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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]

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support. [ABSTRACT FROM AUTHOR]

The dearth of child and adolescent mental health services (CAMHS) is a global problem. Integrating CAMHS in primary care has been offered as a solution. We sampled integrated care perspectives from colleagues around the world. Our findings include various models of integrated care namely: the stepped care model in Australia; shared care in the United Kingdom (UK) and Spain; school-based collaborative care in Qatar, Singapore and the state of Texas in the US; collaborative care in Canada, Brazil, US, and Uruguay; coordinated care in the US; and, developing collaborative care models in low-resource settings, like Kenya and Micronesia. These findings provide insights into training initiatives necessary to build CAMHS workforce capacity using integrated care models, each with the ultimate goal of improving access to care. Despite variations and progress in implementing integrated care models internationally, common challenges exist: funding within complex healthcare systems, limited training mechanisms, and geopolitical/policy issues. Supportive healthcare policy, robust training initiatives, ongoing quality improvement and measurement of outcomes across programs would provide data-driven support for the expansion of integrated care and ensure its sustainability. [ABSTRACT FROM AUTHOR]

Purpose: Between 55–65% of residents living in residential aged care facilities (RACFs) experience dysphagia and are prescribed texture-modified diets by a speech-language pathologist (SLP). The aim of this study was to assess current adherence to prescribed texture modification for people with dysphagia; and explore barriers to implementation in a rural aged care setting. Method: Meal texture audits (N = 42) were completed with residents with dysphagia in a rural RACF who were prescribed texture-modified diets or fluids by a SLP. Semi-structured focus groups were conducted with nursing and food preparation staff (N = 11) to identify barriers to implementation. Result: Mealtime texture audits identified that 54.8% (n = 23) of residents' food modification requirements were incorrectly documented in the manual entry database (kitchen form) and 64.3% (n = 27) of meal trays contained foods that did not meet residents' dysphagia management plans. Focus group data revealed seven main themes impacting on the ability of staff to implement prescribed texture-modified diets. Complicated processes and communication between nursing, food services and SLP staff were identified as major barriers. These were complicated further by time pressures experienced by staff as well as staffing issues, resourcing of the kitchen, accommodating individual dietary preferences and the variety/presentation of dietary options at the aged care facility. Conclusion: There was low adherence to SLP prescribed texture-modified diets and fluids in the participating rural RACF. This study identified major barriers to implementing SLP prescribed texture-modified diets including complicated processes, communication breakdowns, time pressures and limited staffing. Implementation of an online menu management system and regular dysphagia-specific training may address barriers to communication and complicated paper-based menu systems and should be a priority for health services to ensure adequate dysphagia management. [ABSTRACT FROM AUTHOR]

Fire-fighters use informal strategies to manage risks to health and safety during operations. It is not known whether such strategies are used during the high-risk alarm response period. The aim of this study was to determine if informal risk management strategies are employed by Australian firefighters during the alarm response procedure, and if these strategies differ between salaried and retained personnel. Forty-six metropolitan firefighters (all male; mean age 38 years ± 10 years; 22 salaried; 24 retained) participated in semi-structured group interviews. A general inductive data analysis approach revealed that firefighters use multiple informal risk management strategies. Some similar themes were reported by both salaried and retained personnel, for example leveraging team dynamics, communication about sleep and fatigue, stress adaptation, informal debriefs, and enhancing physical preparedness. These findings could be used by fire services to tailor risk management approaches during the alarm response period. Practitioner summary: Identifying informal risk management strategies firefighters use during alarm response will allow their development, refinement and dissemination, and may help other firefighters and emergency service workers to manage these risks. This qualitative study reveals multiple informal strategies that firefighters employ during alarm response to keep themselves and their team-mates safe. [ABSTRACT FROM AUTHOR]

We explore the complexities of language used in providing sexual and reproductive health care to Burma-born refugees in Australia. Twenty-nine providers of refugee services were interviewed to examine these conversational challenges. In the broader study, we found six major themes in relation to effective communication; here we focus on the "Negotiating language and vocabulary" theme, which has four subthemes: (a) different system of reproductive health vocabulary, (b) use of euphemism and metaphors, (c) unfamiliarity with Western concepts of health, and (d) recommendations to improve conversations. Incorporating linguistic nuances (analogies, metaphors, similes) in reproductive literacy interventions could facilitate more purposeful sexual health discussions. [ABSTRACT FROM AUTHOR]

This paper describes the process of engaging young people in a user centred, co-design strategy to define their perfect condom. Our aims were 1) to find a way to destigmatise discussions about sexuality and contraception and 2) to provide information about what characteristics a perfect condom might embody for adolescents. We used arts-based methods to introduce creativity and enjoyment into discussing sensitive topics related to sexual and reproductive health, which is often avoided in relation to youth and usually nuanced by themes of risk and danger. Using theories of objects becoming things through their sociality, we explored what a condom could be to young people through our method of embedding the condom design process into narratives of young people's lives and integration of these ideas into the development of a next-generation condom. [ABSTRACT FROM AUTHOR]

