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Issue Addressed: Interventions targeting health care professionals' behaviours are assumed to support them in learning how to give behavioural advice to patients, but such assumptions are rarely examined. This study investigated whether key assumptions were held regarding the design and delivery of physical activity interventions among health care professionals in applied health care settings. This study was part of the 'Physical Activity Tailored intervention in Hospital Staff' randomised controlled trial of three variants of a web‐based intervention. Methods: We used data‐prompted interviews to explore whether the interventions were delivered and operated as intended in health care professionals working in four hospitals in Western Australia (N = 25). Data were analysed using codebook thematic analysis. Results: Five themes were constructed: (1) health care professionals' perceived role in changing patients' health behaviours; (2) work‐related barriers to physical activity intervention adherence; (3) health care professionals' use of behaviour change techniques; (4) contamination between groups; and (5) perceptions of intervention tailoring. Conclusions: The intervention was not experienced by participants, nor did they implement the intervention guidance, in the way we expected. For example, not all health care professionals felt responsible for providing behaviour change advice, time and shift constraints were key barriers to intervention participation, and contamination effects were difficult to avoid. So What?: Our study challenges assumptions about how health care professionals respond to behaviour change advice and possible knock‐on benefits for patients. Applying our learnings may improve the implementation of health promotion interventions in health care settings. [ABSTRACT FROM AUTHOR]

There is a global movement for health and social care to be person-centred: supporting people's active participation when making health decisions and considering their opinions, beliefs, and needs. The World Health Organization recommend the inclusion of person-centred care in health and social care provision. This research aimed to explore Australian health and social care profession students' language around person-centred care. Final-year health and social care professions students, attending one of two Australian universities, participated in an online questionnaire. Responses were analysed and themed to an existing person-centred care framework, then a sentiment analysis was applied to each response. Of the responses collected from 90 students, 235 statements were linked to the four core values of the person-centred care framework: cultivating communication (44%); respectful and compassionate care (35%); engaging patients in managing their care (20%); and integration of care (<1%). Within these, 24 statements were positively aligned (10%); 100 statements were neutral (43%); and 111 statements contained negative sentiments (47%). Almost half of the responses were not aligned with the core values of person-centred care. This suggests that many of the final-year students are not yet conceptualizing care using a person-centred approach. [ABSTRACT FROM AUTHOR]

The Social Work Department of a large Australian health service has led an organisation-wide risk identification reporting system providing oversight of family violence cases. The availability of this data offered a unique opportunity for robust evidence collection of the victim survivor experience, and the clinical response, over an eight-month period during the COVID-19 pandemic in 2020. The audit of family violence notifications and clinical notes (n  = 283) identified 36 per cent of cases were impacted by pandemic-related factors. Psychological (69 per cent) and physical abuse (64 per cent) were the most identified forms of family violence. Multiple pandemic-related stressors were evident, including financial stress (38 per cent), housing instability (27 per cent) and unemployment (22 per cent). Telehealth was seen as both an opportunity for further control by perpetrators as well as a strategy to stay connected with at risk and isolated patients. Two focus groups with clinical staff (n  = 16) described evidence of an increased shared sense of responsibility amongst multidisciplinary colleagues towards family violence presentations during COVID-19. The findings contribute to emerging knowledge about risks and barriers impacting victim survivors during disasters, such as pandemics, and offer strategies for improving practice. Findings highlight the important role of social workers in data collection and analysis to inform their practice. [ABSTRACT FROM AUTHOR]

