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Secondary prevention efforts, which target risk and protective factors associated with harmful sexual behaviour (HSB) and seek to intervene early in the trajectory of HSB, are underdeveloped in Australia. This study explored design considerations for an online early intervention service for children and young people worried about their sexual thoughts and behaviours. A trauma-informed child right's framework underpinned the study, which involved 10 individual interviews with international experts in HSB, and one group interview (n = 3) with Australian practitioners. Analysis was carried out using thematic analysis. Results reflect design considerations in relation to: theoretical approaches; practice frameworks; service delivery components; and helpseeking challenges. Key tensions emerging from the results are discussed, including the need to move beyond binary constructions of victims and perpetrators. PRACTICE IMPACT STATEMENT: This paper has significant potential to influence practice in the field of harmful sexual behaviour prevention and response. The paper sets out the components of an early intervention online service for children and young people worried about their sexual thoughts and behaviours. The online service could be built and trialed for impact and efficacy in supporting children and young people not to sexually harm. It would be the first service of its kind in Australia and fill a gap in the current service delivery landscape. [ABSTRACT FROM AUTHOR]

Harmful sexual behaviour (HSB) carried out by children and young people can include sexual abuse of younger children or adults, or sexual assault in dating or peer relationships. The aim of this paper is to capture the "practice wisdom" of practitioners and applied researchers about clusters of risk factors associated with HSB onset, as well as possibilities for earlier intervention. Participants included practitioners and applied researchers in the HSB field. Data was collected in 2020 through individual interviews with eight key expert informants, and two group interviews – the first with two applied researchers and the second with three practitioners. Data analysis revealed risk factor clusterings around five key childhood experiences: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. These clusters are discussed in relation to early intervention. PRACTICE IMPACT STATEMENT Harmful sexual behaviour (HSB) is preventable but the early intervention agenda is underdeveloped. In this paper, five risk clusters are identified: being sexually curious; having a sexual interest in children; living with childhood trauma; living with contextual violence; and using pornography. The identification of these risk clusters present opportunities for early intervention that could enhance the prevention agenda to address HSB in Australia and internationally. [ABSTRACT FROM AUTHOR]

Assistive technologies (AT) perform an important social role, interacting with cultural systems to produce or hinder accessibility to biosocial environments. This interaction profoundly shapes not only how an individual body can be experienced by users but also produce and hinder accessibility to biosocial environments. AT users have historically been viewed through a medical model, which deems them disabled by their impairments and by dominant ableist narratives. Therefore, this paper serves to provide an insight into the importance of ageing with and into AT. This paper aims to investigate polio survivors' and diabetic amputees' experiences of assistive technologies in order to better understand impacts upon narrative and identity. By applying an anthropological and sociological lens, a holistic view of the experiences of polio survivor and amputee AT users is developed. This paper draws on 16 in-depth interviews with polio survivors and diabetic amputees in the United States (US) and Australia, which were analysed using an experience-centered narrative approach. Both projects were approved by ethics boards. All participants provided written consent. Five themes were identified: a) disruption to biographies, which reflected AT impact on how narratives become altered; b) impacts to autonomy, which reflected the importance of regaining previous daily activities; c) re-engaging with community life, which highlighted how AT supported participation in valued activities; d) self-perceptions of assistive technologies, which act in opposition to external perspectives and challenge ableist narratives; and e) an intergenerational comparison of new and older AT users highlights the importance of temporalities. This paper offers new perspectives on ageing with assistive technologies, with a focus on identity and narrative. The importance of this paper is to contribute to the existing literature that demonstrates the cultural implications that arise through embodiment and assistive technologies. The use of assistive technology can help individuals regain function, but the individual circumstances require consideration The use of assistive technology is a complex entanglement of bodies, environments, biographies, and imagined futures. The use of assistive technology can provide participants autonomy over their narratives and assist with maintaining their identities [ABSTRACT FROM AUTHOR]

Globally, traumatic brain injury (TBI) has been recognised as a serious health issue not only because of the immediate impacts at the time the injury occurs but even more so due to the longstanding impacts. Even though TBI is a globally recognised condition, the research is disproportionately focused on its incidence in, and immediate and long-term effects on men. A growing body of research suggests that generally, women who experience family violence are at high risk of TBI and suffer its impacts in ways that reflect gendered differences in the patterns and frequency of violence. In Australia, the social and physical costs of TBI are multiplied for Indigenous women, whose experience of disability and access to healthcare lies at the intersection of gender and race in the historical context of settler colonialism. The present study addresses the need for research into the sociodemographic inequalities that affect access to culturally appropriate hospital care, timely response systems, and flexible, safe and engaged social services. This paper draws on data from interviews and focus groups with Indigenous women, hospital staff and community-based service providers and suggests potential pathways for further research in settler-colonial settings elsewhere in the world. [ABSTRACT FROM AUTHOR]

This paper examines the adjustments made to include people with intellectual disabilities in mainstream services. Drawing on in-depth interviews with both people with intellectual disabilities and mainstream service managers in four urban regions in Australia, the paper points to three modes of practice that are operationalised, to different degrees, when people with intellectual disabilities seek access to mainstream services: a commitment and adjustments to support inclusion of a wide range of marginalised people (diversity and inclusion ethos); adjustments to support inclusion of people with intellectual disabilities more specifically (differentiated adjustments); and, personal support for service users with intellectual disabilities. We argue that these three modes, at the service level, correspond in complex ways with three broader approaches to social inclusion: mainstreaming, differentiation and individualisation. Rather than contradictory modes of inclusion, our analysis suggests these approaches should be understood as complementary. Some mainstream services that value 'inclusion' make adjustments to their service in order to better include people from different marginalised groups. Such adjustments have mixed outcomes for people with intellectual disability, whose specific needs are not always met. Some mainstream services operate separate activities for users with intellectual disability. This helps them manage behavioural and communication challenges, and can help people with intellectual disability experience a sense of belonging. But separate activities also limit opportunities for full inclusion in the mainstream. Often people with intellectual disability require their own personal support to be able to use mainstream services. Some mainstream services rely on such personal support as their main strategy to include people with intellectual disability. Other mainstream services work collaboratively with personal supporters to promote inclusion. [ABSTRACT FROM AUTHOR]

