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Low back pain (LBP) clinical practice guidelines recommend referral for patients with persistent LBP however discordance persists between recommended care and implementation in practice. Understanding patient experiences of referral practices and physiotherapy care could be important for optimizing LBP management in primary care settings. This study explored referral experiences of people with nonspecific LBP in Australian primary care and their knowledge and experience of physiotherapy. An interpretive descriptive qualitative framework was used with 17 participants interviewed from community-based physiotherapy practices. Four themes described the participants' experiences of referrals in primary care settings: 1) Referral practices ranged from formal to informal to non-existent; 2) Fragmented inter-and intra-professional LBP care management; 3) Patient perceived differences in the roles of physiotherapists and specialist physiotherapists; and 4) Patient nominated barriers and facilitators to optimal referral practices. Physiotherapists support people with LBP to improve strength and function, whereas the specialist physiotherapist's role was seen as more holistic. Referral pathways that align to clinical guideline recommendations for non-surgical management and treatment remain underdeveloped. Improved referral pathways to clinicians such as physiotherapists with additional credentialed skills and competence in musculoskeletal care could improve people's experiences of care and health outcomes. [ABSTRACT FROM AUTHOR]

Lower limb robotic exoskeletons can assist movement, however, clinical uptake in neurorehabilitation is limited. The views and experiences of clinicians are pivotal to the successful clinical implementation of emerging technologies. This study investigates therapist perspectives of the clinical use and future role of this technology in neurorehabilitation. Australian and New Zealand-based therapists with lower limb exoskeleton experience were recruited to complete an online survey and semi-structured interview. Survey data were transposed into tables and interviews transcribed verbatim. Qualitative data collection and analysis were guided by qualitative content analysis and interview data were thematically analysed. Five participants revealed that the use of exoskeletons to deliver therapy involves the interplay of human elements – experiences and perspectives of use, and mechanical elements – the device itself. Two overarching themes emerged: the "journey", with subthemes of clinical reasoning and user experience; and the "vehicle" with design features and cost as subthemes, to explore the question "Are we there yet?" Therapists expressed positive and negative perspectives from their experiences with exoskeletons, giving suggestions for design features, marketing input, and cost to enhance future use. Therapists are optimistic that this journey will see lower limb exoskeletons integral to rehabilitation service delivery. Further innovation of design features, marketing, and cost are needed to enhance ongoing development and integration. Routine clinical implementation of lower limb exoskeletons is unlikely at this time in Australia and New Zealand. Therapists do expect lower limb exoskeletons to have an ongoing role in future rehabilitation. [ABSTRACT FROM AUTHOR]

There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017–18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n = 63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n = 70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n = 69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained. [ABSTRACT FROM AUTHOR]

Previous research has highlighted that youth gender dysphoria (GD) and gender diversity (GDI) are experienced in unique ways by different family members, with youth outcomes significantly influenced by family support and understanding. Few studies on a national level have explored individual family member experiences, specifically family, social and healthcare experiences, involving young people, parent/carers and siblings. Using an online survey incorporating circular questioning, this study sought to discover individual family member experiences of youth GD/GDI in Australia, within a family, healthcare, and social context. Young people experiencing GD/GDI, parents/carers and siblings were recruited through Facebook advertising and completed an online survey, exploring positive and negative experiences of youth GD/GDI, within and outside of the family. Survey questions predominantly used Likert scales, with free-text fields, enabling both quantitative and qualitative data analysis. Six hundred and sixty young people aged 12-17 years experiencing GD/GDI, 158 parents/carers ranging in age from under 30 years to more than 60 years (most common age band was 40-49 years; 62%), and 40 siblings aged 12-17 years completed at least part of the online survey. Participants reported mixed experiences of youth GD/GDI with varying levels of understanding and support provided by family members and others. Parents and siblings generally felt it important for healthcare professionals to ask everyone's experience in the family, although only one-third of young people felt this was important. Most parents and young people also highlighted the importance of sibling support. The majority of young people felt misunderstood by other family members. Most family members, particularly young people, reported different viewpoints within families and primarily negative experiences. The research findings support sibling inclusion in healthcare appointments in certain circumstances, depending on context, and a whole of family approach overall, if agreeable to the family and unlikely to cause harm. [ABSTRACT FROM AUTHOR]

