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Background: Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. Methods: A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. Results: Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. Conclusions: The intensive screening procedure did not appear to adversely impact adolescents' mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why. Methods: The study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania. Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks. Results: Of 823 patients screened for eligibility, 698 eligible patients, 612 provided consent. Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%). Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion. Conclusions: Our study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor. Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate. [ABSTRACT FROM AUTHOR]

Little is known about the environmental and organisational determinants of workplace violence in correctional health settings. This paper describes the views of health professionals working in these settings on the factors influencing workplace violence risk. All employees of a large correctional health service in New South Wales, Australia, were invited to complete an online survey. The survey included an open-ended question seeking the views of participants about the factors influencing workplace violence in correctional health settings. Responses to this question were analysed using qualitative thematic analysis. Participants identified several factors that they felt reduced the risk of violence in their workplace, including: appropriate workplace health and safety policies and procedures; professionalism among health staff; the presence of prison guards and the quality of security provided; and physical barriers within clinics. Conversely, participants perceived workplace violence risk to be increased by: low health staff-to-patient and correctional officer-topatient ratios; high workloads; insufficient or underperforming security staff; and poor management of violence, especially horizontal violence. The views of these participants should inform efforts to prevent workplace violence among correctional health professionals. [ABSTRACT FROM AUTHOR]

Purpose – While ageing with an intellectual (learning) disability has been subject to increased research in recent years, there remains little knowledge regarding the daily practice issues that disability workers struggle most to support in this cohort. The purpose of this paper is to gain feedback directly from staff regarding the problems they experience in daily work, and to evaluate whether any changes to legislation or practice could potentially alleviate identified areas of concern. Design/methodology/approach – A Delphi project was conducted over three rounds with participants from rural areas of New South Wales (NSW). The panel was composed of support workers who assist people ageing with a learning disability. Participants were asked their perceptions of the main practice issues facing them while they provide support. Findings – The panel identified 29 issues that were considered problematic in the provision of support to people ageing with a learning disability. A thematic analysis indicated three main themes of access to services; time constraints; and funding. Research limitations/implications – The participants in this study were all disability workers employed by non-government organisations in rural NSW, and as such, many of the issues identified may be specific to this population cohort and geographic setting. Any generalisation of these results to other locations or populations must be considered within these limitations. Originality/value – Identification of the issues facing disability staff may facilitate government, health care providers and disability organisations to proactively plan to address current and future problem areas. The consequent effect of improving practices can assist individuals to receive better support and lead to a corresponding improvement in their quality of life. The current implementation of the National Disability Insurance Scheme in Australia is an ideal opportunity for cross-sectoral collaboration to change practice to facilitate better support for a highly vulnerable group of the community. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore characteristics of men procuring sexual services from women. Design/methodology/approach - This is a quantitative study using questionnaires and purposive sampling. The sample was from New South Wales, Australia, and included brothels and outreach organisations where sex work is decriminalised. The participants were 309 men who reported procuring sexual services with women. Findings - Primary motivations for procurement included thrill/excitement and attractiveness of the sex worker. Cluster analysis identified five groups, the most frequent being those with a drive for exciting, thrill-seeking sex with an attractive partner and those with the same drive but not wanting investment. High proportions of men were married, in professional employment and did not present with a criminal history. Sexual experiences procured were conventional. Procurement presented as an enduring behaviour maintained across decades, commencing at a young age. Involvement in procurement preceded decriminalisation. Practical implications - The results do not support men's procurement as primarily "deviant". Professionals may need to explicitly enquire about such behaviour where relevant to do so (e.g. in discussing sexual health) and in doing so ensure procurement is discussed as normative and not as unusual behaviour. Originality/value - Challenges any conceptualisation of procurement as deviant, extending the research base further by capturing users of such services as opposed to attitudes towards procurement. [ABSTRACT FROM AUTHOR]