Previous literature has applied system-focused structures to understand the success of First Nations Peoples' nutrition and exercise group programmes. Existing system-focused measures have included biomedical outcomes, access and service utilization. By broadening the focus of programme success beyond the system, we can evaluate programmes from a First Nations Peoples' lifeworld perspective. Critical hermeneutics and yarning using a lens of Habermas' Theory of Communicative Action to the literature has the potential to transform understandings of "success" in First Nations Peoples' nutrition and exercise group programmes. In this literature interpretation, we explored the critical success factors from a lifeworld perspective, giving scope to go beyond a system perspective to include a cultural, social or personal perspective. Our yarning led us to understand that there is a communicative relationship between explicit system structures and implicit lifeworld concepts that are critical success factors for First Nations nutrition and exercise group programmes. We have developed a set of reflective questions to guide others in considering a lifeworld perspective. Our findings represent a shift away from success measured by the dominant power structure to respect the lifeworld culture, knowledges and values of First Nations Peoples towards shared understanding and mutual decision-making. [ABSTRACT FROM AUTHOR]

Background: A high proportion of individuals seeking treatment for alcohol and other drug (AOD) use report engaging in Intimate Partner Violence (IPV). Interventions to reduce IPV, particularly in the context of AOD use, are generally low in effectiveness. Co-design and consumer input enhance ecological validity and attendance rates yet are not common practice. This study aims to gain an understanding of the relationship between AOD use and IPV for those seeking AOD treatment in the Australian treatment system, and to report their treatment needs and perceptions on program design and delivery. Methods: Semi-structured in-depth interviews were conducted with residents in AOD residential rehabilitation services in Victoria, Australia and analyzed using thematic analysis. Results: Nine males identified two themes related to IPV; the anger, guilt and shame experienced, and the role of AOD use. Treatment needs were focussed on communication and emotion regulation skill building. Conclusions: Participants identified their need for skills in managing relationship difficulties. A greater emphasis on these in treatment programs appears to be a useful step for both AOD treatment and IPV interventions. [ABSTRACT FROM AUTHOR]

Evidence-Based Practice (EBP) is fundamental to speech-language pathology practice. Australian speech-language pathologists (SLPs) who treat communication disorders in children with autism spectrum disorder (ASD) face unique challenges in implementing EBP. Challenges may include selecting an intervention from a myriad of available interventions for use within a complex population. Identification of current practices of Australian SLPs in communication service provision to children with ASD will provide a baseline for use of EBP and may guide future efforts to engage in EBP. A total of 109 Australian SLPs who provide communication services to children with ASD completed an online survey. Descriptive and inferential statistics were used to analyse service delivery and participant experiences of EBP. The most common barrier to delivering EBP was inadequate resources. The most utilised strategy was discussing evidence with colleagues. Most participants reported using therapies which did not adhere to a standard protocol, such as eclectic approaches. The majority also reported use of outcome measures which they believe adequately represent functional communication changes for their client. Resource limitations may result in over-reliance on interventions lacking empirical support and over-reliance on subjective outcome measurement tools. Reflective practice and self-evaluation of communication services to children with ASD may support improved provision of EBP. [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 article examines communication practices within two Australian actor training institutions, investigating strategies employed by actor-trainers to build resilience in students. The study suggests that resilience is beneficial to acting students for two key reasons: (1) to help them navigate the challenges within conservatory-style actor-training institutions and (2) to prepare them for industry-related challenges. The research adopted a qualitative, semi-inductive design and employed semi-structured interviews that were conducted with four trainers and four third-year acting students (in total) from two Australian actor-training institutions. Thematic content analysis was used to analyze the data. The study found that all participants placed value on the role of resilience in both training and in the acting profession. The trainers were able to describe strategies and language used in order to cultivate wellbeing and resilience in their students. Some discrepancies were found between the students' experiences and the trainers' intentions. Although some institutional practices are in place to attend to student wellbeing and resilience, more might be done at an institutional level to support both trainers and students. [ABSTRACT FROM AUTHOR]

To understand the factors that affect the management of people after serious injury in urban and regional settings, beyond hospital discharge from the perspectives of allied health professionals (AHPs). An exploratory qualitative study of AHPs caring for people with serious injuries post-hospital discharge in urban and regional areas of Victoria, Australia was completed. Twenty-five semi-structured interviews were undertaken with AHPs and thematically analysed. Allied health professionals in urban and regional settings reported the benefits of a multi-disciplinary team to deliver high-quality care. However, a number of barriers to service delivery were identified that impacted on their ability to meet the needs of patients. These included insufficient psychological services, a shortage of available carers and an unmet need for external clinical support in regional areas. Communication between AHPs and other services, and care co-ordination of post-discharge services, was also highlighted as key areas to improve for optimal patient care. Factors that influenced optimal patient management included the availability of psychological and carer services, communication between health professionals and coordination of post-discharge care. The experiences of AHPs can offer practical suggestions to optimise service delivery and post-discharge care for people with serious injuries. Allied health professionals (AHPs) face a number of challenges in the provision of optimal care to people with serious injuries. Improving the availability of psychological support and attendant carers is needed in regional areas. A designated care coordinator role may assist people with serious injuries transitioning between hospital and home to engage with necessary services and reduce administrative burden for AHPs. Telehealth may provide facilitate improved communication between health professionals and support regional clinicians caring for people with complex injuries. [ABSTRACT FROM AUTHOR]

