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Describes a two-part study involving 14- to 15-year-old high school students in New South Wales (Australia) that compared two modes of responding to free response examination questions: by computer and by pen and paper. Discusses results of analysis of variance. (Author/LRW)

Studies the development of moral autonomy in 720 Australian secondary school and university students between the ages of 12 and 21. Examines autonomy development in the context of moral judgments. Finds the need to add a dimension of individual differences to the single dimension used to describe developmental changes. (Author/NL)

Addresses applications of the coefficient of variation as a measure of educational inequality or as a means of measuring changes of inequality status. Suggests the Gini coefficient has many advantages over the coefficient of variation since it can be used with the Lorenz curve (Lorenz provides detail Gini omits). (BRR)

In this empirical study, the length of the summary report of evaluation study findings influenced responses of audience members to the summary. Respondents favored a 13-page summary over a five-page version, as evidenced by audience ratings of overall quality and worth of the report. (Author/LMO)

Describes Australian study which investigated relationships between characteristics of disadvantaged elementary and secondary students and their participation in computing activities, both in and out of the classroom. Variables used to define disadvantaged include gender, school ability, socioeconomic status, and ethnic background. Results are analyzed, and 53 references are provided. (Author/LRW)

Describes a study of 323 fifth and sixth grade students which was conducted in Australia to examine cognitive processing of gifted children compared with normal and above average ability children. Highlights include the role of planning in cognition, tests used, and a factor analysis of results. Fifty-one references are listed. (Author/LRW)

The reliability and validity of the Self-Esteem Inventory developed by S. C. Coopersmith (1975) were evaluated via item-total correlation, discriminant analysis, factor analysis, and analysis of variance of data for 352 Australian adults. The instrument had high internal consistency and discriminated well between subjects with high and low self-esteem. (SLD)

Discussion of text segmenting and comprehension highlights a study of elementary students in Australia that tested two hypotheses, one concerning reading abilities and one concerning information processing skills involved in syntactic analysis. Tests that measured vocabulary, comprehension, and processing skills are described, results are analyzed, and further studies are suggested. (24 references) (LRW)

Purpose: The purpose of the study was to examine whether various athletic performances, anthropometric measures, and playing experience differentiate selected and nonselected ultimate Frisbee players trialing to compete in the world championship. Methods: Forty-three Australian male ultimate Frisbee players (age = 21.2 [1.2] y; height = 1.7 [6.8] m; body mass = 69.7 [8.2] kg; playing experience = 3.5 [1.5] y) participated in a 30-m sprint test, single-leg run-up jump approach (both left [JumpLL], and right leg [JumpRL]) and a stationary bilateral vertical jump (JumpBIL), and change-of-direction speed test. Following a selection camp, players were subdivided according to their selection or nonselection into the team. Results: A multivariate analysis of variance revealed that height, 10-m sprint time, acceleration, JumpLL, JumpRL, and JumpBIL were significantly greater for selected players than nonselected players (P <.05). Area under the curve (AUC) was greatest for JumpRL (AUC = 79%; optimal cutoff value of 37.5 cm, sensitivity and specificity values of 77% and 71%, respectively), JumpLL (AUC = 74%; optimal cutoff 38.5 cm, sensitivity and specificity values 77% and 77%, respectively), and JumpBIL (AUC = 78%; optimal cutoff value of 40.5 cm, sensitivity and specificity values 71% and 79%, respectively). The largest AUC (AUC = 81%; 95% CI 0.66–0.97; P =.001) was found when combining the explanatory variables that demonstrated moderate to large effect sizes (ie, height, playing experience, 10-m sprint, acceleration, JumpLL, JumpRL, and JumpBIL), with sensitivity of 93% and specificity of 71%. Conclusion: These athletic performance and anthropometric characteristics differentiating selected and nonselected players may help inform targeted training and player-development strategies. [ABSTRACT FROM AUTHOR]

Purpose: To explore complex system behavior and subsequent team performance in professional rugby union. Methods: Here, we present 2 studies. In the first, we used global positioning system technology to measure player clustering during stoppages in play in nearly 100 games of professional rugby union to explore team (complex system) behavior and performance. In the second, we measured stress hormones (cortisol and testosterone) prior to team meetings and analyzed these relative to amount of time and the frequency with which players looked at peer presenters, as well as subsequent training performance, to explain how stress may lead to behaviors observed in the first study and subsequent match performance. Results: No link between player clustering during stoppages of play and performance was observed. When players (complex system agents) demonstrated greater levels of stress (as indicated by greater cortisol-awakening response and a greater decline in testosterone-to-cortisol ratio across the morning), they tended to look at peer presenters more; however, training quality declined (P =.02). Correlational analysis also showed that training quality was related to testosterone-to-cortisol ratio (P =.04). Conclusions: Team behavior is complex and can be unpredictable. It is possible that under stress, complex system agents (ie, rugby union players) look at (and cluster toward) their teammates more; however, meaningful interaction may not necessarily occur. Furthermore, while complex system (team) analysis may be valuable strategically in rugby union in the context of describing behavior, without understanding "how" or "why" intrateam/interagent behaviors emerge it may have little meaning. [ABSTRACT FROM AUTHOR]

Camp-based reunification is a developmentally informed approach to strengthen the relationships of siblings in out-of-home care. Little is known about the collective impact of these programs, or if there is a benefit to multiple camp experiences. To address this, data were collected from 2,260 youth who were campers at one of 16 sibling reunification programs in the U.S. or Australia between 2013-2019. Increases in resilience, decreases in sibling support, and decreases in sibling conflict were observed among first-time campers. For repeat campers, changes to resilience were greatest during youths' first year of camp. Recommendations for research and practice are provided. [ABSTRACT FROM AUTHOR]

