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The widespread, theoretically-informed practice of curricula embedded academic language and learning development is generally acknowledged as the most productive method of improving tertiary student outcomes. University-wide comprehensive support, however, for the collaborative processes of interdisciplinary research, design, resource and staff development required to achieve this, is not common. Yet many practitioners continue to engage in embedding initiatives in response to faculty requests, despite institutional constraints on time and funding. This paper documents one such initiative, a common yet under-reported type, conducted one small step at a time over a number of years in a first-year core unit in the architecture faculty of a large metropolitan university in Australia. The paper aims to respond Wingate's (2018) call for more thorough documentation of pedagogic principles applied in embedding practice to allow for replicability. This granular examination of the first implementation and later refinements of the initiative shows how aligning practice with proven theoretical models, in this case, Systemic Functional Linguistic (SFL) and the SFL-based pedagogic model, the Teaching/ Learning Cycle (TLC), proved fruitful in constrained circumstances. [Note: The page range (18-36) shown on the PDF is incorrect. The correct page range for this article is p18-35.]

Background: Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas. Methodology: Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process. Results: Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio‐economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process. Conclusion: There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process. [ABSTRACT FROM AUTHOR]

Purpose: This research is situated at a metropolitan university in Melbourne (Australia) where the authors work in initial teacher education programs within the same faculty. The purpose of this study is to raise awareness that collegial, collaborative and "co-caring" environments can foster an improved sense of belonging, acceptance and inclusion in the academy. They also argue that communities of practice may foster an improved sense of belonging that enhances empowerment and harmony among all staff in academia in pandemic times and beyond. Design/methodology/approach: The authors draw on case study methodology as a qualitative approach to understand and illuminate the phenomena under study. Case study methodology provides an in-depth understanding of their trifocal voices, as it allows them to voice their stories through collaborative autoethnography. The authors use self-narratives to unpack their sense of belonging in academic spaces. Collaborative autoethnography (CAE) enabled them to work together as a team of women and as a community of researchers. Findings: The findings foreground the responsibilities of casual staff while concomitantly articulating the challenges faced by both permanent and casual staff to create a "sense of belonging" in the academy. The authors found that social connection engenders a sense of belonging and inclusion within a space that is often beset by neoliberal ideologies of competitiveness and individual achievement. They articulate their stress, pressure and uncertainty as permanent and as casual academics working supportively to develop and maintain identity in very difficult circumstances. They share how they developed professional relationships which bring unforeseen benefits and personal friendship at a time of especially restrictive practices. Research limitations/implications: The paper includes three voices, a limitation in itself, thus generalisations cannot be made to other academics or institutions. Employing CAE offers the possibility of delving more deeply into the emotional complexities inherent within this method for further research. They recommend a sense of "co-caring" as a form of pastoral care in the "induction program" for all academics including casual staff. While this may not "strategically" fit in with many because of power imbalances, the journey of co-caring and sharing and building friendships within the academy has a limited presence in the literature and calls for further investigation. Practical implications: The authors draw attention to the need for higher education institutes to recognise the role permanent staff play when working with casual academics. Social implications: The authors draw attention to the need to be inclusive and collaborative as a way to improve the divide and strengthen connections between permanent and casual academics at university worksites. This is imperative given the shifting demographics within Australia and its workforce. They also highlight issues of race in the academy. Originality/value: This is an original work carried out by the authors. It raises concerns about a sense of belonging in the academy, job certainty and the place of people of colour as these issues may also be experienced by other full-time and casual academics.

Staffing shortages has been a consistent problem for Australian rural schools. This paper addresses the rural staffing shortage by exploring the motivations and barriers faced by pre-service teachers in an Australian metropolitan university as they explore the prospect of teaching in a rural school. The paper examines two research ideas prevalent in the research literature. Firstly, that introducing pre-service teachers to rural placement experiences enhances their desire to seek teaching positions in rural schools. Secondly, that pre-service teachers from regional or rural backgrounds are more likely to seek teaching jobs in rural settings than their metropolitan counterparts. We draw on data from a longitudinal qualitative study with pre-service teachers in a metropolitan university that were interviewed before, during and after their rural placement. We found that while the second idea stands the test, the first idea, undertaking a rural placement, is not a guarantee to redressing the staffing shortage.

Becoming a researcher is one of the roads travelled in the emotional, social, and intellectual process of PhD journeys. As such, developing a researcher identity during doctoral study is a social undertaking. This paper explores instances and practices where doctoral students identify as becoming researchers. Based on interviews with 30 PhD students from two Australian metropolitan universities, this paper presents students' experiences of moments when they feel like researchers. The paper finds identification as a researcher occurs early on in the PhD, and such instances are underpinned by external and internal validation of the student as a researcher. Validation is gained "through research outputs" ("mainly publications"), "doing research," and "talking about research." Such experiences are often mundane, occur daily, and constitute personal, social, informal, and formal learning opportunities for researcher development. Supervisors are largely absent as students draw on multiple individuals on and off campus in assuming a researcher identity.

Australia's major state capitals are surrounded by highly productive food bowls, which are an important source of fresh foods for their growing populations. These food producing biomes are a rich resource for investigating key themes related to Biomes and food security, one of two Year 9 units of study in the Australian Curriculum: Geography. This paper draws on case studies of Melbourne and Sydney to explore challenges to food production in Australia's city food bowls. These challenges include population growth, urban sprawl, water scarcity and the impacts of climate change. We explore the implications of these challenges for the food security of Australia's urban populations, and we highlight the potential for emerging research findings about the significance of these food producing biomes to engage students with key themes of the Year 9 Biomes and food security unit.

Purpose: Third-party arrangements where a university offers its degrees in collaboration with another institution are not a new phenomenon, particularly when the third-party arrangements occur in the form of a cross-border education (or widely known as transnational education). Drawing on a critical review of the literature available on quality assurance of domestic third-party arrangements and through the use of interviews with the sessional teaching staff, the paper offers theoretical as well as practical views on the domestic third-party arrangement and seeks to inform key stakeholders in the academic management of such collaboration. Design/methodology/approach: The study was undertaken with 40 sessional academics who are involved in teaching postgraduate courses at several third-party education providers and universities with metropolitan campuses in Australia. Focus group interviews were conducted with 8-10 participants in each group. The qualitative study included seven open-ended questions. Each focus group interview was between 45- 60 minutes. Findings: The study found 11 universities in Australia offering courses in third-party arrangement with a focus on international students. Online third-party arrangement is also gaining momentum. The study found the following areas that require attention: induction and professional development, quality assurance arrangements, maintenance of standards, adequacy of resources and infrastructure and risk related to academic quality. Research limitations/implications: Limited study has been conducted on third-party arrangements where a university, usually located far from the city vicinity, works in a collaborative mode with another institution, primarily a private institution, to offer degrees at metropolitan city areas in the same country. Further research is needed with a large number of participants. Originality/value: The study is undertaken for the first time in Australia. No research has been undertaken on the growth and quality assurance of a third-party arrangement in Australia and other developed countries. The study involves the engagement of the sessional academic staff.

