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This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [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]

Australia's population is transitioning from traditional family homes to communal living, in either house sharing, institutionally provided housing or, as part of Intentional Community Living Arrangements (ICLAs). Between 2001 and 2016 there was a 42.2% increase to almost five million people living communally. This paper investigates communal living in Australia using data from the 2006, 2011 and 2016 Censuses and introduces ICLAs: group dwellings characterised by five or more unrelated individuals who intentionally combine their efforts in a self-governed manner and share aspects of living for collective community benefit. Unlike other forms of communal housing, ICLAs are not identified in the Census. To address this deficit, the paper draws upon ICLA association websites and online questionnaire responses to estimate a resident population of 25,000 members across 1700 communities. Growing public awareness of the benefits of communal living is likely to place pressure upon planners to facilitate a range of communal housing types. ICLAs have a number of attributes that make them a sustainable form of collaborative, communal housing. The adoption of the ICLA model will, however, require a shift in attitudes among planners and changes to planning regulations. [ABSTRACT FROM AUTHOR]

All papers in this special edition ofMental Health, Religion & Cultureutilise data sets from the 2011 round of the Australian National Church Life Survey (NCLS). This paper presents a methodological overview of the NCLS, including data collection methods, survey instruments and demographic descriptions of church attender and leader data sets. The data sets have good national coverage and denominational diversity, although Pentecostals are under-represented. The data sets may be further affected by self-selection by participating churches; however, the content of the surveys is unlikely to have triggered self-selection biases at the level of individuals. The paper also provides details concerning the measurement of quality of life in the present collection, concentrating on the Personal Wellbeing Index (PWI) which is featured in four of the five empirical papers. Mean PWI scores for churchgoers and leaders were similar to the Australian populace at large, although there was greater variability among churchgoers. The domain of spirituality/religion makes a significant contribution to well-being in these Australian Christian sub-populations. [ABSTRACT FROM AUTHOR]

Participating, learning music and performing are key factors to joining music ensembles. This paper situates itself in Melbourne (Australia) and forms part of my research project Promoting relationships through sound in formal and informal settings where I investigated why members of an instrumental group met to share their music making and practice and how it contributes to their quality of life. I draw on a phenomenological viewpoint from questionnaire and interview data undertaken in May 2018 with the ensemble players. Data were analyzed using Interpretative Phenomenological Analysis that is reported thematically under three broad headings: Music learning for self as a community, wellbeing and spirituality, and sharing music for the community. The findings show that staying active as older adults (50+) contributed to members sense of wellbeing as they continued to engage with music learning and performance. Playing for personal growth contributed positively to members quality of life as a serious leisure activity. Generalization to other instrumental community groups in Australia cannot be made. Further research is required to support the perceived meanings and benefits of planning, preparing, practicing and performing as older musicians. [ABSTRACT FROM AUTHOR]

In responding to the requirements of the sustainable development movement, many retirement village developers endeavor to provide a sustainable living environment for their residents. However, this cannot transpire until a thorough understanding of retirement village residents' preferences for various features of a sustainable living environment is known. The aim of this paper, therefore, is to reveal retirement village residents' perceptions of the importance of 23 sustainable living environment features through a questionnaire survey of 81 residents from 15 retirement villages. The survey results reveal that independent and convenient living, justice and fairness, being respected and valued, and privacy protection are the most preferred sustainability features, all of which are in the triple bottom line dimension of social sustainability, whereas capital gain sharing, community diversity, and care and service provision are the least important. In addition, it is found that the residents of different ages, gender, living experience, and retirement village nature have significantly different preferences toward various sustainability features. The findings of this study contribute to the management and development of sustainable retirement villages, which will eventually lead to an improved quality of life for older people. [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]

Objectives: Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson's (PwPs) in Australia, UK and South Korea. Methods: The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson's health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p <.05. Results: ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. Conclusion: This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson's. The findings are encouraging and warrant further research using more robust designs. [ABSTRACT FROM AUTHOR]

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]

Aims: The current study assesses the impact of youth drug treatment on substance use, offending and wellbeing in a sample of young people recruited from specialist youth alcohol and drug treatment. The paper examines the impact of treatment engagement on the size and substance use profile of the young person's social network and hypothesises that the best treatment outcomes are associated with maintaining the size of the young person's social network but changing its composition to reduce the representation of substance use in social networks. Methods: A cohort study of 112 young people (aged 16–21) engaged in specialist youth alcohol and drug treatment services in Victoria, Australia, were recruited at the beginning of treatment and re-interviewed six months later using a structured questionnaire. Findings: There were improvements in substance use, social functioning, mental health and life satisfaction from baseline to follow-up. While network size was associated with mental health and quality of life markers, only having a lower proportion of substance users in the social network was associated with lower substance use and offending at follow-up. Conclusions: Social networks are a key component of wellbeing in adolescence. This study suggests that through independent analysis of network size and network composition, both the size and the composition of social networks have an important role to play in developing interventions for adolescent substance users that will sustain behaviour changes achieved in specialist treatment. [ABSTRACT FROM AUTHOR]

