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This paper will identify existing models of professional regulatory reform that could ensure a single licensing process that results in multi-jurisdictional licensure. The paper will also distinguish models or ad hoc arrangements that fail to achieve such a result. This is a timely topic in Canada because its professional regulatory framework is being examined for modernization. The Canadian professional regulatory framework for health care providers is a legacy of the Constitution of 1867. It can be characterized as a Federation of 13 different jurisdictional systems with each province or territory having exclusive jurisdiction over regulation of its health professionals. This results in differing entry to practice requirements, standards of practice, classes or categories of registration and transfer criteria for eligibility from other provinces. The United States nursing state board regulators, the Australian Commonwealth, and their state governments have moved from their original regulatory frameworks to modern ones. Their models are more supportive of mobility, cross-border virtual care, education, and health provider professional development and well-being. Aside from recent discussions in the 4 Canadian Atlantic provinces, there has been little will, effort, or advancement to modernize the regulatory framework in Canada to support multi-jurisdictional licensure. This paper aims to briefly describe 6 existing models that support multijurisdictional licensure. In the fall of 2022, the 4 Atlantic Premiers (akin to state Governors in the US) asked each of their medical regulatory authority (akin to State Medical Boards) to develop a licensing system such that physicians could practice in all 4 Atlantic provinces without the need to acquire multiple licenses. Two models will be discussed that meet this recently stated objective of the Atlantic Premiers while the others do not. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Wolters Kluwer India Pvt Ltd) is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic has brought into focus obligations for health services to protect the health and safety of their staff, arising from Occupational, Health and Safety legislation and the duty of care owed by a health service as an employer. Health workers, by nature of their work, are a particularly at-risk population in the context of COVID-19. This article examines the legal standard of care that healthcare employers owe their staff in terms of reduction of risk exposure, both physically and psychologically, to COVID-19, the obligation to provide staff with personal protective equipment, adequate hygiene, cleaning and the consequences for breaching these standards. This article also explores the right to dismiss employees who are non-compliant with their obligations. What is known about the topic?: It is well known that health workers are an at-risk population for COVID-19, particularly those with direct exposure to affected patients. Since early 2020, healthcare services have faced substantial challenges in managing employee risk while complying with Occupational, Health and Safety law in Australia. What does this paper add?: This paper explores the standard of care that healthcare services owe their staff in terms of reduction of risk exposure within the current Australian legal framework, as well as the rights and obligations of healthcare service employees. What are the implications for practitioners?: Health services should be aware of the range of legal obligations to protect healthcare workers from the consequences of COVID-19 in order to minimise risk as much as reasonably practicable for employees. This includes ensuring access to adequate personal protective equipment, psychological support, adequate hygiene and cleaning of the physical workspace as well as the appropriate reporting of incidents and exposures. [ABSTRACT FROM AUTHOR]

Virtual healthcare has the potential to increase access to allied health for people living in rural areas, but challenges in delivery of such models have been reported. The COVID-19 pandemic provided an opportunity for a rural practice of physiotherapists and exercise physiologists to transition service delivery to a virtual model of care which utilised a combination of phone, video, an exercise app and/or paper handouts. This study aimed to evaluate the uptake and outcomes from virtual delivery of allied health services, and to describe patient and clinician experiences of the virtual model of care. A parallel convergent mixed methods study was conducted. De-identified data from patients who were offered the virtual service between 15 March 2020 and 30 September 2020 were extracted from the database of the rural practice, as were data from patients attending the practice in-person during the same time in 2019 to serve as a historical comparison. De-identified data from a monthly survey tracking clinician experiences of delivering care virtually was also obtained from the practice. Quantitative data were presented descriptively. Between-group differences were compared using independent samples t-tests, and within-group longitudinal changes compared using paired t-tests. Semi-structured interviews were conducted among a purposive sample of patients using the virtual service, and focus groups conducted among clinicians providing this model of care. Qualitative data were recorded and transcribed verbatim, then thematic analysis conducted. During the study period, the practice delivered 4% (n = 242) consultations virtually. Thirty-seven of the 60 patients (62%) using the virtual service were new referrals. Patients attended fewer sessional appointments virtually and a smaller proportion of patients reported high satisfaction with virtual care, compared to those who received in-person care the previous year (p <.05). Clinician confidence in delivering virtual care did not change significantly over time (p>.05), though clinicians not providing virtual care in a given month perceived their lower confidence than those who did provide virtual care (p <.05). Five themes influencing the success of virtual allied health provision emerged from patient interviews and clinician focus groups: adaptation of program elements for virtual delivery, conduct of virtual treatment, clinician flexibility, patient complexity and communication. The theme of communication influenced all the other themes. Virtual healthcare is a potential solution to address lack of access to allied health practitioners in rural areas, but may not suit all patients. Establishing a therapeutic relationship and ensuring people have access to adequate resources prior to virtual care delivery will optimise successful adoption of virtual care models. A hybrid model incorporating limited in-person consultations with virtual consultations appears a more viable option. [ABSTRACT FROM AUTHOR]

