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Background: This qualitative study explored the attitudes and experiences of Hong Kong Chinese parents/carers relating to the sexual needs of their child with intellectual disabilities. Methods: Semi-structured interviews were conducted in Hong Kong with seven parents/carers applying Interpretative Phenomenological Analysis to explore their experiences of and attitudes towards the sexual needs of their adult child with intellectual disabilities. Findings: Data revealed three salient variations in participants' attitudes towards the child's sexual needs: concern, reluctance and prohibition. Participants' anxiety about discussing sexuality was evident. Most participants further displayed a layer of feeling that combined 'love' and 'grief'. Based on Goffman's dramaturgical perspective, participants exhibited front stage and back stage behaviours that are believed to be strongly influenced by stigmatisation and collectivist culture. Conclusion: Various levels of intervention to reduce stigma are identified and discussed. This study also highlighted the role of caring professionals in generating awareness of the cultural impact on the family and the need to carefully address the subtle feelings experienced by family members with intellectual disabilities.

Background: Staff members' views can have a significant impact on sexuality issues of people with intellectual disabilities. Research on the impact of sociocultural factors in this area in the Chinese context is sparse. Methods: Semi-structured interviews were conducted with seven professionals (social worker, nurse, life skills trainer and manager) to explore their experiences of and attitudes towards the sexual needs of people with intellectual disabilities by applying interpretative phenomenological analysis. Results: The study identified two major themes, each with two sub-themes: 1. Professional handling of the sexual needs of people with intellectual disabilities (sex education and intervention); 2. Barriers (incompatible approaches and parental resistance). Participants also experienced feelings of resignation facing the barriers they encountered. Collectivism and cultural view about sex are potentially the influencing factors. Conclusion: This study highlights the need to adopt an evidence-based sex education programme whose content and delivery should take account of cultural factors.

Injuries are a leading cause of travel?related mortality and morbidity globally.[sup.1,2] While Australia is not typically considered a dangerous country for visitors, injuries and deaths occur.[sup.2,3] In 2019, there were [...], : Objective: To explore injury deaths in international and domestic interstate travellers, together with those newly arrived to Australia. Methods: A population?based cohort study of all injury?related deaths between 1January 2006 and 31 December 2017 registered with Births Death and Marriages in Australia was conducted using Australian Bureau of Statistics? (ABS) Cause of Death information. Population data on travellers were obtained from Tourism Research Australia. Results: There were 4,503 injury?related traveller deaths (domestic interstate:3,055; international:934; new arrivals:514). The average annual age?standardised mortality rates in domestic interstate travellers was 0.75 per 100,000, compared with 2.22 per 100,000 in international travellers. Leading causes of injury?related death were land transport incidents (n=1495, 33.2%), self?harm (n=786, 17.5%) and falls (n=513, 11.4%), with differences in mechanism by state/territory, traveller type and age group. Intentional self?harm was common amongst all visitor types, however, it was the primary cause of death in new arrivals Conclusion: Age?standardised mortality rates were almost three?fold higher in international than domestic travellers. New arrivals, international and domestic travellers have different injury profiles, and each require specific prevention strategies. Implications for public health: While COVID has restricted travel to and within Australia, this has provided an opportunity for exploration, reflection, and consideration of risk factors for travellers, and to develop targeted injury prevention strategies for visitor types, so travel experience can be optimised and the magnitude of harm can be reduced.

Introduction: Each year, over 700,000 people die by suicide worldwide, and far more attempt and are impacted by the outcome. Agriculture is one of the most dangerous industries in which to work; it is also exposed to a lot of external stressors, such as climatic conditions, market forces (both input and output) and government regulation, as well as internal such as employment and of staff, multiple skills required and isolation. These stressors contribute to the higher rate of farm suicide cases. While there is growing evidence of the protective circumstances (factors) that protect against suicide and suicidality, more needs to be done in the agricultural sector. Objective: To review global literature and consolidate the current knowledge regarding protective factors against suicide and suicidality in agricultural communities and elucidate the implications of these findings. Method: A systematic scoping review following the Preferred Reporting Items for Systematic Scoping Reviews (PRISMA-Sc). A range of databases was searched for the terms "suicide*" or "suicidal behavior", "suicide attempt", or "suicidal ideation", or "suicidality", and "farm*" or 'agricultural worker*' or 'rancher*' and 'protective factors' or protect". Paper included had to be peer reviewed in English, include people living, working in or with agriculture or lived in an agricultural area. Results: Fourteen studies met the study criteria, predominately (72%) from the United States of America and Australia. Four (29%) articles discussed individual coping mechanisms and self-reliance as protective factors against suicide and suicidality, while six (43%) described the influence of social support and perceived sense of belonging on suicide risk. Five (36%) papers examined the association between health-promoting and suicide-prevention initiatives as protective factors in agricultural communities. Conclusion: There is limited, however, growing literature about protective factors for the prevention of suicide in agriculture; however, it is skewed to high-income countries. This review demonstrates a link between the development of individual coping skills as a protective factor against suicide in agricultural communities, with a primary focus on farming occupations within this setting. Social support was found to help reduce suicide risk by increasing a sense of belonging. These need to be exploited to drive down suicide rates. [ABSTRACT FROM AUTHOR]