Australian research indicates that post-parental care transitions are rarely planned and primarily occur following a crisis for a primary carer. This paper examines disability staff perceptions of transitions for people with intellectual disability and their ageing carers in rural South Australia. A focus group interview model was used, with a semi-structured interview guide initiating group discussions. A thematic analysis methodological approach was selected to analyse the data. This paper reports on the theme of Service Delivery, which has three sub-themes of Availability; Distance; and Individual Access. The key findings are presented and supported by the use of exemplar quotes. This research indicates a poor intersection of general and specialist services is inhibiting post-parental transitional care for rural people. Simply allocating money to the individual does not resolve the issues, and the interface between different services needs to be better considered at government level. [ABSTRACT FROM AUTHOR]

This paper reports findings from an ethnographic study of families from culturally and linguistically diverse (CALD) families in Australia caring for children with disability. The study aimed to contribute insights into the unique experiences, challenges and supports that characterise experiences of families of a child with disability living in a country where the mainstream culture is different from their own. Four families from different cultural backgrounds participated in the study over a period of nine months. During this time, they participated in a series of semi-structured interviews during which they shared their encounters with formal early intervention services and reflected on important informal supports. Findings presented here indicate three key areas associated with accessing informal supports that can pose challenges for families who hold values that are different from those of the dominant culture: lack of social support; cultural adaptations, and socialization problems and coping strategies. The findings indicate that formal services could ameliorate feelings of social isolation by enabling parents to access informal supports such as parenting groups. [ABSTRACT FROM AUTHOR]

Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and "treatment as usual" may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Three overarching themes were identified in relation to (i) participants' need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts. What is already known about this topic: Psychologists in private practice make up a substantial group within the Australian mental health workforce who support parents with a mental health condition. Parents who receive mental health care in tertiary mental health settings report a lack of dedicated parenting support and resources. Family-focused practices are effective in supporting parenting and recovery for parents with a mental health condition who receive mental health care in tertiary mental health settings. What this paper adds: Psychologists who support parents in private practice should collaborate with their clients to identify which aspects of their parenting may be relevant to the therapeutic work and provide targeted support for parenting difficulties. Most participants expected that their psychologist would provide targeted support for parenting difficulties, and they felt disappointed when this did not occur. The lived experiences of parents with mental ill-health in private practice psychology services are highlighted, addressing a key knowledge gap in the literature. [ABSTRACT FROM AUTHOR]

Young people with severe and complex depression experience substantial social connectedness difficulties. The aim of this qualitative study was to evaluate the role of social connectedness in a novel group therapy (Relate) for youth living with severe and complex depression from clinicians' perspectives. Semi-structured interviews were conducted with 11 clinicians practicing at Orygen's Youth Mood Clinic in Melbourne. Eight of the 11 clinicians were female, with the sample aged 30–42 years (M = 34 years, SD = 3.6 years) and having an average 4.5 years clinical experience at Orygen. Four key themes were identified by codebook thematic analysis. The first theme pertained to clients' difficulties with social engagement, which impacted their attendance of Relate, but were addressed by the intervention. In the second theme, clinicians identified Relate as providing a safe space. In the third theme, clinicians identified opportunities for positive relational experiences. In the fourth theme, clinicians observed social and clinical improvements in Relate clients, but marked recovery did not always occur after attending. Findings provide initial support for the continuation of Relate. Recommendations for future iterations of Relate include refining the intake criteria for referring clients to Relate and potentially lengthening the program's duration. What is already known about this topic: Group interpersonal therapy is an effective intervention for depression and interpersonal functioning in young people. Few studies have evaluated treatments for young people with severe and complex depression and high suicide risk. Few studies have evaluated group programs within early intervention services. What this paper adds: A relationally-focussed group therapy could improve social connectedness and interpersonal functioning for youth living with severe and complex depression. The Relate group emphasises a safe environment for sharing and social risk-taking, providing opportunities for positive relational experiences with similar others which might be particularly useful for youth with complex social difficulties. Identified issues with engagement suggest clients could benefit from an explicit rationale for how their participation in the group benefits their depression treatment. [ABSTRACT FROM AUTHOR]

Common depictions of buying and selling illicit drugs online centre on how drug market actors engage in dark web drug cryptomarkets, but the supply of illicit drugs also takes place in 'plain site' on the surface web. Drawing on netnographic observations and qualitative interviews with hard-to-reach buyers and vendors (n = 20), this paper explores LeafedOut, a specific, popular surface web platform, that provides a conduit for local cannabis exchanges. We found that the platform enabled easy access and supply at the local level but increased some specific risks to those involved. Actors neutralised the perceived risks of drug supply over this surface web platform through the broader societal normalisation of cannabis use/supply, adopting encrypted messaging applications to cover 'digital traces', and developing various methods to establish trust with an exchange partner (e.g. review systems, sending selfies with drug paraphernalia, selectively choosing meet-up locations). This paper expands our understanding of the growing number of online illicit drug markets by shifting attention from dark web cryptomarkets to the much more widely accessed surface/clear web. Theoretical implications for the study of trust and risk in online illicit drug market exchanges are also considered. [ABSTRACT FROM AUTHOR]

