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Background: Adaptations for scale-up are ubiquitous but are rarely described in detail. Adaptations may be a key reason for the "scale-up penalty" which is when there is a reduction in intervention effect size following scale-up. The Play Active intervention consists of a physical activity policy for early childhood education and care (ECEC) services, with accompanying implementation support strategies. It was first implemented with 81 ECEC services in Perth, Western Australia, in 2021 — with significant positive changes in physical activity practice uptake. The aim of this paper is to describe the extent, type, fidelity consistency, goals, size, scope, and proposed impact of proposed adaptations to the implementation support strategies for scaling-up Play Active. Methods: Proposed adaptations were defined as planned changes, made prior to making the intervention available. The authors created a list of adaptations from a comparison of the Play Active implementation support strategies, before and after adaptation for proposed statewide availability across Western Australia, Queensland and South Australia, Australia. We used the Framework for Reporting Adaptations and Modifications-Enhanced Implementation Strategies (FRAME-IS) to code adaptations to implementation support strategies. Three authors coded each adaptation and rated their size, scope and proposed impact. Results: Fifty-three adaptations to Play Active were identified. Most (68%) were proposed for the 'content' of implementation strategies, including aspects of their delivery. In practice, this involved changing the delivery mode of implementation support strategies from phone call and email support, to website-based delivery. More than half (56%) of adaptations involved 'adding elements' for scale-up. Most adaptations were 'fidelity consistent' (95%). The main goals for adaptations were related to 'increasing the acceptability, appropriateness, or feasibility' (45%), 'decreasing the costs' (19%) and 'increasing adoption of the evidence-based practice' (19%). Adaptations were small to medium in size, with most proposed to have a positive (87%) or neutral (8%) effect on the effectiveness of the intervention, rather than negative (4%). Conclusions: A large number of small, fidelity-consistent, adaptations were proposed for Play Active scale-up. Overall, the process of reporting adaptations was found to be feasible. To understand the impact of these adaptations, it will be important to re-evaluate implementation, effectiveness and process outcomes, at-scale. [ABSTRACT FROM AUTHOR]

Abstract This paper reports on a unique practice based learning model to prepare undergraduate nursing students for clinical placement. The learning and teaching model described in this paper outlines the establishment of an entire on-campus simulated hospital and health service (SHHS) at the University of South Australia, School of Nursing and Midwifery. The model is pedagogically structured to immerse students in an authentic clinical environment to achieve deep learning in preparation for safe practice. A quality improvement cycle was used to evaluate the outcomes of the model in two phases: Phase 1: Purposive sampling of first and second year Bachelor of Nursing students from 2012 to 2015 who were surveyed about their satisfaction with the model of learning. Bachelor of Nursing students were invited to complete a survey about their experience with the teaching and learning model employed in the SHHS in response to the question, 'What aspects of the SHHS are the most important to your success?' Phase 2: External clinical stakeholders working with nursing students in clinical placements were asked to respond to questions about the preparedness of students educated in this model to transition to employment. The evaluation showed that the SHHS model positively influenced students' satisfaction and confidence and increased the perception of clinicians of the work readiness of students. Highlights • Authentic on-campus simulated hospital and health service develops nursing students' professional and practical skills. • Clinical staff report enhanced preparedness of nursing students for clinical placement. • Students report high satisfaction with staff support within the authentic teaching and learning model. [ABSTRACT FROM AUTHOR]

Objective: This paper explores novel training opportunities that the Expanded Setting Training Program (ESTP) provides for advanced psychiatry trainees. It is a reflection of a trainee's learning experiences during a year-long posting in Aboriginal Perinatal Mental Health, working alongside the Aboriginal Family Birthing Program, coupled with reflection and supervision., Conclusions: ESTP provided a fertile area to hone an advanced trainee's skills in the niche areas of Aboriginal mental health, perinatal mental health, culture and psychiatry. In addition, it provided skills in the area of leadership, health advocacy and the establishment and maintenance of successful programs in disadvantaged, culturally and linguistically diverse communities. The ESTP Aboriginal Mental Health rotation provides a unique experience for training, and the learning opportunities are limited only by the creativity of the trainee and supervisor., (© The Royal Australian and New Zealand College of Psychiatrists 2015.)

