Professionals In Australia Research Articles

Surge capacity for critical care specialised allied health professionals in Australia during COVID-19

Significant investment in planning and training has occurred across the Australian healthcare sector in response to the COVID-19 pandemic, with a primary focus on the medical and nursing workforce. We provide a short summary of a recently published article titled “Surge capacity of Australian intensive care units associated with COVID-19 admissions” in the Medical Journal of Australia and, importantly, highlight a knowledge gap regarding critical care specialised allied health professional (AHP) workforce planning in Australia. The unique skill set provided by critical care specialised AHPs contributes to patient recovery long after the patient leaves the intensive care unit, with management targeted at reducing disability and improving function, activities of daily living, and quality of life. Allied health workforce planning and preparation during COVID-19 must be considered when planning comprehensive and evidence-based patient care. The work by Litton et al. has highlighted the significant lack of available data in relation to staffing of critical care specialised AHPs in Australia, and this needs to be urgently addressed.

Career Barriers Experienced by Legal Professionals with an Asian Cultural Background

Despite the increased numbers of culturally diverse legal professionals in Australia over the course of recent decades, barriers into leadership positions persist. Culturally diverse legal professionals continue to be significantly under-represented on the partnership level in law firms, at the Bar and the Judiciary. This study explores the career enabling and constraining structures that legal professionals with an Asian cultural background experience in progressing their career. Based on 65 in-depth interviews, the study identified five mechanisms that shape career enablers and barriers. They are business development requirement, demonstrating dedication, opaque promotion process, informal work allocation process, and an assimilationist culture. The findings revealed these mechanisms disadvantaged culturally diverse legal professionals.

Sexual misconduct by health professionals in Australia, 2011-2016: a retrospective analysis of notifications to health regulators.

To assess the numbers of notifications to health regulators alleging sexual misconduct by registered health practitioners in Australia, by health care profession. Retrospective cohort study; analysis of Australian Health Practitioner Regulation Agency and NSW Health Professional Councils Authority data on notifications of sexual misconduct during 2011-2016. All registered practitioners in 15 health professions. Notification rates (per 10000 practitioner-years) and adjusted rate ratios (aRRs) by age, sex, profession, medical specialty, and practice location. Regulators received 1507 sexual misconduct notifications for 1167 of 724649 registered health practitioners (0.2%), including 208 practitioners (18%) who were the subjects of more than one report during 2011-2016; 381 notifications (25%) alleged sexual relationships, 1126 (75%) sexual harassment or assault. Notifications regarding sexual relationships were more frequent for psychiatrists (15.2 notifications per 10000 practitioner-years), psychologists (5.0 per 10000 practitioner-years), and general practitioners (6.4 per 10000 practitioner-years); the rate was higher for regional/rural than metropolitan practitioners (aRR, 1.73; 95% CI, 1.31-2.30). Notifications of sexual harassment or assault more frequently named male than female practitioners (aRR, 37.1; 95% CI, 26.7-51.5). A larger proportion of notifications of sexual misconduct than of other forms of misconduct led to regulatory sanctions (242 of 709 closed cases [34%] v 5727 of 23855 [24%]). While notifications alleging sexual misconduct by health practitioners are rare, such misconduct has serious consequences for patients, practitioners, and the community. Further efforts are needed to prevent sexual misconduct in health care and to ensure thorough investigation of alleged misconduct.

Use of technology by orientation and mobility professionals in Australia and Malaysia before COVID-19

