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Many countries, including Australia, have laws that enable criminal prosecution of an individual based on reckless or intentional transmission of HIV to another person. Previous research has suggested that criminalisation of HIV may serve to hamper public health efforts by inhibiting HIV status disclosure or testing. Limited research to date has sought to examine the broader impact of criminalisation on the health and wellbeing of people living with HIV, which this paper aims to address. Drawing on cross-sectional data from 895 people living with HIV in Australia, this paper describes associations between standard measures of mental health and resilience with a newly devised scale measuring anxiety about HIV criminalisation. Findings suggest that laws criminalising HIV transmission have a broadly negative impact on wellbeing of people living with HIV, a situation that is exacerbated for gay and bisexual men, and other people living with HIV who may face intersecting forms of marginalisation based on race, gender or class. There is little justification for these laws being applied in Australia and the findings add weight to advocacy seeking to overturn criminalisation across the world. [ABSTRACT FROM AUTHOR]

The United Kingdom IAPT (Improving Access to Psychological Therapies) approach of delivering low intensity therapies for symptoms of depression and anxiety was adapted for Australia and named NewAccess. Clinical outcomes of the service were evaluated in three sites between October 2013 and 2016. This paper describes the clinical outcomes in the Australian health setting. Prospective cohort study with repeated measures. Both intent-to-treat and per protocol analyses were conducted for primary outcomes measures Patient Health Questionnaire-9 (nine item), and Generalised Anxiety Disorder (seven item). Secondary measures were Phobia Scale and Work and Social Adjustment Scale. Three thousand nine hundred and forty-six individuals were assessed, and 3269 attended at least two treatment sessions. Forty percent were males. There was a clinically meaningful reduction (improvement) shown by reliable recovery rates in both depression and anxiety symptoms at post-treatment assessment (68%; 95% CI: 66–70%) with large effect sizes (1.23 for depression and 1.25 for anxiety). Outcomes in PHQ-9 and GAD-7 were not influenced by age or sex, but recovery rates were significantly reduced by relationship status (single or separated). Unemployment reduced PHQ-9 outcomes but not GAD-7 outcomes. NewAccess demonstrated positive clinical outcomes in Australia, that compared favourably with international studies with the same methodology. [ABSTRACT FROM AUTHOR]

This paper identifies and examines the narratives of the lived experience of young adults who had been previously disconnected from mainstream education but who are completing, or have successfully completed, an education in an alternative education programme in a regional city in Australia. It highlights the factors that contribute to successful educational outcomes and foregrounds the pedagogical practices that contribute to success. Semi-structured interviews were conducted with seven current and/or past participants. The narratives and narrative portraits reveal that the structure of learning and teaching environments, supportive relationships, as well as opportunities to identify goals and ambitions and manage fear and anxiety were key factors in achieving successful educational and personal outcomes. Success is influenced by pedagogical practices that are underpinned by an ethos of care, respect and flexibility. [ABSTRACT FROM AUTHOR]

Objective: SMART Recovery provides cognitive behavior therapy based mutual support groups for addictions. The aim of the present study was to explore the impact of cognitive behavior skill use and the influence of a person's social network on psychological distress.Method: Paper based surveys were mailed out to 121 SMART Recovery groups across Australia. A sample of 75 SMART Recovery group members participated. Measures of social network size and composition, psychological distress and cognitive behavior skill use were collected.Results: There are high rates of self-reported mental illness within SMART Recovery respondents. Use of behavioral skills and social network influence was significantly associated with level of psychological distress.Discussion: The current results indicate that engaging in behavioral activation and having a social network of non-drinking or non-using people is associated with lower levels of psychological distress. Given the high rates of self-reported comorbid mental illness in this population, it is important research continues to explore the role of specific cognitive behavioral therapy components and social networks on recovery within mutual support groups. [ABSTRACT FROM AUTHOR]

Increasingly mediatised policy processes influence practice in schools as education becomes a site of parental anxiety and choice exacerbated by standardised national assessment and ranking of schools in the media. This paper analyses the responses to media scrutiny of six principals whose schools’ national test results were reported in the Australian press following the release of the federal Labour Government’s MySchool website in 2010. Drawing on Bourdieu’s theory of social fields, the concept of cross-field effects, and associated research on mediatisation, the evidence suggests that the relationships between the press, education policy and schools are highly contested, and that principals have some agency in talking back regarding their school’s reported ‘performance’. [ABSTRACT FROM AUTHOR]

From 1955 to 1988, the Royal Australian Air Force (RAAF) maintained a large airbase in Northern Malaysia. For the first 15 years of its existence, RAAF Butterworth had a modest and incomplete perimeter fence. With the end of British military colonialism in Malaysia and Singapore following the implementation of the ‘East of Suez’ policy, the Australians became preoccupied with their physical security and the role of the perimeter fence. By exploring the adoption of practices of exclusion via physical barriers in the wake of British withdrawal, this paper argues that the changing psychological outlook of Australian military officials reflected broader Australian anxieties about their own sense of ‘Britishness’ and the nation’s place in a decolonising Asia. As the Australians lost their British ‘blanket’ they built a fence. [ABSTRACT FROM PUBLISHER]

Gestational diabetes mellitus (GDM) complicates ∼16% of pregnancies in Australia and has significant implications for health of both mother and baby. Antenatal anxiety and depression are also associated with adverse pregnancy outcomes. The interaction between GDM and mental health in pregnancy is poorly understood. With the aim of exploring the nuanced interaction between GDM and mental health further, we investigated whether GDM treatment modality (diet versus insulin) influenced psychological wellbeing in women with GDM. Psychological wellbeing was assessed in women with GDM treated with diet (GDM-Diet, n = 20) or insulin (GDM-Insulin, n = 15) and pregnant women without GDM (non-GDM, n = 20) using questionnaires [Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI-6), and in women with GDM, Problem Areas in Diabetes (PAID)] at 24–34 weeks gestation and again at ∼36 weeks gestation. Women in the GDM-insulin group had significantly higher levels of anxiety than the non-GDM group at both time points. Women in the GDM-Diet group had higher levels of anxiety at 24–34 weeks gestation than the non-GDM group but did not differ at ∼36 weeks gestation. Although depression scores tended to be higher in GDM-Insulin and GDM-Diet groups than in the non-GDM group at both time points, this was not statistically significant. Diabetes-related distress was similar in the GDM-Diet and GDM-Insulin groups at both time points and did not change during pregnancy. A high proportion of the GDM-Insulin group had past/current mental illness (60%). In this pilot study GDM was associated with differences in psychological wellbeing, specifically increased anxiety in women treated with insulin. Specialised interventions to support women with GDM should be considered, especially those requiring insulin. Trial registration: Not applicable as this was a purely observational study. [ABSTRACT FROM AUTHOR]

