Experience In Australia Research Articles

"More Than Just Holding the iPad": Family Members' Perspectives on the Work of Video Calling in Aged Care

Video calls are increasingly being adopted to enable older adults living in long-term residential care (aged care homes) to remain socially connected with friends and family. However, care home residents often require extensive support to participate effectively in video calls. Despite growing interest in examining the work involved in facilitating technology use in care homes, the role of caregivers---comprising family members and staff---in facilitating video calls has received limited attention. Drawing on data from a study of family members' experiences in Australia, we analysed the essential work activities required to make video calls function in residential aged care. We show how video calling is underpinned by the development of relationships between families and staff, and how video calling requires considerable work in preparation, facilitation, and troubleshooting. We discuss how video calling systems for care homes might be designed to alleviate unwanted work, lowering the burden of call participation for residents, families, and care staff.

Voluntary versus mandatory food labels, Australia.

To compare uptake of the voluntary Health Star Rating front-of-pack nutrition labelling system with uptake of a mostly mandatory country-of-origin label in Australia over a similar period. We used data on numbers and proportions of products carrying health stars and country-of-origin labelling recorded annually between 2015 and 2023 through surveys of four large Australian food retailers. We determined the proportion of products with health stars and country-of-origin labels for each year by dividing the number of products carrying each label by the total number eligible to carry that label. The uptake of the voluntary Health Star Rating increased steadily between 2014 and 2018, reaching a maximum of 42% (8587/20 286) of products in 2021 before decreasing to 39% (8572/22 147) in 2023. Mandatory country-of-origin labelling uptake rose rapidly and was found on 93% (17 567/18 923) of products in 2023. In categories where country-of-origin labelling was voluntary, uptake by 2023 was 48% (3313/6925). In our 2023 sample of 22 147 products, 11 055 (50%) carried country-of-origin labelling only, 7466 (35%) carried both health star and country-of-origin labelling, 1106 (5%) carried health star labels only and 2520 (11%) carried neither label. The experience with country-of-origin labelling shows that widespread and rapid food labelling change can be achieved when required by law. The Australian government should mandate the Health Star Rating without delay. Australia's experience supports other jurisdictions in implementing mandatory front-of-pack nutrition labelling as well as updates to global guidance to recognize mandatory labelling as best-practice in delivering benefits to consumers.

Capital, labour and currency: book love in the economy of young adult publishing

ABSTRACT This article examines the relationship between emotion, production and sales in the book publishing industry, specifically how ‘book love’ operates in the publication and promotion of Young Adult (YA) titles. Through interviews conducted in 2020–2023, the article examines how commissioning editors, booksellers and associated professionals in Australia experience and use emotion in their production and sale of YA titles. It argues that emotion plays three economic roles in the intersubjective transferral of ‘book love’ through the chain of production, distribution and sales. Australian industry professionals mobilize book love as capital, as labour and as currency in fulfilling the expectations of their roles. This deployment of book love helps titles find their way into the hands of target readers.

Adrift down under: An integrative review of international students’ experiences in Australian higher education including shaping factors

Australia is currently one of the leading destination countries for International Students (IS), ranking third in popularity as a study destination. There is sparse research into the experience of IS including the factors influencing their experience within the Australian higher education system. This integrative review aims to synthesize knowledge on the IS’ experience in Australian higher education, including the factors influencing their experience. The review included 15 qualitative studies, three quantitative studies, three mixed methods studies and two literature reviews. IS perceived their study experience in Australia as challenging. They reported English unproficiency, poor academic performance, lack of academic support, low-quality courses, and work-study imbalance as factors that lead to insufficient learning engagement. IS reported difficulties in adjusting to the culture due to language barrier, negative emotions, and stronger acculturation orientation toward their heritage culture. IS reported the difficulties in establishing rapport with both domestic students, university teachers, and obstacles in building meaningful relationships within the local community as factors hindering the development of rapport with these entities. Despite encountering the challenges, IS have recognised the imperative of seeking avenues to foster connections with their fellow peers, their teachers, and the broader Australian community. They noted that their proactive efforts to connect with others, participation in work integrated learning, engagement in extracurricular activities, and prolonged residency in Australia were influential factors that facilitated opportunities for connectedness. These findings emphasise the significance of fostering networks between international students, domestic peers, university educators, and the Australian community. Such networks facilitate cultural understanding, elevate academic achievements, and contribute to the holistic well-being of students. The findings offer valuable assistance in equipping stakeholders and higher educational institutions with essential insights to effectively support IS and address their needs comprehensively. These insights are significant for global education providers aiming to support IS and cultivate a positive study environment. Further research should explore the experiences of international nursing, medical, and healthcare students, considering their involvement with patients and the healthcare team in the Australian system, potentially influencing their experience.

