Australian Online Research Articles

Doctors' Attitudes to Patient Question Asking, Patient-Generated Question Lists, and Question Prompt Lists: A Qualitative Study.

Participation by patients in their own health care improves quality and safety. Question prompt lists (QPLs) can improve participation, particularly with doctors' endorsement. Few data have explored doctors' attitudes on these tools. We sought the experiences and attitudes of general practitioners and other specialists toward patient question asking and QPLs in their practice. In-depth, semistructured interviews and focus groups with purposively selected Australian doctors were conducted. Interview guides were used to explore doctors' experiences of patient question asking, patients' lists, and a sample QPL created using an Australian government-funded online tool, "Question Builder." Recordings were transcribed verbatim and data analyzed thematically using the method by Braun and Clarke. Focus groups with 3 to 9 participants and a further 17 individual interviews were conducted. There was a total of 40 participants, 23 general practitioners and 17 other specialists (e.g., physicians, surgeons, pediatricians). Our analysis was summarized into several themes. 1) The doctors expected, encouraged, and had significant experience of patient question asking and patients' lists. They described many barriers for patients and their efforts to ensure patients had the information they needed. 2) The doctors felt responsible for creating an environment conducive to patient question asking, the delivery of answers, having strategies for unanswered questions, and balancing the agendas of both parties in the consultation. 3) Structured QPLs that prepared patients and facilitated the consultation agenda were viewed positively. The degree of time pressures participating doctors experienced in their context had a strong influence on how they responded to the sample QPL. Doctors in this study expected patients to ask questions and endorsed the benefits of QPLs. However, there were more diverse views about the feasibility of implementing them in practice. Designing QPLs to fit within current workflows, via more succinct and tailored designs, may result in wider doctor acceptance and endorsement, hence maximizing the benefits of QPLs with improved patient participation and patient safety.

Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines

ObjectiveTo estimate the proportion of influenza vaccines administered in non‐medical settings in Australia in 2019 and identify factors associated with vaccination site. MethodsWe surveyed 1,444 Australian adults online in October 2019. To identify factors associated with vaccination site, we used Pearson's chi‐square test. We used thematic analysis to describe responses to the question, ‘Please explain why you chose to get vaccinated there’. ResultsMost participants (73%) received the influenza vaccine in a medical setting, while 13% received it at a pharmacy and 14% at their workplace. Being vaccinated in pharmacy was associated with being under 65 years of age (p<0.01), marital status (p=0.01), and not having a high‐risk comorbidity (p<0.01). Workplace vaccination was associated with being under 65 (p<0.01), household income (p<0.01), not having a regular general physician/practice (p=0.01), having private insurance (p<0.01), and not having a high‐risk comorbidity (p<0.01). There was no association between site of vaccination and first‐time vaccination (p=0.71, p=0.22). ConclusionsDespite new policies allowing pharmacists to administer influenza vaccines, most Australian adults are still vaccinated in medical settings. Pharmacy and workplace vaccination settings were more common among younger adults without high‐risk comorbidities. Implications for public healthWorkplaces, pharmacies and other non‐medical settings may provide an opportunity to increase influenza vaccination among healthy, working‐age adults who might otherwise forego annual vaccination. Pharmacies may also provide a convenient location for the rollout of the COVID‐19 vaccine, particularly in medically underserved areas.

Factors affecting the adoption of the Community of Inquiry Framework in Australian online nursing education: A transition theory perspective

ObjectivesThis paper aims to understand the factors influencing the adoption of teaching, social and cognitive presence in online nursing education and explain the novice nurse academics journey in adopting these aspects. BackgroundThe quality of the online/blended courses is about the content and a need for suitable pedagogical design, clear instructions and a collaborative environment based on a valid and reliable theoretical framework. Design and settingsA qualitative study involves semi-structured interviews with 11 nurse academics from three Australian Universities and thematic analysis was conducted. Results and conclusionsThe Community of Inquiry framework informed three themes including several factors in each from the interviews: (1) Teaching Presence (TP): the lack of understanding of educational theory use, the inadequate course evaluation and the resources scarcity found to be the factors affecting the adoption of TP in online nursing education; (2) Social Presence: the engagement difficulty and creating a learning community affected the adoption of SP; and (3) Cognitive Presence: the variety in learning styles and formative assessment and discussion forums found to be affecting the adoption of CP. This study paper is unique because it uses the Community of Inquiry framework and Meleis’s Transition Theory and provides insight on how to facilitate the transition [from role insufficiencies to role supplementation to role mastery] of nurse academics’ journey in adopting teaching, social and cognitive presence for online higher education.

