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Problem Routine administration of the Edinburgh Postnatal Depression Scale (EPDS) is intended to promote early detection and preventative support for those who may be at risk of perinatal depression and anxiety. The cultural suitability of the EPDS has not been validated in the Aboriginal Australian context. Background Marked differences in health outcomes and service access between Australian Aboriginal and non-Aboriginal women and infants continue to exist. Aim This study aimed to explore the cultural validity of the EPDS through understanding the experiences of Aboriginal women and midwives. Methods Qualitative data was drawn from semi-structured interviews/yarns with 13 Perth-based Aboriginal antenatal women and 10 non-Aboriginal midwives. Findings Utilising a grounded theory approach, thematic analysis of verbatim transcripts revealed that, surprisingly, women expressed generally favourable views of the EPDS, especially when the relationships between women and midwives were focused on. Midwives, however, expressed reservations about administering the EPDS and used the EPDS as a conversation-starter rather than as a standardised, standalone tool. Discussion In attempt to reconcile conflicting perspectives, analysis of recordings extended to evaluate micro-processes in the interviews. At the process level, it was clear that demand characteristics operated in some interviews, including socially desirable response biases, demand biases and acquiescent response styles. Conclusion This highlights the need for researchers and clinicians to be trained in non-leading interview questioning techniques and in yarning methodology. Researchers and clinicians should also be aware of the cognitive biases and demand characteristics that may influence responding, likely perpetuated by dominant forces of a colonised society.

Currently, there are few robustly evaluated social and emotional wellbeing (SEWB) measures available for use with Aboriginal youth in research, policy, and practice. As such, this study used a Rasch measurement approach to examine the psychometric properties of Strong Souls, a 25-item self-reported SEWB instrument, created for use with Aboriginal youth in the Northern Territory. Our sample (N = 154) included youth (15–25 years old) living on Whadjuk (metropolitan Western Australia; N = 91) and Kamilaroi countries (rural New South Wales; N = 63). Using Rasch modelling techniques, evidence for multidimensionality in the scale was observed, resulting in subsequent analyses conducted separately on two subscales: Psychological Distress and Resilience. The Resilience subscale did not meet the Rasch model assumptions, with poor person and item separation and reliability indexes suggesting the scale was not reliably differentiating between participants’ Resilience scores. The Psychological Distress subscale had mixed separation and reliability index results, with good construct validity implied but poorer ability to target the distress of participants. Our findings provide novel evidence demonstrating the functioning of Strong Souls in a contemporary sample of Aboriginal youth, suggesting further modifications of the instrument are required before it can be used with confidence as a reliable measure in this population group.

Objective: There is a paucity of quantitative measures of resilience specifically validated for young Aboriginal people in Australia. We undertook the first investigation of validity and reliability of the Connor-Davidson Resilience Scale (CD-RISC) in a sample of Australian Aboriginal people, with a focus on youth. Method: We conducted a cross-sectional study of resilience among a sample of 122 Aboriginal youth (15–25 years old) in New South Wales and Western Australia, featuring self-completes of the 10-item CD-RISC in online (N = 22) and face-to-face (N = 100) settings. A Rasch analysis using the 122 CD-RISC responses determined item independence, response category adequacy, differential item functioning, unidimensional measurement, person and item reliability, and item fit. Confirmatory factor analysis was also conducted, complementary to the Rasch analysis. Results: Four problematic items from the original instrument were removed, due to item dependence (items 2, 6 and 9; Q 3,* > 0.30) and differential item functioning (item 4; > 0.43 logits between males and females). The final 6-item instrument exhibited improved item separation (ISI = 2.14) and reliability index values (IRI =.82) – suggesting an improved structure – however several limitations such as a prominent ceiling effect were evident (i.e., positive measure targeting coefficient of 0.99 logits). Conclusion: Findings suggest the CD-RISC instrument should be applied in Aboriginal contexts with caution. Further psychometric examination of the CD-RISC with Aboriginal youth is warranted before it can be used with confidence by researchers and clinicians.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

