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Aim To investigate the level of translation of the Australian Rugby Union 'Mayday' safety procedure into practice among community rugby union coaches in New South Wales (Australia). Methods All registered coaches of senior community rugby union teams in five zones/associations in the north-eastern region of the state were invited to complete a short online questionnaire at the end of the 2010 rugby season. The questionnaire was designed around the five RE-AIMdimensions and assessed: Reach, perceived Effectiveness, Adoption, Implementation and Maintenance of the Mayday procedure. Results Seventy (39%) coaches participated. There was a high level of awareness of the Mayday procedure, and most coaches believed it was effective in preventing injuries. The majority reported training their players in the procedure, although training was generally infrequent. Coaches were confident that their own players could implement the procedure appropriately if required to do so, but less confident that other teams or referees could do so. Barriers to providing training included not enough players at training, players not taking training seriously and technical difficulties (eg, verbalisation of instructions for physical tasks). Conclusion The findings suggest that the translation of the Mayday 'policy' could be improved by building individual coach, and club or zone organisational capacity by ensuring that coaches have the resources and skills in 'how' to train their players to complement their existing knowledge on 'what' to train them; setting expectations that encourage coaches to provide regular training for players; and regular monitoring of player competency to perform the procedure appropriately. [ABSTRACT FROM AUTHOR]

Purpose: To explore the views of healthcare professionals and patients about the advantages and disadvantages of rehabilitation in the home (RITH) for reconditioning, and identify factors that should contribute to the successful implementation of a consensus-based RITH model for reconditioning., Materials and Methods: Interviews with 24 healthcare professionals and 21 surveys (comprising Likert scale and free text responses) of inpatients undergoing rehabilitation for reconditioning provided study data. Interpretive thematic analysis was used to analyse interview data; descriptive statistics analysed Likert scale responses; patient written responses assisted with the interpretation of themes developed from the interview data., Results: Two major themes were elicited in this study: the home is a physical setting and the home is a lived space. Advantages and disadvantages of RITH for patients, carers and healthcare professionals were identified within these themes. Appropriate patient selection; effective communication with patients and carers, and within RITH teams; adequate patient and carer support; ensuring the safety of patients and staff; and education of patients, carers and healthcare professionals are essential for the satisfactory implementation of RITH., Conclusion: The concept of home shapes the delivery of RITH. Recognising the advantages and disadvantages of RITH highlights important considerations needed to successfully implement RITH for reconditioning.

Arts on prescription at home (AoP@Home) is a participatory art-based approach involving a professional artist engaging a person with dementia (and their family carer) in art-making in their own home. This study evaluated the implementation of AoP@Home within a real-world community aged care context. A hybrid effectiveness-implementation design was used to simultaneously test both the AoP@Home intervention and the implementation process. AoP@Home program outcomes included person with dementia and family carer (dyad) health and wellbeing, and personal goal attainment. Implementation outcomes were evaluated according to feasibility, fidelity, acceptability, uptake, and costs via routinely collected data, artist notes, and interviews with program managers, artists, and participant dyads. Four dyads completed an AoP@Home program during the study period. All participants with dementia reported improvements in their overall health and wellbeing, and wellbeing scores improved for all carers from baseline to post-program. Implementation was feasible using existing government funding mechanisms, and programs were acceptable to all stakeholders. It is possible to deliver participatory arts programs for community-dwelling people with dementia and their family, in their home, using sustainable and available funding models. Programs such as AoP@Home should be made more accessible alongside broader allied health and care services., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: At the time of funding application for this study, an AoP artist was included in the team as a research partner to support implementation through a collaborative partnership with the researchers. This artist research partner was included as an interview participant to ensure that all data were captured in this small-scale implementation feasibility study. While this artist research partner is an author on this paper and was involved in study design and manuscript review, they were not involved in interview analysis or interpretation of the results. This project was supported by an Implementing Research Evidence into Practice Grant from the former Dementia Centre for Research Collaboration of the NHMRC, and CMCOC is supported by a Dementia Centre for Research Collaboration Post-doctoral Fellowship. The authors report no other competing interests to declare.

Issue Addressed: This study explores experiences of people with dementia and family carers who participated in an Arts on Prescription at Home (AoP@Home) program, artists who delivered the AoP@Home program and the managers who coordinated the AoP@Home programs., Methods: Semi structured interviews were conducted with the three stakeholder groups to explore experiences around implementation of AoP@Home. Interview questions were specific to each stakeholder group, and designed to capture the varied experiences around coordinating, delivering and participating in AoP@Home programs when delivered as a standard service offering. Qualitative content analysis was applied to evaluate the transcripts., Results: A total of 13 stakeholders participated in interviews: four people living with dementia and four family carers, three artists and two AoP program managers. Three overarching themes emerged across the stakeholder groups: 'what worked well', 'challenges' and 'moving forward'., Conclusions: AoP@Home has potential as an important offering for community-dwelling people with dementia who may no longer be able to access group-based community programs. As AoP@Home is expanded, ongoing implementation monitoring and quality improvement will be essential to ensure maximal applicability of the program across the community aged care sector. SO WHAT?: The implementation of a new AoP@home service has been examined, and finds consumer satisfaction (person with dementia and their carer), and support from staff (artists and program managers). The novel nature of the service, however, requires considerable work to educate service referrers about the service and its benefits., (© 2024 The Author(s). Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Background: The number of older people experiencing homelessness in Australia is rising, yet there is a lack of specialised residential care for older people subject to homelessness with high care and palliative needs. To address this significant gap, a purpose-built care home was recently opened in Sydney, Australia., Methods: This qualitative study explores the experiences of both residents and staff who were living and working in the home over the first twelve months since its opening. Residents were interviewed at baseline (n = 32) and after six months (n = 22), while staff (n = 13) were interviewed after twelve months. Interviews were analysed using a reflexive thematic analysis approach informed by grounded theory., Results: Three main themes emerged: (1) Challenges in providing care for older people subject to homelessness with high care needs; (2) Defining a residential care service that supports older people subject to homelessness with high care needs, and (3) Perception of the impact of living and working in a purpose-built care home after six months (residents) and twelve months (staff) since its opening. A key finding was that of the complex interplay between resident dependency and behaviours, referral pathways and stakeholder engagement, government funding models and requirements, staff training and wellbeing, and the need to meet operational viability., Conclusion: This study provides novel insights into how the lives of older people subject to homelessness with high care needs are affected by living in a specifically designed care home, and on some of the challenges faced and solved by staff working in the care home. A significant gap in the healthcare system remains when it comes to the effective provision of high care for older people subject to homelessness., (© 2024. The Author(s).)