This paper draws upon literature from economics, and the human capital and equity fields in order to present a theoretical framework for a new multidimensional measure of poverty for Australia. Poverty is about having low living standards; but its measurement has traditionally focused only on an individual's income or on other dimensions of living standards that are not appropriate for contemporary Australian society, such as calorie intake. There are two additional capabilities individuals require for adequate living standards: health and education. Each of these is required for basic functioning within modern society, but have traditionally been ignored by measures of poverty. This paper argues that health is a basic capability people need for a fulfilling life, allowing individuals to participate in activities essential in modern society, and that education can also be seen in this light. As such it is vital that health and education be included in measures of poverty. In order to move Australian poverty measurement forward and build upon the work of the past, poverty measurement must move its focus away from only looking at low income, and take a holistic focus on the living standards of individuals by incorporating assessments of health and education. [ABSTRACT FROM AUTHOR]

Increasingly ubiquitous references to night-time economy within urban revitalisation agendas mark the concept as a standard component in a globally circulating 'post-industrial city' script. The merit of the concept rests upon an assumed capacity for diverse and vibrant nightlife to contribute to urban quality of life and city marketability. Its attraction to cities seeking to expand the profitability and utility of the spectacular landscapes of consumption established along waterfront and within inner-city locales reclaimed from post-industrial disuse are readily apparent. However, only certain kinds of nightlife convey the prerequisite cultural sophistication necessary for making a 'correct' contribution to the desired city image. Consequently, nightlife is cast as a site of problematic behaviour and nightlife policy settings aimed at shifting the dominant cultures of night-specific consumption become implicated in demarcating the boundaries of appropriate activity. This paper examines these themes with respect to Newcastle, Australia. Through an analysis of the representations of nightlife cultures in local policy and planning, this paper argues that a significant contributor to the sense of crisis permeating Newcastle's after-dark urban culture has been the entanglement of nightlife in urban renewal and city re-imaging processes. [ABSTRACT FROM AUTHOR]

Our choice for care at the end of our lives is constrained by many factors, including the options available to us, our capacity to choose and the social structures that constrain our options and therefore our choices. Working with the interaction between personal agency and social constraints is a core public health activity. An intentional public health approach to palliative and end-of-life care can elucidate the direct relationship between our social circumstances and the quality of our end of life and uncover the implications of structural inequity for end-of-life choice. The approach reorients systems and settings to achieve accessible and equitable palliative and end of-life care for all, and identifies contributions that all jurisdictions, settings, organisations, sectors and communities can make to improving end-of-life care outcomes. Frameworks that support this shift in practice and policy are however in their infancy. Implementation frameworks that can structure and guide 'how' to translate public health palliative care concepts into sustainable practice are needed. This paper reports on an evidence-based Australian public health palliative care framework designed to achieve this. [ABSTRACT FROM AUTHOR]

This paper describes one aspect of a study that investigated how Advance Care Planning (ACP) was implemented in residential care facilities (RACFs) in Australia and the role of a Clinical Nurse Consultant (CNC) for ACP.Three RACFs were included in the study.This paper focuses on the implementation process of ACP by the CNC in the RACFs.The preliminary findings highlight the need to dispel the myths about ACP and Advanced Care Directives (ACDs), and how the CNC acted as a broker for ACP.The CNC's role is represented by a Nursing Brokerage Model. By revealing how ACP is implemented the research contributes to the limited existing knowledge of options that are currently available to older adults and their families in order to help them make care choices about the end of their lives. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between negative changes in health and life satisfaction, using a sample from the Household, Income and Labour Dynamics of Australia Survey. We use panel data models and estimate the life satisfaction impact of several different changes in health status to calculate the Compensating Income Variation (CIV) of them. Our work innovates with respect to the existing literature by using a more robust CIV method that takes account of the potential measurement error in income. Further, we produce the first set of monetary values for health losses using SF-6D utility values, one of the main measures used to estimate and value health change for economic evaluation. We show that negative changes in SF-6D are significantly associated with a reduction in life satisfaction, and the starting point matters: a drop of 0.1 in SF-6D score is associated with a decrease of 0.12 points in life satisfaction if the starting utility value is 0.8, but the effect is 100% higher if the SF-6D starting point is 0.7. More generally, we find that a 0.1 deterioration in SF-6D has a strong association with life satisfaction and that the CIV value is substantial (over US$ 120,000). [ABSTRACT FROM AUTHOR]

This paper contributes to the advancement of quality-of-life research in tourism by examining complex relationships involving direct, mediated, moderated and moderated mediation relationships among the antecedents to quality-of-life. Using a sample of 222 repeat visitors in an Australian national park, the findings indicate positive significant effects of (1) place satisfaction on quality-of-life; (2) place satisfaction on place attachment; (3) place attachment on quality-of-life; (4) park citizenship on place attachment. The findings further support that (5) place attachment mediates the relationship between place satisfaction and quality-of-life; (6) social involvement moderates the relationship between place satisfaction and place attachment; (7) park citizenship moderates the relationship between place satisfaction and place attachment; (8) social involvement moderates the relationship between place attachment and quality-of-life; (9) social involvement moderates the indirect effect of place satisfaction on quality-of-life. Theoretical and practical implications are discussed. Park managers, for example, need to promote on-site marketing and post-visit communication/interpretation, encouraging repeat visits and behavioural change. Message delivery needs to promote a sense of belonging to the park with personal meaning, creating place distinctiveness. Personal actions to promote include signing petitions supporting the park's biodiversity, and other resources, and volunteering to participate in meetings and other direct actions. [ABSTRACT FROM AUTHOR]

