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The COVID-19 pandemic and associated school closures may have constrained educational participation particularly for students in disadvantaged circumstances. We explore how 30 disadvantaged students in secondary school (14 mainstream/16 Flexible Learning Programme) from Queensland, New South Wales and Tasmania experienced home learning during the first wave of COVID-19, teasing out nuances across two educational models. Drawing on semi-structured interviews with these students, our analysis revealed three interconnected themes inflecting their learning: connection, connectivity and choice. Connection captures the desire for belonging and practices that facilitated meeting this desire during system-wide disruptions to school routines and face-to-face learning. Connectivity captures the impact of digitally facilitated learning at home on students' ability to engage with curriculum content and with their learning community. Choice captures the availability of viable options to overcome barriers students encountered in their learning and possibilities to flexibly accommodate student preferences and learning needs. Students from Flexible Learning Programmes appeared generally better supported to exercise agency within the scope of their lived experience of home-based learning. Findings indicate a need for strengthening student-centred policy and practices aimed at leveraging the affordances of information technology, balancing self-directed and structured learning and providing holistic support to enable meaningful student choice.

This visual essay incorporates photographs from a research project on the changing landscapes of cancer survivorship in Australia. Study participants were asked to tell the story of what cancer looks and feels like and what it means to them. The photographs were captioned and discussed during a follow-up interview. Employing Henri Lefebvre’s rhythmanalysis, these photographs, captions and narrations show how the routines and expectations arising in cancer survivorship reorient life around movement in time and place. They provide insights into the unfolding of cancer survivorship in the ebb and flow of lived experience.

Low-income mothers face disproportionately high risks of engaging with statutory child protection systems. Whilst this is often perceived as a result of poor or irresponsible parenting practices, an increasing body of scholarship foregrounds the role of structural issues—such as poverty and homelessness—that constrain mothers’ agency and impact their ability to care for their children. In this article, we examine Australia’s first permanent Supportive Housing for Families (SHF) programme, which offers low-income mothers practical resources to minimise the risk of statutory child protection intervention. Our research aims to understand low-income mothers’ willingness and ability to care for their children, and how mothers engaged with and made meaning of their experiences residing in SHF. Using a qualitative research design, we analyse interview data with programme mothers (n = 17), programme support workers (n = 10) and statutory child protection officers (n = 7). We find that the resources provided through the programme enabled mothers to care for their children in ways that aligned with their parenting beliefs and aspirations. We conclude that SHF programmes may be an effective means through which low-income mothers can overcome the structural barriers that keep them engaged with statutory child protection systems.

Objective: The aim of this study is to provide the first systematic analysis of differences in the closeness of sibling relations between lesbian, gay, and bisexual (LGB) and heterosexual adults. Background: Across countries, LGB people experience poorer socioeconomic and health outcomes than heterosexual people. Although the reasons for this disadvantage are complex, low levels of family support have been recurrently identified as an important contributor. However, the available literature has concentrated on relations between LGB people and their parents, neglecting other important familial bonds—including sibling bonds. Method: To compare the closeness of sibling relations between individuals with different sexual orientations, this study leverages unique data from an Australian national survey (Household, Income and Labour Dynamics in Australia Survey, n = 13,157 individuals, 35,622 individual-sibling pairs) and multilevel regression models. Results: Key results indicated that—when compared with heterosexual individuals—LGB individuals had less frequent contact with and lived geographically farther from their siblings. The pattern of effects was similar for bisexual and gay or lesbian individuals, and stronger for male than female sexual-minority individuals. There was only sparse evidence of moderation of these associations by individual or sibling traits. Conclusions: The findings of this study are consistent with theoretical perspectives highlighting the unique barriers to socioeconomic inclusion experienced by individuals from sexual minorities. They suggest that these barriers begin within the nuclear family.