The aim of this paper is to report nurses' and midwives' health, vitality and well-being in relation to adherence to current health behaviour recommendations. Healthy lifestyle factors constitute a core set of parameters required if an individual wants to live a healthy life, age successfully and avoid morbidity and a premature mortality. The investigation is an observation study of Australian and New Zealand nurses and midwives. Data were generated from the e-Cohort survey and the healthy lifestyle (HL;N = 338) group categorised as those adhering to physical activity and dietary guidelines, not smoking, consuming moderate alcohol and getting between 7 and 9 hours of sleep in a 24-hour period. All others were categorised as non-healthy lifestyle (NHL;N = 338) irrelevant of the number of factors present. It was found that HL group reported less work place activity but more leisure-time activity and had a lower BMI than NHL. In addition, the HL group was most likely to report improved sleep quality and least likely to report workplace and emotional barriers in day-to-day life. In contrast, those in the NHL group were less likely to report their health as excellent and were more likely to report a history of anxiety, depression and limitations in daily activities. It was concluded that collectively, the professions need to take action and members need to change lifestyle choices around physical activity, diet, smoking, alcohol and sleep. This study has important implications for workforce planners and administrators concerned about the well-being of individual members of the professions and the nursing and midwifery workforce. [ABSTRACT FROM PUBLISHER]

Foster carers have a significant responsibility in caring for vulnerable children. In order to support and facilitate foster carers it is important to understand how they perceive and fulfil this responsibility. A qualitative story-telling study, informed by feminist perspectives, was used to conduct in-depth, semi-structured interviews with 20 women providing long-term foster care in Australia. Thematic analysis revealed these women characterised themselves as mothers, rather than paid carers, to the long-term foster children in their care. Using this maternal self-perception as the starting point, this paper reveals some of the challenges and difficulties participants encountered when mothering within the confines of the child protection system. Implications for nursing practice are discussed. These implications focus on ways that nurses can effectively support foster carers, thus optimising the health and well-being of the vulnerable children in their care. [ABSTRACT FROM AUTHOR]

The distress and anxiety faced by young trans(gender) people generates varied social, medical, and legal concerns. In Australia, minors have had to appeal to the jurisdiction of the Family Court of Australia if they wished to undergo medical or surgical changes to their bodies in order to alleviate 'gender dysphoria' and affirm their gender. In approving almost every application to date and, most recently, dispensing with the requirement to seek Court approval, the Family Court has exhibited care, concern, and compassion when addressing anxieties faced by young trans people and formulating therapeutic determinations to relieve those anxieties. This paper maps out this affective terrain – the alleviation of anxiety and cultivation of care – by exploring key appellate Family Court decisions relating to young trans people made between 2004 and 2018. A queer engagement with Australian Family Court decisions enables us to consider the extent to which alleviating anxiety and cultivating care secure the wellbeing of young trans and gender non-conforming people. [ABSTRACT FROM AUTHOR]

Heavy, pressured workloads are a feature of health workplaces internationally, presenting challenges to communication and contributing to tension and negative emotions. This paper explores supportive and unsupportive workplace conversations between nurses and midwives and their colleagues. The findings focus on qualitative interviews of ten nurses and midwives that were audio-taped and analysed for perceptions about the role of workplace conversations. Conversations between colleagues were significant for building and maintaining collaborative capital, but unsupportive conversations also threatened it. Findings suggest the need for considering the impact of co-worker conversations on workplace culture. Nurse managers and management may play a pivotal role in establishing and maintaining supportive conversations. Recognising the role and potential of workplace conversations for building capacities for support, conflict resolution, job satisfaction and the personal resilience of nurses and midwives can raise the collaborative capital of the workplace. [ABSTRACT FROM AUTHOR]

In 2007, according to newspaper reports, Melbourne streets had become 'booze battlegrounds'. In the year that followed, binge drinking by young Australians was a major news focus and a subject for heightened public anxiety. Young drinkers were perceived to be out of control. In this paper, I draw on two qualitative research projects with young Australians to explore the contradictory social forces shaping their contemporary drinking landscape. Paradoxically, self-control is a major theme in the way participants discuss the management of their alcohol consumption. The concept of 'staging intoxication' is developed to explain how contemporary youth seek to enhance the pleasure and manage the risks of drinking. Ultimately, individual self-control is a weak moderating force on alcohol consumption in the face of market exploitation, incongruous state control and heavy drinking cultural expectations. [ABSTRACT FROM AUTHOR]

This paper explores differences in perceptions of travel risk and safety, anxiety and intentions to travel among international tourists from Australia, Canada, Greece, Hong Kong, the United Kingdom, and the United States. Data were collected from 830 respondents using a structured questionnaire. The results show that there are significant differences in perceptions of travel risk and safety, anxiety and travel intentions among tourists from different countries. Tourists from the United States, Hong Kong and Australia perceived more travel risk, felt less safe, were more anxious and reluctant to travel than tourists from the United Kingdom, Canada and Greece. The marketing implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organizations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this article was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context. A systematic search of key databases and gray literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies and uses a narrative synthesis approach to reporting. There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3–66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 full-time equivalent (FTE) included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4. Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is a minimal amount of trend data available; therefore, it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available. CRD42021232196 [ABSTRACT FROM AUTHOR]