People who use drugs understand drugs and drug use in ways that are often different to the way knowledge of drug use is constructed within the dominant medico-legal discourse. Their experiences are, more often than not, represented in negative ways within dominant discourse, a disconnect that can create adverse consequences for people who use drugs, through the production of stigma and shame leading to poor health and social outcomes. A key difference in how drugs are understood by people who use drugs is the capacity of the former to recognize positive aspects of drug use and create more agentic subjectivities for themselves concerning the use of drugs. Using a thematic analysis of the online forum Australian Drug Discussion, hosted by Bluelight.org, we identify positive drug stories and the contexts of their emergence, as subversions or modifications of dominant understandings. We argue that positive understandings of drug use, as well as recognition of the way their expression serves to generate agency for people who use drugs within or against the confines of dominant discourse, may provide opportunities to limit further the harms flowing from stigmatization and negativity. [ABSTRACT FROM AUTHOR]

Nursing is the single largest professional group within both hospital and community mental health care services, however the role of mental health nurses in under-defined. The nursing workforce is also coming under increasing pressure from internal and external requirements, and nurses themselves are on the frontline of providing patient care in what can be a risky and unpredictable workplace environment. This project explored via interview the ways in which mental health nurses experience and reflect on their personal and professional feelings of nursing success. Participants were 19 nurses who were employed in a range of bed-based and community mental health services in inner south eastern Melbourne. This study complies with the Consolidated Criteria for Reporting Qualitative Research (COREQ). The findings of the project align with existing evidence from the literature. Factors which helped mental health nurses feel successful included: therapeutic success; good teamwork; targeted education; and feedback. Barriers to success included: patients/clients do not engage or recover; poor communication amongst staff; lack of psychological safety in the workplace; and lack of respect from management. Nurses in community settings were more able than nurses in bed-based settings to: make effective use of clinical supervision; make use of targeted training and educational offerings; and practice therapeutically and holistically. Project results offer an opportunity to understand nurses' motivations and reward systems. Better understanding of these issues can improve the way mental health care services manage their workforce planning, maintain staff personal wellbeing, increase staff retention and ultimately improve patient/client care. [ABSTRACT FROM AUTHOR]

In response to a crisis in the child welfare sector in Australia, the OzChild executive leadership team (ELT) moved to adopt evidence-based programs (EBPs) to deliver improved outcomes to children and families. This case study focuses on the adoption and implementation of the first suite of EBPs, examining the strategies, decision-making processes and challenges addressed by the ELT. Interviews with leaders and managers involved are situated within existing research on organizational change and EBP adoption in human service organizations. The case study concludes with a set of questions to encourage discussion and reflection. [ABSTRACT FROM AUTHOR]

A retrospective audit of terminology utilized in discharge summaries to convey the death of inpatients in an Australian tertiary hospital was undertaken. Completion rates of summaries for this patient cohort were also assessed. Less than 60% had a summary finalized, and for those that did, euphemisms were utilized most commonly; passed away was employed in >70% of cases. There is no difference in terminology choice between doctors at the beginning, compared to the end, of their first year as a doctor, nor between first year or more experienced doctors. Irrespective of clinician level, doctors use euphemisms to convey a death. [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]

Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed. Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework. Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis. Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching. Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises. Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine educators' and specialists' provision of communication adjustments for students on the autism spectrum in mainstream and supported education settings. Secondary analysis of data collected from educators and specialists in the Australian Autism Educational Needs Analysis was undertaken. Thematic analysis of adjustment descriptions identified 11 categories. The use of the 11 specific adjustment categories with reference to (a) participant group (educator versus specialists), and (b) setting (mainstream versus supported) were described and associations investigated using Chi-square analyses. Only 32% of the 381 educators and specialists reported using adjustments. Of the adjustments reported, those categorised as "Multimodal Communication", "Structured Teaching", and "Assistive Technology" were frequently included by both groups. Significant associations were apparent between groups and the use of specific adjustments including naturalistic communication strategies. Significant differences were evident in the proportion of specific adjustments used by participants in supported as opposed to mainstream settings. Possible reasons for the differences in the adjustments reported by educators and specialists and the role that setting may play in these are discussed. These include resourcing, the choice of adjustment being driven by school setting rather than student need, and possible differences between professionals in describing the adjustments made. [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]

