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Curriculum, as a policy and way of moving through educational experience, is entwined with an ongoing history of invasion in Australia and similar invader‐colonial contexts. As a result of this, the conceptual foundations of curriculum in Australia reproduce colonial epistemologies as normative modes of knowing and consideration. One way of seeing how this is possible and easily reproduced is through a consideration of how renderings and representations of "place" – the complex entanglements of lands, histories, and identit(y/ies) – mediate both how (a) invasion can be normalised as a historical, geographic, and political "placial" reality, and (b) students and teachers might experience education in and of place. Indeed, "place" is a central guiding concept in official curriculum policy just as much as place is an experienced curriculum both within the school and in the broader world. In this respect, this paper looks to unpack how the concept of place is represented in curriculum policy and the attendant assumptions and implicit discourses that this (re)produces about the experiences of people in/of invaded place. Through a look at the coming revision to the Humanities and Social Science's learning area of the Australian Curriculum, I look to how the curriculum as policy frames place as synonymous with invader place epistemically and how this mediates what students can know and themselves feel about the embodied experience of learning about/in/of place. [ABSTRACT FROM AUTHOR]

Anthropological accounts of sexual and gendered difference often serve the role of footnotes that buttress and even expand the reach of Euro‐American concepts. In contrast to this contained role for anthropology, queer footnotes can push the discipline toward more capacious and experimental engagements with powerful knowledge. In 2020, governments around the world introduced lockdowns and border‐control measures in response to the COVID‐19 pandemic. This was the case in Australia, where I undertook fieldwork with trans‐ and queer Indonesians living in Melbourne. In Australia, COVID‐19 public health measures paralleled and exacerbated migration restrictions on people living with HIV and the criminalization of sex work. Asian, queer, trans‐, and sex worker bodies were addressed as a moral and physiological contagion. Queer anthropology is good for maintaining a critical ethnographic focus on how the state governs through a racial biopolitics of containment, and generates concepts for public health that shift the focus from security to care. [ABSTRACT FROM AUTHOR]

Millions of people cross political borders yearly without having the proper documents. This has led to increased detention and deportation practices in destination countries for reasons related to security and sovereignty. The objective of the current study was to analyze and visualize research publications on the detention and deportation of migrants to identify current research hotspots, research gaps, and potential future research in the field. Relevant research articles were obtained from the Scopus database for the study period from 1900 to December 31, 2022. The analysis included presentations of key contributors to the field and visualization of topics, themes, and international collaboration. In total, 906 articles were found. The earliest was in 1982. The majority of articles were published in journals within the subject areas of social sciences and humanities. The number of publications showed a steep rise from 2011 to 2022. The Journal of Ethnic and Migration Studies was the most prolific, but publications in the Citizenship Studies journal received the highest number of citations per article. Researchers from the United States contributed the most. Mexico ranked fifth in the number of publications. Oxford University was the most prolific institution, followed by three universities in Australia. The majority of articles were single-authored, indicative of limited author-author collaboration. Research hotspots in the field were "human rights" and "mental health". The detention and deportation of Mexican and other Latino migrants in the United States constituted a distinct research theme in the field. International research collaboration was limited by geographical proximity (e.g., the United States and Mexico) or common language (e.g., the United Kingdom and Australia). Future research topics should focus on alternatives to detention, family separation, and healthcare services for detained migrants. Research activity on detention and deportation is required from all world regions, including the source countries of migrants. Future research should promote alternatives to traditional detentions. The contribution of countries in Africa, the Middle East, and South-Eastern Asian regions needs to be encouraged. Future research on the detention and deportation of non-Latino migrants is highly required. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses articles within the issue on topics including issues relating to everyday nursing, changes in nursing education and practice in Australia, and differences in nursing thought inherent in internationalization.

Yolŋu Aboriginal people's knowledge about water ("gapu") and its governance has strong cultural significance and meaning in East Arnhem Land Aboriginal worlds in northern Australia. This study used transdisciplinary research methods to explore the ways in which Yolŋu Aboriginal gapu and Western science hydrological knowledge can work together and contribute towards water management on Milingimbi Island, a small, resource-constrained, bedrock island. Transcending disciplinary boundaries is distinctly different to an interdisciplinary, socio-hydrological perspective, which can pose a risk to hybridizing Aboriginal knowledge and Western science. Community engagement activities and workshops were conducted as part of a three-year research project to bring together the incommensurable knowledge communities. A participatory three-dimensional mapping exercise created a shared space, facilitating an open-dialogue exchange of insight and knowledge among Aboriginal knowledge authorities, hydrologists, public servants, and academic researchers. This paper prompts readers to reconsider the ways water can be perceived and conserved in a decolonizing way. [ABSTRACT FROM AUTHOR]

Racism contributes to health inequities faced by people of colour and marginalised groups. Despite widespread recognition of the impacts of racism, mitigating strategies and legislation have been largely unsuccessful. Research into racism in healthcare has mostly examined personal experiences of healthcare workers and patients, assuming that the definitions of racism and race are similarly understood by all. However, ethnicity and race are often conflated, and racism seen as primarily interpersonal and ahistorical. This paper explores hospital employee understandings of racism, its impacts and how to reduce it. Forty-nine staff within one Australian hospital participated in individual qualitative interviews regarding the definition, impact, and ways of reducing racism. Interviews were analysed with a reflexive thematic analytic approach using a Postcolonial framework. Participants described racism as being experienced by marginalised groups of people in Australia. They identified that racism has detrimental effects on health and wellbeing. Not all were clear regarding what constituted racism: it was not described as an ideology created to justify colonial distribution of power and resources. Some thought that racism was individual prejudice while others noted it was also structural in nature. Participants commonly defined race as involving physical or cultural differences, suggesting that discredited historical and colonial concepts of race continue in Australian society. While many felt that education was the best way to reduce racism and its impacts, some participants noted that being educated did not necessarily change racist behaviour. The lack of accurate understanding of the concept of race and racism likely contributes to the relatively poor effect of current strategies to combat racism. As an initial part of deeper systemic anti-racist reform, this research supports calls for anti-racist education to clarify the definition of racism as an ideology. • Participants understood the detrimental impacts of racism in healthcare. • Participants showed unclear understandings of racism and its causes. • Anti-racist strategies must define race and racism, and acknowledge their history. [ABSTRACT FROM AUTHOR]

Objectives: The standard interview method (SIM) is a guidance framework for information gathering interviews. This article describes the purpose, scope, origin, experimental basis, and practical application of the SIM. It provides an informative overview of developments to date for psychologists and researchers within the behavioural sciences, as well as for practitioners who might use the SIM. The SIM contains core evidence‐based components but is otherwise open to tailoring and modifications to suit a variety of interviewing purposes such as policing, justice, education, and business. It provides an interview structure and exemplar dialogue, aligned with research into best‐practice interview technique. Method: A detailed overview of the SIM's interview phases, instructions, and exemplar dialogue is provided. The basis for these elements is explained in terms of the experimental and qualitative research that has informed their development. Results: The SIM provides evidence‐based guidance for investigative interviewers, and numerous versions have been created to suit different investigation types, interviewee groups, and jurisdictional or organisational requirements. It is continually refined as new findings from experimental research around best‐practice interviewing emerge. Conclusions: Rather than a single entity or completed product, the SIM represents a dynamic evolution of research, collaboration, and testing. Its flexible nature will allow it to keep pace with the ever‐progressing knowledge base that informs interview protocol and guidance development, and adapt to local cultures, legislation, processes, and systems of operation. [ABSTRACT FROM AUTHOR]