Dystonia is a neurological disorder characterised by involuntary muscle contractions. Pain is the primary non-motor symptom, and limited studies have investigated how dystonic pain is experienced. This study aimed to investigate how people with isolated dystonia describe their pain and compare across subgroups of dystonia. Anonymous online survey via social media asking participants to describe their pain in their own words, complete the McGill Pain Questionnaire (MPQ), and answer demographic questions. Thematic analysis identified common themes and frequencies were calculated for demographic and MPQ data. One-hundred and sixty-five respondents were included (mean age 51 years, 85% female). Thematic analysis identified four major themes "Physical sensations", "Temporal features", "Destruction", "Impact on life" with several sub-themes. The most chosen MPQ descriptor was "exhausting" followed by "tight," "sharp," "pulling," and "aching". The most common descriptors showed similar prevalence across subgroups of dystonia. As no objective tests for pain exist, pain sufferers must use language to describe their pain experience. People with isolated dystonia used sensory words combined with metaphorical language to detail temporal features of pain, as well as destructive internal battles or feelings of external forces acting upon them, and the significant toll pain has on everyday life. Pain is a common and debilitating non-motor symptom for people living with dystonia and should be discussed in a persons treatment plan. Pain sufferers use language to discuss their pain experience with others and report they don't feel well understood by others including health professionals. People with dystonic pain commonly described physical sensations, temporal features, destructive forces, and the impact on life caused by their pain. Findings suggest the experience of pain with dystonia is varied and better pain management options for people with dystonia are needed. [ABSTRACT FROM AUTHOR]

In this paper, I analyze the discourse of what I argue are two moral panics that played out in the Australian media during the period 2004-2015: the sexualization of children debate, and the sexting panic, which appeared some years later. I argue that while the issue of the alleged sexualization of children is nothing new, the way that the issue has been constructed in the media has shifted during the last decade, with greater focus on children’s use of technology. By comparing these two panics, we can diagnose a shift in the nature of mass-media-based panics, from concerns about external sources of sexualization to concerns about children’s own practices of self-representation via contemporary technologies. Both panics mobilized a range of broader social anxieties about the commodification and sexualization of culture and the increasing agency of children, and panics in relation to contemporary mobile technologies are a collective response to shifts in the power relations between children, their parents, and other figures of authority. [ABSTRACT FROM AUTHOR]

This study determined changes in multiple aspects of mental health and wellbeing in newly admitted nursing home residents, and identified risk and protective factors. Participants were 204 residents recently admitted to one of 42 nursing homes in Melbourne, Australia. A subgroup of 82 participants were followed up eight months post-admission. Depression, anxiety, stress, adjustment, and quality of life were assessed at baseline and follow-up. Predictive factors (demographics, health, transition factors, nursing home characteristics) were examined in multiple regression analyses. Rates of depression and anxiety were high at both baseline and follow-up. Low self-rated health and medical comorbidity predicted poor wellbeing at baseline. Higher perceived control in the relocation to the nursing home and engagement in meaningful activities were associated with better post-admission outcomes. Baseline psychotropic medication use predicted lower anxiety at follow-up but did not impact depressive symptoms. There were no significant changes in mental health and wellbeing from one to eight months post-admission. The negative effect of residing in a for-profit nursing home requires further investigation. Individual activity scheduling and an opportunity to participate in relocation decision-making and planning may support resident wellbeing post-admission. [ABSTRACT FROM AUTHOR]

Throughout the COVID-19 pandemic, concerns have been raised about an 'infodemic', with information and misinformation being spread across multiple channels and mediums. Information consumption has also been associated with increased anxiety throughout the pandemic. Thus, the present study investigates the mediating role of state anxiety on the relationship between information consumption (defined as mean frequency of information consumption multiplied by number of information sources) and COVID-19 protective behaviours. We compare results across Australian and United States samples and account for personal risk perception and belief in misinformation about COVID-19. Cross-sectional data collected between 28 and 30 April 2020 were analysed using Bayesian structural equation modelling among participants from Australia (N = 201), and the United States (N = 306). State anxiety scores were above the conventional clinical cut-off. Information consumption was positively associated with state anxiety, personal risk perception, and COVID-19 protective behaviours in the Australian and the United States samples. Additionally, the relationship between information consumption and COVID-19 protective behaviours was positively mediated by state anxiety in both nations, suggesting some functional benefits of anxiety. Differences in risk perception and belief in misinformation existed between the Australian and United States sample. Findings provide support for current guidance from organisations such as the WHO, APA, and APS on limiting information consumption to reduce anxiety. To effectively communicate critical public health messaging while minimising potential burdens on mental health, there is a need to develop and test interventions that assist people in calibrating the extent and nature of their information consumption. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In Australia there is widespread community concern about the wellbeing of adolescents, particularly at the important time of approaching the transition from school to post-school life. However, few studies have focused on the wellbeing of Australian Year 12 students. This paper reports on a study investigating wellbeing among 377 Year 12 students in three public high schools in eastern Australia. The study explored wellbeing in terms of environmental and personality variables and investigated whether the school setting provided environmental elements that enhance adolescent wellbeing in ways similar to those provided by employment for adult wellbeing. The results indicated that school contributed significantly to adolescent wellbeing by providing time structure, access to the wider society, and social contact. Personality variables were found to be significant predictors of life satisfaction and affective wellbeing. The findings have implications for the enhancement of environmental features that may optimise the wellbeing of adolescents at school. [ABSTRACT FROM AUTHOR]

Benzodiazepines are among the most widely prescribed psychotropic drugs in the world. According to the Drug Utilisation Subcommittee (1999) in 2001 almost 7 million prescriptions were dispensed through pharmacies in Australia alone (excluding in-patient hospital prescribing). Benzodiazepines are widely used to treat anxiety, insomnia and panic disorder. The existing literature examining the possible effects of long-term use of these drugs yields conflicting results. This paper reviews the available research on short- and long-term effects of benzodiazepines, focusing on the cognitive effects of long-term use. Evidence from studies employing CT scanning methods and studies investigating cognitive improvement following discontinuation are briefly reviewed. Implications for future responsible prescription of benzodiazepines are discussed. [ABSTRACT FROM AUTHOR]