Aim: To evaluate registered nurses' beliefs and related factors regarding pain assessment in people living with dementia. Design: A descriptive cross‐sectional survey was conducted between July 2022 and April 2023. Methods: An online survey comprised of demographics, knowledge scale, and beliefs scale relating to pain assessment in dementia was distributed to registered nurses (RNs) caring for people living with dementia in Australia. Results: RNs (N = 131) completed the survey. Most respondents were females (87.0%) and self‐identified as Caucasian (60.3%). The mean beliefs score was 72.60 (±6.39) out of a maximum possible score of 95. RNs' beliefs about pain assessment varied based on their education, dementia pain assessment knowledge, nursing experience, and ethnicity. Hierarchical multiple regression analysis revealed factors significantly related to the beliefs score (i.e. education and dementia pain assessment knowledge). Conclusion: The relationship between education and knowledge, and the beliefs score indicates the potential to improve RNs' knowledge and overcome their erroneous beliefs about pain assessment in dementia. Implications for the profession and/or patient care: Education and training in assessing pain in people living with dementia should be tailored to overcome RNs' misconceived beliefs. These programmes should be integrated into continuous learning programmes. Impact: Some RNs' beliefs about pain assessment in dementia were not evidence‐based, and knowledge and educational status were the strongest factors related to RNs' beliefs. RNs' erroneous beliefs about pain assessment in dementia need to be addressed to improve pain assessment and management. Researchers should explore the potential of educational interventions to overcome RNs' misconceived beliefs about pain assessment in dementia. Reporting Method: This study was reported adhering to the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Patient or Public Contribution: RNs caring for people living with dementia participated as survey respondents. Additionally, RNs were involved in the pre‐testing of the study's survey instrument. [ABSTRACT FROM AUTHOR]

Introduction: Empirical evidence shows that many family carers, especially immigrants, experience considerable health disadvantages and poorer quality of life. Australia has a rapidly increasing multicultural population, officially referred to as Culturally and Linguistically Diverse (CALD) people. This paper explores similarities and differences in the carer profile and physical and mental health of CALD and non-CALD family carers. Methods: A cross-sectional anonymous survey was conducted of self-reported family carers aged 18 years and older. Identical paper and online survey modes were provided to enable choice. Key variables included demographic and carer profile, diagnosed chronic physical health conditions, and validated scales such as CESD-12 and MOS-SF12, including derivative composite Physical and Mental Component Summary (PCS and MCS, respectively) scores. The sample comprised 649 participants (CALD = 347, non-CALD = 302). The analyses included univariate, bivariate, and multivariable linear regression analyses for three outcome variables: PCS, MCS, and CESD-12. Results: CALD carers were comparatively younger and married, and 54% had university-level education (29% in the gfvnon-CALD group). Women were primary carers in both groups (67.4% versus 72.2%). The weekly care hours were higher for non-CALD carers. Both groups had below population-referenced scores for mean PCS and MCS values. For CESD-12, non-CALD respondents had higher scores (17.5 vs. 11.2, p < 0.022). Regression analyses showed significant differences for demographic, carer, and physical health variables across the three outcome variables. Discussion and Conclusion: Women have a higher domestic workload, which, when combined with high care hours, adversely impacts physical and mental health. The need for improved and culturally aligned care support systems is required. [ABSTRACT FROM AUTHOR]

Background: Individuals with opioid dependence often experience poor oral health, including dental decay, periodontal disease and mucosal infection, frequently exacerbated by factors such as smoking, alcohol consumption, inadequate oral hygiene and low utilisation of oral health services. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) among opioid-dependent individuals and explore their potential associations. Methods: Participants enrolled in an opioid treatment program (OTP) at three Australian urban clinics were assessed using the validated Oral Health Assessment Tool (OHAT) and Oral Health Impact Profile (OHIP-14). Results: The average age of the 75 participants was 44.7 years, with 45% receiving opioid treatment for over 5 years. Dental decay and inadequate oral hygiene were prevalent. Mean OHAT and OHIP-14 scores were 6.93 and 20.95 respectively, indicating moderate oral health severity and poor OHRQoL. Physical pain and psychological discomfort significantly impacted participants' quality of life, with the effects being particularly pronounced for those aged 30 and above. An exploratory analysis revealed a strong correlation between OHAT and OHIP-14 severity scores, with a one-point increase in OHAT associated with 1.85 times higher odds of a lower OHRQoL (odds ratio = 1.85, 95% confidence interval: 1.38–2.49, P = <0.001). Conclusions: These findings underscore the multifaceted impact of oral health on the well-being of OTP clients. Routine dental check-ups, education on oral hygiene practices and timely treatment for oral health problems are crucial recommendations based on this study. Such measures hold the potential to enhance the quality of life for individuals attending OTPs. Opioid-dependent individuals face substantial oral health challenges influenced by both opioid effects and lifestyle factors. This study investigated the oral health status and quality of life among opioid treatment program (OTP) clients, revealing prevalent dental caries and inadequate oral cleanliness, resulting in physical pain and psychological discomfort that impacted their quality of life. This identified correlation between oral health status and quality of life highlights the critical need for timely intervention to enhance the health and well-being of clients attending OTPs. [ABSTRACT FROM AUTHOR]

