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Background: Many people experience withdrawal symptoms when they attempt to stop antidepressants. Withdrawal symptoms are readily misconstrued for relapse or ongoing need for medication, contributing to long-term use (> 12 months). Long-term antidepressant use is increasing internationally yet is not recommended for most people. Long-term use is associated with adverse effects including weight gain, sexual dysfunction, lethargy, emotional numbing and increased risk of falls and fractures. This study aims to determine the effectiveness of two multi-strategy interventions (RELEASE and RELEASE+) in supporting the safe cessation of long-term antidepressants, estimate cost-effectiveness, and evaluate implementation strategies. Methods: Design: 3-arm pragmatic cluster randomised controlled trial effectiveness-implementation hybrid type-1. Setting: primary care general practices in southeast Queensland, Australia. Population: adults 18 years or older taking antidepressants for longer than 1 year. Practices will be randomised on a 1.5:1:1 ratio of Usual care:RELEASE:RELEASE+. Intervention: RELEASE for patients includes evidence-based information and resources and an invitation to medication review; RELEASE for GPs includes education, training and printable resources via practice management software. RELEASE+ includes additional internet support for patients and prescribing support including audit and feedback for GPs. Outcome measures: the primary outcome is antidepressant use at 12 months self-reported by patients. Cessation is defined as 0 mg antidepressant maintained for at least 2 weeks. Secondary outcomes: at 6 and 12 months are health-related quality of life, antidepressant side effects, well-being, withdrawal symptoms, emotional numbing, beliefs about antidepressants, depressive symptoms, and anxiety symptoms; and at 12 months 75% reduction in antidepressant dose; aggregated practice level antidepressant prescribing, and health service utilisation for costs. Sample size: 653 patients from 28 practices. A concurrent evaluation of implementation will be through mixed methods including interviews with up to 40 patients and primary care general practitioners, brief e-surveys, and study administrative data to assess implementation outcomes (adoption and fidelity). Discussion: The RELEASE study will develop new knowledge applicable internationally on the effectiveness, cost-effectiveness, and implementation of two multi-strategy interventions in supporting the safe cessation of long-term antidepressants to improve primary health care and outcomes for patients. Trial registration: ANZCTR, ACTRN12622001379707p. Registered on 27 October 2022. [ABSTRACT FROM AUTHOR]

This paper reports an analysis of interviews conducted with 10 White Australian women who had undertaken intercountry adoption. The paper begins with an overview of how issues of culture play out within discourses of intercountry adoption in general and how this occurs specifically in Australian policy in regard to intercountry adoption. The analysis highlights how the interviewees were in many ways inculcated in broader Australian discourses of intercountry adoption, as much as in some instances there was an attempt to resist this. The paper concludes by discussing how it might be possible for White adoptive mothers in Australia to do other than remain complicit with marginalizing accounts of adoptive children's birth cultures and parents. [ABSTRACT FROM AUTHOR]

Transnational adoption requires adoptive parents to negotiate complexities concerning difference and belonging within the family. Transnational adoption is mediated through societal and governmental prescriptions of suitability that include willingness and competency to raise children to maintain connections to their birth heritages. Tensions in the formation of parental identities are located in different racial, ethnic, cultural and class-based backgrounds to the children they adopt. This contrasts against dominant models of family where constructions of belonging are based on biological ties. A qualitative study of thirty-five Australian adoptive parents explored reflections on adoption processes and how the complex task of performing suitability was negotiated. Theoretical understandings were developed using a grounded theory approach. Contemporary social theory with a focus on race, cosmopolitanism and families further developed emergent theoretical understandings during analysis. Tensions in identity formation are discussed. The paper concludes that issues of race in identity formation are marginalised. [ABSTRACT FROM AUTHOR]

2012 marked historic events in the practice of adoption in Australia. Government focus was on the formulation of apologies to those people affected by past forced adoption practices. A critical reflection on these and other Australian apologies, highlight assumptions that differentiate past domestic adoption practices from past and contemporary practice in intercountry adoption. The importance of social work, founded in the values of social justice and human rights, to ensuring the same practice standards apply to all people who give birth to children regardless of where they live is highlighted. Expanding knowledge on intercountry adoption indicates that Australia should prepare for another apology. [ABSTRACT FROM AUTHOR]

The article discusses the history of Indigenous Australian adoptees, with a particular focus on their role in the larger history of the Stolen Generations of Indigenous Australian children who were forcibly removed from their families. The author emphasizes the unique challenges faced by adult adoptees raised in white homes as they attempted to navigate racism and explore their identities in Australian society. Details on the role of adoption in government policies promoting the assimilation of Indigenous Australians are also presented.

Australian families are changing and parenthood is increasingly being seen as an individual choice. One important arena for exercising such choice is adoption, which today takes place across national boundaries in the form of intercountry adoption. This is now the predominant type of adoption in Australia. In order to reach their goal of parenthood, individuals choosing intercountry adoption must undergo an education and assessment process. This paper presents the findings from research undertaken as part of a larger doctoral study, with prospective intercountry adoptive parents, intercountry adoptive parents, adoption professionals, and support group representatives living in Australia. Three groups were found to exist in relation to the intercountry adoption assessment process: embracers, acceptors, and pragmatists. Factors influencing each group are discussed and suggestions for strengthening the role and efficacy of education and assessment in the selection of Australian intercountry adoptive parents are recommended. [ABSTRACT FROM AUTHOR]

The article discusses the ideas of denial, remembering, and forgetting as related to the Stolen Generations of indigenous Australian peoples who were forcibly removed from their families as children. Particular focus is given to the public reception of the "Bringing Them Home Report" a document prepared by Mick Dodson and Sir Ronald Wilson of the Australian National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. According to the author, many past injustices endured by Aboriginal people are forgotten because they are not considered important or because they contradict or threaten the identities of white Australians. Topics discussed include activist Mary Montgomery Bennett and the adoption of Aboriginal children by white families.

Korean-Australian intercountry adoption has been practiced for 30 years. This longevity provides unique opportunities to develop critical perspectives on a complex, global practice. This paper presents understandings drawn from a study that explores Korean intercountry adoption using Actor Network Theory. It argues that the practice of intercountry adoption in Australia has been shaped by adoption-driven influences and characterised by controversy and competing discourses. It concludes that contemporary understandings necessitate a global, contextual, and critical view that is inclusive of emerging voices and alternate discourses. The challenge for practitioners and policy makers is to ensure the complex nature of the phenomenon is understood by all stakeholders. This will involve remaining child-focused, promoting multilevel interventions, incorporating research findings, and resisting wholly positive discourse that promotes singular perspectives. An awareness of how the internet is used to forge networks and promote discourses is crucial in ensuring multiple perspectives are considered in this contentious practice field. [ABSTRACT FROM AUTHOR]

Presents a preliminary study of the imaginings of white Australians about assimilation. Background on efforts for the assimilation of Aboriginal people in Australia; Details on the adoption of Aboriginal children by white families; Discussion on the Aboriginal Assimilation Policy.

Theorizes the development and articulation of hybrid identity among interracial families, based on interviews in Darwin and Brisbane, Australia. Significance of place, locality and situated racializing practices in the constitution of identity; Stuart Hall's `New Times' and hybridity concepts in relation to interracial issues in postcolonial and post-industrial nation states.