‘Fire and Rehire’: Four Lessons from Australia

Abstract The practice of firing employees and then rehiring them in their same jobs on inferior conditions and lower wages (‘fire and rehire’) has emerged as a matter of acute political controversy. Its use in the United Kingdom has become even more controversial in the period since the Covid-19 pandemic. A brutal example of the practice was seen in the P&O case, which could be viewed as an example of ‘fire and replace’ as well as ‘fire and rehire’. In March 2022, P&O Ferries summarily dismissed 786 seafarers, setting aside £44 million to meet the anticipated compensation costs arising from its failure to comply with multiple employment law obligations owed to the crew. Approximately 100 of those dismissed were re-engaged on new terms, the remainder replaced by new crew engaged through agencies on inferior terms and conditions. This article addresses what would need to be done to ‘ban’ fire and rehire, and the related practice of fire and replace. It is argued that fire and rehire is a symptom of system failure which will not be addressed by sticking plaster solutions or by an unenforceable code, but by addressing the underlying causes. This means better regulation, treating collective agreements and contracts of employment with greater respect, better procedures for the negotiation of change, and more effective remedies designed to restrain employers from acting unlawfully. In addressing these matters we draw extensively on the experience of Australia where fire and rehire as understood or practised in the United Kingdom is largely unknown.

Transition to work: A qualitative exploration of Australian-trained international dietetic graduates' career trajectories.

Interest in the role of employability in student-dietitian transitions is increasing. However, little is known about the cross-cultural transition-to-work experience of Australian-trained dietetic graduates of international backgrounds, as well as strategies to optimise work-readiness. The present study aimed to explore graduates' career narratives and identify employability capitals that enabled successful transitions to work. A qualitative interpretive approach was employed via a cultural lens. Eighteen participants from five Asian countries who had graduated from an Australian university within 3-15 years, with work experience in Australia or in their respective home countries, took part in in-depth interviews. Thematic analysis was performed, guided by the graduate capitals based approach. Transition-to-work was dynamic and non-linear; four themes and 12 subthemes identified: (1) upon graduation, participants felt ambivalent about their decision to either stay in Australia or return home, influenced by graduate visa restrictions, and individual perceptions of their ability to mobilise cultural strengths to gain employment; (2) to get a foot in the door, participants demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities in Australia and their home countries; (3) regardless of which country they worked, graduates reported struggling with their cross-cultural identities in the workplace; and (4) eventually, these graduates appreciated their ethnic capital, thrived in their work and extended a helping hand to their junior cross-cultural dietitians. Initiatives facilitating connections to the host country and supporting cultural and ethnic capital development, along with ongoing research reviewing employability capital applications, will benefit cross-cultural dietetic graduates and the communities they potentially will serve.

Microbiology of acute bacterial dacryocystitis: a tertiary institutional experience in South Australia

