Search

As a trending mobility choice, e-scooters have become popular in many cities. A number of authorities have initiated shared e-scooter trial schemes to assess the feasibility of the vehicles prior to enacting official legalisation. This paper aims to provide an evidence review of shared e-scooters and investigate how existing evidence may inform long-term policies. This carries significant relevance for jurisdictions that are in a conflicting position with e-scooters, such as New South Wales (NSW), Australia whose context motivates this study. The evidence review focuses on three themes derived from experience with shared e-scooters within the broader micromobility landscape, namely: safety; where shared e-scooters fit into the modal landscape; and the environmental impacts. Findings confirm that ensuring the safety of shared e-scooters requires complex solutions, which may include a clear regulatory framework for e-scooters, safety education and skill training, innovative data collection and analysis methods, and an approach to safety management that is user-based, location-based, and time-based. In terms of modal fit policymakers should encourage first and last-mile combinations with public transport, with consideration of user characteristics; while climate impact is strongly correlated to the mode replaced by e-scooter trips. The paper provides insights for policymakers on the regulation and positioning of shared e-scooters. • Many jurisdictions are struggling to determine policies for e-scooters. • Existing e-scooter evidence sheds light on possible long-term policies. • Safety management should consider different users, locations, and times. • First and last-mile combinations with public transport should be encouraged. • Climate impact is strongly correlated to the mode replaced by e-scooter trips. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the prevalence of psychiatric morbidity, alcohol use, burnout and compassion satisfaction among physician trainees in New South Wales, Australia, and examine links between personal, demographic and lifestyle factors. Methods: A total of 67 physician trainees were recruited to the study. Fifty-nine completed the online survey (88% response rate). Outcome measures included the Depression Anxiety Stress Scale, Professional Quality of Life Scale and Alcohol Use Disorders Identification Test. Results: Approximately half the respondents met screening criteria for depression (53%), stress (51%) and anxiety (46%). Secondary traumatic stress was exceptionally high across the cohort, with higher scores in females (P = 0.001). The main reasons for not seeking help for depression or anxiety were lack of time (81%), fear of lack of confidentiality or privacy (41%), embarrassment (39%) and effect on registration (27%). Eighty-eight per cent of respondents agreed that doctors feel they need to portray a healthy image, but only 54% engaged in regular exercise and 24% slept ≤6 h each day. Conclusion: The results demonstrate high levels of non-psychotic psychiatric morbidity among physician trainees and a need to improve their well-being. Workplace systems need to promote healthy work environments and support physician trainees through good mentorship and supervision. What is known about the topic?: Doctors' health and patient care can be affected when doctors experience burnout and psychiatric morbidity. What does this paper add?: This paper adds to the evidence of psychiatric morbidity, burnout, secondary trauma and increased demographic data on a cohort of junior doctors undertaking speciality training. In addition, it provides reasons for not seeking help and positive and negative coping methods used by these junior doctors. What are the implications for practitioners?: The level of distress is high and requires system changes to support both individual health measures and structural change to work and study programs. [ABSTRACT FROM AUTHOR]

Alcohol and other drug (AoD) use is an important health and community issue and may be positively affected by collaborative care programs between specialist AoD services and general practice. This paper describes the feasibility, model of care and patient outcomes of a pilot general practice and specialist AoD (GP-AoD) collaborative care program, in Sydney, Australia, based on usual care data, the minimum data set, service utilisation information and the Australian Treatment Outcome Profile (ATOP), a patient-reported outcome measure. There were 367 referrals to the collaborative care program. GPs referred 210 patients, whereas the AoD service referred 157 patients. Most GP referrals (91.9%) were for AoD problems, whereas nearly half the AoD service referrals were for other issues. The primary drugs of concern in the GP group were either opioids or non-opioids (mostly alcohol). The AoD service-referred patients were primarily using opioids. An ATOP was completed for 152 patients. At the time of referral, those in the GP-referred non-opioid group were significantly less likely to be abstinent, used their primary drug of concern more days and were more likely to be employed (all P < 0.001). A second ATOP was completed for 93 patients. These data showed a significant improvement in the number of days the primary drug of concern was used (P = 0.026) and trends towards abstinence, improved quality of life and physical and psychological well-being for patients in the program. There are few studies of GP-AoD collaborative care programs and nothing in the Australian context. This study suggests that GP-AoD collaborative care programs in Australia are feasible and improve drug use. Alcohol and other drug use is common in Australia and causes serious health and well-being issues. Collaborative care between GPs and specialist alcohol and other drug services may improve this. This is the first Australian study to address collaborative care between GPs and alcohol and other drug services. The study shows that collaborative care is feasible in the Australian setting and suggests that it could help people who use alcohol and other drugs to access care and improve their health and well-being outcomes. [ABSTRACT FROM AUTHOR]

Background Rising demand for sexual health services requires publicly funded service providers to ensure they are seeing members of priority populations. Sydney Sexual Health Centre in New South Wales, Australia developed an innovative online triage tool called 'Am I OK?' to support this goal. Methods This paper outlines the findings of a review that examined the use of the triage tool using retrospective cross-sectional analysis of 2017 data. Results The tool has achieved its purpose in ensuring that non-priority populations are referred to other services, consequently saving a significant amount (approximately 6months equivalent) of phone triage nurse time. Conclusion More work may need to be done to ensure that the tool is not creating a barrier for priority populations wishing to access the service. [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]