Background: Patient Assessment of Care in Chronic Conditions (PACIC+), included in some Australian guidelines, has been shown reliable for measuring patient engagement and perception of their care in primary care settings. Various studies have focussed on PACIC+ use in specific conditions. This study aims to expand PACIC+ to measure patient empowerment to self-manage their chronic condition and validate it in the broader Australian primary care population. This study aims to evaluate internal consistency and reliability of PACIC+ and six new supplementary items proposed to assess patient wellbeing and empowerment to self-manage their chronic condition. Methods: A repeated-measures correlation design study assessed the expanded PACIC+ over three time-points. Particpants were patients with at least one chronic disease, referred by consultant physician, or recruited by advertisement posters in hospital clinic areas. Results: PACIC+ (26-item) had acceptable internal consitency (Cronbach's alpha 0.96). Test–retest reliability (Time-1 and 2, P < 0.01) was acceptable: Total score r (48) = 0.43; and New supplementary items: Confidence r (48) = 0.54; Understanding r (48) = 0.62; Support r (48) = 0.43; Overall Health r (48) = 0.42; Overall Health Change r (48) = −0.31, P = 0.03; and Acute Episodes of Care in 1-month r (48) = 0.42, P < 0.01. Four factors from the original PACIC+ accounted for 66.5% of the variance. Conclusions: The expanded PACIC+ is an improved psychometric tool providing for the patient's voice in a shared health journey. It is a valid, reliable tool to monitor and measure self-management of chronic conditions in Australian population clinic and primary healthcare settings. Six new supplementary patient empowerment and health status measures proved reliable and, in combination with the PACIC+ psychometric tool, could offer a method to monitor and measure the self-management of chronic conditions in the Australian clinic setting and for future research. [ABSTRACT FROM AUTHOR]

Objective: Clinical care ratios are used to quantify and benchmark the activity of allied health professionals. This study aims to review previous recommendations and identify what variables may influence them. Method: Data was collected from the core allied health professions (audiology, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, prosthetics and orthotics, psychology, social work and speech pathology) across eight Australian hospitals. Data for 113 staff who were casual or from smaller professions (audiology, podiatry, prosthetics and orthotics and psychology) were excluded due to insufficient numbers for analysis. The remaining data were analysed according to profession, seniority (tiers 1, 2 and 3) and employment status (permanent versus casual staff). A two-way ANOVA was performed to assess the association of clinical care ratios with tier, profession, employment status and gender. Results: Data from 1246 staff from the five larger professions at participating hospitals were analysed. There were no interactions between profession and gender (P = 0.185) or employment status (P = 0.412). The relationship between clinical care ratio and profession was modified by tier (interaction term, P = 0.014), meaning that differences in clinical care ratios between professions depended on the tier. Conclusion: This research has confirmed that clinical care ratios are a useful tool in workload management and determining staffing levels for allied health professionals. The recommendations from this research provide a starting point that can be finessed with reference to profession, model of care, workforce structure, governance and training requirements. This will lead to increased staff wellbeing and improved patient outcomes. What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the outcomes that are most important to prosthesis users and funders. A Prosthetic Interventions Core Outcome Set (PI-COS) will help researchers and practitioners measure outcomes that are the most important to prosthesis users and funders. Materials and methods: Prosthesis users and funders rated the importance of 121 International Classification of Functioning, Disability, and Health (ICF) second-level categories using a two-round Delphi survey. A Consensus Meeting using the nominal group technique resolved rating differences between groups. The ICF second-level categories were ranked according to importance and a K-Means Cluster Analysis helped establish the PI-COS. Results: 65 users and 8 funders completed the Delphi surveys, followed by a Consensus Meeting. 26 ICF second-level categories were considered important to prosthesis users and funders and a PI-COS of 14 ICF second-level categories drawn predominantly from five ICF chapters was established: Sensory Functions and Pain (b2), Neuromusculoskeletal and Movement-related Functions (b7), General Tasks and Demands (d2), Mobility (d4), and Products and Technology (e1). Conclusions: The PI-COS describes the outcomes that are most important to prosthesis users and funders. The PI-COS can help focus on the most important outcome measures in clinical practice and research, including future prosthetic health economic evaluations. [ABSTRACT FROM AUTHOR]

This study assessed the rate of a.) the total and b.) specific psychiatric comorbidities among the three severity ratings for Anorexia Nervosa (AN): DSM-5, ICD-11 and overvaluation of weight and shape (OWS). The sample comprised 312 treatment-seeking patients with AN (mean age = 26.9). Weight and height were taken at intake to calculate BMI, the foundation for the DSM-5 and ICD-11 severity indices. The EDE-Q was used to assess OWS, and the Mini International Neuropsychiatric Interview was conducted to assess psychiatric comorbidities. For the DSM-5, the mild severity group showed a higher total number of psychiatric comorbidities, especially for panic, social anxiety, generalised anxiety, and post-traumatic stress disorders compared to the severe and extremely severe groups. ICD-11 and OWS severity groups did not significantly differ in total comorbidities, except for major depressive disorder and obsessive-compulsive disorders being more prevalent in the "significantly low BMI" ICD-11 group. The high OWS group displayed a notably higher rate of major depressive disorder than the low OWS group. The study underscores inconsistent patterns across the three severity systems, emphasising the need to recognise the current limitations of the assessed severity classification systems in AN assessment and guiding treatment. [ABSTRACT FROM AUTHOR]