During cultural transition, refugee-background youth in Australia must navigate adolescence and the demands of cultural transition and adaptation, including educational and employment decisions. Using a qualitative methodology we report on a study exploring the influence of family – including parents, siblings and extended family members – on youth aspirations and decision-making regarding education and employment pathways. Based on interviews with 79 participants (46 refugee-background youth aged 15–26 years and 33 parents or caregivers) residing in regional and metropolitan South Australia, we find that although there were some tensions between youth and family expectations, motivations, identities, and acculturation in resettlement, there were also mutual support strategies that strengthened family relationships and supported youth aspirations. We note four key themes: 'motivating and supporting' or how families supported youth to select their future education and employment pathways; 'Independence versus influence' or to what extent families influenced youth decision-making; 'clash of expectations' between parents and youth expectations; and 'family responsibilities' that interfered with youth aspirations. Implications of study findings for future research, policy, and practice are discussed. [ABSTRACT FROM AUTHOR]

Team-Based Learning (TBL) can be associated with administrative processes that are labour intensive. A commercially-available online system offered an opportunity to reduce this burden. The aims of this study were to test the feasibility of integrating digital TBL into health curricula, and to explore the experiences and perspectives of students and educators participating in digital TBL. A prospective mixed methods design was used to survey postgraduate nursing and optometry students (n = 162), and educators (n = 8) at an Australian university. Student and educator perceptions of digital TBL collected were: usability (System Usability Scale); level of student engagement (Student Self-Report of Engagement); and user satisfaction post-participation in digital TBL (Post-Study System Usability Questionnaire). Mean Student Self-Report of Engagement Scores reflected high student engagement with significantly higher levels of engagement reported for digital (x ‾ =4.16, SD = 0.199) over paper-based (x ‾ =3.97, SD = 0.267) TBL (p = 0.001). System Usability Scores revealed students (during: x ‾ = 72.35, SD = 15.70; post: x ‾ = 74.02, SD = 14.00) and educators (x ‾ =75.0, SD = 15.12) perceived usability of digital TBL to be above average for systems on this scale. Students (x ‾ =2.40, SD = 0.19) and educators (x ‾ =2.36, SD = 0.80) were highly satisfied with digital TBL (Post-Study System Usability Questionnaire). High satisfaction and engagement outcomes suggest digital TBL is feasible, efficient, engaging and well accepted by stakeholders. • Digital TBL systems promise improved efficiency during Team-Based Learning delivery. • When implemented, these systems are well accepted by both students and staff. • Crucially, student engagement increases with digital TBL over paper-based methods. • Digital TBL is a highly feasible replacement for traditional TBL delivery methods. [ABSTRACT FROM AUTHOR]

The South Australia Department for Education employs approximately 30,000 people (40.2% outside the major city, Adelaide). This study conducted a cost-benefit analysis of its employee assistance program from the Department's perspective, focusing on remoteness. The employee assistance program utilization rate outside the major city was 13% below that in the major city. Based on improved absenteeism and presenteeism, measured fiscal benefits per user (1,365.79 Australian dollars [AUD] or 1,021.48 US dollars [USD]) were 3.34 times the costs (409.27 AUD or 306.09 USD), indicating a highly favorable return. Our sensitivity analysis found that if the increase in student lifetime earnings, worth about 76,000 AUD (57,000 USD) yearly, had been included, it would have increased the total benefits by 5.3% and raised the benefit-cost ratio to 3.51. Although telephone sessions were available, the average number of sessions per participant was 49% higher for the in-person only modality (2.82) compared to the telephone-only modality (1.89). This apparent preference for in-person sessions indicates a challenge for regional and remote areas, where access is difficult. The study recommends proactive measures to increase utilization outside its major city. [ABSTRACT FROM AUTHOR]