Introduction: No published evidence was identified regarding the use of oxygen in the treatment of drowning in two recent systematic reviews. The aim of our study was to investigate the impact of on scene, pre‐Emergency Medical Services (EMS) oxygen therapy by lifeguards in the resuscitation of drowning victims. Method: We conducted a retrospective case match analysis of drowning patients presenting to the EDs of Sunshine Coast Hospital and Health Service. Patients were matched for age, sex and severity of drowning injury. The primary outcome was in‐hospital mortality. Secondary outcomes included positive pressure ventilation (PPV) by EMS and the ED, as well as admission to the Intensive Care Unit. Results: There were 108 patients in each group. Median (IQR) age was 22 (15–43) in the oxygen group and 23 (15–44) years in the non‐oxygen group. There were 45 females in the oxygen group and 41 females in the non‐oxygen group. Sixteen patients had suffered cardiac arrest and three patients respiratory arrest in each group. There were five deaths in each group. Initial oxygen saturation on arrival of EMS was identical in both groups 89.2% (±19.9) in the oxygen group versus 89.3% (±21.1) (P = 0.294) in the non‐oxygen group. The oxygen group required PPV more frequently with EMS (19 vs 11, P < 0.01) and in the ED (19 vs 15, P < 0.01). Conclusion: On scene treatment with oxygen by lifeguards did not improve oxygenation or outcomes in drowning patients. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents are at-risk of fatal and non-fatal injuries in the farm environment. School-based agricultural safety and farm injury prevention education is likely to be more effective when utilizing co-designed and gamification principles; however, this needs to be tested. This study examined data from a pilot evaluation of a co-designed farm injury prevention gamified educational resource for adolescents. Methods: Online, anonymous surveys were conducted with students studying agriculture in regional Australia who had previously participated in the co-design process to develop "Calm Your Farm". Three courses were developed (vehicles, workshop, and water safety) and before and after playing each of the courses for the first time, students completed survey questions regarding self-reported knowledge on the course topic, and assessment of content, design, ease of play, and how much they learned. Survey data were analyzed using descriptive statistics, chi square tests of association, and independent sample t tests. Results: We analyzed 66 responses (66.7% male; 60.6% aged 13 years). Staged course release meant all respondents assessed the vehicle and workshop courses, while 58% assessed the water safety course. Vehicle and workshop courses were rated 7.64 out of a possible 10 (SD = 1.85) and 7.65 (SD = 1.78), respectively, for the information presented, slightly higher than water safety (7.47 [SD = 1.91]). Statistically significant improvements in self-reported knowledge post play were seen among boys for the water safety course (63% said knowledge improved; X2 = 4.98; p =.026) and 13-year-olds for vehicles (35%; X2 = 4.31; p =.038) and workshop safety (50%; X2 = 4.29; p =.038). Respondents indicated being more likely to replay the game at school (M = 6.62 [SD = 2.96]) than at home (M = 5.57 [SD = 3.07]). Of respondents, 61% (n = 40) agreed that "Calm Your Farm" taught them more about farm safety and was more fun than other farm safety education previously received. Tractor safety (62%), chemical safety (58%), and firearm safety (58%) were the most popular topics suggested to be added to the game. Conclusion: The co-design and gamification approach taken with "Calm Your Farm" appeared to be successful in improving self-reported knowledge around farm injury prevention and was perceived by 62% of the respondents as being fun and educational. Future expansion should incorporate student suggested topics. [ABSTRACT FROM AUTHOR]

Child drowning is a significant public health issue in Indonesia, however, there is insufficient understanding of the issue and its associated risk factors within communities. This qualitative study aimed to explore parental and community perceptions and practices related to child drowning in Indonesian communities, and the perceived causes and risk factors. Seven focus group discussions (n  = 62) were conducted with parents of children aged under-5 years and village community leaders in seven villages across all districts of Lombok Island, West Nusa Tenggara Province of Indonesia. Participants were recruited using purposive and snowball sampling. The thematic analysis, guided by Braun and Clarke's framework, used both deductive approaches, utilizing the Health Belief Model's constructs and inductive approaches. Most participants were unaware of the susceptibility of their children and others in their community to drowning and of the potential severe outcomes of drowning such as injury, disability and death. Participants generally associated drowning with beaches or open seas. Unprotected wells, tubs and buckets were identified as notable risk factors for child drowning in and around the home, shaped by some experience of child drowning incidents in the community. Supervision was identified as protective factor, however, mothers were often unavailable to supervise children, and supervision responsibility was often delegated to other family and community members. This study highlights the urgent need to enhance public awareness regarding children's susceptibility to drowning. Further exploration of local contexts and social determinants of drowning in Indonesian communities is crucial for ensuring effective water safety and drowning prevention strategies. [ABSTRACT FROM AUTHOR]

