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In recent years, the number of autistic people entering university has increased in Australia and worldwide. While an encouraging trend, autistic students' completion rates remain much lower than non-autistic students in Australia. Perhaps unsurprisingly, numerous studies investigating autistic people's experiences at universities have identified stigma and discrimination as a significant barrier facing autistic people in higher education. In this study, our team of autistic co-researchers and non-autistic researchers co-produced an in-depth qualitative study to understand the contexts and circumstances in which autistic people felt stigmatised or experienced discrimination at universities in Australia. We interviewed 21 autistic people who either had completed at least one university course, or were studying a university course, or had enrolled in but discontinued at least one university course in Australia. Using reflexive thematic analysis, we identified four themes: (1) 'My disability is something that people just don't have a clue about', (2) 'the system is really stacked against you', (3) the onus is on autistic students, and (4) 'grit and stubbornness'. Based on these findings, we suggested implementing Universal Design for Learning, neurodiversity-affirming and trauma-informed practices, together with a participatory approach to better design university curricula, processes, and support services for autistic students.

Scholarly studies of international student mobility programs have increased during the last two decades, particularly following the Bologna Declaration. Nevertheless, a systematic review of international student mobility programs and the outcomes and benefits derived from participation in such programs has not been undertaken. This paper provides a comprehensive review of studies examining the various outcomes of student participation in short-term international mobility programs and identifies under-researched areas such as employment and career outcomes. A future research agenda based on the review is outlined, along with recommendations for improving research designs in order to increase our understanding of the short- and long-term outcomes of international student mobility programs.

In recent years, the number of autistic people entering university has increased in Australia and worldwide. While an encouraging trend, autistic students' completion rates remain much lower than non-autistic students in Australia. Perhaps unsurprisingly, numerous studies investigating autistic people's experiences at universities have identified stigma and discrimination as a significant barrier facing autistic people in higher education. In this study, our team of autistic co-researchers and non-autistic researchers co-produced an in-depth qualitative study to understand the contexts and circumstances in which autistic people felt stigmatised or experienced discrimination at universities in Australia. We interviewed 21 autistic people who either had completed at least one university course, or were studying a university course, or had enrolled in but discontinued at least one university course in Australia. Using reflexive thematic analysis, we identified four themes: (1) 'My disability is something that people just don't have a clue about', (2) 'the system is really stacked against you', (3) the onus is on autistic students, and (4) 'grit and stubbornness'. Based on these findings, we suggested implementing Universal Design for Learning, neurodiversity-affirming and trauma-informed practices, together with a participatory approach to better design university curricula, processes, and support services for autistic students. Autistic students experience many challenges at university. One significant barrier identified in past research was autistic students' experiences of discrimination (i.e. being treat differently) and stigma (being judged differently). Our research team included both autistic and non-autistic researchers who designed a project to help explore autistic students' experiences of stigma and discrimination at Australian universities. We interviewed 21 autistic students who went to a university – some had completed qualifications, and some had not. From our interviews, we identified four themes: (1) 'My disability is something that people just don't have a clue about', (2) 'the system is really stacked against you', (3) the onus is on autistic students, and (4) 'grit and stubbornness'. As a result, we recommended changes in the way courses are written and taught so that autistic people have opportunities that meet their ways of learning. It is also important for university staff to understand the impact of trauma experienced by autistic people and that universities work together with autistic people to design courses and supports that include autistic ways of learning, accessible university processes and identify support needs. [ABSTRACT FROM AUTHOR]

School lockers are an essential part of secondary school life and students have been using them for decades. It is unlikely the design has changed since they were used by their grandparents. Although lockers have not changed, school definitely has. Are school lockers something that also need to be changed? A design challenge is an open-ended project that encourages students to ask questions, take initiative, and think creatively. This article presents an example of such a challenge.

Due to the changing nature of learning and teaching in universities, there is a growing need for professional development for lecturers and tutors teaching in disciplines in the mathematical sciences. Mathematics teaching staff receive some training in learning and teaching but many of the courses running at university level are not tailored to the mathematical sciences. This article reports on a collaborative research project aimed at investigating the type of professional development that Australian tertiary mathematics teachers need and their preference for delivery modes. Effective teaching promotes effective learning in our students and discipline-specific professional development will enhance outcomes for teachers, students, and mathematics. (Contains 5 figures and 1 table.)