Social workers play a pivotal role in addressing equity and diversity within Australia using both culturally responsiveness skills and knowledge. This article describes a research project that resulted in the development of the Continuous Improvement Cultural Responsive Tools that can be used by social workers in their practice. This was a large project conducted over three years, which involved engagement and consultation with Aboriginal and Torres Strait Islander community social workers. The community engagement and consultation process included the provision of cultural governance and participation in interviews. The tools developed are linked to seven key domains (Ngurras) that aim to increase the skills, knowledge, and overall confidence of social work practitioners in their culturally responsive practice. This article discusses the tools that provide a clear structure to guide social workers' critical engagement in becoming more culturally responsive social workers and individuals when working with Aboriginal and Torres Strait Islander Peoples. IMPLICATIONS Social work practices need to address the social injustices faced by Aboriginal Peoples by becoming more culturall responsive. The tools were developed to support social workers in their practice to self-assess their transformation in becoming culturally responsive social workers. Continuous improvement in collaborative and culturally responsive social work will improve services for Aboriginal and Torres Strait Islander Peoples. [ABSTRACT FROM AUTHOR]

Self-management can lead to increased self-efficacy and improved quality of life for individuals with chronic conditions; however, there is little research exploring how self-management approaches can be used for chronic communication disorders, such as aphasia. Modifications to self-management approaches would be required to accommodate for aphasia; therefore, the input of people with aphasia (PwA) should be sought. The aims of the present study were: (1) To investigate and document the experiences and perspectives of PwA regarding self-management; (2) To explore how technology can be used to support aphasia self-management. In-depth, semi-structured interviews were conducted with 26 PwA living in Australia. Qualitative content analysis was used to analyse interview data. Analysis resulted in six themes: (1) In self-management, PwA take control of life with aphasia and assume responsibility for engaging in opportunities to improve overall communication; (2) Community aphasia groups are important enablers of self-management because they facilitate peer support; (3) Communication partners (CPs) provide multifaceted support in aphasia self-management; (4) SLPs provide integrated support and coordination in aphasia self-management; (5) Technology supports PwA to self-manage speech therapy and communication in daily life; (6) Psychological and physical health issues and societal factors may impact aphasia self-management abilities. From the perspective of PwA, aphasia self-management involves enhancing skills enabling communication and life participation. PwA are central to aphasia self-management, with support provided by CPs, peers, and SLPs. Technology has a range of applications in aphasia self-management. PwA identified potential personal and contextual barriers that may impact self-management. For people with aphasia, engaging in conversation and social interaction are primary means of managing/improving communicative life participation; therefore, this should be a key focus of aphasia self-management programs. Aphasia self-management approaches should maximise the use of available support and provide tailored information, education, and training in the area of self-management to key stakeholders (people with aphasia, communication partners, and speech-language pathologists). People with aphasia should be supported to use technology for aphasia self-management, encompassing communication specific and daily life use. People with aphasia should be heavily involved in the development of structured aphasia self-management approaches. [ABSTRACT FROM AUTHOR]

End-of-life care involves treatment and support offered to terminally ill individuals and their caregivers. Effective communication and decision-making, illness and symptom management, relationship with doctors, characteristics of the health care team, and the involvement and needs of caregivers have all been proposed to contribute to the quality of the end-of-life experience. This study sought to establish bereaved caregivers' experiences of the quality of the elements of end-of-life care delivered to their loved ones. Bereaved caregivers who had lost a loved one who was cared for in an acute care University-affiliated hospital, with 670 beds, located in the Australian Capital Territory during the previous 6−12 months (N=91), were surveyed using a modified version of the Canadian Health Care Evaluation Project questionnaire. The findings indicated that the bereaved caregivers were generally very satisfied with their loved one's end-of-life care. The age of the caregiver, the preferred location of death for both patient and caregiver, if death was expected, and religious affiliation were associated with satisfaction of the end-of-life care delivered. Key areas for improvement of end-of-life care included factors related to the relationships between doctors and those receiving care, characteristics of the health care team, illness management, communication and decision-making, and the involvement of caregivers. These findings have significant implications for this hospital and those seeking to improve outcomes in end-of-life care settings more widely, by providing baseline data on caregiver-evaluated care quality and identifying high-priority areas for targeted intervention. [ABSTRACT FROM AUTHOR]