This article examines the efficacy of a supportive housing program aiming to provide mothers in violent relationships with the practical resources to minimize child protection intervention. Drawing on qualitative interviews with program mothers, child safety officers, and program practitioners, we explore the extent to which the program enabled mothers and children to live free from fathers’ violence and disengage from the child protection system. We find that, although valuable, the program did not fully mitigate the risks posed by violent fathers. We therefore argue that responsibility must be shifted onto violent fathers to change their behavior and build their parenting capacities.

Adolescence is a time when developmental and contextual transitions converge, increasing the risk for adverse outcomes across the life course. It is during this period that self-concept declines, mental health problems increase and when young people make educational and occupational plans for their future. Considerable research has shown that parent engagement in their child’s learning has positive effects on academic and wellbeing outcomes and may be a protective factor in adolescence. However, it is during adolescence that parent engagement typically declines. Most studies focus on early childhood or use cross-sectional designs that do not account for the high variability in both the child’s development and the parent-child relationship over time. In this chapter, we examine the association between parent engagement and students’ outcomes—self-concept, mental health, and educational aspirations—drawing on national data from the Longitudinal Study of Australian Children, while accounting for the school context—school belonging, peer connection problems, and bullying—and parenting styles using panel fixed effects models. We then explore perceptions of parental engagement and educational aspirations among a sample of adolescent students from highly disadvantaged backgrounds using interviews from the Learning through COVID-19 study. Findings show that parent engagement is important for students’ outcomes such as self-concept, mental health and aspirations in early and middle adolescence, even when accounting for family and school context factors. Further, parent engagement in late adolescence, with students from highly disadvantaged backgrounds, continues to be important for positive student outcomes.

Increasingly, people live longer with advanced cancer, despite having no prospect of full recovery. Ongoing survival is owed to early detection and effective disease management, yet experienced as highly precarious. In this article we explore how cancer chronicity brings into effect a pre-occupation with time, what time is to people with advanced cancer, and what socio-cultural norms inflect everyday practices. We analyse 20 interviews conducted in Queensland, Australia with 11 participants with advanced cancer, to trace the intersections of what time means, what people do with time, and what time feels like. Drawing on scholarship on the moralities around ill health, we discuss how awareness of time emerges in cancer chronicity and raises moral questions on how to live well. Here, imperatives of optimisation (urging people with advanced cancer to make the most of limited time) intersect with imperatives of authenticity (marked by emphasis on how to live one's own best life). These dynamics reveal expressions of living with advanced cancer in morally viable ways. Such ontological processes have implications for the lived experience of people with advanced cancer, their families and oncological care.

In scholarship on cancer survivorship, “normality” is discussed as a strategy to restore and maintain continuity of identity for the person with cancer. I interrogate the strategic deployment of “normality” in what I define as ritual-like practices by drawing on 20 narrative interviews and 455 photographs produced by study participants. The findings explore normality as outcome (being normal), practice (doing normality), and ethical standard (aspiring to normality). They indicate how sociocultural scripts such as the cancer survivor identity and authentic selfhood inflect what it means to be a “normal” person with cancer with repercussions for recognition in lived experience.

Families and relationships are important social domains in which the circumstances of lesbian, gay and bisexual (LGB) people often differ from those of heterosexual people. Gaining a better understanding of the family experiences of Australian LGB populations has important implications for developing our knowledge about the changing demography and dynamics of Australian family life, as well as informing policy, practice and public debate. This paper reports the findings of a review of empirical scholarship on the family experiences and outcomes of Australian LGB people published between 2000 and 2016, including academic publications and grey literature. The search yielded 99 outputs concerned with union formation, intimate partner relationships, pathways to and experiences of parenthood, child wellbeing, ‘coming out’, relationships with family-of-origin, social networks and support and access to family services. There was wide coverage and a marked increase in LGB family scholarship over time, and a predominance of qualitative over quantitative studies. We identified several areas in which further Australian evidence is needed, including union dissolution, child adoption, relationships with extended family, and interactions with institutions providing family services. Australian scholarship would also benefit from leveraging new panel datasets and probability samples, considering intersectionality, and contributing to cross-national comparative studies.

