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Objective: Electrical hazards on farms are one of the occupational risks that contributes to farm injury and fatality. Whilst electricity accounts for a low number of farm injuries each year, it is disproportionately fatal. The aim of this study is to raise the awareness of electrical safety on farms by providing an overview of the literature that explores the evidence of farmers' perception of electrical risk. The review sought evidence of farmers' efforts to promote electrical safety awareness and uptake of electrocution prevention strategies. Method: A rapid review was performed following the Cochrane Rapid Reviews Method Group and PRISMA guidelines, searching grey and peer-reviewed databases with criteria that included both farming and electrical risk. This resulted in 35 key articles of interest and five themes. Results: The prevalent causes and contributing factors of electrical incidents and near misses on farms is not easily explained. Farmers overlook its presence as one of the hazards on farm, but at the same time the element of danger or threat of electrocution deters farmers from taking unnecessary risks. The data to profile farmers at risk of electrical injury is inadequate however the scope of risk is described through five themes: epidemiology, risk perception, exposure, intervention and prevention. Conclusion: Due to the seriousness of electrical injury, intervention and prevention strategies need to specifically address electrical hazards rather than incorporate electricity as a risk into all of the hazards found on farms. The review recommends future work that engages with Australian farmers and farm workers to better understand their experience of electricity exposures, the risks they are willing to take around overhead powerlines, and their insights into how to make working on farms safer. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore women's preferences and experiences of degree of control in decision making when planning an induction of labor (IOL). This multi‐method study was conducted using semi‐structured individual interviews and the completion of two Control Preferences Scales by eight postnatal women from a metropolitan health service in Melbourne, Australia. Four themes were generated from the interview data: "shared decision making"; "changing expectations"; "IOL experience"; and "informed consent." Women's expectations of, and preferences for, an IOL changed during pregnancy and were influenced by their perception of risk to the fetus, indication for the procedure, and trust in clinicians. Information that was personalized to the woman to include practical aspects, risks, and alternative options was rarely provided. Overall, women reported that they did not experience the degree of control they preferred when planning an IOL. Clinician understanding of decision making preferences of women when planning an IOL can assist with care that is individualized and aligned to women's values, which is crucial to improving the quality of care provided. [ABSTRACT FROM AUTHOR]

While flood risk perception has been studied extensively in general populations, there remains a dearth of focus on youth perspectives – a key demographic to mobilising knowledge to achieve disaster risk reduction targets. This study aimed to evaluate university students' perceptions of flood risk and their understanding of common flood probabilities in the Greater Sydney region of Australia. We surveyed 262 university students to better understand how flood preparedness, knowledge, and experience predict flood risk perceptions. Using ordinal logistic regression, we identified that students with past flood experience and women were more likely to have higher flood risk perceptions. In contrast, students with higher flood preparedness were more likely to have lower flood risk perceptions. Age, degree level (e.g. bachelor's, master's), place of residence, and flood knowledge were inconclusive predictors of risk perception. We also assessed differences in how students rated the likelihood of three equivalent flood probabilities presented in different ways: (1) a 1-in-100 year flood; (2) a flood with a 1% of happening in a given year; and (3) a flood with a 55% chance in an 80-year lifetime. Using Friedman and Kruskal-Wallis tests, we compared differences within student responses and across different risk perception groups. We found that students perceived equivalent flood probabilities stated over longer periods of time to be more likely to occur. This study contributes to understanding student perceptions of flood risk, presenting recommendations on how governments and higher educational institutions can improve building students' knowledge of flood hazards. [ABSTRACT FROM AUTHOR]

Aims: To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co‐workers. Design, setting and participants: Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey. Measurements: Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio‐economic status. Findings Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%–62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%–23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13–1.95), younger people, rural, Australian‐born (vs. respondents born overseas in non‐English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model. Conclusions: Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the associated introduction of a novel vaccine has provided researchers with the opportunity to investigate how to support vaccine acceptance and reduce hesitancy using novel approaches. This study aimed to understand the perceptions of COVID-19 unvaccinated Australian adults towards the COVID-19 vaccines and the factors influencing their vaccine decision-making. We also explored their attitudes towards vaccine communication strategies and the availability and quality of resources to support decision-making and preferences during future public health emergencies. In-depth interviews were undertaken with 35 members of the Australian community who self-identified as being unvaccinated against COVID-19 from September to December 2021 and did not intend to vaccinate. Key themes that emerged focused on past experiences of vaccination, feelings of being coerced or pushed into vaccination, concerns about transparency around the development processes used for the COVID-19 vaccines, the value of getting vaccinated and issues regarding the mandates being used. Participants acknowledged that they would be open to talking to peers but held some reservations about the process. Requirements for vaccination have now been lifted in many countries. While governments should continue to strive to promote COVID-19 primary and booster vaccines going forward, this research suggests that there will be a small proportion of the community who continue to actively decline the vaccine. Further work is needed to understand the strategies that can support decision-making during pandemics amongst people who remain uncertain about the need for the vaccines or are concerned about vaccine safety. This includes innovatively exploring the role of peer-to-peer communication and the influence it may have on correcting misunderstandings and supporting confidence. [ABSTRACT FROM AUTHOR]

This article explores enhancement opportunities for Australian Government co‐contributions to superannuation accounts. The article's empirical foundation includes the distributions for variables related to saving, investment and risk perceptions in the 2022 wave of the Household, Income and Labour Dynamics in Australia (HILDA) Survey. As income or wealth increase, there are increases in the probabilities of individuals making additional superannuation contributions, having a saving horizon of at least five years, and being prepared to take more than average investment risks. Four policy changes are suggested in the article, with the potential for superannuation funds to independently implement some of these changes. [ABSTRACT FROM AUTHOR]

Globally, alcohol consumption is a public health issue and a risk factor for drownings among young adults. While studies have identified a prominence of alcohol in youth drownings, little is known about the factors that influence young adults' involvement in alcohol-influenced aquatic activity. The current study aimed to identify the predictors of young adults' intention to participate, and past participation, in alcohol-influenced aquatic activity. A reliable and valid survey, informed by the Theory of Planned Behavior, was distributed to young adults (aged 18-24 years) educated in the UK and Australia. Cumulative odds ordinal logistic regressions with proportional odds were conducted to establish predictors. Overall, 182 participants completed the survey. Subjective norms (Wald χ² (2) = 8.43, p = .015), cognitive attitudes (Wald χ² (2) = 6.40, p = .041) and previous involvement (χ² (1) = 8.98, p = .003) were significant predictors of intention, whilst the influence of friends (Wald χ² (2) = 10.99, p = .004) and intention (Wald χ² (2) = 10.80, p = .005) were significant predictors of behavior. Practitioners should enhance risk awareness and norm perceptions in prevention programs to encourage informed decision making in social aquatic situations. [ABSTRACT FROM AUTHOR]

