Australian Survey Research Articles

Perspectives on oral benzodiazepine use for anxiety in Mohs micrographic surgery: A response to the Australian survey.

This letter responds to the recent Australian survey by Harris and Lee (Australas J Dermatol, 2024, doi: 10.1111/ajd.14361) on the use of oral benzodiazepines for anxiety management in Mohs micrographic surgery (MMS). While commending the authors' efforts, we provide additional perspectives on current practices, recent evidence and safety considerations. We highlight the alignment with U.S. practices, discuss a recent randomized controlled trial supporting diazepam's efficacy and emphasize the importance of non-pharmacological interventions. The letter also addresses the need for flumazenil availability and calls for standardized guidelines and further research to optimize patient care in MMS.

A content analysis of illicit tobacco-related crimes reported in Australian media.

Australian survey and seizure data suggest a growing illicit tobacco market. As an illicit product, accurately tracking trends in illicit tobacco growing, manufacture and sales is challenging. We examined trends in Australian illicit tobacco-related crimes using a content analysis of news articles. We analysed Australian news articles identified in the Factiva database and government press releases describing Australian illicit tobacco-related crimes reported between January 2000 and December 2023. Sources were coded for crime type, location, product type, dollar value of seized products, methods of distribution or storage, agencies involved, and other crimes involved. We identified 447 crimes reported in 389 sources. The number of illicit-tobacco related crimes reported increased between 2000 and 2023. The most common crimes were possession of illicit tobacco (n=196/43.7%) and smuggling (n=187/41.8%), and the most common product type was 'illicit cigarettes' (n=197/44.1%). The most common distribution/storage method reported was via residential premises (n=98/21.9%). One-hundred and twenty incidents involved other crimes such as financial crimes involving money laundering (n=59/13.2%). Across all included news articles, the quantity of seized products totalled 827,529,307 cigarette sticks, 76,185 cartons, 668,687 packs, 239 hectares (of land growing tobacco plants), and 2,149,000 plants of illicit tobacco between 2000 and 2023. The median value (worth; AUD) of each seizure was $1,500,000 (range $43 to $67,000,000). Australian media reporting on illicit tobacco-related crimes increased over the past two decades, particularly since 2018. These findings highlight a need for improved border detection measures, investment in enforcement and other deterrent activities. This media analysis confirms trends identified in national survey data that indicate a growing illicit tobacco market in Australia since 2013 with a marked increase since 2018. While survey data suggests that Australian tobacco tax policy, which has included regular large tax increases since 2010, has decreased consumer demand for tobacco overall, it may have also incentivised criminal networks to supply illicit tobacco products due to it being a 'low risk' and 'high reward' activity. Controlling the Australian illicit tobacco market should be a policy priority.

Access and models of obstructive sleep apnea care: a cross-national comparison of Canadian and Australian patient survey data.

To describe similarities and differences in OSA care pathways and their impact on patients in Australia and Canada, including among urban versus rural participants. In this secondary data analysis of patient surveys exploring OSA care in Australia and Canada, we recruited adults with a prior diagnosis of OSA from market research companies, social media, and patient-facing medical associations. Residential postal codes were used to classify participants as urban or rural. Survey domains included wait times and travel distances for care, providers, and treatments. Data from 589 Canadians (21% rural; 42% female, mean [SD] age = 57 [13] years) and 412 Australians (38% rural; 45% female, mean [SD] age = 58 [14] years) with OSA were included. Participants in both countries most commonly sought initial care for suspected OSA from a primary care practitioner. Canadian participants waited longer to seek care than Australian participants (37% vs 51% within 12 months of symptom onset). Wait times for diagnostic testing were longer in Canada (59% vs 76% within 3 months of initial assessment), especially in urban settings (58% vs 78%). In both countries, >80% of participants were offered positive airway pressure (PAP) therapy. Overall, a greater variety of treatments were offered and used by Australian participants. Greater access to diagnostic testing and a greater variety of treatments were found in Australia compared to Canada. Further research is needed to determine if reduced diagnostic wait times and presentation of increased therapy options found in Australia translate into better patient outcomes.