Purpose: Transoral robotic surgery (TORS) is most commonly undertaken as a minimally invasive approach for early staged oropharyngeal cancers (OPC), with good expectations for a functional recovery. A small number of patients, however, require TORS for recurrent or advanced OPC tumours. Their prospects for longer term recovery of communication and swallowing are both unreported and hypothesised to be poorer than the majority of TORS cases. This case-series describes the recovery of swallowing and communication function post-TORS for this unique group of patients. Method: Consecutive recruitment was carried out prospectively at a quaternity oncology referral centre. Participants were aged 18 years and older, with reconstruction involving a free-flap and tracheostomy. Patients were assessed using Fibreoptic Endoscopic Evaluation of Swallowing, and clinician and patient-reported outcomes 12-months post-TORS. Their pre-operative baseline and three-month post-TORS FOIS scores were collated retrospectively. Result: Six participants were recruited over an 18-month period of which three patients underwent TORS for recurrent, and three for advanced OPC. Those with recurrent-OPC did not return to their baseline diet and demonstrated post-swallow silent aspiration of pharyngeal residue. Three of the six were rehabilitated back to their baseline intelligibility (100%). Conclusion: TORS in the recurrent OPC setting appears congruent with high rates of silent aspiration and prolonged reliance on a feeding tube due to oropharyngeal dysphagia, as well as compromised intelligibility. This is the first study that evaluates this instrumentally and provides clinically relevant evidence to inform practice. [ABSTRACT FROM AUTHOR]

This paper reports on findings of the Sex Ed Dads survey which sought Australian fathers' perspectives on communicating with their young children about relationships and sexuality, as informal sexuality educators. Given the majority of existing family-based sexuality education research draws on the experiences of mothers, gaining insights from fathers is a much needed first step in designing resources to support paternal engagement in sexuality education. A diverse sample of 612 Australian fathers completed an online survey about their views on sexuality education and their role within it. Participating fathers valued sexuality education for their children and believed that their own informal contribution to its provision was important. Fathers reported high levels of comfort discussing a wide range of topics with their child at the age they deemed appropriate, although a gap between what fathers believed they should discuss and what they actually discussed was found. Findings offer insights for schools, resource developers and sexuality education providers seeking to support increased engagement of fathers in the sexuality education domain. [ABSTRACT FROM AUTHOR]

The introduction of a National Disability Insurance Scheme (NDIS) in Australia has changed the basis of service provision for people with disability. This mixed-methods study presents the experiences of parents of children with hearing loss during national rollout of the NDIS. Surveys were completed by 100 parents, with 57 parents reporting their child received NDIS funding. Individual interviews of seven parents in different locations provided further information. Between-group comparisons were made and regression analysis examined the influence of parental disadvantage on NDIS experiences. Qualitative data were analysed for themes and findings were triangulated. The NDIS has improved services for some children with hearing loss but initial access and ongoing navigation can be challenging for others. Barriers included a complicated system, planning delays, poor communication and uninformed National Disability Insurance Agency (NDIA) staff. This study suggests areas of refinement and further investigation that may improve services for children with hearing loss. Parents of children with hearing loss in Australia had difficulty accessing the National Disability Insurance Scheme (NDIS) due to poor communication and delays. Parents reported the NDIS system was challenging and felt they needed high levels of education and advocacy skills to navigate the system and prepare information to justify necessary disability supports for their child. Parents were concerned that disadvantaged families would not receive adequate supports for their child with hearing loss due to the complexity of the NDIS. This small-scale national study indicates that recent and upcoming changes to the NDIS should be evaluated to ensure children with hearing loss can access equivalent funding packages and services regardless of family circumstances. [ABSTRACT FROM AUTHOR]

This study aimed to investigate if a single, early learning experience in an aged care setting could influence speech-language pathology students': (1) attitudes towards older people; (2) confidence in communicating with older people; and (3) career aspirations in aged care. Ninety first-year undergraduate speech-language pathology students participated in a single visit to an aged care community centre. Students participated in recreational activities alongside older people and engaged in conversation. Before and after the visit, students completed surveys which examined their attitudes towards older people (UCLA Geriatrics Attitudes Scale) and self-perceived communication confidence. A Learning Reactionnaire, examining satisfaction with the experience and career aspirations, was completed post-visit. Quantitative data were analysed using descriptive statistics and non-parametric tests. Qualitative data were analysed using inductive content analysis. Students demonstrated positive changes in their attitudes towards older people and increased communication confidence. Students reported increased interest in future employment in aged care. High satisfaction towards the learning experience was reported. These preliminary findings indicate that a single, early learning experience in an aged care setting can positively shape the attitudes and self-perceived communication skills of first-year speech-language pathology students and help foster interest in pursuing a career in aged care. [ABSTRACT FROM AUTHOR]