Purpose Orientation and Mobility (O&M) professionals teach people with low vision or blindness to use specialist assistive technologies to support confident travel, but many O&M clients now prefer a smartphone. This study aimed to investigate what technology O&M professionals in Australia and Malaysia have, use, like, and want to support their client work, to inform the development of O&M technologies and build capacity in the international O&M profession. Materials and Methods A technology survey was completed by professionals (n = 36) attending O&M workshops in Malaysia. A revised survey was completed online by O&M specialists (n = 31) primarily in Australia. Qualitative data about technology use came from conferences, workshops and interviews with O&M professionals. Descriptive statistics were analysed together with free-text data. Results Limited awareness of apps used by clients, unaffordability of devices, and inadequate technology training discouraged many O&M professionals from employing existing technologies in client programmes or for broader professional purposes. Professionals needed to learn smartphone accessibility features and travel-related apps, and ways to use technology during O&M client programmes, initial professional training, ongoing professional development and research. Conclusions Smartphones are now integral to travel with low vision or blindness and early-adopter O&M clients are the travel tech-experts. O&M professionals need better initial training and then regular upskilling in mainstream O&M technologies to expand clients’ travel choices. COVID-19 has created an imperative for technology laggards to upskill for O&M tele-practice. O&M technology could support comprehensive O&M specialist training and practice in Malaysia, to better serve O&M clients with complex needs. Implications for rehabilitation Most orientation and mobility (O&M) clients are travelling with a smartphone, so O&M specialists need to be abreast of mainstream technologies, accessibility features and apps used by clients for orientation, mobility, visual efficiency and social engagement. O&M specialists who are technology laggards need human-guided support to develop confidence in using travel technologies, and O&M clients are the experts. COVID-19 has created an imperative to learn skills for O&M tele-practice. Affordability is a significant barrier to O&M professionals and clients accessing specialist travel technologies in Malaysia, and to O&M professionals upgrading technology in Australia. Comprehensive training for O&M specialists is needed in Malaysia to meet the travel needs of clients with low vision or blindness who also have physical, cognitive, sensory or mental health complications.

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.

Understanding the healthcare needs of Sudanese refugee women settling in Australia

Objective: Explore the healthcare needs of Sudanese refugee women settling in Australia.Background: Refugees from Sudan are the fastest growing community in Australia. Nurses who care for people from the Sudan will be required to be familiar with the needs of this emerging community and offer culturally competent and safe care.Methods: Integrative review of the literature.Results: Sudan is one of the countries in Africa where the practice of female genital mutilation (FGM), cutting or circumcision is considered a social norm. This is a deeply rooted traditional cultural practice that is still prevalent in many developing countries. Healthcare professionals in Australia are ill equipped to care for women and children who have undergone this procedure. This paper explores the Sudanese refugee community in Shepparton, Victoria to explore the nursing considerations caring for women affected by FGM within the Australian health care context.Conclusions: There is a need for more education in undergraduate, postgraduate and continuing professional education on the healthcare needs of women who have undergone female genital mutilation in order to provide appropriate care and support for these women.

The technical issues associated with algae building technology

PurposeAs the impacts of climate change become more evident, the need to adopt new ways of constructing buildings becomes more urgent. The Earth has experienced hotter climates globally for the last 70 years (NASA, 2019), and this has resulted in unprecedented levels of bushfire in Australia, flooding in the UK and drought in Africa in early 2020 (World Resources Institute, 2019). The predictions are for increased temperatures globally and increasing carbon emissions from fossil fuel consumption. There is a critical need to reduce the reliance on fossil fuels as a building energy source (WCED, 1987). Existing renewables focus on solar, wind and wave power, where technological improvements have increased efficiencies (Hinnells, 2008). Uptake of the technologies is variable depending on location and willingness to adopt renewables. As well as further uptake of existing renewable energy sources, we need to look wider and across traditional discipline groups, at new technologies such as biotechnologies. One potential energy source is biofuels. Biofuels are produced from biomass, which is algae. In 2016, the BIQ, a four-storey apartment building, was constructed in Hamburg, Germany. The BIQ features glazed façade panels filled with algae to produce biomass and solar thermal energy. Could algae building technology (ABT), in the form of façade panels, offer a new renewable energy source?Design/methodology/approachWhat are the technical issues associated with Algae building technology? This qualitative research sought to identify what technical issues likely to arise in terms of algae building construction, operation and maintenance. Semi-structured interviews with 24 experienced built environment professionals in Australia were undertaken in 2016 to assess the most likely issues that could arise with this new innovative technology.FindingsAs a result, a greater understanding of the range of technical issues related to design, construction, maintenance and operation were identified, as well as the perceived importance of those issues. It was possible to identify the top ten technical issues built environment professionals are concerned about with regard to ABT. The results can inform future designers of ABT.Research limitations/implicationsThis research was restricted to the views of 24 experienced built environment practitioners in Sydney, Australia. None of whom had direct experience of Algae Building Technology. Though knowledgeable, a greater number of interviews may have identified other technical issues.Practical implicationsNo guidelines exist for Algae Building Technology, and this research identifies a comprehensive range of technical issues that need to be considered for the technology to function at optimum levels. As such, this is a starting point for built environment professionals who may be asked to provide professional advice and guidance.Originality/valueTo date, no evaluation of Australian based built environment professionals has been conducted into the technical issues associated with Algae Building Technology.

