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Objective: As governments grapple with ageing populations, there is a need to understand more about the aged care workforce and how it is managed. Methods: We undertook a scoping review according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) guidelines. Scopus and PubMed were used to identify papers published between 2010 and 2020. We mapped the breadth and scale of the evidence base according to the QuInnE indicators of job quality. Results: Out of 642 titles and abstracts that were screened, 122 were selected. Outcomes were measured across a range of domains, including wages, employment quality, education and training, working conditions, work/life balance and consultative participation and collective representation. These were distributed unevenly, revealing evidence gaps. Conclusions: We identified significant knowledge gaps regarding Australia's aged care workforce at a time when the sector is coming under fresh scrutiny and projections indicate that it will face critical labour shortfalls going forward. [ABSTRACT FROM AUTHOR]

The outbreak of the COVID‐19 pandemic in late 2019 and in 2020 presented challenges to healthcare workers (HCW) around the world that were unexpected and dramatic. The relentless progress of infection, starting in China and rapidly spreading to Europe, North America and elsewhere gave more remote countries, like Australia, time to prepare but also time for unease. HCW everywhere had to readjust and change their work practices to cope. Further waves of infection and transmission with newer variants pose challenges to HCW and health systems, even after mass vaccination. Respiratory medicine HCW found themselves at the frontline, developing critical care services to support intensive care units and grappling with unanticipated concerns about safety, risk and the need to retrain. Several studies have addressed the need for rapid changes in the healthcare workforce for COVID‐19 and the impact of this preparation on HCW themselves. In this paper, we present a scoping review of the literature on preparing HCW for the pandemic, explore the Australian experience of building the respiratory workforce and propose evidence‐based recommendations to sustain this workforce in an unprecedented high‐risk environment. [ABSTRACT FROM AUTHOR]

This paper presents a review of the literature informed by both grounded theory and phenomenology, which explores how culture is addressed in the family therapy field with particular emphasis on Australia. The primary aim of the study is to identify the issues and relevant publications that can inform and guide Australian family therapists in working with clients from culturally and linguistically diverse backgrounds. The secondary aim is to provide recommendations that may inform research directions and clinical practice. The results indicate that this challenge is not unique to Australia; indeed the issue is ubiquitous across the Western world. This paper attempts to provide an impetus for future dialogue and to precipitate discussion around the development of a culturally sensitive approach in the Australian family therapy field. [ABSTRACT FROM AUTHOR]

Introduction: Although various studies have examined availability, access barriers and patient experiences of rural health services for the ageing population, no synthesis of this literature exists in Australia. Objective: The objective of this study was to examine the current literature surrounding rural service provision and to evaluate the barriers to access for older individuals and to recognise gaps in the literature. Design: A systematic scoping review of peer‐reviewed literature from three online databases (PUBMED, SCOPUS and Web of Science). Findings: Thirty‐two papers were included in analysis. The most prominent types of health service discussed were residential aged care (n = 12) and community health care (n = 10). More studies explored the perspectives of health personnel than the service end users. Qualitative synthesis revealed three themes associated with health service and rural ageing: access to services, health workforce experiences and end user experiences. Discussion: Access to health services for the elderly population is a complex issue. Promoting positive experiences for both health providers and patients is critical to assisting in healthy ageing for people living in rural and remote areas. This requires intervention on a social and institutional level. Key research gaps in the literature include the effectiveness of an integrated approach to institutional interventions, utilisation of preventative measures such as screening programs for cancer and greater identification of the health needs and perceptions among culturally diverse elderly residents. These studies are critical to promote appropriate and patient‐centred care for elderly populations in rural and remote areas. Conclusion: The review highlights the need to address availability, retention and service innovations across health services to improve access to care and health outcomes of rural elderly residents. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the literature to investigate the role of the hospital pharmacist and the services provided for Aboriginal and/or Torres Strait Islander people. Methods: A systematic literature review was performed following a search from inception to present of MEDLINE, International Pharmaceutical Abstracts (IPA), EMBASE, Scopus and Pubmed, in accordance with PRISMA guidelines. All forms of published literature were included. Aboriginal and/or Torres Strait Islander people and hospital pharmacists/pharmacy department services in Australia were the populations included. Results: 1592 studies were identified. After removal of duplicates and application of inclusion and exclusion criteria, 16 papers underwent full text review, with 7 papers included in the final review. No high‐level evidence articles were found. Joanna Briggs Institute Levels of Evidence for meaningfulness were low. Settings were varied and included rural, remote and urban sites. Five articles were allocated a Donabedian Model level where the structure was described. Two papers described structure and process. None described outcomes. Hospital pharmacy services included development of models for patient care, partnerships and resource sharing in rural and remote areas and ensuring continuity of care. Conclusion: Systematic review of the literature to determine the role of hospital pharmacy services for Aboriginal and/or Torres Strait Islander people produced limited publications for review. From these, roles identified included: development of models for patient care, partnerships and resource sharing in rural and remote areas and ensuring continuity of care. Future research and publication of work by hospital pharmacists nurturing and developing relationships in partnership with Aboriginal and Torres Strait Islander communities is encouraged. [ABSTRACT FROM AUTHOR]

Background: Spirituality is a fundamental dimension of our human nature that impacts on medical care and yet is relatively neglected by medical education courses in Australia. Aim: This systematic review was conducted to assess the curriculum content currently used to develop medical student understanding of, and engagement with, spirituality in the context of patient care. Methods: Studies published in English from 2010 to the review date were included in order to focus on the most recent curricula. Studies included medical students in undergraduate or postgraduate programmes, doctors in resident training programmes and registrars. Interventions considered for inclusion were curriculum modules on communication skills in spirituality, spiritual needs assessments and holistic care planning. Six databases, including PubMed, Scopus, PsycINFO, Embase, Medline and CINAHL, were searched electronically using the following keywords and MeSH search terms: 'medical students', 'doctor', 'physician', 'spirituality', 'spiritual care', 'religion', 'education', 'history taking' and 'communication skills training' from 2010 to 2020. Results: For 342 articles, three researchers screened the titles and abstracts; disagreements were resolved by discussion. Full-text articles were assessed for eligibility based on study and report characteristics; 17 papers were included in the analysis. Curriculum content of each study was reviewed. The following key features were employed frequently: chaplain shadowing, communications skills training, self-reflection, examining evidence and relationship building. Conclusion: This review has determined the core content, aims and objectives to guide construction of spirituality curricula in Australian medical education. [ABSTRACT FROM AUTHOR]