To evaluate and compare the effectiveness and quality of standard face-to-face and teleaudiology hearing aid fitting follow-up consultations and blended services for adult hearing aid users. Fifty-six participants were randomly allocated to two equal groups, with equal numbers of new and experienced users. One standard and one teleaudiology follow-up consultation were delivered by an audiologist, the latter assisted by a facilitator. The order was reversed for the second group. Outcome measurement tools were applied to assess aspects of participants' communication, fitting (physical, sensorial), quality of life, and service. Cross-sectional and longitudinal outcomes were analysed. Most participants presented with moderate, sloping, and symmetrical sensorineural hearing loss. The duration of teleaudiology (42.96 ± 2.73 min) was equivalent to face-to-face consultations (41.25 ± 2.61 min). All modes of service delivery significantly improved outcomes for communication, fitting, and quality of life (p > 0.05). Satisfaction for both consultation modes was high, although significantly greater with standard consultations. The mode and order of delivery of the consultations did not influence the outcomes. Teleaudiology hearing aid follow-up consultations can deliver significant improvements, and do not differ from standard consultations. Blended services also deliver significant improvements. Satisfaction can be negatively impacted by technical or human-related issues. [ABSTRACT FROM AUTHOR]

To investigate people with Parkinson's disease (PwPD): 1) self-reported communication and swallowing difficulties due to Parkinson's disease (PD), 2) participation and psychosocial impacts of these difficulties and 3) experience with and access to speech-language pathology (SLP) services. A cross-sectional mix-methods survey was conducted using nonprobability, purposive sampling for recruitment. An inclusion criterion was that participants needed to have self-reported communication and/or swallowing changes due to PD. Descriptive statistics and thematic analysis were utilised. All of the 78 PwPD who participated reported changes to their communication (97%) and/or swallowing (93%). A diverse range of participation restrictions was found in social, recreational, vocational and everyday living activities. Adverse emotional impacts including frustration, loss of self-confidence, depression and isolation were reported due to these changes. Only 59% of our sample had accessed SLP services. The most common reason for PwPD not accessing services was that neither their general practitioner nor neurologist had referred them to SLP. The majority of PwPD wanted to access SLP at some point in the future. Wide variability in the SLP services provided was evident. Most of the PwPD who had received SLP support wanted further ongoing management. This study provided insight into the everyday impacts of communication and swallowing changes experienced by PwPD, and the gap between service supply and demand. [ABSTRACT FROM AUTHOR]

Many Aboriginal and Torres Strait Islander children are affected by chronic middle ear infection or otitis media from infancy that has a negative impact on development of listening and communication skills. Deficits in these skills are often not detected until school-age when the opportunity for early intervention is lost. Primary health and early childhood workers need screening tools to assist them with detecting the problem early, but there is a scarcity of tools. This study reports the development and validation of a screening tool for detecting communication problems in young Aboriginal and Torres Strait Islander children. The tool, called the Hearing and Talking Scale (HATS), relies on a systematic use of parent observations of communication behaviours of their children in everyday situations. Developed by using a co-design approach, the HATS is culturally and linguistically appropriate for use with parents/carers of young children by front-line workers not trained in speech-language pathology. We validated the HATS by comparing the HATS score of 68 children (46 Indigenous and 22 non-Indigenous children) with their performance in standardised assessments. The accuracy of the HATS was 80% and 81% when compared to the ASQ-TRAK and the Expressive Vocabulary Test respectively. The HATS takes 5 minutes to administer, and is easy to score and interpret. It can be used as part of a standard ear and hearing health check for young children to support early detection so that those with problems can be referred for specialist diagnosis and treatment at a young age. [ABSTRACT FROM AUTHOR]

