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Background: Public involvement in health research and its translation is well recognized to improve health interventions. However, this approach is insufficiently practised and evidenced in relation to young people. This paper presents an analysis of the process of co‐producing a framework, partnership model and a growing network of young people informing and guiding an adolescent health research community of practice. Methods: A Living Lab is a participatory research approach that brings together a broad range of stakeholders in iterative cycles of research, design, development, pilot‐testing, evaluation and delivery to implement effective responses to complex phenomena. The geographical setting for this study was Sydney, NSW, Australia, and involved both youth and adult stakeholders from this region. The study spanned three phases between July 2018 and January 2021, and data collection included a range of workshops, a roundtable discussion and an online survey. Results: The co‐production process resulted in three key outputs: first, an engagement framework to guide youth participation in health research; second, a partnership model to sustain youth and adult stakeholder collaboration; third, the growth of the public involvement of young people with a range of projects and partners. Conclusions: This study investigated the process of co‐producing knowledge with young people in an adolescent health community of practice. A reflexive process supported youth and adult stakeholders to collaboratively investigate, design and pilot‐test approaches that embed young people's engagement in adolescent health research. Shared values and iterative methods for co‐production can assist in advancing mutual learning, commitment and trust in specific adolescent health research contexts. Public Contribution: Young people guiding and informing an adolescent health research community of practice were involved in this study, and one of the participants is a paper co‐author. [ABSTRACT FROM AUTHOR]

Objective: To explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework. Design: Descriptive case study approach. Setting: The collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non‐governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion. Participants: Stakeholders of the collaborative design including organisations and the community. Intervention: A place‐based approach to co‐designing health services with community in one sub‐region of Western New South Wales. Main outcome measures: A synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework. Results: The collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town‐based planning. Conclusion: This study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability. [ABSTRACT FROM AUTHOR]

This study explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector. Quantitative and qualitative data were collected through an online survey, focus group and interviews with staff and managers employed by one organisation that provided OSHC services in Sydney, Australia. This paper reports on their perceptions about implementing mandatory reporting requirements associated with the concepts of 'significant harm' and 'reportable conduct'. The aim of this paper is to engage OSHC stakeholders, including government, in reviewing child protection policies and practices to support educators in their work with children. Key findings indicate the inadequacy of available training, and the importance of relationships and communication between stakeholders, especially OSHC and school staff. This requires systemic change including raising the status of OSHC and the critical role that these educators have in supporting children's development, learning and wellbeing during the early years of school. Key Practitioner Messages: It is important that leadership supports educators to engage in respectful partnerships with families and schools to ensure child protection, and thereby child wellbeing and learning outcomesTraining in supporting children's safety and wellbeing in OSHC is critical.There is a need for a systems approach to OSHC services which places children's development, learning and wellbeing at the forefront of professional practice. 'Explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector' [ABSTRACT FROM AUTHOR]