Despite the traumatic and fatal nature of motor neurone disease (MND) and the caring experiences being described as unrelenting, little is known about risk of psychiatric morbidity and Prolonged Grief Disorder (PGD) for family caregivers. Methods: A cross-sectional survey of caregivers bereaved in 2016-2018 was distributed by the five MND Associations in Australia (2019). Validated tools for PGD (PG-13), anxiety, depression, and family functioning were included. Multinomial logistic regression was used to compare the factors associated with grief. Findings: Overall, 393 valid responses were received, a 31% response rate. The prevalence of ICD-11 PGD was 9.7%; moderate/severe anxiety 12.3%, moderate/severe depression 18.5% and 18.7% indicated poor family functioning. MND caregivers have higher bereavement risk prevalence than the general bereaved population, with 9.6% in the high-risk group (vs 6.4%) and 54% at moderate risk (vs 35%). Being in the PGD group was 8 or 18 times more likely when the respondent had anxiety or depression, respectively. Poor family functioning significantly increased the likelihood of PGD by four times. Other significant predictors of PGD were a recent bereavement (<12 months), being a spouse/partner of the deceased, insufficient support during the disease journey, the deceased being under 60 years of age, and a shorter period of caring (<1.5 years). Conclusion: In a large national population-based sample of bereaved MND caregivers, 63% required bereavement support over and above that provided by family and social networks. This is a neglected yet seriously ill population that calls for better care provision and clinical practice. [ABSTRACT FROM AUTHOR]

In this article the author informs about the connection between small business ownership and mental health. Topics discussed include positive experiences for many small business owners, the everyday pressures and stressors and the many unique challenges of running a business can affect the mental health of the business owner; and previous failure in business has been shown to be associated with poorer mental well-being.

Background: Anxiety is a prevalent mental health condition in the Western world. Adults experiencing anxiety have been found to use a range of herbal medicines to manage anxiety symptoms. Aim: This study aimed to test a theoretical model based on the theory of planned behaviour that predicted the intention to use herbal medicines for anxiety symptoms, and to identify individual predictors of intention. Methods: An online survey was conducted with Australian adults who experienced anxiety and used herbal medicines (N = 400). A two-step approach to structural equation modelling was used to test a path model predicting the intention to use herbal medicines. Results: The model was found to be well-fitting. Attitude, subjective norms, control beliefs and severity of anxiety symptoms each significantly positively predicted intention to use herbal medicines for anxiety symptoms explaining 56% of the variance. Conclusions: The results suggest that mental health practitioners and policy makers need to ensure people experiencing anxiety have access to accurate and reliable information about herbal medicines to ensure they can effectively manage anxiety symptoms and safely engage in self-care. [ABSTRACT FROM AUTHOR]

Objective: Providing therapy to refugees and asylum seekers who have experienced torture and trauma exposes clinicians to traumatic stories. Additionally, clinicians working with refugees and asylum seekers are often required to work in the context of immigration detention and uncertainty for clients' futures, potentially compounding the already difficult nature of trauma therapy and further impacting clinician wellbeing. There is a paucity of research considering the consequences of working with refugees and asylum seekers, particularly in the Australian context. This mixed‐methods study aimed to explore the impact of working therapeutically with refugees and asylum seekers on the psychological wellbeing of Australian clinicians. Method: Fifty clinicians who work with refugees and asylum seekers participated in an online survey focussing on the impact of their work and protective factors. The survey also comprised open‐ended questions to collect qualitative information. Results: The sample reported low levels of depression, anxiety, stress, compassion fatigue, and average to high levels of compassion satisfaction. Analysis of free‐text comments regarding aspects of the job that impact wellbeing revealed three main themes: government and policy level stressors, work environment, and meaning‐making for the clinician. Conclusion: While the sample reported psychological wellness, qualitative responses revealed that Australian immigration policies impact clinician wellbeing to a greater extent than exposure to traumatic narratives. Engaging in meaning‐making processes regarding work appeared to positively impact clinician wellbeing. Those in leadership or supervisory positions would benefit from understanding what aspects of the work most significantly impact clinicians, in order to best support staff. [ABSTRACT FROM AUTHOR]

Over the past several decades, the paradigm of risk has become increasingly salient for understanding how health care is provided. In more recent years, we have seen an expanding body of literature raising concerns of possible harms that a focus on risk may carry. Despite considerable research interest in risk, relatively little is known about the construction of risk in contexts of allied health resource allocation decision-making. This article reports on qualitative research exploring how allied health leaders construct the concept of risk and how this influences resource allocation decision-making. Data are drawn from forums held in August and September 2014, with a total of 59 participants who occupied leadership roles in allied health in Australia. The findings highlight three domains of risk: resource, patient and organisational risk. Some domains of risk received more attention from participants and exerted greater influence on decision-making than others. Relative to the other domains, patient risk was not a core focus. Risk had a distinct emotive element and some domains of risk led participants to focus on catastrophic outcomes. Patient risk did not evoke emotive responses, whereas both resource and organisational risk did. It appears that perceived risk may be costly for health organisations, as it can be a primary driver underpinning resource allocation decisions. We explore the relative lack of attention to patient risk, the role of fear and anxiety in decision-making, and discuss implications of the impact of a focus on risk in wider society. [ABSTRACT FROM AUTHOR]

Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18–80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder. [ABSTRACT FROM AUTHOR]

During times of war, the immense distance between Australia and the battlefront caused mothers of soldiers to feel a pervasive sense of helplessness. To endure a son's absence, many mothers attempted to manage their emotional vulnerability and anxiety by keeping their hands busy, writing continual correspondence or sending comfort packages to the front. While historical literature regarding the experiences of Australian women during the First World War has been extensive, these studies have tended to focus on wives and war widows, usually depicting mothers through their sacrificial and caregiving roles. This article seeks to broaden the current literature relating to the experiences of the soldier's mother during the First World War and investigate the ways in which they distracted themselves from the absence of their sons. To do this, this study uses an empirical historiographical approach to create a wider understanding of the impact that war had on the home front. In doing so, it becomes clear that, although mothers' experiences of the war were all unique, their sacrifices and struggles united them. [ABSTRACT FROM AUTHOR]