Context: Forested wetlands occurring on fluvial sediments are among the most threatened ecosystems in south-east Australia. The first quantitative diagnosis of forested wetland types in NSW was completed in 2005. Since then, there has been a three-fold increase in survey data on coastal floodplains, vegetation classification systems have been developed in New South Wales, Queensland and Victoria, and methods for the assessment of ecosystem conservation risks have been adopted by the International Union for the Conservation of Nature (IUCN). Aims: To ensure an evidence base that can support conservation decisions and national conservation assessments, there is a need to review and update the classification of forested wetlands and integrate classification schemes across jurisdictions. Methods: We evaluated the efficacy of a multi-stage clustering strategy, applied to data from different sources with largely unknown methodological idiosyncrasies, to retrieve ecologically meaningful clusters. We assessed the veracity and robustness of the 2005 classification of forest wetlands as a framework for national risk assessments over an expanded range. Key results: We derived a quantitative, cross-jurisdictional classification of forested wetlands based on a synthesis of 5173 plot samples drawn from three states and identified the status of our units in relation to IUCN's Global Ecosystem Typology. Conclusions: Our analyses support the retention of the five legacy types which are the basis for threatened ecosystem listings under the NSW Biodiversity Conservation Act 2016 and Commonwealth Environment Protection and Biodiversity Conservation Act 1999. Implications: Our results will support revised assessments of current listings and facilitate their integration at state, national and global scales. This paper presents a revised broad-scale classification of forested wetlands occurring on floodplains in temperate subtropical south-east Australia and identifies relationships with vegetation types of finer thematic scale described in sub-regional classifications in Queensland, Victoria and New South Wales. Patterns in the distribution of forested wetland types are described using statistical models. [ABSTRACT FROM AUTHOR]

This paper describes caregiver-reported patterns of mental health service use for 347 pre-adolescent children in foster and kinship care in New South Wales (NSW), Australia. Children’s mean time in care and mean time with their present caregivers were 4.3 and 3.3 years respectively. Forty-four percent of children received individual therapy or counselling, 45% received interventions in the form of clinical guidance for their caregivers, and 31% received both forms of service. Among children scoring in the clinical range on any CBCL sub-scale (N = 191), equivalent rates of mental health service use were 60%, 55% and 41% respectively. Although not directly comparable, these findings describe a higher rate of service use than that reported for children in care elsewhere. While children with more complex and severe difficulties had higher rates of service use, there was no evidence of variable access for treatment of different types of disorder. Predictors of service use are reported and contrasted with previous findings. The paper considers several features of the NSW child welfare, health and education systems that may account for the relatively high rate of service use. [ABSTRACT FROM PUBLISHER]

Objective: To describe the roles that Australian nurses play, the breadth of skills that they deploy, and the range of contexts in which they practice. Study design and methods: This cross-sectional study used a descriptive survey where data were collected online using Qualtrics©. Survey respondents were nurses whose primary role was caring for people with intellectual and developmental disability. In addition to demographic data, the main outcome measures were: nursing roles, practice and context. Results: Complete responses were collected from 101 nurses; 78 females and 22 males completed the survey, the majority of whom (n=70) were from New South Wales. The major focus of care was direct assessment and care, followed by supervision of support workers, education, and advocacy for people with intellectual and developmental disability. Physical healthcare was consistent across body systems, as it was for all adaptive behaviour domains. Support for mental illness was more likely to be for depression and anxiety. Nurses liaise with a multitude of health and social agencies as part of their nursing practice. Discussion: This is the first study to capture the roles, practice and contexts of these Australian nurses. Nurses caring for people with IDD play a variety of roles and engage in a vast array of practice related to the physical and social needs of people with intellectual and developmental disability across the whole of the lifespan and in multiple, disparate contexts. Conclusion: It is important for the ongoing care of people with intellectual and developmental disability that the value added by this nursing workforce not be overlooked as disability and health policies evolve. Implications for research, policy and practice: This cross sectional study lays the groundwork for further research about these Australian nurses, in particular more focussed research about the economic benefits of disability services employing nurses, description and effect of nursing interventions specific to people with intellectual and developmental disability, as well as theoretical work to conceptualise new, National Disability Insurance Scheme-ready, models of nursing care for people with intellectual and developmental disability. What is already known about the topic? * In the Australian context, little is known about the contemporary roles and practice of nurses who care for people with intellectual and developmental disability. What this paper adds: * This paper offers a detailed and modern insight into the roles and nursing practice of this marginalised group of nurses. Although all nurses offer physical nursing care, unique to these nurses is the breadth and depth of social, behavioural, emotional and adaptive behaviour support across the lifespan. [ABSTRACT FROM AUTHOR]

Purpose Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services.Design/methodology/approach In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews.Findings The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries.Practical implications These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover.Originality/value Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

In this paper, midwives' experiences of working with vulnerable pregnant women who were subject to child protection orders in New South Wales, Australia, and faced the possible removal of their baby at birth, known as 'assumption of care', are described. A qualitative descriptive approach was used to explore the experiences of ten midwives who had been involved in some 91 episodes of assumption of care. In-depth interviews were undertaken and thematic analysis was used to analyse the data-set. Four themes were elicited that demonstrated how midwives worked with vulnerable women and Community Services during the antenatal period. These were labelled: Reporting - Taking the first step; The woman-midwife relationship remains a priority; Jumping through the 'community service' hoops; and Crunch time: The decision... sometimes justifiable sometimes not? Even though the three-way relationship between the woman-midwife-Community Services could be confrontational, it was essential that midwives worked in a positive way with Community Services to improve outcomes for the woman and her unborn child. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Messages Working effectively with Community Services is essential. Sharing information and developing multidisciplinary approaches and pathways will produce the best outcomes for vulnerable newborns and their mothers whilst at the same time supporting health and community workers to work in a cohesive manner to provide quality care., Midwives need to be supported to stay 'woman centred'. Keeping the woman engaged in the system will help ensure the health of the foetus (baby)., Further research is needed to explore the perspectives of all those involved in assumption of care. [ABSTRACT FROM AUTHOR]