Background: The ongoing escalation in the incidence of diabetes is contributing to a growing burden on health services because patients with diabetes as a co-morbidity are now spread throughout the hospital (rather than being located in specific areas). Thus, there is a need for expertise in diabetes care throughout services to ensure optimal care and reduce threats to patient safety. Aims and objectives: To identify new strategies to maintain optimal care for patients with diabetes while in hospital. Design: Mixed methods underpinned by Appreciative Inquiry. Methods: The Diabetes Knowledge Questionnaire Survey (DKQS) (n = 173); focus group interviews with nurses and midwives (n = 40), and individual interviews with recently discharged hospital patients (n = 6). Quantitative data were analysed using descriptive statistics and qualitative data by thematic analysis. Results: Highlight a need to enhance knowledge and confidence of diabetes management among nursing, midwifery, medical and ancillary staff through the introduction of focused education strategies. This, together with improved communication and team work, is required to relieve the burdens on frontline nursing staff and patients caused by delays in prescribing and reviewing insulin requirements and in accessing needed food for people with diabetes. Conclusions: In seeking solutions to the challenges in caring for hospitalised patients with diabetes there is a need to work across the entire hospital workforce and to develop effective and efficient methods for ensuring appropriate skills and knowledge of diabetes management for staff across complex and rapidly changing hospital systems. Relevance to clinical practice: The introduction and implementation of innovative educational and organisational strategies are needed to assist in meeting the challenges posed by an escalating diabetes healthcare burden. The safety of patients with diabetes can be optimised with the timely availability of appropriate meals and snacks, and enhanced coordination and communication between and within multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Purpose: Aboriginal Australians are under-represented in stroke rehabilitation services and rehabilitation practices that are sensitive to the needs of Aboriginal people are not currently available. This project tested the feasibility and acceptability of a rehabilitation model and approach to therapy with Aboriginal people with acquired communication disorders post-stroke. Method: Eight Aboriginal people with acquired communication disorders post-stroke were recruited to this study. Sixteen treatment sessions were provided twice weekly at the person's place of residence by a speech-language pathologist and Aboriginal co-worker. Feasibility was measured by analysing the number of sessions conducted jointly by the speech-language pathologist and Aboriginal co-worker and participant attendance. Participant acceptability was measured through the analysis of a post-therapy questionnaire. The Aboriginal co-worker's and speech-language pathologists' perceptions of the acceptability were collected through semi structured interviews. Result: Across all sessions 84.2% were attended by the Aboriginal co-worker and speech-language pathologist and seven of the eight participants completed all prescribed sessions. Positive feedback was provided by participants, the Aboriginal co-worker and speech-language pathologist on the key components of the programme. Conclusion: The rehabilitation model used within Wangi appears to be feasible and acceptable to participants and therapists. It provides direction to improve the quality of care for Aboriginal stroke survivors. [ABSTRACT FROM AUTHOR]

Background: Communication skills such as listening, empathy and body language are core competencies that entry level occupational therapy students must demonstrate when completing practice placements. Objective: To investigate if interpersonal skills taught to undergraduate occupational therapy students predict their practice performance. Methods: Second, third and fourth year occupational therapy students (n = 132) completed the Active-Empathetic Listening Scale (AELS); the Listening Styles Profile-Revised (LSP-R); and the Interpersonal Communication Competence Scale (ICCS). The Student Practice Evaluation Form–Revised (SPEF-R) measured students' performance at the completion of a placement. Regression analysis examined the relationships between students' interpersonal and listening skills and their fieldwork performance. Results: Higher ICCS Interaction Management subscale scores were significantly associated with better SPEF-R Communication Skills at final evaluation (β = 1.46, p < 0.05). Higher AELS Sensing subscale scores were predictive of greater Self-Management Skill performance on the SPEF-R (β = 0.84, SE = 0.42). Student's demographic characteristics were also predictive of their SPEF-R scores. The ICCS and LSP-R's subscale scores were not predictive of SPEF-R scores. Conclusion: This preliminary evidence identified several interpersonal skills that were predictive of some key SPEF-R competencies. To better prepare students to successfully complete practice placements, these interpersonal skills should be incorporated into occupational therapy education curriculum. [ABSTRACT FROM AUTHOR]

Much of the discourse regarding social care practice focuses on the differences between the various professions, practice fields, geographical, and organizational contexts involved in the provision of social care. This study surveyed Australian social care practitioners' (N = 438) perceptions of influence on their practice and what similarities and differences existed in these perceptions. Eighteen influential factors were identified with minimal differences across the participants' profession, practice field, organizational sector, or geographical context. These findings suggest that a common ground of experience exists that can be used as a basis for critical discussions and interdisciplinary practice and, thereby, provide a foundation for more consistent and integrated service delivery and outcomes. [ABSTRACT FROM AUTHOR]