This paper explored the psychological mechanisms by which leisure enhances well-being by using sentence-by-sentence coding of the best-possible-selves text produced by 112 participants. Of the 1097 sentences, 41% were coded as leisure indicating that leisure is an important component of optimal well-being. The data showed that Australians have significantly less leisure in their daily lives than our sample desired; older and wealthier individuals placed a greater emphasis on leisure but there were no significant differences based on gender. Application of the Detachment-Recovery, Autonomy, Mastery, Meaning, Affiliation (DRAMMA) framework showed the following allocation of sentences to psychological mechanisms: Detachment-Recovery-21%, Autonomy-23%, Mastery-12%, Meaning-11% and Affiliation-33%. In their ideal future, participants imagined that they have the time and money to do what they want, particularly, to travel. We showed leisure is not solely associated with ‘having fun’; 59% of participants wanted to use their leisure time to learn, improve, or contribute to society. [ABSTRACT FROM PUBLISHER]

This paper examines the transformation of open space and how it compares to older residential development. A study has been conducted at the residential level because neighbourhoods have been a basic unit of city design throughout the recent history of urban settlements. Furthermore, the neighbourhood is a more humanly relevant scale of urban development. The method adopted for this research was a comparative urbanism by comparing old and new residential areas. This study found that incremental redevelopment of old residential areas through both re-subdivision and intensification of development on existing allotments has resulted in a progressive loss of open space. However, the study also confirmed that the current supplies of open space across all the study areas (old and new residential areas) are relatively similar. The main difference between the open space supply in older and newer residential areas comes down to the ownership of land (i.e. the proportion of public versus private open space). The study demonstrated that older residential areas with large allotments have experienced a significant loss of private open space – originally from 50%, to current levels of 23–30%. The paper concludes that there is a need for a holistic approach to the provision of public and private open spaces to improve the quality of life at a residential level. [ABSTRACT FROM PUBLISHER]

Rural communities represent a large proportion of Australia's most disadvantaged areas, with a growing percentage of older people concentrated in these locations. Older people residing in these communities are subject to both the disadvantages of rural living, as well as the health and mobility issues associated with ageing. This paper reviews the literature relating to rural disadvantage, and find that the issues are far more complex than previously thought. As well as disadvantages, there are also benefits to rural living, which can alleviate disadvantage for many older people. However, these same socio-cultural and structural factors are inter-related, and can also mask or increase rural disadvantage in certain circumstances or for particular groups. These factors are dynamic, interactive, and often invisible, and can impact on quality of life. Findings suggest a need for research into the relationship between disadvantage, the experience of rural living and the concept of healthy ageing. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

In modern times when we speak of a mobile lifestyle we think of backpackers, fruit pickers, tourists, bikies or people living in caravans. Some people, of course, deliberately choose such a lifestyle. In the context of the historical past, of the people who moved in and out of this place - Kalgoorlie (our conference venue) - one group in particular had a very mobile lifestyle, though not by choice. I refer to the Afghan camel drivers who came to Australia for economic reasons. They mostly arrived as single men and assisted the explorers in their expeditions, and contributed to the development of the infrastructure of the Australian outback. The camel drivers steered the camels, 'the ships of the desert', that carried water tanks out to the mining areas such as Kalgoorlie and Coolgardie and other areas where water was scarce. The camels also carried wool bales and boxes of merchandize from one part of Australia to another. And they carted sleepers for the construction of railway lines from Perth to Coolgardie, and materials for the development of the Overland Telegraph Line in South Australia back in 1870-1872. The mobile nature of the lives of the Afghan camel drivers never permitted them to stay in one place for long. The Afghans were predominantly Muslims. They retained their culture and religion in such a harsh lifestyle. In this paper I examine the pattern of their mobile lifestyle from 1860 to 1930 and discuss their identity when they were with other ethnic groups, conflict when they faced resistance and their outspoken nature when they were regarded as the 'other'. Finally, I consider their loyalty to their Australian employers (and explorers). This paper relies on both primary and secondary sources, including oral testimonies. [ABSTRACT FROM AUTHOR]

This paper reports our experiences with the application of a number of alternative approaches to a study of women's economic circumstances and quality of life in a typical western city. The important work of, especially, Martha Nussbaum on the capabilities approach to evaluations of “quality of life” has highlighted pitfalls associated with the use of a narrow informational base in studies of women's lives and has emphasized the value of qualitative methods in these evaluations. However, to date, most discussions of the relevance of plural approaches to studies of women's lives have been conducted in the context of developing countries. This paper contributes a practical, current example of the relevance of such approaches to assessments of the lives of women in western countries as well. The research findings reported in the paper also cast further light on the importance of several, related themes in the literature on the capabilities approach, namely the importance of understanding how women's aspirations and expectations change with their economic and social experiences; and the importance of appreciating the social uses of language and how this affects the way in which women describe their lives. [ABSTRACT FROM AUTHOR]