Objective To examine urban-rural differences and individual risk factors for a late stage of breast cancer at diagnosis in Australian women. Design Individual-level longitudinal data were linked with cancer registry data from New South Wales (New South Wales Cancer Registry linked by the Centre for Health Record Linkage (CHeReL)), Queensland (Queensland Cancer Registry) and Victoria (The Cancer Council Victoria). Setting Participants were drawn from the Australian Longitudinal Study on Women's Health 1946-1951 cohort (n = 13 715). Participants The sample included 195 women identified from the linked cancer registry data with a breast cancer diagnosis. Interventions Rural or urban residence was measured using Accessibility/Remoteness Index of Australia Plus (ARIA+). Individual characteristics and socio-demographic variables examined included survey year, menopausal status, country of birth, education and marital status. Main outcome measures A late stage of breast cancer at diagnosis was defined based on the TNM Classification of Malignant Tumours. Results A late stage of breast cancer diagnosis was observed in 36% of women residing in urban areas and 40% of women residing in rural areas. After adjusting for individual characteristics, we found that obesity was the strongest risk factor for a late stage of breast cancer at diagnosis. Conclusions Given that women are becoming increasingly obese, and that the rate of obesity is higher in the Australian rural population, this paper provides further evidence for targeting interventions for obesity, particularly in rural Australia, as a public health priority. [ABSTRACT FROM AUTHOR]

Globally, heart failure (HF) is one of the major health issues faced by many older people. It causes significant symptom burden that requires ongoing management. This paper reports on a descriptive–observational study undertaken to: (1) describe the prevalence of pain and analgesic prescription usage in hospitalized older HF patients; (2) determine the degree to which these patients are provided with a pain self-management strategy prior to discharge; and (3) determine if the patients' pain self-management strategy has been detailed in the discharge summary. A total of 122 older HF patients were included in this study. Results indicated that moderate to severe pain (Numeric Rating Scale score ≥4) is experienced by a substantial number of older people hospitalized with HF. There is little documented evidence that older people are provided with adequate analgesic prescriptions and the instructions required to effectively manage their pain on discharge to the community. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The aim of this study was to assess the beliefs and attitudes of preservice health and physical education ( HPE) specialist and nonspecialist schoolteachers toward obese children. METHODS A total of 177 nonspecialist and 62 HPE specialist trainee teachers completed a series of pen-and-paper validated measures of attitudes and beliefs toward obese children. RESULTS Both groups of preservice teachers reported strong implicit and moderate explicit anti-fat bias. Enrollment in the HPE specialist degree was found to be a significant predictor of both implicit bad/good anti-fat bias (β = 3.97, p = .002) and implicit bias on the stupid/smart scale (β = 2.983, p = .016) of the IAT. Beliefs that obese children were less healthy, more self-conscious, and less satisfied with themselves were strongly endorsed by the majority of participants. HPE specialists were found to have significantly lower expectations for obese children in regard to 'reasoning' (mean difference = 0.21, p = .0107) and 'cooperation' skills (mean difference = 0.25, p = .0354) compared to nonspecialist trainees. CONCLUSIONS This study is the first to document the strong anti-fat bias of both preservice nonspecialist and HPE specialist teachers. It is also the first to find that preservice HPE specialist teachers have stronger anti-fat biases and differential expectations regarding particular abilities of obese children, compared to nonspecialists. [ABSTRACT FROM AUTHOR]

A key issue for policy makers and practitioners is finding a way to identify what constitutes a rehabilitative prison. In this study, aspects of a carceral experience that successfully ignite desistance journeys, or that "assist" desistance are identified and measured. We report the findings of a measure to do this, the Macquarie Assisted Desistance Instrument (MADI), which was co-designed with staff and residents in two correctional centers in New South Wales, Australia. Analysis of data from both prison staff and residents (N = 604) revealed that the measure was generally coherent (unidimensional), internally consistent, and stable across time. In addition, those who felt their desistance journeys were being more strongly assisted reported a greater sense of self-efficacy, providing support for the idea that custodial experiences can lead to better rehabilitative outcomes. Suggestions for how to improve prison practice and more meaningfully to assist people to desist from crime are proposed. [ABSTRACT FROM AUTHOR]

Objective. To describe the development of a hospital travel plan and report baseline findings. Methods. The development of a travel plan involved an assessment of organisational barriers and enablers to travel planning, auditing of the transport to and physical environment of the hospital, a staff survey, analysis of distances staff travel to work and interviews with hospital managers. Results. There were no significant organisational impediments to, and consistent managerial support for a travel plan. The staff survey response rate was similar to response rates in workplace surveys delivered mostly online via all staff emails (n = 804, 25%). The majority (83%) of respondents drove to work on most days during the week of the survey, and the majority of drivers (58%) said they were not trying to reduce their car use and not thinking of doing so. Half (47%) of all hospital staff (n = 3222) lived within 10 km and 25% lived within 5 km. People living 5-10km from the hospital were more likely to be active travellers than were those living less than 5 km from the hospital (AOR 2.7, 95% (CI): 1.6-4.5), as were male than female staff (AOR 1.7, 95% CI: 1.1-2.9). Conclusions. The process and baseline findings described in this paper are a useful reference for Australian hospitals developing travel plans. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to determine whether outcomes in a first pregnancy were associated with changes into and out of public maternity care. Methods The study population included 155 492 women with first and second sequential singleton births, 2000-09 in New South Wales. Analyses were stratified by whether obstetric care for the first birth involved private or public maternity care. Interventions, infant and maternal outcomes were assessed as predictors of a change in care. Adjusted odds ratios for changing care were obtained from logistic regression using backwards elimination. Results Similar proportions of women changed from private to public care between first and second births (9.6% compared with 9.4% public to private, P-value = 0.10). Although interventions (operative delivery, epidural) and outcomes (low Apgar, preterm birth, perinatal death, postpartum haemorrhage, perineal tear and severe maternal morbidity) were all associated with changes from public to private care, only poor infant condition (adjusted odds ratio 1.39, 95% confidence interval 1.15-1.68) was associated with a change from private to public care. Conclusions The majority of women had consistent care type for both births. This may indicate that women are generally satisfied with care, they rationalise that their first birth care was optimal or they value continuity of carer across pregnancies. What is known about the topic? There is some evidence to suggest that interventions and outcomes of one pregnancy are associated with changes in type of delivery, timing of delivery and outcomes of subsequent births. What does this paper add? Obstetric interventions and adverse maternal and infant outcomes were associated with changing maternity care sector and influenced whether or not women remained with the same care provider. What are the implications for practitioners? Continuity of carer may be important to women in choosing their subsequent pregnancy maternity care sector. Most women do not change provider, but first-birth experiences appear to influence those who do change. [ABSTRACT FROM AUTHOR]