Background: Communication is a central part of providing family centred care in neonatal nurseries and is associated with a range of positive outcomes for families. However, previous research has indicated that communication is more problematic between health professionals and minority groups of patients and families, although much of this research is atheoretical. The current study used communication accommodation theory to examine nurses’ perceptions of effective and ineffective interactions with typical parents, culturally and linguistically diverse parents (CALD), and adolescent parents in neonatal nurseries. Method: We conducted semi-structured interviews with nurses from two tertiary hospitals in Australia. Twelve nurses from one hospital were asked about interactions with typical parents, and twenty-nine nurses from the other hospital were asked about interactions with CALD and adolescent parents. Interviews were coded for communication strategy and accommodative stance, using a coding system based on communication accommodation theory. Results: Descriptions of interactions with typical parents (who were perceived as Anglo-Australian) differed from those with CALD and adolescent parents. Interactions with CALD parents focused mostly on comprehension and cultural differences, with limited mention of other strategies. Interactions with adolescent parents were regarded as particularly problematic, and involved greater focus on face management than for other groups of parents. Generally, interactions with minority groups were based on a narrower range of strategies, and were more intergroup than interpersonal in focus. Conclusions: Our findings show the importance of studying health professionals’ perceptions of interactions with people from different minority groups. We discuss the implications for our understanding of communicating with diverse patients and families, and educating health professionals, including the utility of communication accommodation theory as a guiding framework for training. [ABSTRACT FROM AUTHOR]

The communication journey of a child with hearing loss is often a complex, interwoven process in which the child's use of language or method of communication may change numerous times. As there has been limited research exploring the caregiver decision-making process behind making such changes, this qualitative descriptive study aimed to explore the factors which influence the caregiver decision making-process to change the communication method of their child with hearing loss. Individual semi-structured in-depth interviews were conducted with seven caregivers of children with hearing loss in Australia. Thematic analysis revealed five key themes which influenced caregiver decisions regarding changes to their child's method of communication, including: (1) family characteristics; (2) family access to information; (3) family strengths; (4) family beliefs; and (5) family-centered practice. The overall finding that the family unit is at the core of decision-making has important clinical implications regarding early intervention professionals’ provision of family-centered services when working with the families of children with hearing loss. [ABSTRACT FROM AUTHOR]

We investigated whether parents who reported more positive parenting practices (i.e., monitoring, involvement, and communication) reported more discussion of child sexual abuse (CSA) with their children. Parents from Australia and the UK (N = 248), with children aged 6 to 11 years, completed an online survey. About half of parents reported directly discussing CSA, whereas 35% reported telling their children that CSA perpetrators may be family members. Rates of discussion were higher for other CSA-related topics such as body integrity and abduction. Correlational analyses showed that parents who reported speaking to their children about CSA also reported more positive parenting practices, more discussion of other sensitive topics, and assessed CSA risk for children (in general) to be higher. Discussion of CSA risk was not associated with parents' CSA knowledge, confidence or appraisal of own-child risk. Parents higher in positive parenting believed their children to be at less CSA risk. Parents who appraised higher own-child risk reported less positive parenting practices and were less confident about their parenting and their ability to protect their children from CSA. The findings are the first to report on the associations of parenting practices with parents' CSA discussion with their children. [ABSTRACT FROM AUTHOR]

Experiential knowledge of elite National Rugby League (NRL) referees was investigated to determine the key attributes contributing to expert officiating performance. Fourteen current first-grade NRL referees were asked to identify the key attributes they believed contributed to their expert refereeing performance. The modified Delphi method involved a 3-round process of an initial semi-structured interview followed by 2 questionnaires to reach consensus of opinion. The data revealed 25 attributes that were rated as most important that underpin expert NRL refereeing performance. Results illustrate the significance of the cognitive category, with the top 6 ranked attributes all cognitive skills. Of these, the referees ranked decision-making accuracy as the most important attribute, followed by reading the game, communication, game understanding, game management and knowledge of the rules. Player rapport, positioning and teamwork were the top ranked game skill attributes underpinning performance excellence. Expert referees also highlighted a number of psychological attributes (e.g., concentration, composure and mental toughness) that were significant to performance. There were only 2 physiological attributes (fitness, aerobic endurance) that were identified as significant to elite officiating performance. In summary, expert consensus was attained which successfully provided a hierarchy of the most significant attributes of expert NRL refereeing performance. [ABSTRACT FROM PUBLISHER]

This study investigated how the type and duration of early intervention (EI) experience impacts hearing parents’ views of the importance of different types of facilitative communication strategies when interacting with their children who are deaf or hard of hearing (D/HH). Sixteen mothers were involved in the study. Respondents were allocated to two groups: one group consisted of eight mothers of D/HH children who had been diagnosed within the last 18 months (Group N – new) and a second group which consisted of eight experienced mothers of D/HH children who had been diagnosed for longer than 24 months (Group E – experienced). Questionnaires were used to gather data relating to the value that the mothers placed on individual communication strategies. To complement these data, 3-minute mother–child play interactions were videotaped and analysed to investigate how individual mothers utilized the strategies with their children. Analysis revealed only minor differences related to time spent in EI and type of programme both in relation to parents’ views of the value of certain strategies and their interactions with their child. The implications of the findings are discussed. [ABSTRACT FROM PUBLISHER]