Sharing personal teaching stories provides opportunities for enhanced wellbeing and learning for both experienced and pre-service teachers. This paper shares the results of a qualitative pilot study that used narrative inquiry to collect and share teacher stories. The research was conducted in two phases. The first phase collected humorous stories from experienced teachers recalled from the first years of their teaching career. Thematic data analysis investigated the wellbeing and learning impact on those teachers when sharing their stories. The second phase invited pre-service teachers to read and evaluate the impact of humorous stories when preparing for their first school placements. Thematic data analysis investigated the wellbeing and learning impact on pre-service teachers reading these stories. The analysis from both phases demonstrated recurring themes regarding the importance of teacher-student relationships for teacher wellbeing. The results also showed that the sharing and reading of stories had beneficial outcomes such as enhanced wellbeing and enhanced learning for both the teacher storytellers and the pre-service teacher readers. This study provides evidence that the inclusion of real-life stories offers a valuable addition to Initial Teacher Education programs as a way of developing professional and reflective practice. [ABSTRACT FROM AUTHOR]

In Australia, like many high-income countries, food insecurity is associated with increased risks of chronic diseases, sub-optimal development outcomes in children, and mental health conditions including depression and anxiety. Food insecure households employ a range of strategies, including the use of food charity, to help alleviate hunger and meet cost of living pressures. The aim of this paper is to investigate the lived experience of food insecurity for welfare-dependent households, and to examine these experiences within a structural violence framework. Structural violence investigations seek to understand the distal causal factors that can help explain poor health patterns and inequities. Semi-structured interviews were conducted with customers (n = 78) of food pantries, soup kitchens, and community development programs (June 2018 to January 2019) in the state of Victoria, Australia. Thematic analysis established evidence of controlling, demeaning and depriving practices in the interactions between the participants and the services and staff at national welfare providers and food charities. The same providers and charities nominally set up to address the exact situations in which participants found themselves. The findings of this study suggest that food and social services are an on-the-ground setting through which structural violence is enacted and experienced. [ABSTRACT FROM AUTHOR]

This paper explores the environmental, interpersonal, and personal outcomes of music performance in a hospital oncology setting. An original, qualitative research study examined the impact of live music for staff, patients, and carers. Data were collected using a multi-method approach of observations and semi-structured interviews and were analysed using inductive and theory-driven theming that was shaped by a determinants of health framework. The research found that live music promoted stronger relationships and calmer environments, among other environmental, social and individual outcomes. Improved communication between staff through the creation of a more supportive environment was a pertinent finding of the research. No negative effects were reported. We discuss research findings in the context of relevant literature and suggest recommendations for future hospital-based live music programs. Results of this study indicate that live music interventions impacted individual, interpersonal, social and environment factors that led to health and wellbeing outcomes for participants. [ABSTRACT FROM AUTHOR]

An increasing focus in aged care policy is supporting older people to age at home. However, there is little recognition of the health and independence of older private renters living in a space they do not own or control. This paper draws on in-depth interviews and assessments undertaken in the homes of 27 older tenants in the Brisbane environs aiming to understand how renting privately influenced their ability to meet their basic needs. An analysis of the findings highlights the disadvantage experienced by many older private renters. Most older private renters were unable to meet their basic needs given unaffordable rent whilst reliant on the aged pension. Further, with limited access to community aged care including home modifications, the health and independence of older private renters was found to be at risk. IMPLICATIONS Community aged care is difficult for older private renters to utilise in Australia, with unaffordable services and tenancy law limiting access to community aged care services including home modifications. It is vital social workers advocate for the community aged care needs of older private renters in practice and policy settings. [ABSTRACT FROM AUTHOR]

Mothering and motherhood can be a very challenging experience in the 21st century, where cultural pressures, on the one hand, and health experts' regular parenting surveillance, on the other, continue to influence mothering decisions and practices. The socially constructed "good mother" discourses and associated pressures/influences can be amplified for vulnerable mothers who may feel marginalized from or judged by the broader society. This article presents findings from a study that involved interviews with ten young mothers and 12 staff working at a leading family welfare agency supporting young parents in Melbourne, Australia. The study examined how digital technology could promote a sense of agency for vulnerable mothers as well as barriers and enablers of accessing digital knowledge and online parenting support. In addition, the study explored how technology could assist community organizations' staff in helping their clients better. This paper argues that, overall, digital technologies can positively influence the experience of mothering and can empower vulnerable mothers by increasing their access to various sources of support. Furthermore, our findings suggest that technology can enhance community and family service providers' practice, opening possibilities for a more supportive relationship with clients by empowering them and increasing agency over their situation. [ABSTRACT FROM AUTHOR]

This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy. The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK). Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities. Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement. [ABSTRACT FROM AUTHOR]

This paper reports on a critical survivor-driven study exploring how Australian lesbian, gay, bisexual, transgender, intersex, queer and asexual (LGBTQA+) adults attempt recovery from religious Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE), and what supports they find useful in this process. The study privileged the critical communal lens of self-titled survivors of perspectives through its reference group, and applied Bronfenbrenner's psycho-social lens, in an effort to ensure research used by psychologists was for and with survivors rather than on them. Qualitative data on SOGIECE survivor experiences and perspectives was collected using two focus groups and interviews including a total of 35 Australian SOGIECE survivors aged 18+ years. Findings suggested that post-SOGIECE recoveries were more successful if survivors experience three provisions: people who are affirming with whom to be freely themselves – especially health and mental health practitioners, family and friends, and survivor support groups; considerable time and internal motivation to enable support to be effective; and conflicting aspects of identities and beliefs are reconciled in ways that foreground survivors' autonomy in their reconstruction. SOGIECE survivors need recovery plans that consider complexities at all levels of their ecology of development; and diversify their exposure to affirming supports and ideas at all levels. Mental health practitioners should be especially careful to foreground survivors' autonomy in therapies, recalling that they likely experienced past abusive therapies/therapy dynamics. Key Points What is already known about this topic: People exposed to Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE) are at increased risk for many mental health conditions. People exposed to SOGIECE are at increased risk of self-harm and suicide. SOGIECE survivors need distinct treatment considerations distinguishing 'pathology' from SOGIECE's 'negative effects', and challenging past social conformity-drives. What this topic adds: SOGIECE survivors need community (re)building aid in their recovery confluent with their own faith goals and avoiding conformity with therapists' (faith-negative/faith-positive) ideals. SOGIECE survivors need considerable time and different phases in recovery processes, to do developmental work discussing and reconciling dualities in identities, beliefs and social (re)engagements. Support approaches and resources closely aligned to SOGIECE survivors' presented identities were emphasised for the initial recovery decision-making, these could later vary more across treatment. [ABSTRACT FROM AUTHOR]