Constructive Messages in Australian Domestic Violence Online News Coverage and Guidelines for Improved Coverage

ABSTRACT This article focusses on the Australian online news’ effectiveness to set the agenda for disseminating constructive messages. It explores obstacles reporters and editors encounter when covering a sensitive issue like domestic violence for the online news platform. By drawing on information from 2324 domestic violence articles in three most-accessed Australian online news sites, and interviews with 12 reporters and editors, this article details how these challenges are best overcome. Content analysis and interview results indicate reporters and editors have made efforts to increase constructive coverage, which continues to remain episodic and lacks meaningful context that helps tackle social factors leading to the abuse. Because much of the domestic violence reporting focusses on murders, reporters and editors are restricted by legal guidelines as to how much context and detail they can provide. Through eight specific guidelines, this study provides insights into how the obstacles can be overcome to improve the coverage. It suggests future research areas which could investigate how a more constructive reportage cognisant of victims’ suffering could be achieved.

Strengthening protection of endemic wildlife threatened by the international pet trade: The case of the Australian shingleback lizard

AbstractUnsustainable wildlife trade threatens an increasing number of species globally. Australia has a particularly rich and endemic herpetofauna, which is coveted on the international pet market. While Australia implements domestic protection of most of its native species, there is little to no regulation of international trade once live animals have been smuggled out of the country. This is a threat for a variety of rare, unique and/or range‐restricted species, subspecies and locality morphs. One of these species is the shingleback lizard (Tiliqua rugosa).We compiled Australian seizure data and international online trade data pertaining to shinglebacks. We found all four subspecies in trade across Asia, Europe and North America. Here we provide evidence that all four shingleback subspecies are illegally extracted from the wild in Australia and smuggled to international destinations, where they are sold and distributed globally.While shinglebacks are a protected species in Australia and can only be exported legally under a federal permit, their import into, and trade between, other countries is often not illegal, even in the absence of such a permit. These contradictory legal frameworks apply to the majority of nationally protected native fauna and must be addressed by each importing country on an individual basis; that is, by changing their legislation to cover and protect species that are nationally protected in their native range. Meanwhile, however, we argue that listingT. rugosain Appendix III of the Convention on International Trade in Endangered Species of Wild Fauna and Flora is a meaningful way to provide other countries with the legal means to confiscate illegally exported shinglebacks from Australia. Our findings and recommendations are directly relevant for potential future Appendix III consideration of other nationally protected species that are found in international trade.

Pregnant women report being denied medications to treat severe nausea and vomiting of pregnancy or hyperemesis gravidarum – findings from an Australian online survey

We conducted an online survey of 249 Australian women who currently or previously experienced severe nausea and vomiting of pregnancy (NVP) or hyperemesis gravidarum (HG) and examined their experiences in being denied medications during pregnancy. One in four women reported being denied medications for NVP/HG, which most commonly involved doxylamine and encounters with community pharmacists. Women's experiences reflected that lack of awareness of guidelines and unfavourable risk-benefit assessments appeared to be key barriers to facilitating medication access. Approaches towards identifying and effectively addressing barriers to the provision of effective treatments for severe NVP and HG are urgently needed.