Objectives.Cancer is the second biggest killer of Aboriginal Australians. For some cancers, the mortality rate is more than three times higher in Aboriginal people than for non-Aboriginal people. The Aboriginal Patterns of Cancer Care Study explored barriers to and facilitators of cancer diagnosis and treatment among Aboriginal and Torres Strait Islander people in New South Wales. Design.Our team – which includes both Aboriginal and non-Aboriginal researchers – conducted in-depth interviews between 2009 and 2010 with Aboriginal people with cancer, their carers and health professionals who care for them. In this paper, we identify recurrent patterns of ‘discursive framing’ in the 16 interviews with health care professionals. We are particularly interested in how these frames assisted participants in constructing a professional position on what ‘cultural difference’ means for the design and delivery of cancer care services to Aboriginal people. Results.Despite geographical, organisational, disciplinary and cultural diversity, these interview participants consistently drew upon six discursive frames, which we have interpreted as eitherelidinga discussion ofdifference(‘everyone is the same’ and ‘everyone is different’) orfacilitatingthat discussion (‘different priorities,’ ‘different practices’ and ‘making difference safe’). An additional strategy appeared to actively resist either of these positions but then tended to ultimately prioritise the eliding frames. Conclusions.While none of our participants were dismissive of the idea that cultural identity might matter to Aboriginal people, their reliance upon familiar narratives about what that means for cancer care services has the potential to both symbolically and practically exclude the voices of a group of people who may already feel disenfranchised from the mainstream health care system. Critically unpacking the ‘taken for granted’ assumptions behind how health care professionals make sense of cultural difference can enrich our understanding of and response to the care needs of indigenous people affected by cancer. [ABSTRACT FROM PUBLISHER]

Background Falls are the leading cause of injury in older people. Rehabilitation services can assist individuals to improve mobility and function after sustaining a fall-related injury. However, the true effect of fall-related injury resulting in hospitalisation is often underestimated because of failure to consider sub-acute and non-acute care provided following the acute hospitalisation episode. Aim This study aims to describe the sub-acute and non-acute health service use of individuals hospitalised in New South Wales (NSW), Australia for a fall-related injury during 2000-01 to 2008-09, to examine the burden of fall-related inpatient rehabilitation hospital admissions from 1998-99 to 2010-11 and to estimate future demand for fall-related inpatient rehabilitation admissions in NSW to 2020. Method Retrospective review of sub-acute and non-acute records linked to hospital admission records during 2001-02 to 2008-09 in NSW. Analysis of temporal trends from 1998-99 to 2010-11 and projections to 2020 for rehabilitation-related (ICD-10-AM: Z47, Z48, Z50, Z75.1) inpatient hospital admissions. Results There were 4317 individuals with a fall-related injury admitted to hospital and subsequently admitted for sub-acute and non-acute care; 84% of these were aged 65+ years; 70.4% were female and 27.2% had femur fractures. For the rehabilitation-related admissions, total mean functional independence measure (FIM) scores improved significantly (from 78.4 to 94.6; P <; 0.0001) between admission and discharge. Fall-related inpatient rehabilitation episodes increased by 9.1% each year between 1998 and 2011 for individuals aged 65 years and older and are projected to rise to 50 000 admissions annually by 2020. Conclusion This is the first study to provide an epidemiological profile of individuals using sub-acute and non-acute care in NSW using linked data. Improvements in data validity and reliability would enhance the quality of the sub-acute and non-acute care data and its ability to be used to inform resource use in this sector. The examination of temporal trends using only the inpatient hospital admissions provides a guide for resource implications for inpatient rehabilitation services. What is known about this topic? Fall-related injuries that result in inpatient hospital admissions are increasing in Australia. However, the extent of the effect of fall-related injuries in the sub-acute and non-acute sector remains unknown, due to data limitations. What does this paper add? Provides the first epidemiological profile of individuals who fall and go on to use sub-acute and non-acute care in NSW using linked data. It highlights where improvements in data quality in the sub-acute and non-acute care data could be made to improve their usefulness to inform resource use in this sector. What are the implications for clinicians? Fall injury prevention and healthy ageing strategies for older individuals remain a priority for clinicians. The current and projected future resource implications for inpatient rehabilitation and follow-up services provide an indication for clinicians of future demand in this area as the population ages. However, data quality needs to improve to provide clinicians with strongly relevant guidance to inform clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To assess the feasibility and the effects of a multi-component education toolkit that used the Aged Care Funding Instrument behaviour (ACFI-BEH) scores to trigger care planning for older people experiencing behavioural and psychological symptoms of dementia (BPSD). Method: Forty-six older people and 209 staff and managers from five Sydney metropolitan residential aged care (RAC) facilities participated in this pre-post intervention pilot study. Results: The face validity and accessibility/acceptability of the toolkit was established, but potential utility of the ACFI-BEH in informing care planning was proven to be negligible. The ACFI-informed education toolkit did not lead to statistically significant improvements in care planning practice or reduce the severity/frequency of the targetted BPSD. Care plan quality remained low post intervention, with between 31% (N = 12/39) and 65% (N = 13/20) of care plans not addressing the persons' BPSD, nor utilising the ACFI information in relation to BPSD. Conclusion: This study has underscored the problems associated with current care planning practice in RAC settings and the need for developing strategies to ensure quality and safe care through individualised care planning practices. Our study processes, results and lessons discussed in this paper could assist future research on this type of research in RAC settings. [ABSTRACT FROM AUTHOR]