Non-standard dialects, such as Australian Aboriginal English (AAE), are spoken across the globe, often by peoples from marginalised groups and communities. Speech-language pathologists in Australia need to be familiar with AAE in order to correctly and appropriately diagnose and intervene with Aboriginal clients. The purpose of this study was to identify the presence of AAE in the communication of pre-school-aged children in a regional area and to describe the features of AAE that these children used. Interactions between early childhood educators and children were videotaped for a sample of 21 Aboriginal and 21 non-Aboriginal children. From these videos specific features of AAE were coded and analysed using parametric and non-parametric tests. The communication of the sample of Aboriginal children differed significantly from that of the non-Aboriginal children. Several features of AAE were identified within this cohort, including: cluster reduction, zero use of /h/ and zero use of copula. Differences in dialect exist in the communication of pre-school-aged children in regional areas of Australia. It is important for educators and health professionals to be aware of the features of AAE dialect so they can support Aboriginal children in their learning journey. [ABSTRACT FROM AUTHOR]

This research explored the role of Australian Speech-Language Pathologists (SLPs) to identify SLP experiences and practices regarding adult palliative care (PC) management. Utilising mixed methods, phase one comprised a literature scoping review of SLP practices in PC. Phase two involved a survey compiling demographic data of Australian SLPs working in adult PC. Phase three involved in-depth interviews exploring SLP experiences in PC. It was found that minimal resources or published literature existed regarding SLPs in PC, however the available literature indicated SLPs can be valuable and influential members of a PC team. Interviewed SLPs acknowledged their proficiency in end-of-life communication and swallowing, nevertheless initially they felt ill-prepared given insufficient knowledge or skills to manage palliative cases based upon their tertiary education and were poorly supported once in the field given a lack of clinical practice guidelines (CPGs). Participants also noted a lack of knowledge among medical, nursing and allied health clinicians about a SLP's contribution to PC, causing barriers for SLPs being professionally accepted within palliative environments. Recommendations included the development of improved resources specifically about SLP practice in end-of-life care, the need for greater exposure at the tertiary level of SLP palliative care practices, and CPGs for SLPs working in adult palliative care. [ABSTRACT FROM AUTHOR]

Background and Purpose: Student-led physiotherapy clinics are a valuable means for providing education opportunities and cost-effective services to the public. Service dissatisfaction is an important construct in understanding how student-led services can maximize patient care and minimize non-attendance while maintaining effective learning environments. Design: A qualitative interview design was used with semi-structured interviews. Results: Eighteen patients from three different university student-led physiotherapy clinics were interviewed. Five themes emerged that were associated with negative perceptions of service provision: (1) inadequate communication, (2) insufficient supervision, (3) loss of autonomy, (4) time commitment, and (5) continuity of care. Conclusion: The results of this study highlight factors that service providers should consider to mitigate negative patient experiences and relevant implications of dissatisfaction including non-attendance. Ensuring transparency of patient expectations of services and enhancing patient continuity of care between physiotherapists and students are important in minimizing the potentially negative factors associated with student-led health services. [ABSTRACT FROM AUTHOR]

Background: Communication is an essential prerequisite for good end-of-life care. Yet, there is a need to better understand the unique features of communication regarding end-of-life care for older people. Aim: To gain an in-depth understanding of family communication and decision-making concerning older people's end-of-life care. Design: Semi-structured interviews were undertaken with four older palliative care patients and seven bereaved family members in Melbourne, Australia. Data were analysed thematically using inductive coding. Findings: Participants preferred not to think about dying as older people trusted others (e.g. medical staff, God) to make decisions for them. This influenced end-of-life communication, resulting in family members making decisions during medical crises. Such decisions were complicated by family conflict and denial of dying. Family members were crucial mediators between older people and health services, helping them to navigate the care system and advocating on their behalf. Being treated with respect, remaining independent and socially connected was integral to participants' perception of good end-of-life care. Conclusions: End-of-life communication and decision-making is multi-layered, and shaped by families' histories and roles. While documenting and implementing care preferences is challenging, understanding these challenges may improve communication between services, families and older people as they approach the final stage of life. [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]

Drawing on data from a longitudinal linguistic ethnographic study of a trilingual (English, Japanese, Spanish) family in Australia, this paper suggests that rather than looking at their language use in terms of family language policy, better insights can be gained by exploring the translingual family repertoire. This repertoire is a central apparatus in the operation of this family, part of what holds the family together, both as an everyday means of communication and as an ideal of family integration. It is a set of resources that different members of the family can draw on in their everyday interactions. Looking at everyday interactions in the family, and the ways these are related both to this repertoire and to surrounding objects and space, this paper suggests that the focus of language use in the family is not on heritage language maintenance or any other kind of language policy, but rather on getting by translingually, on doing family life with the aid of a repertoire of diverse resources. This has important implications for how we think about multilingual families within the wider social domain. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