The Functional Assessment of Cancer Therapy Eight Dimension (FACT-8D), a Multi-Attribute Utility Instrument Derived From the Cancer-Specific FACT-General (FACT-G) Quality of Life Questionnaire: Development and Australian Value Set

ObjectivesTo develop a cancer-specific multi-attribute utility instrument derived from the Functional Assessment of Cancer Therapy - General (FACT-G) health-related quality of life (HRQL) questionnaire. MethodsWe derived a descriptive system based on a subset of the 27-item FACT-G. Item selection was informed by psychometric analyses of existing FACT-G data (n = 6912) and by patient input (n = 82). We then conducted an online valuation survey, with participants recruited via an Australian general population online panel. A discrete choice experiment (DCE) was used, with attributes being the HRQL dimensions of the descriptive system and survival duration, and 16 choice-pairs per participant. Utility decrements were estimated with conditional logit and mixed logit modeling. ResultsEight HRQL dimensions were included in the descriptive system: pain, fatigue, nausea, sleep, work, social support, sadness, and future health worry; each with 5 levels. Of 1737 panel members who accessed the valuation survey, 1644 (95%) completed 1 or more DCE choice-pairs and were included in analyses. Utility decrements were generally monotonic; within each dimension, poorer HRQL levels generally had larger utility decrements. The largest utility decrements were for the highest levels of pain (-0.40) and nausea (-0.28). The worst health state had a utility of -0.54, considerably worse than dead. ConclusionsA descriptive system and preference-based scoring approach were developed for the FACT-8D, a new cancer-specific multi-attribute utility instrument derived from the FACT-G. The Australian value set is the first of a series of country-specific value sets planned that can facilitate cost-utility analyses based on items from the FACT-G and related FACIT questionnaires containing FACT-G items.

Mobilizing extremism online: comparing Australian and Canadian right-wing extremist groups on Facebook

ABSTRACT Right-wing extremist groups harness popular social media platforms to accrue and mobilize followers. In recent years, researchers have examined the various themes and narratives espoused by extremist groups in the United States and Europe, and how these themes and narratives are employed to mobilize their followings on social media. Little, however, is comparatively known about how such efforts unfold within and between right-wing extremist groups in Australia and Canada. In this study, we conducted a cross-national comparative analysis of over eight years of online content found on 59 Australian and Canadian right-wing group pages on Facebook. Here we assessed the level of active and passive user engagement with posts and identified certain themes and narratives that generated the most user engagement. Overall, a number of ideological and behavioral commonalities and differences emerged in regard to patterns of active and passive user engagement, and the character of three prevailing themes: methods of violence, and references to national and racial identities. The results highlight the influence of both the national and transnational context in negotiating which themes and narratives resonate with Australian and Canadian right-wing online communities, and the multi-dimensional nature of right-wing user engagement and social mobilization on social media.

“I Suspect That the Pictures Are Stolen”: Romance Fraud, Identity Crime, and Responding to Suspicions of Inauthentic Identities

Romance fraud impacts the lives of thousands of people globally. Financial losses exceed millions of dollars each year and are steadily increasing annually. It occurs when an offender uses the guise of an intimate relationship to gain a financial advantage. Offenders use a variety of platforms and communications methods to target victims and develop the required trust and rapport to defraud them. As part of this process, offenders use false identities. This can be through the misappropriation of a genuine person’s identity, or it can be through the stealing of photos and other images of a genuine person to create a false or fictitious identity. In this way, romance fraud encompasses two categories of victims: those who lose money through a relationship and those who are subject to identity crime by romance fraud offenders. This article examines how individuals responded to suspicions of inauthentic identities to a person they were communicating with online. It uses romance fraud complaints lodged with Scamwatch (an Australian online fraud porting portal) between July 2018 and July 2019 (inclusive). The qualitative analysis indicates that many complainants used an internet search to verify or refute their suspicions about their partner. This yielded substantiated results in many cases and confirmed that the offender’s identity was not genuine. The article explores the implications for this victim-based detection strategy. In doing this, it argues that while effective for romance fraud victims, responses can further exacerbate the ongoing harms experienced by those whose identities have been compromised by romance fraud offenders. The article concludes with a discussion about the future effectiveness of internet searches to reduce romance fraud and the impact of this strategy on third parties whose identities are compromised by offenders.

The non-government alcohol and other drug workforce in Australia: Findings from a national survey.