Background: Mobile learning studies often focus on teachers' perspectives. This study instead considers students' experiences of learning with mobile devices (i.e., m‐learning) in secondary school mathematics and science. Objectives: The research aims to describe the m‐learning experiences of secondary mathematics and science students, and to determine the extent to which distinctive pedagogical dimensions impact students' perceived learning. Methods: A survey instrument using the iPAC mobile pedagogical framework as a theoretical lens is developed and validated. This framework highlights three pedagogical dimensions: personalization, authenticity, and collaboration. Structural equation modelling is used to investigate how each dimension predicts students' perceived improvement in learning, whilst accounting for usage context, among a sample of students in schools where mobile devices are used extensively. Results and Conclusions: Students were in agreement that personalization was a characteristic of their m‐learning experiences, but authentic and collaborative learning were not as strongly featured. M‐learning activities fostering personalization were most important for improving perceived learning; authenticity and collaboration were also significant, but no differences in perceived learning improvement due to location were found. Authentic m‐learning and perceived improvement in learning with mobile devices were significantly higher in science than mathematics subjects. Implications: When teachers design m‐learning tasks that enhance personalization, collaboration, and authenticity, students are predicted to perceive improvements in their learning. The findings suggest that teachers should consider designing technology‐enhanced tasks that improve students' experiences of collaborative and authentic learning, particularly in mathematics for greatest gains in students' perceived improvement in learning. Lay Description: What is already known about this topic:Mobile learning studies often focus on teachers' perspectives and practices or expert commentaries.Issues of usability, access, engagement, motivation, and potential risk are often highlighted rather than pedagogical factors.Mobile technologies provide students with opportunities for more personalized and autonomous seamless experiences across learning contexts.Science teachers frequently use authentic and project‐based m‐learning opportunities, whilst mathematics teachers prefer didactic, drill and practice approaches.What this paper adds:This study focuses on students' m‐learning in secondary mathematics and science.A multi‐item scale considering aspects of authenticity, personalization, collaboration and context is developed and validated.Personalization in m‐learning activities are most important for perceived learning, followed by authenticity and collaboration.Science students report greater authenticity and perceived learning in m‐learning than mathematics students.Implications for practice and/or policy:Highlighting the student perspective is a valued lens to evaluate m‐learning pedagogy and outcomes in student learning.Efforts should be made to develop mobile pedagogies, particularly with respect to authenticity and collaboration.Teachers in mathematics would benefit most from examining practices that improve authenticity. [ABSTRACT FROM AUTHOR]

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. [ABSTRACT FROM AUTHOR]

Aim: To describe the establishment of a cross‐border and multi‐university collaboration in rural Australia to mitigate potential competition, maximise Rural Health Multidisciplinary Training (RHMT) Programme investments and regional health workforce outcomes. Context: Rural Health Multidisciplinary Training programme investments have enabled the establishment of 19 Australian University Departments of Rural Health (UDRH) and 17 Rural Clinical Schools. The importance of these investments is acknowledged. However, in regional settings, due to limited clinical placement and training opportunities, there is potential for heightened competition between universities who are operating within shared geographical footprints. Competition between universities risks focusing RHMT programme activity on individual reporting requirements and activities, in preference to: regional needs; existing community–university relationships; and place‐based approaches to health workforce development. Participants: A rural New South Wales and Victorian RHMT‐funded departments, collectively known as the Sunraysia Collaboration. Approach: Strategic and operational processes, structures and actions underpinning collaboration formation and relationship consolidation will be described. Co‐design methodologies employed to collectively define collaboration vision and aims, governance framework and guiding principles, reporting structures and co‐contributions to teaching, research and service will be discussed. Collaboration sensitivity to the social, cultural, relationship and economic connectedness within the region and existing health workforce flows will also be explored. Conclusion: The Sunraysia collaboration demonstrates one approach towards mitigating potential competition between RHMT Programme funded universities within rural and remote Australia. The collaboration is an exemplar of co‐design in action providing an alternative approach to address RHMT Programme parameters and regional needs whilst supporting rural‐remote health workforce training and education innovations. [ABSTRACT FROM AUTHOR]

Aim The hospital environment as a workplace has undergone rapid changes over the last 50 years. Despite this, there has been very little research exploring how dietitians working in hospitals perceive their workplace. Moreover, previous studies in this area have focused predominantly on examining the North American experience of dietitians. Only a handful of previous studies have investigated the experiences of Australian dietitians at different stages of their careers. Therefore this study, in part, addresses a gap in the extant literature by examining how New South Wales ( NSW) public-hospital dietitians perceive their workplace and its influence on their ability to function as healthcare professionals. Methods In 2011, 32 in-depth interviews were conducted with dietitians from 11 NSW public hospitals. Participants were selected from four career stages: new graduates, mid-career, specialists and managers. Data from the interviews were analysed through a grounded theory approach. Results Data analysis revealed that dietitians sought validation of their work experience from five sources within the workplace. In this paper, these five sources have been depicted as a conceptual model labelled the ' Five Sources of Value'. The five sources identified were: acquisition of knowledge; relationships with others; work culture; role clarity; and personal attributes. This study also found the relative importance of these values changed according to the career stage of the individual dietitian. Conclusions The retention and engagement of staff within a hospital environment is an ongoing issue for dietetic managers. The ' Five Sources of Value' identified through this study and their relative influence at different career stages may assist managers in developing workplace strategies that addresses the major areas of concern for many staff. As a result of the qualitative nature of this exploratory study, the generalisability of the findings are limited. To address this limitation, future research may follow a more quantitative approach. [ABSTRACT FROM AUTHOR]