To investigate current speech pathology practice regarding working with friends. An online survey was conducted with 68 speech pathologists who worked with TBI across metropolitan and rural settings in Australia. The survey investigated the reasons speech pathologists work with friends, barriers to working with friends and perceptions of successful friendships post TBI. Descriptive statistics and content analysis of open ended responses were used to analyze the data. There were more speech pathologists (40%) who did not include friends compared to those who did. Friends were most commonly included in the rehabilitation process, through the provision of education programs. The primary rationale for working with friends was to prevent negative psychosocial outcomes for the person with TBI. There were numerous barriers to working with friends, most commonly the inability to access friends. Making and keeping friends are a significant part of most people's lives. Therefore, it is important to consider their role in contributing to improved outcomes for people with TBI. With communication partner training being an integral component to recovery and maintenance of relationships post TBI, the development of targeted education and training materials is warranted, to enable the inclusion of friends in the rehabilitation process. [ABSTRACT FROM AUTHOR]

Purpose: Clear correlations exist between the quality and quantity of child-directed speech (CDS) and children's language development. Interventions for children with poor language skills involve manipulation of the quality and/or quantity of CDS in a child's daily experience. Assessment of CDS is therefore important. There are a range of CDS measures reported in the literature, however no data exist on the use of these in clinical practice. The aim of this study was to identify current clinical practices in measurement of CDS. Method: An online survey was developed using the Qualtrics platform. Brief study information and a link to the survey were distributed to speech-language pathologists working in New Zealand and Australia. Result: Responses from 116 clinicians were analysed. Participants mainly reported using informal analysis of adult–child observations, checklists and informal discussion with adults to measure CDS. The barriers to measuring CDS reported were time, teaming with adults and psychometric properties of informal methods. Conclusion: There are few psychometrically validated clinical tools which are "fit for purpose" to measure qualitative aspects of CDS. Automated speech analysis technology appears to have potential as a quantitative measure of CDS to support clinical practice. [ABSTRACT FROM AUTHOR]

Much of the work on media multiplexity theory (MMT) is based on unestablished relationships, in which more channels are presumed to be indicative of higher relational closeness. But a different set of relational dynamics may be at play in preexisting acrimonious partnerships. In this article, we investigate the use of different modes of communication by high-conflict separated parents (media multiplexity), and map changes in modes of communication (modality switching). Qualitative data from 68 separated parents in Australia who reported chronic parental acrimony suggest that a considerable amount of modality switching occurred post-separation. Consistent with MMT, multiplexity was evident but the degree of multiplexity was not as clearly related with the degree of closeness in the co-parental relationship as would be otherwise predicted by MMT. Recent insights into more pernicious forms of family dynamics set an important challenge for communication theories to better account for ex-couple motivational complexities. [ABSTRACT FROM AUTHOR]

Background: Communication with indigenous patients is often a problem for health staff in Australia. Aim: This paper examines the barriers and enablers in communication between health staff and Indigenous carers of paediatric patients in a hospital, about advice to help reduce exposure of children to second-hand smoke (SHS). Methods: Non-indigenous health staff and Indigenous carers, were recruited from a paediatric ward of a regional hospital in the Northern Territory. A constructivist grounded theory with multiphase case study design and semi-structured interviews was used. Results: Health staff and carers had different perceptions about raising the issue of smoking. Health staff lacked confidence to talk about smoking and questioned the cultural appropriateness of doing so. In contrast, carers expected to talk about smoking while in the hospital., and perceived it as part of a caring and protective relationship by health staff. English being a second language for carers was considered a significant communication barrier by staff; carers, however, felt that health staff needed to modify their communication styles. The possible misperceptions about carers' lack of response to messages, led to health staff dropping the subject, when, in fact, carers were struggling with health workers communication styles. Conclusions: Health staff and carers perceive discussion around smoking differently. Cross-cultural communication education may empower staff to provide effective smoking cessation interventions in this setting. Impact statement: Improving communication between health staff will help ensure the optimal provision of smoking cessation support to carers. [ABSTRACT FROM AUTHOR]

Some form of legislative oversight of intelligence has become the norm in most democratic states. The near universal acceptance of the need for democratic oversight does not, however, mark the end of a process of intelligence accountability. In many states following a period of establishment and then consolidation, intelligence oversight mechanisms have begun to evolve as oversight committees have sought extra powers and developed new roles. This article examines reforms in parliamentary intelligence oversight committees in Australia, Canada, New Zealand and the UK, focusing on the form, mandate, membership, powers and resources of the committees as well as their engagement with other parliamentary actors. [ABSTRACT FROM AUTHOR]