There is growing interest in the role of the non-government sector in the alcohol and other drug (AOD) service delivery system. This study examined the demographic profile of AOD workers in the non-government (NGO) compared to government sector, to ascertain their professional development needs, job satisfaction, retention and turnover. This study utilised cross-sectional data from an Australian AOD workforce online survey that assessed participants' demographics, employment profile, professional development needs and barriers. The sample comprised 888 workers in direct client service roles. Binomial logistic regression analysis indicated that NGO workers were more likely to be younger (<35 years), have AOD lived experience and have an AOD vocational qualification. NGO workers were more likely to earn below the national average salary and report job insecurity; but nonetheless were more likely to feel respected and supported at work, believe their work was meaningful and be satisfied working in the AOD sector. Their top professional development barrier was personal financial cost. NGO workers were more likely to report employer financial costs as a professional development barrier, whereas government workers were more likely to report staff shortages. AOD services in Australia rely increasingly on the NGO sector. Quality services and care pivot on the size, capability and maturity of the workforce. This study highlights the need for systemic interventions addressing structural issues, and the professional development and ongoing support needs of the NGO AOD workforce. Without such support, Australia's AOD services will be potentially jeopardised.

Public Preferences for Allocating Ventilators in an Intensive Care Unit: A Discrete Choice Experiment

Background and ObjectiveDuring the COVID-19 pandemic, resources in intensive care units (ICUs) have the potential to be inadequate to treat all those who might benefit. Therefore, it is paramount to identify the views of the community regarding how to allocate such resources. This study aims to quantify Australian community preferences for ventilation allocation.MethodsA discrete choice experiment was designed and administrated to an adult Australian online panel. Each survey respondent answered 12 choice sets from a total design of 120. Each choice set placed the respondent in the role of hypothetical decision maker, prioritising care between two patients. Conditional logit, mixed logit regression and latent class analysis were used to analyse the data. Additionally, we asked a series of attitudinal questions about different methods of making such decisions in practice, focusing on who should be responsible.ResultsA total of 1050 community members completed the survey and responded to each choice. Dimensions considered most important were age, likely effectiveness, smoking status, whether the person has dependents, whether they are a healthcare worker, and whether they have a disability or not. Estimating marginal rates of substitution between patient characteristics and chance of survival if ventilated yielded values of up to 30 percentage points if the patient was 70 years old relative to being 30. However, respondents typically said they would prefer such decisions to be made by medical professionals.ConclusionThis study demonstrated the preferences of the community to allocation of ventilators during the COVID-19 pandemic. The use of such information should be treated with some caution as the underlying reason for such preferences are unclear, and respondents themselves preferred the decision to be made by others.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40271-021-00498-z.

'I know you shouldn't compare to other people, but I can't do anything most people can': Age, family and occupation categorisations in men's reasoning about their anxiety in an online discussion forum.

Despite its prevalence, men's anxiety is arguably under-researched and poorly understood. The present study explores the reasoning provided by male posters to an online discussion forum about the source of their anxiety. Posts were collected from an Australian anxiety online discussion forum. This study utilises discursive psychology, informed by principles of membership categorisation analysis, to describe how age, occupation and family-related identities can be invoked within common sense reasoning about the source of male anxiety. References to various identity categories were routinely employed by male forum posters in their representations of themselves, in order to describe the source of their anxiety in terms of a contrast between how they are, and how they should be. In examining accounts of anxiety and responses to those accounts, we can trace cultural knowledge about issues regarding men, masculinity and anxiety that those accounts make relevant. Findings illustrate how men's descriptions of the source of their anxiety should be understood as culturally bound and related to expectations and obligations associated with their social context and category memberships. By enhancing understandings of how men describe the source of their anxiety, this study offers insight into improving the identification and engagement of men experiencing anxiety in health services.