Evaluation of the 'A walk can work wonders' mass media campaign in South Australia.

Few population-wide efforts have targeted physical activity in Australia. Mass media campaigns are used to promote physical activity and walking, and World Health Organisation recommends their linkage to broader cross-government initiatives. This project evaluates a South Australian (SA) walking mass media campaign linked to the overall SA Walking Strategy. Between January and June 2022, Wellbeing SA (a SA government agency) conducted two waves of a mass media campaign, 'A walk can work wonders', to promote walking. The campaign was part of the SA Walking Strategy, targeting the goal to change the 'community culture towards recognising walking' as convenient, affordable and health-promoting. Evaluation was formative (pre-campaign), process (campaign implementation and delivery) and impact. Formative evaluation comprised concept and tagline testing with adult SAs to develop the campaign messages and theme. Process evaluation was comprised of media monitoring of social media, mainstream media and other media monitoring metrics. The process evaluation was dominated by social media marketing in Wave 1, with substantially more paid TV media and radio in Wave 2. The impact evaluation comprised two independent sample surveys of adult SAs (n = 800 each) following each wave of the campaign. Measures included generic and prompted campaign recall and attitudes to physical activity. An independent South Australian Population Health Survey (SAPHS) tracked walking and physical activity behaviours from 2021 to the end of 2022. Process evaluation showed intensive social media usage in Wave 1, and through increased paid television and radio in Wave 2. Generic recall of any walking message (23.9%) and prompted recall of the specific campaign message (27.8%) reached most socio-demographic groups, especially those with chronic health problems. Increases in intention to increase activity and increased self-reported activity were seen between the campaign Wave 1 and Wave 2 notable as the Wave 2 increase followed substantial television advertising. The SAPHS data showed increased population walking following the campaign waves, compared to the same period in 2021. Detailed and structured evaluation of a comprehensive mass media campaign showed good reach, and population changes in intentions and walking behaviour amongst SAs. SO WHAT?: It is likely that comprehensive approaches are needed to support mass media campaigns and amplify their effects. Serial, sustained campaigns are needed to monitor ongoing effects.

The triangular relationship in platform gig work: Consumers, platform beneficence and worker vulnerability

AbstractPlatform gig work is created and contested in dynamic, triangular relationships between platforms, workers, and consumers. Compared with the first two groups, however, evidence about the role of the third—consumers—is sparse. In this paper, we investigate consumers' changing perceptions of work in the platform gig economy and argue that their perspective warrants greater attention in sociological analyses. Using data from two Australian public opinion surveys conducted 5 years apart (2017 and 2022), we explore how consumers' views of platform gig work evolved during a period of rapid change that includes the first 2 years of the COVID‐19 pandemic. We find that while overall platform use increased markedly, many consumers felt conflicted about gig workers' conditions and key features of platforms' typical labour practices. There is a pronounced, enduring, and consequential tension in consumers' views of the merits and drawbacks of this work; between, on the one hand, an acceptance that platforms do benefit workers to some extent and, on the other hand, misgivings about workers' vulnerability to harm. In centring consumers, our paper empirically enriches current triangular conceptions of labour relations in the platform gig economy, by showing how consumers mediate the interests of platforms and workers, to shape how gig work manifests and who benefits from it. We also contribute useful new practical knowledge, by elucidating the prevailing concerns of consumers that could be developed into resonant themes for campaigns aimed at improving platform gig workers' rights.

Cohort profile: Understanding the influence of early life environments and health and social service system contacts over time and across generations through the Western Australian Aboriginal Child Health Survey (WAACHS) Linked Data Study

PurposeDespite the volume of accumulating knowledge from prospective Aboriginal cohort studies, longitudinal data describing developmental trajectories in health and well-being is limited. The linkage of child and carer cohorts from...