Despite the growing prominence and importance of the field of teacher dispositions for addressing selection criteria and assessment in educational research, there is an absence of psychometrically evaluated instruments to facilitate investigations. Furthermore, research thus far has not explored the relationship between teacher dispositions and better student outcomes. To address this paucity, key dispositional factors conducive to successful teaching and learning were identified through interviewing high performing teachers. Based on the interview, data a 24-item Teacher Disposition Scale (TDS) was constructed consisting of five dimensions: Motivation to teach; Teacher efficacy; Willingness to learn; Conscientiousness; and Interpersonal and communication skill. The scale was psychometrically tested on 179 pre-service undergraduate students at an Australian university. Both factor analysis and Rasch measurement modelling indicated evidence of a reliable and valid multi-dimensional scale. The article concludes with a discussion on the implications of the scale for future research. [ABSTRACT FROM AUTHOR]

This paper examines the provision of youth targeted Relationships and Sexuality Education (RSE) and sexual health interventions in the rural Australian context by examining the perspectives and experiences of a range of community stakeholders. Sixteen participants undertook one-on-one semi structured interviews. Four key themes emerged from the data and included: 'you're not going to get the whole town to start thinking about adolescent sexual health'; backlash, stigma and secrecy; being consistent, credible and available; and small-town communication. This study contributes to the limited literature about RSE and sexual health provision in regional and rural Australia and provides a voice for rural stakeholders who provide RSE and sexual health interventions by default or necessity. The findings of this study have practical implications for rural settings when addressing youth sexual health needs. [ABSTRACT FROM AUTHOR]

Opioid overdose is a growing issue in Australia. Programs to provide opioid consumers with 'take-home' naloxone to reverse overdose exist internationally and in some Australian cities, but uptake remains inconsistent. As an opioid antagonist, naloxone has the capacity to stimulate distressing withdrawal symptoms. These sensations are shaped by complex factors – including the quantity and intervals of naloxone administration – and can contribute to conflict during, and immediately following, revival. This possibility of conflict is thought to negatively affect willingness to use naloxone. Researchers have not yet analysed this conflict in detail nor considered the potential positive social interactions that can occur in the context of take-home naloxone administration. We draw on interviews conducted as part of a broader Australian study of the use of take-home naloxone by people who consume opioids (or 'peer administration') to identify accounts of both conflict and appreciation. Additionally, we analyse the strategies people administering naloxone use to manage and avert potential conflict. Drawing on Science and Technologies Studies, we conceptualise take-home naloxone as a technology that takes shape in practice with effects that are produced through specific practices during particular administration events. Focussing primarily on titration and communication, we argue that those administering naloxone actively manage the potential for conflict during administration. We conclude that if efforts to increase the uptake of take-home naloxone highlight these strategies they have the potential to improve administration experiences and the reputation of take-home naloxone and, in the process, help challenge the stigma faced by people who consume opioids. [ABSTRACT FROM AUTHOR]

Background: Speech-language pathologists (SLPs) measure outcomes to gauge the impact of their interventions and to inform best care for clients. Previous research has explored outcome measurement practices in aphasia rehabilitation, however the factors driving clinician behaviour have not been examined. Aim: To explore current clinical practice and perceived barriers and facilitators to aphasia outcome measurement. Methods and Procedures: Australian SLPs who worked clinically with people with aphasia completed a cross-sectional online survey. Current practice was explored using a combination of multiple-choice questions (with open-text response options) and Likert rating scales. Barriers and facilitators to outcome measurement were explored through ratings of statements aligned with the Theoretical Domains Framework. Data were analysed using descriptive statistics and cross-tabulations. Outcome and Results: Data from 74 Australian SLPs were included. All SLPs reported measuring outcomes and these most frequently related to communication and language. SLPs reported using a diverse range of outcome measures across construct areas and stage-post stroke of service provision, with more than 80 unique instruments/approaches identified. The most frequently used outcome measurement instruments/approaches were: The Western Aphasia Battery – Revised (WAB-R) for language; the Therapy Outcome Measures/Australia Therapy Outcome Measures (TOMs/AusTOMS) for communication, participation, and quality of life; and Goal Attainment Scaling for psychological and carer/significant other outcomes. Overall, SLPs identified more facilitators than barriers to outcome measurement. The main barriers related to the theoretical domains "behavioural regulation" (managing or changing actions) and "memory, attention and decision-making processes" (ability to retain information, focus selectively and choose between alternatives). The main facilitators related to the theoretical domains "beliefs about consequences" (acceptance of the truth, reality, or validity about outcomes of a behaviour) and "social/professional role and identity" (a coherent set of behaviours and displayed personal qualities in a social or work setting). Conclusions: All SLPs reported measuring outcomes with clients with aphasia and these primarily related to language and communication. The outcome measurement instruments/approaches used were heterogeneous within construct areas. SLPs see outcome measurement as part of their role and believe it to be an important activity, however report a need for training and workplace systems and strategies to support optimal practices. The results of this study may inform the development of theoretically informed implementation interventions which seek to improve SLP outcome measurement practice in aphasia rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: To identify in the Australian context: (a) treatment and support services that are accessed by people living with borderline personality disorder (BPD) and their carers, (b) perceived benefits and challenges associated with these services, and (c) changes these individuals would like to see with regards to service provision and access. Method: This project involved semi‐structured qualitative interviews with 12 participants (75% female, M age = 39.9, SD = 11.7), nine with lived experience of BPD, three carers and two identifying with both roles. Additionally, two online focus groups were conducted via online peer support communities involving 11 participants in total. Interview transcripts and focus group text were analysed thematically. Results: Participants described mixed experiences across a range of treatment types, locations and intensities. Themes were: identity and discovery, (mis)communication, complexities of care, finding what works (for me), an uncertain future, and carer empowerment. Participants described community‐based psychotherapy as being critical for reducing symptoms of BPD and improving quality of life, but reported challenges at the macro and micro level with regards to costs, service access, clinician factors and client factors. Experiences were often not aligned with a recovery model of mental health. Conclusions: The current Australian mental health system is not designed to best meet the needs of people living with BPD, which remains highly stigmatised and misunderstood. Future research should consider how the system could be modified or restructured to better support recovery for these individuals and others with complex mental illness. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunction has been described as "a silent epidemic," affecting many people in the community yet under-recognized and insufficiently managed. There is evidence that pelvic floor physiotherapy can manage many of these disorders, however a competency framework to guide and inform pelvic floor physiotherapy training and practice is lacking. The assessment and management of the pelvic floor complex is not addressed as a core component of most entry-to-practice physiotherapy programs despite being within the scope of physiotherapy practice which is in contrast with the knowledge and skills that physiotherapists graduate with in core areas of clinical practice. This results in a registration-competency gap, and the need for post-graduation training to ensure clinicians are appropriately skilled to practice safely and effectively in this area. In addition, there are potential ethical and legal issues unique to this area of physiotherapy practice to be considered. We use a series of clinical scenarios to highlight the domains of knowledge, skills and communication required for practice in this area, based on our experience in Australia. We propose a framework for the future which defines competence in pelvic floor physiotherapy to provide clarity to clinicians about their clinical, ethical and legal obligations to the public, our referrers and third-party payers. [ABSTRACT FROM AUTHOR]