Objective: To provide outcome benchmarks for evaluating student psychologist‐led training clinics providing outpatient adult cognitive behaviour therapy (CBT) for high prevalence disorders, and illustrate their application to the evaluation of a South Australian community mental health‐based psychology training clinic: The Centre for Treatment of Anxiety and Depression (CTAD). Method: Study 1 derived aggregated uncontrolled effect sizes and clinically significant change rates for the CBT and control conditions of randomised controlled trials (RCTs), with critical values for demonstrating equivalence to RCTs and superiority to control conditions for anxiety disorders and depression. Study 2 provided benchmarks for demonstrating equivalence, and superiority to other student clinics. Study 3 calculated outcome effect sizes and clinically significant change rates of 342 consecutive CTAD clients allocated to student psychologists between 2009 and 2015, who provided at least two questionnaires, attended at least three sessions and were primarily seen by a student therapist. Aggregated point prevalence estimates of key demographic characteristics of studies contributing to benchmarks were provided. Results: RCT CBT produced higher effect sizes than student clinics, but similar rates of clinically significant change. The application of benchmarking to CTAD illustrated that evaluations of student psychologist effectiveness would differ depending on the benchmark used. Conclusion: We have provided best‐available benchmarks for evaluating student‐led adult outpatient CBT which we encourage other student clinics to adopt. The benchmarking approach provided a profile of CTAD's strengths and weaknesses. Examples of how benchmark comparisons could be used to inform service improvement were provided. [ABSTRACT FROM AUTHOR]

Objective: To measure psychological and physical health of psychology students during their Honours year of study, in the context of this being perceived as a high stake, "make‐or‐break" degree program in Australia. Method: Psychology honours students from 9 universities (N = 179) completed an online survey that included measures of depression, anxiety and stress, physical activity, drug and alcohol use, self‐rated health status, future study intentions and desired final grade for the degree. Data were collected in the first semester of the academic year. Results: The sample was overall, high on perceived physical health, with around 74.85% being at least minimally active. Around one quarter were overweight or obese. The majority were non‐smokers, and did not regularly misuse drugs or alcohol, although binge drinking was reported by the majority. The majority planned to enter further study to qualify as a registered psychologist. Depression, anxiety, and stress were elevated in the sample, when compared with other comparative reference groups. Those with higher levels of perceived physical health and those aiming for a higher desired final grade were less likely to show elevated scores on psychological distress measures. Conclusions: This study is consistent with published and unpublished data showing that psychological distress levels in this cohort are high. These findings show that this is evident across universities, and that distress is apparent early in the academic year. Educators and the profession have a duty of care and a responsibility to reflect upon the student experience. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) resulting from episodes of domestic violence (DV) is a serious yet greatly underreported issue. Head injuries arising in these circumstances are often concussive or sub-concussive in nature, and are unlikely to be isolated incidents, with victims frequently suffering repetitive TBIs over time. Although men may also be victims of DV, women and children are most at risk of DV via intimate partners and parents, respectively. Due to the complexities of these interpersonal relationships, victims of DV are not always able to receive appropriate clinical diagnoses, care or follow-up after TBI. TBI arising from DV is also likely to occur in a complex milieu of fear, anxiety and depression, the physical and psychological consequences of which may worsen or perpetuate the pathology of TBI. This review examines the complexities of TBI arising from DV from several perspectives, with focus on three pertinent and interrelated topics: 1) pathobiology and complications of single and repetitive TBI, encompassing direct neural consequences, inflammation and hormonal changes; 2) behavioral, cognitive and psychosocial consequences of TBI; and 3) contributing factors to TBI and complications, including strategies to increase clinician recognition of TBI in DV patients, and programs and policies in place in Australia and abroad to decrease rates of offending. [ABSTRACT FROM AUTHOR]

Research indicates that homeless women are reported to experience more mental health issues than women who are not homeless and are an increasing proportion of the overall homeless population. In addition, homeless women are more likely to have alcohol and/or other drug use disorders. We provide a comprehensive review of the contemporary literature that revealed homeless women experience a range of mental health problems including depression, anxiety, post-traumatic stress disorder and alcohol and other drug use disorders. Studies in this literature review indicate that some women have pre-existing mental health issues which precipitate homelessness while others develop mental illness because of their homelessness; domestic violence was also recognised as an antecedent to homelessness, although further research is needed in this area. The results of this study indicate that the homeless cohort is a complex one with distinct needs. We provide information that can help refine assessment processes and plan appropriate services to address the mental health needs of homeless women. Finally, recommendations for mental health nursing practice in regard to caring for homeless women are made. [ABSTRACT FROM AUTHOR]

Following parental separation, child custody decisions continue to be made on the basis of the discretionary best interests of the child. The current study explored mothers and fathers (N = 40) in family violence, or high conflict past two years post separation, and their experiences within the Australian family law system. A thematic analysis was conducted on the interviews of separated mothers and fathers. Results revealed that the experience of engaging with the Australian family law system caused considerable anxiety and distress for these separated parents. Principal themes related to: (a) gendered narratives; (b) parents' concerns not been taken seriously; (c) perceived inadequacies in knowledge or competence of experts and decision makers in relation to family violence; and (d) coercion from some professionals within the family law system. These cumulative experiences tentatively pointed to an aftermath of long-term emotional and psychological trauma, not only for separated mothers and fathers, but also children in their care. [ABSTRACT FROM AUTHOR]

