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This paper is a retrospective look at the last ten years of development in online third-party arrangements within the Australian higher education sector. A total of 42 higher education providers are reviewed. The analysis initially focuses on the state of online third-party arrangements in Australian higher education. It then investigates the current scale of partnership arrangements these universities have with third-party companies that offer education technology platforms to deliver online courses. The analysis indicates that online third-party arrangements are likely to grow in post COVID-19 context. However, despite the scale of the activities, this paper reveals that better data collection and reporting are needed to inform third-party education delivery at the national level. The paper highlights the need for universities to set and monitor standards for the courses delivered in an online third-party arrangement. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9 years. Methods: A retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013–2022. The demographic factors analysed were gender, age, and origin of qualification. Regions of work were defined using the Modified Monash (MM) model. Results: The number of registered doctors increased from 82,408 in 2013 to 111,908 in 2022 but mean hours worked per week decreased from 41 to 39 leading up to 2020. Trends in age and origin of qualification remained stable, but the proportion of female workers increased from 38.5% in 2013 to 44.5% in 2022. While female hours per week (~37) were consistent from 2013 to 2020, male hours per week decreased from 43 to 41. The number of registrations and total full-time equivalent (FTE) outcomes increased consistently in metropolitan (MM1) and rural (MM2–5) regions but did not increase for remote and very remote (MM6–7) regions. Conclusion: The Australian medical workforce both grew and changed between 2013 and 2022. An overall decrease in mean hours worked appears to be driven by a decline in hours worked by male workers and the increased proportion of female workers. While increased gender parity and a decrease in hours worked per week were positive outcomes, a lack of growth in the medical workforce was noted in remote and very remote regions of Australia. What is known about the topic? Changes in the medical workforce over time are likely to impact health service delivery. What does this paper add? This paper examined changes in the gender, age, origin of qualification, and the region of work of Australia's medical workforce from 2013 to 2022. What are the implications for practitioners? An increase in gender parity and a decrease in the mean hours worked suggests improvements in workforce participation and sustainability, but lack of growth in medical workforce was noted in remote and very remote regions of Australia. [ABSTRACT FROM AUTHOR]

Aims: To describe a reflexive account of a mental health nurse as researcher undertaking a mixed methods study as part of a doctoral degree, with women in a secure forensic hospital. Design: A discursive paper that draws upon the primary author's experience of dual roles as a mental health nurse and a novice researcher, and relevant literature pertaining to positionality and reflexivity in the context of conducting mixed methods research. Methods: A mixed methods study was conducted within a secure forensic hospital in Australia, to identify factors associated with the frequency and duration of seclusion for women and, to explore their experiences of seclusion. Notes and a reflective diary were used to demonstrate the reflexive approach and strategies used throughout the study design and data collection stages of the research. Results: Women in the secure forensic hospital setting often have complex histories and experiences and are considered a vulnerable group, which can add additional challenges when undertaking research with this population. As a doctoral student with clinical experience in mental health undertaking research in the forensic hospital setting with women, positionality and the connection with reflexivity requires exploration to understand self and the influence on research. This understanding along with identified strategies to enhance reflexivity, supports the management of the dual nurse as researcher roles to enhance all stages of the research process. Conclusion: Doctoral nursing candidates undertaking clinical research in their area of clinical practice and at the location of previous employment, may experience challenges in relation to identity and the dichotomy of roles. Further challenges can be posed when research involves complex populations and/or controversial practices. Support to balance role conflict and maintain reflexivity is critical to understanding the role of self in research and to enhance credibility. Implications for the Profession and/or Clinical Practice: Women are a complex, yet minority population in forensic mental health settings, however the numbers of women being admitted to services is increasing. Future research may consider the use of the strategies explored here to enhance the reflexive process, and support future researchers in this field to conduct research that aims to support an often‐misheard population to better support health outcomes. Patient or Public Involvement: There was no patient or public contribution to this paper, however the study in which this paper is based on, is grounded in the experience of patients (women). [ABSTRACT FROM AUTHOR]

Objective: To scope how the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) has been applied to measure socio-economic status (SES) in peer-reviewed cardiovascular disease (CVD) research. Methods: The Joanna Briggs Institute's scoping review methodology was used. Results: The search retrieved 2788 unique citations, and 49 studies were included. Studies were heterogeneous in their approach to analysis using SEIFA. Not all studies provided information as to what version was used and how SEIFA was applied in analysis. Spatial unit of analysis varied between studies, with participant postcode most frequently applied. Study quality varied. Conclusions: The use of SEIFA in Australian CVD peer-reviewed research is widespread, with variations in the application of SEIFA to measure SES as an exposure. There is a need to improve the reporting of how SEIFA is applied in the methods sections of research papers for greater transparency and to ensure accurate interpretation of CVD research. What is known about the topic? A socio-economic status (SES) gradient is well established for cardiovascular disease (CVD). Research has generally applied two approaches to classifying SES: at an individual level using income, education or occupation data, and at an area level using a range of existing socio-economic information, including the Australian Bureau of Statistics (ABS) Socio-Economic Indexes for Areas (SEIFA). What does this paper add? This review examined how SEIFA has been applied to measure SES in Australian peer-reviewed CVD research and to identify any variations in research practice. What are the implications for practitioners? It is recommended that researchers provide a clear explanation in the methods section of research papers as to which SEIFA version and index was applied, how it was applied, at what spatial unit, and whether the spatial unit was an ABS or non-ABS unit. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Background: As a result of the ten years (2012-2022) work under the critical revision of the genera of Reticulariaceae, a set of papers was published. Collection data of hundreds of specimens, used as a material for these studies, were provided as supplements of corresponding papers, but remained unpublished in biodiversity databases. New information: Here, we represent an occurrence dataset "Barcoded Reticulariaceae of the World", published in GBIF. It includes data on 523 myxomycete collections (including 36 types) gathered from five continents and spanning 24 countries. The dataset encompasses 43 distinct species and one subspecies of myxomycetes, including rare, endemic, and recently-described taxa. Species included to the database mainly belong to the genera Alwisia, Lycogala, Reticularia, Siphoptychium, Thecotubifera and Tubifera (Reticulariaceae), but as well Lindbladia and Licaethalium (Cribrariaceae). Nearly all of the research material, with the exception of several old collections, underwent molecular barcoding, primarily involving the 18S rDNA gene, but also the elongation factor 1α gene and mitochondrial cytochrome oxidase subunit I gene. For those sequences that are stored in the NCBI GenBank, accession numbers are provided in the dataset. Newly-described species make up a significant part of the studied herbarium collections; many of them can be characterised as common for their region. A particularly high level of taxonomic novelty is observed in Australia, which may be explained by the endemism of the local myxomycete biota. [ABSTRACT FROM AUTHOR]

For more than a decade, the Financial Technology (FinTech) industry has been growing, and it has reshaped how payments were made and brought new financial service products to the market. FinTech has created innovative disruptions to traditional, long-established financial institutions (e.g., banks and investment firms) in financial services markets. The worldwide blooming of FinTech has caused universities around the globe to teach their students (particularly those in the IT and finance disciplines) about practical and contemporary knowledge on FinTech. This paper discusses our recent survey study to investigate the status quo of offering FinTech education and training by Australian universities. Our study involved two rounds of online data collection (one in November 2021 and the other one in June 2022) from 41 sample universities in Australia. Among our various findings, we observed that, although Australian universities are increasingly aware of the importance of and the demand for FinTech studies, FinTech has still not yet become a mainstream study discipline. This observation indicates that, in Australia, FinTech studies have generally gone through the inception stage and entered the growth stage. [ABSTRACT FROM AUTHOR]