PurposeTo provide a comprehensive microbiological profile of bacterial dacryocystitis in South Australia. By identifying the specific microorganism and antibiotic susceptibility, this study intends to aid ophthalmologists in choosing appropriate empirical antibiotic therapies and development of evidence-based clinical guidelines.MethodA retrospective study was conducted at the Royal Adelaide Hospital (RAH) over five years (2018–2023) of patients with acute dacryocystitis. The study included 43 patients, and data encompassed demographic information, clinical presentation, microbiological analysis, management, and outcomes. Patients with chronic dacryocystitis were excluded.ResultsAmong the 43 patients included in the study (female 28 (65%), mean age: 64 years old), the most common clinical features were pain (74%) and swelling (70%). Organisms were identified in 49% of patients, with the predominant bacteria being Staphylococcus aureus (42%), Streptococcus species (19%), and Escherichia coli (8%). Aggregatibacter species (8%), Morganella morganii (4%), Enterobacter cloaceae (4%), Hafnia alvei (4%), mixed anaerobes (4%), E coliforms (4%) and Pseudomonas aeruginosa (4%) were also identified. The most frequently prescribed empirical antibiotics were amoxicillin-clavulanic acid (50%), flucloxacillin (33%) and cefalexin (18%).ConclusionThe microbiological trends of acute dacryocystitis have largely remained consistent, with a predominance of Gram positive organisms. This is the most recent profile analysis of acute dacryocystitis in South Australia and will help form evidence-based clinical guidelines.

'How Your Spirit Is Travelling'-Understanding First Nations Peoples' Experiences of Living Well with and after Cancer.

As the number of people living with cancer increases, it is important to understand how people can live well with and after cancer. First Nations people diagnosed with cancer in Australia experience survival disparities relating to health service accessibility and a lack of understanding of cultural needs and lived experiences. This study aimed to amplify the voices of First Nations individuals impacted by cancer and advance the development of a culturally informed care pathway. Indigenist research methodology guided the relational and transformative approach of this study. Participants included varied cancer experts, including First Nations people living well with and after cancer, health professionals, researchers, and policy makers. Data were collected through online Yarning circles and analysed according to an inductive thematic approach. The experience of First Nations people living well with and after cancer is inextricably connected with family. The overall themes encompass hope, family, and culture and the four priority areas included the following: strength-based understanding of cancer, cancer information, access to healthcare and support, and holistic cancer services. Respect for culture is interwoven throughout. Models of survivorship care need to integrate family-centred cancer care to holistically support First Nations people throughout and beyond their cancer journey.

A Systemic Review of the “Informed Consent” Process for Aesthetic Cosmetic Surgery Procedures

Informed consent is a foundational component of ethical patient care and may be effectively provided when a competent patient is given pertinent information to make well-informed decisions on their health care. Various studies have considered patients’ experiences with surgery for aesthetic reasons, rather than plastic surgery procedures which are medically warranted for reasons such as restoring form and function. Current empirical discourse on the consenting process, and ultimately how informed patients undergoing cosmetic surgical procedures are, is scant, particularly in Australia. The key aim of this review was to synthesize qualitative and quantitative research which considers the consenting process and the factors which impact on the patient’s decision-making process to undergo invasive cosmetic procedures. Eligible studies were identified via systematic searching across the PubMed and Medline databases; and hand searches were conducted of gray literature databases including university databases and Google Scholar. Reference lists of included studies were also examined for relevant studies. Eligible studies had to meet specific participant criteria including an age requirement of 19 to 64 years and discuss factors or present discussion surrounding the “informed consent” process for invasive cosmetic procedures. The characteristics and findings of each study were extracted. The studies were analyzed and presented under question categories. The Mixed Methods Appraisal Tool was used to assess the quality of evidence. Thirty-one studies were eligible for inclusion. Most studies were quantitative (90.3%). The highest proportion of these studies were focused on the United States (51.6%), followed by the United Kingdom (12.9%). The dominant methodology utilized by these studies was questionnaires/surveys (37.5%). The literature identified was classed into one of the 5 groups based on their overall concepts and objective. These 5 categories included (1) articles focusing on the types of information which should be communicated to a patient before they undergo their procedure or provide consent; (2) legal claims and cases based on a lacking informed consent; (3) sources of information patients access to become “informed” on their procedure; (4) studies exploring the readability of online information on certain invasive cosmetic procedures; and (5) studies focusing on the most effective methods of obtaining patient consent for cosmetic surgery procedures. These categories were reformulated into research questions and addressed in the section “Results of the Findings.” Most of the studies included in this review were quantitative (90.3%). Most studies (where gender was mentioned) had a higher population of female participants or respondents. Women have a greater tendency to have cosmetic surgery opposed to men. There are few studies (particularly qualitative studies) exploring the pre-operative patient experience in Australia for those having or seeking cosmetic surgery. A key stage in this process is obtaining and providing informed consent. A “lack of informed consent” is one of the more dominant factors identified consistently throughout these studies which focus on legal case reviews and claims. A significant source of information patients use to become informed of their procedure is through the Internet. This may be problematic as the readability of online materials is most commonly above the recommended reading level in multiple jurisdictions; and some online materials may have questionable accuracy or validity. Whether or not patients verify the information they access through external sources such as this, is of concern. There have been minimal studies identified exploring the patient experience pre-operatively including during their consultations and decision to provide consent.