\u201cYou get exposed to a wider range of things and it can be challenging but very exciting at the same time\u201d: enablers of and barriers to transition to rural practice by allied health professionals in Australia

BackgroundThere is consistent evidence highlighting the mal-distribution of the health workforce between urban and rural and remote regions. To date, addressing this mal-distribution has focused on medicine and nursing with limited initiatives targeted at allied health. Therefore, the aim of this research was to explore the enablers of and barriers to transition to rural practice by allied health professionals across South Australia in Australia.MethodQualitative descriptive methodology was used to underpin this research. Individual, in-depth semi-structured interviews were conducted with employers, managers and allied health professionals from rural regions of South Australia who were identified using purposive maximum variation sampling strategy.ResultsA total 22 participants shared their perspectives on the enablers of and barriers to transition to rural practice by allied health professionals across South Australia. Thematic analysis of the interview data resulted in a number of key issues impacting transition to rural-based practice. These findings could be broadly categorised into three stages during the transition: ‘before’; ‘during’ and ‘after’.DiscussionThis study identified a range of enablers of and barriers to transition to rural practice by allied health professionals. Five overarching themes – nature of rural practice, exposure to rural ‘taster’, social/lifestyle, job availability/characteristics, and mentor and support were identified. In particular, exposure to rural ‘taster’, social/lifestyle, and mentor and support were the key themes reported by the stakeholders. The multifactorial nature of the barriers and enablers highlight the complexity underpinning how AHPs transition to rural-based practice. These barriers/ enablers are often inter-linked and continually evolving which pose significant challenges for health care stakeholders to successfully addressing these.ConclusionThis research sheds light on the complexities that confront and successful strategies that are required for health care stakeholders when considering how best to support allied health professional transition to rural practice.

The uptake of evidence-informed guidelines for reporting suicide into media codes of practice and policies in Australia.

Despite different models and frameworks for effective suicide prevention, a universal intervention that is consistently highlighted is the need for responsible and safe media reporting of suicide. This is based on evidence of an association between media reporting of suicide and subsequent suicidal behaviour. This study examines the extent to which media-led policies and codes of practice in Australia have integrated and aligned with evidence-informed recommendations about reporting suicide. An online search of Australian media agency websites was used to identify codes of practice or similar guidance for news reporting. Content analysis was conducted on all identified documents, assessing alignment with 16 key recommendations from the Mindframe media guidelines for reporting on suicide. A total of 17 documents across 12 media agencies were identified. Ten of the 12 agencies provided specific advice about the reporting of suicide, with all agencies that issue codes of practice or editorial policies including between two and 10 recommendations aligned with the Mindframe guidelines. While the results of this study are positive, significant variation between media agencies shows that there are opportunities to enhance adoption and implementation of evidence-informed guidance for media professionals in Australia. SO WHAT?: With over 3000 people dying by suicide and over 60000 people attempting suicide each year in Australia, the prevention of suicide remains a key public health priority requiring a multi-sector and health-in-all-policies approach. This study reveals that there is a strong platform for ongoing collaboration with the Australian media to ensure safe and sensitive coverage of suicide.

Challenges to trauma care delivery for Australian and New Zealand trauma clinicians

IntroductionThe availability and implementation of evidence-based care is essential to achieving safe, quality trauma patient outcomes. Little is documented, however, about the challenges trauma clinicians face in their day-to day practice, or their views on the availability of evidence. This paper presents the most significant clinical practice challenges reported by multidisciplinary trauma care professionals in Australia and New Zealand, in particular those that may be resolved with focussed research or enhanced implementation activity. MethodsAn exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted between September 2018 and February 2019 using the Snowballing Method. Participants were recruited via a non-random sampling technique to complete an online survey. Thematic analyses were conducted. ResultsThere were nine significant clinical practice challenge themes in trauma care, arising from 287 individual clinical practice challenges reported. The most reported being clinical management (bleeding, spinal, older patients) and operationalisation of the trauma system. There was no consensus as to the availability of evidence to guide each theme. ConclusionFuture research should seek to address the clinical practice challenge of Australian and New Zealand trauma community to enable safe, quality trauma patient outcomes.