Beginning in 2013, the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (referred to as the Royal Commission) bought to public consciousness a history of child sexual exploitation that contradicts dearly held values of the preciousness and innocence of childhood and the trust of public organizations. The Royal Commission has publically validated the trauma that victims have experienced across institutions. It has also identified and raised the issue of a symptomatology ofcultural traumaat work in community and public life. Using the work of contemporary trauma theorists and applying it to one hearing held in Victoria in May 2015, this paper suggests that collective trauma can shape cultural identity and influence the quality of communal life. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to identify groups of cardiac patients who share similar perceptions about their illness and to examine the relationships between these schemata and psychosocial outcomes such as quality of life and depression. A total of 190 cardiac patients with diagnoses of myocardial infarction, stable angina pectoris or chronic heart failure, completed a battery of psychosocial questionnaires within four weeks of their admission to hospital. These included the Brief Illness Perceptions Questionnaire (BIPQ), Beck Depression Inventory II (BDI II) and The MacNew Health-related Quality of Life instrument (MacNew). BIPQ items were subjected to latent class analysis (LCA) and the resulting groups were compared according to their BDI II and MacNew scores. LCA identified a five-class model of illness perception which comprised the following: (1) Consequence focused and mild emotional impact, n = 55, 29%; (2) Low illness perceptions and low emotional impact, n = 45, 24%; (3) Control focused and mild emotional impact, n = 10, 5%; (4) Consequence focused and high emotional impact, n = 60, 32%; and (5) Consequence focused and severe emotional impact, n = 20, 10%. Gender and diagnosis did not appear to reflect class membership except that class 2 had a significantly higher proportion of AMI patients than did class 5. There were numerous significant differences between classes in regards to depression and health-related quality of life. Notably, classes 4 and 5 are distinguished by relatively high BDI II scores and low MacNew scores. Identifying classes of cardiac patients based on their illness perception schemata, in hospital or shortly afterwards, may identify those at risk of developing depressive symptoms and poor quality of life. [ABSTRACT FROM PUBLISHER]

Australians are getting older, faster. This paper presents the statistical picture and describes the implications and opportunities for public library services. The author argues that federal funding for high speed broadband, Internet training, health information services, and for fostering partnerships with other community service agencies would make a major difference to quality of life for ageing Australians. [ABSTRACT FROM AUTHOR]

Urinary Incontinence - the accidental leaking of urine - is a major problem in Australia and has a significant impact on quality of life, affecting the social, psychological, physical and financial aspects of life. The prevalence of urinary incontinence is significantly higher in women than in men. While urine loss itself is a devastating symptom, older women are also likely to suffer lower urinary tract symptoms associated with the overactive bladder syndrome such as urgency, frequency, mixed incontinence and nocturia which are reported more frequently in older women. These symptoms disrupt activities of daily living as well as seriously disturbing sleep and general health status. Conservative nurse interventions have been shown to be effective in the management of these symptoms. Simple assessment tools suitable for use by primary level clinicians and conservative management strategies are discussed within the paper. [ABSTRACT FROM AUTHOR]

The effective management of work/life balance (WLB) is an issue increasingly recognized as of strategic importance to organizations and of significance to employees. We argue that an organization's need to attract and retain valued employees in a highly competitive labour market is a strong motivating factor for increased organizational awareness and action with regard to implementation and management of WLB strategies. In this paper, we report the findings of three surveys conducted annually from 1997 to 2000 with organizations in Australia. We explore the range and usage of WLB strategies in Australian organizations and identify the barriers to those strategies. It is evident that, while some achievements have been made over the years, there remain substantial challenges for the uptake and management of WLB strategies. [ABSTRACT FROM AUTHOR]

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For patients with metastatic, incurable cancer the prognosis itself and its acceptance may influence their subjective well-being. This paper addresses the issue of what patients with incurable cancer should be told about their disease. It considers whether the patients' will to live and perceptions of the information their doctor provides may have consequences for well-being. The analysis is of a subset of data from a study of patients diagnosed with metastatic, incurable cancer who were recruited prospectively from one of several treatment centres in south-east Queensland, Australia. The sample is restricted to 46 patients with evaluable data at three points in time: within two weeks of diagnosis of metastatic, incurable cancer (T1); approximately three months after enrolment in the study (T2); and within eight weeks of death (T3). The results examine the impact of the patients' will to live and beliefs about curability of their disease on their quality of life. The will to live leads to an optimistic assessment of curability, which in turn enhances assessments of subjective well-being or quality of life as patients near death. [ABSTRACT FROM AUTHOR]

Recent research in Australian sociology and political science has debated the extent to which postmaterialist values and economic self-interest shape voting in federal elections. Some researchers have argued that postmaterialist values have partly displaced materialist concerns with physical security and economic well-being in Australian public life. This displacement, coupled with the adoption by major political parties of postmaterialist 'quality of life' issues such as the environment, has meant that voting in Australia has come to be more dependent on postmaterialist values than on perceptions of economic interest. Other research, however, has found no relationship between postmaterialist values and voting behaviour, while economic evaluations remain a strong determinant of voting behaviour. Part of the disagreement reflects methodological differences in the research. But different methodological problems compromise each of the previous studies. In this paper we use data from the 1990, 1993, 1996 and 1998 Australian Election Studies to investigate postmaterialist and economic voting in the Commonwealth House of Representatives and the Senate. Using various statistical methods, we first explore bivariate relationships between key variables and then use multivariate models of postmaterialist and economic voting to adjudicate between the contending positions. [ABSTRACT FROM AUTHOR]