Introduction: The wellbeing of front‐line healthcare workers can be impacted during a pandemic. This paper reports the initial impact on the wellbeing of COVID‐19 on Australasian sonographers. Methods: An online qualitative and quantitative survey was conducted between March and June 2020 to explore the wellbeing of Australasian sonographers in the early stages of the COVID‐19 pandemic. Results: Whilst most sonographers felt supported at work (300/379), those working in public hospitals felt more so than those in private practice. Sonographers in private practice felt more as though their job was at risk and were more likely to consider an alternate source of income. Sonographers felt they were working on the front line and many felt anxious about themselves (74%) or family (78%) contracting COVID‐19 due to their employment. Forty‐one percent of sonographers felt more isolated than normal, with younger age groups (18‐34 years) feeling less like they had enough hobbies or selfcare activities to get them through. Twelve percent of sonographers reported never, or rarely, coping with the juggle of work and home life. Conclusion: The initial impact of the COVID‐19 pandemic on the wellbeing of sonographers is evident. Longitudinal data will enable wellbeing to be tracked over time. [ABSTRACT FROM AUTHOR]

Objective: We conducted a survey to understand the challenges faced by the staff of residential aged care facilities (RACF), during the COVID-19 pandemic. Background: In the current pandemic, the RACF workforce has been required to work under stressful conditions, with immense mental and physical pressures, resulting in anxiety and stress felt towards their jobs. Study design and methods: We electronically surveyed both clinical and non-clinical staff at public and private RACFs in Australia in June and August 2020. The survey asked a mix of openended and closed questions about preparedness for the pandemic, information flow, experience with personal protective equipment (PPE), management of suspected COVID cases, restrictions on visitors, and impact on RACF staff personal and home life. Quantitative data were analysed in SPSS; qualitative data using content analysis. Results: We received 371 responses: 198 from clinical staff and 168 from non-clinical staff. Respondents were between 20--71 years old, and 87% were female most commonly from Victoria (28%) or New South Wales (28%). The majority (80%) felt that Australian RACFs were well-prepared for the pandemic and 87% agreed that relevant healthcare authorities were contactable for information needed. A total of 37% reported challenges in estimating and ordering appropriate quantities of protective equipment. Ninety percent of facilities reported screening residents for possible symptoms and 77% introduced precautions or quarantine measures to protect residents. Most participants (98%) reported their RACF implemented restrictions on visitor access and 43% reported unfair or abusive treatment by family or friends of the residents. Commonly reported personal impacts included: workload increase, stress, emotional toll, family issues and fatigue. Support from colleagues as well as training, de-brief sessions and frequent meetings were identified as helpful facilitators during this time. Conclusion: We identified a wide range of practices and coping strategies among Australian RACFs. Whilst a majority of respondents reported coping well, a large proportion reported struggling both mentally and physically. Factors reported as helpful by the respondents may assist RACFs in planning for future pandemics. Implications for research, policy and practice: Understanding the challenges faced by all levels of staff within RACFs may aid decision-makers on a range of different levels -- researchers, aged care providers, local/regional/state health departments and national leaders within government to help inform the development of interventions that may help the sector to recover, as well as prepare for potential future outbreaks. Of particular importance, are interventions or initiatives that focus on supporting the physical and mental health of staff i.e. those that prevent or minimise worker fatigue, emotional burnout and stress. What is already known about the topic? • Nursing staff in Australian RACFs did not feel prepared for the COVID outbreak in their workplace. • Early in 2020, RACF nurses experienced a greater overall workload and some had their staff hours reduced by their employers due to financial constraints caused by the outbreak. What this paper adds • This paper offers a comprehensive insight into how RACF staff coped both individually and as part of the facility overall during the COVID crisis. • It identified that a commonly reported source of stress was first-hand verbal abuse from family or friends of residents in response to visitor and lockdown restrictions implemented by the authorities. • The paper highlighted that whilst the majority of respondents felt that RACFs were well prepared for managing residents during the pandemic, some facilities experienced significant problems with workloads, PPE and human resourcing. • Furthermore, the survey showed that on an individual level, some staff experienced significant mental and physical stress during the outbreak. [ABSTRACT FROM AUTHOR]

Introduction: The use of telehealth has accelerated with health service delivery restrictions experienced during the COVID-19 pandemic. This research assessed learner enrolments and feedback in an introductory, online, open-access, rural-focused telehealth training course to inform future telehealth education design. Methods: Differences in enrolled learner demographics "before" (n = 331) and "after" (n = 3,776) COVID-19-related changes in Australia were assessed. Content analysis of learner feedback was conducted to understand the beneficial aspects of the course and to inform future telehealth education and training development. Results: Concurrent with telehealth changes announced in Australia in March 2020, enrolments in the course sharply increased. While students comprised most enrolments, initial growth was strongest amongst health educators and health professionals. More learners enrolled from major city areas and other countries. User feedback indicated the flexible delivery mode, policy, links to resources and multimedia content were the most beneficial aspects of the course. Learners would like more client perspectives as well as discipline- and context-specific information. There is also an appetite for more practicebased telehealth education. Conclusions: Growth in demand for the course and positive learner feedback showed it was filling an important introductory training gap. Learner feedback also highlighted several perceived barriers among learners in being able to implement best-practice telehealth in their current or future practice. This feedback could be used to inform the design of further telehealth training for health professionals and students to, ultimately, enhance the use of telehealth technologies. [ABSTRACT FROM AUTHOR]