Associations between weight self-stigma and healthy diet and physical activity among adults with type 2 diabetes:Cross-sectional results from the second Diabetes MILES - Australia (MILES-2) study.

To examine associations between weight self-stigma and healthy diet or physical activity, and potential moderating effects of self-esteem, diabetes self-efficacy, and diabetes social support, among adults with type 2 diabetes. Diabetes MILES-2 data were used, an Australian cross-sectional online survey. Participants with type 2 diabetes who considered themselves overweight, and reported concern about weight management (N = 726; 48% insulin-treated), completed the Weight Self-Stigma Questionnaire (WSSQ; total score and subscales: self-devaluation, fear of enacted stigma), measures of diabetes self-care (diet, exercise), and hypothesised psychosocial moderators (self-esteem, diabetes self-efficacy, and diabetes social support). Adjusted linear regression tested associations and interaction effects, separately by insulin treatment status. Greater weight self-stigma (WSSQ total) was associated with less optimal dietary self-care (both groups: β = -0.3), and with a lower level of exercise (non-insulin only: β = -0.2; all p < 0.001). All hypothesised moderators were negatively associated with weight self-stigma (range r = -0.2 to r = -0.5). Positive associations were identified between the hypothesised moderators and self-care behaviours (strongest between diet and diabetes self-efficacy, r = > 0.5). No significant interaction effects were observed. This study provides novel evidence of negative associations between weight self-stigma and self-care behaviours among adults with type 2 diabetes. Weight self-stigma is a demonstrated barrier to self-care behaviours in type 2 diabetes cohorts. Acknowledgement and strategies to address weight self-stigma are needed in clinical care and health programmes.

Eating frequency, timing of meals, and sleep duration before and after a randomized controlled weight loss trial for breast cancer survivors.

To examine eating frequency, timing of meals, and sleep duration before and after a weight loss intervention for breast cancer survivors. Female breast cancer survivors (n = 159; 55 ± 9years; 31.4 ± 5.0 kg/m2; stage I-III, median [IQR] 9.5 [5.5] months post-diagnosis) participated in a randomized controlled trial of a 12-month weight loss intervention versus usual care. Eating frequency, proportion of daily calories consumed after 5 PM, eating after 8 PM, nightly fasting duration, and sleep duration were estimated and categorized based on existing associations with factors influencing breast cancer prognosis and breast cancer outcomes. These behaviors at baseline were compared to women from an Australian national survey with similar age and BMI range. Mixed-effects linear regression models were used to examine the changes in health behaviors from baseline to 18months between intervention and usual care groups. Before the trial, eating after 8 PM (67%) was higher, and short nightly fasting duration (< 13h, 83%) and long sleep duration (> 9h/day, 26%) were marginally higher, in breast cancer survivors than women in the national survey (52%, 75%, and 17%, respectively). "Less optimal" eating behaviors and sleep duration tended to co-occur. Behaviors remained unchanged over the 18-month follow-up, irrespective of the study group (p > 0.05; Cohen's effect sizes < 0.3). Later timing of eating and long sleep duration were prevalent in breast cancer survivors and continued following a weight loss intervention. Future multi-behavior interventions in breast cancer survivors should consider specific messages to target eating timing behaviors and sleep.

The Australian Music Students Health Survey: impact of past experience on student attitudes to health education

Abstract Widespread research over four decades has shown that musicians suffer physical and psychological injuries that can begin during childhood and early adulthood. A survey of 268 Australian tertiary music students revealed their perceptions of the importance of health education as part of their education. While students rated health knowledge as highly important, they considered its inclusion in their education to be less significant. Thirty-six percent reported current physical pain or injury, and 41% reported current psychological health issues. Significant correlations emerged between students’ reported injury history and prioritisation of health education and particular health topics. This has implications for tertiary music education providers regarding policies for the integration of health education into the curriculum.