Natural hazards can turn into disasters when not managed well. An important part of disaster risk reduction is to understand how well communities are prepared for natural hazards and how well they can cope with and recover from shocks in the long term. This research assesses self‐reported community resilience and asks what makes a community resilient, using Australia as a case study. It reports on an Australian‐wide online survey which included questions related to the Conjoint Community Resiliency Assessment Measurement, a subjective indicator, as well as questions about risk perception, well‐being, and self‐efficacy. Community resilience was found to be moderately high but scores for community leadership and preparedness were low. Perceived community resilience was positively correlated with age and those with high scores for self‐efficacy and well‐being. There was, as expected, an inverse relationship between reliance on external support during natural hazards and self‐efficacy. The results complement previous studies which used different measures of community resilience. [ABSTRACT FROM AUTHOR]

• Lateral distance and passing speed both affect perceived safety. • Similar factors influence perceived safety for the cyclist and the driver. • Female drivers perceive higher risk to themselves when passing cyclists. • Traffic and roadway characteristics are more influential than attitudes. Introduction : Up to 38% of crashes between motor vehicles and cyclists involve overtaking and close passes, contributing to a fear of cycling for both current and potential riders. Consequently, most research has focused on the cyclist's perceptions of risk in passing events; but the driver's perceptions may be more influential determinants of passing distances and thus, objective crash risk. Method: In an online cross-sectional survey, participants viewed 24 video clips of naturalistic passing events (external view akin to being a following driver) on urban roads in Queensland, Australia and judged distance and safety for both the portrayed cyclist and the passing driver. The passing events were filmed at a low-speed site (40 km/h speed limit) and a high-speed site (70 km/h speed limit). Results: The 240 cyclist participants were more likely to rate the pass as unsafe for the portrayed cyclist than the 71 non-cyclist participants. Narrow passing distance, parked vehicles, oncoming vehicles, and higher motor vehicle speeds were significant predictors of rating the pass as unsafe for the portrayed cyclist and the passing driver. In addition, female participants were more likely to rate the pass as unsafe for the driver. Participant age, attitudes toward cyclists and frequency of passing cyclists did not significantly affect safety judgments. Discussion: Traffic and roadway characteristics largely underlie perceptions of safety for both the cyclist and the driver when passing, even after accounting for passing distance. External, objective factors are more important than attitudes toward cyclists. Practical Applications: Attempts to improve the subjective and objective safety of passing events may be more successful if their focus is on modifying traffic and roadway characteristics, rather than attempting to change drivers' attitudes toward cyclists. Limitations on motor-vehicle passing speed should be incorporated as part of safe bicycle passing laws. [ABSTRACT FROM AUTHOR]

Context: Production of rainfed (dryland) cotton (Gossypium hirsutum L.) occurs in many places globally, and is always burdened with greater uncertainties in outcomes than irrigated cotton. Assessing farm financial viability helps farmers to make clearer and more informed decisions with a fuller awareness of the potential risks to their business. Aim: We aimed to highlight key points of uncertainty common in rainfed cotton production and quantify these variable conditions to facilitate clearer decision-making on sowing dates and row configurations. Methods: The consequences of these decisions at six locations across two states in Australia, given estimates of plant-available water at sowing, are expressed in terms of comparable probability distributions of cotton lint yield (derived from crop modelling using historical weather data) and gross margin per hectare (derived from historical prices for inputs and cotton lint yield), using the copula approach. Examples of contrasting conditions and likely outcomes are summarised. Key results: Sowing at the end of October with solid row configuration tended to provide the highest yield; however, single- and double-skip row configurations generally resulted in higher gross margins. Places associated with higher summer-dominant rainfall had greater chance of positive gross margins. Conclusion: In order to maximise the probability of growing a profitable crop, farmers need to consider the variabilities and dependencies within and across price and yield before selecting the most appropriate agronomic decisions. Implications: Given appropriate data on growing conditions and responses, our methodology can be applied in other locations around the world, and to other crops. We highlight key points of uncertainty common in rainfed cotton production and quantify these variable conditions to facilitate clearer decision-making on sowing dates and row configurations. The potential profits at six locations in Australia were derived by combining simulated yields and historical cost data, and were compared under different growing conditions. Given appropriate data on growing conditions and responses, our methodology can be applied in other locations around the world, and to other crops. [ABSTRACT FROM AUTHOR]

Terrorism and climate change debates are often characterized by worst‐case thinking, cost neglect, probability neglect, and avoidance of the notion of acceptable risk. This is not unexpected when dealing with extreme events. However, it can result in a frightened public, costly policy outcomes, and wasteful expenditures. The paper will describe how risk‐based approaches are well suited to infrastructure decision‐making for extreme events. Risk management concepts will be illustrated with current research of risk‐based assessment of climate adaptation engineering strategies including designing new houses in Australia subject to cyclones and extreme wind events. It will be shown that small improvements to house designs at a one‐off cost of several thousand dollars per house can reduce damage risks by 70%–80% and achieve billions of dollars of net benefit for community resilience—this helps offset some the predicted adverse effects of climate change for a modest cost. The effect of risk perceptions, insurance, and economic incentives is explored for another climate adaption measure. The paper will also highlight that there is much to be optimistic about the future, and in the ability of risk‐based thinking to meet many challenges. [ABSTRACT FROM AUTHOR]

Background: Falls in hospitalised patients remain an ongoing challenge for healthcare systems internationally. Limited research exists on the perspectives of older people on falls risk, cause and care. Objectives: This study explored the experiences of patients and their families after a fall in a healthcare facility. Methods: Semi‐structured interviews were conducted with patients and families to explore the experience of having a fall. Data were analysed thematically. Results: The themes that emerged from the 14 interviews included the following: explanations; physical environment; communication; experiences of care; perceptions of risk; ageism; feelings towards the fall; and independence and dignity. Conclusions: This research emphasises the diversity in older people's experiences after experiencing a fall. Falls prevention should be incorporated as one part of healthy, dignified ageing. Implications for practice: Falls prevention and management strategies should be multifactorial, including enhanced communication with the patient and their families. When engaging in education and awareness, falls prevention should be positioned as one component of independent and dignified healthy ageing. [ABSTRACT FROM AUTHOR]