This paper reports on findings from four case studies, as part of a large-scale study undertaken to evaluate the KindiLink initiative across Western Australia in remote, regional and metropolitan communities. KindiLink is an educator-led playgroup initiative in public school sites in Western Australia targeted at Aboriginal children and their families. KindiLink aims included the cultivation of Aboriginal families' and children's developing sense of belonging and engagement at their local primary school. A constructivist paradigm was used to describe the subjective experiences of individuals, which was important to ascertain if the aims of KindiLink had been met. To complement the meaning-making of the experience, qualitative data were collected via detailed studies of four KindiLink sites to capture similarities and differences of the settings and gain depth of experience through the voices of the participants. The study found KindiLink successfully connected Aboriginal children and families to schools and built a sense of belonging and productive relationships between families, staff, school and the community in a culturally safe space. Furthermore, KindiLink developed the capacity and confidence of parents as their children's first teachers and supported the home learning environment. The Aboriginal Indigenous education officer in each programme was critical to the engagement of Aboriginal families and acknowledgement of cultural aspects important to children's growing cultural identities. The relationships built between KindiLink staff and families, and between families, were important for children's and their families' growing sense of belonging to the school, which assisted participation at school.

Schools in Australia are sometimes described, categorised and defined by their locations. These statistical geographical categorisations help to determine how funding is allocated. They help to determine the types of teachers that are recruited, what kinds of teachers are attracted, how they much they are paid. Geographical categories can create perceptions that sometimes end up as stereotypes in the minds of parents and students. At times remote geographical locations are associated with disadvantage. These kinds of categorisations tend to treat schools in binary terms, or on a linear continuum, which may also be associated with value judgements that can be misleading. For example, rural schools are often thought of as disadvantaged, while city schools are therefore advantaged. In this paper the authors argue that the categorisations described above are unhelpful, limiting, misrepresent and are often unwarranted. In this paper they draw from the descriptions offered by schools for the public that are presented on the My School website. They draw a line that starts in the Adelaide suburb of Paradise and runs through to the far north of South Australia. Along the line there is a mix of metropolitan, provincial and remote schools. In analysing this data from My School, they challenge the binaries and continuums associated with geographical labels and propose instead, based on geographical concepts associated with space and place, that schools could be better described in terms of socio-cultural and geographic diversity.

Purpose: The purpose of this paper is to explore relationships between students' self-reported mental health and their perspectives about life at school in metropolitan Adelaide, South Australia. Design/methodology/approach: The Strengths and Difficulties Questionnaire (SDQ) and a purpose designed Living and Learning at School Questionnaire (LLSQ) were administered to 1,715 early adolescents in school Years 7-9. Correspondence analysis, which is a perceptual mapping technique available in SPSS, was used to examine relationships between students' SDQ subscale scores (Emotional Symptoms, Hyperactivity, Conduct Problems, Pro-social Skills) and the LLSQ subscale scores (Motivation, Learning Strategies, Coping with Schoolwork, Bullying, Numbers of Friends, Safety at School and Teacher Intervention in Bullying Events). Findings: The correspondence analysis produced a two-dimensional visual display (a perceptual map) showing that students' abnormal, borderline and normal SDQ subscale scores were closely related to their low, medium and high LLSQ subscale scores, respectively. A clear Dimension (factor) emerged, showing a progression from mental health difficulties to strengths, in close association with students' reports about their school experiences. Research limitations/implications: Caution should be exercised when using the results to interpret events in other contexts. The limitations of self-report methods must be considered. Practical implications: The two-dimensional visual display provides a powerful tool for dissemination of the findings of this study about students' perspectives to system-level and school-based personnel. This can inform the selection of intervention programs, such as strategies for self-regulation of emotions and learning behaviours, fostering friendships, and supporting academic achievement, that are related to positive mental health. Social implications: This paper can inform school-level policies and practices, such as those relating to professional development to support teachers' and students' capabilities (e.g. to manage and prevent bullying) and thus influence the nature of the school experiences that shape students' perceptions. Originality/value: This paper adds students' perspectives to the emerging field concerned with designing programs for mental health promotion in schools.

This paper analyses Australian rural accountants' attitudes and levels of satisfaction with continuing professional development (CPD), based on whether the CPD was delivered by a professional accounting body in a rural or metropolitan area. The paper responds to prior research that finds rural accountants are dissatisfied with professional accounting bodies [Rural and regional Australian public accounting firm services: Service provision, concerns and tensions. "Australian Accounting Review," 23(23), 163-176]. Findings of a survey to which 156 rural accountants responded were that when CPD is delivered into the rural areas, there are greater levels of CPD satisfaction. The study also found that cost was significantly better for rural-delivered CPD and that when more rural-based CPD was attended differences became more significant across a number of satisfaction measures. The findings have important implications for both rural accountants and professional accounting bodies.

Following the invasion, or colonisation as some prefer to call it, Indigenous Australia has been characterised by plummeting populations, largely as a result of introduced diseases and the movement of peoples, following the theft of their lands and in response to colonial and subsequent Australian state and federal government policies. At times, various Aboriginal peoples were completely removed from their homelands. One such case concerns the Kaurna people of the Adelaide Plains in South Australia. Following the abandonment of restrictive policies, Aboriginal people drifted back to Adelaide and many began to identify with their Kaurna ancestry. All Kaurna people have multiple ethnicities within their ancestry, providing opportunities for shifting identities and shifting affinities. This paper investigates the role that the Kaurna language now serves for the returning Kaurna diaspora and for others in metropolitan Adelaide. Within the Kaurna community there are strong pressures for both conformity and non-conformity. We see this in relation to the Kaurna language through language planning measures on the one hand, and on the other through identity politics expressed through the language. Kaurna language is in demand by Kaurna people as a source of names and for emblematic use within the public domain. It is just beginning to make inroads into private domains as several families attempt to raise young children speaking Kaurna. The Kaurna language is also in demand by the wider community, where there is a strong and largely unmet demand for teachers of Kaurna and for Kaurna names and translations of various kinds. The Kaurna language has re-emerged from a point of almost total obscurity 30 years ago to something of an auxiliary language used alongside English. Whilst it will never replace English, it is still on the ascendency, as it addresses needs both for the returning diaspora and wider society.