Recent mental health policy endorses a personal recovery framework that focuses on individual purpose and meaning. Therefore, psychology pre-registration training needs to promote knowledge and attitudes that are aligned with this framework.The 5 + 1 training pathway was recently established in Australia and emphasises readiness for practice. This study examined how provisional psychologists undertaking the 5 + 1 pathway perceived recovery. Semi-structured interviews were completed with nine provisional psychologists completing the coursework component of the 5 + 1 pathway. Interviews focused on perspectives of recovery and were analysed with thematic analysis. Three themes related to perspectives of (i) recovery as a process that involved building capacity to undertake key life roles, (ii) ways that psychologists can promote recovery through their stance and their practices and (iii) factors that have influenced participants' views of recovery. The findings indicate that provisional psychologists in the 5 + 1 pathway are able to develop appropriate but limited perspectives that are generally consistent with the personal recovery framework. Participants were more influenced by client contact than coursework. Learning about recovery could be enhanced by explicitly teaching models of recovery and incorporating views of people with lived experience. Key Points What is already known about this topic: Mental health clinicians' attitudes and perspectives of their work have an impact on the nature of the support they provide. Training plays an important role in developing psychologists' attitudes and perspectives towards recovery. The 5 + 1 internship is a recently established training pathway to registration as a psychologist. What this paper adds: This paper reports on one of few studies related to the Australian 5 + 1 training pathway for psychologists. Although unfamiliar with formal models of recovery, students' perspectives were mostly consistent with personal recovery but there were some indications of conceptual confusion. Recommendations are made for extending development of students' perspectives of recovery. [ABSTRACT FROM AUTHOR]

Limited studies exist exploring employers' capacity in hiring and supporting employees on the autism spectrum, and even fewer have considered interventions targeting employers' skills and knowledge in enhancing employment opportunities. In response to this need, the Integrated Employment Success Tool (IESTTM) was developed and its effectiveness established in a randomized controlled trial (RCT). Furthermore, a process evaluation was conducted to determine the usability and implementation of the IESTTM. The process evaluation was conducted to determine employers' perceived usability, implementation, and perceived barriers and facilitators in using the IESTTM. Employers (N = 29) provided their feedback via an online questionnaire. Of these, 11 participants were interviewed, further exploring their experiences. Data were analysed via descriptive statistics and thematic analysis. While employers' frequency and usage of the IESTTM varied across workplaces, it was predominantly used to increase employers' knowledge of autism and implement workplace strategies. A major barrier was the paper-based format of the intervention, with more than 60% of employers indicating the need for an online version. The process evaluation was a critical step in understanding why the IESTTM was effective, and how it could be further optimized for prospective employers. [ABSTRACT FROM AUTHOR]

Youth-led peer-support initiatives appear well placed to dismantle conventional binaries of youth-adult, as they hold promise as models able to perceive youth outside the role of service recipients. Drawing on ethnographic research at an Australian youth program that included interviews with young people, young and adult volunteers, and staff, this paper investigates the role young people play in determining, creating, and applying change processes for their peers. Through the mechanisms of "cultivating relatability," "establishing a culture of support," and "role-modeling alternative pathways," new possibilities and hope were created. At the core of peer-support efforts was an attempt to increase social integration and a commitment to notions of equality and respect as well as the eradication of unequal power relations between adults and young people. The dual phenomenon of being both the recipient of peer support and facilitators of change processes for others has novel implications for youth programs that work with young people to enhance processes of empowerment and agency and promote positive youth outcomes. Such an approach to working with young people as engaged partners, which gives them a voice and, in particular, asserts the rights of young people to be involved in transforming and recreating their situations, creates opportunities that may both extend the reach and deepen the impact of youth services. [ABSTRACT FROM AUTHOR]

The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of 'cure'). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike. [ABSTRACT FROM AUTHOR]

Lesbian, bisexual, transgender, queer and asexual (LGBTQA+) Australians are vulnerable to religion-based attempts to change or suppress their sexuality and/or gender identity, including conversion ideology messaging in school-based sex education. Conversion bans are currently being debated across the country. This paper reports on a critical survivor-driven study which retrospectively explored Australian LGBTQA+ youth exposure to conversion practices both within and outside of education settings. It privileges the perspectives of self-titled 'survivors' of conversion ideology and practices through the use of a reference group and constructivist grounded theory. Qualitative data were collected 20 from Australian LGBTQA+ conversion ideology and/or practice survivors aged 18 years and over, using focus groups and 35 individual interviews between 2016 and 2020. In conversion-promoting religious contexts including education institutions and groups, messages concerning sexuality and gender changed as individuals grew older and were drawn into more/enclosed settings in which core conversion messages of LGBTQA+ 'brokenness' were prevalent. While individuals progressed through the conversion experience in different ways, their experience was characterised by the absence of any form of affirming LGBTQA+ education – enabling conversion itself to become their LGBTQA+ (mis)information source. School policy addressing conversion, alongside enhanced provision of affirmative age-appropriate gender and sexuality education, may mediate this issue. [ABSTRACT FROM AUTHOR]