Introduction: There is concern around non‐prescribed benzodiazepine use, particularly with increasing detections of counterfeit products containing high‐risk novel compounds. The aims of this study were to investigate how and which non‐prescribed benzodiazepines are being sourced; forms, appearance and packaging; and awareness of risks associated with non‐prescribed benzodiazepines. Methods: Data were collected from a sample of Australians who inject drugs or use ecstasy and/or other illicit stimulants on a monthly or more frequent basis, and who reported past 6‐month use of non‐prescribed benzodiazepines (n = 235 and n = 250, respectively). Data were collected on source, diversion from a known/trusted prescription, product name and aesthetic characteristics for the last non‐prescribed benzodiazepine obtained. Results: Amongst participants who injected drugs, 71% reported that their last non‐prescribed benzodiazepines were diverted from a known/trusted prescription, compared to 59% of participants who used ecstasy/other stimulants. Sourcing via cryptomarkets was rare. Across both samples, the majority reported last obtaining substances sold/marketed as diazepam or alprazolam. Participants sourcing via non‐diverted means were twice as likely to obtain alprazolam. Known sourcing of novel compounds was rare. Amongst participants who used ecstasy/other stimulants, 36% reported confidence in the content/dose of non‐prescribed benzodiazepines even when the source is unknown. Discussion and Conclusions: Most participants obtained substances sold as classic/registered benzodiazepines, mostly via diverted prescriptions, with a substantial minority potentially unaware of counterfeits circulating. While diverted use undeniably presents risks, tightening of prescriptions in Australia could inadvertently lead to greater supply of novel benzodiazepines as seen internationally, reinforcing prioritisation of demand and harm reduction strategies. [ABSTRACT FROM AUTHOR]

Using a cross-sectional online survey we investigated knowledge, attitudes, and risk perception about COVID-19 vaccination and identified factors influencing vaccine uptake among Australian health professional students from October 2021 to January 2022. We analysed data from 1114 health professional students from 17 Australian universities. Most participants were enrolled in nursing programs (n = 958, 86.8%), and 91.6% (n = 858) of the participants received COVID-19 vaccination. Approximately 27% believed COVID-19 was no more serious than seasonal influenza and that they had a low risk of acquiring COVID-19. Nearly 20% disagreed that COVID-19 vaccines in Australia were safe and perceived they were at higher-risk of acquiring COVID infection than the general population. Higher-risk perception viewing vaccination as their professional responsibility, and vaccine mandate strongly predicted vaccination behaviour. Participants consider COVID-19 information from health professionals, government websites, and World Health Organization as the most trusted information sources. The findings highlight that healthcare decision-makers and university administrators need to monitor students' hesitancy with vaccination to improve students' promotion of the vaccination to the general population. [ABSTRACT FROM AUTHOR]

Based on the health action process approach (HAPA) this study examined whether changes in social cognition constructs could predict change in physical activity and fruit and vegetable intake for adult participants in My health for life, an Australian health promotion behaviour change program. Variance-based structural equation modelling was used to analyse data obtained from Australian adult program participants (n  = 167) at baseline (T1), week 14 (T2), week 26 (T2), and 6-month post-program (T4). Change scores were calculated for the social cognition constructs and behaviour. Changes in action self-efficacy and outcome expectancies positively predicted changes in intentions. Action self-efficacy changes also predicted changes in maintenance self-efficacy which, in turn, mediated the effect of action self-efficacy on recovery self-efficacy and planning. Planning was predicted by changes in intentions and maintenance self-efficacy. Findings support the use of the HAPA model in designing complex health behaviour change interventions to achieve sustained behaviour change. [ABSTRACT FROM AUTHOR]

Background: General practitioners (GPs) have played an integral role in Australia's coronavirus disease 2019 (COVID-19) pandemic response. However, little is known about how GPs themselves have been impacted by the COVID-19 pandemic. This study aimed to increase our understanding of the experiences of GPs working during the COVID-19 pandemic. Methods: A qualitative study was conducted using semi-structured interviews. Using purposive sampling, 15 GPs from South-Eastern Australia were asked to reflect on their experiences during the first year of the COVID-19 pandemic. Interview transcripts underwent thematic analysis. Results: Five main themes were identified: fear of infection; uncertainty and information overload; impacts on the government–GP relationship; impacts on the patient–doctor relationship; and teamwork within practices and among GPs. Conclusions: The 15 GPs interviewed in this study provided valuable insights into their experiences working during the first year of the COVID-19 pandemic. From these insights, four recommendations propose what could be done to help support GPs to respond to a pandemic while continuing to deliver primary health care. Although general practitioners (GPs) have played a crucial role in Australia's COVID-19 pandemic response, few studies have explored the impact of the COVID-19 pandemic on GPs themselves. In this qualitative study, 15 GPs from South-Eastern Australia were asked to reflect on their experiences working during the first year of the COVID-19 pandemic in semi-structured interviews. Their reflections enhance our understanding of the experience of GPs working during the COVID-19 pandemic and may help guide future research and work to support GPs. [ABSTRACT FROM AUTHOR]

Background: Over one-third of cancer cases are attributable to modifiable risk factors. Because health-related behaviors are often established at adolescence, it is important that adolescents understand the risks and lifestyle decisions that may reduce their chances of developing cancer. This study aims to identify the levels of cancer awareness of adolescents in Australia. Methods: Paper questionnaires were used to collect information about baseline levels of cancer awareness. These questionnaires included socio-demographic questions and the Cancer Awareness Measure (CAM) with slight modifications to ensure their suitability for the Australian adolescent population. Students aged 11 to 19 years were recruited from 13 Australian high schools between 2016 and 2019. Results: A total of 766 adolescents (58% female, mean age = 14.5 years) completed the questionnaires. Adolescents' cancer awareness was low. Adolescents who knew someone with cancer recognized significantly more cancer risk factors and cancer warning signs than those who did not know someone with cancer (t (756) = 2.35, p =.019; t (747) = 5.57, p =.001). Those from high Index of Community Socio-Educational Advantage (ICSEA) schools significantly recognized more cancer risk factors than those from low ICSEA schools (t (764) = 2.42, p =.016). Females recognized significantly more warning signs than males (t (583) = 3.11, p =.002) and students from senior high school grades recognized more warning signs than those from junior grades (t (754) = 2.24, p =.02). Most adolescents (78%) were aware of skin cancer as one of the most common cancers in Australia, however half or less were aware of other common cancers. Although most adolescents would seek medical help in the presence of possible cancer symptoms as soon as possible, approximately 20% of them would not see a doctor promptly. Emotional barriers were the most common reasons to delay seeing a doctor (56%), for example "being worried about hearing bad news" (27%). Conclusions: Australian adolescents show poor awareness of cancer risk factors and cancer warning signs. A number of demographic and experience factors were found to be related to lower cancer awareness. Education is essential to raise cancer awareness, promote healthy lifestyles from adolescence and avoid a preventable cancer diagnosis. [ABSTRACT FROM AUTHOR]