Background: The prevalence of language disorder in youth offenders far exceeds rates reported in community samples. Youth involved in the justice system are also at increased risk of a range of psychiatric disorders, including internalizing mental health problems (i.e., anxiety, depression). However, the frequency with which these co‐occur in this population is not known. Understanding the co‐occurrence of language disorder with anxiety and depression in youth offenders may contribute to more coordinated and targeted support for these vulnerable youth. Aims: To explore the co‐occurrence of language disorder and anxiety and depression in youth offenders. Methods & Procedures: A systematic literature search of six databases (CINAHL, ERIC, Medline, PyscINFO, PubMED, Scopus) was conducted (September 2021) using key search terms relevant to the systematic review question. Study inclusion criteria were: (1) original research published in English; (2) youth up to 21 years of age involved in the justice system; and (3) reported outcomes on language and anxiety and/or depression. All included studies were appraised using the Joanna Briggs Critical Appraisal tool checklist relevant to study design. Due to the heterogeneity of included studies, data synthesis was narrative. Main Contribution: Eight studies met the eligibility criteria. A range of measures was used to assess language abilities across samples. Only two studies directly addressed the relationship between language disorder and internalizing mental health problems; both found no significant correlation. Conclusions & Implications: Although the results did not support a significant relationship between language disorder and internalizing mental health problems in youth offenders, the two appear to occur comorbidly as evidenced by heightened rates of both in the included samples. This review highlights the need for more robust studies aimed to better understand this relationship. Stronger evidence may contribute to increased collaborative speech pathology and psychology services which might increase youth offenders' accessibility and engagement in intervention programmes (e.g., cognitive–behaviour therapy; interpersonal skills training; individual counselling). WHAT THIS PAPER ADDS: What is already known on this subject: The markedly high rates of language disorder in youth involved in the justice system have been widely reported. It is also known that externalizing mental health problems often bring youth in contact with the justice system. Though there is some information about the prevalence of internalizing mental health problems in this population, the co‐occurrence of language disorder and internalizing mental health problems has not been examined as widely. What this study adds to existing knowledge: This study aimed to identify the frequency of co‐occurrence of language disorder and anxiety and/or depression in youth offenders. Although the results did not support a significant relationship between language disorder and internalizing mental health problems in this population, results of the review provide evidence of heightened rates of both. This study also provides a summary of the various measures used to assess language and internalizing mental health in youth offenders across the eight studies included in this review. What are the potential or actual clinical implications of this work?: It is possible that the tests and sub‐tests used to identify language disorders and internalizing mental health problems were not sensitive enough to identify the full extent of youth offenders' needs. Identifying the presence of language disorders and internalizing mental health problems and recognizing the impact these may have on the communication and behaviours of an individual can better inform staff and therapists as they engage and interact with youth in the justice system. [ABSTRACT FROM AUTHOR]

Objective To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Design Systematic review and matched retrospective cohort study. Setting Australia. Participants Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Main Outcome Measures Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Results Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be diagnosed with localised disease and less likely to receive treatment for their cancer compared to their urban counterparts. Conclusion More research is needed to fully understand geographic differentials in cancer outcomes within the Indigenous population. Knowing how geographical location interacts with Indigenous status can help to identify ways of improving cancer outcomes for Indigenous Australians. [ABSTRACT FROM AUTHOR]

Background: Relative to the oral contraceptive pill, uptake of long‐acting reversible contraceptive methods (LARCs) in Australia continues to be lower than might be suggested by the evidence on their clinical and economic benefits. Aim: To undertake a critical appraisal of published economic evaluations of LARCs to assess the generalisability of their results to the Australian healthcare context. Materials and Methods: A search of the literature was conducted to identify studies of economic evaluations of LARCs using the Medline, Embase and PubMed databases. The quality of the studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: A total of 1009 citations were screened, from which 20 papers, typically reporting the cost per pregnancy avoided, were reviewed. The overall quality of the studies varied but was generally poor (average score of 62/100). To aid comparisons, results have been grouped under the headings IUS (all hormonal intrauterine systems), IUDs (all non‐hormonal intrauterine devices), injectables (all contraceptive injections) and implants (all subdermal contraceptive implants). Overall, the results indicated that LARCs were more effective and less costly than oral contraceptives. Conclusions: Despite evidence that LARCs represent value for money, limitations in study quality and approaches must be taken into account when applying these results to Australia. Differences in healthcare settings aside, LARCs may also have benefits beyond their effect on pregnancy that might be captured in broader analyses, such as cost‐benefit analyses using willingness to pay methods. These would capture benefits beyond health, which seem to be particularly relevant to contraception. [ABSTRACT FROM AUTHOR]

Background: Australian policy reports recommended schools to be leveraged to better support student mental health, with a focus on regional and rural areas where students have poorer mental health outcomes. In designing solutions to address this systemic gap, decision‐makers require an understanding of the barriers and facilitators experienced by regional and rural schools. However, current literature has focused on metropolitan schools and neglected to explore facilitators. Objective: To review the evidence on barriers and facilitators in delivering student mental health support experienced by regional and rural schools in Organisation for Economic Co‐operation and Development nations. Design: A mixed‐methods systematic review of peer‐reviewed and grey literature. Findings: The search identified 4819 studies. A full‐text review by 2 reviewers resulted in 5 papers, which met the inclusion criteria and were assessed using methodological appraisal. One study used qualitative data, 2 studies used quantitative data, and 2 studies were a mixed‐methods design. Discussion: While there was a paucity of studies, this review draws together the most up‐to‐date research. The barriers and facilitators were categorised into 3 themes: access to services and resources; mental health literacy of staff and parents; and communication and collaboration between stakeholders. Conclusion: This review presents a comprehensive synthesis of the literature and highlights opportunities to leverage rural and regional schools to support student mental health, focusing on the quality of communication and collaboration, and increasing access to services and resources, and mental health literacy. Research should explore the unique advantages of rural and regional areas to inform policy, including a focus on strengths. [ABSTRACT FROM AUTHOR]