Evaluation of HealthPathways: an appraisal of usage, experiences and opinions of healthcare professionals in Australia and New Zealand.

Objectives HealthPathways, pioneered in Canterbury, New Zealand, in 2008, is a web-based tool designed to promote health care integration and patient management in primary care and to reduce fragmentation in the delivery of health services. This cross-sectional study evaluated the utilisation and perceptions of this tool among health professionals in Australia and New Zealand. Methods A cross-sectional survey was administered online through Research Electronic Data Capture (REDCap) to general practitioners (GPs), practice nurses and managers, nurse practitioners, specialist and community nurses, hospital clinicians, nurses, managers, and allied health professionals between April and September 2018. The frequency of HealthPathways use in the previous month was modelled as an ordered response using an ordered logistic regression model after adjusting for the possible effects of sex, age, years in clinical practice, location and time spent in practice. Results Health professionals perceived HealthPathways to be useful in primary care management and referral, as well as in the prereferral treatment of patients. GPs in New Zealand, New South Wales and Victoria were 73%, 47% and 27% more likely to have used HealthPathways ≥10 times in the previous month respectively. Conclusion The results suggest that HealthPathways is having a positive effect on healthcare systems in New Zealand and Australia. However, differences in uptake suggests the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change. What is known about the topic? Early evaluations suggest that HealthPathways is a useful tool for health professionals, although uptake and utilisation may be limited. However, there is no comparative evidence regarding uptake and implementation of the tool. What does the paper add? This study is among the first to provide a comparative narrative of the literature assessing the implementation and uptake of HealthPathways across Australia and New Zealand. It is also among the first to compare the perceptions of allied health professionals in the use of HealthPathways across Australia and New Zealand. What are the implications for practitioners? The results of this study suggest the need for focused implementation, integration into eReferral software and expanding the tool to medical students, registrars, allied health professionals and potentially patients to encourage behavioural change.

Does acculturation affect one’s implicit leadership theories? Evidence from Chinese professionals in Australia and China

Notwithstanding the increasing participation of Chinese immigrant professionals in developed countries, our knowledge on the link between acculturation and leadership is scant. By integrating the fields of acculturation and leadership, this study examines the effect of acculturation on the implicit leadership theories held by Chinese professionals in Australia relative to their counterparts in China. Seventy interviews involving Chinese immigrant professionals in Australia and China were conducted to explore the extent to which acculturation into a new and different cultural context changes one’s implicit leadership theories. Analyses of the interview data led to the emergence of five culturally independent and two culturally dependent implicit leadership perceptions. This study contributes to the ongoing debate around the stability of implicit leadership theories and extends the validity of using a follower-centred approach to study leadership.

Knowledge of Australian primary education providers towards dental avulsion injuries: a cross-sectional study.

The aim of this study was to evaluate the knowledge of school professionals regarding the emergency management of dental avulsion. This cross-sectional study utilised a self-administered, pilot-tested questionnaire for school staff from primary schools. Descriptive statistics were used for the analysis - the prevalence and univariate associations between a categorical outcome and the variables under consideration, were evaluated using Pearson's Chi-squared test. This survey yielded a response rate of 43.5% (n=313). Approximately 60% of participants held valid first-aid certificates and 23% had received avulsion advice previously. Over 80% of participants expressed an unwillingness to replant an avulsed tooth, and over 90% believed that there should be greater awareness in this area. This unwillingness to replant was influenced by respondents' age (x2=8.13 df=3, P=0.043) and receiving advice previously (x2=13.15, df=1, P<0.001). Under-preparedness was related to years of experience (x2=15.03, df=5, P=0.010), first-aid training (x2=6.41, df=1, P=0.011) and receiving advice previously (x2=43.47, df=1, P<0.001). It was also evident that first-aid training positively influenced appropriate dental referral in the management pathway (x2=10.49, df=1, P=0.001). This study suggests that there is an inadequate level of knowledge on the appropriate management of dental avulsion injuries amongst primary school professionals in Australia.