Understanding the psychological wellbeing of people with cancer is a key component of assessment and intervention in quality cancer care. However, the unique experiences of rural cancer populations are less often explored than those from urban centres. The aim of this study was to perform a meta-analysis of Australian studies that compared the psychological wellbeing experiences of people with cancer from rural and urban locations. Five databases were searched, and 19 studies, involving 16,947 participants, assessing and comparing the psychological wellbeing of rural and urban populations with cancer were included. The analysis indicated that Australian rural cancer populations have greater odds of worse psychological wellbeing than those from urban areas (OR = 1.54, 95% CI [1.01, 2.35], p = 0.044). This disparity remains when cancer types are analysed separately, with a slightly smaller odds ratio for rural people with breast cancer (OR = 1.29, 95%CI [1.01, 1.64], p = 0.046) and a slightly larger odds ratio when cancers excluding breast cancer were reviewed (OR = 1.78, 95% CI [1.59, 2.01], p = <.001). Significant heterogeneity was found. Despite increasing emphasis in Australia on psychological wellbeing throughout the cancer journey, there remain significant disparities whereby rural people experience greater impacts upon their psychological wellbeing. The wellbeing of Australian rural populations with cancer remains an area in which clinical and political focus is imperative. Whilst screening is a necessary first step, additional clinical implications for improving rural access to appropriately skilled health professionals who provide oncology-specific assessment and intervention are suggested. What is already known: Cancer is a major public health issue, and its psychosocial impacts are substantial, not just on patients but on their families and the broader community. The prevalence of clinically significant psychological distress is higher amongst people with cancer than the general population. However, identification, treatment, and provision of psychological support is inconsistent across services and geographical areas, and notably lacking in rural areas. Disparities in screening, assessment and intervention for psychological wellbeing in people with cancer remain, despite the fact that systematic application of screening, appropriate referral, and intervention can improve quality of life and reduce healthcare costs associated with inpatient and outpatient cancer care. What this paper adds: This article extends outcomes from previous systematic reviews and analyses from Australia and internationally with the addition of meta-analytic methods. It was specifically designed to solely focus on Australian cancer populations. The results suggest that Australian rural populations with cancer may have anywhere from 30% to 70% greater odds of experiencing poorer psychological wellbeing than those from urban areas. This paper highlights ongoing disparities in rural psycho-oncology that may be impacting wellbeing outcomes from rural people in Australia, and urges psychologists, other health professionals, and policy-makers to proactively address these inequities with improved screening, assessment and intervention for their rural populations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to first explore whether Australia and the main metropolitan areas demonstrate significant differences in tenure and property type between generational groups. Second, whether the millennial generation is more likely to rent rather than own. Third, if such variation in tenure and property type by millennials is one of individual choice and lifestyle or the impact of housing market inefficiencies. Design/methodology/approach: This paper employs a comparative research approach using secondary data from the Australian Bureau of Statistics (ABS) to consider housing tenure and type distributions across generations as well as through cross-city analysis. Findings: The results show that home ownership is still the dominant tenure in Australia, but private rental is of increasing significance, becoming the tenure of choice for Millennials. Owner occupation is shown to remain and high and stable levels for older generations and while lower in percentage terms for Generation X; this generation exhibits the highest growth rate for ownership. Significant differences are shown in tenure patterns across Australia. Originality/value: The significance of this paper is the focus on the analysis of generational differences in housing tenure and type, initially for Australia and subsequently by major metropolitan areas over three inter-census periods (2006, 2011 and 2016). It enhances the understanding of how policies favouring ageing in place can contradict other policies on housing affordability with specific impact on Millennials as different generations are respectively unequally locked-out and locked-in to housing wealth. [ABSTRACT FROM AUTHOR]

Manga and anime may no longer be the "new kids" in wider media culture but they are relatively new texts for study in the secondary English classroom. Manga and anime support teachers in their work towards inclusive classroom practices and build multimodal literacies but the cartoony face of the medium belies a depth of analysis required and layers of sensitivity needed in navigating these texts with students. How do English teachers respond to the emergence of manga and anime texts, translated and dubbed in English, when these texts become part of their classroom curriculum and culture? This paper uses a case study of two metropolitan high schools to explore how unexpected text choices brought about deeper insights for these English teachers in the ways they perceived their students' identities, as readers and consumers of manga and anime texts, within a Quality Teaching and learning environment (NSW DET, 2003; Prumm & Patruno, 2016).

For clinicians working in mental health services, 'aggression management' training is generally prioritised, and often mandated. Traditional 'aggression management' training has the potential to reinforce the perception that violence and aggression are inevitable, and thus defensive and coercive practices are needed. This paper outlines the principles and processes that underpinned the development of two training programs designed as recovery-oriented and trauma-informed alternatives to traditional 'aggression management' training. The focus of the paper is on exploring how 'aggression management' training can be aligned with best practice principles. The programs were developed in a metropolitan and rural mental health service and aimed to reduce the need for defensive and coercive practices by promoting therapeutic engagement. A key feature of both programs is an orientation towards safety rather than risk. By embedding the principles of recovery and trauma-informed care in their development and orienting training towards enhancing safety, clinicians are provided with a new way of conceptualising and responding to 'aggression'. Experiential methods in the delivery of the training, and the co-design and co-delivery with peer (consumer) educators were important in supporting attitudinal change. To promote safety, the language and content of training programs must reflect contemporary principles and approaches such as trauma-informed care and recovery. This paper illustrates that to be effective, these principles and approaches must not just be described, but modelled in the development, design, and delivery of the training. [ABSTRACT FROM AUTHOR]

Regional Australia is enjoying renewed interest from policymakers, especially in parts of the country where major metropolitan areas are once again grappling with population pressures. With this interest in mind, this special issue brings together papers that examine opportunities and innovations emerging from regional areas across Australasia. In doing so we have sought to feature a range of stories about where the regions are heading, to ensure that the rich diversity of our regional areas is not overlooked in big picture debates over strategic planning and population trends. [ABSTRACT FROM AUTHOR]

Background: Early identification and intervention for hearing loss is important for supporting language development. Despite this, parents are required to overcome barriers to access hearing assessments for their children. Aims: To identify the enablers and barriers to accessing hearing assessments for Australian children identified by their parents, and to compare between metropolitan, regional and rural areas. Methods & Procedures: This sequential, explanatory mixed‐methods study was undertaken online and included participants in metropolitan, regional and rural area of Queensland, New South Wales, Victoria, South Australia, Western Australia and the Northern Territory. A total of 56 participants participated in the surveys, and 10 participated in semi‐structured interviews. Outcomes & Results: Participants in metropolitan areas were more likely to have services in their area; however, access to hearing assessment was related more to individual circumstances (including health literacy skills) rather than geographical location. Many participants experienced long wait times, reduced flexibility, and a lack of audiologists experienced in working with children. Conclusions & Implications: Barriers to hearing assessments (which assist with early identification and intervention for hearing loss) should be addressed so that children have access to clear auditory information to assist with their speech and language development. WHAT THIS PAPER ADDS: What is already known on the subject: Poor audiological input can lead to poor speech, language and literacy outcomes for children. What this paper adds to the existing knowledge: Although previous research indicates that people in regional and remote locations experience difficulty accessing health services within a reasonable timeframe, in this study barriers were experienced regardless of geographical location, and were dependent on individual circumstances. Many parents are unaware of the impact of hearing on speech and language. What are the potential or actual clinical implications of this work?: Further research might examine how health literacy affects access to hearing assessment. Parents shared several potential solutions to these access barriers which should be considered by service providers. [ABSTRACT FROM AUTHOR]