Development of the Nurse practitioner role and the specialisation of practice is an increasing focus in healthcare. To date, a bibliometric evaluation of scholarly work referring to Nurse Practitioners, has not been located in the published literature. With the aim of identifying the top 100 cited articles in the Nurse Practitioner domain, the Scopus™ database was searched for Nurse Practitioner studies during 2007–2021. Using bibliometric analysis we identified prolific authors; annual trend; citation rates; countries of origin; and study design. There were 1768 papers identified across 360 peer reviewed journals in 33 countries. Finding from this analysis provides evidence of an evolving research area of inquiry which contributes to knowledge of the Nurse Practitioner role and scope of practice. [ABSTRACT FROM AUTHOR]

To identify client and service factors associated with changes in health-related quality of life following community rehabilitation. We conducted a retrospective observational cohort study within a community rehabilitation program. Health-related quality of life was measured using the EuroQol five Dimensions, five response level version (EQ-5D-5L). Our primary outcome was the Visual Analogue Scale (VAS) rating of overall health. Analyses were stratified by diagnostic group: traumatic orthopaedic, elective orthopaedic, neurological, medical, and other. The association between client and service factors and discharge VAS scores, adjusted for baseline scores were determined using multivariable regression. EQ-5D-5L data were available for 981 of 1350 participants. Treatment intensity was associated with a seven-point increase (β = 7.22, 95%CI 2.28–12.2, p = 0.004) in VAS scores for traumatic orthopaedic participants. For neurological participants, there was a positive interaction between comorbidities and intensity of therapy (β = 7.9, 95%CI 2.75–13.1, p = 0.003), indicating that greater therapy intensity in those with higher comorbidity scores was associated with an improvement in VAS scores. Age was negatively associated with VAS scores for traumatic orthopaedic participants and socioeconomic status was positively associated with VAS scores for elective orthopaedic participants. Treatment intensity is a modifiable service factor that may positively influence health-related quality of life. In addition to providing information on client progress towards attainment of individual treatment goals, routine collection of patient reported outcome measures within a community rehabilitation program can elicit information that can inform rehabilitation service improvement. Clients of a community rehabilitation program with a neurological or medical condition demonstrate the least improvement in overall health profile and may require additional rehabilitation or supports. Across all diagnostic groups, problems with anxiety and depression were least likely to improve following receipt of community rehabilitation. Improving access to psychological services and associated referral pathways in community rehabilitation services could improve these outcomes. Initiatives aimed at increasing intensity of therapy such as targeted triage and resource allocation, may improve health-related quality of life for clients of a community rehabilitation program with traumatic orthopaedic conditions. For clients with a neurological condition, initiatives aimed at increasing intensity of therapy may improve health-related quality of life in more complex patients with comorbid health conditions. [ABSTRACT FROM AUTHOR]

With 2020 being designated the Year of the Nurse and Midwife, it is opportune to acknowledge and recognise the role that nurses undertake in primary care environments. Nurses and midwives play a pivotal role in the delivery of high-quality health care, particularly in geographically challenged areas of Australia, where they may be the only provider of care within their communities. Rural and remote health services require strategic planning to develop and implement solutions responsive to the challenges of rural and remote communities. Maintenance of health services in rural and remote areas is a challenge, crucial to the equity of health outcomes for these communities. Many small communities rely on visiting medical officers to provide the on-call care to facility services, including emergency departments, urgent care centres, acute wards and aged care facilities. It is increasingly difficult to maintain the current rural workforce models, particularly the provision of after-hours 'on-call' care necessary in these communities. An alternative model of health care service delivery staffed by nurse practitioners (NP) is one proposed solution. NPs are educated, skilled and proven in their ability to provide an after-hours or on-call service to meet the expectations of rural and remote communities. Achievement of high-quality health care that is cost-efficient, safe and demonstrates improved patient outcomes has been reported in NP-led health care delivery impact evaluations. The value of an NP locum service model is the provision of a transparent, reliable service delivering consistent, equitable and efficient health care to rural and remote communities. Provision of quality health services in rural communities is a challenge, but crucial to ensure equity of health outcomes for community members. Nurse practitioners (NPs) are highly educated, clinically skilled and proven in their ability to augment rural health services. NP-led models of care demonstrate a transparent, reliable service delivering consistent and safe health care that is equitable and efficient for rural communities. [ABSTRACT FROM AUTHOR]

