Search

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]

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 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]

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]

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]

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]

To evaluate and compare the effectiveness and quality of standard face-to-face and teleaudiology hearing aid fitting follow-up consultations and blended services for adult hearing aid users. Fifty-six participants were randomly allocated to two equal groups, with equal numbers of new and experienced users. One standard and one teleaudiology follow-up consultation were delivered by an audiologist, the latter assisted by a facilitator. The order was reversed for the second group. Outcome measurement tools were applied to assess aspects of participants' communication, fitting (physical, sensorial), quality of life, and service. Cross-sectional and longitudinal outcomes were analysed. Most participants presented with moderate, sloping, and symmetrical sensorineural hearing loss. The duration of teleaudiology (42.96 ± 2.73 min) was equivalent to face-to-face consultations (41.25 ± 2.61 min). All modes of service delivery significantly improved outcomes for communication, fitting, and quality of life (p > 0.05). Satisfaction for both consultation modes was high, although significantly greater with standard consultations. The mode and order of delivery of the consultations did not influence the outcomes. Teleaudiology hearing aid follow-up consultations can deliver significant improvements, and do not differ from standard consultations. Blended services also deliver significant improvements. Satisfaction can be negatively impacted by technical or human-related issues. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia. A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media. There were 3810 respondents from four countries, of which 50 − 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health. The results suggest that the COVID-19 outbreak took a toll on people's experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors. [ABSTRACT FROM AUTHOR]

As the popularity of using dogs to assist individuals with disability grows, there is a need for increased understanding of assistance dog handlers' experiences of living and working with their dog. This is particularly pertinent to first-time handlers and during the initial placement period, where the handler and assistance dog, and the relationship forming between them, may be extremely vulnerable. The aim of this study was to better understand first-time assistance dog handlers' experience of the placement period, especially any challenges that they experience. Semi-structured interviews were conducted with two youth and five adult handlers, and one parent of a young handler, recruited from three Australian assistance dog organizations. Interviews were conducted 1 month following the initial acquisition of an assistance dog. Meleis' transitions theory was used to develop a better understanding of the transition process for first-time handlers. Inductive content analysis identified various challenges that first-time handlers experience throughout the transition period. These included: the initial response to living with the assistance dog; renegotiating relationships and social interactions; and, adjusting expectations regarding the assistance dog's behavior and capabilities. First-time handler experiences indicate a need for assistance dog organizations to develop initiatives to further assist their handlers through a smooth transition into assistance dog ownership. Integrating an assistance dog into a first-time handler's life is a long process full of challenges. Provider organizations and other support members markedly impact the ease of transitioning an assistance dog into a handler's life. Organizations should be aware of the role they have and employ strategies to create as smooth a transition as possible. Support from other support members is crucial to ease the challenges experienced. [ABSTRACT FROM AUTHOR]

This pilot study aimed to examine the feasibility and effectiveness of a 6-months multi-component exercise program combined with twice daily consumption of either rice (RicePro) or whey-based (WheyPro) protein supplements (2 × 20 g of protein) on gait speed, grip strength and physical performance in community-dwelling pre-frail and frail older adults. Secondary outcomes included: frailty score, muscle mass, quality of life, nutritional intake, cognitive performance, depression and physical activity levels. A total of 70 participants (mean age 73.34 ± 6.85 years) were randomly allocated to either RicePro (n = 36) or WheyPro (n = 34). No adverse events were reported in regards to the exercise, however, several gastrointestinal symptoms were noted with the whey protein causing two-fold more symptoms compared to the rice protein. No differences were found between the groups (p > 0.05), except the total consumed energy (kJ) (p = 0.014) and fat (g) (p = 0.012) which was significantly lower in WheyPro. The results indicate that the quality of protein may not be as important as long as a sufficient amount is consumed. [ABSTRACT FROM AUTHOR]

There is a dearth of research exploring the unique contribution of social work in residential aged care, particularly in Australia. This scoping review addresses this gap by documenting the international literature on the role of social work. Ten peer-reviewed databases were utilised, resulting in 77 relevant articles. The results demonstrated that social work has a key role in aged-care facilities by contributing to an integrated, person-centred, and holistic model of service delivery. IMPLICATIONS Contributing to the dignity, worth, wellbeing, and quality of life of all people who live in aged care requires a holistic and integrated model of care that involves the inclusion of social work. Australia falls behind other countries in providing holistic, person-centred, psychosocial support. More research is required to capture the contribution social work does make where services are provided. [ABSTRACT FROM AUTHOR]