In this case study we describe how Sydney Local Health District (SLHD) Disability Inclusion and Advice Service (DIAS) provided support to disability group homes during the COVID-19 Delta and Omicron waves. The study provides insights into group home providers' experience of supports implemented by SLHD and other stakeholders. A mixed method approach was undertaken that included analysing data from a database and electronic medical records and a survey of disability group home managers. DIAS developed a range of processes to support prevention, outbreak preparedness and response. This included developing a Disability Shared Living COVID-19 Pathway, engaging with group home providers through a fortnightly Community of Practice, assisting with improving vaccination status and procuring personal protective equipment. During an outbreak DIAS provided a 24 h, 7 days per week on call support, coordinated outbreak management team meetings and collaborated with several internal and external stakeholders. SLHD infection prevention and control nurses were recruited to undertake a process of reviewing outbreak management plans and providing support during an outbreak. Most disability providers (86%) reported that they felt very prepared to manage outbreaks at the time of the survey (August 2022) compared with the pre-Delta wave, for which 36% reported feeling 'not prepared'. The proportion who rated the support from the stakeholders as very supportive/supportive was as follows: SLHD (100%), NSW Health (64%), National Disability Insurance Agency (50%) and National Disability Insurance Scheme Quality & Safeguards Commission (37%). Our case study provides insights into the support that LHDs can provide to disability homes in response to future outbreaks. What is known about the topic? People with a disability (PWD) are at higher risk of morbidity and mortality following COVID-19 infection but little is known about how PWD were supported during the COVID-19 pandemic. What does this paper add? Describes one local health district (LHD's) approach to prevent, manage and minimise COVID-19 outbreaks in disability group homes along with insights from the disability group home managers on their experience of support provided by the LHD and other stakeholders. What are the implications for practitioners? Awareness of effective strategies supporting PWD that could be replicated in health organisations. [ABSTRACT FROM AUTHOR]

As a trending mobility choice, e-scooters have become popular in many cities. A number of authorities have initiated shared e-scooter trial schemes to assess the feasibility of the vehicles prior to enacting official legalisation. This paper aims to provide an evidence review of shared e-scooters and investigate how existing evidence may inform long-term policies. This carries significant relevance for jurisdictions that are in a conflicting position with e-scooters, such as New South Wales (NSW), Australia whose context motivates this study. The evidence review focuses on three themes derived from experience with shared e-scooters within the broader micromobility landscape, namely: safety; where shared e-scooters fit into the modal landscape; and the environmental impacts. Findings confirm that ensuring the safety of shared e-scooters requires complex solutions, which may include a clear regulatory framework for e-scooters, safety education and skill training, innovative data collection and analysis methods, and an approach to safety management that is user-based, location-based, and time-based. In terms of modal fit policymakers should encourage first and last-mile combinations with public transport, with consideration of user characteristics; while climate impact is strongly correlated to the mode replaced by e-scooter trips. The paper provides insights for policymakers on the regulation and positioning of shared e-scooters. • Many jurisdictions are struggling to determine policies for e-scooters. • Existing e-scooter evidence sheds light on possible long-term policies. • Safety management should consider different users, locations, and times. • First and last-mile combinations with public transport should be encouraged. • Climate impact is strongly correlated to the mode replaced by e-scooter trips. [ABSTRACT FROM AUTHOR]

Chronic low back pain is a leading cause of disability worldwide. A clinical model for its cause is lacking. Defining a cause based clinical model and a framework of understanding back pain in terms of peripheral structural and central functional pain is essential for optimal management. We describe the results of the largest published audit of 41 chronic low back pain patients, receiving outpatient sublingual ketamine therapy for defined central functional pain along with conventional peripheral structural pain management. Our clinical model assigns Movement Dysfunction as the primary cause for low back pain symptoms and restores it with Movement Therapy focused rehabilitation which is also defined. Patients were derived from a tertiary single neurosurgical specialist practice in Brisbane Australia over a three year period. Severe pain and disability measurements more than halved and only 13% of patients ceased ketamine prematurely due to predominantly non-sinister side effects common to all pharmaceutical therapies. All other surveyed metrics of utility were highly favourable in this challenging cohort of chronic back pain patients biased to poor outcomes. Outpatient ketamine maintains high efficacy and safety used in conjunction with a unique clinical model that describes chronic low back pain. This paper builds on our previous publications that describe the disease of movement dysfunction as an integral factor to the development of a cause based clinical model for the condition of chronic low back pain symptoms. Our clinical application of this model, applying the necessary dual approach of controlling symptoms arising from peripheral structural pain and central functional pain in conjunction with elimination of root causation has shown favourable outcomes in patients with high levels of pain and disability based on their tertiary referral origin and high Oswestry Disability Scores. Removing chronic low back pain from its position as one of the world's leading causes of pain and disability is more likely if the rehabilitation industry can replicate and test treatment algorithms based around established clinical models of disease which is the important subject of this paper. [ABSTRACT FROM AUTHOR]

Objective: This case study describes the development and outcomes of a new integrated and multidisciplinary care pathway. Spearheaded by allied health, the 'COVID community navigator team', applied established principles of reverse triage to create additional surge capacity. Methods: A retrospective cohort study examined workflow patterns using electronic medical records of patients who received navigator input at the Royal Melbourne Hospital between 20 September 2021 and 20 December 2021. Results: There were 437 eligible patient encounters identified. On average patients stayed 4.15 h in the emergency departments (ED) (s.d. = 4.31) and 9.5 h (s.d. = 10.9) in the short stay unit. Most patients were discharged into a 'low risk pathway' with community general practitioner follow up. Of discharged patients, only 38 re-presented to the ED with symptoms related to their initial COVID-19 diagnosis (34.9% of total re-admissions). Of these re-admissions, more than half did not require admission to a ward. Conclusion: The findings presented here provide support for the clinical utility of a multidisciplinary reverse triage approach in surge planning for anticipated presentation peaks. What is known about the topic? Reverse triage offers the potential to rapidly assess, treat and discharge patients from the emergency department. No known studies have explored this in response to the coronavirus 2019 (COVID-19) pandemic. What does this paper add? This paper supports a reverse triage approach to surge planning during the COVID-19 pandemic. We outline a multidisciplinary initiative to support discharge pathways. What are the implications for practitioners? Spearheaded by allied health, the reverse triage model described could provide a solution for surge planning during health crises. [ABSTRACT FROM AUTHOR]

This letter to the editor highlights methodological and interpretational issues with a recent paper on private outpatient psychiatric consultation fees in Australia. The authors argue that the study's data collection is incomplete and does not accurately reflect real-world clinical practice. They also point out that the paper fails to acknowledge certain factors, such as state-to-federal cost-shifting and government subsidies, which can affect the estimation of out-of-pocket costs for patients. The authors question the validity of the study's findings and criticize the discussion for proposing actions that are not supported by the data. They suggest that broader consideration of the healthcare context and access to cost subsidies may be necessary to improve equitable accessibility to care. [Extracted from the article]

