australia and how they compare to the UK. [ABSTRACT FROM AUTHOR]

There is a workforce crisis in General Practice (GP) within the United Kingdom (UK). High-quality clinical placement experiences in GP influence medical students' interest and likelihood to enter this speciality. GP trainees often express a desire to teach, yet teaching does not feature significantly within their current practice. This study aims to explore outcomes, barriers, and facilitators of GP trainees teaching medical students through a rapid review of published literature. MEDLINE, EMBASE, PsychINFO, Web of Science were searched for articles relating to GP trainees teaching. Studies conducted in the UK and Australia, between January 2000 and October 2022 were included. The Medical Education Research Study Quality Index and the Critical Appraisal Skills Programme checklist were used to assess quality. Twenty-seven publications, 11 qualitative, six quantitative, three mixed-methods and seven opinion pieces, were identified. Many studies have methodological limitations. Empirical studies show that there are benefits of near-peer teaching, but these are limited by trainees' capacity and capability to teach, and GPs' confidence in trainees' teaching. The culture within the practice influenced whether trainees were seen solely as learners or also as teachers for students. When GP trainees teach there are positive outcomes for medical students and trainees. Teaching was considered an activity that trainees did in 'addition to' rather than 'part' of' their training. Appropriate teaching opportunities, and relevant training, were key to trainees' competence and confidence in teaching. Resources and recognition and a strong teaching culture are needed to support GP trainees to teach. [ABSTRACT FROM AUTHOR]

Paracetamol (acetaminophen) was marketed in the 1950s as a nonprescription analgesic/antipyretic without any preclinical toxicity studies. It became used increasingly for self‐poisoning, particularly in the UK and was belatedly found to cause acute liver damage, which could be fatal. Management of poisoned patients was difficult as maximum abnormalities of liver function were delayed for 3 days or more after an overdose. There was no treatment and the mechanism of hepatotoxicity was not known. The paracetamol half‐life was prolonged with liver damage occurring when it exceeded 4 h and the Rumack–Matthew nomogram was an important advance that allowed stratification of patients into separate zones of risk. It is used to guide prognosis and treatment and its predictive value could be increased by combining it with the paracetamol half‐life. The problems of a sheep farmer in Australia in the early 1970s led to the discovery of the mechanism of paracetamol hepatotoxicity, and the first effective treatment of overdosage with intravenous (IV) cysteamine. This had unpleasant side effects and administration was difficult. N‐acetylcysteine soon became the treatment of choice for paracetamol overdose and given early it was very effective when administered either IV or orally. N‐acetylcysteine could cause anaphylactoid reactions, particularly early during IV administration when the concentrations were highest. Simpler and shorter regimes with slower initial rates of infusion have now been introduced with a reduced incidence of these adverse effects. In addition, there has been a move to use larger doses of N‐acetylcysteine given over longer periods for patients who are more severely poisoned and those with risk factors. There has been much interest recently in the search for novel biomarkers such as microRNAs, procalcitonin and cyclophilin that promise to have greater specificity and sensitivity than transaminases. Paracetamol–protein adducts predict hepatotoxicity and are specific biomarkers of toxic paracetamol metabolite exposure. Another approach would be measurement of the plasma levels of cysteine and inorganic sulfate. It is 50 years since the first effective treatment for paracetamol poisoning and, apart from liver transplantation, there is still no effective treatment for patients who present late. [ABSTRACT FROM AUTHOR]

Background: Auditory verbal hallucinations (AVH), or voice-hearing, can be a prominent symptom during fluctuating mood states in bipolar disorder (BD). Aims: The current study aimed to: (i) compare AVH-related distress in BD relative to schizophrenia (SCZ), (ii) examine correlations between phenomenology and voice beliefs across each group, and (iii) explore how voice beliefs may uniquely contribute to distress in BD and SCZ. Method: Participants were recruited from two international sites in Australia (BD=31; SCZ=50) and the UK (BD=17). Basic demographic-clinical information was collected, and mood symptoms were assessed. To document AVH characteristics, a 4-factor model of the Psychotic Symptoms Rating Scale and the Beliefs about Voices Questionnaire-Revised were used. Statistical analyses consisted of group-wise comparisons, Pearson's correlations and multiple hierarchical regressions. Results: It was found that AVH-related distress was not significantly higher in BD than SCZ, but those with BD made significantly more internal attributions for their voices. In the BD group, AVH-related distress was significantly positively correlated with malevolence, omnipotence and resistance, However, only resistance, alongside mania and depressive symptoms, significantly contributed to AVH-related distress in BD. Discussion: Our findings have several clinical implications, including identification of voice resistance as a potential therapeutic target to prioritise in BD. Factoring in the influence of mood symptoms on AVH-related distress as well as adopting more acceptance-oriented therapies may also be of benefit. [ABSTRACT FROM AUTHOR]