Background: Lifetime trajectories of mental ill-health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the cognitive behavioural therapy (CBT)-informed Climate Schools universal eHealth preventive mental health programme, relative to a control. We also explored whether the intervention had differential effects on students with varying degrees of social connectedness. Method: We evaluated the efficacy of the Climate Schools mental health programme (19 participating schools; average age at baseline was 13.6) v. a control group (18 participating schools; average age at baseline was 13.5) which formed part of a large cluster randomised controlled trial in Australian schools. Measures of internalising problems, depression and anxiety were collected at baseline, immediately following the intervention and at 6-, 12- and 18-months post intervention. Immediately following the intervention, 2539 students provided data on at least one outcome of interest (2065 students at 18 months post intervention). Results: Compared to controls, we found evidence that the standalone mental health intervention improved knowledge of mental health, however there was no evidence that the intervention improved other mental health outcomes, relative to a control. Student's social connectedness did not influence intervention outcomes. Conclusion: These results are consistent with recent findings that universal school-based, CBT-informed, preventive interventions for mental health have limited efficacy in improving symptoms of anxiety and depression when delivered alone. We highlight the potential for combined intervention approaches, and more targeted interventions, to better improve mental health outcomes. [ABSTRACT FROM AUTHOR]

New South Wales law on abortion was liberalized by judicial interpretation in 1971. This paper describes the characteristics of the first 1007 women attending a free-standing clinic for induced abortion after it opened in 1974. Compared with Census data for New South Wales females of child-bearing age, the sample contained an over-representation of women who were relatively younger at conception, never married, divorced or separated, born outside Australia, of Catholic religious background, and worked as nurses or in factories. In comparison with background information about abortion experience before 1971, the clinic sample appeared to feel less anxiety and distress during the abortion sequence. [ABSTRACT FROM PUBLISHER]

This study explores the risk of developing clinically significant social, emotional, and behavioural problems among Muslim adolescents living in Australia compared to the general adolescent population living in Australia. A descriptive, cross-sectional, and exploratory survey of 12–17-year-old students across three Islamic schools in New South Wales was conducted. The Strengths and Difficulties Questionnaire (SDQ) was used to measure the risk of developing clinically significant social, emotional, and behavioural problems. Six hundred and thirty-two students (261 males, 371 females), at a response rate of 48%, were recruited via collaborations with three Islamic schools, and children were invited to participate if their parents did not object in writing to their child's participation. Overall, when compared to the general adolescent community sample, Muslim adolescents did not report a significantly higher proportion in the top 10% (i.e., abnormal range) for total difficulties, emotional problems, conduct problems, and peer problems, but did report a significant difference for hyperactivity/inattention problems (18.4% vs. 13.8%). Furthermore, Muslim adolescents (29.0% vs. 23.7%) reported a significantly higher proportion of scores in the top 20% (i.e., borderline range). These differences were explained by Muslim females aged 11–15 years higher hyperactivity (15.1% vs. 11.4%) and total difficulties (31.8% vs. 24%), as younger males and older males and older females showed no difference on any scale. Specifically, Muslim females aged 11–15 years reported a significantly higher proportion of scores in the abnormal ranges for total difficulties (14.3% vs. 9.8%), emotional problems (17.6% vs. 12.6%), and conduct problems (11.2% vs. 7.5%) and marginally for hyperactivity. Muslim females aged 11–15 years may demonstrate higher rates of clinically significant problems and are at a substantial higher risk of developing clinically significant emotional and conduct problems when compared to their age-related female adolescent peers. A review of the current child and adolescent mental health and community services is required to determine if this risk to Muslim females aged 11–15 years in Australia is being mitigated and their needs are being met. Highlights: The study explored the substantial risk of Muslim adolescents in Australia developing clinically significant social, emotional, and behavioural problems compared to the general adolescent population. Socioeconomic status was a significant predictor of scores but was controlled in the analyses. Muslim males (11–17 years) and older Muslim females (16–17 years) are not at higher substantial risk of developing clinically significant social, emotional, and behavioural problems compared to the general adolescent population. Muslim females (11–15 years) are at a substantially higher risk of developing clinically significant emotional and conduct problems than age-related females. Muslim females (11–17 years) were at even greater risk of developing clinically significant conduct problems, emotional symptoms, and hyperactivity-inattention problems than Muslim males (11–17 years). A review of current community and outreach services is required to assess if the psychological needs of Muslim youth in Australia, particularly females aged 11–15 years, are being met. [ABSTRACT FROM AUTHOR]

Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing program at a large university in Western Sydney embedded Indigenous health into the undergraduate teaching program. This paper reviews the negative responses received towards course content on evaluation of the Indigenous health unit and explores the predictors for the negative attitudes towards Indigenous Australians. Two surveys were used (baseline and follow-up) to: 1. Determine the main predictors for negative attitudes towards Indigenous people and; 2. Explore students' perceptions of the educational quality of the Indigenous health unit. The surveys allowed collection of socio-demographic, academic data and included the 18 item ‘Attitude Toward Indigenous Australians’ (ATIA) scale and open-ended responses. Students who were: 1. Overseas born, 2. Enrolment category: International student and; 3. Whose primary source of information about Indigenous Australians were the media and school were significantly more likely to have higher negative attitudes towards Indigenous Australians. Qualitative data revealed some unfavourable comments dismissing the value and educational quality of the content within the Indigenous health unit. Community engagement is paramount to enhancing the student experience. Movement away from media driven ‘hype’ to an educated perspective is necessary to create an accurate portrayal of the Indigenous community. [ABSTRACT FROM AUTHOR]

In 2020 Coronavirus disease (COVID-19) was identified in Australia. During the pandemic, as essential workers, hospital-based social workers have been on the frontline. This cross-sectional study examines the resilience of social workers during the COVID-19 pandemic, how the pandemic impacted on social work and lessons learnt. Hospital social workers working in three states, namely Victoria, Queensland, and New South Wales were invited to participate in an online web-based survey, providing non-identifiable demographic details and information a) relating to their proximity to COVID-19, b) their degree of resilience (CD-RISC-2), c) professional quality of life, d) perceived social support, e) physical health, f) professional and personal growth during the pandemic, and g) impacts of COVID-19 on their practice. Basic descriptive statistics were computed for variables of interest. Within group, comparisons were made using paired t-tests or one-way ANOVAs for continuous variables as appropriate to investigate possible interstate differences. Regression analyses were conducted to determine which factors contribute to resilience. Social workers, during the pandemic, whether working under the constraints of lockdown or not, demonstrated high levels of resilience. These levels were similar across the three states, unaffected by the degree of infection in the community, indicating that as a group, social workers have high innate levels of resilience. This study provides an in-depth understanding of the impact of COVID-19 on hospital social workers, the long-term impact of the pandemic on social work practice, and potentially useful lessons learnt for the future. [ABSTRACT FROM AUTHOR]

Background: The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. Methods: Seventy-one secondary schools across three States participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course (Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and 12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms. Results: Compared to Controls, students in the Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p < 0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p = 0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p = 0.17). Conclusions: The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to prevention of cannabis use and alcohol harms. [ABSTRACT FROM AUTHOR]

Despite clinical guidelines recommending routine nutrition screening, malnutrition in community-living older adults remains under-recognised. This study evaluated the uptake of a model of nutritional care in older adults designed to improve the identification and management of malnutrition. A pragmatic quasi-experimental study was conducted in eight general practices in regional New South Wales between January 2017 and June 2018. Study participants comprised GPs and practice nurses who participated in a training event on the identification and management of malnutrition and patients (aged >65 years) attending the practices recruited to the study. Nutritional screening was conducted using the Mini Nutritional Assessment–Short Form. The specific objectives of the study were to: (1) evaluate the effects of the intervention on knowledge, attitudes and practices of staff related to malnutrition screening using questionnaires and in-depth interviews; and (2) identify patients' experiences and outcome measures following malnutrition screening through self-completed surveys. Across the eight practices, 11 healthcare professionals completed in-depth interviews. Post-training knowledge surveys (n = 25) identified that knowledge increased in 96% of staff (P < 0.001). Fifty-five older adults who were screened (two malnourished, 10 'at risk of malnutrition') reported an increased awareness of risk factors for malnutrition. This study provides proof-of-concept that a model of care that includes routine malnutrition screening and accompanying pathways for management is acceptable to general practice staff and has promising effects on patient outcomes. However, the low number of patients screened suggests that additional processes are required to improve feasibility (e.g. incorporation into Medicare-funded nurse-led consultations such as the 75+ Health Assessment). Malnutrition in community-living older adults is a prevalent but under-recognised condition. This study demonstrated that a model of care designed to improve the identification and management of malnutrition improved staff knowledge about malnutrition and patient awareness of risk factors for malnutrition. The study provides evidence that routine malnutrition screening and accompanying pathways for management can be incorporated into general practice, with promising effects on patient outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of a Consumer Directed Care (CDC) model of service delivery on the quality of life of older people receiving home care packages. Methods: Quality of life was assessed using validated instruments. The relationship between quality of life and length of time exposed to CDC was examined using descriptive statistical and multivariate regression analyses. Results: Consenting older adults (n = 150) in receipt of home care packages participated. Quality of life and capability scores were higher for older people in receipt of a CDC model of service delivery for <12 months compared to those receiving the model of care for longer, although this difference was not statistically significant. However, older people with more recent exposure to CDC indicated a stronger capability to do things that made them feel valued. Conclusion: Extended longitudinal follow‐up is needed to facilitate a detailed examination of the relationship between the evolution of CDC and its longer‐term influences on quality of life. [ABSTRACT FROM AUTHOR]