Objective: Consumer-centred care is fundamental to high-quality health care, with allied health professionals playing a pivotal role in hospital settings. Allied health typically operates within standard weekday working-hours. Consumer preferences for receiving allied health services are largely unexplored but could inform whether weekend and/or out-of-hours services are required. This study aims to understand consumer preferences for hospital-based inpatient and outpatient allied health services. Methods: Using a cross-sectional survey and convenience sampling approach, consumers of a public health service in Melbourne, Australia were surveyed about preferences for allied health service delivery. Electronic health record reviews compared the accuracy of self-reported service delivery times. Descriptive statistics, concordance and predictive values were calculated. Responses to free-text survey items were analysed using content analysis. Results: Of 120 participants (79% response rate), most (69%) received allied health services, however, almost half of inpatient responders (44%) were unsure of the specific allied health professional involved. Audit results found moderate–high concordance overall (range, 77–96%) between self-reported and audit-identified allied health services by profession. Most inpatient responders had no strong day of week preference, equally selecting weekdays and weekend days, with most preferring services between 8 am and 4 pm. Outpatient responders (81%) preferred a weekday appointment between 8 am and 12 pm or before 8 am (29%) to complete scheduled activities early in the day. Conclusion: While provision of allied health services during standard working-hours was preferred by most consumers, some inpatient and outpatient consumers are receptive to receiving weekend and out-of-hours services, respectively. Decisions about offering these services should consider operational capacity and research evidence. What is known about the topic? Research on consumer acceptance of out-of-hours or weekend allied health services is lacking, with an assumption of consumer willingness and demand for these service models. What does this paper add? Hospital inpatients are generally indifferent to the day of allied health services, preferring weekday or weekend day equally, typically between 8 am and 4 pm, while outpatients favour weekday mornings. Although consumers reported that their needs were met by allied health services, there was a lack of awareness about the specific services they received. What are the implications for practitioners? Results highlight the importance of not only aligning service delivery with consumer preferences for timing, but also enhancing awareness and understanding of the available allied health services for consumers. [ABSTRACT FROM AUTHOR]

Objective. Data linkage is a very powerful research tool in epidemiology, however, establishing this can be a lengthy and intensive process. This paper reports on the complex landscape of conducting data linkage projects in Australia. Methods. We reviewed the processes, required documentation, and applications required to conduct multi-jurisdictional data linkage across Australia, in 2023. Results. Obtaining the necessary approvals to conduct linkage will likely take nearly 2 years (estimated 730 days, including 605 days from initial submission to obtaining all ethical approvals and an estimated further 125 days for the issuance of unexpected additionally required approvals). Ethical review for linkage projects ranged from 51 to 128 days from submission to ethical approval, and applications consisted of 9-25 documents. Conclusions. Major obstacles to conducting multi-jurisdictional data linkage included the complexity of the process, and substantial time and financial costs. The process was characterised by inefficiencies at several levels, reduplication, and a lack of any key accountabilities for timely performance of processes. Data linkage is an invaluable resource for epidemiological research. Further streamlining, establishing accountability, and greater collaboration between jurisdictions is needed to ensure data linkage is both accessible and feasible to researchers. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed at determining the factors that contributed to older people presenting from residential aged care facilities (RACFs) to the emergency department (ED) of a regional Victorian hospital located in MM3 regional area. Methods: Appropriateness of transfer was assessed based on predefined criteria, and associated costs for each presentation were calculated. Design: The study carried out a retrospective review of records between July and December 2021. Data were extracted in a MS Excel spreadsheet and transferred to STATA 15.0 for analysis. Setting: Large regional health service in Victoria. Participants: Residential aged care facilities residents presenting to the ED. Main Outcome Measures: Was transfer appropriate or avoidable, costs associated with avoidable transfer, characteristics of the patient and circumstances relating to presentation to hospital. Results: A total of 448 presentations were recorded, and 85% of residents were >75 years of age. More than 60% of presentations occurred during weekends or after hours, with the most common reason being falls (31.9%). Over half (55.6%) of all presentations were avoidable which incurred a cost of $777 200 in 6 months. In multiple logistic regression, higher ED presentations were observed in residents with no prior GP assessment (OR: 1.47, 95% CI: 1.02–2.11). Conclusions: Necessary interventions such as preventing falls and increasing primary care access along with improving the quality of advance care directives (ACD) may reduce RACF transfers to the regional ED. To the best of our knowledge, this is the first paper of this kind that provides new data from an Australian rural and regional perspective and adds value to the growing body of knowledge in the intersection of aged care and acute emergency care. [ABSTRACT FROM AUTHOR]

Objectives: To determine the total annual screening and further-investigation costs of investigating false-positive and true-positive mammograms in the Australian population breast-screening program. Methods: This economic analysis used aggregate-level retrospective cohort data of women screened at a breast-screening clinic. Counts and frequencies of each diagnostic workup-sequence recorded were scaled up to national figures and costed by estimating per-patient costs of procedures using screening clinic cost data. Main outcomes and measures estimated were percentage share of total annual screening and further-investigation costs for the Australian population breast-screening program of investigating false-positive and true-positive mammograms. Secondary outcomes determined were average costs of investigating each false-positive and true-positive mammogram. Sensitivity analyses involved recalculating results excluding subgroups of patients below and above the screening age range of 50–74 years. Results: Of 8235 patients, the median age was 60.35 years with interquartile range of 54.17–67.17 years. A total of 15.4% (ranging from 13.4 to 15.4% under different scenarios) of total annual screening and further-investigation costs were from investigating false-positive mammograms. This exceeded the share of costs from investigating true-positives (13%). Conclusions: We have developed a transparent and non-onerous approach for estimating the costs of false-positive and true-positive mammograms associated with the national breast-screening program. While determining an optimal balance between false-positives and true-positive rates must rely primarily on health outcomes, costs are an important consideration. We recommend that future research adopts and refines similar approaches to facilitate better monitoring of these costs, benchmark against estimates from other screening programs, and support optimal policy development. What is known about the topic? Screening mammogram results suggesting cancer later found to be wrong by follow-up testing (false-positive mammograms) consume healthcare resources unnecessarily and increases anxiety among screened women. What does this paper add? This paper estimates the share of total annual costs of Australia's national breast screening program caused by follow up testing of false-positive mammograms at approximately 15%. What are the implications for practitioners? The share of annual breast cancer screening costs from follow-up testing of false-positive mammograms can be monitored over time using the transparent and non-onerous method developed in this paper. [ABSTRACT FROM AUTHOR]

The Consolidated Framework for Implementation Research (CFIR) is a well-established framework for systematically identifying key factors influencing the implementation of programs. To enhance the classification of existing CFIR definitions, as well as its +2/-2 scoring system, this study incorporated the views of relevant experts to: i) improve how themes are scored; and ii) utilise more information regarding the frequency with which themes are identified. This structured, frequency-based approach to the CFIR's scoring process has been trialled as the CFIR-frequency (CFIR-f). Researchers thematically analysed semi-structured interview data from four groups of policy and program experts (N = 24) delivering two family-based therapies in New South Wales (NSW), Australia. Themes identified by less than 50% were excluded from further analysis. Themes identified by 50% or more of expert participants in the four groups were classified as enablers or barriers using clearly defined criteria. Each theme was allocated a score according to how many experts identified it as an enabler or barrier, and then mapped back onto the latest adaptation of the CFIR comprising 67 constructs. The CFIR-f successfully determined three enablers of, and six barriers to, implementation. Enablers included the family-based therapy programs, therapist training and participant monitoring systems. Barriers included referral, data collection and staffing difficulties, NSW adaptation issues and the suitability and safety of the programs for Aboriginal families. The same enablers and barriers were identified using both the CFIR-f and the original scoring approach, and the identified themes were successfully mapped to almost all CFIR constructs (65/67). This paper proposes a more frequency-based approach to CFIR's scoring process (the CFIR-f). By specifically utilising the frequency with which these barriers and enablers are identified, the CFIR-f engenders a list of ranked themes that service providers and policymakers can use to inform their decisions about program modification and implementation. [ABSTRACT FROM AUTHOR]