Aim The aim of this review was to explore the status of key performance indicators ( KPIs) in Australian hospital pharmacy practice. Data sources For this narrative review, databases ( MEDLINE, PubMed and EBSCO) were searched for relevant publications within the period from April 1980 to April 2014 using the following search terms: hospital pharmacy, key performance indicators, performance measures, clinical indicators and benchmarking. The inclusion criteria were as follows: full text papers (papers only available as abstracts were discarded) and English language. Reference lists of selected papers were also searched to identify additional literature. Results While there are established competencies, standards and quality use of medicines ( QUM) indicators for hospital pharmacy in Australia, there are no standardised KPIs relating to the performance and practice of hospital pharmacy. International research has demonstrated that KPIs are valuable tools for measuring pharmacy performance; the need for KPIs is highlighted in research from the UK, USA, Canada, New Zealand and Australia. Particular challenges associated with KPI implementation include: the need for relevance to all stakeholders; difficulties in measuring pharmacists' activities due to the inherent nature of their work; lack of resources for data collection; limited understanding of KPIs; and negative attitudes toward KPIs by some pharmacists. Conclusion Before nationally standardised KPIs are introduced into Australian hospital pharmacy practice, attention must be paid to developing relevant measures through careful consultation with all relevant stakeholders, including pharmacists themselves. KPIs should provide relevant results, be easy to measure and highlight the value of hospital pharmacy services in a resource-friendly manner. [ABSTRACT FROM AUTHOR]

The quality of the care provided to frail older people in aged care is a concern for all Australians and for the citizens of many other countries internationally. This paper summarizes the methods and findings from an Australian study commissioned by the Royal Commission into Aged Care Quality and Safety to identify and synthesize international literature relating to the quality of care in aged care. A comprehensive literature review was undertaken to search and identify the literature (grey and peer reviewed) relating to quality of care and/or person‐centered care in aged care. The review identified nine key themes as salient to the quality of care experience, which include treating the older person with respect and dignity; acknowledging and supporting their spiritual, cultural, religious and sexual identity; the skills and training of the aged care staff providing care; relationships between the older person and the aged care staff; social relationships and the community; supporting the older person to make informed choices; supporting the older person's health and well‐being; ensuring the delivery of safe care in a comfortable service environment; and the ability to make complaints and provide feedback to the aged care organization. In practice, particularly in the context of residential care, quality of care has traditionally been measured using clinical indicators of care quality. These findings highlight the central importance of person‐centered care and care experience as fundamental tenets of the quality of aged care service delivery in Australia and internationally. Geriatr Gerontol Int 2021; 21: 765–778. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are associated with many health problems in women during pregnancy, including depression/anxiety, gestational diabetes and adverse birth outcomes. However, unlike other health risk factors, screening for ACEs has not been widely implemented in antenatal care settings. Aims: The aim of the scoping review was to explore the challenges in screening for ACEs in antenatal care settings and to provide the lessons learnt and evidence that guide the practice of ACE screening for both healthcare providers and pregnant women. Methods: A five‐stage process for conducting the scoping review was utilised. Searches of four key databases (PubMed, PsycINFO, CINAHL and SCOPUS) and reference lists from relevant studies were conducted. Results: Seven publications met the inclusion criteria. Challenges identified for healthcare providers in screening for ACEs include lack of knowledge and confidence in ACE tool and shortage of time and resources to undertake screening. Impediments for pregnant women include concerns about privacy. However, there were examples of effective practice for ACE screening in antenatal care settings that could apply widely. Conclusion: Addressing impediments to ACE screening is critical in implementing trauma‐informed practices that can identify women at risk of adverse health outcomes during pregnancy. A study on screening for ACEs in antenatal care in both public and private settings is needed to examine its feasibility and acceptability in the Australian context before being included in the National Perinatal Data Collection. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of dietetics practice in primary care. Methods: A scoping review synthesising peer‐reviewed and other literature relevant to the development of Australian practice nurses was conducted. Structured searches using keywords 'general practice', 'nurse' and 'Australia' were conducted in PubMed and Google Scholar in June 2021. Key government websites, Department of Health and Services Australia, were searched to identify grey literature. One reviewer screened the titles and abstracts against inclusion criteria; two reviewers conducted full‐text screening independently. Data on the evolution of practice nursing were extracted based on its interest and transferability to the dietetics workforce. Results: A total of 102 results (82 peer‐reviewed and 20 other literature) were included in the review. Key drivers for practice nurse role development in Australia were government funding, practice nurse practice standards, cost–benefit analyses of practice nurses, career and education opportunities, general practitioner and patient perspectives of practice nurses and, individual, community and local needs. Conclusions: The practice nurse role has grown and strengthened and there are three key learnings that could be translated to strengthen the dietetics workforce in primary care. (1) Use and expansion of government funding, (2) furthering post‐tertiary education and career opportunities, including dietetic primary care practice standards and (3) targeting underserviced areas such as those that are rural and remote and building positive relationships with other stakeholders including practice nurses, general practitioners, patients and the broader primary care team. [ABSTRACT FROM AUTHOR]

People brought in by police (BIBP) to the ED are a potentially vulnerable group. This narrative scoping review aimed to identify, evaluate and summarise current literature regarding the frequency of presentation, demographic and clinical profile of patients (including reason for presentation), care delivery, and outcomes for people BIBP to the ED, and identify current gaps in knowledge. The review involved searching EMBASE, CINAHL and PubMed using a combination of terms: emergency/ED coupled with police custody/watch house or police presentation, for papers published in English language from January 2006 to November 2017. A total of 20 studies met the inclusion criteria. These included 17 observational (non‐randomised controlled trials) quantitative studies and three descriptive case reports. The proportion of presentations to ED that were BIBP varied depending on the study design and sampling frame. People BIBP often presented with mental health problems, substance use problems, aggressive behaviour and injury caused by self or others. Of studies focused specifically on patients arriving to the ED in mental health crisis (i.e. suicidal ideation or self‐harm), 18–27% were BIBP. ED presentations BIBP were mostly male and typically younger than people arriving by other means. The nature of care provided in the ED and outcomes of the acute episode of care were typically not well described. Limited research regarding people BIBP to the ED limits the ability to comprehensively understand their demographic and clinical profile and outcomes of emergency care. Further research is required to inform if and where in the patient's journey further improvements may be targeted. [ABSTRACT FROM AUTHOR]