Objective: High levels of burnout, stress, and distress are reported in trainee psychologists. This study aimed to investigate the effectiveness, acceptability, and feasibility of an 8‐week dialectical behaviour therapy (DBT) skills training group for reducing study burnout and psychological distress and increasing study engagement and wellbeing. Method: Seventeen psychology trainees (16 females; age: M = 31.53; SD = 6.60; range 23–51) took part in the DBT skills training group. Intervention change scores were compared with a non‐randomised control group (n = 57; 53 females; age: M = 30.84; SD = 6.37, range 24–52). Outcome variables included burnout, psychological distress, study demands, engagement, emotional stability, psychological flexibility, and mindfulness. Results: Change scores for the intervention group were significantly higher than those for the control group, and changes were largely maintained at 6‐month follow up. Quantitative and qualitative analysis suggested that the group was well received by participants. Conclusions: Preliminary support was found for the effectiveness, acceptability, and feasibility of the DBT skills training group for psychology trainees in reducing burnout and psychological distress and increasing engagement, psychological flexibility, emotional stability, and mindfulness. More research into burnout and distress reduction in psychology trainees is needed to determine effective and efficacious interventions. [ABSTRACT FROM AUTHOR]

Problem There is a lack of access to simulation-based education ( SBE) for professional entry students ( PES) and health professionals at rural and remote locations. Design A descriptive study. Setting Health and education facilities in regional South Australia and south-west Victoria. Key measures for improvement Number of training recipients who participated in SBE;, geographical distribution and locations where SBE was delivered;, number of rural clinical educators providing SBE., Strategies for change A distributed model to deliver SBE in rural and remote locations in collaboration with local health and community services, education providers and the general public. Face-to-face meetings with health services and education providers identified gaps in locally delivered clinical skills training and availability of simulation resources. Clinical leadership, professional development and community of practice strategies were implemented to enhance capacity of rural clinical educators to deliver SBE. Effects of change The number of SBE participants and training hours delivered exceeded targets. The distributed model enabled access to regular, localised training for PES and health professionals, minimising travel and staff backfill costs incurred when attending regional centres. The skills acquired by local educators remain in rural areas to support future training. Lessons learnt The distributed collaborative model substantially increased access to clinical skills training for PES and health professionals in rural and remote locations. Developing the teaching skills of rural clinicians optimised the use of simulation resources. Consequently, health services were able to provide students with flexible and realistic learning opportunities in clinical procedures, communication techniques and teamwork skills. [ABSTRACT FROM AUTHOR]

Purpose: To investigate if sociodemographic characteristics increase the adverse effects of cardiovascular diseases (CVD) and cardiometabolic risk factors (CMRF) on health-related quality of life (HRQoL).Methods: Cross-sectional, face-to-face survey investigating 2379 adults living in South Australia in 2015 (57.1 ± 14 years; 51.7% females). Questions included diagnosis of CMRF (obesity, diabetes, hypertension, dyslipidaemia) and CVD. Physical and mental HRQoL were assessed using the SF-12v1 questionnaire. Multiple linear regression models including confounders (sociodemographic, lifestyle, use of preventive medication) and interaction terms between sociodemographic variables and cardiometabolic conditions were used in adjusted analysis.Results: The prevalence of CMRF (one or more) was 54.6% and CVD was 13.0%. The physical HRQoL reduced from 50.8 (95%CI 50.2-51.4) in healthy individuals to 45.1 (95%CI 44.4-45.9) and 39.1 (95%CI 37.7-40.5) among those with CMRF and CVD, respectively. Adjustment for sociodemographic variables reduced these differences in 33%, remaining stable after controlling for lifestyle and use of preventive medications (p < 0.001). Differences in physical HRQoL according to cardiometabolic conditions were twice as high among those with lower educational level, or if they were not working. Among unemployed, having a CMRF or a CVD had the same impact on the physical HRQoL (9.7 lower score than healthy individuals). The inverse association between cardiometabolic conditions and mental HRQoL was subtle (p = 0.030), with no evidence of disparities due to sociodemographic variables.Conclusions: A lower educational level and unemployment increase the adverse effects of cardiometabolic conditions on the physical HRQoL. Targeted interventions for reducing CMRF and/or CVD in these groups are necessary to improve HRQoL. [ABSTRACT FROM AUTHOR]

Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive sampling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning divergent sectoral agendas early in the collaborative processwas essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes. [ABSTRACT FROM AUTHOR]