Background: Increasing health professional student numbers in Australia, in response to looming predicted workforce shortages, resulted in a Federal Government call for action to provide clinical supervision education to health professionals. Objectives: This research aimed to develop, implement and evaluate the programme, 'The Art of Clinical Supervision' (ACS), designed to support nurses facilitate a positive learning environment for student nurses. Method: The ACS programme was presented (n = 199) across Western Australia as a doctoral study, with participants from both the public and private healthcare sector working in a variety of specialties. A triangulation approach of surveys, reflective entries and interviews was utilised to determine its impact. Results: The data indicated that participants improved their understanding of supervision and attitude towards students and supervision after attending the ACS. Conclusions: Health service managers are encouraged to evaluate their staffs' knowledge and attitude towards students with findings used to facilitate a positive learning culture. Impact Statement: The Art of Clinical Supervision The purpose of the research was to develop, implement and review a new education programme that could support the development of clinical supervision knowledge and attitude to support student nurse learning. This occurred in an environment of increased student numbers as a strategy to correct a predicted looming workforce shortage. The study findings determined that the programme improved both participant knowledge about how to provide effective clinical supervision (teaching) in the clinical environment, and improved staff attitudes towards students and their place as a learner in the clinical areas. The type of impact was therefore within the domain of quality by improving student learning through effective education strategy. As a result of the doctoral research, involving 200 participants, a Federal Government grant of approx. $500,000 was received to facilitate the training of additional educators to provide the programme across the state of Western Australia. This grant was a partnership between the programme author (researcher) and the Western Australian Government Department of Health. This involved four educators presenting the programme to over 3,000 health professionals in a 3-year period. Despite the cessation of funds with the closure of HWA the programme continues to be delivered through The University of Notre Dame Australia School of Nursing and Midwifery, with only a cost recovery charge. [ABSTRACT FROM AUTHOR]

Background: Health Professionals are required to balance care practices against patient risk to optimise safety. Communicating clinical risk with the patient requires confidence. Objective: The objective was to explore health professionals understanding and confidence of patient-centred communication during conversations of risk prevention. Design: An exploratory study was conducted. Methods: Nurses, physiotherapists and social workers in a metropolitan hospital in Sydney (New South Wales, Australia) completed face to face interviews (n = 16) regarding person-centred communication and clinical risk. Results: The sample was predominately female and had been a health profession for 11.5 years (mean). Six key themes were generated including: Perceptions of person-centred communication; Preparing for person-centred communication and Understanding and prioritising conversations about preventable clinical risk. Conclusions: Person-centred communication was embedded in clinical practice; the 'patient voice' was considered central. Clinical risk was a priority. Education to improve communication was highlighted as a way to enhance person-centred communication. [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]