Objective: As more people live with cancer and for longer time periods, it is important to understand the growing diversity in lived experiences of survivorship. This study explored interpretative repertoires around cancer and their implications for survivorship from the perspectives of people with cancer to inform communication in cancer care. Methods: The sample included 11 participants (7 male, 4 female) with diverse cancer diagnoses and prognoses recruited through two public cancer care centres in Queensland, Australia. A narrative analysis of sequential interviews (n = 20) and photographs produced by the participants (n = 455) was conducted. Results: Four interrelated metaphors and narratives emerged in the interpretative repertoires of participants: cancer as a presence, survivorship as a struggle for meaning, survivorship as movement and survivorship as confluence. Continuities with “battle” and “journey” terminology were evident. However, these were subtly adapted and reimagined within participants' own lived experience. This was particularly pronounced among participants with incurable cancers, as they strived to make sense of contradictions within cancer survivorship. Conclusion: The findings offer in‐depth insights into the complexity and nuances of cancer survivorship. Such insights can contribute to facilitating successful and open‐ended communication between cancer care providers, people with cancer and their families.

Cancer is a multifaceted entity with recent developments in treatment only increasing this diversification. Yet, some cancers are less common, less well understood, and receive less attention. Taking neuroendocrine tumours (NETs) as a case study, we explore the lived experience of people with a type of cancer that is virtually unknown among the general population. Drawing on interviews with 30 people living with NETs in Australia, we explored how their experiences are shaped by social and cultural understandings of cancer, and the tensions between chronicity and terminality. We found that people with NETs draw on common narratives around cancer to make sense of their diagnosis. However, NETs were understood as atypical, because they are often incurable, slowly progressing and not associated with treatment side effects such as hair or weight loss. The embodied effects of NETs made them unrecognisable as cancer to participants and community. The specificities of the NET illness experience resulted in the need to reframe narratives around agency and positivity. This hindered social recognition but also provided opportunities to bracket illness and gain some control over the illness experience. The findings of this study highlight the importance of recognising multiple modes of living with cancer.

Medical research shows that healthy sleep has benefits for human wellbeing. We contribute to the emerging social-epidemiological literature on the social determinants of sleep by considering how living in an area with poor economic circumstances can result in sleep loss through financial worry, uncertainty and stress. We use multilevel regression models and nationally-representative data from the Household, Income and Labour Dynamics in Australia Survey (n = 9181) and find that individuals who live in areas with high unemployment rates or experience individual-level economic vulnerability sleep less than comparable individuals in areas with low unemployment rates, or who do not experience financial hardships. The negative association between local economic conditions and sleep duration is substantially stronger amongst economically vulnerable individuals. This highlights the importance of considering multiple levels in the analysis of health inequalities, as status and location can intersect to produce and reproduce disadvantage systems.

This article provides an account of interwoven and often competing repertoires of cosmopolitanism and nationalism on which Australians draw when encountering diversity. Using interview and focus group data the article first explores how the notion of Australianness grounded in civic virtues such as fairness, openness and egalitarianism effectively enhances cosmopolitan outlooks. It identifies the mechanisms through which these same virtues are mobilized to rationalize the failure to actualize cosmopolitanism in everyday practice. We argue that Australianness understood as the popular ‘fair-go’ principle at times conceptually overlaps with cosmopolitan ethics. However, it also bears the potential to hinder cosmopolitan practices. Ultimately national and cosmopolitan ethical frameworks have to be interrogated simultaneously when applied to micro-level interactions.