Medical diagnosis has traditionally been the role of medical officers. However, mental health nurses working in crisis/emergency settings within Australia are expected to provide a provisional diagnosis postassessment of a consumer. There is limited literature and understanding how mental health nurses develop a provisional diagnosis. In this scoping review, we aimed to first identify and describe the clinical decision‐making processes used by mental health nurses across a variety of clinical settings. Second, we sought to explore the factors influencing mental health nurse's diagnostic practice in a variety of settings. Literature was searched using CINAHL (EBSCOhost), PubMed, and ProQuest. Peer‐reviewed literature published between 2007 and 2017 was used for this scoping review. Two major themes were identified: clinical decision making (CDM) in mental health nursing and diagnostic practice in nursing. A combination of clinician, environmental, and patient factors were found to have influenced CDM. Furthermore, mental health nurses rely heavily on tacit knowledge when making clinical decisions. Little is known about the use of diagnostic practice in mental health nursing in Australia; however, the limited literature revealed an overlap between the factors which influence CDM and diagnostic practice, respectively. Further research is needed into the use of diagnostic practice in mental health nursing to develop frameworks to assist with CDM pertaining to application of provisional diagnosis by mental health nurses working in assessment environments. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a critical review of the most recent literature from 2005 onwards, on the effect of alcohol intake during lactation on the hormonal control of lactogenesis; breastmilk alcohol concentration; the breastfeeding infant, and on the breastfeeding outcomes of the mother and infant dyad. An update on public policy guiding alcohol consumption during lactation nationally and internationally is explored. The databases PubMed, CINAHL, Proquest Health and Medical Complete, ScienceDirect, Medline and ISI Web of Knowledge were searched from 2005 onwards. Alcohol inhibits the role of oxytocin in breastfeeding women, resulting in an increased time to milk ejection and a decrease in total breastmilk yield. Breastfeeding women are less likely to consume alcohol at high-risk levels, and drinking at these levels is associated with the early cessation of breastfeeding. A higher level of education and a higher income level are the characteristics of the maternal drinker during lactation. Available public health policy in Australia provides direction for breastfeeding mothers who choose to drink alcohol during this important stage of infant development. [ABSTRACT FROM AUTHOR]

Introduction: The Australian Government aims to increase the number of individuals on humanitarian resettlement visas allocated to regional locations to 50% by the year 2022. A significant issue with this, given the substantive body of research identifying that refugee populations face chronic mental health concerns during resettlement, is the lack of health‐related research focusing on the resettlement of individuals of refugee background to rural and regional locations in Australia, especially in the area of mental health. Objective: To provide a foundation for rectifying this omission, this review is the first to synthesise mental health research focusing on individuals of refugee background specifically resettled to rural and regional locations in Australia. Design: The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. Findings were synthesised using thematic analytic techniques. Findings: 14 relevant studies (3 quantitative, one mixed‐method, 10 qualitative) were identified. Findings indicated that individuals of refugee background resettled in rural and regional Australia not only experienced higher levels of psychological distress than the general population but also had significant difficulty and limited options when accessing mental health services. Furthermore, resettlement in rural and regional locations increased the risk of experiencing many interrelated factors associated with adverse mental health outcomes and distress, including very limited access to support services, with the latter being identified as vital for well‐being. Conclusion: This review highlights the disparity between the Australian Government's policies and plans regarding regional resettlement, what is happening on the ground, and identifies key gaps in research and practice which must be addressed. [ABSTRACT FROM AUTHOR]

Background/aim The first evidence-based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence-based recommendations for occupational therapists. The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy. Common characteristics of effective occupational therapy programmes for people with dementia are described. Methods Guideline development involved adaptation of existing high-quality guidelines developed overseas and 17 systematic reviews to ensure that the most recent high-quality evidence was included. One of the systematic reviews involved examining the evidence for interventions to promote independence in people with dementia. Specifically, we looked at the evidence for occupational therapy and its effect on activities of daily living, quality of life and carer impact. Results A total of 109 recommendations are included in the Guidelines. Occupational therapy was found to significantly increase independence in activities of daily living and improve quality of life. Effective occupational therapy programmes involve: environmental assessment, problem solving strategies, carer education and interactive carer skills training. Conclusion Occupational therapists working with people with dementia in community settings should ensure that their time is spent on those aspects of intervention that are shown to be effective. [ABSTRACT FROM AUTHOR]

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

Aim The aim of this study was to explore what is known about food literacy programmes targeting adolescents, including identification of the constituents of food literacy addressed, assessment of programme effectiveness, and description of programme design or delivery specific to adolescents. Methods A review of the peer-reviewed literature surrounding adolescent food literacy was conducted using scholarly electronic databases. Programme reports were identified in the grey literature using online searching and cross-referencing to support the research aim. Programmes from 2000 to 2012 targeting adolescents aged 13-17 years were included. Results A total of 19 peer-reviewed papers and four grey literature programmes met the search criteria. Interventions focused on practical cooking and/or food preparation skills and targeted younger adolescent age groups. Programmes were most commonly held in schools and community settings. The majority of programmes (n = 16/23) did not use a theoretical basis for their development. Programme evaluation encompassed the use of pre- and post-intervention questionnaires and focus groups. Only nine studies included a dietary behaviour-based outcome measure. Although 19 of the 23 studies reviewed reported positive changes related to the intervention, these did not include significant changes in diet quality or cooking frequency at home. Conclusions Few existing adolescent food literacy programmes have demonstrated a positive impact on dietary behaviours to date. Adolescent target groups present unique challenges in programme development and delivery. However, the physical, social and emotional health needs of this age group and potential to influence lifelong behaviours highlight the need to design effective and age-appropriate adolescent food literacy programmes. [ABSTRACT FROM AUTHOR]

The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. This article reviewed the worldwide hospital evacuation literature to determine the prevalence of hospital evacuations and common precipitants for evacuation. Factors leading to safe evacuation and areas of ongoing challenge were identified. The findings highlight the need for more structured and detailed reporting of hospital responses to disaster. A number of lessons can be learned from hospitals that have experienced evacuation. Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response. [ABSTRACT FROM AUTHOR]

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

Background: The Northern Territory (NT) of Australia is currently experiencing a syphilis epidemic. Neurosyphilis is commonly considered in the differential diagnosis for patients presenting with neurologic conditions such as dementia and stroke in the NT. Aims: To explore the local epidemiologic, diagnostic and treatment complexities of neurosyphilis in the NT and produce a guideline for clinical practice. Methods: A database search was undertaken and local and global neurosyphilis guidelines were analysed. A guideline was created based on findings of the critical review and consultation with local multidisciplinary experts. Results: Neurosyphilis is frequently encountered in the NT but studies suggest it is often undertreated. Dementia is the most common clinical presentation locally. Establishing a diagnosis of neurosyphilis is complex and requires stepwise evaluation of clinical, laboratory and radiological findings. Conclusions: A clinical guideline and algorithm have been developed for the diagnosis and management of patients with neurosyphilis. [ABSTRACT FROM AUTHOR]