Copyright of Health & Social Care Chaplaincy is the property of Equinox Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Previous research has identified that effective and high-quality communication between patients, families and professionals is a key contributing factor to end-of-life (EOL) care and recovery after bereavement. Increasingly, this communication work is being done by non-clinical staff in places such as homes and community settings. These additional care providers offer important pre- and post-bereavement support that can improve the quality of EOL care as well as promote healthy grieving for families, friends and communities. Despite this contribution, though, little is known about how these non-clinical workers use communication in their daily practices. This paper reports on the analysis of a set of nine in-depth interviews conducted in Hong Kong and in one region of Australia that examined in detail relational aspects of communication that shape interactions between non-clinical workers and service users. Data were collected during the COVID-19 health crisis, when the workers experienced exceptional restrictions on communication. The findings of this study highlight the fundamental importance of both verbal and non-verbal communication to the relationships established between non-clinical workers and service users. Specifically, greater support for the development of communication skills in non-clinical EOL workers will promote improvements in the quality of EOL care. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic provided a unique opportunity to learn about acute health organisations experiences implementing a pandemic response plan in real-time. This study was conducted to explore organisational leader's perspectives and experience activating a COVID-19 pandemic response plan in their health service and the impact of this on service provision, clinicians, and consumers. Methods: This study was conducted at a large metropolitan health service in Australia that provides acute, subacute, and residential aged care services. Semi-structured interviews were conducted with 12 key participants from the COVID-19 leadership team between November-January 2021/2022. A semi-structured interview guide was developed to explore how the health service developed a clinical governance structure, policy and procedures and experience when operationalising each element within the Hierarchy of Controls Framework. Thematic analysis was used to code data and identify themes. A cross-sectional survey of frontline healthcare workers on the impacts and perceptions of infection control practices during the COVID-19 pandemic, was also completed in 2021 with 559 responses. Results: Twelve organisational leaders completed the semi-structured interviews. Key themes that emerged were: (1) Building the plane while flying it, (2) A unified communications strategy, (3) Clinicians fear 'my job is going to kill me', (4) Personal Protective Equipment (PPE) supply and demand, and (5) Maintaining a workforce. When surveyed, front-line healthcare workers responded positively overall about the health services pandemic response, in terms of communication, access to PPE, education, training, and availability of resources to provide a safe environment. Conclusion: Health service organisations were required to respond rapidly to meet service needs, including implementing a pandemic plan, developing a command structure and strategies to communicate and address the workforce needs. This study provides important insights for consideration when health service leaders are responding to future pandemics. Future pandemic plans should include detailed guidance for acute and long-term care providers in relation to organisational responsibilities, supply chain logistics and workforce preparation. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' and family members' perspectives of family care at the end of life, during restricted visitation associated with the COVID‐19 pandemic. Background: To minimise the transmission of COVID‐19, stringent infection prevention and control measures resulted in restricted hospital access for non‐essential workers and visitors, creating challenges for the provision of family‐centred care at the end of life. Design: Qualitative descriptive approach based on naturalistic inquiry. Methods: At a large public hospital in Melbourne, Australia, individual semi‐structured interviews were undertaken with 15 registered nurses who cared for patients who died during restricted visitation associated with the COVID‐19 pandemic, and 21 bereaved family members. COREQ guidelines informed analysis and reporting. Results: Five themes developed from the data: (i) impact of visitor restrictions, which describes uncertain, ambiguous and arbitrary rules, onerous and inconsistent requirements; (ii) nurse‐family communication; (iii) family‐centred care and interrupted connections; (iv) well‐being and negative emotions; and (v) suggestions for a better way, such as moving away from the black and whiteness of the rules, prioritising communication, compassion and advocacy. Conclusions: Negative consequences for communication and the patient‐family connection at the end of life were felt deeply. The evolving COVID‐19 rules that were frequently revised and applied at short notice, and the subsequent consequences for clinical practices and care were felt deeply. Relevance to Clinical Practice: Technology‐facilitated communication, innovation and increased resources must be prioritised to overcome the challenges described in this study. A family‐centred approach to care and emphasising the patient‐family connection at the end of life is fundamental to minimising trauma and distress associated with future public health emergencies. Patient or Public Contribution: Bereaved family members contributed their first‐hand experience. Members of the health service's patient experience team ensured the research was conducted in accordance with health service guidelines for patient and public contribution. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic had an unprecedented global effect on teaching and education. This review discusses research, education and diagnostics from the perspectives of four academic clinicians and researchers across different facilities in Australia. Materials and methods: The study adopted a literature review and an Australian researcher's perspective on the impact of the COVID-19 pandemic on health education, research and diagnostics. Results: At the start of the pandemic, medical facilities had to adhere urgently to major work restrictions, including social distancing, mask-wearing rules and/or the closure of facilities to protect staff, students and patients from the risk of COVID-19 infection. Telemedicine and telehealth services were rapidly implemented and adapted to meet the needs of medical education, the teaching of students, trainee doctors, nursing and allied health staff and became a widely accepted norm. The impact on clinical research and education saw the closure of clinical trials and the implementation of new methods in the conducting of trials, including electronic consents, remote patient assessments and the ability to commence fully virtual clinical trials. Academic teaching adapted augmented reality and competency-based teaching to become important new modes of education delivery. Diagnostic services also required new policies and procedures to ensure the safety of personnel. Conclusions: As a by-product of the COVID-19 pandemic, traditional, face-to-face learning and clinical research were converted into online formats. An hybrid environment of traditional methods and novel technological tools has emerged in readiness for future pandemics that allows for virtual learning with concurrent recognition of the need to provide for interpersonal interactions. [ABSTRACT FROM AUTHOR]