Summary Background The role of infectious diseases (ID) and clinical microbiology (CM) in hospital settings has expanded in response to increasing antimicrobial resistance, leading to widespread development of hospital antimicrobial stewardship (AMS) programmes, the majority of which include antibiotic approval systems. However, inappropriate antibiotic use in hospitals continues, suggesting potential disjunctions between technical advice and the logics of antibiotic use within hospitals. Aim To examine the experiences of doctors in a UK hospital with respect to AMS guidance of antibiotic prescribing, and experiences of a verbal postprescription antibiotic approval process. Methods Twenty doctors in a teaching hospital in the UK participated in semi-structured interviews about their experiences of antibiotic use and governance. NVivo10 software was used to conduct a thematic content analysis systematically. Findings This study identified three key themes regarding doctors' relationships with ID/CM clinicians that shaped their antibiotic practices: (1) competing hierarchical influences limiting active consultation with ID/CM; (2) non-ID/CM consultants' sense of ownership over clinical decision-making and concerns about challenges to clinical autonomy; and (3) tensions between evidence-based practice and experiential-style learning. Conclusions This study illustrates the importance of examining relations between ID/CM and non-ID/CM clinicians in the hospital context, indicating that AMS models that focus exclusively on delivering advice rather than managing interprofessional relationships may be limited in their capacity to optimize antibiotic use. AMS and, specifically, antibiotic approval systems would likely be more effective if they incorporated time and resources for fostering and maintaining professional relationships.

This study contributes to the growing research on everyday cosmopolitanism in diverse societies. We employ a cosmopolitan encounters framework to explore the reflexive openness people perform and the ethical reasoning they draw on to get along with each other. In particular, we look beyond pleasurable cosmopolitan pursuits to consider encounters that cause frictions or require notable efforts to bridge differences as an occasion for cosmopolitan conviviality. Based on qualitative interviews conducted in Australia, we aim to sharpen the demarcation between cosmopolitan encounters and those in which diversity is strategically negotiated by enacting practices of civility. We argue that cosmopolitanism emerges from interactions in encounters between individuals when they reflect on their positionality within unequal power relationships and their actions are guided by a cosmopolitan ethics. The ethical framework we propose is grounded in reflexive acts of sharing going beyond notions of giving and performing hospitality within a host/guest dyad.

Objectives: Escalating antimicrobial resistance worldwide necessitates urgent optimization of antimicrobial prescribing to preserve antibiotics for future generations. Early intravenous (iv) to oral switch campaigns are one strategy that hospital-based antimicrobial stewardship programmes can incorporate to minimize inappropriate antibiotic use. Yet, iv antibiotics continue to be offered for longer than is clinically indicated, increasing hospital length of stay, increasing costs and placing patients at risk (e.g. cannula-related infections). This study aims to identify why this inappropriate prescribing trend continues. Methods: Twenty doctors (9 females and 11 males) working at a teaching hospital in north-east England participated in semi-structured interviews about their experiences of antibiotic use. NVivo10 software was used to conduct a thematic content analysis of the full interview transcripts driven by the framework approach. Results are reported according to COREQ guidelines. Results: Decisions around the choice of iv over oral antibiotics were influenced by three key issues: (i) consumerism, i.e. participants were concerned about the risk of litigation or complaints if patient expectations were not met; (ii) hierarchy of the medical team structure limited opportunities for de-escalation of antibiotics; and (iii) iv antibiotics were perceived as more potent and having significant mythical qualities, which participants acknowledged were not necessarily evidence based. Conclusions: The iv to oral switch interventions should tailor strategies to demystify iv versus oral antibiotic efficacy, engage consumers around the negative effects of iv antibiotic overuse and examine strategies to streamline team decision-making. Addressing these issues has the potential to reduce inappropriate antibiotic use and resistance.