Context This paper explores how structured feedback and other features of workplace-based assessment ( WBA) impact on medical students' learning in the context of an evaluation of a workplace-based performance assessment: the teamwork mini-clinical evaluation exercise ( T- MEX). The T- MEX enables observation-based measurement of and feedback on the behaviours required to collaborate effectively as a junior doctor within the health care team. The instrument is based on the mini-clinical evaluation exercise (mini- CEX) format and focuses on clinical encounters such as consultations with medical and allied health professionals, discharge plan preparation, handovers and team meetings. Methods The assessment was implemented during a 6-week period in 2010 with 25 medical students during their final clinical rotation. Content analysis was conducted on the written feedback provided by 23 assessors and the written reflections and action plans proposed by the 25 student participants (in 88 T- MEX forms). Semi-structured interviews with seven assessors and three focus groups with 14 student participants were conducted and the educational impact was explored through thematic analysis. Results The study enabled the identification of features of WBA that promote the development of collaborative competencies. The focus of the assessment on clinical encounters and behaviours important for collaboration provided opportunities for students to engage with the health care team and highlighted the role of teamwork in these encounters. The focus on specific behaviours and a stage-appropriate response scale helped students identify learning goals and facilitated the provision of focused feedback. Incorporating these features within an established format helped students and supervisors to engage with the instrument. Extending the format to include structured reflection enabled students to self-evaluate and develop plans for improvement. Conclusions The findings illuminate the mechanisms by which WBA facilitates learning. The educational features highlighted include effectively structured feedback processes, support for situated learning, a positive backwash (facilitation of learning through preparation for the assessment), and facilitation of informed self-assessment. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to explore data and Aboriginal and non‐Aboriginal researchers' experiences and reflexivity in co‐designing research about a rural Aboriginal well‐being program to inform practice and policy. Setting: Gumbaynggirr, Birpai, Kamilaroi and Awabakal countries located in regional and rural New South Wales, Australia. Participants: Rural and regionally located research team who co‐designed processes to challenge the status quo about a critically framed, rural‐based Aboriginal well‐being research project. Design: Researchers drew on data from a research project in an interpretive cycle of collaborative Yarning. Data included 90 published articles, 12 Yarning transcripts and 26 reflective journal text sets, as well as researcher experiences and reflexivity. Results: The Duguula Gayirray (Yarning together), Yandaarray (walking together) and Duguula Nguraljili (sharing together) co‐design practice model was developed to represent key actions in the context of an Aboriginal well‐being program in a rural context. Actions were supported by seven interpersonal ways of being and were underpinned by respectful relationships between community and researchers. Discussion Duguula Gayirray, Yandaarray and Duguula Nguraljili are critical to co‐design practice and are grounded in respectful relationships. Our experiences led us to critique our perceptions of power sharing, equitable partnerships and collaborative knowledges towards opportunity for collective research co‐design. Conclusion: Duguula Gayirray, Yandaarray and Duguula Nguraljili transformed our understanding of achieving liberation from dominant western research in the context of a rurally located Australian Aboriginal well‐being program. This study contributes to progression of Aboriginal health research practice and policy recommendations, enabling real cultural change in health care with rurally located Aboriginal communities. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has required an unprecedented surge in the pharmacy workforce to support mass vaccination hubs. This review discusses the challenges faced while training and credentialing a surge pharmacy workforce and how these challenges were overcome. The process used for training and credentialing new employees has been described and recommendations and insights have been provided based on the lessons learned at two COVID‐19 mass vaccination hubs in New South Wales. Operationalising one of the largest mass vaccination hubs in Australia required efficient training and credentialing of the pharmacy workforce. This process included the use of pharmacist‐extenders such as students, assistants, and those from other healthcare and non‐healthcare backgrounds. Training was optimised by using a flipped classroom model, so that the vaccine preparation process was provided via asynchronous online videos. The videos covered each step of vaccine dose preparation with visual cues to guide appropriate technique. On‐site training involved use of simulation and checklists for credentialing. Many factors contributed to the success of this process, including the use of triaging and the re‐allocation of personnel based on skill level, collaboration with the Sydney Pharmacy School to train and support a surge workforce involving students, initial on‐site information technology support in the form of pharmacy superusers, the use of checklists and guides for troubleshooting, and assigned pharmacy educators to train new employees. The public health response to the COVID‐19 pandemic forced us to rapidly adapt to build a pharmacy workforce in record time to support mass vaccination hubs. The recommendations and insights provided from our experience can guide future surges. Some of these concepts may also be applied to pharmacy practice in hospitals when resources are constrained. [ABSTRACT FROM AUTHOR]