Background: The Australian geographically rural and remote disability workforce has historically demonstrated difficulties to keep up with the demand for quality services and supports for people with disability. In 2013, the National Disability Insurance Scheme (NDIS) was launched to provide individualised disability support packages to meet people's needs. To receive funding, people with disability are required to develop a NDIS plan. That plan is then funded by the National Disability Insurance Agency (NDIA), the government agency responsible for managing the NDIS. Although the NDIS has been operating for almost 10 years, there is limited research into the planning experiences of the workforce in regional, rural and remote regions of Australia. This review aims to ascertain the level of scholarly investigation into workers' experiences of NDIS planning. Methodology: Research publication databases were searched using a specific search string to identify publications that included reference to the workforce's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications that focused on those working with Aboriginal and Torres Strait Islander people were also appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications was undertaken to ascertain disability and health workforce experiences of the NDIS planning process. Results: Seven papers met the selection criteria. Two papers were policy reviews and reported the improvements of the NDIS planning process since its inception. These studies reported four reoccurring themes: (1) cultural/socioeconomic and geographical factors; (2) administrative burden and bureaucracy; (3) values, culture and geography; and (4) burden on allied health workers. Conclusion: The NDIS planning process has developed and progressed since its rollout in 2013. There are limited research papers available that describe the workforce's experience of the planning process in regional, rural and remote regions. More research in this area is needed to identify the experiences of the disability workforce in relation to the NDIS planning process. [ABSTRACT FROM AUTHOR]

Purpose “Asian” is an aggregating descriptive term commonly used in Australian media, politics and everyday speech to describe people of diverse backgrounds. The purpose of this paper is to question the extent to which “Asian” Australian residents living in Perth, Western Australia demonstrate spatial or organisational panethnic association.Design/methodology/approach The paper analyses quantitative population data from the 2011 Census using GIS to visualise the spatial residential distribution of individuals born in Asian countries and individuals with Chinese ancestry within the Perth metropolitan area. The paper further uses qualitative data drawn from fieldwork conducted in Perth to consider evidence of organisational panethnic association.Findings For first generation migrants there is currently little spatial or organisation evidence of “Asian” panethnic association in Perth. Migrants from different ethno-national backgrounds exhibit very different residential patterns. Incipient ethnoburbs are developing that appear to be based on ethnicity rather than panethnicity. Migrant organisation in Perth is likewise arranged primarily on the basis of ethnicity although some panethnic work is observed.Research limitations/implications Findings indicate trends towards ethnic residential segregation. Further longitudinal research could expand upon these findings. Qualitative research could determine causes of segregation and implications of (pan)ethnic identities, and explore how individuals from Asian countries respond to the dominant linguistic aggregation of “Asians”.Originality/value This paper offers an original analysis of a common frame of reference that has received little critical attention in the Australian context. It applies the framework of Asian panethnicity developed in the USA and finds it wanting, highlighting an inconsistency between the racialised language used in Australia to describe migrants from Asia and the ways these migrants associate. [ABSTRACT FROM AUTHOR]

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index‐Service Prioritization Decision Analysis Tool (VI‐SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap‐around supportive housing to address poor health outcomes. [ABSTRACT FROM AUTHOR]

To alleviate overpopulation in Australia's metropolitan areas and counter population decline in regional areas, regional settlement of newly arrived migrants and refugees has emerged in recent policy debates. With a new federal government plan to introduce mandatory regional settlement for migrants, significant responsibility is placed on regional schools to cater for the unique needs of students from linguistically and culturally diverse backgrounds. Evoking Bourdieu's thinking tools, this paper examines the perspectives of principals and teachers from two regional schools in Victoria, Australia by exploring their beliefs and dispositions towards English as an Additional Language (EAL) students in mainstream classrooms and their capacity to build student capital within a regional education field. This paper argues that for regional settlement to be 'advantageous', regional schools must look from within to initiate a whole school approach to EAL support and professional development and promote community connections to create advantageous spaces for migrant and refugee youth. [ABSTRACT FROM AUTHOR]

A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues" and "lack of cultural awareness," "not feeling supported by their manager," "not having role models or mentors," and "inflexible human resource policies" predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. [ABSTRACT FROM AUTHOR]

Introduction: Commercial tobacco use was systematically embedded as a valuable commodity through colonisation that continues to be exploited for profit by the Tobacco Industry. There have been significant declines in current smoking prevalence among Aboriginal and Torres Strait Islander peoples 18 years and over, from 55% in 1994 to 43% in 2018–2019. This paper seeks to better understand smoke‐free behaviours, and to systematically quantify associations between a range of SDOH and non‐smoking/never‐smoking among Aboriginal and Torres Strait Islander adults (≥18) living in regional Australia. Objective: To explore the social determinants of health (SDOH) related to non‐ and never‐smoking among Aboriginal and Torres Strait Islander peoples in regional Australia. Design: Cross‐sectional analysis of the NATSIHS, weighted to the Aboriginal and Torres Strait Islander adult population living in regional Australia, was conducted. Participants were characterised as people who were current smokers, never‐smokers and non‐smokers (ex‐ and never‐smokers). The social determinants of health exposures related to socioeconomic position, well‐being and access to healthcare. Setting: Regional Australia is distinct from urban and remote areas, based on the ASGS Remoteness Structure (ABS) 2018–2019. Participants: Aboriginal and Torres Strait Islander adults (≥18 years) who were selected, consented and asked questions about smoking in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS 2018/19). Results: High income was associated with non‐smoking (Prevalence Ratio [PR] = 2.07; 95% CI: 1.66–2.57) and never‐smoking (PR = 2.02; 1.46–2.79), as was completing year 10 (non‐smoking PR = 1.34; 1.12–1.61 and never‐smoking PR = 1.56; 1.20–2.03). Better food security was associated with a higher prevalence of never‐smoking (PR = 2.42; 1.48–3.98). Lower psychological distress scores were associated with non‐smoking (PR = 1.30; 1.10–1.53) and never‐smoking (PR = 1.56; 1.21–2.01). Never‐smoking was more frequent in participants reporting no experiences of unfair treatment (PR = 1.59; 1.22–2.06). Having a usual healthcare provider was associated with non‐smoking (PR = 1.38; 1.02–1.86). Positive exposure to the SDOH were associated with non‐ and never‐smoking among Aboriginal and Torres Strait Islander adults in regional Australia. Structural and systemic changes to address the SDOH, including discrimination and racism, are expected to accelerate non‐smoking behaviours and improve health outcomes for Aboriginal and Torres Strait Islander peoples. [ABSTRACT FROM AUTHOR]