Aim: This study explored the knowledge and confidence levels of nursing academics in teaching both the theories and practical skills of digital health in undergraduate nursing programs. Design: A cross‐sectional study. Methods: A structured online survey was distributed among nursing academics across Australian universities. The survey included two sections: (1) the participants' demographics and their nursing and digital health teaching experience; (2) likert scales asking the participants to rate their knowledge and confidence to teach the theories and practical skills of four main themes; digital health technologies, information exchange, quality and digital professionalism. Results: One hundred and nineteen nursing academics completed part one, and 97 individuals completed part two of the survey. Only 6% (n = 5) of the participants reported having formal training in digital health. Digital health was mainly taught as a module (n = 57, 45.9%), and assessments of theory or practical application of digital health in the nursing curriculum were uncommon, with 79 (69.9%) responding that there was no digital health assessment in their entry to practice nursing programs. Among the four core digital health themes, the participants rated high on knowledge of digital professionalism (22.4% significant knowledge vs. 5.9% no knowledge) but low on information exchange (30% significant knowledge vs. 28.3% no knowledge). Statistically significant (p <.001) associations were found between different themes of digital health knowledge and the level of confidence in teaching its application. Nursing academics with more than 15 years of teaching experience had a significantly higher level of knowledge and confidence in teaching digital health content compared with those with fewer years of teaching experience. Conclusion: There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Nursing academics need to upskill in digital health to prepare the future workforce to be capable in digitally enabled health care settings. Implications for the Profession: Nursing academics have a limited level of digital knowledge and confidence in preparing future nurses to work in increasingly technology‐driven health care environments. Addressing this competency gap and providing sufficient support for nursing academics in this regard is essential. Impact: What problem did the study address? Level of knowledge and confidence among nursing academics to teach digital health in nursing practice.What were the main findings? There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing.Where and on whom will the research have an impact? Professional nursing education globally. Reporting Method: The STROBE guideline was used to guide the reporting of the study. Patient or Public Contribution: The call for participation from nursing academics across Australia provided an introductory statement about the project, its aim and scope, and the contact information of the principal researcher. A participant information sheet was shared with the call providing a detailed explanation of participation. Nursing academics across Australia participated in the survey through the link embedded in the participation invite. [ABSTRACT FROM AUTHOR]

Background: There are limited hospital‐acquired malnutrition (HAM) studies among the plethora of malnutrition literature, and a few studies utilise electronic medical records to assist with malnutrition care. This study therefore aimed to determine the point prevalence of HAM in long‐stay adult patients across five facilities, whether any descriptors could assist in identifying these patients and whether a digital Dashboard accurately reflected 'real‐time' patient nutritional status. Methods: HAM was defined as malnutrition first diagnosed >14 days after hospital admission. Eligible patients were consenting adult (≥18 years) inpatients with a length of stay (LOS) >14 days. Palliative, mental health and intensive care patients were excluded. Descriptive, clinical and nutritional data were collected, including nutritional status, and whether a patient had hospital‐acquired malnutrition to determine point prevalence. Descriptive Fisher's exact and analysis of variance (ANOVA) tests were used. Results: Eligible patients (n = 134) were aged 68 ± 16 years, 52% were female and 92% were acute admissions. HAM and malnutrition point prevalence were 4.5% (n = 6/134) and 19% (n = 26/134), respectively. Patients with HAM had 72 days greater LOS than those with malnutrition present on admission (p < 0.001). A high proportion of HAM patients were inpatients at a tertiary facility and longer‐stay wards. The Dashboard correctly reflected recent ward dietitian assessments in 94% of patients at one facility (n = 29/31). Conclusions: HAM point prevalence was 4.5% among adult long‐stay patients. Several descriptors may be suitable to screen for at‐risk patients in future studies. Digital Dashboards have the potential to explore factors related to HAM. Key points: Hospital‐acquired malnutrition (HAM) is a significant issue among malnourished long‐stay patients. Future research should explore whether factors such as length of stay, tertiary facilities and rehabilitation or subacute wards could assist with screening for HAM. With effective governance digital Dashboards have the potential to explore factors related to HAM. [ABSTRACT FROM AUTHOR]

This study aimed to assess differences in emotion and elaboration quality between clinical and community child cohorts in both past reminiscing and future worry conversations. We analyzed 54 Australian parents (46 mothers, 8 fathers) and their 8- to 12-year-old children (M = 9.63, SD = 1.29; 28 boys, 26 girls) in reminiscing interactions. Dyads were recruited from local schools (community cohort, n = 26) or a children's psychology clinic waitlist (clinical cohort, n = 28). Clinical cohort children engaged in less emotion exploration in both past and future conversations, as did parents for future conversations. Elaboration quality did not differ. Parent-son dyads differed in the clinical cohort, exhibiting significantly lower emotion resolution than the community cohort, or parent-daughter dyads when discussing past events. These findings suggest that discussing anticipated negative events may be a relevant point of family-based intervention for anxious children. Additionally, this study highlights the importance of parent-son emotional discussion. [ABSTRACT FROM AUTHOR]

Background: Across the globe, shortages of nurses and midwives in rural regions persist. Advanced practice nursing has been found to address workforce shortages through career progression aimed at retention. A regional health service sought to consult with staff about developing an advanced practice nursing framework. Aims: This study aimed to explore the perspectives of nurses and midwives at a regional health service on (i) how their roles aligned with the modified Advanced Practice Role Delineation (APRD) tool and (ii) the potential for implementation of such a framework at their service. Design: A case study conducted at Goulburn Valley Health (GVH) in southeast Australia used a mixed method design with a survey of all nursing and midwifery staff and focus groups with senior staff. Methods: All nurses and midwives were asked to complete a validated modified ARPD questionnaire and those in Grades 3–6 were asked to participate in a focus group. Results: From 183 questionnaires and 38 participants in the focus group discussions, findings concurred that nurses and midwives at GVH reported spending most time on direct patient care and minimal time on research activities, publication and/or leadership. While education was strongly embraced and advanced practice usually supported, senior staff cited the lack of resources, the culture and staff shortages as restricting opportunities for education, career development and implementation of an advanced practice framework. Conclusions: While an advanced practice framework could address staff shortages at this health service, implementation of such a framework is constrained by the lack of resources and workforce shortages common in rural health services. A national strategy that embeds advanced practice roles and resources implementation of advanced practice nursing and midwifery frameworks in areas of need is recommended. [ABSTRACT FROM AUTHOR]