• The model and components of acute care that optimise patient-centred outcomes in injured older patients are not defined. • There is variability in models and components of acute care for injured older patients across Australia and New Zealand. • Opportunity exists to standardise and validate models of care optimising patient-centred outcomes in injured older patients. The epidemiology of injured patients has changed, with an increasing predominance of severe injury and deaths in older (65 years and above) patients after low falls. There is little evidence of the models of care that optimise outcomes for injured older patients. This study aims to describe clinician perspectives of existing models of acute care for injured older patients in Australia and New Zealand. This cross-sectional online survey of healthcare professionals (HCP) managing injured older patients in Australia or New Zealand hospitals was conducted between November 2nd and December 12th, 2020. Recruitment was via survey link and snowball sampling to professional organisations and special interest groups via email and social media. HCP were asked, using a Likert scale, how likely four typical case vignettes were to be admitted to one of twelve options for ongoing care. Additional questions explored usual care components. Participants (n=157) were predominantly Australian medical professionals in a major trauma service (MTS) or metropolitan hospital. The most common age defining "geriatric" was aged 65 years and older (43%). HCP described variability in the models and components of acute care for older injured patients in Australia and New Zealand. As a component of care, cognitive, delirium and frailty screening are occurring (60%, 61%, 46%) with HCP from non-major trauma services (non-MTS) reporting frailty and cognitive impairment screening more likely to occur in the emergency department (ED). Access to an acute pain service was more likely in a MTS. Participants described poor likelihood of a geriatrician (highest 16%) or physician (highest 12%) review in ED Despite a low response rate, HCP in Australia and New Zealand describe variability in acute care pathways for injured older patients. Given the change in epidemiology of injury towards older patients with low force mechanisms, models of acute injury care should be evaluated to define a cost-effective model and components of care that optimise patient-centred outcomes relevant to injured older patients. HCP described some factors they perceive to determine care, and outcomes of variability, offering guidance for future research and resource allocation in the Australia and New Zealand trauma system. [ABSTRACT FROM AUTHOR]

Background: Wearables hold potential to improve chronic disease self-management in conditions like cystic fibrosis (CF) through remote monitoring, early detection of illness and motivation. Little is known about the acceptability and sustainability of integrating wearables into routine care from the perspectives of people with CF (pwCF) and their treating clinicians., Methods: A cross-sectional qualitative study involving semi-structured interviews with adult pwCF and focus groups comprising members of a CF multidisciplinary team (MDT) were conducted at a specialist CF centre in Australia. A phenomenological orientation underpinned the study. Inductive thematic analysis was performed using the Framework method. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist., Results: Nine pwCF and eight members of a CF MDT, representing six clinical disciplines, participated in the study. Eight themes were inductively generated from the data, of which four were identified from each group. PwCF valued wearables for providing real-time data to motivate healthy behaviours and support shared goal-setting with healthcare providers. Wearables did not influence adherence to CF-specific self-management practices and had some hardware limitations. Members of the CF MDT recognised potential benefits of remote monitoring and shared goal-setting, but advised caution regarding data accuracy, generating patient anxiety in certain personality traits, and lack of evidence supporting use in CF self-management., Conclusions: Perspectives on integrating wearables into CF care were cautiously optimistic, with emerging risks related to patient anxiety and lack of evidence moderating acceptance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Aim: To inform future training and professional development for individuals who measure, analyse and interpret dietary intake data. Methods: A cross‐sectional online survey was distributed via e‐newsletter to members of Dietitians Australia, Dietitian Connection and Nutrition Society Australia. The survey included 37 questions on three key areas of practice: (a) methods used to assess dietary intake, (b) barriers faced when conducting dietary intake assessment and (c) resources needed to optimise collection, analysis and interpretation of dietary intake data. Results: Of 173 responses, 103 respondents provided complete data over 2 weeks. Of these, 76% were APDs. The majority (90%) indicated that dietary assessment was important in their role. Respondents (63%) undertook dietary assessments to inform individual/patient care. When assessing intakes, the majority (79%) were interested in examining food/food group intakes. Paper based methods were most commonly used and diet histories, food frequency questionnaires and 24‐hour recalls were the most frequently used methods. The biggest barrier identified to implementing dietary assessment methods into practice was participant burden. Over a third of respondents reported they had received specific training on selecting an appropriate dietary assessment method. The majority of respondents (83%) believed having access to a dietary assessment methods toolkit would be useful. Conclusion: Survey findings provide insight into the need for further capacity building strategies, including professional development to improve collection, analysis and interpretation of dietary intake for Australian nutritionists and dietitians. The creation of online resources could help overcome identified barriers and provide a link to best practice methodologies and contemporary tools. [ABSTRACT FROM AUTHOR]