Photoaging and cosmeceutical solutions in sun-overexposed countries: The experience of Australia and Brazil.

Skin aging is the result of physiological changes determined by genetically driven processes and intrinsic factors, and exacerbated by a combination of multiple environmental factors, the main one being sun exposure. The effects of photoaging are particularly apparent on the face, where the appearance of aging signs can have a significant impact on the emotions conveyed and well-being. Photoprotection and facial skin care for managing photoaging signs are thus of particular importance for both physical and mental health. Countries, like Australia and Brazil, where the level of sun exposure is high and the populations have predominantly outdoor lifestyles, are particularly aware of the harms of photoaging and have implemented several measures to help reduce the risk of skin cancer in their populations. However, sun-seeking behaviours are difficult to change, and it takes time before interventions provide perceptible results. Australia still has some of the highest skin cancer incidence and mortality rates in the world. Solutions that target individuals can also be used for minimizing the clinical signs of facial aging and for improving skin quality, with the ultimate aim being not only to improve the appearance of the skin but also to mitigate the occurrence of pre-malignant and malignant lesions. This review summarizes the features of facial skin photoaging in photo-exposed populations, based on evidence gained from studies of Australian individuals, and discusses the various available solutions for skin photoaging, in particular those that are most popular in Brazil, which is a country with many years of experience in managing photoaged skin.

Towards sustainable development: Assessing social sustainability of Australian aged care system

AbstractThe importance of social sustainability, one of the three pillars of sustainable development, is increasingly recognised. Its implementation in the aged care system enhances stakeholders' quality of life and supports sustainable societal development. However, there is limited global research on social sustainability in aged care. This study aims to assess the overall social sustainability of the Australian aged care system and propose measures for its improvement. A conceptual framework was developed and applied to analyse the Final Report: Care, Dignity and Respect by the Australian Royal Commission into Aged Care Quality and Safety. The findings reveal that Australia's aged care system demonstrates significant deficiencies in social sustainability, with unequal access to care, services and facilities, and inadequate health and comfort for the elderly and their families. Employees contend with issues of unfair employment, insufficient compensation, unhealthy work environments, and inadequate education and training. Several measures are proposed to enhance social sustainability. This study provides a comprehensive analysis of social sustainability in the aged care system within a Western context. It enhances our understanding of the components of social sustainability in aged care, assesses its current status, identifies existing challenges, and provides possible directions for improvement. The insights from Australia's experience and potential solutions could inspire other countries to recognise the importance of social sustainability and reform their aged care systems towards sustainable development.

Assessment of breast cancer optimal care timeframes in a regional and rural real-world setting: A regional cancer centre experience in Australia.