We promote a view that more attention should be given to the freight sector in order to recognise that many initiatives designed to impact on passenger travel do also impact on the performance of the movement of freight vehicles and hence the ability to distribute commodities from the locations in which they are generated. This paper develops a practical freight demand model system and applies the models within an integrated passenger and freight model system for the Greater Sydney Metropolitan Area using a distance based charge for trucks and cars as a way of highlighting the importance of not ignoring truck traffic when assessing road pricing reform in the car passenger sector. [ABSTRACT FROM AUTHOR]

Qualitative studies on assisted reproductive technology commonly focus on the perspectives of participants living in major metropolises. In doing so, the experiences of those living outside major cities, and the unique way conditions of spatiality shape access to treatment, are elided. In this paper, we examine how location and regionality in Australia impact upon access and experience of reproductive services. We conducted twelve qualitative interviews with participants residing in regional areas across Australia. We asked participants to discuss their experience with assisted reproduction services and the impacts of location on access, service choice, and experience of care, and analysed the data using reflexive thematic analysis, as outlined by Braun and Clarke (2006, 2019). Participants in this study reported that their location impacted the services available to them, required considerable time in travel, and reduced continuity of care. We draw on these responses to examine the ethical implications of uneven distribution of reproductive services in commercial healthcare settings which rely on market-based mechanisms. [ABSTRACT FROM AUTHOR]

Australian children from regional, rural and remote (RRR) areas exhibit lower educational outcomes than their peers in metropolitan areas. The mechanisms driving the comparatively poorer educational outcomes of children in RRR areas, however, are not well understood. This paper proposes and tests two sets of factors that may be responsible for these disparities: population socio-demographic composition and school climate. Using rich survey and linked administrative data from the Longitudinal Study of Australian Children (n = 9,248 observations), we estimate the relative contribution of these sets of factors to RRR children's disadvantage in NAPLAN numeracy test scores. Our results indicate that both socio-demographic and school climate factors account for part of the educational disparities between children in RRR and metropolitan areas. These findings suggest that hybrid policy approaches that tackle both the social determinants of educational success and use schools as an intervention site are required to close the achievement gap. [ABSTRACT FROM AUTHOR]

To examine the need, feasibility and acceptability of speech-language pathologists (SLPs) implementing a systematic, routine, unmet social needs identification and referral pathway, as a means of promoting health equity and addressing Sustainable Development Goals (SDGs). Quality Improvement methodologies were used to adapt and pilot an unmet social needs identification and referral pathway for use with parents/carers of children with communication disabilities referred to an urban Australian speech-language pathology service. SLPs were surveyed about the acceptability and feasibility of this practice. The majority of parents/carers, 289 of 293 (99%), agreed to participate in the study, with 31 of the 289 (11%) reporting concerns about unmet social needs. The most common unmet need related to household bills (n = 17, 28%), followed by childcare (n = 12, 20%), employment (n = 10, 16%), food (n = 8, 13%), housing (n = 7, 11%), and parent/carer education (n = 7, 11%). The majority of these families, 26 of 31 (84%), requested referral to, or information about, local community services/resources. SLPs reported high levels of acceptability (93%) and feasibility (98%). This study demonstrates the need, feasibility and acceptability of SLPs implementing an unmet social needs identification and referral pathway, and the potential to scale this initiative across other speech-language pathology services and allied health contexts. This paper focusses on SDG 1, SDG 2, SDG 3, SDG 4, SDG 8, SDG 10, SDG 11, SDG 16, and also addresses SDG 17. [ABSTRACT FROM AUTHOR]

This paper (Part 2 in the paper series), building on earlier studies examining the Australian response, extends on findings related to travel activity, commuting, and attitudes towards COVID-19 measures (Part 1 in the paper series). In this paper we focus in detail on the impact of, and experiences with, working from home (WFH), perhaps the largest of the positive unintended consequence of the pandemic, with respect to transport, and a key lens through which the changing patterns in travel activity and attitudes discussed in Part 1 need to be understood. We conclude that through the widespread adoption of WFH as a result of nationwide public health orders, there is evidence emerging that WFH is now seen as an appealing instrument of change by employees and employers, there is growing support to continue to support WFH into the future. This represents a significant potential contribution to the future management of the transport network, especially in larger metropolitan areas. We also discuss policy implications of this result and what the international community may take from the Australian experience. [ABSTRACT FROM AUTHOR]

Background: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. Objective: The aim of this paper was to explore how older patients participated in managing their medications across transitions of care through formal and informal modes of communication. Methods: The study was conducted across two metropolitan hospitals: an acute hospital and a geriatric rehabilitation hospital in metropolitan Melbourne, Australia. A focused ethnographic design was used involving semi‐structured interviews (n = 50), observations (203 h) and individual interviews or focus groups (n = 25). Following thematic analysis, data were analysed using Fairclough's Critical Discourse Analysis. Results: Data analysis revealed two major discursive practices, which comprised of an interplay between formal and informal communication and environmental influences on formal and informal communication. Self‐created patient notes were used by older patients to initiate informal discussion with health professionals about medication decisions, which challenged traditional unequal power relations between health professionals and patients. Formal prompts on electronic medication administration records facilitated the continuous information discourse about patients' medications across transitions of care and encouraged health professionals to seek out older patients' preferences through informal bedside interactions. Environmental influences on communication comprised health professionals' physical movements across private and public spaces in the ward, their distance from older patients at the bedside and utilization of the computer systems during patient encounters. Conclusion: Older patients' self‐created medication notes enabled them to take on a more active role in formal and informal medication communication across transitions of care. Older patients and family members did not have continuous access to information about medication changes during their hospital stay and systems often failed to address older patients' key concerns about their medications, which hindered their active involvement in formal and informal communication. Patient or Public Contribution: Older adults, family members and health professionals volunteered to be interviewed and observed. [ABSTRACT FROM AUTHOR]