Background: Inpatient rehabilitation services are challenged by increasing demand. Where appropriate, a shift in service models towards more community-oriented approaches may improve efficiency. We aimed to estimate the hypothetical cost of delivering a consensus-based rehabilitation in the home (RITH) model as hospital substitution for patients requiring reconditioning following medical illness, surgery or treatment for cancer, compared to the cost of inpatient rehabilitation., Methods: Data were drawn from the following sources: the results of a Delphi survey with health professionals working in the field of rehabilitation in Australia; publicly available data and reports; and the expert opinion of the project team. Delphi survey data were analysed descriptively. The costing model was developed using assumptions based on the sources described above and was restricted to the Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) classes 4AR1 to 4AR4, which comprise around 73% of all reconditioning episodes in Australia. RITH cost modelling estimates were compared to the known cost of inpatient rehabilitation. Where weighted averages are provided, these were determined based on the modelled number of inpatient reconditioning episodes per annum that might be substitutable by RITH., Results: The cost modelling estimated the weighted average cost of a RITH reconditioning episode (which mirrors an inpatient reconditioning episode in intensity and duration) for AN-SNAP classes 4AR1 to 4AR4, to be A$11,371, which is 28.1% less than the equivalent weighted average public inpatient cost (of A$15,820). This represents hypothetical savings of A$4,449 per RITH reconditioning substituted episode of care., Conclusions: The hypothetical cost of a model of RITH which would provide patients with as comprehensive a rehabilitation service as received in inpatient rehabilitation, has been determined. Findings suggest potential cost savings to the public hospital sector. Future research should focus on trials which compare actual clinical and cost outcomes of RITH for patients in the reconditioning impairment category, to inpatient rehabilitation., (© 2024. The Author(s).)

Issue Addressed: Arts on Prescription at Home (AoP@Home) involves a professional artist visiting a person with dementia and their informal carer(s) in their own home to engage them in participatory art making. While there is evidence for the use of these programs, more work is needed to facilitate effective implementation. This study explored contextual barriers and enablers to implementation of AoP@Home within a real-world community aged care service., Methods: Two remote focus groups were conducted at a community aged care provider in Sydney, Australia. Key stakeholders (n = 14) were recruited, representing: people with dementia, informal (family) carers, AoP artists, service referrers and community service managers. Focus group transcripts were analysed using qualitative content analysis and mapped onto the Consolidated Framework for Implementation Research (CFIR). Outcomes were reviewed against the Expert Recommendations for Implementing Change (ERIC) strategy compilation to inform development of a tailored implementation strategy., Results: Four overarching themes described the range of barriers and enablers to AoP@Home implementation: (1) "I don't know enough about it" (awareness and engagement within the sector), (2) artists delivering programs, (3) awareness and engagement of people impacted by dementia, (4) practicalities of implementation. All five domains of the CFIR were represented across the four themes. The ERIC compilation provided a list of practical strategies for implementation of AoP@Home., Conclusions: The implementation of psychosocial interventions for people living with dementia within a community aged care service is complex and multifactorial. So what?: Organisations planning implementation should consider conducting their own pre-implementation analysis to identify context-specific strategies., (© 2023 Australian Health Promotion Association.)

Few studies have investigated the experience of male carers of people with dementia and fewer specifically examined whether male and female carers of people with dementia differ in their approach to the caring role. As such, this research set-out to investigate whether male carers of people with dementia approach the caring role differently to female carers. Data from 167 survey participants (24 males and 143 females) were analysed using a mixed research methodology. Participants' demographics and scores on standardised burden and coping scales were analysed using linear regression. Participants' written responses to open-ended questions were analysed using thematic analysis anchored in theories of hegemonic masculinity. No significant gender differences were identified in carers' coping strategies or self-reported carer burden. However, qualitative analysis revealed strong thematic gender differences like: gendered barriers to help-seeking; gendered service preference; gendered considerations about residential care; gendered expression of burden; and themes of the absent son and exhausted daughter. This research identified that male carers of people with dementia approach help-seeking differently to female carers, typically focusing on addressing functional tasks and refraining from showing emotions, this despite reporting similar carer burden. Rapport building with male carers should start with conversations around functional issues rather than assessing the emotional impact of the caring role. The findings reinforce the need for more qualitative research into the unmet needs of male carers of people with dementia, to inform the design of male-friendly interventions which could facilitate timely access to services by male carers., Competing Interests: Declaration of Conflicting InterestsThe first author Vincent O. Poisson (VOP) works in a management role at Dementia Australia (DA). This online survey was posted on the Research webpage of the DA website and therefore, some participants might have been clients of DA and potentially previously been in contact with the first author. However, participation was voluntary and anonymous, and all participants were clearly guided to read the Participant’s Information and Consent form (which detailed the conflict of interest) prior to starting the survey. Dr. Claire M.C. O’Connor is a recipient of a Dementia Centre for Research Collaboration (DCRC) Post-doctoral Fellowship (2022-26). The authors report no other conflicts of interest.