Examining untreated and treated alcohol problem resolution in an Australian online survey sample

While treatment is an effective way to resolve alcohol problems, many people resolve their alcohol problems in the absence of treatment. Just how many do so is not known and may vary based on the definition of treatment. Various estimates of untreated alcohol problem resolution were calculated in this study, and the differences between people who resolve their alcohol problems with or without treatment were explored in relation to sociodemographic variables, levels of alcohol consumption in the past 12 months and lifetime alcohol problem severity. A cross-sectional online survey was administered to 719 people who had resolved an alcohol problem in Australia. Convenience sampling was used through a recruitment strategy targeted towards the general population via Facebook. Almost half (49.8%) of all people who resolved their alcohol problem did so in the absence of alcohol treatment, whether specialist alcohol treatment, mutual-aid services or digital support services. When accessing mental health treatment is included under the scope of 'treatment', this estimate dropped to 12.8%. The estimated odds of having accessed treatment increased with age and lifetime alcohol problem severity. Other sociodemographic variables, or levels of alcohol consumption in the past 12 months, were not significantly associated with treatment status. It might be beneficial to expand the scope of 'treatment' to include mental health services and focus on the development of cost-effective and less intrusive standalone activities, which can expedite and support alcohol problem resolution for those who choose not to access specialist treatment.

Mapping national news reports on COVID-19 in Australia: Topics, sources, and imagined audiences

News media across the world have played an important role in contributing to public discourse about the COVID-19 pandemic, including the actions being taken by governments to prevent and contain its spread and the role of citizens in the public health response. In this chapter, we analyse news reporting on the pandemic in The Australian newspaper and ABC News Online in Australia between February and August 2020. Our constructed week sampling approach examined news reports across 24 days with particular attention to the topics and sources included in the coverage and the ways in which audiences were addressed in the stories. Conceptually, we take as our starting point Briggs and Hallin’s framework of ‘biomediatisation’ and three predominant models of ‘biocommunicability’ that they identify in health news: biomedical authority, patient-consumer and public sphere. These models variously position social actors in active or passive roles in relation to the flow of health information. Our analysis explores the presence of these models in news coverage of the COVID-19 pandemic and whether or not adaptations or new models are better suited to capture some of the particular characteristics of this profoundly mediatised pandemic.

The Australian digital Online Farm Trials database increases the quality of systematic reviews and meta-analyses in grains crop research

Synthesis and analysis of past cropping research can provide valuable information to direct future decisions around crop management. Systematic reviews and meta-analyses are considered gold standards in the synthesis and analysis of scientific research because they distil large amounts of information about complex issues, provide a summary of knowledge to date, and identify knowledge gaps. However, several issues concerning the methodologies employed to conduct systematic reviews have been identified; among them is the risk of publication bias when a review relies too heavily on ‘white’ literature from published academic sources and in so doing fails identify relevant ‘grey’ literature. Grey literature is inherently difficult to identify and collect, but forms a large portion of information available in many fields including agricultural-based research within Australia. The Online Farm Trials (OFT) database is a digital database of crop research field trial data from across Australia that has the potential for use as a discipline-specific source of grey literature to inform systematic reviews and meta-analyses. Using a case study approach to investigate the amount of information available on time of sowing (sowing date) on crop yield across Australia, we demonstrate that the OFT database provides easy access to transparent and reproducible search results similar to other commonly used academic databases.

Systematic review and content analysis of Australian health care substitute decision making online resources.

Objective Substitute decision makers (SDMs) can be required to make difficult health care decisions on behalf of individuals lacking decision-making capacity. Online resources may be helpful in preparing and supporting SDMs. This study systematically explored the frequency, content and usability of Australian online resources containing health care substitute decision-making content written for consumers. Methods In April 2019, Google searches were conducted to identify online resources containing health care substitute decision-making content for consumers. Analysis comprised mapping resource characteristics, including target audience (individual-specific, SDM-specific, mixed) and thematic analysis of content. Usability was assessed using the Patient Education Materials Assessment Tool (PEMAT). Results Of the 61 resources identified, the most frequent were webpages (57%), individual-specific (43%) and those produced by government organisations (31%). Only 15 resources (24%) were written for SDMs. Content themes identified were: defining the scope of the SDM role (93%); recommended traits or characteristics of SDMs (80%); instructions or principles regarding standards for decision making (75%); duties of SDMs (70%); and supports (46%), rights (16%), barriers (8%) and benefits (5%) for SDMs. The median (interquartile range) PEMAT scores (out of 100) were 66 (27) for understandability and 60 (55) for actionability. Conclusions SDMs have a vital role in making decisions for people lacking decision-making capacity. Online resources are a potential source of information and support for SDMs in Australia. This study identified key gaps in availability, content and usability of existing SDM resources, highlighting the need for the further development of such resources. We suggest that future resource development include SDMs in the design and evaluation processes. What is known about the topic? An aging population and a greater need for decisions to be made on behalf of others who lack capacity means that health care substitute decision-making is occurring more frequently. Appointing one or more SDMs may occur as part of the advance care planning process. However, being a healthcare SDM can be difficult and stressful. People frequently use the Internet to search for health-related information. What does this paper add? This paper systematically examined the frequency, content and usability of existing Australian online resources with substitute decision-making content written for a consumer audience in English, and identified key gaps in online resources available to support SDMs. What are the implications for practitioners? Although there is a need for resources written for SDMs, authors of online resources need to pay careful attention to the purpose, content and usability of their resource. Future resource development should include input from SDMs and involve them in evaluation to assess whether the resources meet target audience needs.