Background: Despite generally high smoking prevalences, stemming from colonization, the relationship of smoking to mortality has not been quantified reliably in an Indigenous population. We investigate smoking and mortality among Aboriginal and Torres Strait Islander adults in Australia, where current adult daily smoking prevalence is 40.2%.Methods: A prospective study of 1388 cardiovascular disease- and cancer-free Aboriginal adults aged ≥45 years, of the 267 153 45 and Up Study participants randomly sampled from the New South Wales general population over 2006-09. Questionnaire and mortality data were linked (through the Centre for Health Record Linkage) to mid-2019. Adjusted hazard ratios (called relative risks, RRs) for all-cause mortality-among current- and past- versus never-smokers-were estimated overall, by smoking intensity and by age at cessation. Smoking-attributable fractions and associated deaths were estimated.Results: Over 14 586 person-years' follow-up (median 10.6 years), 162 deaths accrued. Mortality RRs [95% confidence interval (CI)] were 3.90 (2.52-6.04) for current- and 1.95 (1.32-2.90) for past- versus never-smokers, with age heterogeneity. RRs increased with smoking intensity, to 4.29 (2.15-8.57) in current-smokers of ≥25 cigarettes/day. Compared with never-smokers, RRs were 1.48 (0.85-2.57) for those quitting at <45 years of age and 2.21 (1.29-3.80) at 45-54 years. Never-smokers lived an average >10 years longer than current-smokers. Around half of deaths among adults aged ≥45 years were attributable to smoking, exceeding 10 000 deaths in the past decade.Conclusions: In this population, >80% of never-smokers would survive to 75 years, versus ∼40% of current-smokers. Quitting at all ages examined had substantial benefits versus continuing smoking; those quitting before age 45 years had mortality risks similar to never-smokers. Smoking causes half of deaths in older Aboriginal and Torres Strait Islander adults; Indigenous tobacco control must receive increased priority. [ABSTRACT FROM AUTHOR]