General practitioners (GPs) identify that depression can be difficult to diagnose in populations with high rates of alcohol and other drug (AOD) use. This is a particular concern with gay men who are a population known to engage in high rates of AOD use and who are vulnerable to depression. This paper uses data from 563 gay men and their GPs to describe concordance between assessments of major depression and, in particular, whether AOD use undermines concordance. Data were collected as part of a larger study of male patients and GPs at high HIV-caseload general practices in Australia. Concordance was measured by comparing patients' scores on the Patient Health Questionnaire-9 screening tool, which is based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria, and GPs' ratings of the likelihood of depression for each participant. We observed high concordance between GPs' assessments of major depression and patients' scores on the PHQ-9 (79% agreement), although our analysis also suggested that concordance was better when it related to cases in which there was no depression. The high concordance observed in our study did not appear to be undermined by gay male patients' AOD use, with the exception of frequent use of crystal methamphetamine. Here, men who reported frequent use of methamphetamine were significantly less likely to have concordant assessments (adjusted odds ratio 0.3, 95% CI 0.1-0.8). Overall, GPs appear to identify depression among many of their gay male patients. While GPs should be aware of the potential complications presented by frequent crystal methamphetamine use, other AOD use may have less impact on the diagnosis of depression. [ABSTRACT FROM AUTHOR]

This paper aims to track smokers’ and recent quitters’ recall of tobacco news, compare patterns of recall with patterns of news coverage and assess associations between news recall and smoking-related cognitions and behaviours, by using a quantitative analysis. The Cancer Institute New South Wales (NSW)’s Tobacco Tracking Survey, a continuous tracking telephone survey of adult smokers and recent quitters, was used to monitor recall of tobacco news and smoking-related cognitions and behaviours from January to September 2010 (approximately 50 interviews per week; n = 1952). Thirty per cent of respondents reported semi-prompted recall of tobacco news with patterns of recall closely following peaks in news coverage. Television was the most frequently cited source of tobacco news. Multivariate logistic regression analyses indicated that, controlling for individual characteristics, smokers with high levels of tobacco news recall were significantly more likely to have strong beliefs about harms from smoking [odds ratio (OR) = 1.38] and frequent thoughts about quitting (OR = 1.32). The results show that the news media are an important source of information for smokers, with the potential to influence beliefs and to put or keep quitting on the smokers’ agenda. Media advocacy remains an important component of tobacco control. [ABSTRACT FROM PUBLISHER]

The aim of this paper was to describe and test a social cognitive model of physical activity tailored for adolescent girls. Participants were 1518 girls (aged 13.6 ± 0.02 years) from 24 secondary schools in New South Wales, Australia. Useable accelerometer (≥10 hours day−1 on at least 3 days) and questionnaire data were obtained from 68% of this sample (N = 1035). Participants completed questionnaires assessing psychological, behavioural, social and environmental correlates of activity. The theoretical model was tested using structural equation modelling in AMOS. The model explaining accelerometer counts per minute was an adequate-to-good fit to the data (Tucker–Lewis Index = 0.89, the comparative fit index = 0.97 and the root mean square of approximation = 0.098; 90% confidence interval = 0.075–0.122) but explained only 5% of the variance in activity. There were significant model pathways from self-efficacy (r = 0.11, P = 0.01), school environment (r = 0.07, P = 0.02) and physical self-worth (r = 0.07, P = 0.04) to accelerometer counts. Although the proposed model provided an adequate-to-good fit to the data, it explained a small portion of the variance. Shared method variance may explain the larger portions of variance explained in previous studies. Future studies are encouraged to evaluate theories of physical activity behaviour change using objective measures of physical activity. [ABSTRACT FROM PUBLISHER]

Transparency is an important taxation principle in maintaining integrity in the taxation of land. This paper is a review of improvements in transparency following recommendations for reforms to the valuation of land by the NSW Ombudsman in 2005. Data on objection rates to land values has been sourced from the NSW Department of Lands both pre and post the introduction of the 2005 reforms recommended by the NSW Ombudsman. This paper attempts to measure improvements in transparency via changes in objection rates to land values issued by the Valuer-General, resulting from the availability of sales information to land tax payers from 2005. In conclusion a summary of improvements in transparency are provided as well as recommendations for refinements in the development of further transparency measures which may be adopted. [ABSTRACT FROM AUTHOR]

To address increasing rates of overweight and obesity, a population-based telephone intervention was introduced in New South Wales, Australia. The Get Healthy Information and Coaching Service® (GHS) offered participants a 6-month coaching program or detailed self-help information. Determining the population reach of GHS is of public health importance to ensure that the program reaches disadvantaged groups. This paper describes the socio-demographic and risk profile of participants (n = 4828) in the first 18 months of operations, determines how representative they are of the population, assesses changes in participants’ socio-demographic profile and compares ‘information-only’ and ‘coaching’ participants. The results show that GHS users are representative of the adult population in relation to education, employment status, Aboriginal status, fruit and vegetable consumption and alcohol use. However, more female, middle-aged, English-speaking, rural and socially disadvantaged adults participated in GHS. Coaching Participants were more likely to be overweight and to be ex-smokers than the general population. There was substantial variability in GHS recruitment, when mass-reach television advertising was used, participants enrolled from a major city and from more disadvantaged communities. The GHS has broader population reach than many local interventions, but further efforts are needed to increase reach by Aboriginal communities, other minorities and men. [ABSTRACT FROM PUBLISHER]