Background: Older people subject to homelessness face many challenges including poor health status, geriatric syndromes, and depression, coupled with barriers in accessing health and aged care services. Many are in need of formal aged care at a younger age than the general population, yet, in Australia, specialised aged-care services to support this vulnerable cohort are limited., Methods: This study was an evaluation of a new purpose-built aged care home for people with high care needs and who are homeless or at risk of homelessness. Over the first 12 months post-admission, the study examined: (1) changes in residents' physical, mental, psychological and social health, and (2) the costs incurred by the study cohort, including any cost benefit derived., Results: Thirty-five residents enrolled in the study between March 2020 - April 2021. At admission, almost half of residents were within the range for dementia, the majority were frail, at high risk for falls, and had scores indicative of depression. Over time, linear mixed-effect models showed significant improvement in personal wellbeing scores, with clinically significant improvements in overall health related quality of life. Levels of physical functional independence, frailty, and global cognition were stable, but cognitive functional ability declined over time. Comparison of 12 month pre- and post- admission cost utility data for a smaller cohort (n = 13) for whom complete data were available, suggested an average per resident saving of approximately AU$32,000, while the QALY indicators remained stable post-admission., Conclusion: While this was a small study with no control group, these preliminary positive outcomes add to the growing body of evidence that supports the need for dedicated services to support older people subject to homelessness., (© 2023. The Author(s).)

Background: Reconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning., Methods: A multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses., Results: One-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each., Conclusions: Strong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed., (© 2023. The Author(s).)

Lesbian, gay, bisexual, transgender and gender diverse people, and queer people (LGBTQ people) are at increased risk of some chronic diseases and cancers. NSW Health palliative care health policy prioritises equitable access to quality care, however, little is known about community members' perspectives on palliative care. This study aimed to understand LGBTQ community views and preferences in palliative care in NSW. A community survey and follow-up interviews with LGBTQ people in NSW were conducted in mid-2020. A total of 419 people responded to the survey, with 222 completing it. Six semi-structured phone interviews were conducted with participants who volunteered for follow-up. The sample included LGBTQ people with varied levels of experience in palliative care. Thematic analysis was conducted on survey and interview data, to identify perceived barriers and enablers, and situate these factors in the socio-ecological model of health. Some perceived barriers from community members related to considering whether to be 'out' (i.e., making one's sexual orientation and gender known to services), knowledge and attitudes of staff, concern about potential substandard care or mistreatment (particularly for transgender health), decision making, biological family as a source of tension, and loneliness and isolation. Perceived enablers related to developing and distributing inclusive palliative care information, engaging with community(ies), fostering inclusive and non-discriminatory service delivery, ensuring respectful approaches to person-centred care, and staff training on and awareness building of LGBTQ needs and issues. Most of the participants who had experienced palliative care recounted positive interactions, however, we identified that LGBTQ people require better access to knowledgeable and supportive services. Palliative care information should be inclusive and services respectful and welcoming. Particular consideration should be given to how services respond to and engage with people from diverse population groups. These insights can support ongoing policy and service development activities to further enhance palliative care., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

Purpose: Reablement is a strategy recommended in clinical practice guidelines that could maximise functioning and quality of life in people living with dementia. This project sought to develop a practical handbook for health professionals illustrating the best, currently available evidence via newly-developed composite reablement programs., Materials and Methods: Handbook development occurred over five phases, informed by Normalisation Process Theory: (1) literature review, (2) sector interviews to explore how handbook implementation may impact practice, (3) workshop to determine final handbook content, (4) reablement program synthesis and handbook development, and (5) dissemination and implementation planning to support optimal uptake and normalisation within the sector., Results: Interviews ( n  = 22) identified sector support for development of the reablement handbook. Workshop ( n  = 24 participants) outcomes informed the final eight reablement programs sorted by functional outcomes (everyday living activities; mobility and physical function; and cognition and communication). A technical guide and consumer information booklet were developed to support the handbook. A comprehensive handbook implementation plan involving dynamic assessment and monitoring was developed., Conclusions: The reablement handbook provides a practical and accessible avenue to support function in people with dementia. Robust, coordinated dissemination, implementation and assessment of the new resource across a range of practice settings is now required.Implications for rehabilitationDementia leads to disability and dependence, impacting the person with dementia, their family and society.Reablement, an approach consistent with rehabilitation, is a strategy recommended in clinical practice guidelines that could maximise functional performance and quality of life in people living with dementia.This study describes development of a freely available evidence-informed reablement handbook designed to support delivery of high-quality reablement programs by allied health/nursing professionals for people living with dementia.Outcomes have potential to inform future implementation work and to ultimately improve the quality of services offered within the dementia sector.

Falls among older people are highly prevalent, serious and costly, and translation of evidence about falls prevention needs to occur urgently. GPs can identify older people at risk of falling and put preventative measures in place before a fall. Because GPs are key to identifying older people at risk of falls and managing falls risk, this study explored how GPs adapted to the iSOLVE (Integrated SOLutions for sustainable falls preVEntion) process to embed evidence-based falls prevention strategies within primary care, and whether and how they changed their practice. A theoretically informed qualitative study using normalisation process theory was conducted in parallel to the iSOLVE trial to elicit GPs' views about the iSOLVE process. Data were coded and a thematic analysis of interview transcripts was conducted using constant comparison between the data and themes as they developed. In all, 24 of 32 eligible GPs (75%) from general practices located in the North Sydney Primary Health Network, Australia, were interviewed. Six themes were identified: (1) making it easy to ask the iSOLVE questions; (2) internalising the process; (3) integrating the iSOLVE into routine practice; (4) addressing assumptions about patients and fall prevention; (5) the degree of change in practice; and (6) contextual issues influencing uptake. The iSOLVE project focused on practice change, and the present study indicates that practice change is possible. How GPs addressed falls prevention in their practice determined the translation of evidence into everyday practice. Support tools for falls prevention must meet the needs of GPs and help with decision making and referral. Fall prevention can be integrated into routine GP practice through the iSOLVE process to tailor fall risk management.

Appropriately skilled staff are required to meet the health and care needs of aging populations yet, shared competencies for the workforce are lacking. This study aimed to develop multidisciplinary core competencies for health and aged care workers in Australia through a scoping review and Delphi survey. The scoping review identified 28 records which were synthesized through thematic analysis into draft domains and measurable competencies. Consensus was sought from experts over two Delphi rounds (n = 111 invited; n = 59 round one; n = 42 round two). Ten domains with 66 core competencies, to be interpreted and applied according to the worker's scope of practice were finalized. Consensus on multidisciplinary core competencies which are inclusive of a broad range of registered health professionals and unregistered aged care workers was achieved. Shared knowledge, attitudes, and skills across the workforce may improve the standard and coordination of person-centered, integrated care for older Australians from diverse backgrounds.

