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Objectives Methods Results Conclusions Clinical implications Dementia care scholarship focuses on care challenges and less on positive aspects of care, especially among culturally and linguistically diverse (CALD) carers outside the United States. This article investigates positive aspects of dementia care across eight CALD groups in Australia.We analyzed interviews of 112 family carers using a four-domain framework covering: a sense of personal growth, feelings of mutuality, increases in family cohesion, and a sense of personal accomplishment.Positive associations with care are derived from past relationships, feelings of mutual obligation, valuing changed relationships and enjoying spending time with the person with dementia. Positive aspects of care were not associated with increased family cohesion except in Vietnamese and Arab families; neither was use of ethno-specific residential aged care, except for Greek and Italian families. Religion and spirituality as a coping and comforting mechanism was inconsistently expressed.The study reveals the multi-dimensional nature of care, what resonates, and diverges across CALD populations. Knowing which parts of the framework apply and which do not is useful for interventions seeking to enhance positive aspects of care.Migrant populations are varied and dynamic, and practitioners should be mindful of differences within and between ethnic minority groups. [ABSTRACT FROM AUTHOR]

Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of 'structural burden' to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi‐structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo‐centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno‐specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer‐directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno‐specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible. [ABSTRACT FROM AUTHOR]

With a vaccination program currently planned to protect Singaporean women from human papillomavirus, a need arises for assessing Singaporean women's knowledge of human papillomavirus and attitudes toward human papillomavirus vaccination to identify barriers to a successful program and to help inform health education campaigns. A representative sample of 2,145 women aged between 18 and 49 years were randomly selected from households throughout Singapore and interviewed with a similar questionnaire to that used in a recent study of Australian women. Although Singaporean women's knowledge of human papillomavirus was poor, with only 20% having heard of it, attitudes toward human papillomavirus vaccination were generally positive. The most trusted sources of information about human papillomavirus and vaccination were gynecologists and general practitioners. Based on our findings, an urgent need exists in Singapore for accurate and accessible information about human papillomavirus and the benefits of vaccination. KEYWORDS human papillomavirus, cervical cancer, human papillomavirus vaccination, knowledge, attitudes, women, Singapore

Objectives Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of "boundary crossers," this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Methods Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Results Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families' role. Discussion In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services. [ABSTRACT FROM AUTHOR]

Many health and social care services are implementing video remote interpreting (VRI) to deal with supply shortages and high costs of language interpreting for linguistically diverse clients. This qualitative study examines stakeholders' perspectives on using VRI for home-based cognitive assessments, which are routinely performed with older people during aged care assessments in Australia. We conducted 25 semi-structured interviews with clients, assessors and interpreters in Melbourne and a regional Victorian city. We found that across stakeholder groups participants usually regard VRI as an acceptable alternative to face-to-face interpreting when the latter is not possible. Freelance interpreters said VRI saved on travel time and expenditure and afforded them financial and practical benefits that enabled them to better meet the high demand for their work. However, stakeholders also pointed to the limitations of VRI, including technical challenges, sound and video quality, and difficulties with positioning equipment optimally during interviews. The assessors and interpreters agreed that VRI was inappropriate when clients are known to be cognitively impaired, and that face-to-face interpreting is necessary to support these clients and ensure assessment accuracy. We suggest that plans by health or social care services to replace face-to-face interpreting with VRI should be balanced against the needs of clients and any impacts on professional practice. [ABSTRACT FROM AUTHOR]

Introduction: Ethnicity influences dementia etiology, prognosis, and treatment, while culture shapes help-seeking and care. Despite increasing population diversity in highincome settlement countries, ethnic minorities remain underrepresented in dementia research. We investigated approaches to enhance the recruitment, and consistent collection and analysis of variables relevant to, ethnic minorities in dementia studies to make recommendations for consistent practice in dementia research. Methods:We did a scoping review, searching Embase, PsycINFO, Medline, CENTRAL, and CINAHL between January 1, 2010 and January 7, 2020. Dementia clinical and cohort studies that actively recruited ethnic minorities in high-income countries were included. A steering group of experts developed criteria through which high-quality studies were identified. Results: Sixty-six articles were retrieved (51 observational; 15 experimental). Use of interpreters and translators (n = 17) was the most common method to facilitate participant recruitment. Race and ethnicity (n = 59) were the most common variables collected, followed by information on native language (n = 14), country of birth (n = 9), and length of time in country of settlement (n = 8). Thirty-three studies translated or used a culturally validated instrument. Twenty-three articles conducted subgroup analyses based on ethnicity. Six high-quality studies facilitated inclusion through community engagement, collected information on multiple aspects of ethnic diversity, and adjusted/substratified to analyze the impact of ethnicity on dementia. Discussion: We make recommendations for consistent recruitment, collection, and reporting of variables relating to ethnic and cultural diversity in dementia research. [ABSTRACT FROM AUTHOR]

