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An increasing focus in aged care policy is supporting older people to age at home. However, there is little recognition of the health and independence of older private renters living in a space they do not own or control. This paper draws on in-depth interviews and assessments undertaken in the homes of 27 older tenants in the Brisbane environs aiming to understand how renting privately influenced their ability to meet their basic needs. An analysis of the findings highlights the disadvantage experienced by many older private renters. Most older private renters were unable to meet their basic needs given unaffordable rent whilst reliant on the aged pension. Further, with limited access to community aged care including home modifications, the health and independence of older private renters was found to be at risk. IMPLICATIONS Community aged care is difficult for older private renters to utilise in Australia, with unaffordable services and tenancy law limiting access to community aged care services including home modifications. It is vital social workers advocate for the community aged care needs of older private renters in practice and policy settings. [ABSTRACT FROM AUTHOR]

This study aimed to describe how occupational therapists working in acute care settings in Australia assess cognitive function in patients with TBI, the influences on assessment choice, and clinician perceptions of performance-based assessment. An online survey was completed by 81 occupational therapists. The most common method of cognitive assessment was reported as non-standardized observation of functional tasks (94.7%), followed by carer-report / self-report (93%). Despite their being positive perceptions of performance-based assessment there was limited use in practice. Assessment use was impacted by practical and organizational constraints including access to assessment resources, time and the built environment in acute care. [ABSTRACT FROM AUTHOR]

Individuals with substance use disorders (SUDs) have consistently been shown to report elevated levels of anger and rates of violence perpetration. Given that heightened anger can increase risk for violence and also impede treatment for SUD, it is important to identify correlates of anger and violence among individuals in SUD treatment settings. While previous research has identified factors associated with anger and violence among individuals with SUD, these studies tend not to adequately address the role of comorbidity or trait aggression in their samples. This is particularly important given that comorbid mental health disorders, for example post traumatic stress disorder (PTSD), have been shown to be associated with anger and violence perpetration among individuals with SUD. This paper aims to examine demographic and mental health correlates of anger and violence among individuals in treatment for SUD. Structured interviews were carried out with 58 participants recruited from a residential detoxification clinic. Findings indicate that individuals with comorbid mental health symptoms, particularly symptoms of anxiety, are also likely to present with elevated levels of anger. In addition, a history of childhood trauma exposure and high levels of trait aggression were significantly associated with violence perpetration in the sample. This information can assist clinicians in identifying individuals prone to anger and violence and aid in the development of interventions designed to reduce anger and the likelihood of violence among individuals entering substance use treatment. [ABSTRACT FROM PUBLISHER]

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; "kink") are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people who happen to be survivors of trauma may engage in kink, or trauma play, to heal from, cope with, and transform childhood abuse or adolescent maltreatment. The present study sought a thematic model (Braun & Clarke, Qualitative Research in Psychology, 3(2), 77–101, 2006) of trauma recovery through kink using a critical realist, inductive approach to inquiry. Participants were eligible if they had experienced early abuse, were adults, and practiced kink. Six superordinate themes were generated from semi-structured interviews with 20 participants from five countries: cultural context of healing (e.g. using BDSM norms and previous therapy to reframe kink and trauma), restructuring the self-concept (e.g. strengthening internal characteristics which had been harmed or distorted), liberation through relationship (e.g. learning to be valued by intimate others), reclaiming power (e.g. setting and maintaining personal boundaries), repurposing behaviors (e.g. engaging in aspects of prolonged exposure), and redefining pain (e.g. transcending painful memories through masochism). Notably, participants only reported retraumatizing experiences prior to learning about the structural safeguards of BDSM. Research and clinical implications are discussed by drawing on general models of trauma recovery. [ABSTRACT FROM AUTHOR]

To evaluate a dog-walking program (called "Dog Buddies") designed to address the need for evidence-based programs that create opportunities for people with cognitive disabilities to be more socially included in mainstream society. The research question was: Does community dog walking foster social interaction for people with cognitive disabilities? Single-case experimental design was used with four individuals (three with intellectual disability; one with Acquired Brain Injury (ABI)) recruited via two disability service providers in Victoria. Target behaviours included frequency and nature of encounters between the person with disability and community members. Change was measured from baseline (five community meetings with a handler but no dog) to intervention period (five meetings minimum, with a handler and a dog). Semi-structured interviews, audio-recorded and transcribed verbatim, provided three participants' subjective experiences of the program. Dog Buddies increased the frequency of encounters for all participants. The presence of the dog helped to foster convivial encounters, community members were found to be more welcoming, and some participants were recognised or acknowledged by name over time in the intervention phase. The dog-walking program offered a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. The co-presence of people with disabilities in the community with the general population does not ensure social interaction occurs. Both disability policy, and the programs or support that is provided to people with disabilities, needs to have a strong commitment to the inclusion of people with disabilities in mainstream communities. Dog Buddies is a promising example of a program where the presence of a pet dog has been demonstrated to support convivial, bi-directional encounters of people with cognitive disabilities and other community members. Dog-walking offers a simple means of influencing the frequency and depth of community-based social interactions for people with cognitive disabilities. [ABSTRACT FROM AUTHOR]