As of May 17th 2020, the novel coronavirus disease 2019 (COVID-19) pandemic has caused 307,395 deaths worldwide, out of 3,917,366 cases reported to the World Health Organization. No specific treatments for reducing mortality or morbidity are yet available. Deaths from COVID-19 will continue to rise globally until effective and appropriate treatments and/or vaccines are found. In search of effective treatments, the global medical, scientific, pharma and funding communities have rapidly initiated over 500 COVID-19 clinical trials on a range of antiviral drug regimens and repurposed drugs in various combinations. A paradigm shift is underway from the current focus of drug development targeting the pathogen, to advancing cellular Host-Directed Therapies (HDTs) for tackling the aberrant host immune and inflammatory responses which underlie the pathogenesis of SARS-CoV-2 and high COVID-19 mortality rates. We focus this editorial specifically on the background to, and the rationale for, the use and evaluation of mesenchymal stromal (Stem) cells (MSCs) in treatment trials of patients with severe COVID-19 disease. Currently, the ClinicalTrials.gov and the WHO Clinical Trials Registry Platform (WHO ICTRP) report a combined 28 trials exploring the potential of MSCs or their products for treatment of COVID-19. MSCs should also be trialed for treatment of other circulating WHO priority Blueprint pathogens such as MERS-CoV which causes upto 34% mortality rates. It's about time funding agencies invested more into development MSCs per se, and also for a range of other HDTs, in combination with other therapeutic interventions. MSC therapy could turn out to be an important contribution to bringing an end to the high COVID-19 death rates and preventing long-term functional disability in those who survive disease.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Introduction Decreasing participation levels in health surveys pose a threat to the validity of estimates intended to be representative of their target population. If participants and non-participants differ systematically, the results may be biased. The application of traditional non-response adjustment methods, such as weighting, can fail to correct for such biases, as estimates are typically based on the sociodemographic information available. Therefore, a dedicated methodology to infer on non-participants offers advancement by employing survey data linked to administrative health records, with reference to data on the general population. We aim to validate such a methodology in a register-based setting, where individual-level data on participants and non-participants are available, taking alcohol consumption estimation as the exemplar focus. Methods and analysis We made use of the selected sample of the Health 2000 survey conducted in Finland and a separate register-based sample of the contemporaneous population, with follow-up until 2012. Finland has nationally representative administrative and health registers available for individual-level record linkage to the Health 2000 survey participants and invited non-participants, and the population sample. By comparing the population sample and the participants, synthetic observations representing the non-participants may be generated, as per the developed methodology. We can compare the distribution of the synthetic non-participants with the true distribution from the register data. Multiple imputation was then used to estimate alcohol consumption based on both the actual and synthetic data for non-participants, and the estimates can be compared to evaluate the methodology's performance. Ethics and dissemination Ethical approval and access to the Health 2000 survey data and data from administrative and health registers have been given by the Health 2000 Scientific Advisory Board, Statistics Finland and the National

There is increasing interest in macroalgae farming in European waters for a range of applications, including food, chemical extraction for biofuel production. This study uses a 3-D numerical model of hydrodynamics and biogeochemistry to investigate potential production and environmental effects of macroalgae farming in UK and Dutch coastal waters. The model included four experimental farms in different coastal settings in Strangford Lough (Northern Ireland), in Sound of Kerrera and Lynn of Lorne (north-west Scotland) and in the Rhine plume (the Netherlands), as well as a hypothetical large-scale farm off the UK north Norfolk coast. The model could not detect significant changes in biogeochemistry and plankton dynamics at any of the farm sites averaged over the farming season. The results showed a range of macroalgae growth behaviours in response to simulated environmental conditions. These were then compared with in situ observations where available, showing good correspondence for some farms and less good correspondence for others. At the most basic level, macroalgae production depended on prevailing nutrient concentrations and light conditions, with higher levels of both resulting in higher macroalgae production. It is shown that under non-elevated and interannually varying winter nutrient conditions, farming success was modulated by the timings of the onset of increasing nutrient concentrations in autumn and nutrient drawdown in spring. Macroalgae carbohydrate content also depended on nutrient concentrations, with higher nutrient concentrations leading to lower carbohydrate content at harvest. This will reduce the energy density of the crop and thus affect its suitability for conversion into biofuel. For the hypothetical large-scale macroalgae farm off the UK north Norfolk coast, the model suggested high, stable farm yields of macroalgae from year to year with substantial carbohydrate content and limited environmental effects.