Introduction: Evidence in the literature demonstrates the reliability of cognitive screening assessments using video technology in English-speaking older populations. However, this has not been tested in older culturally and linguistically diverse (CALD) populations who require an interpreter, and what the associated costs would be. The aim was to determine if the Rowland Universal Dementia Assessment Scale (RUDAS) and the Geriatric Depression Scale (GDS) could be reliably administered over video-interpreting methods compared with face-to-face interpreting. In addition, the study aims to compare the costs of video-interpreting with the costs of face-to-face interpreting.Methods: We compared similarity of the RUDAS and GDS scores when administered face-to-face and via video-interpreting. The similarity of scores between methods was analysed using paired t-tests and Bland-Altman plots. A costing analysis was done using a micro-costing approach to estimate the costs of video-interpreting compared with face-to-face, extrapolated to a national level.Results: Analysis found no significant differences in the mean assessment scores between video-interpreting and face-to-face (RUDAS mean difference: -0.36; 95% confidence interval (CI): -1.09, 0.38, GDS mean difference: 0.22; 95% CI: -0.38, 0.83). Bland-Altman plots demonstrated that 71% of RUDAS scores and 82% of GDS scores were within the maximum allowed difference of ±2 units. Costing analysis showed a A$7 saving per assessment when using video-interpreting compared with face-to-face, with a total national saving of A$247,350.Discussion: Video-interpreting was found to be as reliable as face-to-face interpreting for both RUDAS and GDS assessments. Cost analysis indicates that video-interpreting is cheaper than face-to-face interpreting. [ABSTRACT FROM AUTHOR]

Abstract Background Education campaigns seeking to raise awareness of human papillomavirus (HPV) and promoting HPV vaccination depend on accurate surveys of public awareness and knowledge of HPV and related sexual behavior. However, the most recent population-based studies have relied largely on computer-assisted telephone interviews (CATI) as opposed to face to face interviews (FTFI). It is currently unknown how these survey modes differ, and in particular whether they attract similar demographics and therefore lead to similar overall findings. Methods A comprehensive survey of HPV awareness and knowledge, including sexual behavior, was conducted among 3,045 Singaporean men and women, half of whom participated via CATI, the other half via FTFI. Results Overall levels of awareness and knowledge of HPV differed between CATI and FTFI, attributable in part to demographic variations between these survey modes. Although disclosure of sexual behavior was greater when using CATI, few differences between survey modes were found in the actual information disclosed. Conclusion Although CATI is a cheaper, faster alternative to FTFI and people appear more willing to provide information about sexual behavior when surveyed using CATI, thorough assessments of HPV awareness and knowledge depend on multiple survey modes.

Men in the gay liberation generation are approaching or entering older age. Being at the forefront of gay rights movements since the 1970s and 1980s, this generation has experienced dramatic changes in gay life. The present study aimed to provide a greater understanding of this generation by examining some of the ways these men perceive their changing lives. Participants included 439 Australian gay-identified men aged 50 years and older who completed an online survey of their health and wellbeing. These men gave unrestricted open-ended responses to a question on how life had changed for them as a gay man since being aged in their twenties. Responses were analysed qualitatively using a thematic analysis approach to identify main themes. Participants expressed many positive changes to their lives, including greater public- and self-acceptance of their sexuality, greater confidence and self-esteem, and more freedom for same-sex relationships. However, some men expressed a loss of gay community compared to their younger years and a perception that the younger generation under-appreciated the struggles they had endured. Age- and HIV-related stigma from within the gay community, as well as a loss of sexual attractiveness, also emerged as concerns for some participants. These findings may assist researchers, health professionals and aged care services to further understand the needs and experiences of this older generation of gay men. [ABSTRACT FROM AUTHOR]