Aboriginal Heritage Trails are a growing phenomenon in Australia. They come in all shapes and sizes, from mere signage to—in the case of the famous Lurujarri trail out of Broome, Western Australia—a nine-day immersive experience walking the beach with one of the Goolarabooloo family groups. Here people experience the beautiful Indian Ocean coastline, extensive dinosaur footprints, storytelling, and meals of freshly caught fish, mangrove crab, dugong and turtle. These trails are far more than 'tourism products'. For the Aboriginal families, with all ages present, they enact inter-generational knowledge transfer. Academic disciplines also change when they are 'on Country': Palaeontologists learn that the dinosaur footprints are also the traces of the emu ancestor, marala, and their discipline adjusts its epistemological parameters accordingly. Aboriginal walking trails have the potential to change every discipline willing to 're-boot' on a territorial, rather than global, scale. Walking with one's arts of paying attention on alert deepens and extends both European and Aboriginal knowledge, as they find agencies that can transfer and translate the multi-functionality inherent in the ecological 'pluriverse' that is this continent-wide network of dreaming tracks. Could this experiential model of knowledge transfer represent a path away from the nineteenth-century model of knowledge collection, storage and display that we find in universities and museums? [ABSTRACT FROM AUTHOR]

In this article, we contribute to understanding of the mechanisms through which students' socio‐economic family background can translate into academic performance by focusing on the concept of student engagement. Drawing on theoretical perspectives from disciplines across the social sciences, and a major nationally representative dataset from Australia, which links survey responses with administrative records on school performance, we conduct a series of multiple regression models to investigate the mediating role of student engagement on the relationship between students' socio‐economic status (SES) and academic achievement. We find that, first, low‐SES students show lower levels of engagement than other students, particularly in terms of behavioural and cognitive aspects; they also have lower achievement levels as measured by standardised test scores. We further find that lower engagement is associated with lower achievement levels, and that the effects of SES on achievement are partially mediated through student engagement. Although there are clearly other mechanisms in place that operate at the same time, it is important to focus on student engagement since it can be directly influenced by teachers and school leaders, as well as curriculum choices and school resources. This makes it a ripe target for government policies aimed at improving educational outcomes for students from low‐SES families, compared with approaches targeting the influences of family environment or peer groups. [ABSTRACT FROM AUTHOR]

This literature review presents a critical appraisal of the dominant approaches toward the sexuality and relationships of people with acquired brain injury. In particular, we sought to identify and review existing programs focusing on sexuality and relationships which use an educational and/or peer–peer approach. A systematic and comprehensive search of the EBSCOHOST database was conducted within an unlimited time-frame to yield the highest number of relevant results possible, along with hand-searching of key journals and databases. Reports, papers and webpages, documents commonly referred to as 'grey literature' that are not published in peer-reviewed journals, were also hand searched as a part of this review. The database search yielded 862 results, 14 of which were found to be relevant to our research interests. All of the sexuality education programs identified in this review were experienced positively by participants, families, caregivers, and professionals working with people with acquired brain injury. No peer–peer sexuality and relationships programs were identified. However, we found strong support for the use of peer–peer approaches in other programs for people with acquired brain injury. This literature review provides strong support for the development peer–peer sexuality and relationships programs for people with acquired brain injury. However, any future programs would have to overcome the limitations of existing sexuality and relationships programs. [ABSTRACT FROM AUTHOR]

This article addresses the deliberately speculative question of 'What might the school of 2030 be like?', with a specific focus on the influences of digital technologies. The article adopts the methodological approach of 'social science fiction' to explore the ways in which digital technologies might be used in one Australian high school in 2030 (Lakeside), and what this might mean for the people whose lives are enmeshed with these technologies. Through the co-construction of five social science fiction 'vignettes' about life within Lakeside, the article considers the increasing prevalence of dataveillance, digital deskilling and the de-territorialization of schooling. The article then goes on to consider changing relationships between time/place, material and coded structures, as well as the increasingly platformized and data-driven nature of schooling in the 2020s. The article ends by considering the ways in which critical scholars can continue to use the methodological approach of social science fiction writing with regard to unpacking the politics of digital education futures. [ABSTRACT FROM AUTHOR]

Borderline Personality Disorder (BPD) is a highly contentious psychiatric diagnosis with ongoing tensions over nomenclature, aetiology and treatment recommendations. This article examines a number of these tensions and assesses how greater attention to the voices of people living with BPD may help inform the delivery of new modes of person-centred care. To this end, we present a critical social science research agenda for investigating the experiences, social contexts and support needs of people living with BPD. We canvass issues pertaining to the diagnosis of BPD (including its name), the strongly gendered dimensions of BPD, and the pressing need to improve support for people living with this condition. Throughout our analysis, we indicate how critical interdisciplinary inquiry may drive new responses to these challenges. Our analysis is illustrated with reference to experiences of BPD recounted in two Australia-wide surveys conducted in 2011 and 2017. We argue that greater progress towards person-centred care requires novel forms of evidence grounded in critical social inquiry into experiences of treatment and support among people living with BPD, and the varied social, cultural and political contexts underpinning these experiences. [ABSTRACT FROM AUTHOR]

This article addresses the prominence of 'vulnerability' as a way of making sense of disadvantage and suffering in both social policy and social science. It examines the interplay of vulnerability as a material phenomenon and cultural script by foregrounding the experiences of the most marginal benefit claimants in Australia's residual social security system. The article questions whether the everyday disruptions and challenges that unsettle yet settle-into life in poverty are intelligible within authorised idioms of vulnerability that govern access to support. By examining what people surviving on benefits are vulnerable to and how they are compelled to demonstrate their status as vulnerable, it contributes a critical account of lived experiences of vulnerability that holds both its discursive and phenomenological dimensions in view. [ABSTRACT FROM AUTHOR]

Courts are increasingly called upon to adjudicate hard cases involving questions of social facts. In deciding these matters, in a just and efficient manner according to law, courts will desirably have recourse to social science material and, perhaps less desirably, be influenced by underlying assumptions based on the decision-maker's personal views. This article comments on three ways in which courts use social facts and treat social science material in the course of judicial decision-making. The authors suggest a 'best practice' approach for judges in approaching these questions, in the light of identified problems with the status quo. [ABSTRACT FROM AUTHOR]

Encouraged by Communist parties and left-wing trade unions, radical, or working-class, theatre groups of the twentieth century were crucial in the development of a long-lasting left-wing cultural activist impulse in a number of nations. The branches of the Unity Theatre in UK and the New Theatre in Australia had a highly conscious democratic and explicit working class orientation, and presented various combinations of mainstream and radical dramatic genres and plays. Drawing on oral histories and archival research, this chapter explores the politics of popular culture by focusing on the degrees of mobility of ideas, dramatic texts and people and politics between the two theatres. The emergent mobility patterns across these elements demonstrated the effect of 'tyranny of distance' to invoke Blainey's phrase1 and the sociocultural mores of 'Empire' on those transnational flows. Whether it was the mobility of ideas, texts or people, a more complex picture emerged than simple exchange or reciprocal influence. Informing our discussion is the mobility studies literature, following the 'mobility turn' in the social sciences. A number of concepts within mobility studies provide a lens for analysing the movement of ideas, scripts and people between Unity and the New Theatre. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis has a significant cost of illness burden in Europe, UK and the USA, with the majority of costs coming from reductions in productivity. However, information is scarce on if there is a differing impact between endometriosis and other causes of chronic pelvic pain, and if there are modifiable factors, such as pain severity, that may be significant contributors to the overall burden. Methods: An online survey was hosted by SurveyMonkey and the link was active between February to April 2017. Women aged 18–45, currently living in Australia, who had either a confirmed diagnosis of endometriosis via laparoscopy or chronic pelvic pain without a diagnosis of endometriosis were included. The retrospective component of the WERF EndoCost tool was used to determine direct healthcare costs, direct non-healthcare costs (carers) and indirect costs due to productivity loss. Estimates were extrapolated to the Australian population using published prevalence estimates. Results: 407 valid responses were received. The cost of illness burden was significant in women with chronic pelvic pain (Int $16,970 to $ 20,898 per woman per year) irrespective of whether they had a diagnosis of endometriosis. The majority of costs (75–84%) were due to productivity loss. Both absolute and relative productivity costs in Australia were higher than previous estimates based on data from Europe, UK and USA. Pain scores showed the strongest relationship to productivity costs, a 12.5-fold increase in costs between minimal to severe pain. The total economic burden per year in Australia in the reproductive aged population (at 10% prevalence) was 6.50 billion Int $. Conclusion: Similar to studies in European, British and American populations, productivity costs are the greatest contributor to overall costs. Given pain is the most significant contributor, priority should be given to improving pain control in women with pelvic pain [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer imposes a substantial health burden worldwide including in Australia and is caused by persistent infection with one of 13 sexually transmitted high-risk human papillomavirus (HPV) types. The objective of this study was to assess the cost-effectiveness of adding a nonavalent new Gardasil-9® (9vHPV) vaccine to the national immunisation schedule in Australia across three different delivery strategies. Materials and methods: The Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model was used to examine the cost-effectiveness of 9vHPV vaccine introduction to prevent HPV infection. Academic literature and anecdotal evidence were included on the demographic variables, cervical cancer incidence and mortality, treatment costs, and vaccine delivery costs. The incremental cost-effectiveness ratios (ICERs) were measured per disability-adjusted life years (DALYs) averted, using the heuristic cost-effectiveness threshold defined by the World Health Organisation (WHO). Analyses and data from international agencies were used in scenario analysis from the health system and societal perspectives. Results: The 9vHPV vaccination was estimated to prevent 113 new cases of cervical cancer (discounted) during a 20-year period. From the health system and societal perspectives, the 9vHPV vaccination was very cost-effective in comparison with the status quo, with an ICER of A$47,008 and A$44,678 per DALY averted, respectively, using the heuristic cost-effectiveness threshold level. Considering delivery strategies, the ICERs per DALY averted were A$47,605, A$46,682, and A$46,738 for school, health facilities, and outreach-based vaccination programs from the health system perspective, wherein, from the societal perspective, the ICERs per DALY averted were A$46,378, A$43,729, A$43,930, respectively. All estimates of ICERs fell below the threshold level (A$73,267). Conclusions: This cost-effectiveness evaluation suggests that the routine two-dose 9vHPV vaccination strategy of preadolescent girls against HPV is very cost-effective in Australia from both the health system and societal perspectives. If equally priced, the 9vHPV option is the most economically viable vaccine. Overall, this analysis seeks to contribute to an evidence-based recommendation about the new 9vHPV vaccination in the national immunisation program in Australia. [ABSTRACT FROM AUTHOR]