Background: Duplex ultrasound is the first line of investigation for patients seeking treatment for varicose veins disease. In Australia, chronic venous insufficiency ultrasound examinations (CVI‐US) are primarily performed by sonographers. The use of clinical guidelines facilitates the practice of ultrasound, and more importantly, provides an assurance to the integrity and quality of the examinations. Our aim is to assess the quality of currently available guidelines and provide recommendations for choosing the appropriate guideline to use and suggestions for future guideline development. Method: We performed a systematic literature search of the Cochrane, EMBASE, EBSCO, Medline, PubMed, Google and the database of the University of Sydney. The scope covered guidelines from 2000 to 2020 available in English. Identified guidelines were appraised by four independent reviewers (sonographers) using the revised version of the Appraisal of Guidelines Research and Evaluation instrument. Results: A total of 10 guidelines were included for critical appraisal. Analysis of the results showed most guidelines were rated low quality except for the International Union of Phlebology consensus document (2006) and technical guideline by Zygmunt and colleagues (2020). Overall, Domain 1 (Scope and purposes) achieved the highest score (total score = 67.9% ± 17.3%), whereas, Domain 3 (Rigour of development) had the lowest score (total score = 41.1% ± 13.5%). Conclusion: The overall quality of CVI‐US guidelines is poor. This study highlights the demand for developing ultrasound guidelines based on methodologically sound principles along with updated scientific evidence. A stronger emphasis should be given to clinical applicability in the Australian context. [ABSTRACT FROM AUTHOR]

Ultrasound is a diagnostic tool with many advantages, however, concerns over operator wellbeing have arisen in the last 20 years. Many sonographers experience burnout, which has the potential to cause financial loss for radiology clinics, and for sonographers, suboptimal examinations, high turnover and a reduced ability to communicate with patients. The aim of this narrative review was to explore, identify and categorise the causes of burnout in the sonography profession, and to identify burnout prevention and control strategies. A literature search was conducted through Central Queensland University library, accessing the following electronic databases; Wiley Online Library, Gale Academic, Ovid, Sagepub, CINAHL, Elsevier Science Direct, PubMed and ProQuest. Eight articles were reviewed. This study identified two key themes contributing to sonographer burnout: delivering adverse news and increased workload. Twelve causes of burnout were identified, with exposure to adverse news and time constraints the most commonly identified causes. In addition, other causes identified included managerial pressures to perform more scans/tasks within a short‐time frame, followed by the constant exposure to adverse news and the burden of delivering it to patients. Recommendations include considering reducing the required number of scans per week by increasing appointment times, counselling and skills training for adverse news delivery and use of technical assistants to perform soft tasks. Current literature relating to sonographer burnout appears isolated to the obstetrics domain with further study required on sonographer burnout in other fields of sonography, including burnout because of lack of career progression. [ABSTRACT FROM AUTHOR]

Adults with a serious persistent mental illness (SPMI) express a strong desire to work. However, they continue to experience higher levels of unemployment, barriers, and occupational exclusion that impact their vocational outcomes and choice of work. The aim of this study was to investigate the impact of co‐location partnerships between adult mental health and disability employment services (DES) on employment outcomes and consumer choice of work for adults with a SPMI. Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology, a systematic literature review was conducted by searching four databases. The relationship between mental health, employment, and DES was examined. Inclusion criteria were adults with a SPMI; employment services and outcomes; and job retention and sustainability. Twelve studies met inclusion criteria. All studies were peer‐reviewed, Australian‐based, and published between 01 January 2017 and 30 August 2021. Individual placement and support (IPS); DES practice, funding, policy, and reform within the Australian mental health system; and barriers to participation in DES were the three main themes that emerged. Findings highlight the importance of joint, co‐location partnerships between mental health and employment services, including a collaborative approach to policy reform between both services, to assist adults with a SPMI to gain and sustain competitive employment. Vocational, non‐vocational, systemic, and structural barriers still exist; hence, adults with a SPMI continue to face challenges with gaining and sustaining long‐term employment. Hence, it is important for these partnerships to be systematically set up to support the complexity of the employment journey for adults with a SPMI. [ABSTRACT FROM AUTHOR]

Introduction: There has been a recent surge in the use of teledentistry services in Australia that has paralleled the COVID‐19 pandemic. Due to the limited published literature reflecting on this transition, this article employed a systematic scoping review methodology. Objective: The objective was to explore the role of teledentistry in the provision of clinical dental services in Australia. Design: Two independent reviewers searched PubMed, Embase, Scopus, Web of Science and grey literature sources to identify literature eligible for inclusion. The search was restricted to Australia and service delivery. Data were categorically synthesised by modalities and reported benefits and limitations; findings were cross‐referenced with the COVID‐19 pandemic timeline. Findings The systematic search identified 758 articles, of which 25 met the inclusion criteria. Results highlight a range of service providers and definitions of teledentistry. A shift in modality from asynchronous towards synchronous teledentistry pre‐ and post‐COVID‐19 pandemic is detailed. Discussion: Whilst highly useful during the COVID‐19 pandemic, teledentistry provides a unique opportunity to continue to increase the accessibility of dental services, especially for patients in rural areas or those who are immunocompromised. Conclusion: Clinicians and researchers must consider opportunities to merge existing research with the recent clinical uptake of teledentistry for patients that would benefit from teledental services beyond the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Background E-health is increasingly being identified as a cost-effective method to deliver health services and remote monitoring in rural and remote areas. There is a paucity of research that identifies successful implementation of e-health and remote monitoring in rural communities. Objective To identify the evidence relating to the impact of e-health on rural and remote communities and residents. Design A systematic, rapid review of grey and published peer-reviewed literature using CINAHL, MEDLINE, Psych Info, APAIS- Health, ATSI Health, Health Collection, Health & Society, Meditext, RURAL, Pub Med and Google Scholar. Search terms used included telemedicine, telehealth, e-health, regional, rural and remote communities; New South Wales, Australia, and other Organisation for Economic Co-operation and Development countries. Electronic health records and health informatics were excluded. Results The search yielded 105 articles and reports. Following removal of duplicates, initial screening and full text screening, 19 articles remained: 16 peer-reviewed publications and three grey literature. This included two systematic reviews, one literature review, six descriptive reviews of services and nine reviews of specific interventions and identification of barriers and facilitators to implementation of an intervention. There was evidence that e-health can increase access to services across a range of medical specialties without any detrimental effects and improve opportunities for professional development. Conclusion E-health has the potential to increase access to services in rural and remote communities. The evidence shows that it is as safe, effective and reliable as most conventional methods for interacting with patients while enabling people to stay within their own communities. [ABSTRACT FROM AUTHOR]