• Almost half the sample reported driving immediately after consuming cannabis. • 26.8% of participants reported waiting a sufficient time to avoid drug driving. • 173,455 drug driving events were anticipated by the sample in the next year. • Medically prescribed users were willing to wait longer before driving. • Offending behaviours stem from a history of drug use, and a lack of perceived risk. This study aimed to explore the length of time cannabis users typically wait between drug consumption and driving a vehicle, and what factors influence such decisions. A total of 839 Australian cannabis users participated in an online survey (26.3% had a prescription for cannabis). Participants ranged in age between 18 years and 75 years (M = 43.3) and 38.2% were female. Driving immediately after consuming cannabis was reported by 41.6% of the sample and waiting 1 h was the next most common response (17%). About one-quarter of participants reported that they waited at least 4 h, thus driving at a time they may no longer be impaired (26.8%). Factors that predicted waiting less time included: a greater frequency of drug consumption (times per day and per month), earlier age of cannabis use onset, using cannabis without a prescription, reporting past-year driving within four hours of consuming cannabis with an illegal drug, and lower perceptions of risk related to driving after consuming cannabis. Participants were asked to report how many days in the next year they would drive within four hours of cannabis consumption, with the most common response being 365 days (37.9% of sample). Given cannabis use is likely to increase through impending decriminalisation and expansion of prescription access, identifying ways to educate cannabis users and extend the length of time they wait between consumption and driving is critical for road safety. [ABSTRACT FROM AUTHOR]

This study examines the intention of local residents to attend events in their neighborhood when mass gatherings are being perceived as a risky activity, particularly due to a public health risk, and investigates the differences in behavioral intention by personal factors. The survey findings show a strong willingness of community members to attend events and that it varies across household types and the number of previous visits to events. Age and gender, which were shown in previous studies to affect risk perception, have not been found relevant in the context of willingness to attend local events. The identified factors from a focus group, such as trust in government regulations, familiarity with the place, as well as previous positive experiences at events, can be seen as important to reinforce the willingness of residents to attend local events in times of crisis. [ABSTRACT FROM AUTHOR]

Background: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. Design: Indigenist review of the evidence of Aboriginal young people's health and well‐being. Methods: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA‐ScR reporting guidelines. Results: Culture and connection are critical components of Aboriginal young people's health and well‐being. Aboriginal young people describe feeling of powerlessness to influence health and well‐being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well‐being. Conclusion: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. Relevance to clinical practice: Most of the currently available evidence about Aboriginal health and well‐being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength‐based approach which emphasises the strength and resilience of Aboriginal young people. [ABSTRACT FROM AUTHOR]

Drawing on the appraisal theory of emotions and based on an online Qualtrics survey conducted among members of the Australian consumer panel (n = 357), this study examined destination equity considering the changing travel preferences in the post COVID-19 pandemic era. The findings empirically support that in addition to conventional destination equity drivers, tourists in the post-pandemic era consider the internal environment when deciding on a travel destination. Peace of mind was identified as a key manoeuvring factor influencing tourists' behaviours such as higher payment and share-of-wallet. Theoretical and managerial implications of the findings are presented. [ABSTRACT FROM AUTHOR]

Effective risk communication is essential for government and health authorities to effectively manage public health during the Coronavirus disease (COVID-19) pandemic. Understanding the factors that influence people's perceptions of crisis-related risk messages is critical to identify gaps and inequalities in population risk communication. Using a longitudinal survey of a representative adult sample, we examined risk communication about COVID-19 during April-June 2020 in Australia across sociodemographic groups especially the at-risk groups, accounting for and exploring the effects of risk attitudes and media engagement. Our findings showed that individuals who were younger, more left-wing, more risk-tolerant, and had a current or a history of mental disorders perceived risk communication of the Australian Government to be lower quality. On the other hand, greater consumption of information from televisions was found to be associated with more positive attitudes toward government risk communication. Our results also revealed the importance of effective and high-quality risk communication in gaining the public endorsement of various public health directions. We discuss the implications of results in terms of the development of effective public communications that lead to health-protective behaviors and effectively scaffold public understanding of risk. [ABSTRACT FROM AUTHOR]

Objective: To explore health student perspectives of rural and remote placements during the early stages of the COVID‐19 pandemic. Setting: Australia. Participants: Allied health, nursing and medical students with a planned rural or remote placement between February and October 2020. Design Semi‐structured interviews (n = 29) with data thematically analysed. Results: Five main themes emerged from student experiences: (1) 'Do we go? Don't we go? Like how much risk is involved?' related to student concerns regarding acquiring and transmitting COVID‐19 on placement; (2) 'We are sort of just standing at the door trying to watch' encompassed student perceptions of missed clinical learning opportunities in response to health and safety measures related to COVID‐19; (3) 'I, as a student, sort of fell under the radar' related to student perceptions of suboptimal supervision; (4) 'It was a bit more difficult to engage with that wider community' recognised student feelings of social disconnection and their lack of opportunity for community immersion; and (5) 'We felt like we got something that is more than we expected' emerged from student reflections on training during the pandemic and alternative placements (virtual, simulated and non‐clinical) that exceeded expectations for learning. Conclusions: Although most students were willing and able to undertake their rural or remote placement in some form during the early stages of the pandemic and identified unanticipated learning benefits, students recognised lost opportunities to build clinical skills, become culturally aware and connect with rural communities. It remains unknown how these rural and remote placement experiences will impact rural intention and in turn, rural workforce development. [ABSTRACT FROM AUTHOR]

Clinical genomics is a system of multiple stakeholders and institutions. Yet, studies focusing on the comparative perspectives of these stakeholders are limited. This study engages four groups of professionals (clinical geneticists, genetic counselors, laboratory professionals, and researchers) working in clinical genomics to investigate their perceptions of the benefits and risks of using genomics in Australian healthcare. The study is underpinned by a risk governance approach. For data collection, qualitative semi-structured interviews were used. Our results show that all professionals unanimously identified that the benefit of clinical genomics lies in improving health outcomes for patients. However, the risks associated with delivering this benefit differed by professional category. We found that the further the profession was from the patient (e.g. researcher) the narrower the perceived risks were amongst the individuals interviewed. However, "privacy" as a perceived risk was ranked highly by all professions indicating a shared desire for responsible data governance practices. [ABSTRACT FROM AUTHOR]

Aim: To describe current practice, examine the influences and explore barriers and facilitators to accurate documentation, for the administration of intravenous fluids during labour. Design: A descriptive qualitative study was performed. Methods: Qualitative semi‐structured interviews were conducted with Registered Midwives working across Australia. Midwives were recruited via email and social media advertisements. A maximum variation sampling strategy was used to identify potential participants. Interview questions explored four main areas: (i) understanding of indications for IV fluids in labour; (ii) identification of current practice; (iii) barriers to documentation and (iv) benefits and complications of IV fluid administration. Reflexive thematic analysis of recorded‐transcribed interviews was conducted. Results: Eleven midwives were interviewed. Clinical practice variation across Australia was recognized. Midwives reported a potential risk of harm for women and babies and a current lack of evidence, education and clinical guidance contributing to uncertainty around the use of IV fluids in labour. Overall, eight major themes were identified: (i) A variable clinical practice; (ii) Triggers and habits; (iii) Workplace and professional culture; (iv) Foundational knowledge; (v) Perception of risk; (vi) Professional standards and regulations; (vii) The importance of monitoring maternal fluid balance and (viii) barriers and facilitators to fluid balance documentation. Conclusion: There was widespread clinical variation identified and midwives reported a potential risk of harm. The major themes identified will inform future quantitative research examining the impact of IV fluids in labour. Impact The implications of this research are important and potentially far‐reaching. The administration of IV fluids to women in labour is a common clinical intervention. However, there is limited evidence available to guide practice. This study highlights the need for greater education and evidence examining maternal and neonatal outcomes to provide improved clinical guidance. [ABSTRACT FROM AUTHOR]