Background: Australia has one of the highest skin cancer rates in the world. 'SunSmart' is a multi-component, internationally recognised community-wide skin cancer prevention program implemented in Melbourne, Australia, since summer 1988-1989. Following recent reductions in melanoma rates among younger Australian cohorts, the extent of behaviour change and the potential contribution of prevention programs to this decline in melanoma rates are of interest. Sun protection is a multifaceted behaviour. Measures previously applied to monitor change over time in preventive behaviour for this population focused on individual behaviours. The omission of multiple behaviours that reduce exposure to ultraviolet radiation (UV) may have led to underestimates of behaviour change, meriting further analysis of long-term trends to contribute to this debate.Methods and Findings: A population-based survey was conducted in Melbourne in the summer before SunSmart commenced (1987-1988) and across summers in 3 subsequent decades (1988-2017). During summer months, residents (14-69 years) were recruited to cross-sectional weekly telephone interviews assessing their tanning attitudes, sun protection behaviour, and sunburn incidence on the weekend prior to interview. Quotas were used to ensure the sample was proportional to the population by age and sex, while younger respondents were oversampled in some years. The majority of the respondents reported their skin was susceptible to sunburn. Changes in sun protection behaviour were analysed for N = 13,285 respondents in multivariable models, cumulating surveys within decades (1987-1988: N = 1,655; 1990s: N = 5,258; 2000s: N = 3,385; 2010s: N = 2,987) and adjusting for relevant ambient weather conditions and UV levels on weekend dates. We analysed specific and composite behaviours including a novel analysis of the use of maximal sun protection, which considered those people who stayed indoors during peak UV hours together with those people well-protected when outdoors. From a low base, use of sun protection increased rapidly in the decade after SunSmart commenced. The odds of use of at least 1 sun protection behaviours on summer weekends was 3 times higher in the 1990s than pre-SunSmart (adjusted odds ratio [AOR] 3.04, 95% CI 2.52-3.68, p < 0.001). There was a smaller increase in use of maximal sun protection including shade (AOR = 1.68, 95% CI 1.44-1.97, p < 0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s. Inferences about program effects are limited by the self-reported data, the absence of a control population, the cross-sectional study design, and the fact that the survey was not conducted in all years. Other potential confounders may include increasing educational attainment among respondents over time and exposure to other campaigns such as tobacco and obesity prevention.Conclusions: With an estimated 20-year lag between sun exposure and melanoma incidence, our findings are consistent with SunSmart having contributed to the reduction in melanoma among younger cohorts. [ABSTRACT FROM AUTHOR]

Objective: To assess the use of diet and the use of exercise for prostate cancer (and/or its treatments’ side effects) by long-term survivors and whether such use is associated with selected socio-demographic, clinical, health-related quality-of-life (HRQOL) and psychological factors. Design, setting and participants: Population-based cohort study in New South Wales, Australia of prostate cancer survivors aged <70 years at diagnosis and who returned a 10-year follow-up questionnaire. Methods: Validated instruments assessed patient’s HRQOL and psychological well-being. Poisson regression was used to estimate adjusted relative proportions (RRs) of prostate cancer survivor groups who were currently eating differently (‘using diet’) or exercise differently (‘using exercise’) to help with their prostate cancer. Results: 996 (61.0% of 1634) participants completed the 10-year questionnaire of whom 118 (11.8%; 95%CI[9.8–13.9]) were using diet and 78 (7.8%; 95%CI[6.2–9.5]) were using exercise to help with their prostate cancer. Men were more likely to use diet or use exercise for prostate cancer if they were younger (p-trend = 0.020 for diet, p-trend = 0.045 for exercise), more educated (p-trend<0.001, p-trend = 0.011), support group participants (p-nominal<0.001, p-nominal = 0.005), had higher Gleason score at diagnosis (p-trend<0.001, p-trend = 0.002) and had knowledge of cancer spread (p-nominal = 0.002, p-nominal = 0.001). Use of diet was also associated with receipt of androgen deprivation therapy (RR = 1.59; 95%CI[1.04–2.45]), a greater fear of cancer recurrence (p-trend = 0.010), cognitive avoidance (p-trend = 0.025) and greater perceived control of cancer course (p-trend = 0.014). Use of exercise was also associated with receipt of prostatectomy (RR = 2.02; 95%CI[1.12–3.63]), receipt of androgen deprivation therapy (RR = 2.20; 95%CI[1.34–3.61]) and less satisfaction with medical treatments (p-trend = 0.044). Conclusions: Few long-term prostate cancer survivors use diet or exercise to help with their prostate cancer. Survivors may benefit from counselling on the scientific evidence supporting healthy eating and regular exercise for improving quality-of-life and cancer-related outcomes. [ABSTRACT FROM AUTHOR]

The quandong or native peach (Santalum acuminatum R.Br.) has been recognised as an important and tasty food resource among Aboriginal Australians in arid and semi-arid areas of southern Australia. It is valued for its fruit that is consumed raw or dried, and for its kernel, which is eaten raw or ground into paste for medicinal and skin care purposes. This paper reports on a study of ground stone implements within the Murray Darling Basin that has identified quandong stones as a distinct type of implement made specifically for the efficient cracking of quandong nuts. Data are presented on 1,327 ground stone implements from collections in 12 different locations in the Murray-Darling Basin (MDB), an area almost completely devoid of stone sources. Given the paucity of stone, multi-purpose use of implements is widely documented. Although it was common to find pits present in mortars and other ground stone tools demonstrating multiple functions, including use as anvils, a class of single purpose stones with multiple pits and distinctive form was identified. Most of these were found in areas known for groves of quandong and four were analysed for use-wear and residues along with two other ground stone items from the MDB. The results support their identification as specialised anvil stones for cracking quandong nuts. [ABSTRACT FROM AUTHOR]