As the survival rates for prostate cancer (PCa) have improved, there has been an increasing focus on the mental health of couples affected by this condition. There have been several couple‐based psychological interventions, and yet the impact of this treatment modality on the mental health of PCa patients and their spouses is unclear. Consequently, a systematic search was conducted in PubMed, Embase, Cochrane, LILACS, and Web of Science up to March 2023 for randomized controlled trials (RCTs) addressing the impacts of couple‐based psychological interventions on both PCa patients and their spouses. Besides, the Cochrane Risk of Bias Assessment Tool was employed to evaluate the methodological quality and potential bias of the included studies. Moreover, statistical analysis and meta‐analysis were performed utilizing Revman 5.4, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence. A total of nine RCTs were included, utilizing anxiety, depression, distress, communication, and self‐efficacy as outcome indicators to assess mental health. Results demonstrated that couple‐based psychological interventions increased spouses' self‐efficacy (WMD, 0.21; 95% CI: −0.00 ~ 0.42; P = 0.05) and communication (SMD, 0.34; 95% CI: 0.09 ~ 0.59; P = 0.009), while reducing their distress (SMD, −0.21; 95% CI: −0.40 ~ −0.02; P = 0.03). Nonetheless, there is a need for additional research on the effect of couple‐based psychological interventions on the mental health of PCa‐affected couples given the limited evidence supporting this conclusion. [ABSTRACT FROM AUTHOR]

Background: The purpose of this scoping review was to summarize the literature that reported on the experiences of people who use injection drugs' access to hepatitis C testing and diagnosis in Western countries. Methods: The initial search was conducted in 2020 and an updated review was completed in 2022. Seven electronic databases were searched using a peer‐reviewed search strategy and included: full‐text, peer‐reviewed studies with people who inject(ed) drugs, hepatitis C testing or diagnosis, conducted in Western countries. Excluded were studies published prior to 2014 and intervention studies. Two‐step screening was conducted in duplicate. Conventional content analysis was used. Results: Six studies were found from the search. The studies were published between 2014 and 2021 in Australia, United Kingdom, and United States. A total of 19 participant characteristics were extracted to contextualize their experiences, demonstrating a lack of demographic data. Four themes were found: Awareness and Knowledge, Stigma, Healthcare Service, and Psychological Responses. There were 58 occurrences of client quotes where participants described their experiences, 29 occurrences of quotes describing client‐identified barriers, and 14 occurrences of quotes describing client‐identified facilitators. Conclusion: A scoping review was conducted to present the experiences, barriers, and facilitators of people who use injection drugs to hepatitis C testing. The lack of demographic data and connection to client quotes further exacerbates the inequities among the population by overlooking their intragroup identities. Understanding their experiences of accessing hepatitis C testing and collecting demographic data will help advance health policies and interventions targeting people who use injection drugs. [ABSTRACT FROM AUTHOR]

Background: Given limited data regarding the involvement of disadvantaged groups in paediatric diabetes clinical trials, this study aimed to evaluate the socioeconomic representativeness of participants recruited into a multinational clinical trial in relation to regional and national type 1 diabetes reference populations. Methods: Retrospective, cross-sectional evaluation of a subset of adolescent type 1 diabetes cardiorenal intervention trial (AdDIT) participants from Australia (n = 144), Canada (n = 312) and the UK (n = 173). Validated national measures of deprivation were used: the Index of Relative Socioeconomic Disadvantage (IRSD) 2016 (Australia), the Material Resources (MR) dimension of the Canadian Marginalisation index 2016 (Canada) and the Index of Multiple Deprivation (IMD) 2015 (UK). Representativeness was assessed by comparing the AdDIT cohort's distribution of deprivation quintiles with that of the local paediatric type 1 diabetes population (regional), and the broader type 1 diabetes population for which the trial's intervention was targeted (national). Results: Recruited study cohorts from each country had higher proportions of participants with higher SES, and significant underrepresentation of lower SES, in relation to their national references. The socioeconomic make-up in Australia mirrored that of the regional population (p = 0.99). For Canada, the 2nd least deprived (p = 0.001) and the most deprived quintiles (p < 0.001) were over- and under-represented relative to the regional reference, while the UK featured higher regional and national SES bias with over-representation and under-representation from the least-deprived and most-deprived quintiles (p < 0.0001). Conclusions: Significant national differences in trial participation of low SES participants were observed, highlighting limitations in access to clinical research and the importance of reporting sociodemographic representation in diabetes clinical trials. Trial registration: NCT01581476. Registered on 20 April 2012. [ABSTRACT FROM AUTHOR]