Understanding parental practices and attitudes regarding child sexual abuse (CSA) prevention could be used to improve CSA prevention, but little information is available. In this study, we summarise survey data collected from 248 Australian and UK parents (87% female) with at least one child aged 6-11 years (M = 8.6, SD = 1.8). This is the first study to quantify parental use of protective practices, other than prevention education, which may guard against CSA. Parental media mediation, which may safeguard against online dangers, was another unique focus of this study. Participants reported their discussion of sensitive topics with their children including CSA; behaviors that may reduce the incidence of CSA (e.g., monitoring, supervision, delegation of care and checking-in with the child); mediation of their child's media use; and attitudes towards CSA prevention education. Parents reported discussing sexual abuse less than other sensitive topics such as abduction dangers, drugs, and death but more than issues surrounding puberty, sex and pornography. Parents reported using high levels of protective behaviours, however some areas of concern were revealed. Of concern was the low-moderate level of parental media mediation, with substantial numbers of children potentially exposed to online risks such as using devices unsupervised in bedrooms or chatting to individuals unknown to their parents and not having their devices checked for concerning content. Almost all parents were supportive of CSA prevention education and felt they should provide this education. However, two-thirds of parents thought CSA education may be associated with harms for the child and two-thirds of parents believed children could prevent their own abuse. Reported results will aid in our understanding of which areas of parenting could be strengthened to create safer environments for children. This research has particularly highlighted the need for parents to be more protective around their children's access to online devices. [ABSTRACT FROM AUTHOR]

While many countries have experienced more than one wave of the pandemic throughout 2020, Australia has been able to contain the virus in a way that makes it a stand out (with New Zealand) in the way that it has been contained, with an exception in Victoria linked to failed quarantine procedures for travellers returning from overseas. Through descriptive analysis, this paper builds on earlier papers by the authors on the Australian response, with a focus on the changing dynamics of travel activity, concern with public transport, and attitudes surrounding activity given the perception of risk of COVID-19 and the level of public support for regulatory intervention and restrictions on movement. We find that Australia continues to suppress travel, particularly that for commuting, that comfort in completing day-to-day activities continues to rise (with the exception of Victoria where confidence feel significantly), and while support for intervention measures remains high, there has been an erosion in sentiment. As with previous work, we discuss what this might mean for future transport policy, and attempt to draw lessons from the Australian experience. [Display omitted] [ABSTRACT FROM AUTHOR]

Throughout the COVID-19 pandemic, concerns have been raised about an 'infodemic', with information and misinformation being spread across multiple channels and mediums. Information consumption has also been associated with increased anxiety throughout the pandemic. Thus, the present study investigates the mediating role of state anxiety on the relationship between information consumption (defined as mean frequency of information consumption multiplied by number of information sources) and COVID-19 protective behaviours. We compare results across Australian and United States samples and account for personal risk perception and belief in misinformation about COVID-19. Cross-sectional data collected between 28 and 30 April 2020 were analysed using Bayesian structural equation modelling among participants from Australia (N = 201), and the United States (N = 306). State anxiety scores were above the conventional clinical cut-off. Information consumption was positively associated with state anxiety, personal risk perception, and COVID-19 protective behaviours in the Australian and the United States samples. Additionally, the relationship between information consumption and COVID-19 protective behaviours was positively mediated by state anxiety in both nations, suggesting some functional benefits of anxiety. Differences in risk perception and belief in misinformation existed between the Australian and United States sample. Findings provide support for current guidance from organisations such as the WHO, APA, and APS on limiting information consumption to reduce anxiety. To effectively communicate critical public health messaging while minimising potential burdens on mental health, there is a need to develop and test interventions that assist people in calibrating the extent and nature of their information consumption. [ABSTRACT FROM AUTHOR]

• Young adults are more susceptible to the effect of sleepiness. • Sleepiness impaired hazard perception performance with greater impairment with time-on-task. • Decrements in the range of horizontal and vertical scanning also occurred. • Moderate sleep restriction produced concerning performance impairments. Driver sleepiness accounts for a substantial proportion of crashes in Australia and Worldwide. Young adults are overrepresented in sleep-related crashes and are more susceptible to sleepiness, resulting in impaired attention and driving performance. Visual scanning behaviour can affect the role between attention and information acquisition from the driver's environment. Thus, if attention is impaired, visual scanning behaviours are likely to show decrements as well. Overall, 32 young adults aged between 20 and 25 years completed a 60-minute hazard perception task to examine the effect of sleepiness and time-on-task on hazard perception performance, visual scanning behaviours, subjective sleepiness scores, and psychomotor vigilance test performance. The main outcomes include decrements in hazard perception performance and a restriction in horizontal and vertical eye scanning ranges across the 60-minute session, but with a more pronounced effect when sleep-restricted. These outcomes were consistent with increases in subjective sleepiness and behavioural metrics of sleepiness assessed via the PVT. Reductions in scanning range could limit opportunities to attend to hazards and other critical safety events. The current study outcomes provide an important contribution regarding the risks associated with sleepy driving performance. [ABSTRACT FROM AUTHOR]

Background: Poor health outcomes amongst marginalized groups result in part from health inequities related to social and structural determinants of health. Marginalized people report higher incidences of comorbidities, chronic disease and adverse health behaviours than their nondisadvantaged peers. The objective of this review is to examine marginalized Australians' experiences of and access to community‐based primary health services in urban locations. Methods: A systematic search incorporating related MeSH terms and synonyms pertaining to marginalized Australian populations and their health‐seeking was conducted across seven databases. We included qualitative studies that reported experiences of health‐seeking within community‐based primary health care in metropolitan Australia. Participant populations experiencing marginalization due to social stigma and isolation, early‐life disadvantage, poor health and/or financial hardship were included. A meta‐ethnographic framework was used to synthesize themes across selected studies and researcher triangulation was employed to develop higher‐order themes. Results: Search results revealed 26 studies included for critical appraisal and synthesis. Seven higher‐order themes were developed describing experiences of health service engagement amongst marginalized groups: (1) Understanding the patient within the context of family and community, (2) Health and cultural beliefs influence health‐seeking, (3) Lack of information and poor cultural competence limit utilization of services, (4) Motivation for treatment influences health service engagement, (5) Accessing services, a spectrum of experience—from discrimination to validation, (6) Navigating a complex system in a complex society, (7) Preferences for health care and expectations for systemic change. Conclusion: Marginalized Australians experience health disadvantage across micro, meso and macro levels of health system navigation and commonalities in health‐seeking were identified across each of the distinct marginalized groups in our analysis. This review outlines important areas of consideration for health care provision and policy development essential to helping address health inequities for a diversity of marginalized populations. Patient or Public Contribution: Whilst patient voices were reported across all studies included within this review, no further patient or public contribution applies to this study. [ABSTRACT FROM AUTHOR]