This paper describes the integration of a pharmacist into a perioperative environment and the ensuing quality and economic benefits. Deficiencies were identified in medication management in operating theatres (OT) at a large tertiary hospital. A perioperative pharmacist was employed for a 6-month pilot period, with permanent funding dependent on demonstration of agreed economic benefits. A multidisciplinary committee set goals, drove strategic initiatives and was accountable for delivery of outcomes. Pharmaceutical expenditure was analysed and high expenditure items targeted. Cost savings and staff satisfaction were measured at 6 months. Savings of A$63 884 were achieved during the pilot period, resulting from optimised pharmaceutical unit pricing, OT medication stock on hand (imprest) review and redesigned medication management strategies. Improvements in medication management included better access to medications in the OT, rationalising available products to minimise wastage and implementation of guidelines and protocols for high-cost and high-risk medications. At 6 months, 97% of theatre staff supported continuation of the role; the project was extended with demonstrated cost savings of A$157 265 at 12 months. The integration of a perioperative pharmacist resulted in cost savings and medication management improvements in the OT setting. A permanent position was funded. What is known about the topic?: Medication use in OTs involves high volumes of high-risk and high-cost medications. Historically, there has been little pharmacist involvement in OTs, even though evidence has shown that hospital pharmacists can reduce medication errors, improve patient safety and reduce costs. What does this paper add?: This paper provides an overview of the process of establishing a perioperative pharmacist role in an adult tertiary hospital. It takes readers through the journey from pre-implementation audit to trial development, stakeholder consultation and specific medication and process targets. What are the implications for practitioners?: Hospitals and practitioners are faced with the challenge of improving service delivery within the constraints of a finite budget. This paper allows readers to learn from our experience and apply these learnings to their local hospital setting, ultimately improving both patient care and staff satisfaction through the development of a perioperative pharmacist service. [ABSTRACT FROM AUTHOR]

Background/aim: Professionals in health and social care have high workloads and are working with diverse populations in hierarchical and complicated service delivery systems. There is increasing pressure on new graduates because they are expected to be immediately work ready and may not receive adequate support or supervision. It is well known that there can be issues with satisfaction and retention rates of new graduates due to the challenges they experience. Ethical tensions are an unavoidable part of occupational therapy practice and may contribute to unique challenges for new graduates who may not yet have the personal resources to make sense of these independently. New graduate occupational therapy perceptions of ethical tensions have not yet been explored and this study sought to fill this gap. Exploring the ethical tensions experienced by new graduates can inform appropriate policies, procedures, preparedness and standards. Methods: A qualitative study using narrative enquiry was undertaken in which stories were gathered from eight new graduate occupational therapists who had been working for 6–24 months. Semi‐structured in‐depth interviews were used to gather data. Transcripts were analysed following narrative analysis guidelines. Member checking, reflexivity and keeping an audit trail of methodological and analytical decisions were employed to strengthen the rigour of the study. Results: Analysis revealed six predominant themes: working in a business model, respecting client choice, dealing with aggression and death, mandatory reporting is hard to do, differing team values, and feeling devalued and unsupported. Conclusion: The findings highlight the importance of understanding the ethical tensions faced by new graduates and of exploring ways to assist new graduates to respond constructively to ethical dilemmas, distress and uncertainties. To address the risk of attrition, graduates need systems in place for accessing support to increase preparedness to respond to ethical tensions when they do arise. [ABSTRACT FROM AUTHOR]