This study examined whether short sleep duration, physical activity and time spent sitting each day mediated the association between long work hours and body mass index (BMI). Participants included 16,951 middle aged Australian adults who were employed in full time work (i.e. ≥35 h a week). Data on BMI, sleep duration, work hours and other health and demographic variables were obtained through a self-report questionnaire. A multiple mediation model was tested whereby sleep duration, physical activity and amount of time spent sitting were entered as potential mediators between work hours and BMI. The results demonstrated that short sleep partially mediated the association between long work hours and increased BMI in males. In females, long work hours were indirectly related to higher BMI through short sleep. The results provide some support for the hypothesis that long work hours could contribute to obesity via a reduction in sleep duration; this warrants further investigation in prospective studies. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol use and dependence are common among people involved in the criminal justice system but there have been few efforts to assess the utility of diversionary programs for defendants whose offending is related to alcohol use. Method: This paper analyses program completion, health outcomes and recidivism among 202 participants in the Rural Alcohol Diversion (RAD) program, Australia. Logistic regression was used to identify predictors of program completion. Paired t-tests were used to assess changes in alcohol use, general health and mental health from program entry to exit. Recidivism was assessed using Cox proportional hazards modelling. Results: Being male was associated with increased odds of program completion at p = .05. Among participants who completed the program, there were reductions in alcohol use and psychological distress, and improvements in general and mental health. The only predictor of re-offending was number of prior convictions. Conclusions: These findings are suggestive of improved health for RAD participants but do not indicate that completion of RAD is associated with reduced offending. Further research employing a control group is needed to determine if the changes noted in this study are a direct effect of the RAD program. [ABSTRACT FROM AUTHOR]

Objective: This paper draws on questionnaire findings and analysis of students' comments to demonstrate the aspects of rural placements that were effective in engaging students in the learning process. It also examined how a primary health care clinical placement in Aboriginal communities can provide nursing students with a rich and varied learning experience and an insight into the complex aspects of rural life including Aboriginal health. Design: A cohort of eight second-year nursing students from the Australian Catholic University, North Sydney, in partnership with the Broken Hill University Department of Rural Health (BHUDRH), participated in a 4 weeks' rural placement in far western New South Wales. A pre-test/post-test questionnaire was used to capture their experiences with the students completing the questionnaires before and after their clinical placements. Such placements offer students opportunities to deepen their understanding of issues related to rural health in clinical, professional, social and community contexts. Results: The results suggest that clinical experience in rural areas can positively influence attitudes, preparedness for practice and engage students on many levels, deepened their understanding of rural communities and issues related to rural health. Conclusion: This group of undergraduate nursing students indicated they all had a positive learning experience in their rural clinical placement. The value of rural placements as a method for increasing nursing student's practical experience should be promoted. [ABSTRACT FROM AUTHOR]

This paper takes up the notion that service learning might be understood as a 'third space' (Bhabha, 1990, 1994; Soja, 1996) in teacher education. In work with young people designated as 'at risk' in and out of school, the metaphor of the third space evokes a hybrid, in-between, disruptive space that can operate to disturb normative or deficit perceptions and to disrupt pre-service teacher subjectivities. The 'third space' also draws attention to the centrality of embodied space and place in pedagogical encounters. This paper describes three of the service learning strands in the suite of opportunities available to secondary pre-service teacher at the University of Western Sydney, and, using participant reflections on these placements as data, it begins to trace material and metaphoric articulations of third space in teacher education. [ABSTRACT FROM AUTHOR]

Objective. This study investigated whether the provision of financial assistance to patients living in regional New South Wales influenced patients' decisions to participate in a cancer clinical trial (cancer treatment or supportive care) and resulted in improved psychosocial outcomes. Methods. Administrative data were collected from participants, including demographics, travel distances and the value of financial support provided. Qualitative interviews were then conducted with a subset of consenting patients who received financial assistance for a clinical trial. Results. Sixty-four patients with cancer received financial support for a clinical trial, 27 (42%) of whom were interviewed. Participants whose distance to a trial site was over 400 km received almost three times as much financial support (M = A$3194.20, s.d. = A$1597.60) as participants whose distance to a trial site was between 50 and 100 km (M = A$1116.29, s.d. = $A1311.23). Half of participants indicated that receiving financial assistance influenced their decision to participate in a clinical trial, and most indicated the support alleviated the financial burden of clinical trial participation. Conclusions. The provision of financial assistance to patients living in regional areas may reduce inequities in cancer clinical trial participation and improve psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to investigate why registered nurses seek forensic mental health employment and explore their initial impressions of this setting. Design: Explanatory sequential mixed methods. Methods: Registered nurses employed in a forensic mental health hospital completed an online survey about their reasons for seeking work in forensic mental health and their transition into the setting. To fully explore findings, semi‐structured interviews were conducted with a sub‐group of survey respondents. Descriptive statistics were used to analyse survey data, and thematic analysis was used to analyse the interviews. Results: Sixty‐nine respondents completed the survey, and 11 interviews were conducted. Prior interest in forensic mental health and encouragement from hospital staff were considered important influences in seeking forensic mental health employment. New knowledge, changes in clinical responsibility, exposure to patients' background offences and security processes overwhelmed some participants initially. However, participants reported that the initial challenges of their transition revealed opportunities to develop genuine connections with patients. Conclusion: This study provides a new understanding of the reasons why nurses seek employment in forensic mental health and the challenges and opportunities experienced when first working in this setting. Such professional and personal elements need to be considered by organizations to strengthen recruitment strategies and support future nurses' transition into forensic mental health settings. Impact: This study provides new knowledge about recruiting and supporting nurses' transition into forensic mental health employment. As such, it informs policymakers, clinical services and managers about strategies needed to attract and retain this workforce. Patient or Public contribution: No public or patient involvement. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the impact of a web-based positive psychology program delivered universally to secondary school students during school closures caused by the COVID-19 pandemic in New South Wales, Australia. Methods: Using a quasi-experimental design conducted in 2020, 438 students aged 12–15 years (73% male) from 4 secondary schools were invited to complete the 'Bite Back Mental Fitness Challenge'. This web-based program consisted of 7 self-directed modules that targeted 5 key domains of positive psychology. Self-reported symptoms of anxiety and depression and help-seeking intentions for mental health were assessed at baseline prior to school closures (February to March 2020) and at post-test after the return to school (July to August 2020). At post-test, students also reported on their perceived changes in mental health and help-seeking behavior for mental health during the pandemic. Completion of the program modules was recorded. Results: A total of 445 students consented and 336 (75.5%) completed both assessments. On average, participants completed 2.31 modules (SD: 2.38, range: 0 to 7). There was no change in symptoms of anxiety and depression or help-seeking intentions between baseline and post-test, with no significant effects for gender and history of mental illness. Students who were symptomatic for anxiety and depression at baseline reported lower symptoms at post-test, but this change was not significant. Ninety-seven students (27.5%) reported that their mental health had worsened during the pandemic, and a significant increase in anxiety and depressive symptoms was found in this subsample at post-test. Only 7.7% of students reported a change in their help-seeking behavior, with increased mental health support sought from the Internet, parents, and friends. Conclusions: The universal delivery of a web-based positive psychology program during school closures did not appear to be associated with improved mental health symptoms; however, completion of the modules was low. Different effects may emerge when selectively delivered to students with mild or greater symptoms. The findings also suggest that broader measures of mental health and wellbeing, including perceived change, are key to the mental health surveillance of students during periods of remote learning. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between structural characteristics of Australian residential aged care facilities (RACFs) and breaches of the aged care quality standards. Methods: Facility‐level analysis of audits, sanctions and non‐compliance notices of all accredited Australian RACFs between 2015/16 and 2018/19. Structural factors of interest included RACF size, remoteness, ownership type and jurisdiction. Two government data sources were joined. Each outcome was analysed to calculate time trends, unadjusted rates and relative risks. Results: Non‐compliance notices were imposed on 369 RACFs (13%) and 83 sanctions on 75 RACFs (3%). Compared with New South Wales (NSW), non‐compliance notices were less likely in Victoria, Queensland and the Northern Territory (NT), more likely in South Australia (SA), and comparable in Western Australia (WA), Tasmania and the Australian Capital Territory (ACT). RACFs with more than 100 beds and RACFs located in remote and outer regional areas (vs. major cities) also increased the likelihood of non‐compliance notices. Compared with NSW, sanctions were less likely in Victoria, Queensland, NT and WA and comparable in SA, Tasmania and ACT. Additionally, the likelihood of sanctions was higher for RACFs with more than 40 beds. For both non‐compliance notices and sanctions, no significant relationship was found with RACF ownership type. Conclusions: We partially confirmed other Australian findings about the relationship between RACF structural characteristics and regulatory sanctions and reported new findings about non‐compliance notices. Routine and standardised public reporting of RACF performance is needed to build trust that Australia's latest aged care reforms have led to sustained quality improvements. [ABSTRACT FROM AUTHOR]