Background: Participant information sheets and consent forms (PICFs) used in interventional studies are often criticised for being hard to read and understand. We assessed the readability and its correlates of a broad range of Australian PICFs.Methods: We analysed the participant information sheet portion of 248 PICFs. Readability scores were measured using three formulae: the Flesch Reading Ease, the Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook (SMOG). We investigated how various features (including sponsor type and PICF type) correlated with PICF length and readability and examined compliance with other measures known to improve readability.Results: For a sample of 248 PICFs, the mean (standard deviation) Flesch Reading Ease score was 49.3 (5.7) and for the Flesch-Kincaid Grade Level 11.4 (1.1). The mean (SD) SMOG score was 13.2 (0.9). The median document length was 3848 words (8 pages). Commercial PICFs were more than twice as long as non-commercial, but statistically more readable (p = 0.03) when analysed using the SMOG formula. Subgroup analyses indicated that PICFs for self-consenters were statistically more readable than those for proxy consenters. The use of tables, but not the use of illustrations was associated with better readability scores.Conclusions: The PICFs in our sample are long and complex, and only 3 of the 248 achieved the recommended readability score of grade 8 or below. The broader use of best practice principles for writing health information for consumers and the development of more context-sensitive templates could improve their utility. [ABSTRACT FROM AUTHOR]

Sixty-six police officers were given four intimate partner violence (IPV) scenarios to rate for risk of future violence. At the start of the experiment, participants were provided with either a low-risk or high-risk "anchor" scenario of police attending an IPV incident. Next, participants were given three counterbalanced scenarios: high, medium, and low risk. Half the participants were given a structured professional judgment tool to guide their decisions. Participants given the low-risk anchor rated the following scenarios as being of greater risk than those given the high-risk anchor. Participants were consistent in identifying high-, medium-, and low-risk scenarios and the tool made no difference to these ratings. Participants were more confident in their higher risk judgments than their lower risk judgments. Officers distributed a disproportionately high amount of resources to the high-risk offenders and the results suggest that police officers can make decisions consistent with Risk-Need-Responsivity principles. However, anchoring effects and working in a context where violence is more severe and frequent has the potential to bias perceptions and make officers less sensitive to risk. [ABSTRACT FROM AUTHOR]

This paper presents findings from the evaluation of an Australian trial of self‐managed home aged care. The self‐management model was codesigned by advocacy organisation COTA Australia, consumers and service providers. The primary aim of the evaluation was to examine whether self‐management improved consumers' perceptions of their choice, control, and wellbeing. The secondary aim was to examine whether provider prior experience with self‐managed packages significantly influenced consumers' perceptions of choice, control and wellbeing, thereby confounded trial effects. A pre‐test post‐test quasi‐experimental design and mixed‐methods design were used to collect data over nine months in 2018–2019. The pre‐trial methods and findings have been published. The post‐trial evaluation replicated the pre‐trial data collection method of an online survey (n = 60) and semi‐structured telephone interviews with consumers (n = 9), family carers (n = 13), and consumers and carers jointly (n = 2), totalling 24 interviews. Semi‐structured telephone interviews were also conducted with CEOs and senior managers from each of the seven providers (n = 14). Three providers had prior experience supporting self‐management. Parametric and non‐parametric tests examined the statistical data. Qualitative data were analysed thematically and framed according to self‐determination principles and ecological systems theory. Both datasets demonstrated that consumers reported greater choice and control at post‐trial than pre‐trial. This finding was not affected by providers' prior experience with self‐management; therefore, it was not a confounding factor. Participants reported improved wellbeing in interviews, however this was not reinforced statistically. Key desirable features of self‐management included greater autonomy and control over spending, recruiting support staff and paying lower administration fees. There was no evidence of increased risks or fraud. The research limitations included a small sample size, convenience sampling with providers recruiting interview participants, no control group and differences in trial implementation. The findings support the expansion of self‐management opportunities and more comprehensive evaluations that use mixed methods. [ABSTRACT FROM AUTHOR]

Despite recent changes to mental health policy in Australia and overseas, physical restraint continues to be widely employed in mental health services. While mental health nurses have a critical role to play in supporting initiatives designed to reduce restraint, it is unclear how they feel about moves to restrict the use of prone restraint. In this qualitative study, focus group interviews were conducted with mental health nursing staff and lived experience workers (LEWs) to gain their perspectives on the use of physical restraint in general and the restrictions being placed on prone ('face down') restraint. Five themes emerged: justifying the need for restraint, reliance on the prone position, the position is not the issue, time limits, and the psychological impact. Although mental health nurses were concerned about the risks associated with physical restraint, they provided strong justification for continued use of the prone position. LEWs raised concerns about the psychological impact of prone restraint and noted the need for a greater emphasis on de‐escalation and other restraint avoidance strategies. The findings highlight the complexities and challenges to be considered when developing initiatives to reduce reliance on the use of restraint in general, and prone in particular. [ABSTRACT FROM AUTHOR]

Background: Fear of hypoglycemia in people with type 1 diabetes has a detrimental effect on glycemic control and quality of life. The association between continuous glucose monitoring (CGM) and hypoglycemia confidence and fear has not previously been assessed in the young adult population. Methods: This was a prospective cohort study using questionnaires to assess the impact of CGM on hypoglycemia confidence (using the Hypoglycemia Confidence Scale [HCS]) and hypoglycemia fear (using the Hypoglycemia Fear Survey II [HFS]) in 40 young adults with a preexisting diagnosis of type 1 diabetes. Results: Scores on the HCS were greater at baseline for those with a longer duration of diabetes. Participants with higher general anxiety scores on the Generalized Anxiety Disorder 7-item scale had higher hypoglycemia fear at baseline (total score and worry component, but not behavior component of the HFS). Between baseline and follow-up, HCS scores increased on average by 0.2 (95% CI 0.1–0.4, P = 0.01) on a scale of 1–4. HFS scores decreased by 1.8 (95% CI −3.0 to −0.5, P = 0.006) on a scale of 0–24 for the worry component and by 2.5 (95% CI −4.4 to −0.6, P = 0.01) on a scale of 0–44 for total (worry + behavior components). At follow up, 83% of participants planned to continue using CGM all or most of the time. There was a very high self-reported effect of CGM on life with diabetes (median 8.0 [interquartile range 6.5–10.0], where 10 indicated a very big difference). Conclusion: Hypoglycemia confidence and fear improve with CGM use in young adults. [ABSTRACT FROM AUTHOR]