Background: The value of a life is regularly monetised by government departments for informing resource allocation. Guidance documents indicate how economic evaluation should be conducted, often specifying precise values for different impacts. However, we find different values of life and health are used in analyses by departments within the same government despite commonality in desired outcomes. This creates potential inconsistencies in considering trade-offs within a broader public sector spending budget. We provide evidence to better inform the political process and to raise important issues in assessing the value of public expenditure across different sectors. Methods: Our document analysis identifies thresholds, explicitly or implicitly, as observed in government-related publications in the following public sectors: health, social care, transport, and environment. We include both demand-side and supply-side thresholds, understood as societies' and governments' willingness to pay for health gains. We look at key countries that introduced formal economic evaluation processes early on and have impacted other countries' policy development: Australia, Canada, Japan, New Zealand, the Netherlands, and the United Kingdom. We also present a framework to consider how governments allocate resources across different public services. Results: Our analysis supports that identifying and describing the Value of a Life from disparate public sector activities in a manner that facilitates comparison is theoretically meaningful. The optimal allocation of resources across sectors depends on the relative position of benefits across different attributes, weighted by the social value that society puts on them. The value of a Quality-Adjusted Life Year is generally used as a demand-side threshold by Departments of transport and environment. It exceeds those used in health, often by a large enough proportion to be a multiple thereof. Decisions made across departments are generally based on an unspecified rationing rule. Conclusions: Comparing government expenditure across different public sector departments, in terms of the value of each department outcome, is not only possible but also desirable. It is essential for an optimal resource allocation to identify the relevant social attributes and to quantify the value of these attributes for each department. [ABSTRACT FROM AUTHOR]

This study explored parental alienating behaviours experienced by grandparents with limited or no contact with their grandchildren. Twelve alienated grandparents participated in semi-structured interviews investigating their experience of alienation. The data were analysed using an inductive thematic analysis approach. Alienated grandparents reported being exposed to 13 parental alienating behaviours used by the alienating parent. These behaviours are consistent with those reported by targeted parents and adult alienated children in other studies. This study showed that parental alienating behaviours also affects grandparent-child relationships. Further research is needed to better understand the impact of parental alienation on grandparents and the wider family system. [ABSTRACT FROM AUTHOR]

Objective. The objective of this research is to appraise current practice in hospitals against the ‘Framework to achieve value in healthcare’ (the Framework) and to identify additional contributory factors that support or hinder its application. Methods. A multi-site case study was undertaken with five hospitals in Australia, the USA and UK using purposeful sampling to identify hospitals to participate. Data collection took place between September and November 2022. The hospitals included in the study had Process Improvement (PI) programs of more than 5 years duration, with strong executive engagement and broad outcomes measurement, including financial benefits. All hospitals were acute public hospitals or private, not for profit. Results. All hospitals indicated current practice according to Steps 1–5 for some part of their PI programs. All hospitals indicated that they were more likely to include financial benefits measurement for activities aimed specifically at improving cost rather than reducing non-value adding activities or improving the value of clinical care. Step 5 (reinvestment of cost savings) of the Framework is dependent on the accomplishment of Step 4 (measurement and realisation of financial benefits) and the contributory elements are important in supporting hospitals to utilise the Framework. Conclusions. The ‘Framework to achieve value in healthcare’ provides a practical guide for hospitals to reduce non-value adding activities, improve the value of clinical care and reduce costs. Further research is indicated to establish its reliability in hospitals in other countries and hospitals that do not have an established PI program. [ABSTRACT FROM AUTHOR]