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

This paper examines the degree of commonalities present in the cyclical behaviour of the eight largest metropolitan housing markets in Australia. Using two techniques originally proposed in the business cycle literature we firstly consider the degree of synchronisation present and secondly decompose the series into their permanent and cyclical components. Both empirical approaches reveal similar results. Sydney and Melbourne are closely related to each other and are relatively segmented from the smaller metropolitan areas. In contrast, there is substantial evidence of commonalities in the cyclical behaviour of the remaining cities, especially those on the eastern and southern coasts of Australia. [ABSTRACT FROM PUBLISHER]

Objective To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Design Systematic review and matched retrospective cohort study. Setting Australia. Participants Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Main Outcome Measures Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Results Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be diagnosed with localised disease and less likely to receive treatment for their cancer compared to their urban counterparts. Conclusion More research is needed to fully understand geographic differentials in cancer outcomes within the Indigenous population. Knowing how geographical location interacts with Indigenous status can help to identify ways of improving cancer outcomes for Indigenous Australians. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to further our understanding of second opinions among medical oncology patients by examining the proportion of patients who sought a second opinion about their cancer treatment, and why. Methods: The study was conducted between 2013 and 2015 in three medical oncology clinics located in public hospitals in Australia: in metropolitan New South Wales, metropolitan Queensland, and in Tasmania. Those patients who provide written informed consent were asked to complete a brief paper and pencil survey in the clinic containing questions on sociodemographic, disease and treatment characteristics. Approximately 1 month later, participants were mailed a second paper and pencil survey which contained questions about whether they had sought a second opinion and their motivation for doing so. Non-responders were followed up by letter at 3 and 6 weeks. Results: Of 823 patients screened for eligibility, 698 eligible patients, 612 provided consent. Of those who consented, 355 completed both the initial survey and the second survey and were included in the analyses. Of the 57 patients who sought a second opinion, the most frequent reasons given for doing so were the need for reassurance (49.1%) and the need to consider the range of treatment options (41.8%). Of the 297 (83.6%) participants who did not seek a second opinion, the main reason was confidence in the first doctor (88.7%). Only 3.1% patients did not know that they could ask for a second opinion. Occasionally the doctor will initiate the referral for a second opinion. Conclusions: Our study suggests that a minority of cancer patients seek a second opinion at some phase during their care. Most did so for reassurance or to ensure that they had covered all of the treatment options and not because of discomfort or distrust of their treating doctor. Few patients reported a lack of awareness of second opinions. This suggests that second opinions form part of a patient-centred approach to information provision about care options. Whether the second opinion improves the quality of care or indeed outcomes has been difficult to demonstrate. [ABSTRACT FROM AUTHOR]

Objective: A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods: A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results: Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expanded-scope paramedics, health promotion and the role of paramedics as key members of local communities. There were no studies specifically related to the paramedic role in health education, although many papers referred to health education as one of many roles paramedics engage in today. Conclusion: This review highlights a broadening of paramedicine's traditional scope of practice, and an indication of how vital paramedics could be to local communities, particularly in rural and remote areas. An expanded role may help address health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers. What is known about the topic?: A broadening of paramedicine's traditional scope of practice has been linked to improvements in health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers, such as rural and remote Australia. Health education, as well as health promotion, primary health care and chronic disease management, have been proposed as potential activities that paramedics could be well placed to participate in, contributing to the health and well-being of local communities. What does this paper add?: This paper identifies and synthesises literature focusing on paramedic-initiated health education in the Australian context, assessing the current health education role of paramedics in metropolitan, rural and remote areas. It provides an understanding of different geographical areas that may benefit from expanded-scope prehospital practice, indicating that the involvement of paramedics in health education in Australia is significantly determined by their geographical place of work, reflecting the influence of the availability of healthcare resources on individual communities. What are the implications for practitioners?: Today's paramedics fill broader roles than those encompassed within traditional models of prehospital care. Rural and remote communities facing increasing difficulty in obtaining health service provision appear to benefit strongly from the presence of expanded-scope paramedics trained in health promotion, primary injury prevention, chronic disease management and health education: this should be a consideration for medical and allied health practitioners in these areas. Australian paramedics are uniquely placed to 'fill the gaps' left by shortages of healthcare professionals in rural and remote areas of the country. [ABSTRACT FROM AUTHOR]

Background: The RUBY randomised controlled trial was found to be effective in promoting breastfeeding continuation, in the setting of a high income country, through a program of proactive telephone-based peer support in the first 6 months postpartum. This paper explores women's experiences of receiving the peer support intervention in the RUBY trial. Methods: Ten in-depth, face-to-face interviews were conducted between December 2015 and November 2016 in Metropolitan Melbourne, and regional Victoria, Australia. Participants were women who received the peer support intervention in the RUBY trial and were between 11 and 15 months postpartum at the time of interview. Interviews were underpinned by social support theories and were analysed using inductive thematic analysis. Results: A global theme of 'non-judgemental support and guidance' was identified, which included five organising themes. Four of the organising themes centred on the support from the peer, in which women felt the support was a 'positive experience with empathy and understanding', 'non-judgemental', 'practical advice', and a 'social connection that was more than just breastfeeding'. In contrast to the support from peers was the theme 'not all support from family and friends is supportive'. Conclusion: Participants, including those who considered that they had adequate and available family and friend support for breastfeeding, valued and appreciated the non-judgemental, empathetic and understanding support from peers. This support, facilitated by the anonymity of the telephone-based program, allowed open and honest conversations, normalising women's experiences and helping them feel less alone in their challenges with breastfeeding and transition to motherhood. These findings can inform the design, and upscaling, of innovative and sustainable peer support models, ensuring delivery of effective and engaging support with a broad population reach. [ABSTRACT FROM AUTHOR]

Background: Australian policy reports recommended schools to be leveraged to better support student mental health, with a focus on regional and rural areas where students have poorer mental health outcomes. In designing solutions to address this systemic gap, decision‐makers require an understanding of the barriers and facilitators experienced by regional and rural schools. However, current literature has focused on metropolitan schools and neglected to explore facilitators. Objective: To review the evidence on barriers and facilitators in delivering student mental health support experienced by regional and rural schools in Organisation for Economic Co‐operation and Development nations. Design: A mixed‐methods systematic review of peer‐reviewed and grey literature. Findings: The search identified 4819 studies. A full‐text review by 2 reviewers resulted in 5 papers, which met the inclusion criteria and were assessed using methodological appraisal. One study used qualitative data, 2 studies used quantitative data, and 2 studies were a mixed‐methods design. Discussion: While there was a paucity of studies, this review draws together the most up‐to‐date research. The barriers and facilitators were categorised into 3 themes: access to services and resources; mental health literacy of staff and parents; and communication and collaboration between stakeholders. Conclusion: This review presents a comprehensive synthesis of the literature and highlights opportunities to leverage rural and regional schools to support student mental health, focusing on the quality of communication and collaboration, and increasing access to services and resources, and mental health literacy. Research should explore the unique advantages of rural and regional areas to inform policy, including a focus on strengths. [ABSTRACT FROM AUTHOR]