Objective To describe and evaluate a programme where medical students designed and implemented Indigenous health placements for students with an interest in rural/Indigenous health. Design, setting and participants In 2011, a student-led programme at the University of Adelaide was set up to give medical students the opportunity to undertake outreach trips and clinical placements in remote Indigenous communities. Twenty-four medical students attended trips to remote communities between 2012 and 2014. Here we evaluate our programme using a single-arm experimental design. Main outcome measures Responses to questionnaire items before and after attending an outreach placement, scored on 6-point Likert scales. Results Following their remote Indigenous health placement, participants expressed a significantly higher mean likelihood of working in an Indigenous community in the future (3.17 (2.69-3.64) versus 4.00 (3.65-4.35); P < 0.007). Furthermore, after their placement participants felt better prepared to work in Indigenous communities (mean 1.79 (1.44-2.14) versus 3.21 (2.88-3.54); P < 0.001). Conclusions A placement programme initiated and run by medical students can provide meaningful exposure to Indigenous health. Implementation of this student-led model in other medical schools may encourage nationwide development of the Indigenous health workforce. [ABSTRACT FROM AUTHOR]

Background: In 2011, more than half of the patients with stroke in Australian hospitals were not assessed for the need for rehabilitation. Further, there were no recommended criteria to guide rehabilitation assessment decisions. Subsequently, a decision-making tool called the Assessment for Rehabilitation Tool (ART) was developed. The ART was designed to assist Australian hospital clinicians to identify the rehabilitation needs of patients with stroke using evidence-based criteria. The ART was released and made freely available for use in 2012. This study evaluated the effectiveness of an education-only intervention (1 onsite education session and distribution of the ART) and a multifaceted intervention (2 or more onsite education sessions, distribution of the ART, audit and feedback, barrier identification, site-specific strategy development, promotion of interdisciplinary teamwork, opinion leaders and reminders) for improving assessments of rehabilitation needs after stroke.Methods: Ten hospitals in 2 states of Australia were randomly assigned to an education-only or a multifaceted intervention. Medical records were audited by assessors blinded to group allocation before and after the implementation period. Difference in the proportion of patients assessed for rehabilitation before and after the intervention was analysed using mixed-effects logistic regression analysis, with time period as the dependent variable, an interaction between intervention type and time included to test for differences between the interventions, and hospital included as the random effect to account for patient clustering.Results: Data from 586 patients (284 pre-intervention; 302 post-intervention; age 76 years, 59 % male) showed that the multifaceted intervention was not more effective than education-only in improving the proportion of patients whose rehabilitation needs were assessed (reference category education-only; odds ratio 1.29, 95 % confidence interval 0.63-2.67, p = 0.483). Post-intervention, the odds of a patient's rehabilitation needs being assessed was 3.69 times greater than pre-intervention (95 % confidence interval 2.57-5.30, p < 0.001). Evidence-based criteria were not consistently used when patients were deemed to have no rehabilitation needs.Conclusions: A multifaceted intervention was not more effective than education-only in improving the assessment of rehabilitation needs of patients with stroke. Further interventions are required to ensure that all patients are assessed for the need for rehabilitation using evidence-based criteria.Trial Registration: ANZCTR (Australian New Zealand Clinical Trials Registry), ACTRN12616000340437. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Background Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. Design An integrative literature review. Methods Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's ( Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. Results This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. Conclusion It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. Relevance to clinical practice An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing students, along with adequate recognition of the additional time required to effectively supervise these students. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To measure the impact of an undergraduate research education program on the attitude, skill and uptake of evidence-based practice among undergraduate student nurses. Background. The contribution of evidence-based practice to clinical decision-making, quality of care and patient outcomes is well-documented. One approach to improving evidence-based practice uptake in clinical practice is through the provision of undergraduate research education; notwithstanding, the impact of research training on nursing practice is poorly established. Design. Descriptive longitudinal survey. Methods. Three hundred and fifty four third-year nursing students enrolled in a Bachelor of Nursing program of a large Australian University were invited. Pre-(Phase 1) and post-completion (Phase 2) of a 16-week research education program, participants were asked to complete the Evidence-Based Practice Attitude and Utilization Survey; an 82-item online questionnaire measuring attitudes, skills and use of evidence-based practice, and barriers and facilitators of evidence-based practice uptake. Results. The survey was completed by 84 (24%) participants in Phase 1 and 33 (39% of Phase 1) participants in Phase 2. Program exposure resulted in a significant improvement in median skill and use subscores, but not median attitude subscore. Participants perceived inadequate skills in the interpretation, appraisal and application of research findings to clinical practice as being less of a barrier to evidence-based practice uptake posteducation, and access to online critical appraisal tools as being significantly more useful in facilitating evidence-based practice uptake posteducation. Conclusions. The findings suggest that undergraduate research education may have a significant effect on nursing students' research skills and use of evidence-based practice, and minimise barriers to evidence-based practice uptake posteducation. Relevance to clinical practice. Undergraduate research education may play an important role in improving student nurse uptake of evidence-based practice; whether these changes can be sustained when transitioning from student nurse to registered nurse is a question for further research. [ABSTRACT FROM AUTHOR]