Dystonia is a neurological disorder characterised by involuntary muscle contractions. Pain is the primary non-motor symptom, and limited studies have investigated how dystonic pain is experienced. This study aimed to investigate how people with isolated dystonia describe their pain and compare across subgroups of dystonia. Anonymous online survey via social media asking participants to describe their pain in their own words, complete the McGill Pain Questionnaire (MPQ), and answer demographic questions. Thematic analysis identified common themes and frequencies were calculated for demographic and MPQ data. One-hundred and sixty-five respondents were included (mean age 51 years, 85% female). Thematic analysis identified four major themes "Physical sensations", "Temporal features", "Destruction", "Impact on life" with several sub-themes. The most chosen MPQ descriptor was "exhausting" followed by "tight," "sharp," "pulling," and "aching". The most common descriptors showed similar prevalence across subgroups of dystonia. As no objective tests for pain exist, pain sufferers must use language to describe their pain experience. People with isolated dystonia used sensory words combined with metaphorical language to detail temporal features of pain, as well as destructive internal battles or feelings of external forces acting upon them, and the significant toll pain has on everyday life. Pain is a common and debilitating non-motor symptom for people living with dystonia and should be discussed in a persons treatment plan. Pain sufferers use language to discuss their pain experience with others and report they don't feel well understood by others including health professionals. People with dystonic pain commonly described physical sensations, temporal features, destructive forces, and the impact on life caused by their pain. Findings suggest the experience of pain with dystonia is varied and better pain management options for people with dystonia are needed. [ABSTRACT FROM AUTHOR]

Cerebral palsy is a leading cause of physical impairment worldwide. Community support and acceptance influence the opportunities people with cerebral palsy have to participate in all areas of life, but very little is known about the general community's understanding of cerebral palsy. This study investigated knowledge and perceptions of cerebral palsy in the Australian community. A sample of 1,217 adults responded to an open-ended question: 'What is the first thing that comes to mind when you think about cerebral palsy?' Almost half of the sample indicated some awareness that cerebral palsy is a physical disability involving difficulties with muscle control, movement and coordination; however, 20% of the participants had no knowledge or stated incorrect facts. Wheelchairs were the first thing that came to mind for 10% of the sample. Few participants mentioned common comorbidities such as cognitive or communication difficulties. A substantial minority of responses (8%) were characterised by stigma or insensitivity. Although many people in the general community appear to have accurate knowledge about cerebral palsy, misperceptions and stereotypes are likely to impact on quality of life and personal well-being for individuals with cerebral palsy and their families. [ABSTRACT FROM AUTHOR]

Australia's Royal Commission into Aged Care Quality and Safety has reported abuses, neglect and a level of systemic apathy and unwillingness to innovate across the nation's aged care sector. Isolation and loneliness stand out as the sector's two most pernicious problems which the current pandemic has only exacerbated. To attempt to ameliorate the situation, the author created a fieldwork intervention that puts undergraduate students into aged care facilities to work with residents on discussing, transcribing, editing and publishing the resident's biography. The "Biography Project" provides much needed contact and connection for residents but also touches on the quality of relationships with family, friends and care staff and supports intergenerational connections for undergraduate students. The article describes the project and its outcomes for students in the hopes of providing a model for geriatric education that could be implemented elsewhere. [ABSTRACT FROM AUTHOR]

An important part of the feminist planning project is to make visible the many and varied contributions of women in planning. However, despite the substantial advances of feminist movements, planning education and practice has yet to consistently understand and address the needs of marginalised groups, particularly women, and has struggled to adopt intersectionality as a fundamental planning concern. This has significant practical and political implications. Spatial and kyriarchal power structures create gendered experiences of the built environment and the planning and provision of infrastructure and services can have significant impacts on women’s safety, quality of life and access to opportunities. This special issue explores the multiple ways that women are the objects and subjects of planning within structures of power. This editorial positions the contributions in this issue by considering the extent to which planning has addressed the needs of women. While we cannot trust that progress in this regard will continue to be linear and cumulative, we find cause, through these contributions, to celebrate both the legacy and the future of women in planning. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) is associated with elevated rates of eating disorders (EDs), but the nature and impact of specific ED features are unclear. This study sought to identify which ED features are common in BD, and whether these relate to quality of life (QoL) impairment and body mass index (BMI). A clinical sample of 73 adults with BD completed self-report measures of health, ED features, emotion regulation ability, impulsivity, and QoL. Binge eating (45%), excessive dietary restriction (39%), overvaluation of weight/shape (51%), purging (16%) and driven exercise (27%) were common, and associated with a poorer clinical picture, including poorer QoL and poorer emotion regulation. Furthermore, regular binge eating episodes explained a significant proportion of variance in QoL impairment after controlling for other significant predictors. The best predictors of BMI were number of medical conditions, impulsivity and positive beliefs about binge eating. ED features that may not meet criteria for a fully diagnosable ED – particularly overvaluation of weight/shape and binge eating – warrant greater attention, as they may still significantly worsen QoL. Future research should focus on modifying existing psychological interventions to better target ED features among individuals with BD and thereby improve clinical outcomes. [ABSTRACT FROM AUTHOR]