Little is known about the predictors of quality of life among refugee women. 104 refugee women-at-risk were recruited within 6 months of arriving in Australia. A structured questionnaire was administered using standardized tools to assess pre-migration trauma, post-migration living difficulties, social capital, social networks, and quality of life. Hierarchical multiple and logistic regressions assessed factors predicting quality of life. Post-migration factors such as low trust in the community, and lack of support from individuals in their social networks predicted poorer quality of life. These findings have implications for community and social programs for refugee women-at-risk. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between vision-related quality of life (VRQoL) and depressive symptoms in residents with vision impairment (VI) in aged care facilities. Methods: In this cross-sectional study using baseline data from a cluster-randomized controlled trial (ACTRN12615000587505) assessing the effectiveness of a novel eye care model, 186 English-speaking residents (mean age 84 years, SD[standard deviation] = 8.7; 33.9% male) with VI and moderate cognitive functioning or better were recruited from 38 facilities across Victoria, Australia. VRQoL was measured using Rasch-transformed scores from the 'Reading'; 'Mobility', and 'Emotional' scales of the Impact of Vision Impairment for Residential Care (IVI-RC) questionnaire. Outcomes were presence of depressive symptoms (binary score: Cornell Scale for Depression in Dementia [CSDD] > 0 vs. CSDD = 0) and severity of depressive symptoms (continuous CSDD score; sample range 1-21). Independent associations with presence and severity of depressive symptoms were examined using zero-inflated logistic and linear multivariable models, respectively. Results: Of the 186 participants, n = 79 (42.5%), n = 94 (50.5%) and n = 13 (7%) reported no, mild (scores 1-7), and clinically significant depressive symptoms (score ≥8), respectively. Better vision-related Mobility (OR = 0.64; 95% CI: 0.44, 0.95, p = 0.02) was associated with reduced odds of depressive symptoms. With every unit improvement in vision-related Reading (β=-0.48; 95% CI: -0.94, -0.01, p = 0.04) and Emotional (β=-0.56; 95% CI: -1.09, -0.02, p = 0.04), severity of depressive symptoms reduced, independent of sociodemographic and medical issues. Conclusion: Better VRQoL was independently associated with reduced depressive symptoms. Supporting older people in aged care to maintain optimal levels of vision-specific functioning, independence, and emotional well-being may protect their mental health. [ABSTRACT FROM AUTHOR]

Research has consistently demonstrated that young people who identify as lesbian, gay, bisexual, or queer (LGBQ) show greater levels of psychosocial risk than general cohorts of young people. Young people engaged with youth alcohol and other drug (AOD) services are some of the most marginalized of all young people. Hitherto research is yet to investigate if young people identifying as LGBQ fare worse in these psychosocial domains than their non-LGBQ co-clients within AOD services. This study compared outcomes for 103 matched pairs of LGBQ identified and non-LGBQ identified young people (N = 206) using youth AOD services in Australia from a youth needs census. The results indicated that youth identifying as LGBQ reported more family dysfunction; and had experienced more violent crime, sexual, physical, and emotional abuse; and accumulated trauma than the non-LGBQ group. They had significantly more substance related harms, greater polysubstance use, and greater severity in their substance use. The LGBQ group also demonstrated poorer psychological health, quality of life, and were more likely to report a history of mental illness, and non-suicidal self-injury according to their youth worker. Overall these data indicate a need to direct more support to this particularly at risk group of young people. [ABSTRACT FROM AUTHOR]