Background: There is poor uptake of psychosocial interventions offered to people with cancer who record high scores on distress screening scales. Intervention uptake may be influenced by a mismatch between consumer (bottom-up) and professional (top-down) paradigms of wellbeing. The current research aims to compare cancer survivors’ ‘self-judgements’ about their levels of anxiety, depression and stress, to classifications derived via a professional-driven measure, the Depression, Anxiety and Stress Scale (DASS-21). Methods: A cross-sectional study was undertaken with haematological cancer survivors recruited from three population-based cancer registries in Australia. Consenting participants were mailed a questionnaire package; and non-responders received a second questionnaire package after 3-weeks and a reminder call after 6-weeks. The consumer-driven perspective was assessed via three separate single items asking survivors to self-classify their levels of anxiety, depression and stress over the past week on a scale from ‘normal’ to ‘extremely severe’. The professional-driven classification was assessed via the DASS-21. Kappa statistics were used to assess agreement between consumer- and professional-driven measures. Results: Of 2,971 eligible haematological cancer survivors, 1,239 (42%) provided written consent and were mailed a questionnaire package. Of these, 984 (79%) returned a completed questionnaire. The simple kappa for agreement between the DASS-21 and self-classified measures for anxiety was 0.47 (95% CI: 0.39 to 0.54, p<0.0001). The weighted kappa for agreement between the DASS-21 and self-classified measures of depression was 0.60 (95% CI: 0.53 to 0.67, p<0.0001) and for measures of stress was 0.51 (95% CI: 0.44 to 0.59, p<0.0001). Conclusions: Moderate agreement between self-classification and professional-driven assessments was found. The value of screening is predicated on the assumption that those with identified needs will be offered and take up services that will benefit them. Our results suggest that to improve the utility of distress screening it may be important to include assessment of survivor views about their symptoms. [ABSTRACT FROM AUTHOR]

Background: While drink driving continues to be significantly more common among male drivers, there is evidence from many countries that shows a growing trend of women engaging in this risky behaviour. The aims of the current study were threefold: (i) determine to what extent a sample of women drivers reported engaging in drink driving behaviour by expanding the construct into a range of definitions, (ii) determine if there were significant differences in self-reported engagement in drink driving behaviours in accordance with hazardous drinking behaviour, and (iii) identify which situational or personal factors would increase women drivers’ likelihood to engage in drink driving through presenting a range of scenarios. Method: Data were collected using an on-line, purpose-designed survey and promoted to reach women aged 17 years and older, living in Queensland, Australia. In addition to questions relating to demographic characteristics, participants completed items relating to engagement in seven drink driving related behaviours in the previous 12-month period, hazardous drinking as measured by the Alcohol Use Disorders Identification Test, and likelihood of driving when unsure if over the legal limit for licence type across a range of scenarios manipulating different situational factors. A total of 644 valid responses were received in the two-week period the study was advertised. Results: The results demonstrate women’s self-reported engagement in drink driving behaviour ranged from 12.6% (driving when they believed they were over the legal limit) to over 50.0% (driving when unsure if over the legal limit the morning after drinking alcohol) and was significantly more likely among those who reported hazardous levels of alcohol use. Circumstances in which women reported they would drive when unsure if over the legal BAC limit were when they were a few blocks from home, if they subjectively felt they were not too intoxicated, or if they needed their car to get somewhere the next morning. Conclusion: Examining drink driving behaviour by way of responses to nuanced definitions provided valuable insight into self-reported engagement in the behaviour and highlights the usefulness of multi-measure dependent variables in order to illuminate a more accurate acknowledgement into both the type (and extent) of drink driving behaviours. [ABSTRACT FROM AUTHOR]

Telehealth is an alternative method of delivering health care to people required to travel long distances for routine health care. The aim of this systematic review was to examine whether patients and their caregivers living in rural and remote areas are satisfied with telehealth videoconferencing as a mode of service delivery in managing their health. A protocol was registered with PROSPERO international prospective register of systematic reviews (#CRD42017083597) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of Ovid Medline, Embase, CINAHL, ProQuest Health Research Premium Collection, Joanna Briggs Institute and the Cochrane Library was conducted. Studies of people living in rural and remote areas who attended outpatient appointments for a health condition via videoconference were included if the studies measured patient and/or caregivers’ satisfaction with telehealth. Data on satisfaction was extracted and descriptively synthesised. Methodological quality of the included studies was assessed using a modified version of the McMaster Critical Review Forms for Quantitative or Qualitative Studies. Thirty-six studies of varying study design and quality met the inclusion criteria. The outcomes of satisfaction with telehealth were categorised into system experience, information sharing, consumer focus and overall satisfaction. There were high levels of satisfaction across all these dimensions. Despite these positive findings, the current evidence base lacks clarity in terms of how satisfaction is defined and measured. People living in rural and remote areas are generally satisfied with telehealth as a mode of service delivery as it may improve access to health care and avoid the inconvenience of travel. [ABSTRACT FROM AUTHOR]

Background: Widespread use of antibiotics has led to the development of antibiotic resistance. However, there are limited data describing antibiotic use in the community setting, and examining factors associated with greater use. Our study aimed to quantify antibiotic dispensing in older adults in the community according to socio-demographics and health services use. Methods: Prospective analysis of a population-based cohort study of 239,981 adults aged ≥45 years in Australia (the Sax Institute’s 45 and Up Study). Data on socio-demographics and health from a questionnaire, were linked to 2015 antibiotic dispensing data from the Pharmaceutical Benefits Scheme (PBS), as well as other administrative health databases. We estimated the Defined Daily Dose (DDD) of systemic antibiotics dispensed, defined by an Anatomic Therapeutic Classification code beginning with J01, in 2015. We also conducted Poisson regression with robust standard errors to identify factors associated with antibiotic dispensing. Results: Overall, 49.3% of 45 and Up Study participants had at least one systemic antibiotic dispensed in 2015 with a total of 392,856 prescriptions dispensed and an average of 36.5 DDDs/1000-persons/day in the study population. The quantity of antibiotics dispensed increased with increasing age (25.6 DDDs/1000/day in <60 years old versus 50.4 DDDs/1000/day in 80+ year old) and was higher comparing women to men (39.9 versus 32.4 DDDs/1000/day). Of factors examined, the greatest dispensing of antibiotics was among those who had been resident in an aged care facility and those with >15 general practitioner consultations in the last year (80.5 and 88.3 DDDs/1000/day, respectively). These factors remained strongly associated with greater antibiotic dispensing after adjusting for age, sex, education, income, area of residence and co-morbidities. Conclusions: Residence in aged care facilities and high GP visits are associated with greater antibiotic dispensing. This study provides important evidence regarding high use groups for antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Translocated saltwater crocodiles (Crocodylus porosus) in the Northern Territory (NT) of Australia often return to their original capture sites, which complicates management interventions aimed at reducing human-crocodile conflict. We examined the spatial events implicated in this homing ability, using ARGOS satellite tracking devices. Five large male C. porosus (3.03 m to 4.02 m TL) were shifted and released 100–320 km from their capture sites, and 3 additional ones (3.67 m to 4.23 m TL) were released at their site of capture as controls. Translocated crocodiles were more mobile than the controls, and moved at sea in the direction of their original capture site. However, they were unable or unwilling to swim around a geographic structure, Cobourg Peninsula, which prevented homing being achieved in all five cases. Two control crocodiles remained near their capture sites, but one, after the first year, made a 900km journey for six months, before returning to its original capture and release site. Genetic analysis of tissue samples from nests across the NT coast demonstrated significant genetic structure across the coast, and confirmed that Cobourg Peninsula contributes to genetic differentiation among populations along the NT coast. These results provide new insights into C. porosus movements, which have management significance for the maintenance of public safety. [ABSTRACT FROM AUTHOR]