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ). Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas. Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health. Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes. What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction. [ABSTRACT FROM AUTHOR]

Agriculture is one of the most important and also hazardous industries in Australia. Having a sound knowledge and understanding of the circumstance of injury events is critical to developing evidence-based intervention programs. This paper aims to provide a brief historical snapshot of the development of data systems underpinning the assessment of fatal farm injury in Australia and how it has impacted on safety policy and practice. The first Australian studies used coronial information to explore agricultural fatalities, these studies reviewed paper-based records (in-situ) and collected the information for analysis and reporting. This task was laborious and costly. When the National Coronial Information System (NCIS) was established in 2000, this allowed access to coronial records online. Information provided about the deceased includes demographics, contextual details on the nature of the fatality and autopsy, toxicology, and police reports, as-well-as the coroner's finding. Information from the NCIS, along with media reports, have been used to develop the farm fatality database. This information has been used to inform the safety goals and targets for farm commodity groups, identify key risks, provide long-term benchmark indicators and underpin the development of prevention materials and training resources. Without accurate, timely, concise and relevant data about injury occurring on farms, there is no evidence to drive policy and practice or to evaluate programs of work. As such, the continued utilization and extension of the NCIS data will prove crucial to further reducing the burden of preventable fatal injuries on Australian farms. [ABSTRACT FROM AUTHOR]

Background The wellbeing and safety of international tourists is a paramount concern for governments and stakeholders. Mortality among travellers and the causes of death serve as a significant metric of destination safety. We describe the epidemiology and causes of death among international travellers in Peru. Methods Data retrieved from the Peruvian government's deaths certificates registry included all non-residents who died between January 2017 and December 2021. We analysed the national incidence and causes of death among international travellers in Peru. Causes of death were classified into non-communicable diseases (NCD), communicable diseases and injuries. We classified fatalities according to the existence of preventive measures that could be provided during the travel medicine consultation to decrease the risk. Results We obtained records from 1514 deaths among international travellers (973 males, 64%). The incidence increased from 0.2 deaths per 10 000 travellers in 2017 to 9.9 in 2021. NCDs were the most common causes of death (n  = 560, 37%), followed by communicable diseases (n  = 487, 32%), and injuries (n  = 321, 21%). Causes of death were unknown in 9.7% of the records. The leading causes of death in these categories were cancer, cardiovascular disease, COVID-19 and trauma. We found similar sex distribution of NCDs in travellers aged >50 years and higher rates of communicable diseases among males across all ages. Injury-associated deaths were significantly higher among males aged 18–29 years (P  < 0.001) compared with other sex-age groups. We estimated that for 57.7% of deaths risk could have been decreased through pre-travel advice. Conclusion Rates of deaths among travellers to Peru increased over time. Most deaths were due to NCDs, followed by communicable diseases and injuries. Pre-travel medical optimization and effective advice focused on age-sex and destination specific risks could reduce risk among travellers. Increased awareness among travel medicine practitioners and improvement of emergency medical response systems in Peru could decrease mortality. [ABSTRACT FROM AUTHOR]

Objective: The primary aim is to explore rural clinicians' self‐reported knowledge, skills and attitudes in the decision‐making process for requesting aeromedical retrieval of patients with suspected appendicitis. A secondary aim is to understand the supports and barriers of rural clinicians experience in this clinical scenario. Setting: Clinician interviews conducted face‐to‐face in three rural hospitals in Central Queensland. Participants: Rural doctors and nurses. Design: A five‐part qualitative content analysis. Results: The majority of 44 participants identified the strong and effective teamwork. The decision to request aeromedical retrieval was a shared, joint process and identified a supportive collegial culture which supported the asking of questions and not expecting to have all the answers. Perceived barriers were lack of receiving clinicians understanding of transfer agreements, and data connectivity. Clinician pessimism was identified for perceived patient outcomes. Discussion Effective teamwork can nurture trust and collaboration across multiple health service roles. High job satisfaction may counter the physical isolation in some rural environments. Fragmentation of care is the unintended consequence of interhospital transfer and may impact rural clinicians' perception of patients' outcomes and hinder receiving clinicians' understanding of rural service limitations. Conclusion: Future work in the area of linked electronic medical records could remove a barrier for rural clinicians and improve their reflective practice by challenging their perception of definitive patient outcomes. Increased awareness by receiving clinicians of the limitation of rural services, may minimize communication barriers and thereby, improve timely patient care transfers. [ABSTRACT FROM AUTHOR]