The use of social media for work-related knowledge sharing by construction professionals

ABSTRACT Use of social media for work-related knowledge sharing (KS) by professionals has become widespread globally. The extent, nature and patterns of this use have been little explored to date in the construction industry. This paper aims to investigate the frequency, nature and determinants of social media use for KS among the construction professionals. The objectives are to measure the current level of use of the three major social media platforms by the construction professionals for KS; and to empirically validate an extended version of the Unified Theory of Acceptance and Use of Technology (UTAUT) that identifies the impact factors of adoption of social media for work-related KS by the construction professionals. Survey data were collected from 120 construction professionals in Australia and were analysed using Structural Equation Modelling (SEM) techniques. Findings show that Facebook and LinkedIn were used by almost half of the survey respondents. Passive KS was the most common type of KS activity. Performance Expectancy (PE), and Knowledge Sharing Self-Efficacy (KSSE) had positive impacts on the construction professionals’ intention to use (IU) social media. IU and Facilitating Conditions (FC) had positive direct impacts on the use of social media for work-related KS. The findings shed light into the potential ways of improving social media use for KS by the construction professionals.

Physical capacity of New South Wales ambulance paramedics.

Paramedics are among the most frequently injured health professionals in Australia. A lack of physical capacity may contribute to injury risk in this occupational population. This study sought to describe and compare the physical fitness of male and female paramedics across age groups to ascertain differences in physical capacity. A group of regional Australian paramedics (n = 140; 78 males; mean ± SD 37.4 ± 9.9 years; body mass index 28.1 ± 4.9 kg/m2) underwent a fitness assessment. Measures included upper, lower and core-body muscular strength and flexibility. Outcomes were compared between genders and across age groups using two-way between-groups analysis of variance. Male paramedics had greater upper body strength (P < 0.05; push-ups) mean (95% CI): 22.6 (19.4-25.9) versus 18.7 (15.2-22.3); similar lower body strength (single-leg wall squat): 39.0 (32.6-45.3) s versus 36.7 (27.1-46.3) s; greater core strength (P < 0.05; prone plank hold): 87.9 (77.6-98.3) s versus 73.8 (63.7-83.8) s; similar upper body flexibility (back scratch): -4.0 (-6.7 to -1.3) cm versus -0.3 (-2.2 to 1.7) cm; and similar lower body flexibility (sit and reach): 20.4 (18.2-22.6) cm versus 26.1 (23.5-28.7) cm to female paramedics. Core, upper and lower body strength all decreased with age (P < 0.05). Core, upper and lower body strength and upper body flexibility were poorer for older compared to younger regional paramedics in New South Wales, Australia. Future research should investigate whether these outcomes are associated with occupational injury risk. This information would assist in the design of injury prevention interventions for paramedics such as tailored workplace exercise programs.

Priorities for trauma quality improvement and registry use in Australia and New Zealand

IntroductionThe Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities. MethodsAn exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted using the Snowballing Method between September 2018 and February 2019. Participants were recruited via a non-random sampling technique to complete an online survey. Descriptive statistical and content analyses were conducted. ResultsThe data use priorities identified by 102 trauma professionals from a range of locations participated were clinical improvement and system/process improvement (86.3%). Participants reported that access to trauma data should primarily be for clinicians (93.1%) and researchers (87.3%). Having a standardised approach to review trauma cases across hospitals was a priority in trauma quality improvement. ConclusionTrauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand.

Health Practitioner Regulation: Has the National Law Produced National Outcomes in Serious Disciplinary Matters?