Background: With the introduction of consumer‐directed care in the Australian community aged care sector, there are more opportunities for occupational therapists to provide evidence‐based services that meet consumer needs. There is also an increasing requirement for health professionals to promote their interventions to consumers. Particularly for the implementation of new programs within organisations. However, occupational therapists have historically neglected widely promoting the role of occupational therapy services for older people. This study examines the perceptions of occupational therapists and their managers in promoting their service; the Care of People in their Environment (COPE) Program. Methods: This study utilised a qualitative interpretative description; including 28 in‐depth interviews. Purposeful sampling ensured a variety of occupational therapists from different health contexts. Thematic analysis captured key emergent themes related to promoting occupational therapy interventions and implementation. Results: Many occupational therapists were apprehensive about promoting or selling their services and interventions. Greater levels of confidence in promoting the program were present when the program aligned with traditional models of service delivery and organisational processes. Occupational therapists described having limited opportunity to directly promote the program to consumers as community case managers were mostly the main contact at the organisation. There was limited consideration of promotion strategies and therefore limited enactment of strategies by organisations. Not‐for‐profit and non‐government organisations recognise that the changed community aged care market provided new business opportunities. Conclusion: With changes in the Australian aged care system, occupational therapy has great opportunity to provide diverse, evidence‐based interventions driven by the needs of consumers. Reframing the notion of 'selling', to empowering consumers to be more informed about their options, will allow occupational therapists to build confidence in their promotional skills. Promoting evidence‐based programs will have positive outcomes for the visibility, professional identity and recognition of occupational therapy. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Public support for restrictions on late night trading of licensed venues increased substantially between 2001 and 2013, a period with very few policy interventions in Australia. In early 2014 a set of high profile restrictions were introduced in Sydney, New South Wales. In this study, we examine whether these 2014 policy interventions affected public support for late trading restrictions.Design and Methods: We use data from the National Drug Strategy Household Survey, focussing especially on the 2013 (n = 23 521) and 2016 (n = 23 425) waves. A series of regression models with interaction terms between socio-demographic variable and year were used to examine how trends in support for late trading policies varied between different population groups.Results: Support for late trading restrictions fell substantially between 2013 and 2016-from 2.58 to 2.35 on a 0-4 point scale. In particular, support fell more in New South Wales than in other jurisdictions. Among New South Wales residents, support fell more for middle-aged and older respondents and more for drinkers than non-drinkers.Discussion and Conclusion: Support for late trading restrictions fell sharply, especially among those affected in New South Wales. Advocates for public health-oriented alcohol policy restrictions need to pay attention to public support in the aftermath of policy 'wins'. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient-assessment framework into emergency nursing practice. Background An evidence-informed patient-assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation. Design A mixed-method convergent study design was used. Methods Thirty eight early career emergency nurses from five Australian hospitals participated in an education workshop on the HIRAID assessment framework. Simulated clinical scenarios enabled participants to experience conducting a patient assessment with and without using the framework. All participants completed surveys, interviews and focus groups to identify potential facilitators and barriers. Twenty three participants completed follow-up telephone surveys 4-6 months later. Quantitative and qualitative data were analysed separately using descriptive statistics and inductive content analysis, prior to integration. Implementation interventions were selected using the Behaviour Change Wheel. Results Nine facilitators and nine barriers were identified to potentially effect implementation of the HIRAID assessment framework. Twelve of the 23 participants (52.2%) who completed follow-up surveys reported using the framework in the clinical setting. To optimise future implementation, the education workshop needs refinement, and environmental restructuring, modelling and social support are required. Conclusion A multimodal strategy is needed to promote future successful implementation of the HIRAID assessment framework into emergency nursing practice. Relevance for clinical practice The successful implementation of the HIRAID assessment framework has the potential to improve nursing assessments of patients in emergency and other acute care settings. This study demonstrates how to systematically identify facilitators and barriers to behaviour change and select interventions to optimise implementation of evidence-informed nursing practices. [ABSTRACT FROM AUTHOR]

Background: Individual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation. Methods: Data on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA "disease maps" and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage. Results: Within-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4-32.0), 69.4 (95% CI 69.1-69.7), and 56.1 (95% CI 55.8-56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12-1.29) and 1.07 (95% CrI 1.01-1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01-1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors. Conclusions: Walkability is associated with area-level prevalence and geographic variation in sufficient walking and sufficient MVPA to improve health in Sydney, Australia. Our study supports the use of walkability indexes at multiple spatial scales for informing population-level action to increase physical activity and the utility of spatial analysis for walkability research and planning. [ABSTRACT FROM AUTHOR]

Objective This study aimed to describe demographic and socio-economic characteristics and to assess baseline health status and care needs among Japanese residents aged 60 years and over living in New South Wales, Australia. Methods A postal questionnaire was used to survey older community-dwelling Japanese residents recruited from a number of different sources. Results Eighty-two residents responded to the questionnaire (mean age: 70.5 years, range 60-85), and 56 (68.3%) were female. The respondents appeared to be socio-economically comfortable. While 63.4% of respondents noticed reduced strength and balance, and 45% had at least one chronic medical condition, the majority did not require help with personal care or domestic chores. However, there were respondents who were considered at risk of subsequent development of major mobility limitations. Conclusion Overall, the respondents in this study demonstrated good function. There may be a role for interventional programs aimed at maintaining functional independence. [ABSTRACT FROM AUTHOR]