Supplemental Material for Patterns and Correlates of Consumer Protection Tool Use by Australian Online Gambling Customers

Supplemental Material for Patterns and Correlates of Consumer Protection Tool Use by Australian Online Gambling Customers

On a Wing and a Prayer! An Exploration of Students’ Experiences of External Supervision

Abstract Field education is a core component of social work courses globally and has been recognised as providing significant learning opportunities to develop professional practice. Evidence highlights the strong correlation between student satisfaction with their supervisory relationship and their satisfaction with placement, but current practices have resulted in more reliance on placements with a variety of supervisory arrangements, which may be compromising a quality and supportive supervisory relationship. This article reports on an Australian online survey of 284 social work students about their experience of supervision, focusing on 119 students who received external supervision. Both quantitative ratings and qualitative comments showed that students generally described their external supervision as valuable and offered space to reflect critically on practice. Nevertheless, many felt disadvantaged without a social work presence onsite and not being observed or observing social work practice. Concerns were raised about task supervisors who offered supervision ‘on the run’ and had limited understanding of social work roles and values. Many students struggled on placement and felt that, once placement was confirmed, they received minimal support from University staff. Findings should alert field education programmes that students require consistent and ongoing involvement.

Negotiating Gendered Religious Space: Australian Muslim Women and the Mosque

Women’s presence and role in contemporary mosques in Western countries is contested within and outside Muslim communities, but research on this topic is limited and only a few studies consider women’s roles inside mosques in Australia. There is a complex intersection of gender and religion in public sacred spaces in all religious communities, including Muslim communities. Women’s role in these spaces has often been restricted. They are largely invisible in both public sacred spaces and in public rituals such as congregational prayers. Applying a feminist lens to religion and gender, this article explores how a mosque as a socially constructed space can both enable and restrict Australian Muslim women’s religious identity, participation, belonging and activism. Based on written online qualitative interviews with twenty Muslim women members of three Australian Muslim online Facebook groups, this article analyses the women’s experiences with their local mosques as well as their views on gender segregation.

Treatment Burden for Pediatric Eosinophilic Esophagitis: A Cross-Sectional Survey of Carers.

To investigate treatment burden and impact on health-related quality of life (HRQoL) for children with eosinophilic esophagitis (EoE) and their carers. An Australian cross-sectional online survey of carers of children aged 18 years and under with EoE between September 2018 to February 2019. Of 181 complete responses, more than half of carers experienced reduced HRQoL since their child's diagnosis. Reported mean out-of-pocket expenditure for healthcare utilization (practitioner visits and treatment) was AUD$3064.3 annually. Backwards stepwise linear regression models showed that reduced ability to manage on income and missing more than one workday in the previous 30 days were significant predictors of lower carer HRQoL. Ability to manage on the current income described as "difficult some of the time," "difficult all of the time," and "impossible" were associated with lower child HRQoL. When compared with EoE diagnosis between 13 and 23 months of age, diagnosis between 2 and 4 years was a significant predictor of lowered child HRQoL. Pediatric EoE in Australia leads to high treatment burden for carers. Changes in carer employment and income manageability can negatively impact carer psychosocial wellbeing. Carers of children with EoE need to be informed about available financial and social support to reduce treatment-related burden and improve the quality of life of both the carer and child.