National strategies to prevent sports injuries can potentially improve health outcomes at a population level and reduce medical costs. To date, a compilation of the strategies that countries have attempted, and their effectiveness, does not exist. This scoping review sets out to: identify nationwide attempts at implementing sports injury prevention strategies; examine the impact of these strategies; and map them onto the Translating Research into Injury Prevention Practice (TRIPP) framework. Using Levac's scoping review method, we: (a) identified the research questions, (b) identified relevant studies, (c) identified the study selection criteria, (d) charted the data, and (e) reported the results. A search of MEDLINE, Scopus, SPORTDiscus, CINAHL, and Web of Science databases for articles published pre-June 2019 was conducted. We identified 1794 studies and included 33 studies (of 24 strategies). The USA (n = 7), New Zealand (n = 4), Canada (n = 3), the Netherlands (n = 3), Switzerland (n = 2), Belgium (n = 1), France (n = 1), Ireland (n = 1), South Africa (n = 1), and Sweden (n = 1) have implemented nationwide sports injury prevention strategies with 29 (88%) of the included studies demonstrating positive results. Mapping the strategies onto the TRIPP framework highlighted that only four (17%) of the 24 included strategies reported on the implementation context (TRIPP Stage 5), suggesting an important reporting gap. Nationwide sports injury prevention efforts are complex, requiring a multidimensional approach. Future research should report intervention implementation data; examine the implementation context early in the research process to increase the likelihood of real-world implementation success; and could benefit from incorporating qualitative or mixed research methods., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Reablement has potential for enhancing function and independence in people with dementia. In order to enhance the use of evidence-based reablement in this population, this study sought to understand the current practices and needs of the sector around these interventions., Methods: A purposive sample of 22 Australian aged and community-care providers participated in a semi-structured interview. Qualitative content analysis was applied to the data, with key themes interpreted within the context of the study aims: to explore (1) what reablement interventions are currently being offered to people living with dementia in Australia, and (2) what are key factors that will contribute to enhanced uptake of reablement interventions in dementia practice., Results: Four themes emerged: (1) 'what reablement interventions are being offered', outlined a range of exercise and cognitive/social interventions, with only a proportion generated from a clear evidence-base, (2) 'what's in a name', illustrated the range of terms used to describe reablement, (3) 'whose role is it', highlighted the confusion around the range of health professionals involved in providing reablement interventions, and (4) 'perceived barriers and enablers to providing reablement to people living with dementia', described a range of factors that both hinder and support current reablement practice., Conclusions: Reablement interventions currently provided for people living with dementia in Australia are variable, with confusion around the definition of reablement, and apparently limited use of evidence-informed interventions. A multifaceted approach involving an evidence-informed and freely-accessible resource, and taking into account the varied levels of influence within the aged care sector would support uptake and implementation of reablement interventions for people living with dementia.

Active transport, including cycling, is promoted as an effective way of increasing children's physical activity and health. Parents can support children's riding by riding with them and it is important to address relevant safety issues. Little is known about parents' experience of safety-relevant aspects of riding with children. Participants in the Safer Cycling Study in New South Wales, Australia, who reported that they had ridden with children in the last 12 months were questioned about how they ride with children, and their experience of safety issues and crashes. Among the 187 respondents who had ridden with children on their bicycle, the most common form of carrier was a rear-mounted seat (48%) followed by a trailer (29%). Many respondents (79%) identified risks specific to riding carrying children, including those linked with specific carrier types and with use of footpaths. Most (92%) indicated that they change their behaviour when carrying a child on their bicycle; for example, riding more slowly, more carefully, and away from roads. Among crashes with a child on the bicycle, most were falls. Among the 345 participants who had ridden to accompany a child on a bicycle, approximately three quarters identified risks specific to accompanying children, such as managing the child's limited skill, awareness and predictability. Ninety-seven percent reported behavioural changes including positioning themselves as a barrier for their child and caution crossing roads. Findings suggest strategies to support parents in riding safely with children., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: There is growing international interest in maximising the functional ability of older people., Objective: The aim of this article is to discuss 'reablement' and 'restorative care' in the context of providing a function-focused approach in primary care to address the needs of older people with functional decline., Discussion: Loss of functional ability can profoundly affect an older person and is often what prompts them to seek healthcare. The emergence of reablement and restorative care is a welcome development in policy. Reablement and restorative care are discussed in relation to current Australian Government-funded programs. These programs increase the availability of multidisciplinary services in community settings and support general practitioners (GPs) to take a comprehensive, 'function-focused' approach to the management of functional decline. GPs are important to identify and refer older people likely to benefit, and they play an essential part in effective program delivery.

Published evidence for the role of participatory art in supporting health and well-being is growing. The Arts on Prescription model is one vehicle by which participatory art can be delivered. Much of the focus of Arts on Prescription has been on the provision of creative activities for people with mental health needs. This Arts on Prescription program, however, targeted community-dwelling older people with a wide range of health and wellness needs. Older people were referred to the program by their healthcare practitioner. Professional artists led courses in visual arts, photography, dance and movement, drama, singing, or music. Classes were held weekly for 8-10 weeks, with six to eight participants per class, and culminated with a showing of work or a performance. Program evaluation involved pre- and postcourse questionnaires, and focus groups and individual interviews. Evaluation data on 127 participants aged 65 years and older were available for analysis. We found that Arts on Prescription had a positive impact on participants. Quantitative findings revealed a statistically significant improvement in the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) as well as a statistically significant increase in the level of self-reported creativity and frequency of creative activities. Qualitative findings indicated that the program provided challenging artistic activities which created a sense of purpose and direction, enabled personal growth and achievement, and empowered participants, in a setting which fostered the development of meaningful relationships with others. This evaluation adds to the evidence base in support of Arts on Prescription by expanding the application of the model to older people with a diverse range of health and wellness needs., (© 2018 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.)

Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs). An evaluation of the service was undertaken, focussing on the self-reported impact of the service on family carers (FCs), with triangulation of findings from community palliative care teams and CCWs. Service evaluation data were obtained through postal surveys and/or qualitative interviews with FCs, community palliative care teams and CCWs. FCs also reported the experience of their loved one based on 10 items drawn from the Quality of Death and Dying Questionnaire (QODD). Thematic analysis of surveys and interviews found that the support provided by CCWs was valued by FCs for: enabling choice (i.e. to realise end-of-life care in the home); providing practical assistance ("hands-on"); and for emotional support and reassurance. This was corroborated by community palliative care teams and CCWs. Responses by FCs on the QODD items indicated that in the last week of life, effective control of symptoms was occurring and quality of life was being maintained. This study suggests that satisfactory outcomes for patients and their families who wish to have end-of-life care in the home can be enabled with the additional support of specially trained CCWs. A notable benefit of the PCHSP model, which provided specific palliative care vocational training to an existing community care workforce, was a relatively rapid increase in the palliative care workforce across the state., (© 2017 John Wiley & Sons Ltd.)

As society grapples with an aging population and increasing prevalence of disability, "reablement" as a means of maximizing functional ability in older people is emerging as a potential strategy to help promote independence. Reablement offers an approach to mitigate the impact of dementia on function and independence. This article presents a comprehensive reablement approach across seven domains for the person living with mild-to-moderate dementia. Domains include assessment and medical management, cognitive disability, physical function, acute injury or illness, assistive technology, supportive care, and caregiver support. In the absence of a cure or ability to significantly modify the course of the disease, the message for policy makers, practitioners, families, and persons with dementia needs to be "living well with dementia", with a focus on maintaining function for as long as possible, regaining lost function when there is the potential to do so, and adapting to lost function that cannot be regained. Service delivery and care of persons with dementia must be reoriented such that evidence-based reablement approaches are integrated into routine care across all sectors.

This paper investigates events in which cyclists perceive a cycling crash is narrowly avoided (henceforth, a near miss). A cohort of 2038 adult transport and recreational cyclists from New South Wales (Australia) provided self-reported prospectively collected data from cycling diaries to allow the calculation of an exposure-based rate of near misses and investigation of near miss circumstances. During 25,971days of cycling, 3437 near misses were reported. For a given time cycling, cyclists who rode mainly for transport (compared with those who rode mainly for recreation), and cyclists with less experience (compared to those with more experience) were more likely to report a near miss; older cyclists (60+ years) were less likely to report a near miss than younger cyclists (25-59 years). Where type of near miss was recorded, 72.0% involved motor vehicles, 10.9% involved pedestrians and 6.9% involved other cyclists. Results indicate some similarities between near misses and crashes reported by this cohort during the same reporting period. A bias toward reporting near misses with motor vehicles was suggested, which likely reflects cyclists' perceptions that crashes involving motor vehicles are particularly serious, and highlights their impact on perceived safety. Given the relative rarity of crashes, and the limited breadth and depth of administrative data, collection of near miss data may contribute to our understanding of cycling safety by increasing the volume and detail of information available for analysis. Addressing the causes of near misses may offer an opportunity to improve both perceived and actual safety for cyclists., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher's exact test. The vast majority (81.5%) of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9) per athlete-year, 11.8 (95% CI: 10.4, 13.4) per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9) per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3%) of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo.