With rates of coercive control (CC) increasing, there is a need to ensure that intervention programs are underpinned by evidence-based research. Current interventions are scarce, with their efficacy rarely established. Most current interventions appear to rely on victims seeking support from formal sources/agencies, despite suggestions that victims are more likely to confide in people they know, such as their friends. Researchers suggest that a victim's friends may provide an effective source of support and intervention. The aim of this study was to fill the gap in the literature exploring whether the closeness of the relationship to the victim, bystander gender, and bystander concerns influenced attitudes toward intervening in CC situations. The study used an experimental design, whereby participants were randomly allocated to read a vignette depicting a CC scenario involving a friend, colleague, or stranger, and quantitative methods were used to examine bystanders' willingness and concerns about intervening. The sample was 340 Australian participants (229 female, 111 male), recruited from social media, namely community Facebook groups. The results indicated that friends were significantly more willing to intervene than colleagues or strangers, while strangers reported the highest concerns about intervening. Females reported significantly higher willingness to intervene than men despite also reporting higher concerns. Exploratory analysis of concerns about intervening revealed that the participants were most concerned about risk of harm and their beliefs in their ability to successfully intervene. These findings have implications for bystander intervention programs and campaigns, including offering a range of potential directions to enhance intervention program content. [ABSTRACT FROM AUTHOR]

Background: Traditional models of palliative care have been tested by the challenges of caring for increasing numbers of people at the end stages of a chronic non-malignant illness. The COVID-19 pandemic and consequent reliance on telehealth services, has enabled the development of creative models of care. Aims: To improve home-based palliative care for people with chronic illness using telehealth, and this was demonstrated using quality-of-life measures. Methods: A total of 35 non-cancer referrals to a community palliative care service were recommended for the pilot project, with one specialist palliative care nurse as their contact. All were offered a telehealth service with a specially designed app to self-monitor their symptoms, a session on advance care directives, and self-rated quality-of-life measures using the RAND 36-Item Health Survey (Version 1.0), consisting of 36 items that cover nine domains. Statistical analysis was performed using SPSS software. Findings: Over the 21 months of the pilot study, 13 people chose to participate in the pilot. For participants, telehealth meant more control over their symptoms, fewer emergency presentations and appointment travel time was alleviated. Quality-of-life surveys highlighted physical impairments, which did not change over time. Conclusion: This pilot programme demonstrated an innovative approach to addressing the demands of people dying of chronic illness, with further work required to explore the place of telehealth consultations in the overall healthcare system. [ABSTRACT FROM AUTHOR]

Objective: A feasibility study to test the proposed methodology for a larger randomised control trial was conducted, investigating the comparative effectiveness of the two types of pressure management support surfaces with regards to healing pressure injuries (PI). A secondary objective was to provide insights into the user acceptability of the two types of pressure management support surfaces. Method: A randomised control feasibility study was conducted in a community health setting in Canberra, Australia. Patients aged ≥65 years with an existing Stage 2 PI who slept in a bed were eligible. Participants were randomised to either the active mattress group or the reactive mattress group for use on their bed. All participants received standard wound care by community nursing staff and were provided an air-flotation cushion for use when not in bed. Photographs were taken and used for blind assessment of wound healing. Secondary information was gathered through a survey regarding user acceptability of the support surfaces and changes in habits regarding PI prevention strategies. Results: In total, five patients were recruited, with one passing away prior to mattress allocation. Results were inconclusive with regards to comparative effectiveness and user acceptability due to the small sample size; however, secondary data indicated an increasing implementation of PI prevention strategies. Conclusion: This study confirmed the need for further high quality research comparing reactive and active pressure mattresses. Trends indicate the importance of including education on PI prevention strategies to promote changes in behaviour. Changes to the proposed methodology will be made to increase recruitment in the primary study. [ABSTRACT FROM AUTHOR]

High staff turnover is common within the Australian public mental health workforce, contributing to workforce shortages and ultimately impacting the ability to provide stable efficient, effective, and ongoing optimal care to the community. In this study, we aimed to (a) establish the most pertinent factors associated with increased turnover intention in the public mental health workforce in Australia, and (b) establish whether such factors differ between metropolitan and rural services. We used a cross‐sectional, correlational design using an online survey method. In total, 235 mental health service staff of various disciplines and levels, from four public hospitals in Victoria, Australia participated in the study. We used three feed‐forward multiple regression analyses to assess the study aims. We found that job satisfaction, occupational burnout, and understaffing may be the most pertinent factors to consider regarding turnover intention. Job satisfaction and occupational burnout were factors endorsed across the entire sample, as well as specifically within both the metropolitan and rural services, while understaffing was a pertinent factor regarding turnover intention across the entire sample and for rural services, but not metropolitan services. Our findings regarding the pertinence of job satisfaction, occupational burnout, and understaffing in turnover intention provide key information that may be used to inform interventional targets aimed at reducing attrition from the public mental health workforce in Australia. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to identify segments in the Gen Z population (born between 1996 and 2010) in Europe, the USA and Australia, based on brand- and lifestyle-related variables and perceptions about their online activities. This study explores how these segments differ and provide insights into cross-country similarities and differences. Design/methodology/approach: An online survey was conducted with 4,304 participants, and cluster analysis and analysis of variance were used to identify and profile Gen Z segments in each of three geographical areas. Findings: Five segments in Europe and four segments in the USA and in Australia were identified. Segments differ in terms of the importance they attach to exclusivity, inclusivity and sustainability of brands, how Gen Z members perceive money issues and stand in life and how they perceive their online activities. Similar segments are found in the three geographical areas. Research limitations/implications: This study proposes a conceptual and analytical approach for exploring intra-cohort diversity. Future research can apply this approach to different generational cohorts and use it to study intra-cohort diversity in other parts of the world. Practical implications: This study provides input for marketing practitioners to create better focused and more effective campaigns. Originality/value: Cross-country generational cohort research is scarce, and especially intra-cohort diversity is under-researched. This study offers a deep and fine-grained insight into the diversity of the Gen Z cohort across three geographical areas, based on representative samples in these areas. [ABSTRACT FROM AUTHOR]