Background Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance (AMR). The impact of Antimicrobial Stewardship (AMS) programs seeking to preserve viable antibiotic drugs by governing their use in hospitals has hitherto been limited. Pharmacists have been delegated a critical role in antibiotic governance in AMS teams within hospitals but the experience of pharmacists in influencing antibiotic use has received limited attention. In this study we explore the experiences of pharmacists in antibiotic decision-making in two Australian hospitals. Methods We conducted 19 semi-structured interviews to explore hospital-based pharmacists’ perceptions and experiences of antibiotic use and governance. The analysis was conducted with NVivo10 software, utilising the framework approach. Results Three major themes emerged in the pharmacist interviews including (1) the responsibilities of pharmacy in optimising antibiotic use and the interprofessional challenges therein; (2) the importance of antibiotic streamlining and the constraints placed on pharmacists in achieving this; and (3) the potential, but often under-utilised expertise, pharmacists bring to antibiotic optimisation. Conclusions Pharmacists have a critical role in AMS teams but their capacity to enact change is limited by entrenched interprofessional dynamics. Identifying how hospital pharmacy’s antibiotic gatekeeping is embedded in the interprofessional nature of clinical decision-making and limited by organisational environment has important implications for the implementation of hospital policies seeking to streamline antibiotic use. Resource constraints (i.e. time limitation and task prioritisation) in particular limit the capacity of pharmacists to overcome the interprofessional barriers through development of stronger collaborative relationships. The results of this study suggest that to enact change in antibiotic use in hospitals, pharmacists must be supported in their negotiations with doctors, have increased presence on hospital wards, and must be given opportunities to pass on specialist knowledge within multidisciplinary clinical teams. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1290-0) contains supplementary material, which is available to authorized users.

Objective To understand Australian hospital pharmacists’ accounts of antibiotic use, and the potential role of pharmacy in antibiotic optimisation within a tertiary hospital setting. Design, setting and participants Qualitative study, utilising semistructured interviews with 19 pharmacists in two hospitals in Queensland, Australia in 2014. Data was analysed using the framework approach and supported by NVivo10 qualitative data analysis software. Results The results demonstrate that (1) pharmacists’ attitudes are ambivalent towards the significance of antibiotic resistance with optimising antibiotic use perceived as low priority; (2) pharmacists’ current capacity to influence antibiotic decision-making is limited by the prescribing power of doctors and the perception of antibiotic use as a medical responsibility; and, (3) interprofessional and organisational barriers exist that prevent change in the hospital setting including medical hierarchies, limited contact with senior doctors and resource constraints resulting in insufficient pharmacy staffing to foster collaborative relationships and facilitate the uptake of their advice. Discussion While pharmacy is playing an increasingly important role in enhanced antibiotic governance and is a vital component of antimicrobial stewardship in Australia, role-based limitations, interprofessional dynamics and organisational/resource constraints in hospitals, if not urgently addressed, will continue to significantly limit the ability of pharmacy to influence antibiotic prescribing.

Objective To understand Australian hospital pharmacists’ accounts of antibiotic use, and the potential role of pharmacy in antibiotic optimisation within a tertiary hospital setting. Design, setting and participants Qualitative study, utilising semistructured interviews with 19 pharmacists in two hospitals in Queensland, Australia in 2014. Data was analysed using the framework approach and supported by NVivo10 qualitative data analysis software. Results The results demonstrate that (1) pharmacists’ attitudes are ambivalent towards the significance of antibiotic resistance with optimising antibiotic use perceived as low priority; (2) pharmacists’ current capacity to influence antibiotic decision-making is limited by the prescribing power of doctors and the perception of antibiotic use as a medical responsibility; and, (3) interprofessional and organisational barriers exist that prevent change in the hospital setting including medical hierarchies, limited contact with senior doctors and resource constraints resulting in insufficient pharmacy staffing to foster collaborative relationships and facilitate the uptake of their advice. Discussion While pharmacy is playing an increasingly important role in enhanced antibiotic governance and is a vital component of antimicrobial stewardship in Australia, role-based limitations, interprofessional dynamics and organisational/resource constraints in hospitals, if not urgently addressed, will continue to significantly limit the ability of pharmacy to influence antibiotic prescribing.