Background: Reflections on the response to the COVID‐19 pandemic often evoke the concept of 'resilience' to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representatives in healthcare services in initiating changes to the way they participated in the pandemic response in the state of New South Wales in Australia. Methods: In‐depth interviews were conducted with two cohorts of consumer representatives. Cohort A included experienced and self‐identified consumer leaders, who worked together in a COVID‐19 Consumer Leaders Taskforce; Cohort B included participants outside of this group, and purposively included consumer representatives from rural and regional areas, and culturally and linguistically diverse communities. Results: The pause in consumer engagement to support health service decision‐making in responding to the pandemic forced consumer representatives to consider alternative approaches to participate. Some initiated networking with each other, forming new collaborations to produce consumer‐led research and guidelines on pandemic‐related patient care. Others mobilized support from community and politicians to lobby for specific healthcare issues in their local areas. Conclusion: The response to the COVID‐19 pandemic made visible the brittle nature of previous engagement processes of involving consumers in organizational design and governance. However, the momentum for proactive self‐organization in an unexpected crisis created space for consumer representatives to reset and reimagine their role as active partners in health services. Their ability to adapt and adjust ways of working are key assets for a resilient health system. Patient or Public Contribution: This project is a collaborative study between academic researchers and health consumer (patient and public) representatives. It followed the principles of codesign and coresearch, whereby both consumer representatives and academic researchers contributed equally to all stages of the project. The study was cofunded by both academic institutions and consumer representative organizations. [ABSTRACT FROM AUTHOR]

With continued growth in the demand for nursing care, many organizations have incorporated nursing assistants into the acute care workforce. However, role descriptions are often generic and do not provide clarity in specialist areas such as mental health inpatient settings. Issues have been noted regarding the role of assistants, delegation, and their integration with the nursing team. This study extended an existing set of care activities and explored the perceptions of nursing assistants and registered nurses regarding these activities. A modified Delphi approach added 14 new care activities for nursing assistants. A follow‐up survey found significant differences between nursing assistants and registered nurses regarding utilization of the activities, delegation, teamwork, and role clarity. Future research must incorporate the perspectives of those with lived experience of mental health issues, and develop an understanding of the interactions between nursing assistant care activities and other factors such as local supports, skillmix, and the practice environment, as these may impact how an organization can introduce nursing assistants to specialty areas while maintaining consumer and staff safety. [ABSTRACT FROM AUTHOR]