In this article, we look at the regulation of Assisted Reproductive Technology (ART) from the perspectives of service providers and regulators in three Australian states, each with a different approach to regulating ART. We explore how the interests of the child were considered in the development of recent legislative changes, namely, the establishment of central donor registers and changes to eligibility criteria for accessing ART. From participants’ perspectives, abolishing donor anonymity is considered to be a key way in which the interest of the child can be preserved through legislation. The imposition of eligibility criteria on who can access ART is considered more controversial. We suggest that the welfare of the child principle is used to justify restrictions to ART access that are politically expedient. In fact, the disparate range of approaches to the regulation of ART in Australia provides the potential for the welfare of the child to be undermined. [ABSTRACT FROM PUBLISHER]

Health service use and experiences of people who identified as transgender, in Australia and New Zealand, were examined. Participants were invited to complete a web-based survey that allowed for closed and open responses. In total, 253 respondents completed the survey; 229 were from Australia and 24 from New Zealand; 75.5% (191) reported the sex recorded on their birth certificate as male and 24.5% (62) as female; 82.2% of participants reported they had a regular doctor; of these, 83.4% reported a check up in the last year. Mental health professionals had been accessed by 47.4% of the sample. Approximately 73% reported use of hormone treatments for gender-related reasons and 39.1% of respondents reported having had gender-related surgery. Similar proportions of assigned males and females reported surgery. Participants cited many examples of positive and negative experiences with health professionals. Health and medical services play a critical role in gender affirmation for many transgender people but they were also subject to strong criticisms from participants. [ABSTRACT FROM AUTHOR]

This research had its beginnings in an act of trans activism, including a campaign by a number of trans organizations advocating the need for research dealing with health, wellbeing and access to health services in relation to this population. This study set out to recruit the broadest possible community sample by using a range of recruitment techniques and an online survey. In total, 253 respondents completed the survey. Of these, 229 were from Australia (90.5%) and 24 (9.5%) were from New Zealand. Respondents rated their health on a five-point scale; the majority of the sample rated their health as 'good' or 'very good'. On the SF36 scale, respondents had poorer health ratings than the general population in Australia and New Zealand. Respondents reported rates of depression much higher than those found in the general Australian population, with assigned males being twice as likely to experience depression as assigned females. Respondents who had experienced greater discrimination were more likely to report being currently depressed. Respondents were asked about their best and worst experiences with a health practitioner or health service in relation to being trans. They contrasted encounters where they felt accepted and supported by their practitioners with others where they were met with hostility. [ABSTRACT FROM AUTHOR]

Background: Education campaigns seeking to raise awareness of human papillomavirus (HPV) and promoting HPV vaccination depend on accurate surveys of public awareness and knowledge of HPV and related sexual behavior. However, the most recent population-based studies have relied largely on computer-assisted telephone interviews (CATI) as opposed to face to face interviews (FTFI). It is currently unknown how these survey modes differ, and in particular whether they attract similar demographics and therefore lead to similar overall findings. Methods: A comprehensive survey of HPV awareness and knowledge, including sexual behavior, was conducted among 3,045 Singaporean men and women, half of whom participated via CATI, the other half via FTFI. Results: Overall levels of awareness and knowledge of HPV differed between CATI and FTFI, attributable in part to demographic variations between these survey modes. Although disclosure of sexual behavior was greater when using CATI, few differences between survey modes were found in the actual information disclosed. Conclusion: Although CATI is a cheaper, faster alternative to FTFI and people appear more willing to provide information about sexual behavior when surveyed using CATI, thorough assessments of HPV awareness and knowledge depend on multiple survey modes. [ABSTRACT FROM AUTHOR]

The article outlines the plans to develop a way for dementia research and translation for culturally and linguistically diverse (CALD) communities in Australia. The NHMRC National Institute for Dementia Research (NNIDR), in partnership with the National Ageing Research Institute (NARI) and key stakeholders, develop the five-year action plan aimed at increasing the representation of Australians from CALD backgrounds in dementia research.

In an online survey of transgender people conducted in Australia and New Zealand, half the respondents (50.6%) reported having made attempts to amend formal documentation to reflect their current gender identity, and that this was crucial to their sense of personal and identity recognition, as well as an affirmation of citizenship. Experiences and outcomes varied, even within the same organisation, leading to different degrees of difficulty and frustration. For gender to be changed on some documentation, the individual is required to show evidence of having had a related surgical procedure. Almost 90% of participants who had undergone surgery had also made attempts to change documentation, and a quarter of participants who had not undergone any surgical procedures had made similar attempts. Participants who had been able to successfully change their documentation experienced this as affirming of their gender, and as recognition of civil belonging. [ABSTRACT FROM AUTHOR]