Background: Mild stroke occurrences are rising and in order to comprehensively understand the experience of this health phenomenon, the context in which people with mild stroke live must be explored. Spouses are an important part of the lives of this population, but their experiences are yet to be fully understood. Aims/Objectives: To answer the question: "What is the essence of the mild stroke experience from the perspective of spouses during the first 9-months after acute hospital discharge, in Australia?" Materials and Methods: Qualitative study involving four spouses at 9-months post-acute hospital discharge for their family member. Interpretative phenomenological analysis used to analyze interview transcripts. Results: Two themes identified: (1) Activities gained but time lost, and (2) Small changes but big impacts. The first theme portrays the increase in daily activity that spouses experienced due to caregiving related activities, which impacted on their occupational participation. The second highlights the impact that people with mild strokes' behavioral and emotional changes can have on spouses. Conclusions and Significance: Whilst spouses generally return to their daily routines after a family members' mild stroke, some will experience increased time pressures and occupational disruptions. Health providers should prepare spouses for behavioral and emotional changes in people with mild stroke. [ABSTRACT FROM AUTHOR]

Objective: To identify in the Australian context: (a) treatment and support services that are accessed by people living with borderline personality disorder (BPD) and their carers, (b) perceived benefits and challenges associated with these services, and (c) changes these individuals would like to see with regards to service provision and access. Method: This project involved semi‐structured qualitative interviews with 12 participants (75% female, M age = 39.9, SD = 11.7), nine with lived experience of BPD, three carers and two identifying with both roles. Additionally, two online focus groups were conducted via online peer support communities involving 11 participants in total. Interview transcripts and focus group text were analysed thematically. Results: Participants described mixed experiences across a range of treatment types, locations and intensities. Themes were: identity and discovery, (mis)communication, complexities of care, finding what works (for me), an uncertain future, and carer empowerment. Participants described community‐based psychotherapy as being critical for reducing symptoms of BPD and improving quality of life, but reported challenges at the macro and micro level with regards to costs, service access, clinician factors and client factors. Experiences were often not aligned with a recovery model of mental health. Conclusions: The current Australian mental health system is not designed to best meet the needs of people living with BPD, which remains highly stigmatised and misunderstood. Future research should consider how the system could be modified or restructured to better support recovery for these individuals and others with complex mental illness. [ABSTRACT FROM AUTHOR]

As the number of older people in the developed world continues to rise, attention has turned to the contribution of leisure activities to quality of life. Leisure behaviour has been studied in numerous activities, including outdoor leisure. Scuba diving research has revealed the typical diver profile to be young and male. Yet with an active and ageing population, these stereotypes are being challenged. One notable group is the over 40s female diver. To understand more about leisure and older women, a qualitative study investigated the benefits scuba diving brings to a group of mature aged Australian women. Utilizing empirical research conducted in a beachside community, this research revealed the benefits older women gained from participation in diving activities and how diving activities contributed to their well-being. Findings contribute to the knowledge of serious leisure and continuation theory for adventurous older Australian women, an unexplored segment of the growing scuba diving community. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability (ID) experience poor oral health and are at greater risk of dental decay and periodontal diseases. This impacts on their general health and wellbeing. This review summarises the research literature about oral health status and contributing factors to poor oral health Method: We conducted a literature review using "intellectual disability" and "oral health" as our two core areas of focus. Results: People with ID had poorer oral health, greater numbers of tooth extractions, more caries, fewer fillings, greater gingival inflammation, greater rates of endentulism, and had less preventative dentistry and poorer access to services when compared to the general population. Anxiety during dental procedures was a key issue for females with ID. Conclusions: Further research is needed to identify, pilot and test appropriate and effective interventions that can reduce this preventable health disparity. The design of an ID-specific dental anxiety scale is another priority. [ABSTRACT FROM AUTHOR]

Background: Research indicates the value of active support in achieving good outcomes across a number of quality of life domains for people with intellectual disabilities. However, implementation is not easy, and little research has explored why. We aimed to identify some of the factors that impact on implementation of active support in supported accommodation services. Methods: Data on the quality of active support, staff training and practice leadership were collected through staff questionnaires, observations and manager interviews, for between two and four years across six organisations. Results: Active support improved over time for more able people with intellectual disability, but not for people with higher support needs. There was a weak positive correlation between active support and (1) practice leadership scores, and (2) the percentage of staff reporting active support training. Conclusions: It is important to recognise the influence of practice leadership and staff training on the quality of support and ensure provision for these in funding schemes. [ABSTRACT FROM AUTHOR]