Background: The sexual and reproductive health care of people with HIV and those at risk of HIV has largely been delivered face-to-face in Australia. These services adapted to the coronavirus disease 2019 (COVID-19) pandemic with a commitment to continued care despite major impacts on existing models and processes. Limited attention has been paid to understanding the perspectives of the sexual and reproductive health care workforce in the research on COVID-19 adaptations. Methods: Semi-structured interviews were conducted between June and September 2021 with 15 key informants representing a diverse range of service settings and professional roles in the Australian sexual and reproductive health sector. Inductive themes were generated through a process of reflexive thematic analysis, informed by our deductive interest in clinical adaptations. Results: The major adaptations were: triage (rapidly adapting service models to protect the most essential forms of care); teamwork (working together to overcome ongoing threats to service quality and staff wellbeing), and the intwined themes of telehealth and trust (remaining connected to marginalised communities through remote care). Despite impacts on care models and client relationships, there were sustained benefits from the scaleup of remote care, and attention to service safety, teamwork and communication. Conclusions: Attending to the experiences of those who worked at the frontline of the COVID-19 response provides essential insights to inform sustained, meaningful system reform over time. The coming years will provide important evidence of longer-term impacts of COVID-19 interruptions on both the users and providers of sexual and reproductive health services. Health services were profoundly impacted by coronavirus disease 2019 (COVID-19) restrictions, and difficult choices were made to sustain essential services for people with HIV and those at risk of HIV. We interviewed clinicians working in sexual and reproductive health services around Australia, who described the most important adaptations as being related to triage, teamwork, telehealth and trust. Insights gained from service adaptations caused by COVID-19 have the potential to drive long-term innovations in the sexual and reproductive healthcare sector. [ABSTRACT FROM AUTHOR]

Objective: The Australian COVID‐19 Frontline Healthcare Workers study examined the prevalence and severity of mental health symptoms during the second wave of the COVID‐19 pandemic. This substudy examined the differences in psychological well‐being between rural and metropolitan health care workers (HCWs). Design: A nationwide survey conducted between August and October 2020. Setting and Participants: Australian HCWs were recruited through multiple strategies. Main outcome measures: Demographics, mental health outcomes (anxiety, depression, post‐traumatic stress disorder [PTSD] and burnout). Results: Complete responses were included from 7846 participants, with 1473 (18.8%) in regional or remote ('rural') areas and 81.2% in metropolitan areas. Rural participants were older, more likely to work in allied health, nursing or in health administration, and had worked longer in their profession than metropolitan participants. Levels of resilience were similar (p = 0.132), but there was significantly higher prevalence of pre‐COVID‐19 pandemic mental illness in the rural workforce (p < 0.001). There were high levels of current mental health issues: moderate–severe PTSD (rural 38.0%; metropolitan 41.0% p = 0.031); high depersonalisation (rural 18.1%; metropolitan 20.7% p = 0.047); and high emotional exhaustion (rural 46.5%; metropolitan 43.3% p = 0.002). Among rural participants, mental health symptoms were associated with younger age, worry about being blamed if they contracted COVID‐19, fear of transmitting COVID‐19 to their family, experiencing worsening relationships and working in primary care or allied health. Conclusion: Despite having low COVID‐19 case numbers in rural Australian health services compared with metropolitan counterparts over the course of 2020, there were widespread mental health impacts on the workforce. Rural health services need specific and flexible training, education, work policies and practices that support psychological well‐being now in preparedness for ongoing or future crises. [ABSTRACT FROM AUTHOR]

