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Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

This article describes the experiences of teaching undergraduate psychology students in an Australian context. The degree course the students take has no community or critical units, but it is one of very few in Australia that has a compulsory standalone unit in qualitative methods. While qualitative methods are by no means necessarily inherently critical or community focused, it has presented an opportunity to the teachers of the unit (the authors of this paper). The authors of this paper, who employ community critical methodologies in their research, aim to design teaching which is also grounded in such theory, wherever possible and despite significant limitations. Such teaching is informed by: challenging taken for granted assumptions; deconstruction and problem posing; making things uncomfortable; and relating differently. The paper describes a design of teaching where all the students undertake research projects exploring the research question: "what does psychology offer community?" Following a description of the methodologies and teaching practices, the authors reflect subjectively on their experiences working with the students, on opportunities which arose and on structural boundaries which appear to make community critical methodologies in university teaching very difficult. [ABSTRACT FROM AUTHOR]

In Australia the movement toward evidence based practice was supported by the first National Mental Health Strategy. For mental health clinicians the shift from evaluating process to outcome measurement also brought greater focus on specific disorders and targeted interventions, raising questions about the efficacy and effectiveness of treatment. The gap between research and practice is well documented, and has engendered much debate particularly in regard to empirically supported treatments ( ESTs) and the technologies to widely disseminate practice whilst supporting treatment adherence. In this paper we first, describe the Attachment Based Family Therapy ( ABFT) model before giving consideration to the criticisms of ESTs, and reviewing the dissemination of ABFT in Australia, and the perspectives of Australian clinicians in respect to the model and its relevance to their practice. Finally, we turn to the mission of this Special Issue which is to increase the awareness of ABFT primarily amongst practicing clinicians as we introduce the selected papers that demonstrate the application of the model to a variety of clinical presentations, and clinical settings. [ABSTRACT FROM AUTHOR]

During the period 1930-46, drought and wind erosion turned parts of the US and Australia into dust bowls. While the US events are well studied, historical research on similar processes in Australia is less abundant. The first part of the paper focusses on the transnational transfer of soil conservation policy and science from the US to Australia, claiming it stimulated the diffusion of an ecological conservationist's conscience within the wider Australian society. The dust storm years were therefore a key period for the evolution of ecological thought and environmental ethics in Australia. Taking the example of four key figures of Australia's conservation movement of the 1960s and later, the second part of the paper shows intellectual continuities between these precursors and the later conservation movement. [ABSTRACT FROM AUTHOR]

As treatment improves, people living with HIV (PLWHIV) can now expect to live longer, which means that the foci of HIV‐related care for them and their medical practitioners continue to change. With an increasingly older cohort of patients with HIV infection, practitioners’ key considerations are shifting from issues of acute treatment and patient survival to multiple comorbidities, toxicities associated with chronic therapy, and ongoing health maintenance. Within this context, this paper explores the current standard of practice for the management of HIV infection in Australia. We surveyed 56 Australian practitioners currently involved in managing HIV infection: ‘HIV section 100’ (HIV therapy‐prescribing) general practitioners (s100 GPs; n = 26), sexual health physicians (SHPs; n = 24) and hospital‐based physicians (HBPs; n = 6). Survey results for practice approaches and challenges were broadly consistent across the three practitioner specialties, apart from a few key areas. s100 GPs reported less prophylaxis use among patients whom they deemed at risk of HIV infection in comparison with SHPs, which may reflect differences in patient populations. Further, a higher proportion of s100 GPs nominated older HIV treatment regimens as their preferred therapy choices compared with the other specialties. In contrast with SHPs, s100 GPs were less likely to switch HIV therapies to simplify the treatment protocol, and to immediately initiate treatment upon patient request in those newly diagnosed with HIV infection. Considerably lower levels of satisfaction with current HIV practice guidelines were also reported by s100 GPs. It appears that greater support for s100 GPs may be needed to address these identified challenges and enhance approaches to HIV practice. Across all specialties, increasing access to mental health services for patients with HIV infection was reported as a key management issue. A renewed focus on providing improved mental health and wellbeing supports is recommended, particularly in the face of an ageing HIV‐infected population. [ABSTRACT FROM AUTHOR]