Objective: People with allergic rhinitis (AR) often self-manage in the community pharmacy setting without consulting health care professionals and trivialize their comorbidities such as asthma. A mobile health application (mHealth app) with a self-monitoring and medication adherence system can assist with the appropriate self-management of AR and asthma. This study aimed to identify an app effective for the self-management of AR and/or asthma. Methods: MHealth apps retrieved from the Australian Apple App Store and Android Google Play Store were included in this study if they were developed for self-management of AR and/or asthma; in English language; free of charge for the full version; and accessible to users of the mHealth app. The mHealth app quality was evaluated on three domains using a two-stage process. In Stage 1, the apps were ranked along Domain 1 (Accessibility in both app stores). In Stage 2, the apps with Stage 1, maximum score were ranked along Domain 2 (alignment with theoretical principles of the self-management of AR and/or asthma) and Domain 3 (usability of the mHealth app using Mobile App Rating Scale instrument). Results: Of the 418 apps retrieved, 31 were evaluated in Stage 1 and 16 in Stage 2. The MASK-air achieved the highest mean rank and covered all self-management principles except the doctor's appointment reminder and scored a total MARS mean score of 0.91/1. Conclusions:MASK-air is ranked most highly across the assessment domains for the self-management of both AR and coexisting asthma. This mHealth app covers the majority of the self-management principles and is highly engaging. [ABSTRACT FROM AUTHOR]

Background: Forward with Dementia is a co-designed campaign to improve communication of dementia diagnosis and post-diagnostic support., Methods: Webinars, a website, social and traditional media, and promotions through project partners were used to disseminate campaign messages to health and social care professionals (primary audience) and people with dementia and carers (secondary audience). The campaign ran between October 2021 and June 2022, with 3-months follow-up. The RE-AIM framework was used for process evaluation. Measurements included surveys and interviews, a log of activities (e.g. webinars, social media posts) and engagements (e.g. attendees, reactions to posts), and Google Analytics., Results: There were 29,053 interactions with campaign activities. More than three-quarters of professionals (n = 63/81) thought webinars were very or extremely helpful. Professionals and people with dementia and carers reported that the website provided appropriate content, an approachable tone, and was easy to use. Following campaign engagement, professionals planned to (n = 77/80) or had modified (n = 29/44) how they communicated the diagnosis and/or provided post-diagnostic information and referrals. Qualitative data suggested that the campaign may have led to benefits for some people with dementia and carers., Conclusions: Forward with Dementia was successful in terms of reach, appropriateness, adoption and maintenance for professionals, however flow-through impacts on people with dementia are not clear. Targeted campaigns can potentially change health professionals' communication and support around chronic diseases such as dementia., (© 2023. The Author(s).)

Background: Health care professionals play a central role in offering reproductive genetic carrier screening but face challenges when integrating the offer into practice. The aim of this study was to design, execute, and evaluate theory-informed implementation strategies to support health care professionals in offering carrier screening., Methods: An exploratory multi-method approach was systematically employed based on the Theoretical Domain Framework (TDF). Implementation strategies were designed by aligning TDF barriers reported by health care professionals involved in a large carrier screening study, to behaviour change techniques combined with study genetic counsellors' experiential knowledge. The strategies were trialled with a subset of health care professionals and evaluated against controls, using findings from questionnaires and interviews with healthcare professionals. The primary outcome measure was the number of couples who initiated enrolment., Results: Health care professionals (n = 151) reported barriers in the TDF Domains of skills, e.g., lack of practice in offering screening, and challenges of environmental context and resources, e.g., lack of time, which informed the design of a skills video and a waiting room poster using the TDF-behaviour change technique linking tool. Following implementation, (Skills video n = 29 vs control n = 31 and Poster n = 46 vs control n = 34) TDF barrier scores decreased across all groups and little change was observed in the primary outcome measure. The skills video, though welcomed by health care professionals, was reportedly too long at seven minutes. The waiting room poster was seen as easily implementable., Conclusions: As carrier screening moves towards mainstream healthcare, health care professionals report barriers to offering screening. To meet their needs, developing and testing experiential and theory-informed strategies that acknowledge contextual factors are essential., (© 2023. The Author(s).)

Adolescents and young adults 15 to 25 years of age with incurable cancer are a unique patient group. There is growing evidence of the emotionally taxing nature of this work, yet limited understanding of the health care professional experience across professional disciplines. This exploratory study, comprising in-depth semistructured interviews, undertaken at a major cancer center in Melbourne, Australia, describes the challenges facing health care professionals and the factors enabling them to deliver care with greater confidence. The findings provide a platform for further research with key recommendations to enhance the delivery of care to young people with a life-limiting cancer diagnosis. [ABSTRACT FROM AUTHOR]

This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government–funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce. [ABSTRACT FROM AUTHOR]