Background: With the advent of COVID-19, many healthcare workers (HWs) in Australia requested access to powered air purifying respirators (PAPR) for improved respiratory protection, comfort and visibility. The urgency of the response at our hospital required rapid deployment of innovative training to ensure the safe use of PAPRs, in particular, a video-feedback training option to prepare HWs for PAPR competency. Aim: To explore the feasibility, acceptability, and utility of video-feedback in PAPR training and competency assessment. Methods: Semi-structured interviews were conducted with 12 HWs, including clinicians from Intensive Care, Anaesthetics and Respiratory Medicine, at a large teaching hospital in Australia. Findings: Participants believed that the use of video-feedback in PAPR training was feasible, acceptable and useful. They described a variety of benefits to learning and retention, from a variety of ways in which they engaged with the personal video-feedback. Participants also described the impact of reviewing personalised practice footage, compared to generic footage of an ideal performance. Conclusion: By conceptualising video-feedback using a pedagogical approach, this study contributes to knowledge around optimising methods for training HWs in PPE use, particularly when introducing a new and complex PPE device during an infectious disease outbreak. [ABSTRACT FROM AUTHOR]

Purpose: Research examining psychological well‐being associated with COVID‐19 in rural/regional Australia is limited. This study aimed to assess the extent of psychological distress, fear of COVID‐19, and coping strategies among the attendees in COVID‐19 screening clinics at 2 rural Victorian settings. Methods: A cross‐sectional study was conducted during July 2020 to February 2021 inclusive. Participants were invited to fill in an online questionnaire. Kessler Psychological Distress Scale (K‐10), Fear of COVID‐19 Scale, and Brief Resilient Coping Scale were used to assess psychological distress, fear of COVID‐19, and coping, respectively. Findings: Among 702 total participants, 69% were females and mean age (±SD) was 49 (±15.8) years. One in 5 participants (156, 22%) experienced high to very high psychological distress, 1 in 10 (72, 10%) experienced high fear, and more than half (397, 57%) had medium to high resilient coping. Participants with mental health issues had higher distress (AOR 10.4, 95% CI: 6.25‐17.2) and fear (2.56, 1.41‐4.66). Higher distress was also associated with having comorbidities, increased smoking (5.71, 1.04‐31.4), and alcohol drinking (2.03, 1.21‐3.40). Higher fear was associated with negative financial impact, drinking alcohol (2.15, 1.06‐4.37), and increased alcohol drinking. Medium to high resilient coping was associated with being ≥60 years old (1.84, 1.04‐3.24) and completing Bachelor and above levels of education. Conclusion: People who had pre‐existing mental health issues, comorbidities, smoked, and consumed alcohol were identified as high‐risk groups for poorer psychological well‐being in rural/regional Victoria. Specific interventions to support the mental well‐being of these vulnerable populations, along with engaging health care providers, should be considered. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

This study is the first to obtain data on the prevalence of, contributors to, and supports required for, pandemic-related distress within the residential aged care sector in Australia. A nested mixed-methods approach was used to examine aged care leaders' opinions about the impact of COVID-19 on the mental health of aged care residents and staff. A total of 288 senior staff of Australian residential aged care facilities (care managers, clinical care coordinators, and lifestyle team leaders; mean age = 52.7 years, SD = 10.3) completed an online survey between 10th September and 31st October 2020. On average, nearly half of their residents experienced loneliness (41%) and a third experienced anxiety in response to COVID-19 (33%). The most frequently noted contributors to poor mental health among residents were restrictions to recreational outings and watching news coverage relating to COVID-19. Participants emphasized the need for increased access to counseling services and improved mental health training amongst staff. Residential care staff were similarly impacted by the pandemic. More than a third of staff were reported as anxious (36%) and 20% depressed, in response to COVID-19. Staff were worried about introducing COVID-19 into their facility and were impacted by news coverage of COVID-19. Staff would feel supported by financial assistance and by increased staff-resident ratios. Senior staff perceive that the mental health of Australian aged care residents and staff was negatively impacted by the COVID-19 pandemic. The most noted contributors were identified, as was the mental health support for aged care communities. This study provides government and policymakers with clear intervention targets for supporting the sector. Clinicians can support residential aged care communities by providing on-site or telehealth counseling, and upskill and train residential aged care staff on how to respond to the emotional needs of residents in response to COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: Since the World Health Organization declared the coronavirus outbreak a global pandemic several million cases and more than three million deaths have been already confirmed worldwide due to COVID‐19. Design and Methods: Early Career Psychiatrists from all over the world present an overview of what happened in their own countries and what they have learned so far by this experience in everyday clinical practice. Practice Implication: We tried to take a real time picture of this unexpected situation, drawing useful hints for now and the future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic significantly changed the lives of a majority of the world's population. People have been encouraged to implement social distancing behaviors enforced by governments, and have experienced loss of employment or changes to their usual working environment. In the mental health sector, psychologists and psychiatrists have been forced to alter the standard care of patients without compromising safety. This article documents the experiences of the authors – mental health professionals in four countries, Canada, Russia, Australia and Japan – at the time of the COVID-19 pandemic, and offers recommendations on how clinical, training, and research practices may need to be adjusted to deal with lockdown situations. Clinicians adapted their usual best practices by learning new skills and updating their knowledge base. Mental health clinicians noticed that the pandemic led to symptomatic changes in some of their patients. Most clinicians moved towards providing telemental health services, such as conducting assessments and treatments remotely. Those who continued seeing patients in person employed personal protective equipment with various impacts on the clinician–patient relationship. The dilemmas of mass quarantines need to be carefully examined, as their effects on numerous health and psychosocial variables appear to be far-reaching. [ABSTRACT FROM AUTHOR]