Background: Domestic violence and abuse (DVA) is a major health problem that affects individuals across the world. Nurses, midwives and healthcare providers need to be confident and competent in identifying and responding to DVA. Aims: To measure current levels of knowledge, opinions and preparedness towards DVA and how it is managed by registered nurses and midwives residing in Australia and the UK. Methods: A cross‐sectional study design was used. Data were collected using the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) measuring the perceived preparation and knowledge, actual knowledge, opinions and practice issues. Australian data were collected in 2018 and UK data were collected in 2017–2018. Descriptive and inferential statistics were used to analyse the data and differences in knowledge and attitudes of British and Australian nurses. Findings: Nurses and midwives (n = 368; 130 from Australia; 238 from the UK) responded to the survey. Minimal previous DVA training was reported by the participants. Participants had minimal knowledge about DVA, though had a positive attitude towards engaging with women experiencing DVA. Discussion: Most participants felt unprepared to ask relevant questions about DVA and had inadequate knowledge about available resources. Australian participants scored better than British participants; however, the mean difference in all aspects remained statistically insignificant. Conclusion: Australian and British nurses and midwives have a positive attitude towards women experiencing DVA; however, the knowledge and skills to support women experiencing DVA are limited. Implications for nursing policy: Nursing institutions should develop strategic policies regarding mandatory preparation and training of nurses for domestic violence assessment and management. [ABSTRACT FROM AUTHOR]

The dramatic growth in health expenditures is an important health policy concern worldwide. Therefore, understanding the factors that increase health expenditures provides policy makers with evidence for decision-making. We aim to examine long-term effects of carbon dioxide emission, urbanization rate and GDP per capita on health expenditures. This study investigates the effect of carbon dioxide emission, urban population, and GDP per capita on health expenditure for 21 OECD countries over the period 1992–2018. Panel ARDL Approach and Gengenbach, Urbain and Westerlund Panel Co-integration Test have been used in the article. Test results indicate the long-run relationship among health expenditure and carbon dioxide emission, urban population, and GDP per capita. Effect of carbon dioxide emission (CO2), urban population, and GDP per capita is significant and positive on health expenditure. Rapid economic growths of OECD countries recently and environmental pollution have increased health expenditures in the long term. [ABSTRACT FROM AUTHOR]

The inadequacy of training and support for academic middle managers in the US, UK, and Australia is well documented. What remains unclear is what would make for better professional development. This study fills this gap by investigating what associate deans at US research universities report learning 'on the job'. Drawing on their perspectives and experiences, as documented via semi-structured interviews, this study found that associate deans spend significant time and effort learning how to make administrative decisions, learning how the university works for the purposes of making decisions, learning how to manage people relative to decision-making processes and outcomes, and learning how to manage themselves with regard to their decision-making role. It is argued that professional development for associate deans should focus on administrative decision-making as an essential skill in learning to lead. Recommendations for a curricular framework that can be adapted to individual-, role- and context-specific needs are offered. [ABSTRACT FROM AUTHOR]

Aims and methods: Loneliness is a prevalent and significant issue. It has been identified as a particularly important physical and mental health risk for older people. This article critically explores and discusses a recent study that sought to qualitatively explore the lived experiences of existential loneliness in a large sample of older people living in retirement community contexts. Findings: The data pointed to complex, multilayered challenges, often brought about by ageing, that give rise to unique experiences of existential loneliness for many older people. Conclusions: For clinical practitioners, understanding how older people experience existential loneliness is essential if we are to develop support mechanisms that compassionately and empathically respond to them. [ABSTRACT FROM AUTHOR]

The Australia-United Kingdom-United States (AUKUS) partnership arose because of Australia's need to replace its ageing submarine fleet, opting for nuclear-powered submarines to be built with American and British assistance. Perceptions of a deteriorating strategic situation vis-à-vis China were a major factor in this decision. Through AUKUS, the United Kingdom will also acquire additional submarines and expand its strategic role in the Indo/Asia-Pacific region. In addition to the submarine plan, AUKUS has a focus on the development of advanced defence technology. AUKUS has significant implications for Asian and Pacific Commonwealth countries, with their responses reflecting their strategic outlooks and perceived defence needs, [ABSTRACT FROM AUTHOR]