Objective To review Australian rural health ( ARH) publications in Pub Med from 2006 to 2012 and address ARH issues raised by the 2013 Health and Medical Research report. Design Retrospective observational study. Setting Internet-based bibliometric analysis using Pub Med. MEDLINE-indexed ARH publications from 2006 to 2012 were retrieved using Pub Med queries. ARH publications were defined as Australian publications that explore issues relevant to the health of the regional, rural or remote Australian population. Two authors independently reviewed a random sample of 5% of publications for validity. Main outcome measures Analysis determined country of origin ( Australia); publications relevant to the National Health Priority Areas, the 2013 National Rural Health Alliance priority areas and Rural Clinical Schools/ University Departments of Rural Health; and journal frequencies and publication types. Results ARH publications increased from 286 in 2006 to 393 in 2012 and made up 1.4% of all Australian Pub Med publications. Combined, the health priority areas were addressed in 52% of ARH publications. Rural Clinical Schools/ University Departments of Rural Health articles made up 7% of ARH publications. An increase in cohort studies, systematic reviews and reviews indicated improved quality of articles. ARH articles were most commonly published in the A ustralian J ournal of R ural H ealth (15.9%), R ural and R emote H ealth (13.4%) and the M edical J ournal of A ustralia (6.3%). Striking a balance between broadening the queries (increasing sensitivity) and limiting the false positives by restricting the breadth of the queries (increasing specificity) was the main limitation. Conclusions This reproducible analysis, repeated at given timelines, can track the progress of ARH publications and provide directions regarding future rural health research. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to systematically review qualitative evidence regarding the experiences and perceptions of General Practitioners and the factors influencing retention in remote areas of Canada and Australia. The objectives were to identify gaps and inform policy to improve retention of remote doctors, which should in turn reduce health inequalities for remote communities. Design: Meta‐aggregation of qualitative studies of General Practitioners and general practice registrars who had worked in a remote area of Australia or Canada for a minimum of 1 year and/or were intending to stay remote long term in their current placement. Results: Six synthesised findings were identified: peer and professional support, organisational support, uniqueness of remote lifestyle and work, burnout and time off, personal family issues and cultural and gender issues. Conclusions: Long‐term retention of doctors in remote areas of Australia and Canada is influenced by a range of negative and positive perceptions, and experiences with key factors being professional, organisational and personal. All 6 synthesised findings span a spectrum of policy domains and service responsibilities, and therefore, a central coordinating body could be well placed to implement a multifactorial retention strategy. [ABSTRACT FROM AUTHOR]

Ambient (outdoor) air pollution is a key risk factor for health for which effective policy plays an important preventative role. Australian federal and related state air quality standards have historically relied on international evidence for guidance, which may not accurately reflect the Australian context. However, there has been a large increase in Australian epidemiological studies over recent years. The aim of this study is to provide an updated systematic literature review of peer‐reviewed epidemiological studies that examined the health impacts of outdoor air pollution in Australia, including short‐ and long‐term exposure. Following PRISMA guidelines, we conducted a systematic literature review. Broad search terms were applied to two databases (PubMed and Web of Science) and Google Scholar. Quality assessment and risk of bias were assessed using standard metrics. Included studies were summarised by tabulating key study characteristics, grouped by health outcomes. In total, 72 studies were included in the review. Sixty‐four (89%) studies used daily or hourly pollutant concentrations to examine short‐term exposure impacts, of which 59 (92%) revealed significant associations with one or more health outcomes, including cardio‐respiratory, all‐cause mortality or morbidity and birth outcomes. Eight (11%) studies used annual average pollutant concentrations to investigate the long‐term exposure finding significant associations with asthma, reduced lung function, atopy and cardio‐respiratory mortality across five studies. The remaining three studies found no significant association with asthma, mortality and a range of self‐reported diseases, respectively. Ambient air pollution has substantial health impacts in Australia. The body of domestic evidence has increased markedly since national air quality standards were first set in the 1990s, which could be drawn on by policy‐makers when revising the existing standards, or considering new standards. [ABSTRACT FROM AUTHOR]

Aboriginal and Torres Strait Islander peoples continue to suffer adverse experiences in healthcare, with inequitable care prevalent in emergency settings. Individual, institutional and systemic factors play a significant part in these persisting healthcare disparities, with biases remaining entrenched in healthcare institutions. This includes implicit racial bias which can result in stereotyping of racial minorities and premature diagnostic closure. Furthermore, it may contribute to distrust of medical professionals resulting in higher rates of leave events and hinder racial minorities from seeking care or following treatment recommendations. The aim of this review is to analyse the effect of implicit bias on patient outcomes in the ED in international literature and explore how these studies correlate to an Australian context. [ABSTRACT FROM AUTHOR]

Objective: To examine unintentional drowning by remoteness in Australia. Design: A systematic review of both peer‐reviewed and grey literature published between January 1990 and December 2019 (inclusive). Method: Using Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non‐fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control. Result: Thirty‐two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control. Conclusion: Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost‐effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe. [ABSTRACT FROM AUTHOR]

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

Introduction: Tom Kitwood's theoretical framework of person‐centred care is extensively and internationally referred to in healthcare services. However, despite the broad use of Kitwood's approach in clinical practice, the research examining experiences with the approach has not been mapped. Aim: To map the available literature on current empirical experiences in clinical practice of Kitwood's approach to person‐centred care for people with dementia, living in institutional settings in primary health care. Methods: A total of 154 studies concerning the experiences of people with dementia and their formal caregivers' use of Kitwood's framework of person‐centred care for residents living in institutional settings in primary health care were compiled from scientific databases. All three authors engaged in a systematic selection process, leading to nineteen articles being included in the review. Results: The results showed an overall tendency towards positive experiences gained from applying person‐centred approaches in clinical practice influenced by Kitwood's theoretical framework. Through the synthesis of data from the selected studies, six categories related to our research aim were identified 'Theoretical evaluation of Tom Kitwood's model of care', 'Models and frameworks', 'Interventions', 'Communication', 'Dementia Care Mapping' and 'Environment'. Conclusion: The present review included nineteen studies published from 1998 to 2016 and consisted mainly of peer‐reviewed scientific articles, followed by dissertations, conference posters and nonpeer‐reviewed articles. All studies were undertaken in Western countries. The vast majority of the studies considered Kitwood's theoretical framework to be beneficial and useful in practice. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the global incidence of ameloblastoma and to provide a profile of ameloblastoma patients. Material and Methods: A systematic review and meta‐analysis was conducted. Searches were performed in PubMed, EMBASE, SCOPUS, and Web of Science for articles published from 1969 to 2018 for the global incidence and from 1995 to 2018 for the profile of ameloblastoma patients. Results: Seven studies on the incidence rate of ameloblastoma were included in the meta‐analysis. These studies only covered Europe, Africa, and Australia. The pooled incidence rate was 0.92 per million person‐years (95% CI: 0.57–1.49), with significant heterogeneity between studies. Forty‐two articles provided profile data of 6,446 ameloblastoma patients. Mean age was 34 years and the peak age incidence in the third decade of life. In Europe and North America, ameloblastoma mostly occurred at an older age when compared to Africa and South America. A slight male preference (53%) was found, and the mandible appeared to be the preferred site. The most common type of ameloblastoma was multicystic. The histopathologic patterns were mostly follicular and plexiform. Conclusions: This is the first study assessing the global incidence of ameloblastoma. The pooled incidence rate was determined to be 0.92 per million person‐years. [ABSTRACT FROM AUTHOR]