Objective: To examine psychological distress and professional burnout in a cohort of Australian mental healthcare workers during the COVID-19 pandemic Methods: This study examined a multi-disciplinary cohort of mental healthcare workers in a large metropolitan service in Australia. Demographic information as well as information on employment and individual's personal experience of the COVID-19 pandemic was collected and correlated with cross-sectional assessments of anxiety, depression and professional burnout using validated clinical questionnaires Results: Mental healthcare workers reported high levels of anxiety, depression, and professional burnout. Participants reported some reduction in anxiety since the early phases of the pandemic, but the reduction was more modest in mental healthcare workers identifying as being "vulnerable" employees. Conclusion: Despite the low numbers of COVID-19 cases, mental healthcare workers in Australia report significant levels of psychological distress and professional burnout during the pandemic. [ABSTRACT FROM AUTHOR]

Objective. This study examined the content and impact of a new digital communication medium, called a VIDCAST, implemented at a large hospital and health service when the COVID-19 pandemic was announced, and the key concerns held by staff at the time when the health service was preparing for the COVID-19 pandemic to arrive in this health service. Methods. A mixed-methods approach was used. Thematic analysis of 20 transcripts of daily VIDCASTS broadcast between 30 March and 24 April 2020 was undertaken, in addition to descriptive analysis of feedback from an anonymous online survey. Results. Survey feedback from 322 staff indicated almost universal satisfaction with this new communication method. The VIDCASTS provided a new COVID-safe method for the Executive to connect to staff at a time of uncertainty. Thematic analysis of the content of the VIDCASTS revealed three themes: 'Accurate Information', 'Reassurance and Support' and 'Innovation'. The Executive was able to reassure staff about what the organisation was doing to safeguard the health and wellbeing of all, and enabled an effective response to the pandemic. Conclusions. The digital communication channel of VIDCASTS, rapidly operationalised at a major Australian hospital and health service in March 2020, provided important information and support for staff as it prepared for the anticipated COVID-19 surge. [ABSTRACT FROM AUTHOR]

Background: The annual recruitment of new graduate nurses and midwives is key to recruiting large numbers of staff with the right attitude, skills and knowledge who are the best fit for the organisation. Virtual interviews were undertaken in 2020 due to the surge worldwide in the COVID-19 crisis. This study evaluates those virtual interviews and explores the sustainability of the model.Methods: A cross-sectional study was conducted at a large health organisation in New South Wales, Australia. Data were collected over 3 weeks using two online surveys, one for interviewees (n = 512) and the other for interviewers (n = 68). Quantitative data were analysed using descriptive statistics and frequency distributions, and additional free-text comments were analysed using content analysis.Results: Response rates were 55% (n = 280) interviewees and 54% (n = 37) for interviewers. The majority of interviewees (58%, n = 184) and interviewers (78%, n = 29) stated the interview was seamless or very seamless and 55% (n = 156) of interviewees and 73% (n = 27) of interviewers agreed interviewees conveyed themselves well during interviews. Over half of interviewees (65%, n = 182) and interviewers (51%, n = 18) agreed the virtual interview was fair or very fair for interviewee performance, regardless of age, race, or socio-economic status. However, many expressed a need for better internet access, equipment, and support, and a longer interview time to personally connect. Both new graduate interviewees (60%) and interviewers (75%) agreed virtual interviews are a suitable model for future use. However, some respondents indicated they preferred face-to-face interviews.Conclusions: The use of virtual interviews to select new graduates is considered acceptable, cost-effective and sustainable, as well as fair by the majority of participants. Study findings inform policy development, future planning, support the use of flexible selection practices and provide other health care professionals with a virtual recruitment model to consider when developing strategies to grow their future health workforce. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has dramatically impacted cancer care worldwide. Disruptions have been seen across all facets of care. While the long-term impact of COVID-19 remains unclear, the immediate impacts on patients, their carers and the healthcare workforce are increasingly evident. This study describes disruptions and reorganisation of cancer services in Australia since the onset of COVID-19, from the perspectives of people affected by cancer and healthcare workers. Two separate online cross-sectional surveys were completed by: a) cancer patients, survivors, carers, family members or friends (n = 852) and b) healthcare workers (n = 150). Descriptive analyses of quantitative survey data were conducted, followed by inductive thematic content analyses of qualitative survey responses relating to cancer care disruption and perceptions of telehealth. Overall, 42% of cancer patients and survivors reported experiencing some level of care disruption. A further 43% of healthcare workers reported atypical delays in delivering cancer care, and 50% agreed that patient access to research and clinical trials had been reduced. Almost three quarters (73%) of patients and carers reported using telehealth following the onset of COVID-19, with high overall satisfaction. However, gaps were identified in provision of psychological support and 20% of participants reported that they were unlikely to use telehealth again. The reorganisation of cancer care increased the psychological and practical burden on carers, with hospital visitation restrictions and appointment changes reducing their ability to provide essential support. COVID-19 has exacerbated a stressful and uncertain time for people affected by cancer and healthcare workers. Service reconfiguration and the adoption of telehealth have been essential adaptations for the pandemic response, offering long-term value. However, our findings highlight the need to better integrate psychosocial support and the important role of carers into evolving pandemic response measures. Learnings from this study could inform service improvements that would benefit patients and carers longer-term. [ABSTRACT FROM AUTHOR]