Objectives: To advance the rural practice in working with Aboriginal communities by (a) identifying the extent of community partners' participation in and (b) operationalising the key elements of three community‐based participatory research partnerships between university‐based researchers and Australian rural Aboriginal communities. Design: A mixed‐methods study. Quantitative survey and qualitative one‐on‐one interviews with local project implementation committee members and group interviews with other community partners and project documentation. Setting: Three rural Aboriginal communities in New South Wales. Participants: Thirty‐seven community partners in three community‐based participatory research partnerships of which 22 were members of local project implementation committees and 15 were other community partners who implemented activities. Intervention: Community‐based participatory research partnerships to develop, implement and evaluate community‐based responses to alcohol‐related harms. Main outcomes measures: Community partners' extent of and experiences with participation in the community‐based participatory research partnership and their involvement in the development and implementation processes. Results: Community partners' participation varied between communities and between project phases within communities. Contributing to the community‐based participatory research partnerships were four key elements of the participatory process: unique expertise of researchers and community‐based partners, openness to learn from each other, trust and community leadership. Conclusion: To advance the research practice in rural Aboriginal communities, equitable partnerships between Aboriginal community and research partners are encouraged to embrace the unique expertise of the partners, encourage co‐learning and implement community leadership to build trust. [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapy can be essentially described as enabling social inclusion through occupational participation. How does this best happen? The answer is through working in deeply collaborative, power and knowledge sharing partnerships with individuals, families, communities and populations of people across contextual boundaries. Methods: In this lecture, critical consideration is given to first, ways of working with communities of interest in service co‐design, knowledge co‐production and as co‐researchers and how the philosophical underpinnings of the profession are consistent with such approaches. The second part of the lecture examines epistemic and hegemonic 'blind‐spots' of the profession which can act as barriers to such person centred interactions, further reproducing dynamics of exclusion and marginalisation of already vulnerable persons and communities. Finally, the lecture considers the 'next era' in occupational therapy in which, in response to entrenched situations of occupational injustice globally, we may work with people in what has been termed 'radical solidarity' using de‐colonising and occupation‐centred approaches such as the Participatory Occupational Justice Framework and the Capabilities, Opportunities, Resources and Environments approach. Results: Using approaches that represent authentic partnerships between occupational therapists and the people they serve can result in powerful and potentially transformative outcomes. This is because working with people as co‐designers of services and as co‐researchers in evaluating service effectiveness, means that knowledge is co‐produced within specific contexts. This in turn means the traditional evidence/practice gap is closed. Conclusions: Working in authentic, power sharing partnerships with diverse people in diverse settings using diverse approaches, will be the way in which occupational therapy can make its strongest societal contribution. Aligning occupational justice with epistemic and hermeneutic justice is fundamental to this vision, providing a platform in which members of the profession can work collaboratively with people and go further together towards societal change. [ABSTRACT FROM AUTHOR]

Abstract: This qualitative study explores inpatient mental health consumer perceptions of how collaborative care planning with mental health nurses impacts personal recovery. Semi‐structured interviews were conducted with consumers close to discharge from one unit in Sydney, Australia. The unit had been undertaking a collaborative care planning project which encouraged nurses to use care plan documentation to promote person‐centred and goal‐focussed interactions and the development of meaningful strategies to aid consumer recovery. The interviews explored consumer understandings of the collaborative care planning process, perceptions of the utility of the care plan document and the process of collaborating with the nurses, and their perception of the impact of collaboration on their recovery. Findings are presented under four organizing themes: the process of collaborating, the purpose of collaborating, the nurse as collaborator and the role of collaboration in wider care and recovery. Consumers highlighted the importance of the process of developing their care plan with a nurse as being as helpful for recovery as the goals and strategies themselves. The findings provide insights into consumers’ experiences of care planning in an acute inpatient unit, the components of care that support recovery and highlight specific areas for mental health nursing practice improvement in collaboration. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe features that promote transformational and sustainable community engaged health partnerships and services in rural and remote Australian locations. Design: A pragmatic qualitative study using focus groups and individual semi‐structured interviews. Data were analysed using four stages of data comparison. Setting: Far west New South Wales, Australia. The health partnership, initiated by primary school principals in 2008, aimed to address allied health service inequities experienced by regional children. A service‐learning program was developed, aligning allied health student placements to student‐led services. The program has been operational since 2009. Participants: Community participants included school principals (n = 7) and senior managers (n = 2) from local facilitating agencies. Campus participants included allied health students (n = 10) and academics (n = 2), one rurally located with student supervision responsibility and one metropolitan located with a strategic partnership role. Measures: All data were collected by an independent researcher. Four stages of data comparison were undertaken. A thematic analysis was conducted and six key features identified through Stage Four comparison, a comparison across the findings from discrete community and campus groups, reflecting transformational community engagement were identified. Results: These six features are: (i) identifying and responding to community need, (ii) providing services of value, (iii) community leadership and innovation, (iv) reputation and trust, (v) consistency, and (vi) knowledge sharing and program adaptation. Conclusion: We propose that these features contributed to the transformational engagement of community and university participants. These features can inform health sector approaches to community engagement, enhancing rural and remote service accessibility, acceptability, and sustainability outcomes. [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapists consider the impact of autism spectrum disorder on occupational performance at school. Occupational therapists work with teachers to support student participation. Atypical sensory processing is common in children with autism. Therefore, collaborating with teachers to enable students with autism to appropriately process sensory information within classrooms may be necessary. This qualitative pilot study aimed to capture teachers' perceptions of using a Sensory Activity Schedule, a sensory based intervention, in the classroom. Methods: A qualitative descriptive approach was used to analyse semi‐structured interview responses from 19 qualified teachers who taught children with autism from seven different autism specific special schools in NSW. Teachers were asked about their motivation to complete the intervention as well as helpful and difficult aspects of the intervention. Findings: Three main categories and eight sub‐categories were identified from the 19 respondents who reported that helping their students was an important motivation for using a Sensory Activity Schedule as well as the opportunity to evaluate whether sensory based intervention was beneficial. Teachers reported that learning new ideas, working with an occupational therapist and seeing an increase in concentration and a reduction in undesired behaviours were positive aspects of utilising the intervention. Timing, staffing and fidelity of the intervention were areas of concern. Conclusion: Collaboration with classroom teachers is an essential part of school‐based occupational therapy. Insights from teachers who implemented a sensory based intervention in the classroom assist occupational therapists to better support students with autism spectrum disorder in schools. [ABSTRACT FROM AUTHOR]