Objective: To identify the barriers and facilitators of achieving continuity of care between health services for patients with chronic conditions living in regional, rural and remote Australia. Design: A systematic literature review of peer‐reviewed journal publications between January 1990 and April 2018. Setting: Publications were sourced from medical and scientific databases, including: PubMed; Embase; OvidSP; ProQuest research library; and ScienceDirect. Participants: Studies, involving two groups, were included in the review: (a) Australian adults, residing in non‐metropolitan areas with a chronic condition, who accessed health care services; and (b) health care service providers (eg, doctors) who provided care to non‐metropolitan patients. Main outcome measures: Facilitators and barriers of continuity of care for non‐metropolitan patients with a chronic condition. Results: Initially, 536 studies were included in the review. Of these, 12 studies were found to have met the eligibility criteria and were included in the final analysis. Conclusions: Coordination of health care services for non‐metropolitan patients with chronic conditions substantially improves the outcomes for patients. Overall, communication, availability of resources and location are the major barriers and facilitators to continuity of care, depending on how they are managed. Recommendations have been provided to assist practitioners and policy‐makers to improve the experience of shared care and health outcomes for non‐metropolitan patients. [ABSTRACT FROM AUTHOR]

Background: Historically, pre‐pregnancy diabetes (PPDM) is a recognised risk factor for poor pregnancy outcome. Co‐existing pathology and adverse social determinants including rural‐metropolitan inequities in health and healthcare access may confer additional risks. Multidisciplinary care before, during and after pregnancy can improve outcomes for women with PPDM and their infants. The extent to which rural Australian women and their families share in improved outcomes is unknown. We aimed to summarise maternal characteristics and pregnancy outcomes for women with PPDM, including women in rural settings and examine applications of existing clinical guidelines to rural Australian practice. Methods: We sought English language population and cohort studies about PPDM using Medline, Embase, PubMed, Australian epidemiological and international clinical practice guidelines. Results: Women with PPDM are changing: older, more obese, of lower parity, less likely to smoke, more likely to have type 2 rather than type 1 diabetes and shorter duration of PPDM. Women with PPDM continue to experience excess adverse pregnancy outcomes, including maternal morbidity, complicated birth, perinatal loss, congenital anomalies and mother‐infant separation. On face value, clinical guidelines appear relevant to women living in rural settings but there are only a few, conflicting outcome studies for rural women with PPDM. Conclusions: PPDM is changing. A significant minority live in rural locations, and although perinatal mortality/morbidity seems to be improving, it is unclear if this is also true for rural women due to a lack of recent Australian studies. Further research is necessary to achieve excellence everywhere for women with PPDM and their babies. [ABSTRACT FROM AUTHOR]

Abstract: Acute hand and wrist injuries are a common presentation to the ED and are associated with large individual and societal costs. Appropriate management of these injuries in the ED is crucial given that optimal hand function is essential for daily activities and quality of life. This rapid review investigated best practice for the assessment and management of common closed hand and wrist injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites. Primary studies, systematic reviews and guidelines published in English language in the past 12 years that addressed the acute assessment, management, follow‐up plan or prognosis were considered for inclusion. Data extraction of included articles was conducted, followed by quality appraisal to rate the level of evidence. The search revealed 2454 articles, of which 55 were included in the review (n = 23 primary articles, n = 26 systematic reviews and n = 6 guidelines). This rapid review provides clinicians who manage common closed fractures and soft tissue injuries of the hand and wrist in the ED, a summary of the best available evidence to enhance the quality of care for optimal patient outcomes. There is evidence to support taking a thorough history and physical examination with consideration of occupational and functional factors, restoring alignment and immobilising when necessary and referring onwards. Key points regarding the diagnosis and management of these injuries are provided. [ABSTRACT FROM AUTHOR]

ABSTRACT: Pressure injuries are a significant health concern in all clinical settings. The current body of research on pressure injuries reported in the literature presents primarily low level evidence. The purpose of the current study was to identify and prioritize pressure injury research issues. The approach entailed evidence scoping and implementing a formal consensus process using a modified nominal group technique based on the Research and Development/University of California at Los Angeles appropriateness method. Sixteen Australian pressure injury experts participated in five consensus voting rounds in May to June 2015. From 60 initial research issues, the experts reached agreement that 26 issues are a priority for future pressure injury research. The highest priorities were strategies to assess skin and tissues, appropriate outcome measures for indicators of pressure injury healing and recurrence, heel pressure off‐loading and shear reduction strategies, economic cost of pressure injuries and their management and effectiveness of skin moisturizers and barrier products. Developing a prioritized research agenda, informed by clinical and academic pressure injury experts, can assist in reducing the burden of pressure injuries by identifying topics of the highest need for further research. A web‐based nominal group voting process was successful in engaging expert decision‐making and has wide‐reaching international appeal in facilitating cost‐effective consensus methodologies. The priority list generated from this research is currently used in Australia to inform government investment in pressure injury research. [ABSTRACT FROM AUTHOR]