Academic and lay discourses around disadvantaged urban areas often draw on the language of ‘dumping grounds’ to encapsulate the poverty, marginalisation and social problems often found there. Yet the concept of a dumping ground remains insufficiently theorised. This paper addresses this issue by identifying five constituent features of the dumping ground: the perception of people as waste whose fate is to be discarded; the need to accommodate this human ‘waste’ and the logic by which places are selected for this purpose; the mechanisms through which this spatial sorting occurs as problem populations are moved to their ‘rightful’ place; the relations of power which enforce or encourage this mobility; and finally, the reactions of incumbent residents in neighbourhoods that are compelled to host unwanted social groups. In the second part of this paper, these themes are illustrated via a case study of the Australian city of Logan where residents complain that their city has been treated as a dumping ground in order to explain its poor reputation. [ABSTRACT FROM AUTHOR]

Background: In Australia, the distribution of occupational therapists, physiotherapists, and podiatrists density (per 10,000 population) by measure of location/rurality, usual resident population, and area-level socioeconomic status has not been described. Objective: To describe the national as well as states-and territories-wide distribution of registered allied health workforce—occupational therapists, physiotherapists, and podiatrists—by measures of rurality and area-level socioeconomic position in Australia. Methods: A linked data study that brings together (1) the location of health practitioners' principal place of practice from the Australian Health Practitioner Regulation Agency, (2) a measure of location/rurality—Modified Monash Model (MMM), and (3) an area-level measure of socioeconomic status—Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD). The provider-to-population ratio (i.e., density) of three Australia's allied health workforce (occupational therapists, physiotherapists, and podiatrists) was calculated according to the MMM classifications (i.e., Modified Monash 1–7) and IRSAD quintiles at state and national level. Results: Nationwide, the density of occupational therapists and physiotherapists was highest in metropolitan areas (Modified Monash 1) and decreased with the increasing levels of the MMM categories. The national density of podiatrists was highest in Modified Monash 3 areas. The density of occupational therapists, physiotherapists, and podiatrists was highest in areas with IRSAD quintile 5 (i.e., the highest socioeconomic position) and decreased with the declining levels of the IRSAD quintiles nationwide. Moreover, there were notable disparities in the density of occupational therapists, physiotherapists, and podiatrists across each state and territory in Australia when stratified by the MMM classifications and IRSAD quintiles. Conclusions: There was uneven distribution of registered occupational therapists, physiotherapists, and podiatrists when stratified by measures of location/rurality and area-level socioeconomic status across Australian jurisdictions. The density of these three groups of allied health workforce tended to be more concentrated in metropolitan and most advantaged areas while remote and most disadvantaged areas exhibited less allied health workforce distribution across each state and territory. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The nature of interactions between health care professionals and families may have a significant impact on families' experience and outcomes of critical illness. The value of encouraging positive relationships with families is well documented; however, it is argued that the lack of theoretical frameworks to guide practice in this area may be a barrier to improving patient‐ and family‐centred care. Aims: The study on which this paper is based aimed to understand families' experiences of their interactions when a relative is admitted unexpectedly to an Australian intensive care unit and to generate a substantive theory that represents families' interactions that can be used to guide critical care nursing practice when caring for patients' families in this context. Design and Methods: A grounded theory methodology was adopted for the study. Data were collected between 2009 and 2013 using in‐depth interviews with 25 family members of 21 critically ill patients admitted to a metropolitan, tertiary‐level intensive care unit (ICU) in Australia. Findings: A core category of regaining control has been generated from our study. This paper focuses on Disconnectedness, which leads to increased emotional vulnerability and is also a barrier to families' regaining control. Families feel disconnected when staff emotionally and physically disengage from them, when staff interact insensitively and in a manner that offers families limited hope. Conclusion: Our findings offer an in‐depth understanding of staff engagement with families and its impact on the families' ability to regain control. Although some themes have been previously identified in the literature in isolation, the interrelationships of the categories within a theoretical framework to represent family resilience in the context of an ICU situated in the Australian health care system are a novel finding. Relevance to Clinical Practice: The findings can be used to support patient‐ and family‐centred care interventions in the ICU. [ABSTRACT FROM AUTHOR]

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

Purpose: Third-party arrangements where a university offers its degrees in collaboration with another institution are not a new phenomenon, particularly when the third-party arrangements occur in the form of a cross-border education (or widely known as transnational education). Drawing on a critical review of the literature available on quality assurance of domestic third-party arrangements and through the use of interviews with the sessional teaching staff, the paper offers theoretical as well as practical views on the domestic third-party arrangement and seeks to inform key stakeholders in the academic management of such collaboration. Design/methodology/approach: The study was undertaken with 40 sessional academics who are involved in teaching postgraduate courses at several third-party education providers and universities with metropolitan campuses in Australia. Focus group interviews were conducted with 8–10 participants in each group. The qualitative study included seven open-ended questions. Each focus group interview was between 45–60 minutes. Findings: The study found 11 universities in Australia offering courses in third-party arrangement with a focus on international students. Online third-party arrangement is also gaining momentum. The study found the following areas that require attention: induction and professional development, quality assurance arrangements, maintenance of standards, adequacy of resources and infrastructure and risk related to academic quality. Research limitations/implications: Limited study has been conducted on third-party arrangements where a university, usually located far from the city vicinity, works in a collaborative mode with another institution, primarily a private institution, to offer degrees at metropolitan city areas in the same country. Further research is needed with a large number of participants. Originality/value: The study is undertaken for the first time in Australia. No research has been undertaken on the growth and quality assurance of a third-party arrangement in Australia and other developed countries. The study involves the engagement of the sessional academic staff. [ABSTRACT FROM AUTHOR]

Background: There is paucity of research from Australia about comorbidity in older people with intellectual disability (PwID). This paper examines the burden of chronic diseases and associated sociodemographic correlates in a cohort of PwID aged 60+. Methods: A cross‐sectional survey was used with community‐dwelling older PwID in urban/rural regions of two Australian states. Recruitment was undertaken via a multi‐prong approach and each subject (N = 391; 236 urban/155 rural) personally interviewed. Results: Findings show older PwID experience considerable multimorbidity (X = 3.8; 53.5% had 2–6 conditions). Conditions included arthritis (40%), diabetes (26%), cardiovascular diseases (23.6%), asthma (16.1%), carcinomas (10.0%) and mental health disorders (34.5%). Conclusions: There was significant multimorbidity in older PwID, with evolution of life trajectories of select conditions associated with socioeconomic disadvantage and heath facility access barriers. Greater scrutiny of progressive health debilitation leading into older age and increased engagement by healthcare systems is required earlier in the lives of PwID. [ABSTRACT FROM AUTHOR]