e12614 Background: The Breast Cancer Optimal Care Pathway (Cancer Australia) is a national patient-centred guideline that seeks to standardise the management pathway for breast cancer patients and spans from early diagnosis through to survivorship. The guideline provides suggested optimal management-based timeframes including the time from general practitioner (GP) referral to specialist review (<2 weeks), time from specialist review to completion of investigations and multidisciplinary discussion (MDT) (<2 weeks), time to initiation of neoadjuvant therapy from MDT (<4 weeks) and time to surgery following completion of neoadjuvant therapy (<6 weeks). Methods: Retrospective data was obtained for patients undergoing neoadjuvant systemic therapy for newly diagnosed breast cancer between 2021 and 2023 at a regional tertiary cancer centre in Australia (Townsville University Hospital). Data included baseline patient demographics, tumour characteristics, staging, key optimal care pathway timepoints, treatment regimen and outcomes. Median and interquartile range were calculated for key timepoints. Results: Overall, 53 patients (100% female) were identified for inclusion. 10% of patients identified as Indigenous (n=5), 36% lived rurally (n=19) and 13% were treated using a tele-chemotherapy model (n=7). Receptor status was triple-negative in 20 patients (38%), hormone-positive in 17 patients (32%) and HER2-positive in 16 patients (30%). 15% of patients had stage I disease (n=8), 58% had stage II disease (n=31), 21% had stage III disease (n=11), while 6% of patients had oligometastatic stage IV disease at diagnosis (n=3). 24 patients (50%) were seen by a specialist within 2 weeks of GP referral (median: 15 days; IQR 9-19). 46 patients (87%) had a definitive management plan formulated at MDT within 2 weeks of specialist review (median: 5 days; IQR 4-9), with delays most commonly due to pending investigations (n=5; 9%). 48 patients (91%) proceeded with neoadjuvant therapy within 4 weeks of MDT (median: 14 days; IQR 11-22), with delays most commonly due to concurrent infections including COVID. 90% of patients (n=46) were ultimately commenced on neoadjuvant treatment within the 8-week optimal care timeframe from initial GP referral (median: 34 days; IQR 27-47). In comparison to patients living locally, patients residing in rural areas were less likely to achieve this target (79% v 97%, p=0.05). 83% of patients (n=43) underwent surgery within 6-weeks of completion of neoadjuvant treatment (median: 30 days; IQR 27-34). Conclusions: The neoadjuvant breast cancer optimal care timeframes were feasible to achieve in a regional and rural setting. However, further targeted research is needed to improve adherence to optimal care standards for patients from rural areas, such as the timeframe from initial referral to completion of investigations and MDT.

A just energy transition for Indigenous peoples: From ideal deliberation to fairness in Canada and Australia

In response to the global climate crisis, renewable energy projects are being developed on Indigenous territories. As renewable energy sources are not without social and ecological impacts, it is crucial to consider who benefits from these projects and who bears the consequences. In settler states such as Canada and Australia, the power dynamics are affecting the role of Indigenous peoples in the energy transitions. This paper proposes a theoretical framework for a just energy transition (JET) based on a comprehensive literature review of justice movements, energy transitions, and Indigenous experiences in Canada and Australia. The literature on environmental, climate, and energy justice examines three dimensions of justice: procedural, distributional, and recognition. While these dimensions offer important perspectives for our analysis, they are not sufficient on their own. This paper argues that promoting justice for Indigenous knowledge renewal is crucial for establishing a fair energy future. In addition to knowledge renewal, our framework comprises two more JET components: socioeconomic impact distribution, and procedural power. We argue that the JET components are deeply interrelated in an insidious loop effect. This means that all justice issues have the same roots, perpetuated by the historical consequences of colonisation. The question is how to simultaneously address them to transform a negative cycle into a positive one. Drawing on Indigenous rights in Canada and Australia this paper highlights the importance of improved bilateral communication strategies to break the insidious loop effect. Before discussing project strategies, it is crucial to consider the fairness of the decision-making process.

Determining the future role of clinical practice guidelines: The experience of Australia and New Zealand.

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly.

Mental Health Carers’ Support Experiences in Australia

Informal mental health carers play a crucial role in supporting individuals with depression and anxiety. However, there is a lack of knowledge on how to effectively support these carers and promote their well-being. This mixed-method study aimed to explore the support needs of carers of a person with depressive or anxiety symptoms, living in Australia. Sixty-seven carers (female 76 %, median age 48) completed an online survey, and 22 completed semi-structured interviews about their support experiences. Over half of the survey respondents reported high levels of psychological distress on the Kessler Psychological Distress Scale (K10), and 63% reported understanding and adjusting to the caregiving role as the most needed areas of support, as identified on the Caregiver Perspective Questionnaire (CPQ). Through thematic analysis of the interviews, four key themes emerged describing carers’ support experiences and needs: connecting with formal services, responding to the care-recipient, connecting socially, and caring for the self. The analysis also found that time constraints and stigma can be significant support barriers for these carers. This is the first time that a study has investigated the support experiences and needs of carers of a person with depressive or anxiety symptoms, living in Australia. The findings contribute to current literature on mental health carers and offer novel and tangible insights into future research and support opportunities.