The impact of economic crises on philanthropic funding to, and fundraising by, nonprofit organisations is a surprisingly under-researched field. Internationally, data is scant and comparisons are impeded by different categorisations and definitions of funders and sectors, different timeframes and the dominance of the US in the body of published research. A search and review of the literature identified 60 journal articles and professional reports that we analysed by theme. This paper brings together, reviews and analyses what is known from four national contexts - the US, the UK, Australia and Aotearoa New Zealand. Analysis covers the impact of multiple recessions, with a particular focus on the Global Financial Crisis (GFC) of 2008-09. Key findings include that losses of funding are not as uniform nor as sustained as media coverage would suggest and that different sectors are impacted in different ways. Philanthropic sources including individuals, trusts and foundations, and corporate philanthropy vary in the timing of their responses to economic crises, and though the impact of economic crises on nonprofit sectors is variable, giving as a whole is better sustained than popularly supposed. [ABSTRACT FROM AUTHOR]

Objectives Glucocorticoids (GCs) ('steroids') are used to treat rheumatic diseases but adverse effects are common. We aimed to explore the impact of GC therapy on health-related quality of life (HRQoL), to inform the development of a treatment-specific patient-reported outcome measure (PROM) for use in clinical trials and practice. Methods Semi-structured qualitative interviews were conducted with patients from the UK, USA and Australia, treated for a rheumatic condition with GCs in the last 2 years. Purposive sampling was used to select participants with a range of demographic and disease features. An initial conceptual framework informed interview prompts and cues. Interviews elicited GC-related physical and psychological symptoms and salient aspects of HRQoL in relation to GC therapy. Interview data were analysed inductively to develop initial individual themes and domains. Candidate questionnaire items were developed and refined. Results Sixty semi-structured qualitative interviews were conducted (UK n  = 34, USA n  = 10, Australia n  = 16). The mean age was 58 years; 39/60 were female; and 18 rheumatic diseases were represented. Some 126 individual themes were identified and organized into six domains: physical symptoms; psychological symptoms; psychological impact of steroids; impact of steroids on participation; impact of steroids on relationships; and benefits of steroids. Candidate questionnaire items were tested and refined by piloting with patient research partners, iterative rounds of cognitive interviews and linguistic translatability assessment, informing a draft questionnaire. Conclusion We describe an international qualitative study to develop candidate items for a treatment-specific PROM for patients with rheumatic diseases. A future survey will enable the validation of a final version of the PROM. [ABSTRACT FROM AUTHOR]

The objectives of the study were: 1) Describe the thematic structure and evolution of the field of physical therapy; 2) identify the main research producers (i.e. countries and institutions); and 3) compare their research output and citation impact. Papers related to physical therapy indexed in Web of Science (2000–2018) were identified to delineate the field, using keywords, journals, and citation networks. VOSviewer software, advanced bibliometric text mining, and visualization techniques were used to evaluate the thematic structure. We collected data about the country and institutional affiliation of all the authors and calculated production and citation impact indicators. 85,697 papers were analyzed. Eleven thematic clusters were identified: 1) "health care and education"; 2) "biomechanics"; 3) "psychosocial, chronic pain and quality of life outcomes"; 4) "evidence-based physical therapy research methods"; 5) "traumatology and orthopedics"; 6) "neurological rehabilitation"; 7) "psychometrics and cross-cultural adaptation"; 8) "gait-balance analysis and Parkinson's disease"; 9) "exercise"; 10) "respiratory physical therapy"; and 11) "back pain." The United States, the United Kingdom, and Australia were the most productive countries. Netherlands, Norway, and Sweden had the highest citation impact. Our bibliometric visualization approach makes it possible to comprehensively study the thematic structure of physical therapy. The ranking of producers has evolved and now includes China and Brazil. High research production does not imply a high citation impact. [ABSTRACT FROM AUTHOR]

Continuing professional development (CPD) is a substantial, but hitherto largely unappreciated component of lifelong learning and education (LLL/LLE). CPD encourages analysis of the LLL/LLE of those with high education in early years. It draws attention to the influence of particular organisations, professional associations and regulatory bodies, not only as suppliers of LLL/LLE, but also as facilitators of perpetual cycles of learning and in so doing connect lifelong learning with individual identities as professionals. This study highlights the importance of bringing a sociological perspective into understanding participation in LLL/LLE through consideration of a wider range of stakeholders. Data is presented on these organisations' CPD policies from a large-scale survey carried out in the UK triennially between 2003 and 2018, in addition to interviews, focus groups and other surveys of employees of these organisations in the UK, as well as in Australia, Canada and Ireland reported in many publications. The development path of CPD and the changes this has led to for the exercise of professionals' lifelong learning and for the functioning of these organisations themselves is analysed. CPD policies and programmes are portrayed as a structured system distinct from university continuing education and training. [ABSTRACT FROM AUTHOR]