This paper examines self-reported retrospective data for a 12 month period from 2038 adult cyclists from New South Wales (Australia), and compares cyclists according to whether they self-identify as riding mainly for transport or mainly for recreation. Statistically significant differences were found in the demographic characteristics, cycling patterns, and crash experiences between these two groups of cyclists. Transport cyclists tended to be younger, travel more days per week, and within morning and evening peak hours than recreational cyclists; recreational cyclists were more likely to identify fitness as a purpose for cycling. The proportion of cyclists experiencing a crash or crash-related injury in the previous 12 months was similar for transport and recreational cyclists, but there were differences in crash types and location which likely reflect different cycling environments. Heterogeneity within transport and recreational cyclists was also found, based on self-reported riding intensity. An understanding of the different cycling patterns and experiences of various types of cyclists is useful to inform road safety, transport and health promotion policy., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This paper examines self-reported prospectively collected data from 2038 adult transport and recreational cyclists from New South Wales (Australia) to determine exposure-based incident crash and injury rates. During 25,971 days of cycling, 198 crashes were reported, comprising approximately equal numbers of falls and collisions. The overall crash rate was 0.290 (95% CI, 0.264-0.319) per 1000km or 6.06 (95% CI, 5.52-6.65) per 1000h of travel. The rate of crashes causing any injury (self-treated, or medically attended without overnight hospital stay) was 0.148 (95% CI, 0.133-0.164) per 1000km or 3.09 (95% CI, 2.79-3.43) per 1000h of travel. The rate of crashes causing a medically attended injury (without overnight hospital stay) was 0.023 (95% CI, 0.020-0.027) per 1000km or 0.49 (95% CI, 0.43-0.56) per 1000h of travel. No injuries requiring an overnight stay in hospital were reported on days meeting the inclusion criteria. After adjustment for exposure in hours, or for the risks associated with different infrastructure utilisation, the rates of crashes and medically attended injuries were found to be greater for females than males, less experienced than more experienced cyclists, and for those who rode mainly for transport rather than mainly for recreation. Comparison of estimated crash and injury rates on different infrastructure types were limited by the small number of events, however findings suggest that the separation of cyclists from motorised traffic is by itself not sufficient to ensure safe cycling., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: To determine the level of adherence by transport cyclists to road rules in traffic situations and their reasons for non-adherence., Design: The Safer Cycling Study was a prospective cohort study of transport and recreational cyclists. Over 2000 cyclists were recruited between March and November 2011., Subjects and Setting: 770 Transport cyclists aged 18 years and older, who lived in New South Wales, Australia. Participants completed a baseline questionnaire plus provided data during a further six survey weeks over 12 months. In one of their survey weeks, cyclists were asked how often they infringed road rules and what contributory factors led to their road rule infringement. Data were collected via web-based online questionnaires., Methods: Quantitative data were analysed descriptively. Qualitative data were analysed to identify themes derived from the text., Results: Riding on the footpath and red light infringement were the most commonly reported road rule breaches. Poor infrastructure design was the most frequently identified contributing factor to road rule breaches, followed by the speed of motorised traffic and the behaviour of other road users., Conclusions: A transport network needs to facilitate cyclists of all capabilities to reach their required destination in a safe and timely manner, and encourage compliance with the road rules., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objectives: The "Mayday Safety Procedure" (MSP) is included in the Australian Rugby Union (ARU) Medical and Safety Recommendations and the mandatory SmartRugby training for coaches. Previous research indicates that translating the Mayday Safety Procedure into practice among community rugby coaches is challenging. This study investigated whether Mayday Safety Procedure translation could be enhanced by systematically planning and implementing a range of theory-informed and context-specific diffusion strategies., Design: A controlled before-and-after study., Methods: Coaches of senior community rugby teams in five zones in New South Wales (Australia) were invited to complete a questionnaire about their Mayday Safety Procedure knowledge and practice at the end of the 2010 and 2011 rugby seasons. During 2011, coaches in the intervention zone were exposed to a range of strategies to promote Mayday Safety Procedure diffusion which were planned by following Step 5 of the Intervention Mapping protocol. Coaches in the other four zones were exposed to usual strategies to promote Mayday Safety Procedure diffusion., Results: Using the RE-AIM evaluation framework, statistically significant improvements were found among intervention zone coaches in: knowledge of most Mayday Safety Procedure key criteria; the number of coaches recognising their zone policy requiring them to train players in the Mayday Safety Procedure; frequency of provision of Mayday Safety Procedure training to players; coach perceptions of the quality of Mayday Safety Procedure training for players; and in confidence that referees could implement the Mayday Safety Procedure during a game if required., Conclusions: The findings suggest that the translation of injury prevention policy into community practice can be enhanced by developing and implementing a theory-informed, context-specific diffusion plan, undertaken in partnership with key stakeholders., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: This paper describes the development of a theory-informed and evidence-informed, context-specific diffusion plan for the Mayday Safety Procedure (MSP) among community rugby coaches in regional New South Wales, Australia., Methods: Step 5 of Intervention Mapping was used to plan strategies to enhance MSP adoption and implementation., Results: Coaches were identified as the primary MSP adopters and implementers within a system including administrators, players and referees. A local advisory group was established to ensure context relevance. Performance objectives (eg, attend MSP training for coaches) and determinants of adoption and implementation behaviour (eg, knowledge, beliefs, skills and environment) were identified, informed by Social Cognitive Theory. Adoption and implementation matrices were developed and change-objectives for coaches were identified (eg, skills to deliver MSP training to players). Finally, intervention methods and specific strategies (eg, coach education, social marketing and policy and by-law development) were identified based on advisory group member experience, evidence of effective coach safety behaviour-change interventions and Diffusion of Innovations theory., Conclusions: This is the first published example of a systematic approach to plan injury prevention programme diffusion in community sports. The key strengths of this approach were an effective researcher-practitioner partnership; actively engaging local sports administrators; targeting specific behaviour determinants, informed by theory and evidence; and taking context-related practical strengths and constraints into consideration. The major challenges were the time involved in using a systematic diffusion planning approach for the first time; and finding a planning language that was acceptable and meaningful to researchers and practitioners.

Unlabelled: Routinely collected hospitalisation data are widely used to monitor injury trends, provide estimates of the burden of injury and healthcare costs, and to inform policy. This study examined the impact of different ICD-10 based case selection criteria commonly used by Australian and international reporting bodies on the number and nature of burn-related hospitalisations identified., Methods: Burn cases from a state-wide administrative hospitalisation dataset were identified and compared using three different case selection criteria: (1) principal diagnosis code of burn 'T20-T31', (2) first external cause code denoting burn 'X00-X19' and (3) both principal diagnosis code of community acquired injury 'S00-T98' and first external cause code denoting burn 'X00-X19'., Results: Principal diagnosis codes 'T20-T31' and first external cause codes 'X00-X19' identified a similar number of cases, however only 78% of these were captured by both definitions. Principal diagnosis codes identified chemical, electrical and contact burns not identified as burns using external cause codes. First external cause codes identified readmission cases which were not identified by principal diagnosis codes. Using principal diagnosis codes of community acquired injury combined with external cause code of burn under-numerated hospitalisations by forty percent., Conclusion: The development, implementation and evaluation of health policy and prevention measures rely on good quality, consistent data. Current methods for identifying burn cases in hospitalisation data provide wide differences in estimation of number and nature of cases. It is important for clinicians to understand the implications of coding on the epidemiology and measurement of the burden of burn., (Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.)

In 2006, New South Wales (NSW) state legislation changed from requiring smoke alarms in new houses only to all houses. We evaluated the impact of this legislative change on residential fire injury and smoke alarm ownership characteristics. Residential fire injuries for 2002 to 2010 were identified from hospitalization data for all hospitals in NSW. Data relating to smoke alarm ownership and demographic factors were obtained from the NSW Population Health Survey. Negative binomial regression analysis was used to analyze trends over time. Prior to the introduction of universal legislation, hospitalization rates were increasing slightly; however, following the introduction of legislation, hospitalization rates decreased by an estimated 36.2% (95% confidence interval [CI], 16.7-55.8) annually. Smoke alarm ownership increased from 73.3% (95% CI, 72.5-74.2) prelegislation to 93.6% (95% CI, 93.1-94.2) 18 months postlegislation. Thirty percent of households reported testing their alarms regularly. Speaking a language other than English (relative risks [RRs], 1.82; 95% CI, 1.44-2.99), allowing smoking in the home (RR, 1.73; 95% CI, 1.31-2.27), and being part of the most disadvantaged socioeconomic group (RR, 1.47; 95% CI, 1.14-1.91) remain major risk factors for nonownership. Broadening the scope of state legislation has had a positive impact on residential fire-related hospitalizations and smoke alarm ownership. However, it is of concern that the legislation has been the least effective in increasing smoke alarm ownership among non-English-speaking households, in households where smoking is allowed, in low socioeconomic households, and that a high proportion of householders do not test their smoke alarms regularly. Targeted campaigns are needed to reach these high-risk groups and to ensure that smoke alarms are functional.