The establishment and productivity of new forest plantations can be significantly impacted by the presence of native vegetation. In a study site in New South Wales, Australia, the growth of a Pinus radiata plantation has been virtually halted in areas dominated by the native shrub Allocasuarina nana , effects that persist for decades even after its physical removal. To determine the mechanism by which A. nana impedes P. radiata growth, we compared the fungal soil community and metabolomic profile of soils in patches rich in A. nana with adjacent healthy P. radiata patches and the transition zone between them. This data was complemented by a pot experiment to assess P. radiata growth in soils from the different vegetation areas with and without a viable soil community or the addition of A. nana roots or exudates. Together, the data demonstrates that these A. nana soils are likely inhibitory to P. radiata growth through a dual mechanism: impacting the growth of the pine directly through root associated metabolites and indirectly through the inhibition of the fungal community supporting P. radiata health, including ectomycorrhizal fungi. • The Australian native shrub Allocasuarina nana severely impacts Pinus radiata growth. • Soils occupied by A. nana show a reduction in mycorrhizal fungi beneficial to pine. • A. nana root exudates have a negative effect on growth of pine and beneficial fungi. [ABSTRACT FROM AUTHOR]

This paper reports on a prospective study exploring risk factors specifically related to the onset of non-suicidal self-injury (NSSI) during adolescence. We examined cumulative incidence and predictors of onset of NSSI over 1 year among 1,973 school-based adolescents (13-19 years old; M = 14.9, SD = 0.96) from five states in Australia. Data showed cumulative incidence of 3.8 % (95 % CI [3.0-4.7 %]) over 1 year. Multiple socio-demographic and psychosocial factors were assessed using sequential logistic regression models. Onset of NSSI was associated with being female (OR = 3.47, 95 % CI [1.48-8.18]), being born outside of Australia (OR = 3.05, 95 % CI [1.10-8.47]), not identifying as religious or spiritual (OR = 1.80, 95 % CI [1.04-3.10]), increased psychological distress (OR = 1.12, 95 % CI [1.08-1.16]), poor social support from family (OR = 0.89, 95 % CI [0.83-0.95]), poor self-esteem (OR = 0.90, 95 % CI [0.83-0.98]), and poor problem-solving coping (OR = 0.90, 95 % CI [0.82-0.99]). These findings may assist to better identify young people more likely to start self-injuring and also highlight issues to provide a focus for prevention initiatives. [ABSTRACT FROM AUTHOR]

While researchers are beginning to reach consensus around key psychological correlates of non-suicidal self-injury (NSSI), comparatively less work has been done investigating the role and influence of peers. Given evidence that engagement in this behavior may be susceptible to peer influence, especially during the early stages of its course, the current study prospectively explored whether knowing a friend who self-injures is associated with the onset, severity, and subsequent engagement in NSSI. The moderating roles of adverse life events, substance use and previous suicidal behavior in this relationship also were explored. Self-report data were collected from 1,973 school-based adolescents (aged 12-18 years; 72 % female) at two time points, 1 year apart. Knowing a friend who self-injured, negative life events, psychological distress and thoughts of NSSI differentiated those who self-injured from those who did not, and also predicted the onset of NSSI within the study period. Further, adverse life events and previous thoughts of NSSI moderated the relationship between exposure to NSSI in peers and engaging in NSSI at Time 2. However, the effect of having a friend who self-injures was not related to the severity of NSSI. Having a friend who self-injures appears to be a risk factor for self-injury among youth who are experiencing high levels of distress. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) and under-age alcohol use are dysfunctional coping behaviors used to alleviate negative feelings. However, little is known regarding what mechanisms lead to engagement in NSSI as opposed to alcohol use, or what might influence co-occurrence of these behaviors. A total of 2,590 secondary school students (aged 12-17) from five Australian states completed self-report questionnaires measuring NSSI, alcohol use and a range of sociodemographic and psychosocial factors. The findings suggest that adolescent engagement in NSSI is associated with more internal factors, such as psychological distress, poor coping and problem-solving skills, whereas alcohol use is associated with age and gender, as well as more external factors, such as social support and coping by turning to others. Co-morbidity between alcohol use and NSSI is associated with a combination of these factors. Implications of these findings will be discussed with regard to prevention and early intervention initiatives. [ABSTRACT FROM AUTHOR]