Disproportionately high numbers of Aboriginal young people access residential alcohol and other drug programs in Australia. While demand is high, these programs often have low numbers of Aboriginal staff. Residential programs, however, generally offer supports that reflect features of Aboriginal health care – holistic, group-based, connected to local communities, and addressing determinants of health. The qualitative research outlined in this paper was a collaboration between a mainstream residential therapeutic community program and two Aboriginal community-controlled organisations, and Aboriginal young people and researchers, with Aboriginal research leadership. It used an Aboriginal healing framework to understand the experiences of 12 young Aboriginal people in the program, triangulated with 19 key informant interviews. This provided an opportunity to understand how Indigenous knowledge about healing related to mainstream programs and the experiences of Aboriginal young people. This moves beyond individualist and deficit-focused conceptions of youth alcohol and drug use and centres Aboriginal cultures as healing. Findings point to the need for critically self-reflective mainstream organisations, a larger Aboriginal workforce with leadership roles, partnerships with Aboriginal Elders and organisations, and an investment in Aboriginal community-controlled alcohol and other drug services. [ABSTRACT FROM AUTHOR]

The increasing number of children on the autism spectrum entering mainstream schools requires classroom teachers with the knowledge and skills to create supportive and inclusive environments in which these students can thrive. This paper reports the perspectives offered by 33 teachers who volunteered to trial an Early Years Model of Practice (EY-MoP) designed to provide information and guidance on foundational practices supportive of students on the spectrum. All teachers worked in Australian primary schools and had at least one student on the spectrum in their early years classrooms. In pre-and post-trial interviews, teachers shared their impressions of, and experiences with, the EY-MoP. In general, they endorsed the model as a resource outlining foundational practices for working with students on the spectrum. Insights shared pointed to the positive impact that this kind of comprehensive, foundational resource can have on teaching practice both in everyday planning and as a reflective tool. Responses also indicated that the model enhanced teachers' knowledge and confidence in supporting students on the spectrum. Taken together, these teacher data provide preliminary evidence for the viability of the EY-MoP as a resource to support both beginning and experienced teachers in their work with young children on the spectrum. [ABSTRACT FROM AUTHOR]

Like in many countries, the Australian Government has conducted an inquiry into child sexual abuse that occurred in institutional settings (The Royal Commission into Institutional Responses to Child Sexual Abuse). Drawing on the findings from a qualitative study commissioned by the Royal Commission, this paper explores the perceptions of victim/survivors1 of the ways in which institutions (or individuals within them) responded supportively when sexual abuse was reported. While researchers and inquiries have reported on inadequacy of institutional responses, this paper addresses a research gap by investigating responses that victims/survivors perceived as helpful, while mindful of the overwhelmingly negative nature of their experiences. The paper contributes to the literature on institutional responses to child sexual abuse methodologically – by reporting on the challenges of a study of this type – and theoretically, by proposing a framework indicating how different helpful elements of an institutional response to child sexual abuse relate to each other in the victim/survivors' experiences. The findings are relevant for research on best practice in institutional responses to child sexual abuse. [ABSTRACT FROM AUTHOR]

This paper explores the role of evidence and its use in a cluster of Australian community-based child development programs. The paper draws on findings from a 2016–2017 study commissioned by a not-for-profit organization to review their programs' alignment with government evidence-based program expectations. Cunningham and Duffee's (2009) evidence-based practice style typology is utilized to examine how different purposes of use drive styles of and approaches to evidence sourcing, application, and reporting. Perspectives on what constitutes evidence and how such evidence is valued, used, and reported can vary considerably between individual programs, irrespective of enforced standards and expectations. It is argued that a single-dimensional approach to program evidence-based evaluation and reporting is not appropriate and potentially damaging in contexts where community-based programs have different purposes, structures, cultures, and intentions. Given a program's particular evidence-use style, evidence-based criteria, processes, and reporting requirements should be matched accordingly. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

Amendments to various state laws have made it easier for cisgendered lesbian, bisexual and queer (LBQ) women to access Australian fertility clinics. When women conceive through clinics, they generally use intrauterine insemination (IUI) or in vitro fertilisation (IVF). IUI is cheaper and requires less invasive medical intervention than IVF. A recent survey found that almost 60% of Australian cisgendered LBQ women who conceived with clinical assistance did so using IVF, despite most presenting to clinics without a diagnosis of infertility and seeking donor sperm only. In this paper, based on 20 interviews with Australian clinicians who treat LBQ patients seeking pregnancy, we explore potential explanations for why over half of LBQ women using Australian fertility clinics to conceive used IVF rather than IUI. A 'perfect storm' of factors appears to converge in this tendency. Although some LBQ women are purposefully choosing IVF to achieve biological relatedness for two mothers, other pressures toward high intervention conceptions include the distinction between 'social' and 'clinical' infertility by Medicare (the Australian national health insurance scheme), the relative profitability of IVF procedures and issues with the supply and quality of donor sperm. Accessing sperm from clinics appears to set some Australian women without male partners on a potentially unnecessary path to a high intervention and costly conception. [ABSTRACT FROM AUTHOR]

Prevention of chronic diseases happens within systems of action across whole communities. In local communities, organisations play important roles that influence health, but many are in non-health sectors where health or 'prevention' is not their main remit. In this paper, we explore how organisations in communities perceive their role as part of a local system of chronic disease prevention. We use interview data from 'Prevention Tracker', an investigation undertaken with Australian communities that aimed to describe how local prevention systems are organised. Four communities participated – one regional, one remote, and two urban. In each, local advisory groups identified key informants for semi-structured interviews (n = 80). We applied the Ottawa Charter for Health Promotion as a sensitising framework to categorise responses; and undertook inductive thematic analysis to generate deeper insights into organisations' orientation to prevention. While some respondents clearly recognised and articulated linkages between their organisation's activities and prevention, sometimes drawing from health promotion principles to do so, many did not and were prompted by the interview to consider their contributions. A proportion explicitly distanced themselves from prevention despite their work directly addressing the social determinants that underscore health. For some, this distancing reflects a tactical decision to reduce competition and promote partnership between organisations, and to engage clients. This study demonstrates that diverse organisations make contributions to prevention – often outside of 'core business' – whether or not the organisations themselves realise, relate to and/or self-identify as playing this role. [ABSTRACT FROM AUTHOR]

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support. [ABSTRACT FROM AUTHOR]