Objective: To systematically investigate the factor structure and predictive validity of the Kessler‐10 (K10) in an Australian child and adolescent population. Method: Confirmatory factor analyses were undertaken on data from 2,967 youth aged 11–17 years from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Receiver operating characteristic analyses and penalised logistic regressions were used to explore the ability of K10 factor scores to predict Diagnostic Interview Schedule for Children Version IV (DISC‐IV) identified mental disorders. Results: A bifactor model with two‐group factors (Anxiety and Depression) provided the best fit for youth with past‐month mental disorders. A four‐factor solution (Nervousness, Agitation, Fatigue, and Negative Affect) fit best for youth without past‐year mental disorders; however bifactor analyses indicated that these factors accounted for little common variance after controlling for the effects of general distress. When controlling for age and gender, Agitation factor scores predicted DISC‐IV behavioural disorder diagnoses and neither Anxiety scores nor Nervousness scores were predictive of DISC‐IV diagnosed social phobia, separation anxiety, obsessive–compulsive disorder, casting doubt over the suitability of K10 items to capture anxiety symptoms in youth. Conclusion: The K10 is "unidimensional enough" in the Australian child and adolescent community population. Associations between K10 and mental disorders are mainly represented by items comprising Negative Affect and Agitation factors, which raises the possibility that briefer versions might be equally useful, either for capturing the general distress factor or a version that is more predictive of mental disorders in youth. [ABSTRACT FROM AUTHOR]

Objective: In Australia, residential early parenting services (REPS) provide structured, psycho‐educational programs for unsettled infant behaviour and associated maternal difficulties. Thus far, most studies have focused on the psychological functioning of women admitted to these services; few studies have investigated the mental health of their male partners and none have used standardised measures to assess alcohol use, fatigue, sleepiness, and sleep quality. The aim of this exploratory survey was to assess mental health problems, alcohol use, and sleep‐related functioning among men whose partners and infants were admitted to a privately funded REPS. Method: Male partners of women admitted to an REPS in Melbourne, Australia, during a 5‐month period completed surveys including self‐report measures of depression, anxiety, stress, irritability, alcohol use, fatigue, sleepiness, and sleep quality. Surveys were completed by 53 men; mean age was 36 years. Mean scores on standardised instruments were compared with normative or comparison data. The proportions of participants scoring in the clinical range on each measure are reported. Results: Mean scores on measures of stress, irritability, fatigue, sleepiness, and sleep quality were significantly worse than norms for healthy adults. Fifty‐one percent of men screened positive for alcohol misuse; 53% reported clinically significant fatigue and 82% scored in the clinical range for poor sleep quality. Conclusions: This study provides preliminary evidence that men whose partners are admitted to an REPS may have impaired psychological and sleep‐related functioning, which might affect interactions with their partners and infants. Service enhancement to assess and address the needs of men is indicated. [ABSTRACT FROM AUTHOR]

Objectives: This article examines relationships between experiences of ageism and four specific mental health outcomes among older Australian adults, including whether these relationships vary depending on age, gender, and sexual orientation. Methods: A survey was conducted nationwide involving 2137 participants aged 60 years and older. Mental health variables included depressive symptoms, anxious symptoms, general stress, and positive mental health or flourishing. Results: Recent experiences of ageism were found to be strongly related to poorer mental health on all four mental health variables. However, experiences of ageism appeared to have a greater effect on the mental health of those who were younger in age (specifically depression), of men more so than women (specifically depression), and of those who identified as heterosexual as opposed to other sexual orientations (specifically general stress). Conclusion: These findings suggest that experiences of ageism may be an important factor in the health and well-being of older adults, especially for those who are younger, male, and heterosexual, and may need to be taken into account when devising strategies for supporting healthier and happier ageing. [ABSTRACT FROM AUTHOR]

Objective: Adolescent males are often reluctant to seek help for mental health problems. Computerised psychological treatment may be a more appealing method of psychological intervention for this population because it minimises many of the barriers to traditional treatment. However, it is not clear if current computerised mental health treatment programs both attract and engage adolescent males with anxiety disorders. A qualitative methodology was utilised to investigate adolescent males’ attitudes to computerised mental health intervention generally and more specifically, computerised anxiety treatment programs. Method: The views of 29 adolescent males, both with and without experience of clinical anxiety symptoms, were elicited using semi‐structured interviews and focus groups. Verbatim transcripts were analysed using content analysis. Results: The major themes identified related to computerised help‐seeking involving “risk,” “effort” and “the need for a human connection.” Conclusion: The results of the study suggest that a number of barriers exist in relation to adolescent males utilising computerised mental health interventions, such as unfamiliarity with this form of help, perceived control over decision‐making, effort involved and concerns around confidentiality. However, the findings also suggest that an increased awareness of computerised mental health help‐seeking, facilitated through schools, parents or social media, also has the potential to increase formal help‐seeking in this population. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the mental health of a cohort of 262 female and 168 male grandparents across the first two years of their transition to grandparenthood, with particular focus on the impact of providing childcare for the grandchild. Method: Baseline assessments were made during the pregnancy with the first grandchild, and subsequent assessments were at one and two years after the birth. The influence of demographic and psychosocial variables which could be expected to influence change in mental health from baseline was explored. Results: The lack of change in mental health measures in this cohort was more prominent than change. Specifically, there was a small significant decrease in anxiety over the first year for females, and a small significant increase in depression for males. Other variables, not unique to the transition to grandparenthood such as physical health and adverse life events, were strongly associated with changes in mental health. Notably, more time spent babysitting the grandchild was associated with improvement in mental health. Conclusion: The transition to grandparenthood did not have any substantial adverse impact on five well-validated measures of mental health, in contrast to earlier American findings of adverse effects which implied that childcare was burdensome. [ABSTRACT FROM AUTHOR]