Vegan dietary patterns are increasingly being adopted by endurance athletes, yet research examining the influence of this dietary pattern on exercise‐related physiology is limited. This pilot study, therefore, aimed to explore nutrient status, diet quality and cardiovascular and inflammatory responses in aerobically trained adult males following vegan and omnivorous dietary patterns during aerobic exercise. An incremental ramp running test was used to assess peak oxygen consumption (VO2peak) in males aged 18–55 years, engaging in >4 h training/week. Exercise testing was performed during walking and steady‐state running conditions (60% and 90% of VO2peak). Participants were grouped by dietary pattern type and were equivalent for age, training volume and VO2peak. When compared to the omnivorous group (n = 8, age 35.6 years, VO2peak 55.7 mL/kg/min), the vegan group (n = 12, age 33.4 years, VO2peak 56.4 m/kg/min) consumed more energy from carbohydrates (p = 0.007), and less energy from protein (p = 0.001) while exhibiting a higher overall diet quality score (p = 0.008). No differences in inflammatory biomarkers were observed before or after running. Total red blood cell count, haemoglobin and haematocrit levels were lower in the vegan dietary group. In summary, aerobically trained males, following a long‐term vegan diet, can tolerate a short bout of running broadly comparatively to their omnivore counterparts. More arduous endurance exercise conditions should be explored to further uncover potential outcomes of consuming a vegan dietary pattern and exercise‐related physiology. [ABSTRACT FROM AUTHOR]

Introduction: Children often present to occupational therapy with delays in pre-school occupations, with underlying skill deficits. If unaddressed, deficits may affect adjustment to school, jeopardising educational progress. Although evidence supports group-based interventions, evaluation can be time-intensive and expensive. We developed and piloted an evaluative toolkit to measure and report outcomes for short school readiness groups. Method: We sought measures that were inexpensive, reliable and responsive to change in key domains. Skills and pre-school occupations were measured in children [ n = 58; mean = 5 years] before and after our school starters group program. Parents rated their children's skills, school readiness and level of school-related anxiety. Results: Our resource-efficient, multi-measure, skills-based evaluative toolkit reliably recorded changes in children's performance in our school readiness program. Measures were adapted for groups. Children demonstrated improvements in skills important for successful school transition pre-post program; including static and dynamic balance, pencil grasp/control, pre-writing/drawing skills and name writing. Parents' confidence in their child's readiness for school increased, while school-related-anxiety decreased. Conclusion: The evaluative toolkit proved responsive to change and showed excellent inter-rater reliability. Measures were practicable for groups, easy to administer and score, and engaged parents in their child's progress. In our six-session School Starters group, important pre-school skills were improved in participating children. [ABSTRACT FROM AUTHOR]

Introduction: Delayed discharge from inpatient mental health units is the continued hospitalisation of consumers after being assessed as ready to be discharged. This is common in adult inpatient mental health services and is usually due to a lack of appropriate housing for discharge. Research indicates a range of possible negative impacts, but no studies have explored consumers' perspectives on this issue. This study explores consumers' perspectives of the experience of housing related delayed discharge (HRDD). Method: Using a grounded theory approach, in‐depth interviews were conducted with 10 consumers. All consumers were experiencing HRDD from inpatient mental health units in one Sydney local health district. The data were analysed using constant comparative analysis. Findings: A lack of choice and control was the central theme that characterised participants' experiences. The combined experience of being delayed in hospital and being homeless led to a lack of choice and control over the basics in life, how consumers spent their time and with whom, and their futures. This lack of autonomy was shaped by the features of the hospital and participants' personal circumstance. The hospital features included rules and routines, physical and social environments, resources, and support from staff. Personal circumstances included individual situations, social networks, and support from community organisations. Participants described a variety of impacts, including reduced mental and physical well‐being, and anticipated difficulty transitioning back into the community. Conclusion: This study is the first of its kind and provides consumer perspectives on the impacts of HRDD on their well‐being and recovery. The inability to participate in meaningful and necessary occupations is an occupational injustice and implies the need for occupational therapists to advocate for both the prevention of HRDD through government investment in affordable and readily available housing and the mitigation of its effects through modified hospital environments and practices. [ABSTRACT FROM AUTHOR]