Aim: This study examined the level of agreement between referral reason and diagnostic outcome for pre-school aged children showing developmental delays and differences. In particular, the level of agreement when there was concern about autism spectrum disorder (ASD) was investigated.Methods: Clinical records for children (n = 677) assessed for developmental concerns at a multidisciplinary assessment clinic in Sydney, Australia, were examined. Referral reason and diagnostic outcome were compared. Referral sources and factors including age, developmental level and language functioning, were explored for potential association with the consistency between referral reason and diagnosis.Results: Approximately 30% of children referred for developmental assessment with ASD concern were not diagnosed with ASD. Agreement between referral reason and diagnosis was similar regardless of referral source and child age. Of children where diagnostic outcome was discordant with referral reason, 24% had delayed language. Variability in cognitive or developmental profiles was common (64%), regardless of diagnostic outcome.Conclusions: Referral for ASD diagnostic assessments in the cases where ASD is not the primary cause for a child's difficulties increases pressure on assessment services, can delay access to ASD-specific intervention services for children who do have ASD, and can contribute to parent anxiety unnecessarily. The current evidence that a substantial minority of children were referred for ASD diagnostic assessments when ASD was not the primary cause for the difficulties emphasises the value of adopting a developmental differences framework, focusing on dimensions of behaviour and functioning, rather than an autism-specific service structure. [ABSTRACT FROM AUTHOR]

Background While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference ( PFs OR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings. Methodology Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years. Findings Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFs OR; (iii) resistance to PFs OR; and (iv) using PFs OR to enhance professional repertoires. Findings pointed to the need to ensure PFs OR include occupational considerations for occupation-based practice in mental health. Conclusion A occupation-based perspective means balancing PFs OR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFs OR lest their most visible practical actions appear psychologically based rather than occupation based. [ABSTRACT FROM AUTHOR]