Background: Research into parents' experiences of living with a family member with intellectual disability and challenging behaviour does not specifically address what parents say about themselves and their lives. This paper explores "I-statements" parents made about their day-to-day actions in life with their family member. Methods: Semi-structured interviews were conducted with 26 parents, of which 91% were mothers. "I-statements" were analysed using process analysis from systemic functional linguistics and thematic analysis. Results: "I-statements" showed that parents enacted a range of complex and sometimes extreme activities across a variety of life domains. Parents spoke about: managing relationships with services; educating themselves and others; seeking support; resisting poor service delivery; assisting others; and making both small and significant changes. Conclusion: The paper provided insights into the complex lives of these families and offered observations on the implications of the potential misalignment between the supports the data suggests are needed and those that, in reality, are available to them. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

It is well established that social determinants are crucial to health outcomes. However, the link between how social determinants contribute to health inequalities for people with disability has often failed to be acknowledged. For example, Australian disability policy has paid little attention to social determinants of health, despite people with disability faring particularly badly on a range of outcomes. This paper identifies barriers to policy action on the social determinants of health for people with disability in Australia. Data obtained from interviews with key disability policy stakeholders are analysed using a micro, meso, macro level policy analysis framework. Our analysis identifies a "services drift" acting as an important barrier to policy action, where attention is focused on health service access rather than broader social determinants such as housing, employment and education. We also identify issues in how disability policy is made that hinders action on social determinants of health. The environments people live, work and interact in like their housing, employment and education, have been shown to be more important for good health than having access to health services, yet these areas are often neglected in policy for people with disability. Using interviewees with people involved in disability policy in Australia this article aims to explore why these areas are neglected in policy relative to the focus on access to health services. Reasons for focusing more on health services compared to other policy areas include people's attitudes towards disability such as thinking about it as a medical problem rather than a social problem. There are also issues with how disability policy is being made, such as a lack of consultation with people with disability, and a lack of co-ordination between government levels and departments. Identifying these policy barriers is an important step in finding ways to get more policy action on improving the environments people with disability live in. [ABSTRACT FROM AUTHOR]

Although Indigenous practitioners around the world emphasise the importance of spirituality in social work, epistemic injustices often perpetuate the neglect of traditional knowledge in everyday practices. This paper explores the experiences of six Māori practitioners who work from cultural perspectives in the New Zealand context. Since these individuals subscribe to Indigenous Māori philosophies, Kaupapa Māori Theory is an important part of this study's epistemology. The research findings provide some unique interpretations of Māori spirituality while highlighting the value of Indigenous knowledge within the broader spheres of social work practice and education. IMPLICATIONS Social work practice is decolonised through culturally responsive methods and prioritising the Indigenous voice within Australian and New Zealand social services. Social work education is strengthened through the recognition of culturally responsive pedagogical frameworks within mainstream curricula and institutes. [ABSTRACT FROM AUTHOR]

This two-year (2016–2018) study aimed to identify what a good life is for Aboriginal people with disability in remote Central Australia and how service providers can support them to achieve a good life. This paper presents the findings that relate to barriers to delivering services for Aboriginal people with disability. In-depth interviews and focus groups were held with Aboriginal people with disability and their carers aged at least 18 years from the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Lands and community organisations providing services there. The data were analysed using thematic analysis. There were 109 participants, of whom 47 were workers in service provider organisations and 62 were Aboriginal people. From the data, barriers to delivering services to support Aboriginal people to live a good life and solutions to overcome the barriers, were identified and described under the headings of environmental barriers and systemic issues. We discuss the policy implications of these findings with regard to addressing Indigenous disadvantage and how governments, service providers, communities, and Aboriginal people with disability and their families can work in partnership to address these barriers. Indigenous people with disability living in remote and very remote communities experience significant access and equity barriers to culturally responsive services that enable them to live a socially and culturally engaged life. Localised government and service provider disability policy approaches in Indigenous communities need to focus on both environmental and systemic issues. Greater investment in local remote communities is required to build the capacity of Indigenous families to support Aboriginal people with a disability to live a culturally and socially included life. [ABSTRACT FROM AUTHOR]

Advances in the management of chronic diseases, combined with an aging population, have escalated the prevalence of people with life-limiting conditions and demand for palliative care. In Australia, this has prompted calls for change in policy frameworks, service systems and funding models that underpin care. The complex social, cultural and policy transformation required to enact these changes has been problematic. This paper reports on qualitative research into a unique, Australian Community Palliative Care program reflecting these aspirational changes. The research examined the program design and its implementation through the perspectives of program staff and volunteers. [ABSTRACT FROM AUTHOR]

Drawing on findings from a study of two social generations of gender and sexuality diverse Australians, this paper offers a critical analysis of expectations and experiences of inclusive health care for LGBTQ+ youth. Data were collected by means of individual and focus group interviews with people from two different social generations who grew up in regional or urban Australia: those born in the 1970s (n = 50) and those born in the 1990s (n = 71). Data were analysed inductively to develop insights into what inclusive health care meant, and what this revealed about the potential for fostering belonging in healthcare settings. Findings raise critical questions about how inclusiveness of care might best be understood in encounters between gender and sexual minorities and health professionals. In particular, forms of 'inclusivity labour' were observed across the social generations, both in terms of the work involved in seeking to locate supportive services, and in assessing the performance of clinicians in healthcare settings, with implications for the continued engagement of LGBTQ+ young people with essential forms of care. Mobilising contemporary forms of inclusivity labour, including attention to the affective dimensions of healthcare engagement, has the potential to promote both better health and more meaningful experiences of belonging for gender and sexual minorities. [ABSTRACT FROM AUTHOR]