Since 2010, a national scheme regulates the registration, accreditation and discipline of health professionals in Australia (the ‘National Law’). This research examines disciplinary cases from tribunals nationwide to address the question: Has the national regulation of health professionals produced consistency in outcomes in serious cases of professional misconduct? All publicly available Australian tribunal-level decisions concerning complaints of serious misconduct and/or impairment brought against the five most populous regulated health professions (nurses and midwives, doctors, psychologists, pharmacists and dentists) were analysed for the period from 1 July 2010 to 30 June 2017. Each case was coded by reference to a typology of misconduct, practitioner characteristics and outcome, allowing for comparisons to be drawn both as between the professions and as between jurisdictions. Major disparities were identified in outcomes across the professions, with doctors being subject to less severe outcomes than other professions, in particular in comparison with nurses, even when the same main head of misconduct was in issue. Marked disparities were also identified between outcomes in different states and territories, suggesting that the National Law is not being applied in a uniform manner. This article examines these disparities and explores possible contributing factors.

‘Are we there yet?’ Australian HR professionals and the Fourth Industrial Revolution

Although still in its early stages, the Fourth Industrial Revolution (FIR), which involves a broad range of artificial intelligence, robotics and machine learning technologies, will fundamentally change the way many of us work and relate to one another. Driven by technology, this transformation presents a range of challenges, as well as opportunities, where we might expect Human Resource (HR) professionals would lead the way. However, little is currently known in relation to how prepared HR professionals in Australia are to ready their organisations for this new era of work and associated resourcing. Consequently, this paper goes some way towards closing that gap. Specifically, the study reported here sets out to explore the levels of preparedness amongst Australian HRM professionals for the impact of the FIR on organisations, workplaces, jobs and skills, as well as on their own professional roles and competencies. The study utilised a sequential mixed methods research design with two phases, the first was qualitative focus groups (n = 5) followed by a quantitative online survey of selected senior HR practitioners (n = 150). The findings indicate that, while most believe that FIR technologies might be useful for their organisations and assist with improving job performance, increasing productivity and making jobs easier for employees, contrarily many did not intend to use them in the foreseeable future. Marginal support was also evident in relation to the potential contributions of FIR technologies to HR process enhancement and overall HR effectiveness. Most respondents were also not impressed with the lack of current Australian government FIR strategies and policies.

The impact of an integrated diabetes and kidney service on patients, primary and specialist health professionals in Australia: A qualitative study.

BackgroundTo address guideline-practice gaps and improve management of patients with both diabetes and chronic kidney disease (CKD), we involved patients, health professionals and patient advocacy groups in the co-design and implementation of an integrated diabetes-kidney service.ObjectiveIn this study, we explored the experiences of patients and health-care providers, within this integrated diabetes and kidney service.Methods5 focus groups and 2 semi-structured interviews were conducted amongst attending patients, referring primary health professionals, and attending specialist health professionals. Maximal variation sampling was used for both patients and referring primary health professionals to ensure an equal representation of males and females, and patients of different CKD stages. All discussions were audiotaped and transcribed verbatim, before being thematically analysed independently by 2 researchers.ResultsThe mean age (SD) for specialist health professionals, primary care professionals and patients who participated was 45 (11), 44 (15) and 68 (5) years with men being 50%, 80% and 76% of the participants respectively. Key strengths of the diabetes and kidney service were noted to be better integration of care and a perception of improved health and management of health. Whilst some aspects of access such as time between referral and initial appointment and having fewer appointments improved, other aspects such as in-clinic waiting times and parking remained problematic. Specialist health professionals noted that health professional education could be improved. Patient self-management was also noted by to be an issue with some patients requesting more information and some health professionals expressing difficulty in empowering some patients.ConclusionsHealth professionals and patients reported that a co-designed integrated diabetes kidney service improved integration of care and improved health and management of health. However, some aspects of the process of care, health professional education and patient self-management remained challenging.

Views of health professionals on the clinical recognition of orthorexia nervosa: a pilot study.

We present pilot, cross-sectional online survey data of health professionals in Australia and New Zealand about their attitudes towards orthorexia nervosa (ON), the proposed health food eating disorder. Our primary outcome was whether the professionals believed that ON should be a distinct, clinically recognised eating disorder. Fifty-two health professionals, predominantly psychologists and dietitians, completed the survey. Nearly, three-quarters of respondents (71%) believed that ON should be a distinct, clinically recognised eating disorder. This finding should be extended in a full study to inform future iterations of diagnostic manuals and the recognition and treatment of obsessively healthy eating. Level V, descriptive study of opinions of health professionals.