Problem Chronic kidney disease ( CKD) is a significant health problem impacting Australia's Aboriginal and Torres Strait Islander population. After age adjustment, the prevalence of kidney disease is 3.7 times higher in Aboriginal people and 7.3 times higher for end-stage kidney disease compared with the wider population. Yet at an Aboriginal Community Controlled Health Service ( ACCHS) with a significant patient population, fewer than expected numbers of Aboriginal patients were identified with CKD. Design The ACCHS engaged a nurse practitioner to lead a systematic approach to the identification and treatment of CKD. Setting: This nurse practitioner-led approach to CKD was developed and implemented at a rural NSW ACCHS, with the support of a partnership formed between the nurse practitioner, the ACCHS, a nephrologist from a referral hospital and a statewide NGO. Key measures for improvement The primary measure for improvement has been to identify and stage patients with CKD and establish management plans as appropriate. Strategies for change This nurse-led project was established to: (i) identify patients with CKD; (ii) provide access for CKD patients to appropriate services; (iii) commence pharmacological and non-pharmacological strategies that enable remission or regression of CKD; and (iv) educate practice GPs and other staff members on CKD clinical guidelines and best practice. Effects of change The CKD project has improved access to essential health care for vulnerable and at-risk populations, with 187 patients to date having been identified with kidney disease and staged for its severity. Lessons learnt The need for strong multi-disciplinary teamwork has been demonstrated with good communication strategies implemented. [ABSTRACT FROM AUTHOR]

The Mental Health Nurse Incentive Program ( MHNIP) is a government-funded programme, which, since 2007, has enabled mental health nurses to work in primary care settings in Australia in collaboration with general practitioners ( GPs) or private psychiatrists. To date, small-scale qualitative studies have explored outcomes of the programme from the point of view of nurses, consumers, and the perceptions of GPs. This study reports on an on-line survey of credentialed mental health nurses perceptions of outcomes of the MHNIP. Two hundred and twenty five nurses who worked in MHNIP provided detailed narrative responses that were examined using thematic content analysis. The most commonly-cited outcomes were reductions in symptoms or improved coping, improved relationships, and enhanced community participation. Other reported outcomes included reduced hospitalization or use of state-funded mental health services, better use of health services, the continuation or establishment of meaningful occupation, improved physical health and medication management, less use of coercive interventions, and greater independence. [ABSTRACT FROM AUTHOR]

To evaluate an innovative rural service offering comprehensive primary health care for mental health service clients. A formative evaluation using mixed methods. A rural NSW community. Fifteen health care providers and 120 adult clients. A monthly clinic held in a general practice to provide primary health care for clients of the community mental health team. Client utilisation and clinic activity data. Provider views of service effectiveness, possible improvements and sustainability. The GP Clinic has operated successfully for 2.5 years without access block. Some 52% of clients had no physical illness and 82% were referred to other health and community services. In total, 40% continued to attend the clinic while 32% went on to consult a GP independently. Client access to care improved as did collaboration between the community mental health team and primary care providers. The GP Clinic is a straightforward and flexible service model that could be used more widely. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore perceptions held by nurses on the use of distraction and the role of a child life specialist in caring for children undergoing painful procedures. Design and Methods: A qualitative focus‐group design was conducted with 18 nurses from a 24‐bed pediatric unit in New South Wales, Australia; this represented 51% of the staff from the unit. Three focus groups were conducted and transcribed verbatim followed by thematic analysis. Results: Findings revealed five main themes that reflected the perceptions of the nurses' use of distraction and the impact of the child life specialist. The theme "Distraction as part of everyday nursing practice" was viewed by nurses as an integral component of nursing practice. The theme "Influence of child life specialist" revealed that the child life specialist created a feeling of ease during procedures. Differences were acknowledged between the two roles, "Contrast of roles" the child life specialist was seen as positive for children and families, whereas nurses viewed themselves as mean and unkind due to the nature of their work. The theme "The value of collaboration for positive healthcare experiences" acknowledged distraction as a contributing factor in ensuring the child and their family had a positive healthcare experience. The types of "nurses perception of the child's experience with distraction" shared in each of the focus groups identified nurses felt their techniques for distraction were much more simplified than the child life specialist; nurses felt disadvantaged at times in not having access to the same tools. Practice Implications: The findings indicate the positive impact that a child life specialist has on a nurse's role while caring for children undergoing painful procedures. Nurses felt they were able to focus on the procedure, therefore ensuring the physician received the right amount of assistance. This reassured the nurses in knowing the child and their families emotional needs were being taken care of. The child life specialist was viewed as being able to provide a positive healthcare experience for the child and families, nurses felt this added to the value of care provided in the pediatric unit. Recommendations include further exploration of the child life specialist role in the pediatric inpatient setting. [ABSTRACT FROM AUTHOR]