Young people of parents with a mental illness are at significant risk of developing a mental illness. This risk may be reduced if appropriate interventions are provided. While there are several supports available, their needs are rarely heard in either intervention development or evaluation. This study presents young people's perspectives of the types of supports they want. One hundred and seventy-two young people (13-17 years) whose parent has a mental illness completed a self-constructed questionnaire and six of these participants engaged in individual follow-up interviews. Frequency data indicated that youth want to learn how to cope or manage their parent's mental illness and highlighted a need to access support online. Interview thematic analysis reflected a need for psycho-education, confidential and/or anonymous support, and a preference to access information from health care professionals. Given the diversity of views presented, this study suggests that 'not one size fits all'. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals engage in discharge planning of people with dementia during hospitalisation, however plans for transitioning the person into community services can be patchy and ineffective. The aim of this study was to report acute, community and residential care health professionals' (HP) perspectives on the discharge process and transitional care arrangements for people with dementia and their carers.Methods: A qualitative descriptive study design and purposive sampling was used to recruit HPs from four groups: Nurses and allied health practitioners involved in discharge planning in the acute setting, junior medical officers in acute care, general practitioners (GPs) and Residential Aged Care Facility (RACF) staff in a regional area in NSW, Australia. Focus group discussions were conducted using a semi-structured schedule. Content analysis was used to understand the discharge process and transitional care arrangements for people with dementia (PWD) and their carers.Results: There were 33 participants in four focus groups, who described discharge planning and transitional care as a complex process with multiple contributors and components. Two main themes with belonging sub-themes derived from the analysis were: Barriers to effective discharge planning for PWD and their carers - the acute care perspective: managing PWD in the acute care setting, demand for post discharge services exceeds availability of services, pressure to discharge patients and incomplete discharge documentation. Transitional care process failures and associated outcomes for PWD - the community HP perspective: failures in delivery of services to PWD; inadequate discharge notification and negative patient outcomes; discharge-related adverse events, readmission and carer stress; and issues with medication discharge orders and outcomes for PWD.Conclusions: Although acute care HPs do engage in required discharge planning for people with dementia, participants identified critical issues: pressure on acute care health professionals to discharge PWD early, the requirement for JMOs to complete discharge summaries, the demand for post discharge services for PWD exceeding supply, the need to modify post discharge medication prescriptions for PWD, the need for improved coordination with RACF, and the need for routine provision of medication dose decision aids and home medicine reviews post discharge for PWD and their carers. [ABSTRACT FROM AUTHOR]

Objectives: Health care professionals (HCPs) caring for people with primary malignant glioma (PMG) and their carers see many of the profound challenges facing this group, yet their perspectives are not documented. This study aimed to understand and document the unique perspective of HCPs in relation to the supportive and palliative care needs of patients with PMG and their carers, with a view to developing a model of care.Methods: Qualitative study involving semi-structured focus groups and interviews with 35 medical, nursing and allied health staff actively engaged in providing care for this patient group. Purposive and theoretical sampling from two major metropolitan hospitals and one community palliative care service in Australia was utilised to seek perspectives from a variety of disciplines and health care settings. Thematic analysis was conducted by three independent researchers, using a constant comparative method influenced by grounded theory.Results: Key themes relating to the needs of people with PMG which were apparent from the HCPs included: The difference in the illness course of glioma compared to other cancers; Limitations of current medical care; Challenges in balancing hope with reality of the illness; and Recommendations to improve care, including recognising the role of family and moving from a model where services are offered in response to demonstrated needs. Significance of the results: Current models of care based upon the classic cancer trajectory are unresponsive to the needs of people with PMG. Care may be enhanced by moving towards a proactive approach, extending the goals of care beyond medical needs and broadening the focus of care to include family needs. [ABSTRACT FROM AUTHOR]