Objectives: This study explored unique and personal domains associated with quality of life (QOL) in 153 mid-aged and older Australian adults over age 50, using an innovative measure of individualized QOL, the Schedule for the Evaluation of Individual Quality of Life (SEIQOL-DW). Methods: Demographic measures as well as the SEIQOL-DW were administered. The qualitative responses on this scale were analyzed by Leximancer, a text analysis program that extracts semantic meaning and relational information automatically from text. Results: For the sample as a whole, the most important QOL domain was found to be Relationships, followed by Family, Health, Activities, Community, Security, Beliefs, Independence and finally Wellbeing. When the sample was broken down into age bands for analysis, the most important domain theme was Family (50-59 year olds), Relationships (60-69 year olds), Relationships (70-79 year olds), and Health (80+ year olds). Conclusions: The wide range of concepts elicited in each domain via Leximancer underscores the argument for analyzing QOL in an individualized way, as it was clear from these concepts that different domains had unique meanings to each person. Clinical Implications: Understanding QOL at the level of which domains in an individual are important to QOL in later life is critical to providing services to both healthy aged as well as those with health and mental health needs. The SEIQOL-DW affords clinicians a unique tool with which to describe an individual's unique and relevant quality of life areas, and affords a way to measure change in these areas as a result of interventions. [ABSTRACT FROM AUTHOR]

There is evidence that digital technologies including the Internet have the potential to improve older adults' social participation and inclusion. This in turn is said to improve their quality of life. Older Internet super-users are in a unique position to inform us about what it takes to be a successful "silver surfer". This article reports on a study exploring the digital experiences of older Australian (65+) retirees, who are Internet "super-users". Super-users are defined as those who effectively use many Internet applications as part of the normal rhythm of daily life. The data gathering methods of this study were (1) photovoice, (2) a diary of Internet use, and (3) a semi-structured telephone interview. The project identified what makes a good Internet experience for older adults. This was then translated into a set of guidelines to improve Internet use for other older adults, who are yet to fully realize the potential of the Internet to enhance daily life and wellbeing. The results are considered from the perspectives that older adults' digital participation is best conceptualized by incorporating self-efficacy theory, digital competence and personal learning environments (PLEs) and demonstrates a pathway toward digital participation for older adults through the development of digital self-efficacy. [ABSTRACT FROM AUTHOR]

The evidence is now clear that more than one half of those who have a lifetime addiction to alcohol or drugs will eventually achieve stable recovery. As documented in the Life in Recovery surveys and elsewhere, recovery often brings about positive changes across a diverse range of life domains. Although this suggests that there are some universal experiences of recovery, there has been a lack of comparative recovery research examining the variations in recovery experiences across different settings and cultures. Using a combined data set of the United Kingdom and Australian Life in Recovery surveys and the three-stage model of recovery, the authors compare life achievements at each stage across the two settings. There are differences in patterns of recovery, with elevated levels of ongoing mental health problems in Australia, and significant involvement with the criminal justice system in the United Kingdom, suggesting a contextual and structural role in understanding recovery pathways. The implications for policy and practice are reviewed around structural barriers and the role of social justice in advancing recovery models and pathways. [ABSTRACT FROM AUTHOR]

Debate over the validity of post-traumatic stress disorder (PTSD) in culturally and contextually diverse groups with histories of trauma needs to consider clinical response, and while not overlooking the presence of PTSD, sensitivity to contextual variation in response to trauma is important. We report on a study that examined PTSD within two culturally distinct populations living in Australia: Sudanese refugees and Holocaust survivors. Measures used included the Harvard Trauma Questionnaire - Revised and the World Health Organization Quality of Life Scale - Brief (WHOQOL-Bref). Samples were contrasted using T-tests for PTSD case-ness, Mann-Whitney U’s to compare PTSD symptom endorsement and Pearson correlations to explore relationships between PTSD case-ness and symptoms with quality of life (QOL). Whilst PTSD case-ness was found to negatively correlate with QOL in both groups, group differences were found in relationship strength between traumatic memory and QOL. Difference indicates the need to contextualize PTSD and its symptoms not only by considering symptom endorsement, but also by symptom interpretation. [ABSTRACT FROM AUTHOR]