Objective: To investigate coronavirus disease 2019 community transmission concerns and adherence to social distancing and hygiene practices across metropolitan, regional, rural and remote areas in Australia. Design: Cross‐sectional online survey of Australian adults conducted between April and May 2020 through convenience snowball sampling. Setting: A range of locations across all states and territories of Australia. Participants: Six hundred and seventy‐seven Australian adults, of which 78.8% lived outside of a metropolitan area. Main outcome measures: Perceived threat of coronavirus disease 2019; social distancing guidelines and adherence; infection concerns; hygiene practices; frequency of leaving the house; impact of coronavirus disease 2019 on day‐to‐day life. Results: Almost all respondents perceived the threat of the coronavirus disease 2019 pandemic was serious. There were high levels of support for the Australian Government's social distancing guidelines, although the perception that social distancing guidelines in participants' communities were 'too strict' increased with remoteness area classification. Most respondents reported adherence with Australian Government social distancing guidelines. There was an association between remoteness and risk perception, with non‐metropolitan respondents more likely to feel safe when leaving the house. However, there was no association between geographical remoteness and self‐reported adherence with Australian Government social distancing guidelines. Conclusions: This study provides an important initial insight into Australian perceptions and behaviours relating to the coronavirus disease 2019 pandemic, and how perceptions and behaviours varied by geographical remoteness. The geographical remoteness of communities should be considered by policy makers to ensure effective communication with the Australian public regarding coronavirus disease 2019 and ongoing adherence with preventative health behaviours. [ABSTRACT FROM AUTHOR]

Introduction: Understanding reasons for choosing not to inject drugs, among those who have never injected before, may be helpful for reducing transitions to injecting drug use. This study examines opportunities to inject and reasons for never injecting in young adults who used stimulants. Methods: Data are from a population‐based study of young adults who used ecstasy and methamphetamine (n = 313), recruited in Queensland, Australia in 2008/2009. At the follow‐up, participants who had never injected (n = 293) completed a 13‐item instrument on reasons for never injecting. We conducted a principal components analysis to identify types of reasons (scored 0–100) and multivariate regression to predict endorsement of these reasons. Results: Approximately one‐in‐five of all participants ever had an opportunity to inject and there was no gender difference in the propensity to accept an opportunity. Four types of reasons, labelled risk perception, subjective effects, social environment and aversion, were identified. Male gender was associated with lower endorsement of risk perception (β = −7.94; 95% confidence interval [CI] −13.37, −2.51) and social environment (β = −7.35; 95% CI −13.15, −1.54). Having friends who injected was associated with lower endorsement of the social environment (β = −8.88; 95% CI −14.83, −2.94), and higher endorsement of aversion (β = 7.67; 95% CI 1.44, 13.89). Discussion and Conclusions: Our findings suggest that injecting drug use opportunities are common among young adults engaged in recreational drug use, with males and females equally likely to accept an opportunity. A strong aversion to injecting and a hedonic preference for non‐injecting drug use may reduce the likelihood of accepting these opportunities. [ABSTRACT FROM AUTHOR]

Understanding attitudes toward sharks and the factors associated with them is important for promoting positive attitudes and support for conservation initiatives. We aimed to investigate attitudes toward two different shark species in an Australian context: white sharks (Carcharodon carcharias, a species that can harm humans) and whale sharks (Rhincodon typus, species that cannot harm humans). Four types of attitudes were assessed (naturalistic, moralistic, scientific, and utilitarian) in a between-group survey design with an Australian sample (n = 400; 69.5% female and 30.0% male). Results showed that at least half of the participants in both shark conditions (white and whale) scored positively on each attitude aside from the naturalistic attitude toward white sharks. Pathway diagrams were constructed to identify factors associated with each of the attitudes. The identified associated factors included perception of risk of sharks, acceptance of sharks, shark tourism experiences, connection and relatedness to nature, sensation seeking, and gender. Many of these factors are stable constructs that cannot be altered; however, they allow for researchers, conservation marketers, and policymakers to understand who to target shark conservation campaigns toward. Shark tourism experiences and perception of the risk of sharks are factors that can be altered and should, therefore, be the focus of future research in this area. Assessing four different types of attitudes toward sharks accounted for, and further supported, the complex nature of attitudes toward sharks, and the scale utilized should be considered for future research. [ABSTRACT FROM AUTHOR]

Across the world, cities are growing, blurring lines between urban and rural. In Australia, peri-urban areas are undergoing demographic shifts and extensive development. In the literature, these shifts are characterised by differences in the risk perceptions and hazard experiences between established and incoming residents. In this paper, we illustrate how some of these differences are perceived by focusing on house and contents insurance in the bushfire-prone City of Whittlesea on the fringes of Greater Melbourne. This location captures the complex relationship between growing population and high bushfire risk, and is the site of the country's deadliest bushfire event, Black Saturday, in 2009. Through in-depth interviews, we observe that residents perceive insurance as playing a role in peri-urban change. Specifically, underinsurance is understood to be a challenge faced by many impacted by the Black Saturday fires, and contributes to feelings of uncertainty regarding the capacities of changing communities to work together to prepare for and recover from future fires. Our focus on insurance is informed by the need to better understand the social qualities of this dimension of disaster preparedness and recovery, and how perceptions of insurance amid peri-urban change may help produce social patterns and trends. [ABSTRACT FROM AUTHOR]

This paper examines the differences in consumers' risk perception when intending to purchase travel online across Millennials and Baby Boomers. The proposed research model was tested using structural equation modeling. The results show that perceived financial risk, perceived risk privacy, and psychological risk are significant for both Millennials and Baby Boomers. Overall risk was found to have a stronger negative impact on consumers' intention to purchase travel online. Results from this study will be helpful to travel businesses to determine which cohorts are averse to different types of risk and reduce consumers' risk perception and increase online purchase intention. [ABSTRACT FROM AUTHOR]

The use of e-cigarette or vape devices is a growing concern on an international scale, given the devices' addictive nature and questions regarding their short- and long-term health impacts. Their use is especially an issue in young people, many of whom have little or no previous nicotine use experience. This study tested an integrated dual process model in 363 young Australian undergraduates where prospectively measured e-cigarette use was predicted by the psychological constructs of the theory of planned behavior, supplemented with risk perception, e-cigarette dependence, habit, and implicit attitude. Intention to use an e-cigarette was predicted by affective attitude, subjective norm, and e-cigarette dependance, but not instrumental attitude, perceived behavioral control, or risk perception. E-cigarette use was predicted by e-cigarette dependance, intention, habit, implicit attitude, and previous nicotine use, although perceived behavioral control did not directly predict behavior nor moderate the intention-behavior relationship. Current findings provide evidence for important psychological predictors of e-cigarette use, signposting potential intervention targets. Specifically, interventions may benefit from using strategies that tap affective or normative beliefs alongside automatic constructs and dependence, while focusing less on beliefs about the health impacts of e-cigarettes or control over using., (© 2024 The Author(s). Applied Psychology: Health and Well‐Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.)