Background: Understanding the perspective of health care professionals (HCPs) is significant to the implementation of deprescribing in older adults with limited life expectancy (LLE) but a tool to assess this is lacking., Objective: This study aimed to develop and validate a survey tool for assessing HCPs attitudes towards deprescribing (HATD) in older adults with LLE., Methods: An online survey was used to collect data to determine the psychometric properties of a 49-item questionnaire generated from literature review, expert opinion and pretesting. 108 HCPs (doctors, nurses and pharmacists) with experience or interest in palliative care or a member of a palliative care team/organisation completed the survey., Results: Principal component analysis of the participants' data resulted in a 23-item questionnaire structured in five factors, named HATD tool. The factors were related to concerns about deprescribing (7 items), perceived burden of medications on patients (7 items), organisational support for deprescribing (4 items), assurance to deprescribing (2 items) and perceived involvement of patients in medication management (3 items). The HATD tool had valid descriptive statistics (Kaiser-Meyer-Olkin measure: 0.708; Bartlett's test of sphericity: p < 0.001, determinant: 1.35E-5; variance explained: 60.4%; nonredundant residuals with absolute values > 0.05: 39%). The reliability statistics of all the factors were ≥0.750 for both Cronbach's alpha (α) and composite reliability (CR) except for the patient-involvement factor (α = 0.644 but CR = 0.787)., Conclusions: The 23-itemed HATD tool is a valid and reliable tool to assess the attitudes and beliefs of HCPs towards deprescribing in older adults with LLE in the Australian setting., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Although people with life-limiting conditions report a desire to have spiritual concerns addressed, there is evidence that these issues are often avoided by health care professionals in palliative care. This study reports on the longitudinal outcomes of four workshops purpose-designed to improve the spiritual knowledge and confidence of 120 palliative care staff in Australia. Findings revealed significant increases in Spirituality, Spiritual Care, Personalised Care, and Confidence in this field immediately following the workshops. Improvements in Spiritual Care and Confidence were maintained 3 month later, with Confidence continuing to grow. These findings suggest that attendance at a custom-designed workshop can significantly improve knowledge and confidence to provide spiritual care. [ABSTRACT FROM AUTHOR]

Although trust has significant implications for health outcomes, the mechanisms by which its presence or absence influences these outcomes require elucidation. Drawing on ethnographic research conducted in southeast Australia, we explore the tasks of rehabilitation for people who lost a limb because of vascular disease, and the importance of trust in the relationships of patients with their health professionals. Trust underpins procedures and practices designed to minimize problems that might delay rehabilitation or result in the continuing need for medical support and surveillance. Patients develop trust in the rehabilitation team based on three factors: competence, agency, and caring. Our findings emphasize how social skills, as well as technical competence, enable health professionals to gain and maintain their patients' trust. [ABSTRACT FROM AUTHOR]

Successful HIV prevention programs--such as sterile needle and syringe programs--have ensured that incidence and prevalence of HIV among people who inject drugs remains low in Australia. However, between 1999 and 2006, 20 of the 46 injecting-related HIV notifications in Melbourne (Australia's second-largest city) were ethnic Vietnamese heroin users. Through in-depth interviews we explored and documented the coping tactics and strategies of 9 ethnic Vietnamese heroin injectors. We explored their experiences of living with HIV, and in this article identify factors that appear to have contributed to limiting the spread of HIV beyond this cluster of people. The data reveal factors associated with this self-limiting outbreak, including consciously avoiding opioid withdrawal and having closed injecting networks. Early and effective engagement with participants by health care workers also appears to have played an important role in containing the transmission of HIV within this group of ethnic Vietnamese heroin injectors. [ABSTRACT FROM AUTHOR]

• Healthcare and 'other essential' workers are on the frontlines of the COVID-19 outbreak. • We aimed to characterise the top concerns endorsed and mental health of these groups. • Top concerns across all groups related to the health and well-being of loved ones. • Healthcare and other essential workers respectively had the best and worst mental health. • More supports should be devoted to other essential workers to safeguard their well-being. The novel coronavirus (COVID-19) has necessitated many healthcare workers operating on the frontlines. Another segment of the population whose mental well-being is being tested are the 'other essential workers' (e.g. supermarket workers). The current study aimed to compare the mental health of healthcare versus other essential workers in the early stages of the COVID-19 outbreak. The COVID-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project is a nationwide online mental health survey launched on 1 April 2020, aimed at identifying key mental health concerns. Adults currently living in Australia were invited to take part, and non-discriminative snowball sampling was employed. Participants were partitioned into healthcare workers (HCW; n =905), other essential workers (OEW; n =810), and the general population (GNP; n =3443). Across all groups, top COVID-19 related concerns were primarily associated with the health and well-being of loved ones. In terms of current levels of depression, anxiety, stress and quality of life, HCWs fared the best, and OEWs fared the worst (with the GNP falling in between). In the face of this medical crisis, Australian HCWs seem to be managing their mental health relatively well, but more supports need to be devoted to OEWs to safeguard their mental well-being. [ABSTRACT FROM AUTHOR]