Differences in LGBTQ young people’s mental health, wellbeing, and community involvement by residential location

ABSTRACT Residential location can significantly impact the mental health, wellbeing, and community involvement of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) young people. While research has explored geographical differences in LGBTQ adult wellbeing, limited knowledge exists regarding LGBTQ young people’s experiences. Using a large Australian cross-sectional survey of 6,620 LGBTQ individuals aged 14–21, this study examined the associations between residential location and wellbeing outcomes. Findings revealed that LGBTQ young people in rural and remote areas reported higher levels of psychological distress. Cisgender young people in rural areas experienced more verbal and physical harassment, while those in inner-suburban areas faced increased sexual harassment. Participants were also particularly vulnerable to experiencing homelessness when living in regional towns and rural and remote areas. Trans young people were more likely to attend LGBTQ events in inner-suburban areas. These results emphasize the need for policy changes to foster diversity and inclusion in rural areas, along with targeted support services to enhance the mental health and wellbeing of LGBTQ young people. Understanding the unique experiences of LGBTQ young people across different residential locations is vital, calling for tailored interventions and support in all settings.

The use of oral benzodiazepines for patient anxiety associated with Mohs micrographic surgery: An Australian survey.

A survey of Mohs surgery specialists in Australia showed diazepam was the preferred agent and felt to be the safest oral benzodiazepine for perioperative anxiolysis.

Measuring health literacy to inform actions to address health inequities: a cluster analysis approach based on the Australian national health literacy survey.

Measuring health literacy can inform interventions to address health inequities. This study used cluster analysis to examine health literacy data to determine if it can provide more insightful information than standard descriptive analysis to better inform intervention development. Using data from the Australian National Health Survey (2018), this study compared descriptive analysis and cluster analysis results of two states-New South Wales (NSW) and Victoria-generated from the Health Literacy Questionnaire (HLQ). Based on the nine scale scores of the HLQ, a hierarchical cluster analysis using Ward's method for linkage was undertaken. The number of NSW and Victoria respondents was 1018 and 923, respectively. The nine HLQ scale full sample mean scores from both states were similar. However, the cluster analyses identified 11 clusters for NSW and 12 clusters for Victoria. While six clusters from each state presented similar health literacy patterns, five and six clusters from NSW and Victoria, respectively, displayed unique health literacy patterns. The results demonstrate that descriptive analysis only provides an overview and may lead to one-size-fits-all interventions. The varying health literacy patterns among subgroups resulting from the cluster analysis pave the way to inform tailored actions to improve health equity.

Sheep producers report docking tails shorter than recommended, knowledge–practice gap, and inconsistent length descriptions: an Australian survey

Sheep producers report docking tails shorter than recommended, knowledge–practice gap, and inconsistent length descriptions: an Australian survey

Public Perceptions of the Australian Health System During COVID-19: Findings From a 2021 Survey Compared to Four Previous Surveys.

This study examines the perceptions of the Australian public canvassed in 2021 during the COVID-19 pandemic about their health system compared to four previous surveys (2008, 2010, 2012 and 2018). In 2021, a nationwide online survey was conducted with a representative sample of Australians (N = 5100) recruited via market research panels. The results were compared to previous nationwide Australian survey samples from 2018 (N = 1024), 2012 (N = 1200), 2010 (N = 1201) and 2008 (N = 1146). The survey included questions consistent with previous polls regarding self-reported health status and overall opinions of, and confidence in, the Australian health system. There was an increase in the proportion of respondents reporting positive perceptions at each survey between 2008 and 2021, with a significantly higher proportion of respondents expressing a more positive view of the Australian healthcare system in 2021 compared to previous years (χ2(8, N = 9645) = 487.63, p < 0.001). In 2021, over two-thirds of respondents (n = 3949/5100, 77.4%) reported that following the COVID-19 pandemic, their confidence in the Australian healthcare system had either remained the same (n = 2433/5100, 47.7%) or increased (n = 1516/5100, 29.7%). Overall, respondents living in regional or remote regions, younger Australians (< 45 years) and women held less positive views in relation to the system. In 2021, the most frequently identified area for urgent improvement was the need for more healthcare workers (n = 1350/3576, 37.8%), an area of concern particularly for Australians residing in regional or remote areas (n = 590/1385, 42.6%). Irrespective of disruptions to the Australian healthcare system caused by the COVID-19 pandemic, Australians' perceptions of their healthcare system were positive in 2021. However, concerns were raised about inadequate workforce capacity and the cost of healthcare, with differences identified by age groups and geographical location. Health consumer representatives from the Consumers Health Forum of Australia contributed to the co-design, deployment, analysis and interpretation of the results of this survey. J.A. and L.W. from the Consumers Health Forum of Australia contributed to the development of the paper.

Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey.

Background Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16-29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results Aboriginal and Torres Strait Islander (n =231) and non-Indigenous (n =2062) respondents reported similar condom use (40% vs 43%, P =0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P =0.002), STIs (60% vs 49%, P P =0.006) testing, STI diagnosis (29% vs 21%, P =0.042), and intoxication during last sex (30% vs 18%, P Conclusions Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.

Barriers Experienced by Community-Dwelling Older Adults Navigating Formal Care: Evidence From an Australian Population-Based National Survey.

This study aims to identify the relationship between psychosocial factors and unmet needs among community-dwelling older adults who have received or who expect to receive formal home-based aged care services. A subsample of the national Survey of Disability, Ageing and Carers was used to examine the prevalence of having any unmet needs among older adults navigating care. We also examined associations between older adults' psychosocial factors and their unmet needs using logistic regression. Regression analyses highlighted that perceived social isolation (OR = 1.62, 95% CI: 1.30-2.01), high/very high psychological distress (OR = 2.11, 95% CI: 1.52-2.93), and occasional assistance from informal support (OR = 1.92, 95% CI: 1.22-3.05) were associated with increased odds of having unmet needs, after adjusting for other covariates. Our study suggests that older adults facing psychosocial difficulties or lacking informal support are more likely to encounter barriers in accessing formal care. Future policy should address the psychosocial needs and support networks of older adults.

Mental health and wellbeing outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia

Background Gender affirmation is known to improve mental health among trans adults, but its impact on young people has been questioned. This study examined the mental health outcomes associated with social, medical, and legal gender affirmation among trans young people in Australia. Methods Data from 1697 trans young people aged 14–21 who participated in an Australian national survey were analyzed using multivariable logistic regression analyses. We measured associations between gender affirmation and various mental health variables, including levels of happiness, psychological distress, anxiety, self-harm and recent suicidal ideation and suicide attempts. Associations between gender affirmation and young people’s wellbeing, including experiences of verbal harassment, homelessness, and drug use were also examined. Results Participants who had affirmed their gender legally and medically (via hormone therapy or surgery/ies) reported lower levels of anxiety and psychological distress, while legal gender affirmation was associated with lower suicidal ideation. Social affirmation was not directly associated with wellbeing outcomes but was linked to an increased likelihood of verbal harassment and homelessness. All forms of gender affirmation were associated with increased drug use, which likely reflects the greater opportunities for social connection and LGBTQ-community involvement that trans young people experience when they take steps to affirm their gender. Conclusion All forms of gender affirmation were positively associated with the wellbeing of trans young people. Though young people who had socially affirmed their gender faced higher likelihoods of experiencing verbal harassment and homelessness, this is likely linked to their increased visibility and subsequent vulnerability to discrimination. These findings highlight the need for targeted interventions to address transphobia and discrimination. A comprehensive approach to supporting the wellbeing of trans young people should include legal, medical, and social affirmation, as well as addressing potential negative outcomes via societal education.

An Australian survey of health professionals' perceptions of use and usefulness of electronic medical records in hospitalised children's pain care.