Traditional methods for assessing coastal hazards have not typically incorporated a rigorous treatment of uncertainty. Such treatment is necessary to enable risk assessments which are now required by emerging risk based coastal zone management/planning frameworks. While unresolved issues remain, relating to the availability of sufficient data for comprehensive uncertainty assessments, this will hopefully improve in coming decades. Here, we present a modelling framework which integrates geological, engineering and economic approaches for assessing the climate change driven economic risk to coastal developments. The framework incorporates means for combining results from models that focus on the decadal to century time scales at which coasts evolve, and those that focus on the short term and seasonal time scales (storm bite and recovery). This paper demonstrates the functionality of the framework in deriving probabilistic coastal hazard lines and their subsequent use to establish an economically optimal setback line for development at a case study site; the Narrabeen–Collaroy embayment in Sydney, New South Wales. [ABSTRACT FROM AUTHOR]

Background Acupuncture services form a significant part of the Australian healthcare setting, with national registration of acupuncture practitioners, public subsidies for acupuncture services and high use of acupuncture by the Australian public. Despite these circumstances, there has been little exploration of the interface between acupuncture providers and conventional primary healthcare practitioners in rural and regional Australia. Methods A 27-item questionnaire was sent by post in the second half of 2010 to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia to explore their practices and attitudes to a variety of complementary and alternative medicine (CAM) practices. Their responses on other therapies have been published previously; this report covers acupuncture. Results A total of 585 GPs completed the questionnaire; 49 were returned as 'no longer at this address', resulting in an adjusted response rate of 40.7%. Two-thirds of GPs (68.3%) referred patients to an acupuncturist at least a few times per year, while only 8.4% stated that they would not refer patients to an acupuncturist under any circumstances. GPs being older (OR=6.08), GPs being women (OR=2.94), GPs practising in a rural rather than remote area (OR=6.25), GPs having higher levels of selfreported knowledge of acupuncture (OR=5.54), the use of complementary medicine (CAM) by a GP for their personal health (OR=2.37), previous prescription of CAM to other patients (OR=2.99), lack of other treatment options (OR=4.31) and GPs using CAM practitioners as the major source of their CAM information (OR=3.05) were all predictive of increased referral to acupuncture among rural GPs. Conclusions There is a significant interface between acupuncture and Australian rural and regional general practice, with generally high levels of support for acupuncture. [ABSTRACT FROM AUTHOR]

Gallagher R, Sullivan A, Hales S, Gillies G, Burke R, Tofler G. International Journal of Nursing Practice 2012; 18: 133-139 Symptom patterns, duration and responses in newly diagnosed patients with heart failure This study investigated the symptom patterns and duration and associated predictors occurring prior to first heart failure (HF) admission. Data from the Managing Cardiac Function (MACARF) program from January to December 2007 were reviewed in relation to preadmission symptoms and contacts with health professionals. Patients ( n = 242) were aged 78.7 years (SD 12 years), male (54%) and married (45%). Patients experienced up to seven symptoms (Mean 2.7, SD 1.4) for a median of 4.47 days (range 1-7) before admission, most commonly increased dyspnoea on exertion (88%), and for the shortest duration chest discomfort. Less than half (48%) contacted a health professional before hospitalization, most often a general practitioner (37%). The duration patients experienced before presenting to hospital was increased if they presented during business hours (beta = 2.68) or the evening (beta = 1.88) (and therefore less from midnight to 8:30 am), or with a change in symptom (beta = 1.4), whereas duration was reduced by chest discomfort (beta = −2.01) and older age (beta = −0.07). There is a significant time window during which patients and health professionals may detect and act on worsening HF symptoms. Newly diagnosed patients with HF need support to recognize and respond to these symptoms to avoid hospital admission. [ABSTRACT FROM AUTHOR]

Richardson G, Whiteley I. International Journal of Nursing Practice 2011; 17: 621-627 A comparison of nurses' perceptions of elective laparoscopic or elective open colorectal resections The purpose of this study was to develop an instrument to measure the perceived benefits nurses observe in the recovery of patients who have undergone elective laparoscopic colorectal resections vs. traditional open elective colorectal resections. Secondly, to determine if there are perceived differences in the intensity of nursing required to care for these patients. A twenty-three-point questionnaire was developed and distributed to 23 colorectal nurses working in a single tertiary referral hospital. There was an 83.6% response rate. The findings demonstrate that the participants believe there are significantly better outcomes for the laparoscopic patients in the postoperative period. These benefits include more rapid resumption of independence, decreased pain and fewer complications. The nurses also perceived less time and effort was required when caring for these patients. [ABSTRACT FROM AUTHOR]

Chow J, Miguel SS. International Journal of Nursing Practice 2010; 16: 484-491 Evaluation of the implementation of Assistant in Nursing workforce in haemodialysis units The aim of this project was to evaluate the introduction of Assistant in Nursing (AINs) in the haemodialysis units at a major tertiary Area Health Service in Sydney, Australia. All nursing staff were asked to complete a baseline and follow-up survey to determine changes to their attitudes to the new skill mix model and their satisfaction with the new organization of care delivery in their dialysis units. Comparison of the baseline and follow-up surveys in the paired data was favourable with nurses acknowledging that they would cope well with the introduction of AINs, and they were more likely to disagree with the statement that their workload would increase after the introduction of AINs in the follow-up survey. There was little difference in (i) the workload of the dialysis units before and during the intervention; and (ii) the incidence of patient and nursed related adverse outcome events. [ABSTRACT FROM AUTHOR]