Podcasts are increasingly being recognized as an effective platform to facilitate the continuous professional development (CPD) of health care professionals (HCPs). Compared with face-to-face meetings and other more traditional forms of CPD, podcasts allow for flexible learning and are less expensive to develop. Podcasts are at the cutting edge of digital education and can be an important element of a pharmaceutical company's multichannel communications plan to improve HCP engagement and CPD in specific therapy areas. However, developing a successful podcast can have significant challenges. In this viewpoint paper, we provide our perspectives on medical podcasts as a medium for educating HCPs in the digital age. We describe our experience in developing an HIV-focused podcast for Australian HCPs, creating a series that has now expanded to other therapy areas in several countries. Practical considerations and unique challenges associated with industry-sponsored podcasts are outlined. Overall, we believe that the process of developing a podcast can be a challenging but rewarding experience, and CPD delivered via podcasting should be more routinely considered by pharmaceutical companies., (©Julliana Newman, Andrew Liew, Jon Bowles, Kelly Soady, Steven Inglis. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 27.08.2021.)

Introduction: The challenges of becoming a mature adult may distract young adults with type 1 diabetes from disease self-management, increasing risks for premature morbidity and mortality. Despite the importance of young adults with type 1 diabetes engaging with preventative diabetes-related health care services, few studies report health care professionals' experiences and perceptions of the support that is available, including during the period of transition. This study sought to determine these factors across diverse contexts in one health jurisdiction., Methods: This qualitative study was undertaken in New South Wales, Australia. Recruitment was based on a snowball sampling technique, which began with members of an established diabetes service group. Data were collected by individual semistructured interviews with 16 health care professionals, most of whom were registered nurses (75%), working at differing levels of expertise and responsibility across metropolitan and regional/rural areas. Data were analysed using thematic analyses., Results: Participants overwhelmingly recognized the time and care needed to support young adults with type 1 diabetes to prepare them for adult self-management and to work with adult diabetes services, and the importance of youth-friendly services. They reported shortfalls and inequitous distribution in services for these young adults. Two themes, addressing the present and future possibilities, expressed their perceptions of services for this population: working with what is available and mapping a route to better services., Conclusion: Findings identify opportunities for development in the planning and provision of specialist multidisciplinary health care support for this population. New ideas are needed for policy and practice innovation and for the infrastructure to facilitate this, to ensure that young adults with type 1 diabetes have access to consistent and coordinated diabetes health care services, particularly in nonmetropolitan settings., (© 2019 John Wiley & Sons, Ltd.)

Background: In 1997 the "Wessex Research Network (WReN) Spider" was developed and validated to assess the research experience of general practice based researchers. This bibliometric study traces the use and development of this instrument over 15 years. Methods: We performed a bibliographic search to identify all the citations of the original article since 2002. Results: Thirty one relevant papers were found. Publications were classified according to whether they used (N = 18) or cited (N = 13) the WReN Spider. The majority of these papers came from Australia (N = 18) and 10 papers focussed on the research training of Allied Health Professionals. The WReN Spider was used in 12 studies to assess baseline experience before a training intervention or to compare before and after training scores. The WReN Spider was often (N = 9) modified to additionally assess interest, confidence or interest in up-skilling in each of its 10 limbs. It was also often (N = 14) used in tandem with open ended questions to gain a more detailed understanding of people's research skills, or with additional questions focussing on the research context, culture and team. None of the papers confirmed the validation of the WReN Spider, although it was applied in contexts that differed from the one in which it was developed. Conclusions: The WReN Spider continues to be used to measure the research experience of health care practitioners, but it is frequently enhanced with other questions to look at the wider issues of research success, including collaborators, resource and environment. [ABSTRACT FROM AUTHOR]

Meeting the primary health care needs of an aging population is an increasing challenge for many Western nations. In Australia, the federal government introduced a program to develop, test, and evaluate nurse practitioner models in aged care settings. In this article, we present a documentary analysis of 32 project proposals awarded funding under the Nurse Practitioner-Aged Care Models of Practice Program. Successfully funded models were diverse and were operated by a range of organizations across Australia. We identified three key priorities as underlying the proposed models: "The right care," "in the right place," and "at the right time." In this article, we explore how these priorities were presented by different applicants in different ways. Through the presentation of their models, the program's applicants identified and proposed to address current gaps in health services. Applicants contrasted their proposed models with available services to create persuasive and competitive applications for funding., (© The Author(s) 2014.)