Menstrual pain in Australian adolescent girls and its impact on regular activities: a population-based cohort analysis based on Longitudinal Study of Australian Children survey data.

To determine the proportion of Australian adolescent girls who experience menstrual pain (dysmenorrhea); to assess associations of dysmenorrhea and period pain severity with adolescents missing regular activities because of their periods. Prospective, population-based cohort study; analysis of Longitudinal Study of Australian Children (LSAC) survey data. Female adolescents in the nationally representative cross-sequential sample of Australian children recruited in 2004 for the Kinder cohort (aged 4-5 years at enrolment). Survey data from waves 6 (mean age 14 years), wave 7 (16 years) and wave 8 (18 years) were analysed. Severity of period pain during the preceding three months (very, quite, a little, or not at all painful); number of activity types missed because of periods; relationship between missing activities and period pain severity. Of the 1835 participating female members of the LSAC Kinder cohort at waves 6 to 8, 1600 (87%) responded to questions about menstruation during at least one of waves 6 to 8 of data collection. At wave 6 (14 years), 227 of 644 respondents (35%) reported dysmenorrhea, 675 of 1341 (50%) at wave 6 (16 years), and 518 of 1115 (46%) at wave 8 (18 years). Of the 366 participants who reported period pain severity at all three waves, 137 reported no dysmenorrhea at all three waves (37%), 66 reported dysmenorrhea at all three waves (18%), 89 reported increasing period pain over time (24%), and 38 reported declining pain (10%). At wave 6, 223 of 647 participants reported missing at least one activity because of their periods (34%), 454 of 1341 at wave 7 (34%), and 344 of 1111 at wave 8 (31%). Of the participants who experienced very painful periods, 72% (wave 6), 63% (wave 7), and 65% (wave 8) missed at least one activity type because of their periods, as did 45% (wave 6), 36% (wave 7), and 40% (wave 8) of those who experienced quite painful periods. A large proportion of adolescent girls in Australia experience period pain that affects their engagement in regular activities, including school attendance. Recognising adolescent period pain is important not only for enhancing their immediate quality of life with appropriate support and interventions, but also as part of early screening for chronic health conditions such as endometriosis.

Heavy steers and heifers run at low stocking rates enhance drought resilience in a pastoral region of Australia

CONTEXTThe semi-arid mulga lands of the Southern Rangelands of Western Australia experience frequent droughts. Maintaining a profitable animal grazing enterprise whilst preserving rangeland condition requires selecting an appropriate stocking rate and herd structure. OBJECTIVEWe construct and apply bioeconomic models of beef enterprises for the semi-arid Southern Rangelands of Western Australia, to assess the profitability and relative riskiness of three different livestock production systems and three different stocking rates when exposed to different frequencies of drought. METHODSWe construct bio-economic models of herd structures that separately focus on producing either: (i) 200 kg heifers and 210 kg steers (ii) live export of 340 kg heifers and 380 kg steers, or (iii) 500 kg heifers and 560 kg steers for local slaughter. The models are applied to assess the financial and production resilience of each herd structure for three different stocking rates, given the incidence of drought and various price scenarios. RESULTS AND CONCLUSIONSComparing the three herd structures, option (iii) produces more kilograms of beef at an equivalent grazing pressure and recovers fastest from drought. Considering cattle prices over the 7-year period ending in 2021, live export and slaughter production systems generate comparable financial returns to graziers' actual reported results. Under two different scenarios of future prices, option (iii) provides the most profitable outcome. Applying a stocking rate that is 66% of a recommended stocking rate allows use of residual rangeland feed (known as ‘haystack’) during drought, generates greater profit, and produces a more stable herd size and income. Not matching the haystack with the longest modelled drought reduces the grazier's average annual profit by $172,000. The optimum herd structure identified in this study targets the production of 500 kg heifers and 560 kgs steers for local slaughter, and relies on a conservative stocking rate that leaves enough haystack to increase resilience if ever consecutive droughts occur. SIGNIFICANCEIn the Southern Rangelands of Western Australia, there are financial and environmental merits in a herd structure that produces heavy steers and heifers for local slaughter yet is underpinned by conservative stocking rates.