Yoga is increasing in popularity. As a holistic practice, it is being applied and researched as a healing modality for physical ailments, assisting with mental health issues, and addressing traumatic symptoms. However, little is known about how social workers understand and include Yoga in their personal lives or professional practice. As part of a larger narrative study, practitioners in an Australian regional centre were asked: "What, if any, impact do embodied practices like Yoga have on your experience and your clients' experience?" This paper explores the stories told by three of the practitioners interviewed both individually and in focus groups. The dominant themes that emerged highlight that: a personal Yoga practice can be varied; the impact it has on professional outcomes is difficult to quantify; there is a lack of theoretical discussion about the body and embodied experience in social work; the challenges associated with introducing Yoga into social work practice are complex. Embodied practices such as Yoga provide social workers opportunities to increase self-awareness, their capacity to engage with clients and self-care. Theoretical understandings of the body and embodiment need to be better articulated in social work if embodied practices like Yoga are to be included in the professional conversation. [ABSTRACT FROM AUTHOR]

Women's coping strategies may be affected by many factors, including their health and wellbeing, their social roles, and the broader environment. While the coping strategies of vulnerable women have been studied, little qualitative research has focussed on how women from the general population cope with their difficulties. The aim of this paper is to explore difficulties and coping strategies among Australian women. Women's perspectives on their ways of coping with the difficulties they had faced in their lives were thematically analysed from semi-structured telephone interviews with 36 women purposively sampled from over 7,000 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. Difficulties were identified with health, relationships, finances, and work/study. Coping strategies included using resources, support from others, lifestyle strategies, and cognitive strategies. It is helpful for psychiatric mental health nurses and other health professionals to understand women's coping strategies in order to better support women experiencing difficulties. [ABSTRACT FROM AUTHOR]

Objective: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country. Design: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants’ experiences. Results: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable. Conclusion: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in promoting chronic disease self-management among the elderly. These interventions have the potential to empower and encourage individuals to take control and better manage their chronic disease. [ABSTRACT FROM AUTHOR]

Despite the frequent occurrence of unwanted disclosure of HIV status in Australia, there is little understanding of its determinants and consequences. This paper offers an analysis of lived experiences of unwanted disclosure amongst 28 people with HIV in urban settings in Australia. Of the 28 individuals interviewed, 17 men and 8 women had experienced unwanted disclosure of their HIV status by other people in work, health, social and other settings. Through the lenses provided by the concepts of habitus and agentic practice, this paper focuses on unintentional and deliberate practices of unwanted disclosure, and the consequences that may arise from this. Findings reveal how unwanted disclosure may lead to reflexive and agentic action among people with HIV as they struggle to reclaim control over their lives and how they are perceived. Despite what is sometimes assumed, the negative social responses the HIV epidemic has given rise to persist in Australia. Some 30 years into the epidemic, findings highlight the need to establish a social climate that is intolerant of unwanted disclosure, and which recognises the damage it may cause. [ABSTRACT FROM AUTHOR]

This paper examines the role of the research process in shaping the construction of knowledge about sensitive topics in in-depth interviews particularly with regard to researcher identity and cultural influences or norms. We argue that these influences shape all aspects of the research process and that researchers will benefit from reflecting upon them when planning, undertaking and interpreting qualitative studies. Drawing on an empirical study interviewing Australian women aged 55 years and older about sexuality we address differences and similarities between researchers and participants; cultural constructions of sexuality and ageing, and generational influences. Using examples from our interview data we interrogate the contribution of each of these aspects to the interview dynamic and the co-production of meaning. Our analysis draws attention to the fluidity of insider and outsider status and to the existence of hidden boundaries that impact on how certain topics can be discussed in interviews. The paper argues that knowledge about sensitive topics such as older people’s sexuality must be viewed as a situated occurrence shaped by the particularities of the interview and the cultural context. Finally, we discuss the implications of these findings for qualitative inquiries into sensitive topics. [ABSTRACT FROM PUBLISHER]

Responsible Gambling Codes of Conduct (CoC) are used around the world to describe electronic gambling machine (EGM) operator commitments to reducing harm from gambling. In addition to the provision of passive product information and warnings, CoC describe how venues should assist EGM users displaying signs of problematic gambling. The focus in this paper is on venue adherence to the active strategies described in these documents relating to supporting ‘responsible gambling’ and discouraging harmful, intensive and extended gambling. The paper triangulates data from aspirational statements by EGM operators published in CoC documents; structured, unannounced observations by the research team in 11 EGM venues; and interviews and focus groups conducted with 40 gamblers and 20 professionals in Melbourne, Australia. Results showed only isolated evidence of supportive interactions between staff and gamblers to address gambling harm. The weight of evidence demonstrated that venues often fail to respond to signs of gambling problems and instead encourage continued gambling in contradiction of their CoC responsibilities. Signs of gambling problems are a normalised feature of EGM use in these venues. To genuinely address this public health and public policy challenge, improved consumer protection for gamblers may be achieved through legislation requiring venues to respond to signs of gambling problems. This may include a range of measures such as banning food and beverage service at machines and limiting withdrawals of cash by gamblers, as well as using behavioural tracking algorithms to identify problematic gambling patterns and binding universal pre-commitment systems to complement supportive interventions by venue staff. [ABSTRACT FROM PUBLISHER]

Purpose:This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). Methods and results:An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. Conclusions:TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings.Implications for RehabilitationTriangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners.TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support.TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals. [ABSTRACT FROM PUBLISHER]

This paper addresses some of the results from a large-scale-funded research project into the coronial conceptualisation and adjudgement of suicide, founded upon an ongoing dissatisfaction with the validity of suicide data. The research is based upon in-depth interviews with 32 coroners from all but one Australian jurisdiction and focuses upon the administrative, epistemological and ontological categorisation of suicide as a type of death. The coroners express a range of concerns over the options available to them in order to produce more defensible statistics. First, coroners generally expressed a dissatisfaction with the fundamental binary finding of 'suicide/not suicide', but see little point in expanding the administrative categories available to them Second, epistemologically, coroners are open to the introduction of a classification of 'sub-intentional suicide/self-manslaughter' as a way of dealing with the issue of intent. Finally, those coroners who have significant experience with Indigenous suicide– propose the abandonment/replacement of the category of suicide altogether, due to its ontological incoherence, and its cultural flexibility. The central conclusion is that, if more valid statistics of self-inflicted death are to be produced, at very least, coroners need more choices of finding than are currently available. [ABSTRACT FROM AUTHOR]