Background: Inappropriate utilization of prescription opioids and benzodiazepines is a public health problem. This study examined and compared user-types and trends in dispensing of these medicines, and identified associated factors related to the duration of dispensing in Australia. Methods: A random 10% sample of unit-record data of opioids and benzodiazepines dispensed nationally during 2013–2016 was analyzed. Users were categorized into four types: single-quarter (i.e., three months), medium-episodic (dispensed 2–6 quarters), long-episodic (dispensed 7–11 quarters), chronic (dispensed 12–16 quarters). Dispensing quantity was computed in defined daily dose (DDD). Generalized multilevel ordinal models were developed to examine the factors associated with the duration of dispensing. Results: There were similarities in terms of trends of dispensing of opioids and benzodiazepines in Australia. Overall, more people were dispensed opioids than benzodiazepines. Around 52% of opioids users and 46% of benzodiazepines users were dispensed these medicines for a single quarter. However, chronic users were dispensed 60% of opioids and 50% of benzodiazepines in DDD/1000 people/day, respectively. On average, 16.6 DDD/1000 people/day of opioids and 14.2 DDD/1000 people/day of benzodiazepines were dispensed in Australia during the study period. Tasmania was dispensed the highest quantity (in DDD/1000 people/day) of these medicines, followed by South Australia and Queensland. Women compared to men, and clients of age-group 20–44, 45–64 and 65+ compared to age-group 0–19, were significantly more likely to have dispensed opioids/benzodiazepine for a relatively long duration. Clients with a history of dispensing of one of these two medicines were significantly more likely to have dispensed the other for a relatively long period. Conclusions: There were similarities in patterns of dispensing of opioids and benzodiazepines in terms of user characteristics and structural variables. Consistent use of real-time drug monitoring program and tailored intervention are recommended. [ABSTRACT FROM AUTHOR]

Introduction: Globally, over half of pregnancies in developed countries are unplanned. Identifying and understanding the prevalence and complexity surrounding pregnancy preparation among Australian women is vital to enable sensitive, responsive approaches to addressing preconception and long-term health improvements for these women with varying motivation levels. Aim: This study evaluated the reliability and validity of a comprehensive pregnancy planning/intention measure (London Measure of Unplanned Pregnancy) in a population of pregnant women (over 18 years of age) in Australia. Methods: A psychometric evaluation, within a cross-sectional study comprising cognitive interviews (to assess comprehension and acceptability) and a field test. Pregnant women aged over 18 years were recruited in early pregnancy (approximately 12 weeks’ gestation). Reliability (internal consistency) was assessed using Cronbach’s alpha, corrected item-total correlations and inter-item correlations, and stability via a test-retest. Construct validity was assessed using principal components analysis and hypothesis testing. Results: Six women participated in cognitive interviews and 317 in the field test. The London Measure of Unplanned Pregnancy was acceptable and well comprehended. Reliability testing demonstrated good internal consistency (alpha = 0.81, all corrected item-total correlations >0.20, all inter-item correlations positive) and excellent stability (weighted kappa = 0.92). Validity testing confirmed the unidimensional structure of the measure and all hypotheses were confirmed. Conclusions: The London Measure of Unplanned Pregnancy is a valid and reliable measure of pregnancy planning/intention for the Australian population. Implementation of this measure into all maternity healthcare, research and policy settings will provide accurate population-level pregnancy planning estimates to inform, monitor and evaluate interventions to improve preconception health in Australia. [ABSTRACT FROM AUTHOR]

There is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is rare for such policy approaches to be applied systematically. To examine the usefulness of political and social science theory in understanding the reasons for this disjuncture between evidence and practice, researchers and public servants gathered in Adelaide for an Academy of the Social Sciences in Australia (ASSA) Workshop. This paper draws together the learnings that emerged from the Workshop, including key messages about the usefulness of various theories as well as insights drawn from policy practice. Discussions during the Workshop highlighted that applying multiple theories is particularly helpful in directing attention to, and understanding, the influence of all stages of the policy process; from the construction and framing of policy problems, to the implementation of policy and evaluation of outcomes, including those outcomes that may be unintended. In addition, the Workshop emphasized the value of collaborations among public health researchers, political and social scientists and public servants to open up critical discussion about the intersections between theory, research evidence and practice. Such critique is vital to render visible the processes through which particular sources of knowledge may be privileged over others and to examine how political and bureaucratic environments shape policy proposals and implementation action. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the context and culture of nursing surveillance on an acute care ward. Background: Prevention of patient deterioration is primarily a nursing responsibility in hospital. Registered nurses make judgements and act on emerging threats to patient safety through a process of nursing surveillance. Organisational factors that weaken nursing surveillance capacity on general wards increase the need for patient rescue at the end point of clinical deterioration with poorer outcomes. Yet little is known about cultures that enable and sustain ward nursing surveillance for patient safety. Design: Workplace observations and semistructured interviews using a critical lens as the first stage of a larger emancipatory practice development project. Methods: Researcher immersion including 96 hr of nonparticipant observation with 12 semistructured interviews during July–August 2017. This study adhered to the COREQ guidelines. Results: We offer a metaphor of nursing surveillance as the threads that support the very fabric of acute care nursing work. These hidden threads enable nurses to weave the tapestry of care that keeps patients safe. This tapestry is vulnerable to internal and external forces, which weaken the structure, putting patients and staff at risk. Conclusion: Understanding local context is essential to supporting practice change. This workplace observation challenges us to find ways to creatively engage nurses with the underlying cultural and systems issues that so often remain hidden from view in the deteriorating patient literature. Relevance to clinical practice: Building cultural values that strengthen nursing surveillance is a prerequisite for safe and effective hospital care. As such, practice‐based research that empowers frontline nurses and teams to develop person‐centred workplace cultures can hold the key to unlocking sustainable improvements in patient safety. [ABSTRACT FROM AUTHOR]

“Why are neurotypicals so pig-ignorant about autism?” an autistic person wrote on the Curtin Autism Research Group’s on-line portal as a response to a call for research questions. Co-produced with an autistic researcher, knowledge about and attitudes towards autism were analysed from 1,054 completed surveys, representing the Australian neurotypical adult population. The majority, 81.5% of participants had a high level of knowledge and 81.3% of participants had a strong positive attitude towards autism. Neither age, nor education level had an impact on attitudes. However, attitudes were influenced by knowledge about ‘Societal Views and Ideas’; ‘What it Could be Like to Have Autism’; and the demographic variables ‘Knowing and having spent time around someone with autism’; and gender (women having more positive attitudes than men). Thus, targeted interventions, geared more towards men than women, to increase knowledge about autism could further improve attitudes and increase acceptance of the autistic community. [ABSTRACT FROM AUTHOR]

Reconstructing past sea levels can help constrain uncertainties surrounding the rate of change, magnitude, and impacts of the projected increase through the 21st century. Of significance is the mid-Holocene relative sea-level highstand in tectonically stable and remote (far-field) locations from major ice sheets. The east coast of Australia provides an excellent arena in which to investigate changes in relative sea level during the Holocene. Considerable debate surrounds both the peak level and timing of the east coast highstand. The southeast Australian site of Bulli Beach provides the earliest evidence for the establishment of a highstand in the Southern Hemisphere, although questions have been raised about the pretreatment and type of material that was radiocarbon dated for the development of the regional sea-level curve. Here we undertake a detailed morpho- and chronostratigraphic study at Bulli Beach to better constrain the timing of the Holocene highstand in eastern Australia. In contrast to wood and charcoal samples that may provide anomalously old ages, probably due to inbuilt age, we find that short-lived terrestrial plant macrofossils provide a robust chronological framework. Bayesian modelling of the ages provide improved dating of the earliest evidence for a highstand at 6,880±50 cal BP, approximately a millennium later than previously reported. Our results from Bulli now closely align with other sea-level reconstructions along the east coast of Australia, and provide evidence for a synchronous relative sea-level highstand that extends from the Gulf of Carpentaria to Tasmania. Our refined age appears to be coincident with major ice mass loss from Northern Hemisphere and Antarctic ice sheets, supporting previous studies that suggest these may have played a role in the relative sea-level highstand. Further work is now needed to investigate the environmental impacts of regional sea levels, and refine the timing of the subsequent sea-level fall in the Holocene and its influence on coastal evolution. [ABSTRACT FROM AUTHOR]

Demand for training life scientists in bioinformatics skills led to the development of a train-the-trainer collaboration between the European Molecular Biology Laboratory–European Bioinformatics Institute (EMBL-EBI) and 2 Australian organisations, Bioplatforms Australia and Commonwealth Scientific and Industrial Research Organisation (CSIRO) in 2012. The goal of the collaboration was to establish a group of trained instructors who could develop and deliver short bioinformatics courses nationally. A train-the-trainer course introduces instructors to aspects of andragogy and evidence-based learning principles to help them better design, develop, and deliver high-quality training. Since then, both the number of trainers in the network and the course portfolio have grown. Best practises have been developed and shared between the Australian cohort and EMBL-EBI to address common challenges in bioinformatics training. The Australian trainer cohort undertook a train-the-trainer instructor course, again with EMBL-EBI, and subsequently successfully delivered train-the-trainer courses to interested bioinformatics trainers within Australia. We conclude that a train-the-trainer approach can help build national capacity and maintain a critical mass of trained instructors. [ABSTRACT FROM AUTHOR]