Background Surveys have shown that women are highly satisfied with their maternity care. Their satisfaction has been associated with various demographic, personal, and care factors. Isolating the factors that most matter to women about their care can guide quality improvement efforts. This study aimed to identify the most significant factors associated with high ratings of care by women in the three maternity periods (antenatal, birth, and postnatal). Methods A survey was sent to 2,048 women who gave birth at seven public hospitals in New South Wales, Australia, exploring their expectations of, and experiences with maternity care. Women's overall ratings of care for the antenatal, birth, and postnatal periods were analyzed, and a number of maternal characteristics and care factors examined as potential predictors of 'Very good' ratings of care. Results Among 886 women with a completed survey, 65 percent assigned a 'Very good' rating for antenatal care, 74 percent for birth care, 58 percent for postnatal care, and 44 percent for all three periods. One factor was strongly associated with care ratings in all three maternity periods: women who were 'always or almost always' treated with kindness and understanding were 1.8-2.8 times more likely to rate their antenatal, birth, and postnatal care as 'Very good.' A limited number of other factors were significantly associated with high care ratings for one or two of the maternity periods. Conclusions Women's perceptions about the quality of their interpersonal interactions with health caregivers have a significant bearing on women's views about their maternity care journey. [ABSTRACT FROM AUTHOR]

Commercial phonics programmes (e.g. Jolly Phonics and Letterland) are becoming widely used in the early years of school. These programmes claim to use a systematic explicit approach, considered as the preferred method of phonics instruction for teaching alphabetic code-breaking skills in Australia and the UK in the first years of school (Department of Education, Science and Training, 2005; Rose, 2006). However, little is known about the extent to which they are being used in prior-to-school settings, and the reasons behind decisions to use them. This study surveyed 283 early childhood staff in Sydney, Australia and found that commercial phonics programmes were being used in 36% of the early childhood settings surveyed. Staff with early childhood university qualifications and staff working in not-for-profit service types were less likely to use a commercial phonics programme than staff without university qualifications and staff working in for-profit services. Staff with less than 10 years’ experience were also more likely to use a commercial phonics programme. The rationale behind decisions determining whether or not staff used the programmes ranged from pragmatic reasons, such as parent pressure or higher management decisions, to pedagogical reasons, such as teacher beliefs about how children learn to read and write. The practices staff engage in to teach phonics are explored. [ABSTRACT FROM PUBLISHER]

One measure of the impact of a high-stakes test is the attitudes that test takers hold towards it. It has been suggested that positive attitudes produce beneficial effects while real or anticipated negative experiences can result in the development of attitudes that erode confidence and potentially impact negatively on performance. This study investigated test taker attitudes by exploring the opinions, beliefs, and feelings of a group of overseas trained teachers preparing for a professional gate-keeping test, and examining correlations between attitudes and demographic and experiential factors. The participants were 105 candidates who were enrolled in a preparation course for the Professional English Assessment for Teachers. They were asked to complete a written survey questionnaire with three parts: to determine the nature of their attitude towards the test, to explore the relationship of attitudes and demographic data, and to investigate their perceptions of the sources of their attitudes. Results indicated that there was a slight predominance of negative attitudes, particularly among candidates who had unsuccessfully attempted the test. The main reported sources which correlated with a negative attitude were personal experiences and feelings as well as the impact of other people: notably teachers and other candidates. [ABSTRACT FROM AUTHOR]

This study aims to develop a self-administered needs assessment questionnaire for people with systemic lupus erythematosus (SLE), assess its face, content and construct validity and test the reliability of the instrument. Eighty-four people with SLE, registered with a Lupus Resource Centre in New South Wales, Australia participated in a series of focus groups and pre and pilot testing phases in the development of a needs instrument and 594 people from a SLE support association were sent the SLE needs questionnaire (SLENQ) and the MOS-SF-36 and asked to complete both. Face and content validity were found to be high following pre and pilot testing. Principal components analysis identified seven factors with eigenvalues greater than 1, which together accounted for 53% of the total variance (psychological/spiritual/existential, health services, health information, physical, social, daily living and employment/financial needs). Internal reliability coefficients (Cronbach's alpha) of all seven factor-based scales were found to be substantial, ranging from 0.77 to 0.96. Moderately significant correlation between the domains of the SLENQ and the MOS SF-36 were supportive in ascertaining concurrent validity. These findings suggest that the SLENQ provides a reliable and valid index of the global needs of people with SLE. [ABSTRACT FROM AUTHOR]