Objectives: Suicide among nursing home residents is a growing public health concern, currently lacking in empirical research. This study aims to describe the frequency and nature of suicide among nursing home residents in Australia.Methods: This research comprised a national population-based retrospective analysis of suicide deaths among nursing home residents in Australia reported to the Coroner between July 2000 and December 2013. Cases were identified using the National Coronial Information System, and data collected from paper-based coroners' records on individual, incident, and organizational factors, as well as details of the medico-legal death investigation. Data analysis comprised univariate and bivariate descriptive statistical techniques; ecological analysis of incidence rates using population denominators; and comparison of age and sex of suicide cases to deaths from other causes using logistic regression.Results: The study identified 141 suicides among nursing home residents, occurring at a rate of 0.02 deaths per 100 000 resident bed days. The ratio of deaths from suicide to deaths from any other cause was higher in males than females (OR = 3.56, 95%CI = 2.48-5.12, P = <0.001). Over half of the residents who died from suicide had a diagnosis of depression (n = 93, 66.0%) and had resided in the nursing home for less than 12 months (n = 71, 50.3%). Common major life stressors identified in suicide cases included the following: health deterioration (n = 112, 79.4%); isolation and loneliness (n = 60, 42.6%); and maladjustment to nursing home life (n = 42, 29.8%).Conclusions: This research provides a foundational understanding of suicide among nursing home residents in Australia and contributes important new information to the international knowledge base. [ABSTRACT FROM AUTHOR]

Aim: To describe health-related quality of life of Australian children and adolescents with Down syndrome and compare it with norm-referenced data.Method: A cross-sectional survey was conducted with parents of 75 children and adolescents (43 males, 32 females) with Down syndrome aged 5 to 18 years (mean age 13y 2mo, SD 4y 8mo). The proxy-report KIDSCREEN-27 questionnaire was administered and five dimensions of health-related quality of life were measured. Data were analysed descriptively and compared with normative data.Results: Total group mean scores for psychological well-being, autonomy and parent relation, and school environment dimensions were within normal threshold values, whereas mean scores for physical well-being, and social support and peers dimensions, were poorer. For participants with Down syndrome aged 8 to 18 years, the difference with normative data for proxy-reported physical well-being, psychological well-being, and social support and peers dimensions favoured typically developing children. Adolescents (13-18y) with Down syndrome scored poorer on all dimensions than children (5-12y) with Down syndrome.Interpretation: Our findings assist a better understanding of the lived experiences of children and adolescents with Down syndrome, as perceived by their parents, and suggest aspects of health that could be influenced to optimize their quality of life.What This Paper Adds: Proxy-reported psychological well-being and autonomy were within the normal range for children with Down syndrome. Physical well-being and social support scores were significantly lower than normative data. Proxy-reported scores for adolescents with Down syndrome were consistently poorer than for children with Down syndrome and the differences were clinically important. [ABSTRACT FROM AUTHOR]

Aim: To determine whether intrathecal baclofen (ITB) therapy improves performance and performance satisfaction in goal areas identified by patients' parents.Method: This study formed part of an ongoing multicentre national audit involving six paediatric ITB pump implant centres across Australia. The Canadian Occupational Performance Measure was the primary outcome measure utilized at baseline, 6 months, and 12 months after pump implants in paediatric patients receiving ITB therapy for the first time between 31st December 2009 and 31st December 2014.Results: Twenty-five children had goals identified (mean age 11y 1mo), 19 had a diagnosis of cerebral palsy and 22 were at Gross Motor Function Classification System level IV, V, or equivalent. Strong evidence for an improvement in goal performance (2.33, 95% CI 1.70, 2.96, p<0.001) and performance satisfaction scores (3.08, 95% CI 2.28, 3.88, p<0.001) were demonstrated at 6 months, compared to baseline. The differences were clinically significant and were sustained to 12 months.Interpretation: ITB therapy in paediatric patients with hypertonia results in clinically significant improvements in average performance and performance satisfaction scores.What This Paper Adds: The most commonly identified goals of parents of children treated with intrathecal (ITB) therapy were: improving ease of dressing, positioning, and transfers. ITB therapy is effective in improving performance and performance satisfaction in children with hypertonia. Score improvements are mainly evident within the first 6 months of therapy. [ABSTRACT FROM AUTHOR]