Objectives: The Code of Ethics of pharmacy practitioners in Australia recognises the obligation to provide care to patients in a culturally safe and responsive manner. The aim of this exploratory study was to examine how Australian community pharmacists understand and experience the concept of ‘culture’ in their everyday practice environment. Methods: Voluntary, semi-structured interviews were conducted at community pharmacy placement sites in South-East Queensland, Australia. Pharmacists were asked to recall an incident that evoked their cultural awareness during the course of their practice. The question stated, verbatim: “We are preparing our students to be pharmacists in a highly multicultural community. Can you think of an incident where you learnt something about another person’s culture or it made you more aware of your own culture? Please briefly describe the incident.” Reportable responses were collected from 59 of the 92 visited pharmacists. These responses were audio-recorded and transcribed. The data were collated and analysed through iterative, reflexive, thematic analysis using constant comparison. Results and significance: The responses provided a rich selection of lived experiences within Australian multicultural pharmacy practice, describing professional dilemmas, fears and the strategies employed to overcome practice challenges. Six main response categories were identified: (i) Language/communication challenges, (ii) Cultural attitudes and behaviours, (iii) Exposure to culture due to pharmacy location, (iv) Religion, gender, and age, (v) Prejudiced/perceived racist attitudes and discrimination towards ‘other’ cultures, (vi) Perceived ‘sameness’ of different cultures. The study has provided valuable insights into community pharmacists’ experiences of culture in their day-to-day professional practice, also highlighting the associated strategies used to maintain a high standard of practice. There is merit in ensuring that the pharmacy curriculum and professional development programs are designed to respond to the ethical obligation of pharmacists to practise in a culturally safe, responsive manner that acknowledges and incorporates the importance of culture, cultural differences and intercultural relations, while addressing culturally unique needs in a skilled and professional manner. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the main on-farm welfare issues likely to be encountered in extensive sheep farming systems. Thirty-two commercial sheep farms in Victoria, Australia were involved in this study. Of the 32 farms involved, 30 were visited twice (at mid-pregnancy and weaning), and 2 farms only once (both at weaning). In total, 62 visits were conducted and 6,200 ewes (aged 2–5 years) were examined using six animal-based indicators: body condition score (BCS), fleece condition, skin lesions, tail length, dag score and lameness. In addition, the number of ewes that needed further care (such as sick or injured sheep) was recorded and reported to the farmers. Generalised linear mixed models were conducted to investigate associations between welfare outcomes and visit, ewe breed and location, with all three, and their interactions, as fixed factors. In all instances, farm was set as a random factor to account for specific variation between farms. Overall, the welfare of the ewe flocks, based on the six indicators measured, was considered good. A total of 86.9% of the ewes were in adequate BCS (2.5–3.5), 91% had good fleece condition, 69.2% had no skin lesions, 97.1% had low dag scores, and overall lameness was 4.7%. An important and prevalent risk to welfare identified across farms was short tail length; with 85.7% of ewes having tails docked shorter than the third palpable joint. While the welfare of the flock was good, ewes in need of further care were identified at all farms. There were 185 (3.0%) cases needing further care, and the extent of welfare compromise of these animals was considered significant. Main reasons for further care were moderate/severe lameness or foot-related issues, BCS ≤ 2 and active dermatophilosis or broken wool. To our knowledge, this study constitutes the largest assessment of ewes conducted in Australia, and the findings provide valuable insight into the main welfare issues likely to be encountered in extensive sheep farming enterprises. Future studies should develop practical technologies that can assist in the detection of the welfare issues identified in this study. In addition, the thresholds identified here could be used for future comparison and sheep welfare benchmarking programs to assess farm performance and measure continuous improvements. [ABSTRACT FROM AUTHOR]

During the past decade, over 3000 shell middens or shell matrix deposits have been discovered on the Farasan Islands in the southern Red Sea, dating to the period c. 7,360 to 4,700 years ago. Many of the sites are distributed along a palaeoshoreline which is now 2–3 m above present sea level. Others form clusters with some sites on the shoreline and others located inland over distances of c. 30 m to 1 km. We refer to these inland sites as ‘post-shore’ sites. Following Meehan, who observed a similar spatial separation in shell deposition in her ethnographic study of Anbarra shellgathering in the Northern Territory of Australia, we hypothesise that the shoreline sites are specialised sites for the processing or immediate consumption of shell food, and the post-shore sites are habitation sites used for a variety of activities. We test this proposition through a systematic analysis of 55 radiocarbon dates and measurement of shell quantities from the excavation of 15 shell matrix sites in a variety of locations including shoreline and post-shore sites. Our results demonstrate large differences in rates of shell accumulation between these two types of sites and selective removal of shoreline sites by changes in sea level. We also discuss the wider implications for understanding the differential preservation and visibility of shell-matrix deposits in coastal settings in other parts of the world extending back into the later Pleistocene in association with periods of lowersea level. Our results highlight the importance of taphonomic factors of post-depositional degradation and destruction, rates of shell accumulation, the influence on site location of factors other than shell food supply, and the relative distance of deposits from their nearest palaeoshorelines as key variables in the interpretation of shell quantities. Failure to take these variables into account when investigating shells and shell-matrix deposits in late Pleistocene and early Holocene contexts is likely to compromise interpretations of the role and significance of shell food in human evolutionary and socio-cultural development. [ABSTRACT FROM AUTHOR]

Social Networking Sites (SNS) such as Facebook and Instagram have relocated a large portion of people's social lives online, but can be intrusive and create social disturbances. Many people therefore consider taking an "SNS vacation." We investigated the effects of a one-week vacation from both Facebook and Instagram on subjective well-being, and whether this would vary for passive or active SNS users. Usage amount was measured objectively, using RescueTime software, to circumvent issues of self-report. Usage style was identified at pre-test, and SNS users with a more active or more passive usage style were assigned in equal numbers to the conditions of one-week SNS vacation (n = 40) or no SNS vacation (n = 38). Subjective well-being (life satisfaction, positive affect, and negative affect) was measured before and after the vacation period. At pre-test, more active SNS use was found to correlate positively with life satisfaction and positive affect, whereas more passive SNS use correlated positively with life satisfaction, but not positive affect. Surprisingly, at post-test the SNS vacation resulted in lower positive affect for active users and had no significant effects for passive users. This result is contrary to popular expectation, and indicates that SNS usage can be beneficial for active users. We suggest that SNS users should be educated in the benefits of an active usage style and that future research should consider the possibility of SNS addiction among more active users. [ABSTRACT FROM AUTHOR]

Miscarriage occurs in up to one in four pregnancies and can be a devastating event affecting both men and women. Unfortunately, the male partner’s experience of miscarriage is seldom researched, particularly within Australia. This qualitative study involved semi-structured telephone interviews with 10 Australian men, whose partners miscarried between three months and ten years ago. Participants were recruited through professional networks and support organisations. Interviews explored men’s general miscarriage experience and the support received or lacking from both healthcare providers and social networks. Online health seeking behaviour and opinions on online support were also discussed. Data was transcribed verbatim and analysed thematically. Most men described feeling significant grief following miscarriage and felt that there was little acknowledgment of their loss, both from healthcare providers and within their social networks. Feelings of sadness, devastation, powerlessness, fear, shock and a loss of identity were common. All men felt their primary role at the time of miscarriage was to support their partner. Most men did not want to burden their partner with their emotions or grief, and struggled to find people within their social networks to talk to about their loss, leading to feelings of isolation. Overall participants felt there was inadequate support offered to men affected by miscarriage. Men wanted information, informed professionals to talk to and male-orientated support networks. A website was one mechanism suggested by men which could adequately contribute to information and support needs during this time. Men are often greatly affected by miscarriage and yet there is all too often little acknowledgement or support available to them at this time. Men affected by miscarriage want and need further support, including reputable, Australian based information and resources tailored their needs. [ABSTRACT FROM AUTHOR]