Background: In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice. Aims: This integrative review's aims are to explore how professionals perceive the challenges regarding patient participation in the treatment course in mental health care. Design: An integrative review. Findings: Seven studies met the inclusion criteria: six employed qualitative methodologies and one utilised a mixed‐methods approach. The empirical studies took place in Norway, the UK and Australia, all in a mental health setting. Three themes were identified: ‘Patient participation as collaboration between the healthcare professional and patient’, ‘Challenges to participation’ and ‘From a professional's perspective – what expectations do patients have when participating in decision‐making?’ Conclusion: Different synonymous terms describing the patient's active role during treatment – user participation, collaboration, partnership, user involvement and patient participation – are linked to a recovery‐oriented approach, shared decision‐making, shared ownership and care plans. This integrative review achieves specific knowledge around patient participation, comparing the situation for adult patients with various mental disorders. However, upon reflecting on the included studies, patient participation is not clearly defined, and it is therefore difficult to transfer it to clinical practice. [ABSTRACT FROM AUTHOR]

Aim: Food security is defined by four dimensions: food availability, access, utilisation and stability. Resettled refugees face unique struggles securing these dimensions and, thus, food security when moving to a new country. This systematic review aimed to identify the challenges Australian refugees experience in achieving the four dimensions of food security. Methods: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed; the SPIDER tool was used to determine eligibility criteria. Three databases were searched using terms relating to food in/security and refugees from 2000 to 20 May 2017. Results: Seven articles were retained for analysis. Studies were categorised against the four dimensions, with four studies identifying challenges against all dimensions. Challenges contributing to high levels of food insecurity in each dimension included: availability and cost of traditional foods, difficulty in accessing preferred food outlets, limited food knowledge and preparation skills and food stability due to low income and social support. Conclusions: Food insecurity adversely impacts refugee health and integration. Methodical research framed by the four dimensions of food security is imperative to address challenges to securing food security in refugee groups and assisting in the development of sustainable interventions. [ABSTRACT FROM AUTHOR]

Aims World-wide, more than 30 million people move through prisons annually. Record linkage studies have identified an increased risk of death in ex-prisoners. In order to inform preventive interventions it is necessary to understand who is most at risk, when and why. Limitations of existing studies have rendered synthesis and interpretation of this literature difficult. The aim of this study was to describe methodological characteristics of existing studies and make recommendations for the design, analysis and reporting of future studies. Methods Systematic review of studies using record linkage to explore mortality in ex-prisoners. Based on analysis of these studies we illustrate how methodological limitations and heterogeneity of design, analysis and reporting both hamper data synthesis and create potential for misinterpretation of findings. Using data from a recent Australian study involving 42 015 ex-prisoners and 2329 observed deaths, we quantify the variation in findings associated with various approaches. Results We identified 29 publications based on 25 separate studies published 1998-2011, mainly from the United Kingdom, United States and Australia. Mortality estimates varied systematically according to features of study design and data analysis. A number of common, avoidable and significant methodological limitations were identified. Substantial heterogeneity in study design, methods of data analysis and reporting of findings was observed. Conclusions Record linkage studies examining mortality in ex-prisoners show widely varying estimates that are influenced substantially by avoidable methodological limitations and reducible heterogeneity. Future studies should adopt best practice methods and more consistent methods of analysis and reporting, to maximize policy relevance and impact. [ABSTRACT FROM AUTHOR]

Aim: The availability of high-quality, validated food frequency questionnaires is useful for the conduct of robust population dietary iron-related research. This review aimed to evaluate the validation quality of recently validated food frequency questionnaires that measure iron intakes in Australian or New Zealand adults. Methods: Articles validating food frequency questionnaires that measured iron intakes in Australian or New Zealand adults, published from 1995, were sourced from a range of databases using standard search terms. Eligible validation studies were assessed for validation quality using recommendations from international reviews of food frequency questionnaire validation studies, and a quality score was calculated. Results: Nine studies validating food frequency questionnaires were located. Seven of the nine studies had achieved at least an acceptable quality validation score. More than half of the international validation recommendations were met in at least half of the eligible studies. Studies generally did not report or consider nutrient supplementation, did not validate the food frequency questionnaire against a biomarker, nor measured survey repeatability. Conclusions: The majority of food frequency questionnaire validation studies had achieved at least an acceptable quality validation score; however, some food frequency questionnaires had undergone a higher quality validation process than others. Applying the international validation recommendations to future validation studies may improve the quality of the food frequency questionnaire validation process and, potentially, population dietary iron-related research. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Decisions on whether and how to 'schedule' drugs (i.e. to determine their legal status and penalties to be applied for sale or possession) are often heavily criticized. We sought to assess more comprehensively the results of such decisions for newly emerging drugs. Methods Through analysis of legislation and secondary sources, we identified 63 substances that have emerged since 1971, including all that have been added to the most restrictive schedule by the United Nations, United States, United Kingdom, Canada, Australia and/or New Zealand. Measurements For each jurisdiction we recorded whether, when, and how the substance was scheduled and note what decisions engendered substantial criticism or controversy within the international treaties' framework of balancing medical benefits with risk of abuse. Findings (i) The rate of emergence of new drugs has been fairly steady. (ii) There is broad cross-national agreement on what should be scheduled. (iii) The United States often acts first. (iv) Temporary bans that delay final decisions by 12-18 months can sometimes allow final decisions to be grounded on a substantially expanded research base. (v) It appears that no more than seven of the decisions reached by the United States with respect to the 63 substances are candidates for being considered errors, and arguably the United States has committed at most one serious Type I and one serious Type II error. Results for other countries are broadly similar. Conclusions The process for determining the legal status of new psychoactive substances appears to function reasonably well, within the framework of international treaty obligations. Most criticisms relate to one or a few substances (e.g. 3,4-methylenedioxymethamphetamine) and/or complaints that the decisions discount benefits that are not recognized by the treaties (e.g. recreational or religious use). [ABSTRACT FROM AUTHOR]

Aim: To undertake a systematic literature review to examine the effect of food cost on diet quality and risk factors for chronic disease, specifically focusing on diet-related lifestyle diseases affecting the Australian population. Methods: A search of six databases resulted in the inclusion of one systematic review, three cohort studies, 41 cross-sectional studies and four modelling studies in this review. Results: Between 2000 and 2006, the price of healthy foods has increased more than the price of less healthy foods. Healthy Food Access Basket surveys show that a healthy diet may often be unaffordable for low- and average-income households. Diets of higher energy density were associated with lower diet cost, whereas diets of higher nutrient density and nutritional quality were associated with higher diet cost. Recent studies report an inverse association between food price and food consumption. Consequently, an increase in food cost was associated with a significant reduction in weight, waist circumference, body mass index, obesity and insulin resistance. Conclusions: Manipulation of food cost may alter food consumption and therefore risk factors for chronic disease. Further longitudinal studies investigating the impact of pricing strategies on diet quality and disease risk are needed. [ABSTRACT FROM AUTHOR]