The Sub-Saharan African-born community in Australia is significantly underrepresented in health research, partly, due to challenges associated with collecting their primary data. Based on experience from a mixed-method study comprising 24 in-depth interviews and a survey of 253 participants in the community, this communication paper highlights a number of 'high-level' practical issues that might be encountered when collecting primary data from the community and provides suggestions for future studies. Included in this paper is a brief discussion of important lessons from the fieldwork that are critical for achieving successful data collection from the community. The lessons include difficulty of proving external validity for samples drawn from the community, difficulty of developing a reliable sampling frame, challenges in selecting appropriate support organisations, risk of low response to surveys and language barrier. The study concludes that understanding the ethnic diversities in this community and engaging appropriate support organisations are critical to achieving a successful data collection experience. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Research suggests that the Dynamic Appraisal of Situational Aggression (DASA) is a useful risk assessment instrument to identify individuals who might be at risk of aggression in mental health inpatient units.Although, risk assessment research has typically focused on an individual's risk of aggression, recent research has begun exploring whether the DASA could be used to assess the likelihood that a group of patients would be aggressive. What the paper adds to existing knowledge: While the DASA was useful for assessing whether an individual was likely to be aggressive, the group average score was not a useful indicator for the likelihood of aggression once the individual DASA score was taken into consideration.Unexpectedly, patients who were assessed as high risk on the DASA were more likely to be aggressive on settled units compared to unsettled units, which included other individuals whose risk was elevated. What are the implications for practice: There is not enough evidence to suggest that the group DASA average improves the identification of aggression above the individual DASA score. Introduction: The Dynamic Appraisal of Situational Aggression (DASA) is an inpatient aggression risk assessment instrument. Recently, research explored whether the unit atmosphere, as indicated by a unit's average DASA score, was related to inpatient aggression risk, but failed to control for individual risk. Aim: Investigate whether the DASA unit average score or an interaction between the unit average and an individual patient's DASA score was related to the likelihood that an individual would act aggressively. Method: Cox regression with repeated assessments and recurrent events was used to analyse 11,243 DASA risk assessments of 113 inpatients collected via retrospective file review. Results: The unit DASA average score was not related to aggression towards staff. There was a negative interaction between the individual and the unit DASA average scores when identifying patient‐to‐patient aggression; high‐risk patients engaged in less aggression when the unit average was heightened relative to units with lower DASA average scores. Discussion: It is possible that there were more nursing interventions and/or patients engaged in greater self‐regulation on unsettled units, thus reducing aggression. Implications for Practice: Currently, there is insufficient evidence to suggest that the unit average score should be used to supplement individual DASA scores to identify aggression risk. [ABSTRACT FROM AUTHOR]

Introduction: Although various studies have examined availability, access barriers and patient experiences of rural health services for the ageing population, no synthesis of this literature exists in Australia. Objective: The objective of this study was to examine the current literature surrounding rural service provision and to evaluate the barriers to access for older individuals and to recognise gaps in the literature. Design: A systematic scoping review of peer‐reviewed literature from three online databases (PUBMED, SCOPUS and Web of Science). Findings: Thirty‐two papers were included in analysis. The most prominent types of health service discussed were residential aged care (n = 12) and community health care (n = 10). More studies explored the perspectives of health personnel than the service end users. Qualitative synthesis revealed three themes associated with health service and rural ageing: access to services, health workforce experiences and end user experiences. Discussion: Access to health services for the elderly population is a complex issue. Promoting positive experiences for both health providers and patients is critical to assisting in healthy ageing for people living in rural and remote areas. This requires intervention on a social and institutional level. Key research gaps in the literature include the effectiveness of an integrated approach to institutional interventions, utilisation of preventative measures such as screening programs for cancer and greater identification of the health needs and perceptions among culturally diverse elderly residents. These studies are critical to promote appropriate and patient‐centred care for elderly populations in rural and remote areas. Conclusion: The review highlights the need to address availability, retention and service innovations across health services to improve access to care and health outcomes of rural elderly residents. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the long-term influence of having a child at risk of different developmental delays (communication, mobility, self-care, relating, learning, coping, or behaving) on parental labor force participation as the child grows. Method: A retrospective cohort was conducted using data from the Longitudinal Study of Australian Children survey, Waves 1–8 covering birth to 15 years of age of children. Multivariable logistic regressions were used to explore the odds ratio of mothers being out of the labor force at different children's ages. Cox proportional hazards models were utilized to identify the 'risk' of mothers returning to the workforce after leaving. All models were adjusted for the mother's age, education attainment, and employment status at time of birth, as well as marital status at the current wave. Results: There were 5,107 records of children, and 266 of them were at risk of any developmental delays at age 4–5 years. This sample represents 243, 026 children born in Australia in 2003/04. After adjusting for potential confounders, mothers of children at risk of each type of developmental delay (except mobility and self-care) had greater odds of being out of, and not returning to the labor force from children aged 2–3 to 14–15 years, when compared to mothers of children who are not at risk of developmental delays. Similar differences were found for fathers but were distinctly small and with narrower fluctuations, compared to mothers. Conclusion: Policies and programs funded by the government are greatly needed to support the mothers of children at risk of developmental delays. Significance: What is already known: Maternal labour force participation has been negatively affected by having a child with chronic health conditions, whereas paternal labour force participation is not significantly influenced. What this paper adds: Having a child at risk of developmental delays negatively influenced maternal and paternal labour force participation, where the influence on fathers was distinctly small and with narrower fluctuations during the 14 to 15 years of follow-up. [ABSTRACT FROM AUTHOR]

Objective: To systematically review evaluated local, community or peer‐delivered well‐being and employment interventions delivered within regional, rural and remote Australia. Design: Searches within nine databases retrieved peer‐reviewed and grey literature from an initial pool of 3186 papers published between 2012 and 2022. PRISMA guidelines were adhered to, and the Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the well‐being or employment (or both) articles. Findings: A total of 19 items met the inclusion criteria, which included two quantitative, 12 qualitative and five mixed‐methods evaluations. Intervention cohorts included Indigenous Australians, youth, older people, workers and the general community. The average methodological rating was 83%. The overall level of evidence for the interventions was low due to mostly descriptive studies. Discussion: Interventions that appeared effective in improving well‐being tended to focus on addressing social connectedness and self‐determination. Unexpected employment outcomes were evident across many of the studies, which highlighted the reciprocity between well‐being and employment. Conclusion: This review highlights promising interventions for improving well‐being by focusing on social connectedness and self‐determination. Further empirical evidence is encouraged to explore the reciprocal relationship between well‐being and employment, emphasising the significance of social connectedness and self‐determination in this context. [ABSTRACT FROM AUTHOR]

In Australia, a new system of collecting data on school-aged students with disability is in the early phases of implementation. The nationally consistent collection of data on school-age students with disability (NCCD) establishes a mandatory data collection process in which teachers categorise and report on individual students' level of additional educational needs. This data is used to determine funding allocations for students with disability. Under this policy, teachers are responsible for assessing students' needs, and for documenting their own teaching practice. This paper reports on the early phases of policy implementation. It presents data from teachers at two schools to make visible the new work teachers must undertake. Drawing on Dorothy E. Smith's sociological contributions, we show how the NCCD reorients teachers' work towards documentation and the production of evidence. After exploring teachers' work, we analyse how the NCCD is being taken up in ways that do not contribute to policy aims of ensuring teachers are better able to understand and meet student requirements. Our aim is to understand how the everyday realities of how teachers' work intersects with NCCD goals, and whether this new national policy is likely to make sustained inroads into achieving broader inclusive education ideals. [ABSTRACT FROM AUTHOR]