Objective: There are numerous health effects associated with excess sugar-sweetened beverage (SSB) consumption. Interventions aimed at reducing population-level consumption require understanding of the relevant barriers and facilitators. This study aimed to identify the variables with the strongest relationship with intentions to reduce SSB consumption from a suite of variables derived from the literature.Design: Random-digit dialling of landline and mobile phones was used to survey adults using computer-assisted telephone interviews. The outcome variable was 'likelihood of reducing SSB consumption in next 6 months', and the predictor variables were demographics, SSB attitudes and behaviour, health risk perceptions and social/environmental exposure.Setting: Australia.Participants: A subsample of 1630 regular SSB consumers from a nationally representative sample of 3430 Australian adults (38 % female, 51 % aged 18-45 years, 56 % overweight or obese).Results: Respondents indicated that they were 'not at all' (30·1 %), 'somewhat' (43·9 %) and 'very likely' (25·3 %) to reduce SSB consumption. Multivariate nominal logistic regressions showed that perceiving future health to be 'very much' at risk was the strongest predictor of intention to reduce SSB consumption (OR = 8·1, 95 % CI 1·8, 37·0, P < 0·01). Other significant predictors (P < 0·01) included self-perceptions about too much consumption, habitual consumption, difficulty reducing consumption and likelihood of benefitting from reduced consumption.Conclusions: Health risk perceptions had the strongest relationship with intentions to reduce consumption. Age and consumption perceptions were also predictors in the multivariate models, whereas social/environmental exposure variables were not. Interventions may seek to incorporate strategies to denormalise consumption practices and increase knowledge about perceived susceptibility to health risks. [ABSTRACT FROM AUTHOR]

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We conducted an updated epidemiological study of Leber hereditary optic neuropathy (LHON) in Australia by using registry data to establish the risk of vision loss among different LHON mutations, sex, age at onset, and mitochondrial haplogroup. We identified 96 genetically unrelated LHON pedigrees, including 56 unpublished pedigrees, and updated 40 previously known pedigrees, comprising 620 affected individuals and 4,948 asymptomatic carriers. The minimum prevalence of vision loss due to LHON in Australia in 2020 was one in 68,403 individuals. Although our data confirm some well-established features of LHON, the overall risk of vision loss among those with a LHON mutation was lower than reported previously—17.5% for males and 5.4% for females. Our findings confirm that women, older adults, and younger children are also at risk. Furthermore, we observed a higher incidence of vision loss in children of affected mothers as well as in children of unaffected women with at least one affected brother. Finally, we confirmed our previous report showing a generational fall in prevalence of vision loss among Australian men. Higher reported rates of vision loss in males with a LHON mutation are not supported by our work and other epidemiologic studies. Accurate knowledge of risk is essential for genetic counseling of individuals with LHON mutations. This knowledge could also inform the detection and validation of potential biomarkers and has implications for clinical trials of treatments aimed at preventing vision loss in LHON because an overestimated risk may lead to an underpowered study or a false claim of efficacy. [ABSTRACT FROM AUTHOR]

Law and ethics require that risk assessment should be cross-culturally valid and fair, but Australian research in this regard is underdeveloped. A logical first step in progressing the work required to build a strong evidence base on culturally sensitive risk assessment in Australia is to determine the expert views of those in the field. We interviewed 13 Australian evaluators who assess Indigenous sexual offenders' recidivism risk to determine their perceptions of the risk assessment instruments they use and the attributes they believe evaluators doing cross-cultural assessments should have. Our central findings are that evaluators use the available instruments because they believe that the same factors predict sexual recidivism for Indigenous and non-Indigenous offenders, but that they do so cautiously knowing the limitations of the instruments. Evaluators nevertheless want more research data to guide them when they use the available instruments to assess people from cultures that differ from those of people in the normative sample. Participants acknowledge that the unique challenges of assessing Indigenous sexual offenders require non-Indigenous evaluators to be culturally competent and confident. These findings should be valuable to evaluators and those who train or supervise evaluators and/or intend to establish or improve the validity of risk instruments in Australia. [ABSTRACT FROM AUTHOR]

Objectives: Risk-stratified ultrasound screening for hepatocellular carcinoma (HCC), informed by a serum biomarker test, enables resources to be targeted to patients at the highest risk of developing cancer. We aimed to investigate the cost-effectiveness of risk-stratified screening for HCC in the Australian healthcare system.Methods: A Markov cohort model was constructed to test 3 scenarios for patients with compensated cirrhosis: (1) risk-stratified screening for high-risk patients, (2) all-inclusive screening, and (3) no formal screening. Probabilistic sensitivity analyses were undertaken to determine the impact of uncertainty. Scenario analyses were used to assess cost-effectiveness in Australia's Aboriginal and Torres Strait Islander peoples and to determine the impact of including productivity-related costs of mortality.Results: Both risk-stratified screening and all-inclusive screening programs were cost-effective compared with no formal screening, with incremental cost-effectiveness ratios of A$39 045 and A$23 090 per quality-adjusted life-year (QALY), respectively. All-inclusive screening had an incremental cost-effectiveness ratio of A$4453 compared with risk-stratified screening and had the highest probability of being cost-effective at a willingness-to-pay (WTP) threshold of A$50 000 per QALY. Risk-stratified screening had the highest likelihood of cost-effectiveness when the WTP was between A$25 000 and A$35 000 per QALY. Cost-effectiveness results were further strengthened when applied to an Aboriginal and Torres Strait Islander cohort and when productivity costs were included.Conclusions: Cirrhosis population-wide screening for HCC is likely to be cost-effective in Australia. Risk-stratified screening using a serum biomarker test may be cost-effective at lower WTP thresholds. [ABSTRACT FROM AUTHOR]

Objective: To evaluate aged care staff's 'willingness to help an older person with risk‐taking activities' that improve quality of life ('dignity of risk'). Methods: Opportunity‐based cross‐sectional anonymous electronic survey in four Australian jurisdictions, conducted immediately after screening a short animated narrative film describing 'dignity of risk'. Survey comprised nine questions including respondent demographics, professional role, risk‐taking and outcome. Results: From 24 separate screenings, there were 929 respondents. Agreement to 'help an older person with risk‐taking activities' was associated with respondent prediction of the least severe harm occurring (OR = 2.22 [1.20, 4.12], P =.001). Conversely, respondents in non‐executive, non‐managerial roles—that is, nurses and care workers—were unlikely to agree to help with risk‐taking activities (OR 0.36‐0.49, P ≤.03). There was not an association with respondent's age grouping (P =.6). Conclusion: Staff self‐reported attitudes towards dignity of risk are important to understand to enhance in an older person's quality of life. [ABSTRACT FROM AUTHOR]