A key goal of the NDIS, the federally funding individualised funding scheme for people with a disability in Australia, is to facilitate an ordinary life for them in their communities. This study examined family perceptions of the contribution NDIS made to create an ordinary life for their adult member with intellectual disability. Semi-structured interviews were conducted with 20 families. The families found this to be a complex process in that while the move to the new funding system supported some elements of a life more aligned to that of similar aged peers, there were also a number of missed opportunities. The opportunities that were available to the adult with intellectual disability were affected by stakeholders' differing views of disability. NDIS presents an opportunity to continue to build towards enabling people with a disability to make their own choices and, with support when needed, build a life similar to their peers. The National Disability Insurance Scheme (NDIS) is the new federal individualised funding scheme for people with a disability in Australia. The National Disability Insurance Scheme gives people with a disability their own funding. This helps them to be able to make their own choices about what they want to do and what support they need. The National Disability Insurance Scheme hopes to support an ordinary life for people with a disability in their communities. This study investigated how it is working for adults with intellectual disability. It showed that it is a complicated process. Some aspects of the National Disability Insurance Scheme are working well but there are missed opportunities. There is a need to keep talking about how people think about disability so we can understand the impact different views have on the National Disability Insurance Scheme planning and outcomes for adults with intellectual disability. [ABSTRACT FROM AUTHOR]

Social and financial remittances from the Australian Seasonal Worker Programme (SWP) have transformed the livelihood capabilities of participating households from Timor-Leste. Timorese workers generally participate in SWP for a six-month period, with many returning for subsequent seasons. Qualitative, multi-sited research investigated the livelihood strategies of 50 Timorese worker households over a three-year period. Their net earnings averaged between 4000 and 8000 USD per season, varying with the type of employment, living costs and their ability to save. Remittances assist in strengthening livelihoods by consolidating financial, physical, social, natural and human capital, improving the quality of life for returning workers, their households and communities. Remittances maintain and consolidate social relationships, and enable investments in entrepreneurial activities, education and house building. Migrant workers exhibited a strong preference for developing social capital, with many investments in other livelihood assets underpinned by a desire to strengthen social relationships, reflecting beliefs that this enhances livelihood resilience. While remittances have made greater direct contributions to livelihoods than economic production within Timor-Leste, at least for participating households and their immediate networks, this expenditure on social capital also suggests the broader structural limitations of using remittances in a 'productive' way (through capital accumulation) within labour-sending countries. [ABSTRACT FROM AUTHOR]

For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. [ABSTRACT FROM AUTHOR]

To extend the authors' previous research by investigating the maintenance of work performance over time and the long-term experience of employment following traumatic brain injury (TBI). Semi-structured interviews were conducted with a sample of 72 individuals with predominantly severe TBI, up to 10-years post-injury. Thematic analysis of transcribed interviews was conducted. Four key themes were identified: brain injury influences on work performance and long-term employment; factors optimising long-term employment; and need for compromise and acceptance, which all impacted the final theme, quality of life outcome. While TBI-related difficulties such as fatigue, cognitive, and emotional difficulties still impacted work many years post-injury, work modifications and employer and vocational rehabilitation (VR) support were important factors optimising long-term employment. The timing of return to work (RTW) was also an important and potentially modifiable factor influencing work performance, which appeared to have long-term effects on the maintenance of employment. Support for acceptance of altered career goals is needed. Findings support the need for early VR to facilitate employer contact, to maximise adjustment and preparation time before RTW, to educate both employees and employers and to implement work modifications to support continuing employment after TBI. The maintenance of employment following TBI is of critical importance for financial independence, psychological and social well-being, and improved quality of life. Injury-related difficulties still impact work performance many years after injury requiring individuals with TBI to continue working in modified roles and for reduced hours over the long-term. Ongoing VR and employer support is needed to facilitate long-term work modifications and compensatory strategies to support work performance. Early VR involvement to facilitate employer contact and maximise adjustment and preparation time before returning to work is necessary to avoid the negative and potentially dire consequences of returning too early. Psychological support to facilitate acceptance of role changes and career compromises is also important. [ABSTRACT FROM AUTHOR]

Self-management can lead to increased self-efficacy and improved quality of life for individuals with chronic conditions; however, there is little research exploring how self-management approaches can be used for chronic communication disorders, such as aphasia. Modifications to self-management approaches would be required to accommodate for aphasia; therefore, the input of people with aphasia (PwA) should be sought. The aims of the present study were: (1) To investigate and document the experiences and perspectives of PwA regarding self-management; (2) To explore how technology can be used to support aphasia self-management. In-depth, semi-structured interviews were conducted with 26 PwA living in Australia. Qualitative content analysis was used to analyse interview data. Analysis resulted in six themes: (1) In self-management, PwA take control of life with aphasia and assume responsibility for engaging in opportunities to improve overall communication; (2) Community aphasia groups are important enablers of self-management because they facilitate peer support; (3) Communication partners (CPs) provide multifaceted support in aphasia self-management; (4) SLPs provide integrated support and coordination in aphasia self-management; (5) Technology supports PwA to self-manage speech therapy and communication in daily life; (6) Psychological and physical health issues and societal factors may impact aphasia self-management abilities. From the perspective of PwA, aphasia self-management involves enhancing skills enabling communication and life participation. PwA are central to aphasia self-management, with support provided by CPs, peers, and SLPs. Technology has a range of applications in aphasia self-management. PwA identified potential personal and contextual barriers that may impact self-management. For people with aphasia, engaging in conversation and social interaction are primary means of managing/improving communicative life participation; therefore, this should be a key focus of aphasia self-management programs. Aphasia self-management approaches should maximise the use of available support and provide tailored information, education, and training in the area of self-management to key stakeholders (people with aphasia, communication partners, and speech-language pathologists). People with aphasia should be supported to use technology for aphasia self-management, encompassing communication specific and daily life use. People with aphasia should be heavily involved in the development of structured aphasia self-management approaches. [ABSTRACT FROM AUTHOR]