The aim of this paper is to report the adherence of clinician prescription to the evidence-based herpes simplex keratitis (HSK) guideline at the Sydney Eye Hospital, Australia, in order to assess the sustainability of guideline implementation. A retrospective review was conducted of patients, aged 18 years and above, receiving anti-viral treatment for HSK at the Sydney Eye Hospital from 1 January 2018 to 31 December 2019. Patients were identified from pharmacy records, viral swab results, and hospital coding data. Three hundred and thirty-six eyes of 335 patients, median age 58 years (range 18–103); 61% males were included. Anti-viral therapy was given for therapeutic and prophylactic indications at presentation in 287 (86%) and 48 (14%) patients, respectively. The dose of prescribed antivirals was in alignment with the guidelines in 69% (231/335) of eyes compared to 75% (64/85) in 2017 (P = 0.254) in our prior study. For the type of HSK, alignment with the guidelines was found in 80/112 eyes (71%) with epithelial, 43/68 (63%) with stromal, 13/17 (76%) with endothelial, 52/90 (58%) with keratouveitis, and 43/48 (90%) on prophylaxis. Clinicians were similarly adherent to a HSK treatment guideline 2 years after its implementation. Regular activities are needed to sustain knowledge. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively analyse the key factors associated with listing decisions by the Pharmaceutical Benefits Advisory Committee (PBAC) for medicines for diabetes and its complications on the Pharmaceutical Benefits Scheme. Methods: The clinical and economic evidence were retrieved from public summary documents (PSD) of all major submissions between July 2005 and March 2020. A multivariate binary logit regression analysis was conducted to assess the relationship between the categorical explanatory variables and PBAC recommendations. Results: We identified a total of 211 PSD of which 118 (56%) were recommended for listing. Clinical and economic uncertainty were significantly and inversely associated with the PBAC recommendation. Submissions with high clinical and economic uncertainty were less likely to be recommended. Conclusion: Our findings will enhance the understanding of medical professionals, pharmaceutical companies, and other stakeholders about the rationale of PBAC reimbursement decisions for these medicines and assist prospective applicant sponsor companies in preparing their submissions. What is known about the topic? Most studies on Pharmaceutical Benefits Advisory Committee (PBAC) decisions focused mainly on the cost-effectiveness, while some assessed only the financial impact of medicines. A few PBAC studies analysed the reimbursement decisions for medicines targeting specific disease groups, e.g. oncology, orphan disease, and multiple sclerosis. What does this paper add? This study presents an in-depth retrospective analysis of the PBAC decisions for listing medicines related to diabetes and its complications on the Pharmaceutical Benefits Scheme and contributes to the existing evidence-based knowledge of health technology assessment. What are the implications for practitioners? Our findings will enhance the understanding of medical professionals, pharmaceutical companies, and other stakeholders about the rationale of PBAC reimbursement decisions for these medicines and assist prospective applicant sponsor companies in preparing their submissions. [ABSTRACT FROM AUTHOR]

Optimal design facilitates intelligent data collection. In this paper, we introduce a fully Bayesian design approach for spatial processes with complex covariance structures, like those typically exhibited in natural ecosystems. Coordinate exchange algorithms are commonly used to find optimal design points. However, collecting data at specific points is often infeasible in practice. Currently, there is no provision to allow for flexibility in the choice of design. Accordingly, we also propose an approach to find Bayesian sampling windows, rather than points, via Gaussian process emulation to identify regions of high design efficiency across a multi-dimensional space. These developments are motivated by two ecological case studies: monitoring water temperature in a river network system in the northwestern United States and monitoring submerged coral reefs off the north-west coast of Australia. [ABSTRACT FROM AUTHOR]

Policy and research acknowledge that the quality of end-of-life care in hospitals can be poor, with families reporting significant concerns regarding physical and psychosocial care. In order to design appropriate evidenced-based care approaches, we conducted qualitative research examining the perspectives of bereaved families of patients who received end-of-life care in our health network. This paper reports on ethical dilemmas facing practitioner-researchers conducting interviews with bereaved families. We recruited 40 bereaved family members to participate in semi-structured interviews discussing the care a loved one received while a patient under the general medicine units. Bereaved participants expressed grief, humour and anger regarding their experience, and several reported perceptions of negligent and harmful care. Irrespective of the protocols in place to mitigate distress, this posed an ethical dilemma for the practitioner-researcher as a member of the health network, who needed to balance clinical and research roles when responding to distress. The practitioner-researcher's own bias and assumptions emerged when analysing families' distressing recollections. More broadly, the issues discussed have clinical implications for models of hospital bereavement support. Participants' use of photos and mementos jointly served to include the presence of the deceased in the research interview, but also highlighted the potential to utilise visual methods to examine sensitive research issues. It helps every practitioner-researcher to distinguish between research-oriented goals and clinical responsibilities to care provision as they consider their human research ethics application before beginning any research. [ABSTRACT FROM AUTHOR]

In Australia there is limited understanding of the scale and nature of energy hardship or poverty. Energy poverty remains a concept with no clear definition and therefore no clear objectives, targets, metrics for data collection nor institutions to monitor and report on. Europe, in the last decade, has gone from limited public recognition of, and policy action on, energy poverty, to now having sophisticated quantitative measurement and monitoring tools, and institutional governance arrangements that promote transparency and accountability. In this paper, drawing on the European experience, we focus attention upon the measures and indicators of energy poverty and discuss their advantages and disadvantages. We propose institutional options for understanding and tackling these problems in the context of Australia's energy transition. [ABSTRACT FROM AUTHOR]

Background: For Aboriginal and Torres Strait Islander women, the premature burden of cardiovascular disease is affecting their capacity to fulfil roles in society, and promote the health and wellbeing of future generations. In Australia, there is limited understanding of the difference in primary preventive cardiovascular care experienced by women, despite knowledge of sex and gender differentials in health profile and receipt of guideline-based acute care. This paper sought to explore the health profile and receipt of assessment and management of cardiovascular risk for Aboriginal and Torres Strait Islander women accessing preventive primary health care, and investigate gender differentials. Method: Records of 1200 current clients, 50% women, aged 18–74 years from three Aboriginal Health Services in central and South Australia for the period 7/2018–6/2020 were reviewed. Results: Twelve percent had documented cardiovascular disease. Compared with men, women with no recorded cardiovascular disease had a greater likelihood of being overweight or obese, a waist circumference indicative of risk, diabetes, and depression. Women were less likely to report being physically active. Conclusions: The research concluded that gaps exist in the provision and recording of guideline-recommended primary preventive care regardless of sex. These are stark, given the evident burden. Variance in cardiovascular risk and disparities in care have been documented for women; however, the knowledge about gaps in care is less explored for sub-populations, such as Indigenous populations. This study explores the health profile and receipt of preventive risk assessment and management in primary health services for Aboriginal and Torres Strait Islander women compared with men, finding women and men alike experience gaps in the provision of care to meet identified health needs. [ABSTRACT FROM AUTHOR]

Objective: To investigate demographics, clinical patterns and outcomes of rapid response reviews in hospital, reviewing indications for and outcomes of rapid response reviews initiated for clinical concern and to understand the role of clinical concern in identifying the deteriorating patient and at-risk patient populations. Method: This was a retrospective analysis of General Medical inpatients at Alfred Hospital from 1 January 2018 to 31 July 2020. Data extraction from electronic medical records identified patients who had a rapid response review during admission. Demographic and clinical data, investigations and clinical outcomes from rapid response reviews were investigated. Comparisons were performed using χ 2 or Fisher's exact test where appropriate. Odds ratios and 95% confidence intervals were calculated for factors associated with rapid response reviews for clinical concern and clinical outcomes. Results: There were 10 797 admissions of 7409 individual patients. There were 2359 rapid response reviews during the study period, occurring in 13% of admissions. Patients were majority female (50.4%), and the median age was 79 ± 17.6 years. Rapid response reviews were for cardiovascular (46.8%), respiratory (25.3%) and neurological (14.3%) indications. A total of 11% of rapid response reviews (n = 258) were for clinical concern. Inpatient falls accounted for a significant proportion of rapid response reviews for clinical concern. Reviews were more common in older patients, those admitted after-hours, and patients with disabilities. The latter group were more likely to have rapid response reviews for clinical concern. Rapid response reviews initiated for clinical concern were more likely than those initiated for standard criteria to change patients' clinical status, particularly the withdrawal of active management. Conclusions: Rapid response reviews for clinical concern are important triggers to identify clinical deterioration in vulnerable patients. Reviews were initiated for clinical concern were more likely than those initiated for standard criteria to result in a change in patients' resuscitation status and care trajectory. Clinician concern, even when prompting review for parameters outside of standard clinical review criteria, remains an important factor in recognising the deteriorating patient. What is known about the topic? Rapid response reviews, including those initiated for clinician gestalt for clinical concern, are important tools to identify deteriorating patients in the inpatient setting. What does this paper add? Rapid response reviews for clinical concern are of particular relevance in vulnerable populations and may be important in identifying deteriorating patients and reassessing care trajectory. What are the implications for practitioners? Clinical concern may be just as clinically relevant as rapid response reviews prompted by standard criteria, especially in vulnerable populations. This might prompt investigation of better identifiers and tools for escalation of concerns for vulnerable patients, which may improve outcomes in this patient group. [ABSTRACT FROM AUTHOR]