Aim: To identify a cohort of children with cerebral palsy (CP) from hospital data; determine the proportion that participated in standardized educational testing and attained a score within the normal range; and describe the relationship between test results and motor symptoms.Method: This population-based retrospective cohort study used data from New South Wales, Australia. We linked hospital data for children younger than 16 years of age admitted between 1st July 2000 and 31st March 2014 to education data from 2009 to 2014. Hospital diagnosis codes were used to identify a cohort of children with CP (n=3944) and describe their motor symptoms. Educational outcomes in the CP cohort were compared with those among children without CP.Results: Of those with educational data (n=1770), 46% were exempt from reading assessment because of intellectual or functional disability, 7% were absent or withdrawn from testing and 47% participated in testing. About 30% of all children with educational data had test scores in the normal range. The proportion was greatest among those with hemiplegia (>40%) and lowest among those with tetraplegia (<10%).Interpretation: One-third of children with CP participated in standardized testing and achieved a result in the normal range. The proportions were lower in children with more severe motor symptoms.What This Paper Adds: From 2009 to 2014, most Australian children with cerebral palsy (CP) attended a mainstream school. The rate of disability-related exemption from standardized educational testing was almost 50%. Thirty per cent of children with CP achieved educational scores in the normal range. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Substance use disorders (SUDs) are common and frequently co-occur with mood and anxiety disorders. This paper provides a detailed analysis of patterns, prevalence and correlates of mood and anxiety disorders among those with a (i) pure SUD; (ii) SUD plus a mood or anxiety disorder (SUDs + 1); and (iii) SUD plus a mood and anxiety disorder (SUDs + 2).Design and Methods: Data came from the 2007 National Survey of Mental Health and Wellbeing; a nationally representative household survey of 8841 Australians aged 16-85 years.Results: The 12-month prevalence of SUDs was 5.1%. Of those with a 12-month SUD, 65% met the criteria for pure SUDs, 19% for SUDs + 1 and 16% for SUDs + 2. Major depression was the most common mood disorder in both comorbid groups. One-third of SUDs + 1 experienced social phobia, while over half of SUDs + 2 experienced generalised anxiety disorder. Compared with pure SUDs, SUDs + 1 experienced two times more and SUDs + 2 experienced over four times more days out of role in the preceding 30 days. Both comorbid groups were more likely to experience severe levels of impairment. SUDs + 2 were over 18 times more likely to experience suicidal thoughts in the same year. SUDs + 1 were over three times and SUDs + 2 were over 10 times more likely to have had one or more consultations with a health professional in the previous year.Discussions and Conclusions: These findings highlight the complexities inherent with responding to and treating multiple comorbidities among substance users and emphasise the need for coordinated, cohesive responses from drug and alcohol treatment services.[Prior K, Mills K, Ross J, Teesson M. Substance use disorders comorbid with mood and anxiety disorders in the Australian general population. Drug Alcohol Rev 2017;36:317-324]. [ABSTRACT FROM AUTHOR]

Objective: As uptake of cervical screening continues to decline, this systematic review synthesises the qualitative literature on women's perceptions and experiences of cervical screening in the context of an organised call-recall programme, in order to understand the barriers to informed uptake.Methods: We searched nine databases for English language peer-reviewed publications reporting on qualitative data from screening-eligible women, exploring barriers to cervical screening in countries that offer a nationally organised call-recall programme. Evidence was integrated using thematic synthesis.Results: Thirty-nine papers from the UK, Australia, Sweden and Korea were included. The majority of participants had attended screening at least once. Two broad themes were identified: (a) should I go for screening? and (b) screening is a big deal. In considering whether to attend, women discussed the personal relevance and value of screening. Women who had previously attended described how it was a big deal, physically and emotionally, and the varied threats that screening presents. Practical barriers affected whether women translated screening intentions into action.Conclusions: The variation in women's understanding and perceptions of cervical screening suggests that interventions tailored to decisional stage may be of value in increasing engagement with the invitation and uptake of screening in those who wish to take part. There is also a need for further research with women who have never attended screening, especially those who remain unaware or unengaged, as their perspectives are lacking in the existing literature. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