Current therapy to slow disease progression in patients with neovascular age-related macular degeneration (AMD) entails regular intravitreal anti-vascular endothelial growth factor (VEGF) injections, often indefinitely. Little is known about the burden imposed on patients by this repetitive treatment schedule and how this can be best managed. The aim of this study was to explore the psychosocial impact of repeated intravitreal injections on patients with neovascular AMD. Forty patients (16 males, 24 females) with neovascular AMD undergoing anti-VEGF treatment were recruited using purposive sampling from a private ophthalmology practice and public hospital in Melbourne. Patients were surveyed using the Macular Disease Treatment Satisfaction Questionnaire (MacTSQ; Bradley, Health Psychology Research Unit, Surrey, England) and underwent semi-structured, one-on-one interviews. Interview topics were: treatment burden and satisfaction; tolerability; barriers to adherence; treatment motivation; and patient education. Interviews were audio recorded and thematic analysis performed using NVivo 10 (QSR International, Doncaster, Australia). Patients recognised the importance of treatment to preserve eyesight, yet experienced significant psychosocial and practical burden from the treatment schedule. Important issues included treatment-related anxiety, financial considerations and transport burden placed on relatives or carers. Many patients were restricted to sedentary activities post-injection owing to treatment side effects. Patients prioritised treatment, often sacrificing family, travel and social commitments owing to a fear of losing eyesight if treatment was not received. Whilst anti-VEGF injections represent the current mainstay of treatment for neovascular AMD, the ongoing treatment protocol imposes significant burden on patients. An understanding of the factors that contribute to the burden of treatment may help inform strategies to lessen its impact and assist patients to better manage the challenges of treatment. [ABSTRACT FROM PUBLISHER]

Maternal psychological distress during pregnancy is a potential risk factor for various birth complications. This study aimed to explore psychological factors associated with adverse birth outcomes. Symptoms of psychological distress, individual characteristics, and medical complications were assessed at two time points antenatally in 285 women from Australia and New Zealand; birth outcomes were assessed postpartum, between January 2014 and September 2015. Hierarchical multiple regression analyses were conducted to examine the relation of psychological distress to adverse birth outcomes. Medical complications during pregnancy, such as serious infections, placental problems and preeclampsia, and antenatal cannabis use, were the factors most strongly associated with adverse birth outcomes, accounting for 22 percent of the total variance (p < .001). Symptoms of depression and/or anxiety, low social support, and low sense of coherence were not associated with birth complications. In unadjusted analyses, self-reported diagnosis of anxiety disorder during pregnancy and an orientation toward aRegulatormothering style were associated with adverse birth outcomes; however, after controlling for medical complications, these were no longer associated. Our study results indicate that antenatal depressive and/or anxiety symptoms were not independently associated with adverse birth outcomes, a reassuring finding for women who are already psychologically vulnerable during pregnancy. [ABSTRACT FROM PUBLISHER]

Research into second language anxiety (SLA) has largely focused on second language learners rather than immigrants. However, living in an environment where the target language (TL) is the language of everyday communication may constitute a significant source of anxiety that generalises beyond the language classroom [Pappamihiel, N. E. 2001. “Moving from the ESL Classroom into the Mainstream: An Investigation of English Language Anxiety in Mexican Girls.” Bilingual Research Journal 25: 31–39. doi:10.1080/15235882.2001.10162783; Rose, Glenda. 2008. “Language Acculturation Anxiety in Spanish Apeaking Adult Immigrants Learning English in the United States.” PhD diss., University of Texas. Available from ProQuest Dissertations and Theses database (UMI No. 3315370); Woodrow, L. 2006. “Anxiety and Speaking English as a Second Language.” RELC Journal 37: 308–328. doi:10.1177/0033688206071315]. This study explored SLA across different social contexts in a sample of 190 adult immigrants from Latin America to Australia who spoke Spanish as their first language (L1) and English as their second language (L2). The aims were to (a) investigate the presence and severity of SLA among L2 long-term immigrants, and (b) examine sources of individual differences in SLA. Results indicated that SLA exists among L2 immigrants at moderate, high and very high levels, and that levels of anxiety vary significantly across social contexts. Self-perceived L2 proficiency was found to be the strongest predictor of SLA followed by extroversion and age, with higher scores on all three variables associated with lower SLA. Gender, education level, duration of residency in Australia, and emotional stability did not predict SLA in any of the contexts. These findings suggest that SLA is a significant problem for adult immigrants, permeating most aspects of their everyday lives. Practical implications and recommendations for future research are discussed. [ABSTRACT FROM PUBLISHER]

Objective There is evidence that some transgender people find aspects of the S tandards of C are ( SOC ) for the H ealth of T ranssexual, T ransgender, and G ender N onconforming P eople, and/or their implementation by health professionals, problematic and counterproductive to transitioning. This study evaluated the significance of this dissatisfaction to the transitioning and mental health of transgender people. Method 161 self-identified transgender people responded to an online survey that assessed satisfaction with health services provided in accordance with SOC guidelines, satisfaction with health professionals assisting with their transition, personal hardiness, gender congruence, steps to transition, and depression, anxiety, and stress. Results Although results revealed dissatisfaction with the Standards of Care and with health professionals (particularly psychiatrists), subsequent path analyses conducted via structural equation modelling failed to reveal associations between this dissatisfaction and factors relevant to transitioning or mental health. However, personal hardiness was found to be associated with greater progress in transitioning and, by way of this, improved gender congruence, self-esteem, and mental health. Conclusion While the results reveal dissatisfaction with the Australian health system and its professionals, this does not appear to translate into poor mental health outcomes. Rather personal hardiness during transition is the important predictor of transitioning and mental health. This argues for greater emphasis to be placed on building and supporting personal resilience in transgender people. [ABSTRACT FROM AUTHOR]

Objective This article questions an assumption that modern young adults are unwilling to grow up, do not wish to take on traditional adult roles, and experience their current lives as carefree. Goals and beliefs for adulthood, and current mental health, were assessed. Methods A total of 518 Australian university students aged 18-25 (73% female, mean age 19 years, 72% Australian born) completed surveys of their goals for age 40, the goals they believed significant others held for them, and their views of life now and in the future, as well as standard assessments of mental health and well-being (Center for Epidemiologic Studies Depression Scale 10; Goldberg anxiety subscale, Life Orientation Test-Revised, Perceived Stress Scale, and Multidimensional Scale of Perceived Social Support). Results Students overwhelmingly aspired to 'traditional' adult roles: over 90% wanted to be married, with children, and to be in paid employment. Their highest priorities were finishing education, finding a life partner, and finding satisfying work. They generally selected positive adjectives to describe their futures, but selected negative adjectives to describe their current lives, and reported high levels of depressive symptoms, anxiety, and stress. Conclusions Findings suggest that these modern young adults are not leading carefree lives, nor are they reluctant to 'grow up.' Aspirations for family and employment, coupled with positive views of the future, are encouraging, while high levels of depressive symptoms, anxiety, and stress are cause for concern. Clinical responses to young people need to acknowledge instability that can result from spending extended periods of time 'in-between.' [ABSTRACT FROM AUTHOR]