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic?: Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add?: We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners?: Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved. [ABSTRACT FROM AUTHOR]

Aims: To describe clinic management and referral pathways among adults with type 1 diabetes (T1D) aged > 25 years attending a public outpatient diabetes service. Methods: Retrospective cohort study of people with T1D aged > 25 years seen by endocrinologists in one Australian urban public outpatient in 2017. Electronic and paper medical records were reviewed using a dataset adapted from the UK National Institute for Health and Care Excellence 2015 guidelines. Results: Among the 111 people with T1D (mean age 41 ± 13 years, 55% men, mean body mass index 27.1 ± 5.6 kg/m2), mean HbA1c was 8.1 ± 1.9% (66 ± 19 mmol/mol) (lower than the Australian National Diabetes Audit: 8.5%/69 mmol/mol) with 25.5% meeting the guideline target of < 53 mmol/mol (7.0%). Most people had seen a diabetes educator (80.2%) or dietitian (73.0%) and had complication screening. Complication rates were high (nephropathy 20.4%, retinopathy 27.4%, peripheral neuropathy 30.1%, ischaemic heart disease/acute infarction 10.5%). Overall, 27% of referrals occurred following an acute inpatient admission or emergency department presentation and 13% for management of diabetes in pregnancy. Conclusions: A high proportion of people with T1D accessed public specialist care either during pregnancy or after a largely avoidable acute glycaemia-related hospital presentation. Subsequent care was in line with national specialist standards. This area has a "wait for acute event" rather than "complication prevention" model of care, associated with under-referral to the local multidisciplinary specialist service. Understanding how widespread this model of care is, and ways to reduce its prevalence, are urgently required. [ABSTRACT FROM AUTHOR]

The literature speaks of a 'deluge' of scientific and research data and the importance of capturing and managing it for use beyond its original creating community, purpose, and time. Data value increases as it is interconnected, networked, shared, used, and re-used. This paper extends the conversation about data sharing to 'wild data': that is, data generated and held outside of 'academic' or 'professional' science, as in the case of environmental voluntary groups (EVGs). Currently, important data generated by these groups are likely to be inaccessible to the academic community, or any community or body outside those often-small EVGs. Although large quantities of data are often generated by EVGs, management of these data may be poor or non-existent; and quality control of data may be haphazard and spasmodic. This article reports on a pilot project which explored the data sought, generated, stored, and shared by members of EVGs. The project also investigated members' views about data management and sharing for the future. Finally, as Australian university libraries are at the forefront of research and practice to promote the better management of data created by research, the paper also explores whether there might be a collaborative role for university libraries in the management of wild data [ABSTRACT FROM AUTHOR]

The Longitudinal Surveys of Australian Youth (LSAY) is a large, nationally representative study that follows youth cohorts for ten years at a time as they transition from school into further study, work and other destinations. With more than 20 years of unit record data, LSAY provides researchers with information for six cohorts of Australian youth, offering insight into the pathways of young people across multiple generations. This well-established study programme provides rich information across areas of school and post-school education, employment, household characteristics and key demographics. LSAY data sets are provided free of charge and supported by a dedicated website containing user guides, technical papers and interactive online summary data tools. This study profile introduces readers to LSAY by providing a brief history of its origin and establishment, before examining its design, data collection methods and survey outputs. [ABSTRACT FROM AUTHOR]

In recent years, there have been increasing calls for an overall transformation of the nature of engineering Ph.D. programs and the way theses are assessed. There exists a need to understand the examination process to ensure the best quality outcome for candidates in engineering. The work we present in this paper uses data collected between 2003 and 2010 for a total of 1220 Australian Ph.D. theses by analysing examiner reports. Our analysis indicates that Ph.D. theses in engineering,N = 106, differ considerably from those in other fields in areas such as gender of candidates and examiners and the examiners’ geographical location. We also found that assessment areas such assignificance and contribution of the thesis,publications arising from the thesis,breadth, depth and recency of the literature reviewandcommunication and editorial correctnessare areas in which the proportion of text of engineering examiners' comments differs significantly from other fields. [ABSTRACT FROM PUBLISHER]

Objective: Despite the usefulness of quantitative research, qualitative research methodologies are equally needed to allow researchers to better understand the important social and environmental factors affecting food choice and eating habits. The present paper contributes insights from narrative inquiry, a well-established qualitative methodology, to a food-related doctoral research study. The connections between food shoppers and the producer, family, friends and others in the food system, between eaters and the earth, and how these connections affect people's meaning-making of food and pathways to food citizenship, were explored in the research.Design: The research used narrative inquiry methodology and focus groups for data collection.Setting: Five different food-ways in the Canberra region of Australia were selected for the present research; that is, community gardens, community-supported agriculture, farmers' markets, fresh food markets and supermarkets.Subjects: Fifty-two people voluntarily attended eight focus groups with four to nine participants in each.Results: From a practical perspective, the present paper offers a guide to the way in which narrative inquiry has been applied to one research project. The paper describes the application of narrative inquiry methodology, revealing the important place of narratives in generating new knowledge. The paper further outlines how phased narrative analysis can lead to a defensible and rigorous interpretive framework grounded in the data generated from people's stories and meaning-making.Conclusions: We argue that individual, social and system change will not be possible without further rigorous qualitative studies to inform and complement the empirical basis of public health nutrition practice. [ABSTRACT FROM AUTHOR]

Objective. The objective of this study was to evaluate changes in the inclusion of pertinent information on electronic discharge summaries (eDS) after implementation of a revised template and electronic medical record (EMR) workflow. Methods. A retrospective medical record audit of eDS at three metropolitan hospitals was undertaken for adult inpatient encounters in June 2021 (pre-intervention, n = 100) and June 2022 (post-intervention, n = 100). The eDS were evaluated against 16 components listed in the Australian National Guidelines for the OnScreen Display of Discharge Summaries. Nine components were further broken down to between two and 11 sub-components. Sub-analysis compared a hospital with full EMR to pooled results from hospitals with hybrid EMRs. Components and sub-components were evaluated for inclusion only; accuracy or relevance of the information was not assessed. Results. Inclusion of three out of 16 components (presentation details: 47% vs 62%, problems and diagnosis: 61% vs 86% and recipient details: 82% vs 93%) and eight out of 36 sub-components (discharge destination, principal diagnosis, history of presenting complaint, infection risk, pressure injury, screening and/or diagnosis of delirium and GP phone number and address) was higher in the postintervention group (all P < 0.05). Reduced eDS information inclusion in the post-intervention group was observed for discharge date and falls risk only (both P < 0.05). Reporting of falls history decreased at the hospital with full EMR (71% vs 20% P < 0.001) but not at hospitals utilising hybrid EMRs (24% vs 30% P = 0.5). Conclusion. The intervention was associated with improved inclusion of pertinent information as described in the Australian National Guidelines for the On-Screen Display of Discharge Summaries. [ABSTRACT FROM AUTHOR]