Background/aim: The main purposes of this study were to determine the injury incidence and severity in Australian amateur taekwondo athletes, and to investigate potential risk factors for injury in competition taekwondo., Methods: Data were collected at New South Wales State Championships in 2010 and 2011. Injuries were diagnosed by onsite sports medicine personnel and the actual number of days lost from full participation was used to determine injury severity. Injury incidence rates were calculated per 1000 athlete-exposures (injury incidence rate (IIRAE)) and per 1000 min of exposure (IIRME) and presented with 95% CI., Results: The overall IIRAE and IIRME were 59.93 (95% CI 51.16 to 69.77) and 16.32 (95% CI 13.93 to 19.00), respectively. Children under 10 years had significantly lower IIRAE compared with older age groups and black belts had significantly higher IIRAE compared with yellow belts, however, after accounting for the exposure time it was revealed that 10-year-olds to 14-year-olds and red belts incurred higher IIRME. This study highlights the importance of including IIRs that account for exposure-time. In contrast with previous estimates, the current data indicated that one-third of injuries were moderate to severe. Relative to other body regions the upper limb had a higher proportion of moderate-to-severe injuries, and compared with the lower limb there was a disproportionate number of upper limb injuries resulting in fractures., Conclusions: The findings suggest that the impact of injury on taekwondo athletes is significant, and should serve as an impetus to stakeholders to develop and implement injury prevention activities within the sport.

Objectives: Pedestrian and pedal cycle injuries are important causes of child morbidity and mortality. The combination of Bayesian methods and geographical distribution maps may assist public health practitioners to identify communities at high risk of injury., Methods: Data were obtained on all hospitalizations of children from NSW (Australia), for pedestrian and pedal cycle injuries, from 2000-2001 to 2004-2005. Using Bayesian methods, posterior expected rate ratios (as an estimate of smoothed standardized hospitalization ratios for each injury mechanism) were mapped by local government area (LGA) across the state., Results: There were over 7,000 hospitalizations for pedestrian and pedal cycle injuries. High risk LGAs accounted for more than one third of hospitalized pedestrian and pedal cycle injuries in NSW., Conclusions: LGAs at high risk for pedestrian injury tended to be urbanized metropolitan areas with a high population density, while high risk LGAs for pedal cycle injury tended to be either in urban regional areas, or on the margin of urbanized metropolitan areas. Geospatial analyses can assist policymakers and practitioners to identify high risk communities for which public health interventions can be prioritized.

Introduction: There are clear personal, social and environmental benefits of cycling. However, safety concerns are among the frequently cited barriers to cycling. In Australia, there are no exposure-based measures of the rates of crash or 'near miss' experienced by cyclists., Design and Setting: A prospective cohort study over 12 months, with all data collected via web-based online data entry., Participants: Two thousand adults aged 18 years and older, living in New South Wales (Australia), who usually bicycle at least once a month, will be recruited from March to November 2011., Methods: In the 12 months following enrolment, cyclists will be surveyed on six occasions (weeks 8, 16, 24, 32, 40 and 48 from the week of the enrolment survey). In these survey weeks, cyclists will be asked to provide daily reports of distance travelled; time, location and duration of trips; infrastructure used; crashes, near misses and crash-related injuries. Information on crashes and injuries will also be sought for the intervening period between the last and current survey. A subsample of participants will receive bicycle trip computers to provide objective measurement of distance travelled., Discussion: This study protocol describes the prospective cohort study developed to assess near misses, crashes and injuries among cyclists by time and distance travelled and by type of infrastructure used, with recruited participants entering data remotely using the internet. We expect to be able to calculate event rates according to exposure overall and for different infrastructure types and to report in-depth information about event causation.

Sports injuries are an important public health issue. A multi-agency key stakeholder partnership was formed to develop a state-wide response to sports injury prevention in New South Wales, Australia. This study evaluated the partnership approach to injury prevention policy development. The partnership approach to policy development was evaluated pre- and post-partnership using semi-structured telephone interviews and questionnaire data gathered from participants. Participants were satisfied with the partnership operation and outcomes. Challenges included: maintaining focus and efficiency; time constraints; sector diversity limiting the likelihood of addressing needs and reaching consensus; and ensuring commitment from all relevant organisations. Potential benefits included: a sense of policy ownership; a broad-based approach across the sector and savings from resource sharing. Policy resulted from a shared understanding of the injury problem, and of an appropriate response. A credible industry leader, investment in partnership management and a consultative approach facilitated the success of the partnership.

Objective: To determine the current level of knowledge of first aid for a burn injury and sources of this knowledge among the general population of New South Wales., Design, Setting and Participants: People aged 16 years or older were interviewed as part of the 2007 NSW Population Health Survey, a continuous telephone survey of NSW residents., Main Outcome Measure: Weighted proportion of the population with optimal first aid knowledge for burns., Results: In total, 7320 respondents were asked questions related to burn injuries and first aid. Of the surveyed population, 82% reported that they would cool a burn with water, and 9% reported that they would cool the burn for the recommended 20 minutes. Few respondents reported that they would remove the patient's clothing and keep the injured person warm. The most common sources of first aid information were a first aid book (42%) and the internet (33%). Speaking a language other than English at home, and being over 65 years of age were associated with a lack of first aid knowledge., Conclusions: A minority of people living in NSW know the optimal time for cooling a burn injury and other appropriate first aid steps for burns. This study demonstrates a gap in the public's knowledge, especially among non-English speaking people and older people, and highlights the need for a clear, consistent first aid message.