Objective: The following mixed methods study aimed to decipher the factors influencing the psychological wellbeing of language brokers. Specifically, ethnic identity, attitudes towards brokering, family connectedness, and high intensity brokering situations were examined. Method: One hundred and twenty four individuals completed surveys in either paper pencil format or online. Six survey participants also volunteered to participate in semi‐structured interviews. Results: The quantitative results revealed ethnic identity and attitudes towards brokering positively correlated with psychological wellbeing, no support was found for family connectedness or for brokering in high intensity contexts. The moderating effects of ethnic identity, attitudes, and family connectedness on the relationship between high intensity brokering and wellbeing were not supported by the quantitative analysis. Emerging themes from the six interviews provided insight into familial relationships, community connection, and multicultural Australia with the sub‐themes of acceptance and non‐acceptance of diversity. Conclusion: These results support the current policies requiring health services and legal aid to provide free interpreters for individuals not fluent in English. Additionally, these results my assist in government bodies and policy makers providing additional support and resources to language brokers in the home setting and the community. [ABSTRACT FROM AUTHOR]

Background: This paper reports on a qualitative study utilising in-depth interviews of sixteen Australian mental health nurses (MHNs) working in general practice. On 1st July 2015, the commonwealth government of Australia established 31 primary health networks (PHN) to increase the efficiency and effectiveness of medical services for people, particularly those at risk of poor health outcomes, and to improve coordination of care. Aim: This study explores the experiences of Australian MHNs working in general practice. Design: Data were analysed using thematic analysis. Four themes emerged through the data analysis: (1) autonomy and flexibility, (2) opportunity for more clinically focused work, (3) health promotion and preventative health and (4) excited to work in general practice. Findings: Study Participants identified many clinical opportunities working in primary practice and noted that the autonomy and flexibility of their role was quite different from other areas they had previously worked. They reported having more time to spend with the patients and being able to engage in health promotion. Conclusions: In order to make mental health care more accessible it is important to have a well-qualified workforce within primary health care (PHC) settings such as general practice. The participants of this study have identified ways they have been best utilised in the Primary Care workforce. They embrace the autonomy of the role and the ability to engage with consumers by providing clinical interventions that can assess and intervene with people experiencing mental illness. [ABSTRACT FROM AUTHOR]

Background: Communication with indigenous patients is often a problem for health staff in Australia. Aim: This paper examines the barriers and enablers in communication between health staff and Indigenous carers of paediatric patients in a hospital, about advice to help reduce exposure of children to second-hand smoke (SHS). Methods: Non-indigenous health staff and Indigenous carers, were recruited from a paediatric ward of a regional hospital in the Northern Territory. A constructivist grounded theory with multiphase case study design and semi-structured interviews was used. Results: Health staff and carers had different perceptions about raising the issue of smoking. Health staff lacked confidence to talk about smoking and questioned the cultural appropriateness of doing so. In contrast, carers expected to talk about smoking while in the hospital., and perceived it as part of a caring and protective relationship by health staff. English being a second language for carers was considered a significant communication barrier by staff; carers, however, felt that health staff needed to modify their communication styles. The possible misperceptions about carers' lack of response to messages, led to health staff dropping the subject, when, in fact, carers were struggling with health workers communication styles. Conclusions: Health staff and carers perceive discussion around smoking differently. Cross-cultural communication education may empower staff to provide effective smoking cessation interventions in this setting. Impact statement: Improving communication between health staff will help ensure the optimal provision of smoking cessation support to carers. [ABSTRACT FROM AUTHOR]

This paper examines the food provisioning practices of low-income single mothers affected by market-driven welfare reforms in Australia. We explore the tensions between women's care responsibilities and the government's welfare-to-work reform, and the effects of these tensions on the nutritional health and wellbeing of women and their children. Conducting a thematic analysis of 20 interviews with single mothers receiving either Parenting Payment Single, Newstart Allowance (NSA), or the Disability Support Pension, we found that when women's income and time were significantly compromised, especially when women were transferred onto the less generous unemployment benefit NSA, that food provisioning became more psychologically taxing and nutritional health decreased. The findings suggest that public health researchers must focus on challenging the structural antecedents of women's food work and hunger to alleviate the responsibilities of single mothers in countries facing similar circumstances. [ABSTRACT FROM AUTHOR]

Many Australians living with a disability find themselves recipients of Newstart Allowance when applying for the Disability Support Pension (DSP). Newstart Allowance is designed as a short-term payment for people looking for work, with a lower fortnightly payment and limited medical and transport subsidies compared to the DSP. This paper describes the financial challenges of living with a disability while on Newstart Allowance. With a focus on the experiences of Aboriginal and Torres Strait Islander (Indigenous) Australians from two regional towns, qualitative semistructured interviews and focus groups documented experiences of 39 community members and 21 medical and nonmedical service providers supporting clients living with a disability on Newstart Allowance. Four themes were identified: (i) living with severe financial hardship, (ii) challenges complying with the DSP application, (iii) being financially penalised for not complying with Newstart Allowance conditions, and (iv) supporting community members to manage severe financial stress. Although people living with a disability on Newstart were experiencing severe hardship and poverty, there was limited participation of Centrelink-employed social workers within their described experiences with Centrelink. We argue that social workers can work to humanise human service settings and potentially help to mitigate these financial challenges. IMPLICATIONS Indigenous Australians living with a disability experience severe disadvantage and poverty while living on Newstart Allowance. Social workers must be easily accessible at Centrelink customer service centres and to Newstart Allowance recipients to help coordinate service engagement. Newstart Allowance should be increased to ensure recipients can respond to cost of living pressures. [ABSTRACT FROM AUTHOR]