Background: Burnout and workforce shortages comprise a vicious cycle in medicine, particularly for Australian general practitioners (GPs). Professional diversification, whereby individuals work multiple roles across their week, may help address this problem, but this strategy is under-studied. Methods: We surveyed 1157 Australian GPs using qualitative and quantitative questions examining professional diversification, values, autonomy, and wellbeing. Quantitative data were analysed using inferential statistics, whilst qualitative data were analysed using inductive thematic analysis. We triangulated the data by using the qualitative findings to inform further quantitative testing. Results: Approximately 40% of the sample had diversified. Although diversifying was not significantly associated with wellbeing, the qualitative data indicated that diversification supported GPs' wellbeing by enhancing career sustainability, accomplished through various pathways (e.g. value fulfilment, autonomy, variety). Subsequent quantitative analyses provided evidence that these pathways mediated the relationship between diversification and wellbeing. To diversify, GPs needed particular personal qualities, external supports, flexibility, and serendipity. Barriers to diversifying mirrored these factors, spanning individual (e.g. skillset) and situational levels (e.g. autonomy, location). Conclusions: Diversification can support GPs' wellbeing if it meets their needs. Organisations should focus on publicising opportunities and accommodating requests to diversify. Professional diversification and developing new skillsets can assist general practitioners to sustain their own well-being and engagement with their work. Features that can mediate this relationship include value fulfilment, autonomy, variety, external supports, flexibility, and serendipity. This may help address the current international epidemic of burnout and workforce shortages in general practice. [ABSTRACT FROM AUTHOR]

Research into the use of bereavement photography is limited and the experiences of volunteer photographers remains understudied. For families with perinatal loss, bereavement photography allows for lasting mementos of a child and facilitates the maintenance of continuing bonds. This study investigated bereavement photographers' reasons for volunteering, factors predicting their compassion satisfaction, and the support and retention of volunteer photographers. Utilizing a mixed methods design, 141 Australian and New Zealand volunteer bereavement photographers completed the Volunteer Motivation Inventory. The strongest motivators for volunteering related to Values, Reciprocity and Recognition. The results concur with other research showing altruistic motivation has the greatest influence on becoming a volunteer in end of life services. Moderate to high levels of Compassion Satisfaction were found on the Professional Quality of Life Scale Version 5. Support from the volunteering organization and a higher number of photography sessions with families predicted higher Compassion Satisfaction. Additionally, 31 photographers participated in semi-structured interviews. Motivators for volunteering identified by the thematic analysis were: Giving Back, Being Appreciated, Healing Past Grief, and Satisfaction with the Organization. Overall, the findings suggested that providing sensitive supportive care, experiencing positive interactions with families, feeling supported, and having a sense of purpose led to higher levels of CS. [ABSTRACT FROM AUTHOR]

Background: Self-guided digital interventions can reduce the severity of suicidal ideation, although there remain relatively few rigorously evaluated smartphone apps targeting suicidality. Objective: This trial evaluated whether the BrighterSide smartphone app intervention was superior to a waitlist control group at reducing the severity of suicidal ideation. Methods: A total of 550 adults aged 18 to 65 years with recent suicidal ideation were recruited from the Australian community. In this randomized controlled trial, participants were randomly assigned to receive either the BrighterSide app or to a waitlist control group that received treatment as usual. The app was self-guided, and participants could use the app at their own pace for the duration of the study period. Self-report measures were collected at baseline, 6 weeks, and 12 weeks. The primary outcome was severity and frequency of suicidal ideation, and secondary outcomes included psychological distress and functioning and recovery. Additional data were collected on app engagement and participant feedback. Results: Suicidal ideation reduced over time for all participants, but there was no significant interaction between group and time. Similar improvements were observed for self-harm, functioning and recovery, days out of role, and coping. Psychological distress was significantly lower in the intervention group at the 6-week follow-up, but this was not maintained at 12 weeks. Conclusions: The BrighterSide app did not lead to a significant improvement in suicidal ideation relative to a waitlist control group. Possible reasons for this null finding are discussed. [ABSTRACT FROM AUTHOR]