Regulations to restrict the temperature of domestic hot tap water were introduced in NSW in 1999. This study investigates the impact of the regulations on the knowledge, attitude and practice of workforce professionals responsible for their uptake and enforcement. Telephone surveys were conducted with a random sample of 110 plumbers and 30 regulating authorities. Surveys were recorded, transcribed and coded. Written questionnaires were completed by 151 plumbing students. The regulations are well known and supported by the majority of plumbers, students and regulators; however 75% of plumbers reported customer dissatisfaction with them. Only a minority of plumbers (11%), students (7%) and regulators (27%) correctly appreciated the impact of a decrease in water temperature in reducing burns. This study identifies the need to improve plumbers and students' understanding of the safety issues underlying the regulations in order to promote more effective advocacy for homes not currently covered by the regulations, and to provide more public education to increase acceptance of them. As only houses built or substantially renovated after June 1999 are likely to have been impacted by the current regulations, there is a need to increase the scope of the regulations to include not only new installations, but also the replacement of existing heated water units if the goal of universal protection is to be achieved., (Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.)

Routine screening for intimate partner violence (IPV) has been widely introduced in health settings, yet screening rates are often low. A screening policy was introduced statewide in Australia in antenatal, mental health, and substance abuse services. Annual snapshot indicates a sustained screening rate of 62%-75% since 2003. Focus group research with health care workers from 10 services found that initial introduction of screening was facilitated by brief, scripted questions embedded into assessment schedules, training, and access to referral services. Over time, familiarity and women's favorable reactions reinforced practice. Barriers remain, including lack of privacy, tensions about limited confidentiality, and frustration when women remain unsafe. Screening added to the complexity of work, but was well accepted by workers, and increased awareness of and responsiveness to IPV.

Routine screening of women for intimate partner violence (IPV) has been introduced in many health settings to improve identification and responsiveness to hidden abuse. This cross-sectional study aimed to understand more about how women use screening programmes to disclose and access information and services. It follows women screened in ten Australian health care settings, covering antenatal, drug and alcohol and mental health services. Two samples of women were surveyed between March 2007 and July 2008; those who reported abuse during screening 6 months previously (122) and those who did not report abuse at that time (241). Twenty-three per cent (27/120) of women who reported abuse on screening were revealing this for the first time to any other person. Of those who screened negative, 14% (34/240) had experienced recent or current abuse, but chose not to disclose this when screened. The main reasons for not telling were: not considering the abuse serious enough, fear of the offender finding out and not feeling comfortable with the health worker. Just over half of both the positive and negative screened groups received written information about IPV and 35% of the positive group accessed further services. The findings highlight the fact that much abuse remains hidden and that active efforts are required to make it possible for women to talk about their experiences and seek help. Screening programmes, particularly those with established protocols for asking and referral, offer opportunities for women to disclose abuse and receive further intervention., (© 2010 Blackwell Publishing Ltd.)

Scalds from hot tap water are serious injuries that are potentially preventable by restricting the temperature of hot tap water delivery. In July 1999, regulations were introduced in NSW to require that all new hot water installations deliver water at temperatures not exceeding 50 degrees C to sanitary fixtures. This study investigates trends in hot tap water scald injury hospitalisations following the introduction of these regulations. Hot tap water scald cases for 1999-2007 were identified from hospitalisation data for all public and private hospitals in NSW. To investigate hot tap water scald hospitalisations over time, negative binomial regression analysis was performed. There were 845 hospitalisations for hot tap water scalds in NSW over the period of the study. Hospital admission rates for hot tap water scalds decreased by an estimated 6% (3.2-8.5, 95%CI) per year since the introduction of regulations. While those most at risk were infants, toddlers and the elderly, almost a third of hospitalisations were for adults (25-64 years). The majority of hot tap water scalds were sustained at home and a further 4% occurred in a residential institute or school. The majority of scalds were severe, and a quarter required admission for longer than a week. The introduction of regulations in NSW appears to have had a positive impact on the rates of hospitalisations for hot tap water scalds; however, scalds continue to cause significant morbidity and mortality. This highlights the need for a review of the scope and implementation of the existing regulations and ongoing education of the general public to the dangers of hot tap water., (2009 Elsevier Ltd and ISBI. All rights reserved.)

Objectives: To determine acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A (HAV) and B (HBV) in persons subject to homelessness., Methods: A convenience sample of clients (n=201) attending a medical clinic for homeless and disadvantaged persons in Sydney was enrolled. Serological screening for HAV and HBV was undertaken. An appropriate vaccination program was instituted. Post-vaccination serology determined serological response., Results: Although many clients had serological evidence of past infection, at least 138 (69%) clients had the potential to benefit from vaccination. For hepatitis A and B vaccinations, completion rates were 73% (73 of 100 clients) and 75% (69 of 92 clients), respectively; after vaccination, protective antibody was found in 98.2% (56 of 57) and 72% (36 of 50) of clients, respectively., Conclusion: A successful vaccination program can be mounted with a vulnerable population. We consider a clinic with a well-established history of acceptance and utilisation by the target group; a low staff turnover and regular clientele; inclusion of vaccination as part of routine client care; and counselling (part of pre- and post-serological testing) essential components in achieving good vaccination completion rates., (© 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.)

This evaluative study measured self-reported changes in abuse-related measures six months after routine screening for intimate partner violence. Participants were 122 women who disclosed abuse and 241 who did not report abuse, screened in antenatal, substance abuse, and mental health services according to an existing standardized protocol used in New South Wales, Australia. Six months after initial screening, abused women were more likely to report increased agreement with a number of attitudes relating to abuse, in particular that being hurt by a partner affects a woman's health and that health services should ask about abuse. The proportion reporting current abuse was significantly lower after six months. While 6% (7/119) reported negative emotional reactions, 34% (41/120) reported useful effects-most frequently re-evaluating their situation and reducing isolation. Women who had experienced abuse, but elected not to disclose it reported similar effects. The results of this study lend support to the use of protocols for asking about abuse and responding to disclosures of abuse.