This study determined changes in multiple aspects of mental health and wellbeing in newly admitted nursing home residents, and identified risk and protective factors. Participants were 204 residents recently admitted to one of 42 nursing homes in Melbourne, Australia. A subgroup of 82 participants were followed up eight months post-admission. Depression, anxiety, stress, adjustment, and quality of life were assessed at baseline and follow-up. Predictive factors (demographics, health, transition factors, nursing home characteristics) were examined in multiple regression analyses. Rates of depression and anxiety were high at both baseline and follow-up. Low self-rated health and medical comorbidity predicted poor wellbeing at baseline. Higher perceived control in the relocation to the nursing home and engagement in meaningful activities were associated with better post-admission outcomes. Baseline psychotropic medication use predicted lower anxiety at follow-up but did not impact depressive symptoms. There were no significant changes in mental health and wellbeing from one to eight months post-admission. The negative effect of residing in a for-profit nursing home requires further investigation. Individual activity scheduling and an opportunity to participate in relocation decision-making and planning may support resident wellbeing post-admission. [ABSTRACT FROM AUTHOR]

To provide evidence-based guidance specific to allied health and nursing practice for the assessment and management of individuals with Duchenne muscular dystrophy (DMD). Thirteen key focus areas were identified in consultation with health professionals and consumer advocacy groups. A series of systematic literature reviews were conducted to identify assessment and management strategies for each key focus area. A consensus process using modified Delphi methodology, including an Australia-New Zealand expert consensus meeting, was conducted. Recommendations underwent consultative review with key groups before being finalised and prepared for dissemination. This clinical practice guideline (CPG) generated 19 evidence-based recommendations, 117 consensus-based recommendations and five research recommendations across the 13 focus areas to inform allied health assessment and management of individuals with DMD. The resulting recommendations can be used in conjunction with existing medical CPGs to improve, standardise and advocate for allied health and rehabilitation care in DMD. The process used here may be useful for the development of CPGs in other rare diseases. Implementation-ready evidence-based statements to guide clinical care of individuals with DMD are provided with the potential to improve participation, function in the community and quality of life. A model for developing best practice statements for other rare neurological diseases is described. Allied health and nursing health professionals should focus research efforts to generate quality evidence to support rehabilitation practice. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated inconsistency in the effectiveness of staff training programs in consumer directed care (CDC) as a means of enhancing the quality of life (QoL) of residents. The aim of this study was to investigate why this might be the case. We analyzed disaggregated cluster-by-cluster resident QoL outcomes after nursing home staff completed a CDC training program. In total, 33 nursing homes (11 clusters) participated in the study. As with previous studies, the outcomes across nursing homes were inconsistent – QoL improved at some sites but at many it remained stable or declined. Analysis of facilitator notes from the most and least successful clusters indicated that a lack of organizational support, for both the training and subsequent practice of CDC, was potentially the key barrier to effective implementation of training and so improvement in resident QoL. These findings demonstrate that all levels of aged care organizations – on the floor staff, managers and senior staff – need to fully support a CDC model of care to optimize outcomes for residents. Staff require training in CDC as well as long-term culture change within the nursing home so that training can be translated into practice. [ABSTRACT FROM AUTHOR]

Objective: To provide a critical analysis of evidence describing the implementation and effectiveness of cranberry products for the prevention of urinary tract infections in the setting of residential aged care. Methods: A critical analysis of the literature. Results: The current evidence indicates that cranberry products decrease the occurrence of urinary tract infections in aged care residents who are likely to benefit from the use of cranberry products as a preventative measure; however, some of the results were limited and contradictory, because of gaps and insufficient research in relation to the active ingredients of cranberries – proanthocyanins. Conclusion: This critical analysis demonstrates benefits in the use of cranberry products in the prevention of urinary tract infections for residents of aged care facilities. Further research and education on preventative measures could potentially lower the use of antibiotics and the incidence of urinary tract infections in residential aged care. [ABSTRACT FROM AUTHOR]

Purpose: To examine (1) the association between low language (LL) and caregiver's health-related quality of life (HRQoL), (2) whether persistent LL affects caregiver's HRQoL and (3) whether child social-emotional-behavioural (SEB) difficulties attenuates the association between LL and caregiver's HRQoL. Method: Data were from the Early Language in Victoria Study (ELVS) and the Longitudinal Study of Australian Children (LSAC). Caregiver's HRQoL was measured using the EuroQoL-5 dimensions and the Assessment of Quality of Life-8 dimensions. Language ability was determined using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool-2nd or 4th edition (ELVS) and the Peabody Picture Vocabulary Test-3rd edition or CELF-4 recalling sentences subscale (LSAC). Child SEB difficulties were measured using the Strengths and Difficulties Questionnaire. Multivariable linear regression was used for the analysis. Result: At 11–12 years, an association between LL and reduced caregiver's HRQoL was found in LSAC, but not in ELVS. Persistent LL from 4–11 years seemed to not affect caregivers' HRQoL in either cohort. Child SEB difficulties attenuated the association between caregiver's HRQoL and LL. Conclusion: Both LL and SEB difficulties contributed to reduced caregiver's HRQoL at children age 11–12 years. Interventions supporting children with LL should consider caregiver's well-being in provision of care that meets families' needs. [ABSTRACT FROM AUTHOR]