Objectives. We investigated ethical issues in school-based immunization programs for adolescents and how they are addressed. Methods. We used qualitative methods and an ethnographic approach to observe 9 secondary schools on immunization days in South Australia in 2011; concurrently, we conducted 9 focus groups with female secondary school students, 6 semistructured interviews with parents, and 10 interviews with nurses and teachers. We explored ethical challenges from the perspective of these groups. Results. We identified ethical challenges for the delivery of adolescent immunization in a school-based setting in 3 main areas: informed consent, restrictions on privacy, and harm to students in the form of fear and anxiety. Conclusions. We found areas in which the design and delivery of school-based immunization programs can be improved. Information about immunization should be provided in ways that are appropriate to young people and their parents, and privacy protections should be enhanced when possible. Involving young people in the design and delivery of programs would assist with making these improvements. [ABSTRACT FROM AUTHOR]

Sellicks Beach, located on the eastern shore of Gulf St Vincent, South Australia, is subject to wave-dominated processes and northward longshore transport. During winter, when wave energy is typically vigorous, gravel deposits are exposed across most of the beach, and three step-like berms are well developed. Sand is restricted to a narrow strip that is exposed only at low tide. In contrast, during summer, when wave energy is generally moderate to low, much of the gravel is covered by a thin veneer of sand and only the high berm, on the landward edge of the beach, remains as an obvious feature. Steeply dipping Neoproterozoic to Cambrian strata that outcrop strongly across Sellicks Hill are the original source rocks for the beach gravel; distinctive sedimentary textures, structures and fossils in the cobble-size clasts can be confidently matched with those of the provenance rocks. Much of the sediment entered the modern beach environment as a consequence of coastal erosion of transitional alluvial fan sediments. The oldest alluvial fan sediments are of late Pliocene to earliest Pleistocene age. Mount Terrible Gully provides a conduit for the input of fluvial sediment at the mouth of Cactus Canyon, where clasts as large as boulders accumulate across the beach. Sellicks Beach gravels are subject to longshore transport northwards. Relatively softer clasts, such as those derived from the Heatherdale Shale, are rare beyond Cactus Canyon. In contrast, quartzite clasts are more abundant towards the north. This lithological differentiation is attributed to preferential survivorship of clasts that are physically harder and chemically less reactive. The change in the shapes of clasts northwards, from predominately shingle-like ‘very platy’ and ‘very bladed’ at Cactus Canyon, to more ‘compact’ towards the boat ramp, is in accord with the more massive fabric of the surviving quartzite clasts. At Sellicks Beach, preservation of uplifted, coarse gravels, with entire and comminuted marine molluscan shells, of last interglacial age, provides evidence of neotectonism. At the landward margin of the beach, imbricated gravels in which pore spaces have been infilled with mud, and which show no evidence of modern coastal erosion, may provide evidence of continuing uplift during the recent Holocene. The geological setting, geomorphic framework and modern sedimentary regime at Sellicks Beach combine to provide an exceptionally useful outdoor laboratory for education in field geology. [ABSTRACT FROM AUTHOR]

An obituary for researcher Christopher Nordin, a pioneer in the field of bone and calcium metabolism, is presented.