Aim: The Australian 'There is no place like home' project is implementing a paediatric low‐risk febrile neutropenia (FN) programme across eight paediatric hospitals. We sought to identify the impact of the coronavirus disease 2019 (COVID‐19) pandemic on programme implementation. Methods: Paediatric oncology, infectious diseases and emergency medicine health‐care workers and parent/carers were surveyed to explore the impact of the COVID‐19 pandemic on home‐based FN care. Online surveys were distributed nationally to health‐care workers involved in care of children with FN and to parents or carers of children with cancer. Results: Surveys were completed by 78 health‐care workers and 32 parents/carers. Overall, 95% of health‐care workers had confidence in the safety of home‐based FN care, with 35% reporting changes at their own hospitals in response to the pandemic that made them more comfortable with this model. Compared to pre‐pandemic, >50% of parent/carers were now more worried about attending the hospital with their child and >80% were interested in receiving home‐based FN care. Among both groups, increased telehealth access and acceptance of home‐based care, improved patient quality of life and reduced risk of nosocomial infection were identified as programme enablers, while re‐direction of resources due to COVID‐19 and challenges in implementing change during a crisis were potential barriers. Conclusion: There is strong clinician and parent/carer support for home‐based management of low‐risk FN across Australia. Changes made to the delivery of cancer care in response to the pandemic have generally increased acceptance for home‐based treatments and opportunities exist to leverage these to refine the low‐risk FN programme. [ABSTRACT FROM AUTHOR]

Objective: It has been widely predicted that the COVID-19 pandemic will have a detrimental impact on the mental health (MH) of individuals. This has been dubbed as the MH 'second wave'. In Australia, these impacts have been partly mitigated by institutional responses such as increased access to psychotherapy. Consultation Liaison (CL) psychiatry services provide MH care to acutely unwell patients in general hospitals. It was hypothesised that the number of referrals to the studied service had increased since the start of the pandemic.Methods: From the Electronic medical records (eMRs), the authors collected daily referral numbers, over 3 consecutive years, to a large CL service in metropolitan Sydney.Results: Referrals were significantly increased by 25%, 95% CI [1.14, 1.36], p < .001 since the start of the pandemic. This increase was delayed, and remained elevated despite a reduction in COVID-19 infections.Conclusion: This study adds evidence to the existence of the MH 'second wave', highlights a key impact on healthcare workers' well-being and will assist in guiding resource allocation decisions in the near future. [ABSTRACT FROM AUTHOR]

We present information on acute stroke care for the first wave of the COVID-19 pandemic in Australia using data from the Australian Stroke Clinical Registry (AuSCR). The first case of COVID-19 in Australia was recorded in late January 2020 and national restrictions to control the virus commenced in March. To account for seasonal effects of stroke admissions, patient-level data from the registry from January to June 2020 were compared to the same period in 2019 (historical-control) from 61 public hospitals. We compared periods using descriptive statistics and performed interrupted time series analyses. Perceptions of stroke clinicians were obtained from 53/72 (74%) hospitals participating in the AuSCR (80% nurses) via a voluntary, electronic feedback survey. Survey data were summarized to provide contextual information for the registry-based analysis. Data from the registry covered locations that had 91% of Australian COVID-19 cases to the end of June 2020. For the historical-control period, 9,308 episodes of care were compared with the pandemic period (8,992 episodes). Patient characteristics were similar for each cohort (median age: 75 years; 56% male; ischemic stroke 69%). Treatment in stroke units decreased progressively during the pandemic period (control: 76% pandemic: 70%, p < 0.001). Clinical staff reported fewer resources available for stroke including 10% reporting reduced stroke unit beds. Several time-based metrics were unchanged whereas door-to-needle times were longer during the peak pandemic period (March-April, 2020; 82 min, control: 74 min, p = 0.012). Our data emphasize the need to maintain appropriate acute stroke care during times of national emergency such as pandemic management. [ABSTRACT FROM AUTHOR]