Data collection for fresh-water regions of The Ecosystem Health Monitoring Program (EHMP), in southeast Queensland, Australia, involves the sampling of over 130 sites among 19 catchments twice per year and has been ongoing for over ten years. The sampling design was derived following an exhaustive process of indicator and site selection to develop a composite indicator that represented aquatic ecosystem health. After 13 years of implementation, there was an interest in identifying redundancies in sampling to reduce sampling costs without making a substantial impact on the integrity of the program and its capacity to report on ecosystem health. This paper focuses on identifying a subset of sites and times that could be removed from sampling with a minimal impact on the subsequent ecosystem health scores. Herein, Mixed models are employed to assess a variance structure from which optimality criteria are utilized to identify the scheme. Integer programs are then used to ensure specific practical constraints are observed. [ABSTRACT FROM AUTHOR]

What if data used to inform knowledge is incomplete or false, leading to misunderstandings about the social world? In Australia, what is known about ethnic diversity is based on an outdated definition and inadequate measure of multiculturalism. This article explores how gaps in data can lead to and further entrench disempowerment. Using a sociodemographic approach, this paper examines the ways in which data can create and maintain poor representation; via collection, analysis and infrastructure. This paper demonstrates that what is counted matters for equality, and lays out what is necessary to help promote ethnic diversity through data collection. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome (PRO) data is central to the delivery of quality health care. Establishing sustainable, reliable and cost-efficient methods for routine collection and integration of PRO data into health information systems is challenging. This protocol paper describes the design and structure of a study to develop and pilot test a PRO framework to systematically and longitudinally collect PRO data from a cohort of lung cancer patients at a comprehensive cancer centre in Australia.Methods: Best-practice guidelines for developing registries aimed at collecting PROs informed the development of this PRO framework. Framework components included: achieving consensus on determining the purpose of the framework, the PRO measures to be included, the data collection time points and collection methods (electronic and paper), establishing processes to safeguard the quality of the data collected and to link the PRO framework to an existing hospital-based lung cancer clinical registry. Lung cancer patients will be invited to give feedback on the PRO measures (PROMs) chosen and the data collection time points and methods. Implementation of the framework will be piloted for 12 months. Then a mixed-methods approach used to explore patient and multidisciplinary perspectives on the feasibility of implementing the framework and linking it to the lung cancer clinical registry, its clinical utility, perceptions of data collection burden, and preliminary assessment of resource costs to integrate, implement and sustain the PRO framework. The PRO data set will include: a quality of life questionnaire (EORTC-QLQ-C30) and the EORTC lung cancer specific module (QLQC-LC-13). These will be collected pre-treatment (baseline), 2, 6 and 12 months post-baseline. Also, four social isolation questions (PROMIS) will be collected at baseline.Discussion: Identifying and deciding on the overall purpose, clinical utility of data and which PROs to collect from patients requires careful consideration. Our study will explore how PRO data collection processes that link to a clinical data set can be developed and integrated; how PRO systems that are easy for patients to complete and professionals to use in practice can be achieved, and will provide indicative costs of developing and integrating a longitudinal PRO framework into routine hospital data collection systems.Trial Registration: This study is not a clinical trial and is therefore not registered in any trial registry. However, it has received human research ethics approval (LNR/16/PMCC/45). [ABSTRACT FROM AUTHOR]

This paper examines how language development aid is managed and distributed via grant programs administered by federal and state Aboriginal affairs departments across Australia. While these departments are not the only organisations offering grants for development and language-related projects in Australia, they are in a good position to administer such grants as they often work across government departments to provide leadership on Indigenous matters. This paper uses data collected from Aboriginal affairs departments’ websites about grant programs offered for the financial years ending 2014–2016. Each grant program was reviewed for: the goals of the program, amount of funding available, recipients of the grant, and whether any language component was included in the grant. This information is then compared across states, looking at the types of projects grants are used for and how language is, or is not, integrated into the projects. Findings of the study show that language-related projects attract only a small amount of grant funding compared to the wider pool available from federal and state/territory Aboriginal affairs departments. No grants appear to have been given for projects that include language as a component of a broader socio-economic development program. The paper also discusses the implications of the findings in relation to social and economic impact, well-being, education and translation. It argues that governments need to both increase funding for language-focussed project and to encourage other non-language-focussed development projects to consider the role of language in the context of Indigenous communities. [ABSTRACT FROM PUBLISHER]

The COVID-19 disease continues to cause unparalleled disruption to life and the economy world over. This paper is the second in what will be an ongoing series of analyses of a longitudinal travel and activity survey. In this paper we examine data collected over a period of late May to early June in Australia, following four-to-six weeks of relatively flat new cases in COVID-19 after the initial nationwide outbreak, as many state jurisdictions have begun to slowly ease restrictions designed to limit the spread of the SARS-CoV-2 virus. We find that during this period, travel activity has started to slowly return, in particular by private car, and in particular for the purposes of shopping and social or recreational activities. Respondents indicate comfort with the idea of meeting friends or returning to shops, so authorities need to be aware of potential erosion of social distancing and appropriate COVID-safe behaviour in this regard. There is still a concern about using public transport, though it has diminished noticeably since the first wave of data collection. We see that working from home continues to be an important strategy in reducing travel and pressure on constrained transport networks, and a policy measure that if carried over to a post-pandemic world, will be an important step towards a more sustainable transport future. We find that work from home has been a generally positive experience with a significant number of respondents liking to work from home moving forward, with varying degrees of employer support, at a level above those seen before COVID-19. Thus, any investment to capitalise on current levels of work from home should be viewed as an investment in transport. • Aggregate travel has increased by 50% but is still less than two-thirds of that which occurred prior to COVID-19. • Motor vehicle travel rebounding more than other modes, those planning a return to train and bus intended to do so strongly. • Large increases in activity planned for shopping and social and recreation purposes. • People feel most comfortable with meeting with friends, going to the shops and visiting restaurants. • Working from home continues, and has been largely positive for those who have been able to do so.. • Concern about the risk of COVID-19 has decreased significantly since the initial outbreak. [ABSTRACT FROM AUTHOR]

Objective: To report the qualitative findings of the inaugural survey of sonographer skill‐teaching practices in Australia using the SonoSTePs tool. Method: A national cross‐sectional survey of all qualified sonographers registered with the Australian Sonographer Accreditation Registry. A mix of quantitative and qualitative data was collected. This paper reports on a content analysis of the qualitative data relating to factors that impact on teaching. Results: A total of 528 respondents provided a range of qualitative data in five extended text questions. Five key themes emerged from the analysis: limited protected teaching time; perceived skill complexity; learner skill level and credentials; avoiding overwhelming the learner; and patient well‐being and their willingness to be scanned. Novel teaching interactions between the educator and the student sonographer were identified. Information was provided to learners at four time‐points across the continuum of clinical practice performance. The type, quantity and purpose of the information provided by the educator to the learner differed at each of these four time‐points and included the following: (i) pre‐task clarification, guidance and practice norms; (ii) in‐task verbal information and scanning support; (iii) post‐task support and information; and (iv) end‐task or terminal feedback. Conclusion: This is the first published study which reports the push and pull factors affecting pedagogical approaches to teach and learn complex scanning skills. These results provide a corpus of new knowledge, and the first analysis and review, about the pedagogical findings related to teaching scanning skills for clinical practice. This study provides a basis for further research and practice improvements. [ABSTRACT FROM AUTHOR]