Many stroke survivors require care from informal carers such as family members and friends who may experience adverse impacts. This study aimed to qualitatively explore the unmet needs of carers of stroke survivors, and their preferences for interventions and support services. We conducted 24 semi-structured, qualitative interviews with carers of stroke survivors from the Hunter region, Australia. Inductive thematic analysis was used in the context of a needs-led framework to identify key themes of their unmet needs. Key unmet needs identified by carers of stroke survivors in this study centred on four main themes: (1) social relationships and support; (2) adequacy of information; (3) taking care of oneself; and (4) accessing appropriate services. Carers of stroke survivors desired the development of services which provide connectivity to information, training, education and community support; and inclusion in a community with social relationships and other carers of stroke survivors. Ongoing unmet needs often result in adverse health and quality of life outcomes for carers of stroke survivors. Co-designed programs and resources for carers, particularly relating to unmet needs in social, information, self-care and service access domains are needed. [ABSTRACT FROM AUTHOR]

Background: Home visiting programs are implemented in high income countries to improve outcomes for families with young children. Significant resources are invested in such programs and high quality evaluations are important. In the context of research trials, implementation quality is often poorly reported and, when reported, is variable. This paper presents the quality of implementation of the right@home program, a sustained nurse home visiting intervention trialled in Australia, and delivered in a ‘real world’ context through usual child and family health services. right@home is structured around the core Maternal Early Childhood Sustained Home-visiting (MECSH) program, which is a salutogenic, child focused prevention model. Method: At each visit right@home practitioners completed a checklist detailing the client unique identifier, date of contact and activities undertaken. These checklists were collated to provide data on intervention dose, retention to program completion at child age 2 years, and visit content, which were compared with the program schedule. Quality of family-provider relationship was measured using the Session Rating Scale. Exploratory factor analysis was conducted to identify clusters of activities and allow qualitative assessment of concordance between program aims and program delivery. Results: Of 363 intervention families offered the program, 352 (97·0%) commenced the program and 304 (87·3%) completed the program to child age 2 years. 253 of 352 (71·9%) families who commenced the program received more than 75 percent of scheduled visits including at least one antenatal visit. Families rated the participant-practitioner relationship highly (mean 39.4/40). The factor analysis identified six antenatal and six postnatal components which were concordant with the program aims. Conclusions: The right@home program was delivered with higher adherence to program dose, schedule and content, and retention than usually reported in other home visiting research. Program compliance may have resulted from program design (visit schedule, dose, content and delivery flexibility) that was consistent with family aims. [ABSTRACT FROM AUTHOR]

The history of colonization contributed to Aboriginal and Torres Strait Islanders becoming one of the most disadvantaged groups in Australia. The multiple social inequalities, and therefore the constant insecurities for many about low income, poor living conditions, unemployment, and discrimination, generate chronic stress in this population. In the Baby Teeth Talk Study, an oral-health randomized controlled trial, the Perceived Stress Scale (PSS-14) was administered to 367 pregnant Aboriginal women at baseline. The aim of the present study was to evaluate the validity and reliability of the PSS-14 in an Aboriginal population. The study analysed: (a) model fit; (b) dimensionality; (c) local dependence; (d) differential item functioning; (e) threshold ordering and item fit; (f) targeting; (g) reliability; and (h) criterion validity. The dimensionality analysis indicated a two-factor structure, with negatively and positively worded items clustering together and 21.7% (95% Agresti-Coull C.I. [17.8%, 26.2%]) statistically significant t-tests between the persons’ estimates. After the creation of composite items, the revised Perceived Distress (χ2 (21) = 11.74, p = 0.946) and Perceived Coping (χ2 (28) = 17.63, p = 0.935) subscales fitted the Rasch model. Reliability was modest (PersonSeparationIndexdistress = 0.72; PersonSeparationIndexcoping = 0.76). The latent correlation between the Perceived Distress and Perceived Coping subscales was r = 0.14. It is hypothesized that the social inequalities experienced by the Aboriginal population are so pronounced that even Aboriginal pregnant women that perceived themselves as coping well with life challenges ended up endorsing items regarding high levels of stress. The present research showed that a revised PSS-14 is a culturally valid and modestly reliable psychological instrument to measure stress in a population of pregnant Aboriginal women in Australia. [ABSTRACT FROM AUTHOR]

Background: There are few quantitative studies on palliative care provision to Indigenous Australians, a population known to experience distinctive barriers to quality healthcare and to have poorer health outcomes than other Australians. Objectives: To investigate equity of specialist palliative care service provision through characterising and comparing Indigenous and non-Indigenous patients at entry to care. Methods: Using data (01/01/2010–30/06/2015) from all services participating in the multi-jurisdictional Palliative Care Outcomes Collaboration, Indigenous and non-Indigenous patients entering palliative care were compared on proportions vis-à-vis those expected from national statutory datasets, demographic characteristics, and entry-to-care status across fourteen ‘problem’ domains (e.g., pain, functional impairment) after matching by age, sex, and specific diagnosis. Results: Of 140,267 patients, 1,465 (1.0%, much lower than expected from statutory data) were Indigenous, 133,987 (95.5%) non-Indigenous, and 4,905 (3.5%) had a missing identifier. The proportion of patients with a missing identifier diminished markedly over the study period, without a corresponding increase in the proportion identified as Indigenous. Indigenous compared with non-Indigenous patients were younger (mean 62.8 versus 73.0 years, p<0.001), a higher proportion were female (51.5% versus 46.3%; p<0.001) or resided outside major cities (44.2% versus 21.5%, p<0.001). Across all domains, Indigenous compared with matched non-Indigenous patients had lower or equal risk of status requiring prompt intervention. Conclusions: Indigenous patients (especially those residing outside major cities) are substantially under-represented in care by services participating in the nationwide specialist palliative care Collaboration, likely reflecting widespread access barriers. However, the similarity of status indicators among Indigenous and non-Indigenous patients at entry to care suggests that Indigenous patients who are able to access these services do not disproportionately experience clinically important impediments to care initiation. [ABSTRACT FROM AUTHOR]

The study of domestic money goes at the heart of debates about independence and equality in intimate relationships. It provides an important window on the individualization of family life and how couples reconcile ideals around egalitarian marriage ideologies with enduring gender inequality in society and the labor market. This study approaches these issues from the prism of couples’ banking arrangements (separate vs. joint accounts), an aspect of financial organization that approximates the executive management of household resources and which has received comparatively little attention. As such, it is amongst the first to deploy large-scale, household panel data (Household, Income and Labour Dynamics in Australia Survey, n = 15,379 observations from 7,054 couples) and binary and multinomial random-effect logistic regression models to examine trends over time in couples’ banking arrangements and their socio-demographic predictors. Key findings indicate that a large share of couples in Australia favors ‘mixed’ bank account strategies (i.e., holding both joint and separate accounts), but ‘egalitarian’ choices (i.e., dual separate accounts) are prevalent and on the rise. Couples’ bank account choices are influenced in theoretically-meaningful ways by economic resources, transaction costs, relationship history, gender-role attitudes, and family background. [ABSTRACT FROM AUTHOR]