Pain in hospitalised children is common, yet inadequately treated. Electronic medical records (EMRs) can improve care quality and outcomes during hospitalisation. Little is known about how clinicians use EMRs in caring for children with pain. This national cross-sectional survey examined the perceptions of clinician-EMR users about current and potential use of EMRs in children's pain care. One hundred and ninety-four clinicians responded (n = 81, 74% nurses; n = 21, 19% doctors; n = 7, 6% other); most used Epic (n = 53/109, 49%) or Cerner (n = 42/109, 38%). Most (n = 84/113, 74%) agreed EMRs supported their initiation of pharmacological pain interventions. Fewer agreed EMRs supported initiation of physical (n = 49/113, 43%) or psychological interventions (n = 41/111, 37%). Forty-four percent reported their EMR had prompt reminders for pain care. Prompts were perceived as useful (n = 40/51, 78%). Most agreed EMRs supported pain care provision (n = 94/110, 85%) and documentation (n = 99/111, 89%). Only 39% (n = 40/102) agreed EMRs improved pain treatment, and 31% (n = 32/103) agreed EMRs improved how they involve children and families in pain care. Findings provide recommendations for EMR designs that support clinicians' understanding of the multidimensionality of children's pain and drive comprehensive assessments and treatments. This contribution will inform future translational research on harnessing technology to support child and family partnerships in care.

The relationship between health behaviors and quality of life: the mediating roles of activities of daily living and psychological distress.

The aim of this study is to examine the role of activities of daily living performance (ADLs) and psychological distress in mediating the process by which health behaviors affect QOL. A non-probabilistic study was conducted among 1,065 older adult people older than 60 years. Participants were assessed using the Barthel Index, Functional Activities Questionnaire (FAQ), Kessler Psychological Distress Scale (K10), Australian Active Survey, and EQ-VAS score. The SPSS22.0 software was used to analyze the differences in QOL scores among older adults with different demographic characteristics. Pearson correlation analysis was used to analyze the correlation between health behaviors, psychological distress, ADLs, and QOL. Amos23.0 software was used to construct structural equation model (SEM) to analyze the path of health behavior affecting QOL and the mediating role of BADLs, IADLs and psychological distress. (1) The direct effect of health behaviors on QOL was not significant in the model; (2) ADLs had multiple mediating effects on the relationship between health behaviors and QOL, and the incidence of ADL limitation was negatively correlated with the reported QOL in the older adult; (3) Psychological distress had a significant mediating effect on the relationship between health behaviors and QOL. The results of this study elucidated the mechanisms of the correlation between health behaviors and QOL, and added to the existing literature. In addition, these mediating factors and indirect pathways have been identified as targets for intervention to improve the QOL of older adult individuals, which is important for achieving healthy aging.

OzDES reverberation mapping program: Stacking analysis with Hβ, Mg ii and C iv

Abstract Reverberation mapping is the leading technique used to measure direct black hole masses outside of the local Universe. Additionally, reverberation measurements calibrate secondary mass-scaling relations used to estimate single-epoch virial black hole masses. The Australian Dark Energy Survey (OzDES) conducted one of the first multi-object reverberation mapping surveys, monitoring 735 AGN up to z ∼ 4, over 6 years. The limited temporal coverage of the OzDES data has hindered recovery of individual measurements for some classes of sources, particularly those with shorter reverberation lags or lags that fall within campaign season gaps. To alleviate this limitation, we perform a stacking analysis of the cross-correlation functions of sources with similar intrinsic properties to recover average composite reverberation lags. This analysis leads to the recovery of average lags in each redshift-luminosity bin across our sample. We present the average lags recovered for the Hβ, Mg ii and C iv samples, as well as multi-line measurements for redshift bins where two lines are accessible. The stacking analysis is consistent with the Radius-Luminosity relations for each line. Our results for the Hβ sample demonstrate that stacking has the potential to improve upon constraints on the R − L relation, which have been derived only from individual source measurements until now.