Objective University students are vulnerable to depression and other co-occurring mental disorders, but few receive treatment. Male university students are at particular risk of not receiving assistance. A better understanding of gender differences in the experience of depression may assist in improving its detection and the provision of appropriate support and prevention strategies. Accordingly, this study aimed to identify whether male and female university students have different patterns of self-reported depression and co-occurring anxiety and stress. Method A total of 1,401 first year students from a regional Australian university completed the 21-item version of the Depression Anxiety and Stress Scales. Data were collected in 2001, 2006, 2010, and 2012. Multidimensional scaling analyses were conducted to identify patterns of depression, anxiety, and stress in men and women with different depression severity. Results Depressed men reported mixed patterns of depression, anxiety, and stress that were clustered by behavioural and physiological function, whereas depressed women reported distinctive patterns of depression, anxiety, and stress as prescribed by categories of the individual Depression Anxiety and Stress Scales. Conclusions Depressed male and female university students may categorise and interpret their psychological distress differently. Depressed men might tend to categorise symptoms by function and physiology, whereas depressed women might prefer to use common verbally defined constructs of psychological distress. It may be important for mental health professionals to consider these gender differences in categorisation and patterns of symptoms when screening for depression to increase chances of university students receiving appropriately targeted treatment. [ABSTRACT FROM AUTHOR]

Objective:This study investigates communication challenges faced by Filipino patients with chronic diseases when engaging with healthcare professionals (HCPs). Design:Nine focus groups were conducted between November 2010 and June 2011. Results: Two main categories of themes were identified: patient-related and HCP-related factors. Patient-related factors included three subthemes: (1) lack of confidence in their English language abilities in clinical situations; (2) cultural attitudes; and (3) strategies used to improve communication. Older Filipinos with chronic disease were anxious about their lack of ability to explain their symptoms in English and were concerned that asking questions was conveying distrust in the HCPs. Most of the elderly simply nodded their head to indicate they understood even if they did not, for fear of being thought ‘stupid’. Many participants preferred Filipino GPs or have a relative interpret for them. Two subthemes were related to HCPs including (1) not being listened to and (2) assumptions of understanding. HCPs were thought to assume English language skills in Filipino patients and therefore were not careful about ensuring understanding. Conclusions: These findings highlighted the need for HCPs to be more aware of ‘grey areas’ in English-language proficiency and the cultural lens through which migrants understand health. [ABSTRACT FROM AUTHOR]

Background: In the absence of aphasia, many people with severe traumatic brain injuries (TBI) have difficulty with communication. In particular, they have difficulty understanding conversational inference. Poor social cognition is also prevalent following TBI. Aims: This study aimed to examine the role of social cognition in the ability to recognise conversational inference in the form of hints. Methods and procedures: 31 adults (22 men: mean age 45 years) with chronic (mean time since injury = 15.12 years) and severe TBI (mean post traumatic amnesia (PTA) of 32.74 days) and 24 adults (14 men: mean age 46.1 years) from the community participated. They were compared for their comprehension of two kinds of video vignettes in which professional actors made progressively more explicit hints. In one version, the conversational tone was neutral, in the other emotional. They were also assessed on an independent measure of social cognition (TASIT). Outcomes &results: The adults with TBI recognised neutral hints at a normal rate but, unlike the community controls, were not facilitated by overtly emotional hints. Social cognition performance was related to performance on both types of hint. Improved performance on the emotional hints was not uniquely predicted by social cognition but, rather, by processing speed and possibly also stress in the group with TBI. Conclusions: People with TBI appear to have difficulty using emotional cues to infer speaker meaning. This may reflect cognitive slowing and also anxiety and stress. This has implications for both remediation of such deficits and for educating others who interact with people with TBI. [ABSTRACT FROM PUBLISHER]

Outward appearance is one of the means by which age is determined, and fear of looking old may stem from fears about social identity and death. This study explored how social identity theory and terror management theory may help to explain the dread of looking old. University students from the United States, England, and Australia (N = 1,042) completed a questionnaire regarding their attitudes about aging and older adults. Results indicated that sex, age, beliefs about personal aging, and death anxiety explained 30.4% of the variance for participants’ dread of looking old. Theoretical hypotheses were supported by our findings. [ABSTRACT FROM PUBLISHER]

Background: Death anxiety is a known phenomenon in older people of culturally and linguistically diverse backgrounds (CALD) hospitalised for end-of-life (EOL) care. Little is known about how nurses assuage death anxiety in this population. Aims: To investigate strategies used by nurses to assuage death anxiety and facilitate a good death in older CALD Australians hospitalised for EOL care. Methods: Advanced as a qualitative descriptive inquiry, a purposeful sample of 22 nurses was recruited from four Victorian healthcare services. Interviews were transcribed verbatim and analysed using thematic analysis processes. Findings: Nurses used three key strategies: recognising death anxiety; delineating its dimensions; and initiating conventional nursingcaring behaviours to help contain it. Contrary to expectations, cultural similarities rather than differences were found in the strategies used. Conclusions: Nursing strategies for recognising, delineating, and managing death anxiety in older CALD people hospitalised at the EOL is an important component of quality EOL care. [ABSTRACT FROM AUTHOR]

Background: Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees' mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. Objective: This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations--Austria and Australia. Method: Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Results: Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. Conclusion: These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host societyon post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations. [ABSTRACT FROM AUTHOR]