Midwives and doctors require effective information-sharing strategies to provide safe and evidence-based care for women and infants, but this can be difficult to achieve. This article describes maternity care professionals’ perceptions of communication in their current workplace in Australia. We invoke social identity theory (SIT) to explore how these perceptions affect interprofessional practice. A survey was conducted with 337 participants (281 midwives and 56 doctors). Using exploratory factor analysis we developed three scales that measured interprofessional workplace practice collaboration. Results indicated an intergroup environment in maternity care in which the professionals found exchange of ideas difficult, and where differences with respect to decision making and professional skills were apparent. Although scores on some measures of collaboration were high, the two professions differed on their ratings of the importance of team behaviors, information sharing, and interprofessional socialization as indicators of collaborative practice. These results highlight the complexities among maternity care providers with different professional identities, and demonstrate the impact of professional identity on interprofessional communication. [ABSTRACT FROM PUBLISHER]

The National Disability Insurance Scheme (NDIS) is one of the most significant initiatives in Australian social policy history. Its complexity has been compounded by a fast-paced introduction and ongoing refinement throughout the initial trial phase. Parents and carers of very young disabled children face particular challenges accessing and navigating NDIS systems. This article presents findings from a mixed-method pilot study examining the perspectives of parents and carers of disabled children in one NDIS trial site – the Hunter Region of New South Wales. The research highlights a number of policy assumptions potentially impacting on NDIS take up for young disabled children and their families in regional contexts. Based on research findings a number of policy suggestions and improvements for disabled children and their families entering the NDIS and other individualised funding schemes are outlined. [ABSTRACT FROM PUBLISHER]

The Home Medicines Review (HMR) involves a home visit from an accredited HMR pharmacist to review a patient’s medicines, and a report to the patient’s general practitioner (GP) with recommendations for improving medicine management. Notwithstanding evidence supporting the benefits of medicines review, broad uptake by GPs in Australia remains low. We developed the 10-item Home Medicines Review Inventory (HMRI) to assess GP attitudes and behaviours regarding the HMR and modelled factors associated with the frequency of GP engagement with HMRs. Four items assessing frequency of behaviours and six items assessing attitudes related to HMR were answered by 180 GPs in a national GP survey. The HMRI’s psychometric properties were examined with exploratory factor analysis (EFA), Rasch analysis, and correlations with related instruments. Structural equation modelling was used to evaluate factors associated with HMR-related behaviours. EFA and Rasch analysis generally supported the current format of the instrument. Attitudes to HMR, gender, previous positive experiences with pharmacists, a system for working together, and participation in joint education activities predicted frequency of HMR-related behaviours. Although GPs’ attitudes to HMR were generally positive, HMR-related behaviours tended to occur with low frequency. This instrument may be used to investigate why HMR uptake has thus far been low and also help identify opportunities for building interprofessional communication and trust between GPs and pharmacists. [ABSTRACT FROM PUBLISHER]

Aims:Workforce entry is a key transition period. It offers an ideal, but under-utilised opportunity to implement intervention strategies to prevent mental health and substance use problems among young people. A brief psychological wellbeing and substance use intervention targeting a high-risk group – apprentice chefs – was undertaken to explore this opportunity.Method:A RCT design (N = 71) was used. The intervention group received two face-to-face sessions, and controls received five related information sheets during the first 2 weeks of training, with 4-month follow-up.Results:These apprentices were a high-risk group for alcohol and other drug harm and poor psychological wellbeing. At T1, 70% of the participants had AUDIT scores indicating problem drinking; 28% had used cannabis and 18% had used amphetamines in the last 12 months; and 24% had high K10 scores. At T2, the intervention group had significantly reduced risky alcohol use (p = 0.008), improved psychological distress (p = 0.045) and ability to talk with supervisors about work issues (p = 0.001) and cope with work stress (p = 0.001) and verbal abuse (p = 0.005), compared to the control group.Conclusions:Brief tailored interventions, delivered in an occupational training environment, have potential to reduce substance use risk and enhance young workers’ psychological wellbeing. [ABSTRACT FROM PUBLISHER]