The living experience of First Nations Peoples and Forensic Mental Health systems: listening to the deep stories behind the numbers

While First Nations Peoples in Australia experience high rates of criminal justice contact, there is limited research on their experiences of the forensic mental health system. This study aims to develop new understandings of how First Nations Peoples experience and understand the forensic mental health system in NSW. Interviews were conducted with ten First Nations Peoples in contact with the forensic mental health system, including forensic patients and their family members. Participants described challenging life experiences prior to their contact with the forensic mental health system, with community services often failing to respond to their mental health needs. While participants reported some positive experiences with the forensic mental health system, they ultimately described an urgent need for culturally appropriate programs that facilitate connections to family and Community. Forensic mental health services should be co-designed alongside First Nations Peoples and communities to improve outcomes and avoid re-traumatisation through contact with services.

THE USE OF OUTCOME MEASURES IN EXERCISE PHYSIOLOGY CLINICAL PRACTICE IN AUSTRALIA

INTRODUCTION AND AIMS Outcome measure (OM) implementation in clinical settings has become a standard in allied health evidence-based practice over the last 20 years, with their use being encouraged by governing and funding bodies. This study investigated the application of standardised OMs by accredited exercise physiologists (AEPs) in Australia. This study aimed to identify commonly used OMs and explore the barriers and facilitators to OM implementation in AEP clinical practice in Australia. METHODS This study utilised a questionnaire-based, cross-sectional, descriptive design to determine the OMs used by AEPs in current clinical practice and investigated trends related to OM use within different AEP demographics and settings. Participants were also asked to identify any barriers and facilitators that affected their use of OMs in clinical practice. The OMs that were most frequently used were identified and the results analysed according to demographic variables, to determine how they influenced OM use in clinical practice. RESULTS Eighty-seven OMs were assessed, with 41% ‘never’ used by most participants. A further 48% of the OMs were identified as being underutilised with over 50% of respondents selecting ‘never’ or ‘sometimes’. Only three OMs were used frequently by most respondents. The most common barriers to OM use identified related to a lack of time, knowledge, and limited perceived value from clinicians. These reflect the barriers identified in prior research related to other allied health professions. CONCLUSIONS AEPs in Australia experience many of the same barriers to OM use as other allied health disciplines. Currently, the standardised OM resource for AEPs is outdated and underutilised in clinical practice. Updated resources for clinicians in the form of educational seminars and a searchable online database with easy access to evidence-based outcome measures are essential to the promotion of OMs to support evidence-based practice for AEPs.

Blueprint for Blue Economy implementation

Many nations aspire to development of the Blue Economy (BE), however, the concept remains vague and there is wide need for a practical framework for implementation and evaluation of success. Based on our experience in Australia and Canada, where there is increasing BE activity, new developments being added to areas with existing uses are leading to ocean crowding and increasing the risk of undesirable outcomes. We propose a blueprint for implementation of an integrated approach to BE in an area involving four steps: 1) articulation of common BE objectives (ecological, economic, social-cultural and governance), 2) development of a governance framework in which BE objectives can be applied in management of all activities in an area, 3) a process to address conflicts, risks and trade-offs, and 4) evaluation of cumulative effects and performance of management. We illustrate the blueprint using candidate objectives relevant to the addition of offshore wind energy development. While there is a potential problem under BE for ocean crowding and for ‘plan crowding’ caused by a proliferation of sector-based planning, we suggest that there is the potential for the BE concept, properly implemented, to assist in overcoming long-standing deficiencies in existing sector-based approaches and to avoid deficiencies in planning and management associated with new or expanding BE industries. Implementation of BE will also facilitate achieving ambitious aspirations associated with national and international initiatives including the High Level Oceans Panel and Sustainable Development Goals.