This discussion paper identifies and examines several tensions inherent in traditional approaches to understanding older people's suicide. Predicted future increases in the absolute number of elderly suicides are subject to careful interpretation due to the underreporting of suicides in older age groups. Furthermore, a significant number of studies of older people's death by suicide examine risk factors or a combination of risk factors in retrospect only, while current approaches to suicide prevention in the elderly place disproportionate emphasis on the identification and treatment of depression. Taken together, such tensions give rise to a monologic view of research and practice, ultimately limiting our potential for understanding older people's experience of suicide and suicidal behaviour. New approaches are necessary if we are to move beyond the current narrow focus that prevails. Fresh thinking, which draws on older people's experience of attempting to die by suicide, might offer critical insight into socially-constructed meanings attributed to suicide and suicidal behaviour by older people. Specifically, identification through research into the protective mechanisms that are relevant and available to older people who have been suicidal is urgently needed to effectively guide mental health nurses and health-care professionals in therapeutic engagement and intervention. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of primary midwife-led care ('caseload midwifery') on women's experiences of childbirth.Design: Randomised controlled trial.Setting: Tertiary care women's hospital in Melbourne, Australia.Population: A total of 2314 low-risk pregnant women.Methods: Women randomised to caseload care received antenatal, intrapartum and postpartum care from a primary midwife, with some care provided by a 'back-up' midwife. Women in standard care received midwifery-led care with varying levels of continuity, junior obstetric care or community-based medical care.Main Outcome Measures: The primary outcome of the study was caesarean section. This paper presents a secondary outcome, women's experience of childbirth. Women's views and experiences were sought using seven-point rating scales via postal questionnaires 2 months after the birth.Results: A total of 2314 women were randomised between September 2007 and June 2010; 1156 to caseload and 1158 to standard care. Response rates to the follow-up questionnaire were 88 and 74%, respectively. Women in the caseload group were more positive about their overall birth experience than women in the standard care group (adjusted odds ratio 1.50, 95% CI 1.22-1.84). They also felt more in control during labour, were more proud of themselves, less anxious, and more likely to have a positive experience of pain.Conclusions: Compared with standard maternity care, caseload midwifery may improve women's experiences of childbirth.Tweetable Abstract: Primary midwife-led care ('caseload midwifery') improves women's experiences of childbirth. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the attitudes and practices of Australian general practitioners (GPs) regarding infant gastro-oesophageal reflux disease (GORD) diagnosis and management.Methods: A national cross-sectional survey, involving a random sample of currently practising Australian GPs (n = 2319) was undertaken between July and September 2011. GPs attitudes and management of infant GORD were surveyed via an online and paper-based 41-item questionnaire.Results: In total, 400 responses were analysed (17.24% response rate). The majority of GPs employed empirical trials of acid-suppression medication and/or lifestyle modifications to diagnose infant GORD. GPs frequently recommended dietary modification despite the belief that they were only moderately effective at best. In addition, GPs frequently prescribed acid-suppression medication, despite concerns regarding their safety in the infant population. Other GP concerns included the lack of clinical guidelines and education for GPs about infant GORD, as well as the level of evidence available for the safety and efficacy of diagnostic tests and treatments.Conclusion: Despite the important role Australian GPs play in the diagnosis and management of infant GORD, high-level evidence-based guidelines for GPs are lacking. Consequently, GPs engage in diagnostic and management practices despite their concerns regarding the safety and effectiveness. [ABSTRACT FROM AUTHOR]

Background The Hospital Outreach Medication Review ( HOMR) service at Monash Health is a pharmacist-led service that targets patients at high risk of medication misadventure in the immediate post-discharge period. Aim To determine the views of patients and general practitioners ( GPs) who were involved with a HOMR in 2012. Method A standardised risk assessment tool was used to identify patients at high risk of medication misadventure at Monash Health. A HOMR was provided by a clinical pharmacist from the Monash Health Pharmacy Department who undertook a structured evaluation of a patient's medications and produced a report on the issues identified and recommended management strategies. This report was disseminated to the patient's GP with a feedback questionnaire. Patient perceptions were determined using an anonymous self-administered, paper-based questionnaire. Results A total of 487 home visits were conducted in 2012 (49.7% male patients, 50.3% female, mean age 72.8 ± 14.1 years). A total of 217 patients (45%) returned feedback forms. About 99% of patients who responded felt the HOMR was worthwhile (very much 88%, partly 11%) and 84% indicated they were more confident and less confused about their medications. In all, 105 (21.6%) GPs of 487 responded to the feedback form. Ninety-six percent of GP respondents indicated they agreed with the recommendations made and 92% indicated they would adopt either some (44%) or all (48%) of the recommendations. Conclusion The positive views shared by patients and their GPs are indicative of the importance of medication reviews in promoting medication safety and encouraging autonomous medication adherence. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Indicators suggest an escalation in opioid use globally, with recent HIV outbreaks linked to non-medical pharmaceutical opioid (NMPO) use. Little is known about how young Australians engage in NMPO use.Design and Methods: During 2015, we conducted qualitative interviews with young people (16-29 years) who reported oral NMPO use at least twice in the past 90 days. The study included a sample of injecting (n = 14) and oral (n = 22) users. This paper focuses on the oral user group.Results: Most participants grew up in affluent areas of Sydney, reported few health problems, rarely accessed health or welfare services and had limited contact with police. NMPO use was part of a repertoire of drug use involving: (i) use to come down from stimulants; (ii) use in conjunction with cannabis and alcohol; and (iii) use by itself. Participants reported limiting their use in order to avoid stigma and dependence.Discussion and Conclusions: Results suggest culture of self-limiting NMPO use characterised by stable housing, disposable income and intimate friendship networks. Despite the adverse health outcomes observed in other settings, our data suggest that the patterns and meanings of NMPO use observed in this small sample may help explain the limited nature of problematic use among young Australians to date. Findings indicate a need for epidemiological data, including longitudinal data, to assess possible demographic shifts in NMPO use in Australia, and to address risk factors for dependence and transitions to injecting and heroin use in this population. [Dertadian GC, Dixon TC, Iversen J, Maher L. Self-limiting non-medical pharmaceutical opioid use among young people in Sydney, Australia: An exploratory study. Drug Alcohol Rev 2017;00:000-000]. [ABSTRACT FROM AUTHOR]