Background: Understanding the characteristics of drug users in the night-time economy (NTE), and whether particular drugs are associated with risky practices and experience of harm, is necessary to inform targeted policy responses in this context. Objectives: To investigate the correlates of drugs used in the Australian NTE relating to demographics, alcohol use, and experience of harm. Methods: Patrons were interviewed in the NTE of five Australian cities in 2012–2013 (n = 7,028; 61.9% male, median age 22 years). A custom designed survey gathered demographic data, alcohol, and substance use on the current night, and experience of harm in/around licensed venues in the past 3 months. Multivariate logistic regression analyses examined the correlates of drug use. Results: Ecstasy was most commonly reported (4.0%), followed by cannabis (2.9%), methamphetamine (2.6%), and cocaine (1.6%). Ecstasy users were more likely to be younger and report energy drink consumption. Cannabis users were more likely to be male, and to have been involved in intoxication-related accidents/injuries and sexual aggression in/around licensed venues in the past 3 months. Methamphetamine users were more likely to have been interviewed later, and to have engaged in pre-drinking. Cocaine users were more likely to be male, aged 21 years or more, have a blood alcohol concentration of greater than 0.10%, and to have been involved in intoxication-related accidents/injuries in the past three months. Conclusions/Importance: We identified significant differences between types of drug users and the harms they experience, underscoring the need to develop innovative harm reduction policies in the NTE rather than blanket population-based approaches. [ABSTRACT FROM AUTHOR]

Work organisation has well-established associations with health. This study compares the associations of Pressure, Disorganisation and Regulatory Failure (PDR) and effort–reward imbalance (ERI) with health and well-being among older workers. Participants were 714 Australian workers aged 45–65 (56.3% female), with a mean age of 54.6 years (SD= 5.0) and a mean of 34.7 working hours per week (SD= 13.9). Hierarchical regression analyses tested the strengths of the associations of both ERI and PDR with work–life conflict and mental health. Independent variables were entered in blocks: demographic characteristics (age and gender), working hours and then ERI or PDR (measured using the four subscales: financial pressure, reward pressure, disorganisation and regulatory failure). Compared to ERI, the PDR subscales collectively accounted for slightly less variance in work–life conflict and slightly more variance in mental health. The PDR subscales also accounted for extra variance in both dependent variables when ERI was included in the model. These findings indicate that PDR is a promising construct that includes elements of work organisation not addressed by ERI. [ABSTRACT FROM PUBLISHER]

Depression represents an increasing global health epidemic with profound effects in the workplace. Building a business case via the quantification of potentially avertable costs is essential to convince organizations to address depression at work. Our study objectives were to: (1) demonstrate a process path whereby job strain and bullying are related to productivity loss via their effects on depression; (2) estimate the costs to employers of sickness absence and presenteeism that are associated with depression; (3) investigate the relationship between depression severity and costs; and (4) estimate the contribution of job strain and bullying to depression-related productivity loss. A population-based telephone survey was conducted across two Australian states (N = 2074), with a one-year follow-up (cohort design). Results confirmed job strain and bullying affected productivity via depressive symptoms. Total national annual employer costs for lost productivity due to depression were estimated at $AUD8 billion per annum, most of which was due to mild depression. We calculated a population-attributable risk (PAR) estimate of 8.7% for depression attributable to bullying and job strain, equating to $AUD693 million in preventable lost productivity costs per annum. Findings suggest that even sub-clinical levels of depression represent a significant productivity and economic burden not previously recognized. [ABSTRACT FROM AUTHOR]

The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were diagnosed with post-traumatic stress disorder. Post-traumatic stress disorder diagnosis corresponded to a significant loss of quality of life. Survival analysis was used to estimate the lifetime persistence of post-traumatic stress disorder symptoms. The average time between post-traumatic stress disorder onset and remission was 11.4 years. Results suggest that successful treatment of post-traumatic stress disorder will save 2.05 quality adjusted life years per child or adolescent with post-traumatic stress disorder. [ABSTRACT FROM AUTHOR]

Previous research has consistently documented high rates of tobacco smoking and substance use disorders among people with serious mental illness. However, limited studies have been conducted outside traditional clinical settings. In an attempt to address this shortfall and to better understand the needs of people accessing its services, a national community managed mental health service (Neami) examined the prevalence and impact of substance use among 489 consumers from across Australia. Results indicated extremely high rates of tobacco use, with 64.8% of participants identified as daily smokers. Approximately 86% of participants met abuse or dependence criteria for their caffeine use. In addition, 27.6% met criteria for an alcohol use disorder, whilst 28% met criteria for a cannabis use disorder. Overall rates of other illicit substance use were low. This study reinforces the need for routine alcohol and drug screening and assessment across all mental health settings, as well as appropriate support strategies that address high level smoking and caffeine intake. [ABSTRACT FROM PUBLISHER]