This is the first study to explore bereaved individuals' experiences of funeral service providers using these services' databases. A total of 839 Australians participated in a postal survey, 6–24 months into their bereavement. Funeral providers were reported to be the third most prevalent form of bereavement support after friends and family. Analysis found six themes related to perceived helpful or unhelpful support: instrumental support, professionalism, informational support, financial tension, communication, and emotional support. Funeral providers could improve their support by adopting a proactive approach to bereavement needs and offering personalized and ongoing support. We develop these suggestions by exploring their potential contributions to building community capacity around death, dying and bereavement. [ABSTRACT FROM AUTHOR]

Goals-of-care discussions aim to establish patient values for shared medical decision-making. These discussions are relevant towards end-of-life as patients may receive non-beneficial treatments if they have never discussed preferences for care. End-of-life care is provided in Emergency Departments (EDs) but little is known regarding ED-led goals-of-care discussions. We aimed to explore practitioner perspectives on goals-of-care discussions for adult ED patients nearing end-of-life. We report the qualitative component of a mixed methods study regarding a 'Goals-of-Care' form in an Australian ED. Eighteen out of 34 doctors who completed the form were interviewed. We characterised ED-led goals-of-care consultations for the first time. Emergency doctors perceive goals-of-care discussions to be relevant to their practice and occurring frequently. They aim to ensure appropriate care is provided prior to review by the admitting team, focusing on limitations of treatment and clarity in the care process. ED doctors felt they could recognise end-of-life and that ED visits often prompt consideration of end-of-life care planning. They wanted long-term practitioners to initiate discussions prior to patient deterioration. There were numerous interpretations of palliative care concepts. Standardisation of language, education, collaboration and further research is required to ensure Emergency practitioners are equipped to facilitate these challenging conversations. [ABSTRACT FROM AUTHOR]

Approximately 25 years ago, special measures were adopted in many jurisdictions to support child sexual assault complainants in legal proceedings. This study tracked activities of a multi-agency committee of criminal justice professionals, including social workers, in enacting those provisions. We manually reviewed 99 sets of minutes of meetings of the New South Wales Sexual Assault Review Committee, spanning over two decades. Findings identified numerous gaps between legislation and practice, and the actions of this group, led by prosecutors, to narrow those gaps. Qualitative analyses revealed more focus on legislative issues and research in the early years, when closed-circuit television (CCTV) use commenced. Key evidence-based recommendations of the Committee were: (1) prerecorded evidence-in-chief of complainants; (2) cross-examination via CCTV; and (3) witness intermediaries. Investigation of and responses to stakeholder feedback on practice issues was an integral and consistent function of the Committee. In later years, the focus shifted to technological and administrative difficulties with prerecorded police interviews, CCTV, and court closure. Longitudinal analyses revealed longstanding and robust issues in implementing special measures to improve experiences of vulnerable complainants in giving evidence. Proactive prosecution leadership and multidisciplinary membership contributed to a well-informed, evidence-based focus on the needs of vulnerable witnesses. Stakeholders from multiple agencies collaborated efficiently to resolve many practical issues, but improvements to certain systemic issues require resources beyond their capacity. [ABSTRACT FROM AUTHOR]

Peer-to-peer streaming has emerged via software developed for swapping and sharing digital content (such as music, films, TV shows and live sports) with others across the internet. Peer-to-peer streaming has become an expedient technique for end-users, because it allows access to digital content without downloading it. However, while it is a novel advancement in technology, peer-to-peer streaming has heralded new challenges for copyright-protected works. This is because peer-to-peer streaming can affect the right of communication to the public, which is the exclusive right of the copyright owners. The process of making digital content available for others through peer-to-peer streaming can result in copyright-protected work being distributed illegally. This paper examines whether peer-to-peer streaming infringes the right of communication to the public in Australia. [ABSTRACT FROM AUTHOR]

Objectives: Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. Design: A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Results: Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Conclusion: Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will assist in addressing gaps in the clinical response to hepatitis B. [ABSTRACT FROM AUTHOR]

Submarine cables are vital to the global economy and the national security of States. While their importance and role in transmitting most of the world's data and communications is increasingly being recognised by States, the legal regime governing submarine cables is often characterised as a neglected area of the law the sea. The security implications arising from an intentional attack on international submarine cables cannot be underestimated. Despite the significant security risks and vulnerabilities, the legal regime governing submarine cables is limited and there are a number of crucial gaps in the regulation of submarine cables. This article examines the existing legal options available to States to close the 'security gap' using the Australian experience as a case study. A number of respected commentators in this area have argued that the best way to close the security gap in the regulation of submarine cables would be to develop a new counter–terrorism convention to criminalise the intentional damage of international submarine cables. This article reflects on whether additional legal options are necessary or available to effectively close these gaps given the institutional, legal and political context surrounding the 'orphan' of international law: submarine cables. [ABSTRACT FROM AUTHOR]