This paper reports the impact of a major life event–death–on the physical, psychological and social well-being of the deceased’s close friends. We utilised data from a large longitudinal survey covering a period of 14 years (2002–2015) consisting a cohort of 26,515 individuals in Australia, of whom 9,586 had experienced the death of at least one close friend. This longitudinal cohort dataset comprises responses to the SF-36 (health related quality of life measure) and allowed for analysis of the short and longer-term impacts of bereavement. In order to manage the heterogeneity of the socio-demographics of respondents who did/not experience a death event, we use a new and robust approach known as the Entropy Balancing method to construct a set of weights applied to the bereaved group and the control group (the group that did not experience death). This approach enables us to match the two groups so that the distribution of socio-demographic variables between the two groups are balanced. These variables included gender, age, marital status, ethnicity, personality traits, religion, relative socio-economic disadvantage, economic resources, and education and occupation and where they resided. The data show, for the first time, a range of negative and enduring consequences experienced by people following the death of a close friend. Significant adverse physical and psychological well-being, poorer mental health and social functioning occur up to four years following bereavement. Bereaved females experienced a sharper fall in vitality, suffered greater deterioration in mental health, impaired emotional and social functioning than the male counterparts up to four years after the death. The data show that the level of social connectedness plays an important role in bereavement outcomes. Specifically, we found that less socially active respondents experienced a longer deterioration in physical and psychological health. Finally, we found evidence that the death of a close friend lowered the respondent’s satisfaction with their health. Since death of friends is a universal phenomenon, we conclude the paper by reflecting on the need to recognise the death of a close friend as a substantial experience, and to offer support and services to address this disenfranchised grief. Recognising bereaved friends as a group experiencing adverse outcomes can be used internationally to prompt health and psychological services to assist this specific group, noting that there may be substantial longevity to the negative sequelae of the death of a friend. Facilitating bereaved people’s support networks may be a fruitful approach to minimising these negative outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Improving mental health outcomes for children and young people has become a priority for policy makers in the developed world. In Australia, up to half of all children and adolescents meeting criteria for mental health disorders receive suboptimal levels of treatment (or no treatment at all) despite the availability of effective treatments. Children with complex mental health conditions are particularly at risk of inadequate treatment as optimal care requires coordination from medical, educational and social services. In Australia, clinicians including pediatricians, psychologists and child and adolescent psychiatrists deliver the bulk of mental health care for children with complex mental health conditions. We aimed to determine perspectives of these Australian clinicians on barriers and enablers within the current system and components of an optimal model of care. Methods: Inductive content analysis was used to analyse 30 semi-structured interviews with key clinicians managing the care of children with complex mental health conditions across Australia. Interviews were conducted using vignettes with Attention Deficit Hyperactivity Disorder (ADHD) and Autism as exemplars. Findings: Multiple barriers to optimal care exist at a systemic, clinician and family level. However, regional health systems provide an enabling environment from which metropolitan models could learn. Transitioning to adult services was highlighted as the most compromised area of care. Clinicians identified short (e.g. empowering parents to advocate for and deliver their child’s care, case conferencing with schools) and long term (e.g. co-locating disciplines to deliver care, workforce training) solutions. Conclusions: Whilst multiple barriers to optimal care for children with complex mental health conditions exist, clinicians identify several enablers including developing networks with other disciplines and empowering parents to advocate for and co-ordinate care. Systemic changes based on multidisciplinary, co-located and integrated care services should be developed as longer term solutions. [ABSTRACT FROM AUTHOR]

We used a retrospective cohort study to measure the impact of caring for children on female Australian researchers. Our aim was to see whether caring for children was associated with reduced outputs and collaboration. Women were randomly selected for inclusion if they published a first author paper in one of three Australian journals during 2007 to 2015, women who did not publish during this time were not included. One-hundred and sixty women were approached and 95 (59%) completed a survey on their history of caring for children. Two key outcomes were the women's publication and citation counts, which were accessed from Scopus. We also examined the number of authors, affiliations and countries on their published papers, as a reduction in these numbers could indicate an impaired ability to collaborate. We examined the probability of being first or last author as a measure of esteem. There was a small increase in publication counts after the first child that was reversed after the second child. Average citations counts declined after children, particularly after the second child. There was some evidence of a reduced collaboration with overseas collaborators after the first child. The probability of being the last author increased after the second child. Three women were identified as statistically influential and all three had children and were in the top 10% of overall publications and citations. After removing these women the estimated changes in outcomes were noticeably different for most of the outcomes. The repeated presence of statistically influential women shows that it may be impossible to find an "average impact" of caring for children when considering research output. Adjustments may need to be made individually, with women explaining how caring for children has altered their career. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance represents one of the world's most pressing public health problems. Governments around the world have—and will continue to—develop policy proposals to deal with this problem. However, the capacity of government will be constrained by very low levels of trust in government. This stands in contrast to 'medical scientists' who are highly trusted by the public. This article tests to what extent trusted sources can alter attitudes towards a policy proposal to regulate the use of antibiotics. We find that respondents are much more likely to support a policy put forward by 'medical scientists.' This article provides some initial evidence that medical scientists could be used to gain support for policies to tackle pressing policy challenges such as AMR. [ABSTRACT FROM AUTHOR]

Background: The benefits of clinical supervision are more pronounced for health professionals in rural and remote areas. Most clinical supervision studies to date have occurred in metropolitan centres and have used the survey methodology to capture participant experiences. There is a lack of qualitative research that captures participants’ lived experiences with clinical supervision at the frontline. Methods: Participants were recruited from rural and remote sites of two Australian states using a purposive maximum variation sampling strategy. Data were collected through individual, semi-structured interviews with participants. Data were analysed using content analysis and themes were developed. Sixteen participants from six professions completed the interviews. Results: Eight themes were developed including the content of supervision, context of supervision, value of supervision, increased need for professional support and unique characteristics of rural and remote clinical supervision. Conclusions: This study has highlighted the value of clinical supervision for the rural and remote health professional workforce. Furthermore, it has shed light on the unique characteristics of clinical supervision in this population. This information can be used by organisations and health professionals to ensure clinical supervision partnerships are effective thereby enhancing rural and remote workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Background: The use of robotic-assisted surgery (RAS) is becoming increasingly prevalent across a range of surgical specialties within public hospitals around Australia. As a result, it is critical that organisations consider workplace factors such as staff knowledge, attitudes and behaviours prior to the implementation of such new technology. This study aimed to describe the knowledge and attitudes of operating theatre staff from a large public tertiary referral hospital prior to the commencement of an RAS program. Methods: A cross-sectional survey of nursing, medical and support staff working in the operating theatre complex of a large public tertiary referral hospital was completed over a one-week period in June 2016. A 23-item questionnaire was utilised for data collection. Results: 164 (66%) theatre staff returned the surveys and were included in this study. The majority of medical staff reported being knowledgeable about RAS, whilst the majority of nursing and support staff did not. Overall the theatre staff were neutral about the potential benefits of RAS to patients. The majority of medical staff believed the implementation of RAS will increase the value of staff roles and job satisfaction, while nursing and support staff were uncertain about these benefits. All three staff groups were concerned about the impact of an RAS program on Workplace Health and Safety, and care and handling. Conclusion: Operating theatre staff presented different knowledge and attitudes prior to the introduction of RAS. Whilst theatre staff were more favourable towards RAS than negative, they largely reserved their judgement about the new system prior to their own experiences. Collectively, these findings should be taken into consideration for training and support strategies prior to the implementation of a RAS program. [ABSTRACT FROM AUTHOR]

Although recently the internal structure of the non-supranuchal fossa of Homo sapiens has been described and compared to that observed in the Neandertal suprainiac fossa, until now it has not been examined in any modern human children. In this study, the internal structure of this fossa in the occipital bones of three children (two aged 3‒4 years and one aged 5 years ± 16 months) and one adult individual representing recent Homo sapiens from Australia was analysed and compared to that of the Neandertal suprainiac fossa. In order to analyse the internal composition of the fossae of the examined specimens, initially, high-resolution micro-CT datasets were obtained for their occipital bones; next, 3D topographic maps of the variation in thickness of structural layers of the occipital bones were made and 2D virtual sections in the median region of these fossae were prepared. In the fossa of one immature individual, the thinning of the diploic layer characteristic of a Neandertal suprainiac fossa was firmly diagnosed. The other Neandertal-like trait, concerning the lack of substantial thinning of the external table of the bone in the region of the fossa, was established in two individuals (one child and one adult) due to the observation of an irregular pattern of the thickness of this table in the other specimens, suggesting the presence of an inflammatory process. Our study presents, for the first time, Neandertal-like traits (but not the whole set of features that justifies the autapomorphic status of the Neandertal supraniac fossa) in the internal structure of non-supranuchal fossae of some recent Homo sapiens. We discuss the phylogenetic implications of the results of our analysis and stress the reasons that use of the 3D topographic mapping method is important for the correct diagnosis of Neandertal traits of the internal structure of occipital fossae. [ABSTRACT FROM AUTHOR]