Engagement in everyday activities has been identified as an important element in personal recovery from the experience of mental illness and a key priority for service-users. This study explored the role of everyday activities in recovery. This study used a photovoice participatory research. Twenty-one participants experiencing mental illness were recruited from a community-managed mental health service in Melbourne, Australia. Data collection included individual interviews and photovoice courses. The courses included group discussions and required participants to take photographs about their everyday activities that support recovery. A lived experience co-facilitator contributed to development and delivery of the course. The interviews and group discussions were transcribed verbatim and analysed using constant comparative methods. Recovery as a "journey of living well" was identified as the central theme that encompasses three interlinked categories: (1) living a life on hold; (2) choosing to recover; and (3) learning and navigating strategies. The findings suggest that recovery involves a range of experiences embedded in people's everyday lives. Recovery-oriented practice should provide opportunities for engagement in meaningful activities, to help consumers identify their potential and strategies to live well, and to adopt co-production at all levels. [ABSTRACT FROM AUTHOR]

Lesbian women and gay men are at greater risk of post-traumatic stress disorder (PTSD) than heterosexual people, however few studies have examined PTSD in older lesbian women and gay men. This study examined predictors of having ever been diagnosed with PTSD, as well as relationships to current quality of life, among 756 lesbian women and gay men aged 60 years and older in Australia. Participants were surveyed on their sociodemographic characteristics, experiences of sexual orientation discrimination over their lifetime, whether they had ever been diagnosed with PTSD, whether they were currently receiving treatment for PTSD, and their current quality of life. After adjusting for sociodemographic variables, participants who reported having a PTSD diagnosis (11.2%) had significantly more frequent experiences of discrimination over their lifetime and were significantly less likely to currently be in a relationship. Older lesbian women were significantly more likely than older gay men to report ever having had a PTSD diagnosis. Additionally, having ever been diagnosed with PTSD significantly predicted current poorer quality of life. These findings suggest that a history of PTSD among older lesbian women and gay men is linked to experiences of discrimination and other factors, with associated links to current quality of life. [ABSTRACT FROM AUTHOR]

In Australia there is widespread community concern about the wellbeing of adolescents, particularly at the important time of approaching the transition from school to post-school life. However, few studies have focused on the wellbeing of Australian Year 12 students. This paper reports on a study investigating wellbeing among 377 Year 12 students in three public high schools in eastern Australia. The study explored wellbeing in terms of environmental and personality variables and investigated whether the school setting provided environmental elements that enhance adolescent wellbeing in ways similar to those provided by employment for adult wellbeing. The results indicated that school contributed significantly to adolescent wellbeing by providing time structure, access to the wider society, and social contact. Personality variables were found to be significant predictors of life satisfaction and affective wellbeing. The findings have implications for the enhancement of environmental features that may optimise the wellbeing of adolescents at school. [ABSTRACT FROM AUTHOR]

A recent general population study of Chew and Spit (CHSP) behavior in adults found a 0.4% prevalence, predominantly in females. The current study explores this further by examining the same phenomenon in secondary-school aged adolescents. This study also explores the relationship between CHSP and other demographic and eating disorder (ED) features in 5111 adolescents (11-to-19 years of age) from 13 schools in New South Wales, Australia. Participants completed measures of ED symptoms and behaviors and change to impairment with two components: psychological distress (K-10) and health related quality of life (HRQoL; PedsQL). CHSP was found to have a 12.2% (95% CI 0.114, 0.132]) point-prevalence rate. Participants who indicated engaging in CHSP reported significantly higher levels of psychological distress (K-10) and lower HRQoL scores (PedsQL) compared to those that did not report CHSP. There was a dose-response relationship between CHSP frequency, psychological distress and HRQoL physical scores but not for HRQoL emotional and HRQoL social scores. Participants who reported regular CHSP were more likely to be female, younger, and to engage in compensatory behaviors such as purging. The high frequency of CHSP behavior in adolescents with disordered eating could suggest that CHSP should be considered in routine ED screening practices. Future studies may examine how to treat CHSP or investigate more focused treatment approaches, in order to target the behavior of CHSP more directly. [ABSTRACT FROM AUTHOR]

In recent years, academic staff unions and associations have argued for higher salaries for academics on the grounds that existing salaries have not kept pace with inflation, are well below commercial salaries and, most glaringly, are much lower than the salaries of their overseas counterparts. However, most international comparisons are made based on exchange rate conversions, which is inappropriate since purchasing power differentials are only reflected in exchange rates in the long term. Furthermore, the volatility of exchange rates make such conversions highly inaccurate. A comparison is provided of real academic salaries by converting the nominal salaries in each country to their purchasing power equivalents , using the Big Mac Index. Our results show that real academic salaries are highest in Hong Kong and Singapore, relative to the developed countries, while Hong Kong tax and social security deductions are lowest. Furthermore, real salary levels, combined with intrinsic considerations such as the quality-of-life, indicate that Canada and New Zealand are unattractive places for visiting/migrating academics, while Australia and the USA are relatively attractive. It is suggested that these findings could be of use to policy-makers and academic unions in salary negotiations, as well as academics making relocation decisions. [ABSTRACT FROM AUTHOR]