Issue Addressed: The aim of this study was to use a novel approach to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability.Method: This study used national census data and the survey of disability, ageing and carers data to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability.Result: The results in this study show that there were more people living in the least disadvantaged areas (wealthiest) when compared to the most disadvantaged (poorest) areas. Whereas for people with a disability as the relative socio-economic disadvantage of the area increased, the number of people reporting any disability also increased, with the highest number coming from the most disadvantaged areas. The maps show a significant distribution with fewer cases of disability in metropolitan areas and relatively higher number in the rural area along with the higher proportion of people with disability living in the relatively more disadvantaged areas.Conclusion: Socio-economic profile is one of the key factors influencing the various aspects of health and hence should hold an important place during policy making. Policy should be formulated and implemented to help reduce the inequality by either directly aiming at the most disadvantaged group or by trying to bridge the gap between them. SO WHAT?: This paper provides a geographic visualisation of the distribution of people with profound and severe disability to help identify priority areas with high prevalence of disability. [ABSTRACT FROM AUTHOR]

Purpose Child and family health (CAFH) services in Australia initially provide at least one nurse-home-visit following the birth of a child. Planning and referral then commences for the on-going provision of appropriate services to families. Unfortunately, services in rural and regional communities in Australia can be fragmented and poorly resourced. Little is known about CAFH nurses’ experiences of working with families in these communities. The purpose of this paper is to examine the way CAFH nurses work within a universal health service model that may be compromised by isolation, discontinuity and fragmentation.Design/methodology/approach Focus groups with 26 CAFH nurses from five rural, two regional and one urban community in New South Wales (NSW), Australia were conducted. A secondary, thematic analysis of the qualitative data were undertaken to reflect on change and continuity in the field of universal CAFH services. Analysis was driven by two key research questions: How do CAFH nurses experience their role in universal home-based CAFH services within rural and regional areas of Australia and, what unique factors are present in rural and regional areas that impact on their CAFH nursing role?Findings The experience of the CAFH nurses as presented by these data revealed a role that was family centred and concerned for the welfare of the family, yet compromised by the need to meet the disproportionately complex needs of families in the absence of a strong network of services. The opportunity to present the findings provides insight into the way in which families engage with available services in isolated communities. CAFH nurses in the study attempted to maintain service integrity by adapting to the unique context of their work.Originality/value It is important to understand the mechanisms through which CAFH nurses operate to work effectively with families referred to their service. This paper describes the way in which CAFH nurses work with families not meeting the threshold for more intensive and targeted home-visiting service delivery in rural and regional communities of NSW, Australia. [ABSTRACT FROM AUTHOR]

Background: Planning and transport agencies play a vital role in influencing the design of townscapes, travel modes and travel behaviors, which in turn impact on the walkability of neighbourhoods and residents' physical activity opportunities. Optimising neighbourhood walkability is desirable in built environments, however, the population health benefits of walkability may be offset by increased exposure to traffic related air pollution. This paper describes the spatial distribution of neighbourhood walkability and weighted road density, a marker for traffic related air pollution, in Sydney, Australia. As exposure to air pollution is related to socio-economic status in some cities, this paper also examines the spatial distribution of weighted road density and walkability by socio-economic status (SES).Methods: We calculated walkability, weighted road density (as a measure of traffic related air pollution) and SES, using predefined and validated measures, for 5858 Sydney neighbourhoods, representing 3.6 million population. We overlaid tertiles of walkability and weighted road density to define "sweet-spots" (high walkability-low weighted road density), and "sour- spots" (low walkability-high weighted road density) neighbourhoods. We also examined the distribution of walkability and weighted road density by SES quintiles.Results: Walkability and weighted road density showed a clear east-west gradient across the region. Our study found that only 4 % of Sydney's population lived in sweet-spot" neighbourhoods with high walkability and low weighted road density (desirable), and these tended to be located closer to the city centre. A greater proportion of neighbourhoods had health limiting attributes of high weighted road density or low walkability (about 20 % each), and over 5 % of the population lived in "sour-spot" neighbourhoods with low walkability and high weighted road density (least desirable). These neighbourhoods were more distant from the city centre and scattered more widely. There were no linear trends between walkability/weighted road density and neighbourhood SES.Conclusions: Our walkability and weighted road density maps and associated analyses by SES can help identify neighbourhoods with inequalities in health-promoting or health-limiting environments. Planning agencies should seek out opportunities for increased neighbourhood walkability through improved urban development and transport planning, which simultaneously minimizes exposure to traffic related air pollution. [ABSTRACT FROM AUTHOR]

The paper investigates how the interplay between six organisational elements of public transport systems (conditions) – i.e. integration of planning responsibilities within an authority at the regional/metropolitan level; land-use and transport integration; long-term metropolitan public transport planning; agency over funding; fare integration, and allocation of risks between government and operators - influence two key performance indicators (outcomes) – modal split and cost-recovery. The study focuses on selected metropolitan areas in Europe, Australia, and Canada, and employs Qualitative Comparative Analysis (QCA). QCA can handle multiple explanatory conditions in combination, framing the relationship between conditions and studied outcomes in terms of necessity and sufficiency. The paper reveals three alternative combinations of organisational elements that are sufficient for achieving each outcome, underscoring that modal split and cost-recovery depend on the combined effects of multiple conditions (conjunctural causality), and that different paths can lead to similar results (equifinality). Furthermore, even though both outcomes are linked to higher usage of public transport, findings suggest that each of them might require decision-makers to give attention to different elements. Higher modal split is closely linked to both integration between land-use and transport, and the integration of planning responsibilities within an authority at the regional/metropolitan level. Higher cost-recovery, in turn, requires focus on the way agency over funding and risk allocation strategies shape incentives for savings and/or revenue generation. [ABSTRACT FROM AUTHOR]

Aims: Life expectancy for both sexes in Australia exceeds 80 years, with individuals with intellectual disability also increasingly living into older age. This research aimed to comparatively examine perceptions of staff supporting either older adults or age peers with lifelong intellectual disability. Methods: This project asked 420 medical, health, and support workers about training adequacy, health services access, and trigger points for premature institutionalisation. This paper is based on a subsample of 196 respondents who provided quantitative and qualitative responses. Results: There was considerable variation in confidence in supporting ageing individuals, while only 23.7% of doctors reported their training was adequate to support adults ageing with intellectual disability. A lack of services and poor carer health were identified as triggers for premature institutionalisation. Conclusions: The study revealed key differences in staff perceptions of support provision and training adequacy when comparing ageing individuals with intellectual disability to the general ageing population. [ABSTRACT FROM AUTHOR]