Background: Mental health problems are common among university students, yet many students do not seek professional help. Digital mental health interventions can increase students' access to support and have been shown to be effective in preventing and treating mental health problems. However, little is known about the extent to which students implement therapeutic skills from these programs in everyday life (ie, skill enactment) or about the impact of skill enactment on outcomes. Objective: This study aims to assess the effects of a low-intensity video-based intervention, Uni Virtual Clinic Lite (UVC-Lite), in improving skill enactment relative to an attention-control program (primary aim) and examine whether skill enactment influences symptoms of depression and anxiety (secondary aim). The study also qualitatively explored participants' experiences of, and motivations for, engaging with the therapeutic techniques. Methods: We analyzed data from a randomized controlled trial testing the effectiveness of UVC-Lite for symptoms of depression and anxiety among university students with mild to moderate levels of psychological distress. Participants were recruited from universities across Australia and randomly assigned to 6 weeks of self-guided use of UVC-Lite (243/487, 49.9%) or an attention-control program (244/487, 50.1%). Quantitative data on skill enactment, depression, and anxiety were collected through baseline, postintervention, and 3- and 6-month follow-up surveys. Qualitative data were obtained from 29 intervention-group participants through open-ended questions during postintervention surveys (n=17, 59%) and semistructured interviews (n=12, 41%) after the intervention period concluded. Results: Mixed model repeated measures ANOVA demonstrated that the intervention did not significantly improve skill enactment (F3,215.36=0.50; P=.68). Skill enactment was also not found to influence change in symptoms of depression (F3,241.10=1.69; P=.17) or anxiety (F3,233.71=1.11; P=.35). However, higher levels of skill enactment were associated with lower symptom levels among both intervention and control group participants across time points (depression: F1,541.87=134.61; P<.001; anxiety: F1,535.11=73.08; P<.001). Inductive content analysis confirmed low levels of skill enactment among intervention group participants. Participants were motivated to use techniques and skills that were perceived to be personally relevant, easily integrated into daily life, and that were novel or had worked for them in the past. Conclusions: The intervention did not improve skill enactment or mental health among students with mild to moderate psychological distress. Low adherence impacted our ability to draw robust conclusions regarding the intervention's impact on outcomes. Factors influencing skill enactment differed across individuals, suggesting that it may be necessary to tailor therapeutic skills and engagement strategies to the individual user. Theoretically informed research involving collaboration with end users is needed to understand the processes underlying skill enactment in digital mental health interventions. [ABSTRACT FROM AUTHOR]

Virtual Reality simulation (VRS) is an innovative and emerging technology that has the potential to offer increased numbers of pre-registration students authentic learning experiences compared to traditional simulation- based education (SBE) with simulated participants. The aim was to evaluate learner outcomes of SBE compared to 4 fully immersive VRS scenarios, for vocational and higher education nursing students at a training and further education institute in Melbourne, Australia. A mixed methods quasi-experimental design study was conducted over two semesters from 2019 to 2020. Participants were 675 pre-registration nursing students. The intervention group (VRS n = 393) received 4 three-dimensional, immersive VRS modules. The control group (SBE n = 282) received 4 face-to-face large group immersive simulations. In the VRS group 95% of students actively participated, compared to SBE (on average 15%). Knowledge test scores were initially significantly greater (p < 0.01) for VRS versus SBE students, but not maintained post clinical placement. Intervention students found VRS to be realistic and prepared them for clinical practice. Some technical difficulties were identified with VRS. VRS was found to be more cost effective than SBE. VRS fostered critical thinking and provided an efficient and sustainable platform for learning about complex clinical situations. [ABSTRACT FROM AUTHOR]

Asthma is a key illness driving children to present to emergency departments, and although paediatric emergency asthma presentations have been examined, the temporal trends remain somewhat elusive. The aim is to highlight, describe, and model the temporal trends of emergency paediatric asthma presentations, using comprehensive hospital emergency presentation data. A retrospective cross-sectional study examined de-identified paediatric (0 to 14 years) emergency asthma presentation data over a three-year period. Data were obtained from nine healthcare facilities in Victoria, Australia. Episode-level data were collected through RAHDaR, a comprehensive emergency data register which includes missing data (35.0%) among rural health facilities not currently captured elsewhere. Monthly presentation rates demonstrate a significant difference in presentations between fall/autumn and spring, and males had higher presentation rates in February and June–August. Emergency presentations were more likely to occur Sunday–Tuesday, peaking in the time periods of 8–9 a.m., 11 a.m.–12 p.m., and 8–9 p.m. Significant differences were noted between all age groups. Examining previously unavailable rural data has highlighted patterns among emergency asthma presentations for children 0–14 years of age. Knowledge of these by season, month, and day of the week, in combination with time of day, offers scope for more focused workforce education and planning, and nuanced referral pathways, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Speed and accuracy of lexical access change with healthy ageing and neurodegeneration. While a word's immediate phonological neighbourhood density (i.e. words differing by a single phoneme) influences access, connectivity to all words in the phonological network (i.e. closeness centrality) may influence processing. This study aimed to investigate the effect of closeness centrality on speed and accuracy of lexical processing pre- and post- a single word-training session in healthy younger and older adults, and adults with logopenic primary progressive aphasia (lvPPA), which affects phonological processing. Participants included 29 young and 17 older healthy controls, and 10 adults with lvPPA. Participants received one session of word-training on words with high or low closeness centrality, using a picture-word verification task. Changes in lexical decision reaction times (RT) and accuracy were measured. Baseline RT was unaffected by age and accuracy was at ceiling for controls. Post-training, only young adults' RT were significantly faster. Adults with lvPPA were slower and less accurate than controls at baseline, with no training effect. Closeness centrality did not influence performance. Absence of training effect for older adults suggests higher threshold to induce priming, possibly associated with insufficient dosage or fatigue. Implications for word-finding interventions with older adults are discussed. [ABSTRACT FROM AUTHOR]