Parents play an essential role in the development of children's sexuality, yet often feel uncomfortable and anxious about how best to communicate with their children about sexual matters. This study had three main aims: (1) to examine parental views and confidence in relation to communicating with their child about sexuality; (2) to explore predictors of parental self-efficacy in communicating with their child about sexuality; and (3) to assess parental preferences for programme content. Data were collected across Australia by means of an online survey. Parents in the study felt relatively knowledgeable and confident discussing sexuality topics with their child, although they noted that there were topics they would not feel comfortable talking about. The extent to which the parent felt knowledgeable and comfortable in educating their child about sexuality and their use of effective parenting strategies were significantly related to parental confidence. Finally, parents rated all potential parenting intervention topics as being useful, but the most relevant topics were those related to prevention of child sexual abuse and encouraging a positive sense of self and body image. The implications of these findings for intervention design and development and further research are discussed. [ABSTRACT FROM AUTHOR]

Background The impact of music therapy on the communicative behaviours of young people with profound intellectual and developmental disability has not yet been established. Method Four adolescents participated in individual music therapy (MT) and toy play sessions with the same therapist in a 6-month period. Sessions were video-recorded and analysed based on The Inventory of Potentially Communicative Acts (Sigafoos, J., Arthur-Kelly, M., & Butterfield, N. (2006). Enhancing everyday communication for children with disabilities. Baltimore, MA: Brookes) to compare the communicative behaviours within each condition. Results Both conditions successfully engaged the young people, with slightly more communicative behaviours observed in MT in response to singing, and more rejecting behaviours in toy play. MT was therefore considered equivalent to toy play in terms of quantity, but distinctive in eliciting more mutually enjoyable interpersonal encounters. Conclusion MT creates engaging and motivating conditions for interactions with others, which suggests the need for greater integration of music therapy into special education classrooms. [ABSTRACT FROM AUTHOR]

BackgroundPeople who have profound intellectual and multiple disabilities face significant challenges to participating in their community and are reported to have few friends. In this paper, the issue of how this is addressed by parent-carers of young women with Rett syndrome is explored. MethodTranscripts of in-depth interviews with 6 families registered with the population-based Australian Rett Syndrome Database were examined, guided by a theory of social construction, for themes of participation. ResultsThe majority of parent-carers saw social participation as an unrealistic expectation due to their daughters’ difficulties with communication. At the same time, parent-carers spontaneously recounted details of their daughters’ social connections within their local communities. This was positively associated with the presence of siblings. ConclusionsYoung women with Rett syndrome participate socially in their community. Encouraging parent-carers to continue with small-scale strategies that pay heed to their concerns and fears has the potential to enhance their daughters’ access to the benefits associated with friendship. [ABSTRACT FROM PUBLISHER]

Two hundred and twelve Australian mothers completed an online survey examining features of mother–child communication about child sexual abuse prevention. Two-thirds (67.5%) of respondents had discussed child sexual abuse prevention with their children, with proportions varying according to age range (highest for mothers with children aged 5–12 years) and only-child status (lowest for mothers of only children). The number of topics discussed with their children differed according to child gender (greater number of topics discussed by mothers with both girls and boys) and age range (greater number of topics discussed by mothers with children aged 5–12 years). These findings provide new insights into mother–child communication about child sexual abuse prevention. [ABSTRACT FROM PUBLISHER]

This study explored the responses of a group of 111 mothers who experienced distress and/or depression in the early months after childbirth and who received an innovative home visiting service until their child's first birthday. The current study reports a thematic content analysis of the qualitative questionnaire responses returned by the mothers after completing the intervention. The mothers valued the home visiting program for its capacity to increase their parenting confidence and to enhance their bond to their infants. They attributed this to the reassurance provided by the program and the skills and qualities of the home visitors. Their responses complement the benefits identified in quantitative analysis of the program and demonstrate its impact from participants' viewpoint. [ABSTRACT FROM AUTHOR]

Breast cancer is a significant health problem for aging women. Despite constant efforts to promote mammography in Australia to facilitate early detection, screening rates through the national mammography screening service remain at just 57%. Based on a theoretical rationale informed by Family Communication Patterns theory, the current study used semi-structured interviews with Australian mother-daughter dyads (N = 8) to examine their health communication, with a view to exploring the potential for daughters to deliver mammography promotion messages to their mothers. Consistent with results of previous studies conducted in different cultural contexts, the Australian mothers and daughters in this sample frequently communicated about health topics. Daughters were a source of information and influence for their mother's health decision making. The delivery of mammography promotion messages to the mother by the daughter may be most successful for dyads that value bidirectional conversation. Aspects of the Australian culture may facilitate the success of this strategy. [ABSTRACT FROM AUTHOR]