Objective: To examine psychological distress in healthcare workers (HCWs) during the COVID-19 pandemic in April–May 2020. Methods: A cross-sectional survey examining demographic, employment and mental health characteristics of HCWs in a large metropolitan hospital in Australia. Results: HCWs showed significant symptoms of moderate-severe level depression (21%), anxiety (20%) and posttraumatic stress disorder (PTSD; 29%), associated with burnout, prior psychiatric history, profession and resilience. Conclusion: Despite low levels of COVID contact, moderate to high levels of psychological distress were reported. Continued monitoring and support for HCWs' mental well-being is warranted as the COVID-19 pandemic develops. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and associated system disruptions are impacting all children and young people (CYP) in Australia. For vulnerable groups of CYP, who already experience poorer health and well‐being, these impacts are amplified. Challenges include reduced access to usual services, reduced community supports, financial instability, unemployment and other life circumstances that threaten to widen pre‐existing inequities. This article aims to present the reasons for vulnerability of CYP during the pandemic, and to focus on actions by health professionals that mitigate additional challenges to their health and well‐being. Using a rapid review of the literature and team‐based discussions, eight vulnerable groups were identified: CYP with disabilities, mental health conditions and chronic diseases; CYP facing financial hardship; within the child protection system; Aboriginal; migrant and refugee; in residential care; rural; and isolated CYP. Recommendations for action are required at the level of governments, health professionals and researchers and include enhancing access to health and social supports, prioritising vulnerable CYP in resuming health activity and elevating the voice of CYP in designing the response. The pandemic can be conceptualised as an opportunity to create a more equitable society as we document the inequities that have been exacerbated. Vulnerable groups of CYP must be recognised and heard, and targeted actions must focus on improving their health outcomes during the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Objective: To characterise the working arrangements of medical research scientists and support staff in Australia during the COVID-19 pandemic, and to evaluate factors (in particular: wearing pyjamas) that influence the self-assessed productivity and mental health of medical institute staff working from home.Design: Prospective cohort survey study, 30 April - 18 May 2020.Setting, Participants: Staff (scientists and non-scientists) and students at five medical research institutes in Sydney, New South Wales.Main Outcome Measures: Self-assessed overall and task-specific productivity, and mental health.Results: The proportions of non-scientists and scientists who wore pyjamas during the day were similar (3% v 11%; P = 0.31). Wearing pyjamas was not associated with differences in self-evaluated productivity, but was significantly associated with more frequent reporting of poorer mental health than non-pyjama wearers while working from home (59% v 26%; P < 0.001). Having children in the home were significantly associated with changes in productivity. Larger proportions of people with toddlers reported reduced overall productivity (63% v 32%; P = 0.008), and reduced productivity in writing manuscripts (50% v 17%; P = 0.023) and data analysis (63% v 23%; P = 0.002). People with primary school children more frequently reported reduced productivity in writing manuscripts (42% v 16%; P = 0.026) and generating new ideas (43% v 19%; P = 0.030). On a positive note, the presence of children in the home was not associated with changes in mental health during the pandemic. In contrast to established researchers, early career researchers frequently reported reduced productivity while working at home.Conclusions: Our findings are probably applicable to scientists in other countries. They may help improve work-from-home policies by removing the stigma associated with pyjama wearing during work and by providing support for working parents and early career researchers. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted healthcare services around the world. Pharmacists are front-line healthcare professionals and integral members of the healthcare team. The deployment of a specialized 'COVID pharmacist' within our institution has demonstrated that the skills of the pharmacist can be adapted, expanded and utilized to alleviate the pressure of doctor shortages, reduce healthcare worker exposure to infected patients, contribute to therapeutic decisions and work collaboratively to tackle the challenges faced during this pandemic. This commentary details an Australian hospital pharmacy response to the COVID-19 pandemic, describing the unique clinical and practical contributions made by a specialized COVID pharmacist in our institution. [ABSTRACT FROM AUTHOR]

Aims: COVID-19 is now a global pandemic. At the time of survey, fewer than 150 children in Australia and New Zealand had documented infection. The aim of this study was to assess attitudes, readiness and confidence in the early stages of the COVID-19 pandemic through an online survey of paediatric physicians and sub-specialists across Australia and New Zealand.Methods: Multiple email list groups were used to contact paediatric physicians to undertake an online Likert scale survey between 17 and 24 March. Respondents' specialty, experience and work setting were recorded. Ordinal logistic regression was used to determine respondent factors.Results: There were 542 respondents from across Australia and New Zealand: an estimated 11% of the paediatric physician workforce. A minority (36.6%) agreed that their national response had been well coordinated; the majority (92.7%) agreed that senior-level hospital administrators were taking the situation seriously. Most reported a good understanding of the natural history of COVID-19 in children, and knowledge of where to find local information. A large proportion of physicians (86.1%) were worried about becoming infected through their work; few (5.8%) reported that they would not come to work to avoid infection. Closure of school and childcares would reduce the ability to continue work at current capacity for 23.6% of respondents.Conclusion: Despite limited experience in pandemics, most paediatric physicians felt informed. Concern about exposure at work is common; most were willing to work regardless. The closure of schools and daycares may have an impact on staffing. Coordination and leadership will be critical. [ABSTRACT FROM AUTHOR]