Objective: To enrich and compare three extracellular vesicles—EV subtypes (apoptotic bodies, microvesicles and small EV) from three periodontal cells (periodontal ligament cells—PDLCs, alveolar bone‐derived osteoblasts—OBs and gingival fibroblasts—GFs), and assess uptake and cell function changes in buccal fat pad‐derived mesenchymal stromal cells (BFP‐MSCs). Background: Periodontal cells such as PDLCs, OBs and GFs have the potential to enhance bone and periodontal regeneration, but face significant challenges, such as the regulatory and cost implications of in vitro cell culture and storage. To address these challenges, it is important to explore alternative 'cell‐free' strategies, such as extracellular vesicles which have emerged as promising tools in regenerative medicine, to facilitate osteogenic differentiation and bone regeneration. Methods and Materials: Serial centrifuges at 2600 and 16 000 g were used to isolate apoptotic bodies and microvesicles respectively. Small EV—sEV was enriched by our in‐house size exclusion chromatography (SEC). The cellular uptake, proliferation, migration and osteogenic/adipogenic differentiation genes were analysed after EVs uptake in BFP‐MSCs. Results: Three EV subtypes were enriched and characterised by morphology, particle size and EV‐associated protein expression—CD9. Cellular uptake of the three EVs subtypes was observed in BFP‐MSCs for up to 7 days. sEV from the three periodontal cells promoted proliferation, migration and osteogenic gene expression. hOBs‐sEV showed superior levels of osteogenesis markers compared to that hPDLCs‐sEV and hGFs‐sEV, while hOBs‐16k EV promoted adipogenic gene expression compared to that from hPDLCs and hGFs. Conclusions: Our proof‐of‐concept data demonstrate that hOBs‐sEV might be an alternative cell‐free therapeutic for bone tissue engineering. [ABSTRACT FROM AUTHOR]

Purpose: Although speech-language pathologists have provided genderaffirming voice training for trans women since the 1970s, evidence for this training’s effectiveness remains weak. Our study aimed to redress limitations of earlier studies and evaluate voice training effects on outcomes important to trans women. Method: Seventy-four trans women (19–54 years old) who wanted a more female-sounding voice were recruited through two health facilities and provided with an eight- to 12-session voice training program based on contemporary literature, usual clinical practice, and client-centered care principles. Self-reported outcomes and an audio-recorded reading sample were collected 3 months before, immediately before and after, and 3 months after training. Forty cisgender speakers were audio-recorded reading the same sample material as comparison voices. Seventy-nine naive listeners made gender-related voice ratings of an extract from these audio recordings. Training effectiveness was evaluated using group-level analyses (linear mixed-effects models) and individual-level analyses to establish what proportion of participants improved to a predetermined relevant degree. Results: Group-level analyses demonstrated positive training effects, maintained 3 months posttraining, for trans women’s vocal satisfaction, perceptions of voice-related social participation, and self- and listener perceptions of their voices. Individual-level analyses also demonstrated positive effects. Two thirds of trans women increased vocal satisfaction to a relevant degree, one third who reported restricted social participation before training reduced this restriction to a relevant degree, and all were rated more female-sounding after training (although not all to a relevant degree). Conclusions: All trans women participants made progress toward their voice goals and maintained those gains at follow-up. These findings provide evidence that gender-affirming speech-language pathology services warrant prioritization. Further research is warranted to investigate factors predicting outcomes of voice training for trans women. [ABSTRACT FROM AUTHOR]

This study examined verbal and non‐verbal features of mother–infant shared book reading in Australia during the first year of life and explored the relationship between these features and infant cognition. Mother–infant dyads were observed in this cross‐sectional study reading an unfamiliar book in a laboratory setting when infants were aged 6 months (n = 17), 9 months (n = 14), or 12 months (n = 17). High frequency maternal behaviours coded from video were the production of attention attracting behaviours, immediate talk, and verbal encouragement to maintain infant book engagement. Few significant relationships were found for infant problem‐solving scores. Infant communication scores were however associated with non‐immediate talk at 6 months, maternal questions at 9 months, and non‐book related talk at 12 months. Shared book reading provides opportunities for verbal responsiveness and literacy engagement which likely serve as an important vehicle for facilitating early cognitive development. [ABSTRACT FROM AUTHOR]

PURPOSE International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required. MATERIALS AND METHODS We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted. RESULTS A total of 650 individuals diagnosed between 2000 and 2020 were included, 63%(411 of 650) seminoma and 37%(239 of 650) nonseminoma. Themedian age was 34 years (range 14-74). 26% (106 of 411) with seminoma and 15% (36 of 239) nonseminoma received adjuvant chemotherapy. After a median follow-up of 43 months (range 0-267) postorchidectomy, relapse occurred in 10% (43 of 411) of seminoma and 18% (43 of 239) of nonseminoma. The two-year relapse-free survival was 92%(95% CI, 89 to 95) and 82% (95%CI, 78 to 87) in seminoma and nonseminoma, respectively. All relapses (86 of 86) were detected at a routine surveillance visit; 98% (85 of 86) were asymptomatic and detected solely through imaging (62 of 86, 72%), tumor markers (6 of 86, 7%), or a combination (17 of 86, 20%). The most common relapse site was isolated retroperitoneal lymphadenopathy (53 of 86, 62%). No nonpulmonary visceral metastases occurred. At relapse, 98% (84 of 86) had International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis; 2 of 86 intermediate prognosis (both nonseminoma). No deaths occurred. CONCLUSION In our cohort of stage 1 testicular cancer, where national surveillance recommendations have been widely adopted, recurrences were detected at routine surveillance visits and, almost exclusively, asymptomatic with IGCCCG goodprognosis disease. This provides reassurance that active surveillance is safe. [ABSTRACT FROM AUTHOR]