Introduction: Smoking remains the single-most significant preventable cause of poor pregnancy outcomes, yet around 12% of Australian women smoke during pregnancy. Many women are motivated to quit when they find out they are pregnant, yet few are successful. While previous studies have examined the profile of the maternal smoker compared to her nonsmoking counterpart (Aim 1), little is known about what differentiates women who quit during pregnancy to those who do not (Aim 2). Here, we present results from a study investigating the characteristics of women who were able to quit during pregnancy.Methods: Data were drawn from the Tasmanian Population Health database of women who had received antenatal care between 2011 and 2013 (n = 14300). Data collected included age, relationship status and ethnicity of expectant mothers, antenatal details, mental health conditions, and drug use. Independent samples t tests were used to compare differences between women who had, and those who had not, quit during pregnancy. The 19.4% of women who self-reported as smoking in the first half (first 20 weeks) of their pregnancy were further grouped and analyzed comparing those who reported still smoking in the second half of their pregnancy (smokers: n = 2570, 92.4%) to those who quit (quitters: n = 211, 7.6%).Results: Quitters (57.8%) were more likely to be in a relationship than their non-quitting counterparts (49.6%, p = .022) and were less likely to suffer from postnatal depression (2.4% vs. 6.0%, p = .029). No other differences between quitters and smokers were observed.Conclusions: Determining the profile of women who are able to quit during pregnancy may be important to improve the relatively poor cessation rates among maternal smokers and may assist in more effectively targeting at-risk women.Implications: Smoking cessation interventions have traditionally targeted socially disadvantaged women, for good reason: the majority of smoking pregnant women fall into this category. However, despite the significant attention and resources dedicated to antenatal smoking cessation interventions, most are ineffective with only 7.6% of the present sample quitting smoking during pregnancy. This paper may assist in developing more effective antenatal smoking cessation interventions by more clearly describing the profile of maternal smokers who successfully quit during pregnancy. Specifically, this paper highlights the need to acknowledge and address women's relationship status and mental health in order to promote smoking cessation in pregnancy. [ABSTRACT FROM AUTHOR]

Gaining accurate information on illicit drug use and policing in real-world settings is a challenge. This study examines the utility of a smartphone app ('Going Out In Sydney') to prospectively follow up illicit drug use and policing encounters at music festivals and licensed entertainment precincts in Sydney, Australia. In all, 38 regular festival and licensed entertainment venue attendees used the app to log nights out over a 3-month period, including (1) where they went (eg, festival, nightclub), (2) the prevalence of illicit drug use, and (3) the incidence and nature of police encounters. A survey and interview were then conducted about the utility of the app. The app enabled rich data collection (n = 353 entries) about illicit drug use and policing at both target settings. Follow-up surveys indicated that most participants were extremely satisfied with the ease of use of the app and privacy afforded, and compared with other data collection modes, such as paper-based logs and online surveys, rated the app the most desirable method of data collection. This suggests smartphone apps may be a viable option for future studies on illicit drug use and policing of drugs. [ABSTRACT FROM AUTHOR]

Qualitative researchers are compelled to use their personal judgements before, during and after interviews, particularly when their interview subjects are drawn from vulnerable groups. This paper discusses the dilemmas qualitative researchers encounter when collecting data that is ethically ‘sensitive’; and situates the discussion in the realm of the Australian Occupational Health & Safety (OH&S) legislative requirement of ‘duty of care’ using the Rapidly Degenerative Neurological Diseases Pilot Program in Western Australia as the case example. The paper is focussed upon the practicalities and ethical concerns of the researchers conducting qualitative data collections. The discussion seeks to provide practical reflections on lessons learned and suggestions for self-care practice for researchers in the field and calls for policies that instruct and protect them. [ABSTRACT FROM PUBLISHER]

In recognition of the aging population and the importance of health-supporting urban environments, including urban green spaces, to maintain well-being, scholars and policymakers have increasingly investigated the associations between urban green spaces and the well-being of older people. However, few studies specifically investigate minority older groups such as those with diverse cultural backgrounds, and many studies often ignore the design attributes of green spaces which may contribute to the well-being of those in such groups. In order to address these gaps, this paper explores how green spaces influence the well-being of older Chinese immigrants. This case study analyzes how older Chinese immigrants interact with green spaces on the Gold Coast, Australia, and adopts the value of place as a conceptual framework to understand the relationship. Two qualitative methods, namely, in-depth interviews and travel diaries, were used to collect data. The results show that parks, as a place, play a crucial role in older Chinese immigrants' ability to undertake outdoor activities. The relationship between green spaces and well-being can be classified into two themes. The first theme is concerned with how older Chinese immigrants perceive and experience green spaces. This finding indicates that green spaces can fulfill their values of keeping healthy, maintaining active lifestyles, and being social, all of which benefit well-being. The second theme relates to daily activities undertaken within green spaces. Issues of accessibility and personal preferences regarding activities complicate the relationship between green spaces and well-being. Good accessibility to green spaces is congruent with older Chinese immigrants' values of being physically active, while difficulties in conducting preferred activities counteract these values which then generate negative perceptions of green spaces. Overall, there is great potential for understanding how personal values can inform the design of inclusive green spaces for minority or less mobile groups. [ABSTRACT FROM AUTHOR]

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This paper draws upon accountability and legitimacy theories to explore for what social enterprises are accountable, how they communicate accountability, and to what extent they publicly communicate accountability. Case study methodology was employed, examining four work-integrated social enterprises in Australia. Data collection involved interviews with managers of each social enterprise, and a review of various secondary data including social enterprise websites and internal and external reports. Findings reveal a temporal dimension of accountability, as social enterprises acknowledged their dual social and financial accountability, but prioritised financial over social performance. Communication of social performance was limited, with publicly available reports partial and selective in nature. Communication of financial performance was even more limited, reporting typically directed to internal stakeholders. Implications include the need for social enterprises to communicate social and financial performance more broadly, in order to advance their legitimacy from moral (based on intentions) to consequential (based on achievements). [ABSTRACT FROM AUTHOR]

Aim: This paper describes the incidence and outcomes of childhood renal malignancies in Australia using national population-based data from the Australian Childhood Cancer Registry.Methods: De-identified data for children (0-14 years) diagnosed with renal malignancies from 1983 to 2015 inclusive were extracted. Cause-specific (CSS) and event-free survival up to 20 years from diagnosis were estimated using the cohort method. Adjusted excess mortality hazard ratios were calculated using a multivariable flexible parametric survival model. Details relating to second primary malignancies (SPMs) were also examined.Results: There were 1046 children diagnosed with renal malignancies in Australia between 1983 and 2015 (91% nephroblastoma), generating an annual age-standardised incidence rate of 8 per million children, which remained constant over the study period. CSS was 89% (95% confidence interval = 87-91%) and 88% (86-90%) at 5 and 20 years, respectively, and 5-year event-free survival was 82% (80-84%). Five-year CSS did not change over the study period and was highest for nephroblastoma (91%). Of the 94% of patients achieving remission, 15% relapsed and subsequent 5-year CSS was 49% (40%-58%). Eleven children were diagnosed with SPM (standardised incidence ratio = 2.9, 95% confidence interval = 1.6-5.3, P < 0.001), and five of them (45%) died within 5 years of the second diagnosis.Conclusions: Children treated for renal malignancies in Australia have excellent long-term survival, which is unchanged since 1983. SPMs are uncommon following treatment for childhood renal cancer but carry a poor prognosis. Relapse carries a similarly poor prognosis to SPM but is more common. These data are comparable to registry outcomes in similarly developed nations. [ABSTRACT FROM AUTHOR]