© 2018 HERDSA. Like other Westernised countries, Australia’s history of colonisation, racism and oppression has impacted upon Indigenous Peoples’ health and well-being. It is also evident that institutional racism and ongoing colonisation are present in the Australian health system. Better preparation of health professionals to work in a culturally respectful way can contribute to addressing health disparities and prejudices. One approach to enabling the development of cultural respect is through embedding an Indigenous graduate attribute (IGA) across curricula and ensuring the process is thoughtfully developed and assessed. This paper describes and discusses the process of developing an assessment criteria template (ACT) to assess Indigenous cultural respect in an undergraduate nursing degree programme. Critical to the project was meaningful engagement with Indigenous stakeholders and Indigenous leadership to inform the development and implementation process. Although the context will vary globally due to the diversity of Indigenous Peoples and each country’s history of colonisation, by publishing this work, we intend to provide transparency into the process we undertook to embed and assess an IGA ACT in an undergraduate nursing curriculum. We hope this is helpful for other tertiary institutions internationally who are also engaging in this space.

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Indigenous representation is essential to ensure the health workforce is culturally capable and safe for Indigenous patients. However, Indigenous Peoples remain underrepresented in tertiary education and the health workforce. Aim: This aim of this paper is to offer an unmediated, Aboriginal nurses’ perspective, on the experience, barriers and challenges of undertaking a Bachelor of Nursing degree. Design: Referenced reflection. Results: Education providers must be culturally capable themselves before teaching Indigenous content and facilitating sensitive classroom discussions. Financial, social and educational support is crucial to equip Indigenous students for tertiary study. Conclusion: To retain Indigenous students and contribute to a culturally capable workforce, it is imperative to listen and respond to Indigenous Peoples voices to shape learning experiences and support.

BACKGROUND: Emergency departments (EDs) face increasing service demands and the imposition of treatment targets which has led to continual process redesign and changes in staff skill mix and functions. OBJECTIVE: To identify extended ED pharmacist roles that could improve medication management and to implement and evaluate one such role change. METHODS: A focus group of clinicians sought to redesign processes around ED medication management. Preparation of medication charts for patients admitted from ED was selected. Baseline data were obtained to define elements of existing medication charting processes. Suitably trained ED pharmacists' trialled the effectiveness of making therapeutic suggestions on a medication chart 'sticker' or by direct 'consultation' with medical staff. At the conclusion of the study focus groups at each site evaluated clinical staff perceptions of the change. RESULTS: Focus group participants thought that ED pharmacists could undertake extended roles in analgesia, nausea control, antibiotic cover, addiction management and preparation of medication charts for admitted patients. In the pre-intervention audit (n = 140), 74% required at least one intervention by the ward pharmacists to address medication discrepancies. Ward pharmacists detected 292 medication discrepancies (median 1, IQR 0-3). In the 'sticker' intervention the ED pharmacist made 84 therapeutic suggestions of which 66 (78.6%) were accepted by medical staff. In the 'consultation' intervention 230 therapeutic suggestions were made of which 219 (95.2%) were accepted. The qualitative evaluation found that pharmacist-prepared medication charts within the processes established were deemed safe, timely, accurate, complete and legible. CONCLUSION: Support exists for ED pharmacists to expand their medication-related roles. ED pharmacists can safely prepare medication charts in a timely fashion and their therapeutic suggestions within a 'consultative' framework are more beneficial than writ