The MuSeS project: a mixed methods study to increase understanding of the role of settlement and multicultural services in supporting migrant and refugee women experiencing violence in Australia.

BACKGROUND: Violence against women is a major human rights and public health issue globally. The experience of violence affects women across Australia, including the large number of migrant and refugee women who permanently or temporarily resettle in the country. Many women who experience violence find it difficult to access support, and evidence suggests women who have resettled in Australia face additional barriers to violence-specific services. Previous research, however, indicates many migrant and refugee women experiencing violence have contact with, and may disclose violence to, settlement and multicultural services. There has been limited research documenting current knowledge of, and practices by, settlement and multicultural services in relation to violence. The MuSeS project will address this knowledge gap and identify strategies settlement and multicultural services can use to better support women experiencing violence. METHODS: This mixed methods research project will be conducted in six geographic communities across three Australian states: South Australia, Tasmania and Victoria. The different migration and resettlement patterns seen in these jurisdictions will enable generation of data relevant to settings across the country. The project has been designed in consultation with partner organisations from the settlement and multicultural service sector to ensure the research addresses their concerns and priorities. A mix of quantitative and qualitative methods will be used to generate rich data to inform strategies for settlement and multicultural services to better support women experiencing violence. These methods include an anonymous online survey of settlement and multicultural service providers to assess current knowledge, practices and professional development needs; in-depth interviews with settlement, multicultural and specialist (refugee) mental health service providers; in-depth interviews with refugee women; and focus group discussions with frontline workers and volunteers working with settlement and multicultural services. DISCUSSION: Findings from this two-year research project will generate an in-depth understanding of the current and potential role of Australian settlement and multicultural services in supporting migrant and refugee women experiencing violence, and inform strategies to strengthen services' capacity to appropriately respond. Given the prevalence of violence against women globally, findings will be useful for services engaging with migrant and refugee populations around the world.

Untangling the Threads: Stakeholder Perspectives of the Legal and Ethical Issues Involved in Preparing Australian Consumers for Commercial Surrogacy Overseas.

This article focuses on the complexities of regulating Australians' access to commercial surrogacy overseas. Altruistic surrogacy is allowed in Australia but access to women willing to act as surrogates is limited and many Australians now seek surrogacy arrangements via commercial agencies overseas. This qualitative study interviewed key stakeholders in Australia, including clinicians providing reproductive medicine, lawyers providing legal services, consumer advocates, counsellors and health policy regulators. The aim of the study was to explore perceptions of various experts concerning commercial surrogacy overseas so as to identify issues for the establishment of ethical guidelines and surrogacy policies in Australia. A number of issues relevant to Australians seeking commercial surrogacy overseas were identified and in particular, relating to the level of informed decision-making required by intending parents as well as concerns for the welfare of children born. Amendments to current ethical guidelines and protections for children born and entering Australia are recommended.

The role of emotional vulnerability and abuse in the financial exploitation of older people from culturally and linguistically diverse communities in Australia.

While the literature acknowledges that older people from culturally and linguistically diverse (CaLD) communities are particularly susceptible to financial abuse by their family members, there is a dearth of research that explores the nature of CaLD older people's vulnerability to this form of abuse. This case study examines unique dynamics shaping this form of abuse and demonstrates how emotional vulnerability and dependence, exacerbated by cultural and linguistic disconnection, can place older people at risk.

What are school leavers' priorities for festival preparation?

This paper reports on the findings from a qualitative research study that explored how young people prepared to minimise and/or avoid alcohol-related harm while attending a Schoolies Festival (SF). SFs are mass gatherings at which young people (schoolies) celebrate their graduation from high school. The attendance of schoolies, in various Australian communities, ranges between 10 000 and 30 000 individuals during the event. The literature suggests that schoolies are at higher than normal risk of harm at SF from misuse of alcohol, unsafe sex, aggressive behaviour, and other risk-taking factors. As a result of these concerns, SF organisers developed an infrastructure that treats alcohol-related harm, and provides on-site care (first aid stations) by St John Ambulance staff. This study used focus groups to identify strategies used by schoolies to avoid alcohol-related harm during SFs. Data revealed that schoolies did not actively seek health information before attending the event and did not display an interest in doing so. It is important to note that schoolies planned to use alcohol to celebrate and have a good time. Therefore a harm minimisation approach with a focus on providing the necessary infrastructure at SFs to minimise the dangers associated with excess alcohol use is important. Schoolies indicated that they had no desire for information about the hazards of alcohol ingestion. If any health messages were to be used by health authorities, it would be far more appropriate to promote the message of 'take care of your mate', to contribute to building a supportive environment at the event. This may be of more benefit to minimise harm at SFs than funding other health messages.

Third-year Australian nursing students' attitudes, experiences, knowledge, and education concerning end-of-life care.

BACKGROUND: Nurses have a vital role in providing end-of-life care to patients and their families, and it is important that nursing students are adequately prepared for this role. AIM: This article reports on qualitative findings from research that explored a cohort of third-year undergraduate Australian nursing students' attitudes, experiences, knowledge, and education concerning end-of-life care. METHODS: The study used open-ended questions in a purpose-designed, self-administered questionnaire and thematic analysis of the responses. FINDINGS: Five themes emerged from the analysis: the importance of the students' values and beliefs, the influence of experience, their views on what constitutes a good or bad death, their knowledge of ethics and legislation surrounding end-of-life care, and how they perceived their level of education and knowledge. CONCLUSION: The need for more education on end-of-life care has implications for curriculum development in undergraduate nursing programmes, which need to provide graduating nurses with the necessary knowledge and skills to deliver quality care to patients who are dying and their families.

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review.

Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education.

Building public policy to support young people in reducing alcohol-related harm when partying at Schoolies Festivals.

Mass gatherings such as Schoolies Festivals are often situated in existing communities. Schoolies Festivals are generally unbounded, transient mass gathering events that are situated within various coastal communities around Australia. Mass gatherings are traditionally examined as separate case studies or through using a mass gathering framework to assess patient safety. However, mass gathering frameworks and single case studies do not go far enough to examine events such as Schoolies Festivals. Schoolies Festivals often consist of a bounded ticketed dry zone for night time activities, surrounded by open dry zones, which are an unbounded part of the general community social space and can include hotels, caravan parks and the local community services. We believe that the Ottawa Charter provides the necessary broader lens through which to examine the safety of young people participating in Schoolies Festivals. The Ottawa Charter views health in terms of the whole population and although developed in 1986, maintains its relevance in contemporary social and health contexts. As a primary health care framework, the Ottawa Charter provides researchers and policy makers with the capacity to think 'outside the square' to develop strategies to prevent harm for young people attending such events. In addition the Ottawa Charter is a useful framework as it views the health of whole populations and maintains its relevance today. Through examining the needs of the community through a primary health care framework, the interface between the Schoolies event and the wider community can be examined to address some of the underlying structural factors that contribute to the safety of young people at Schoolies Festivals.

Conceptual framework of the nursing centre for the integration of community health nursing practice, education, and research.

AIM: To develop a conceptual framework that can be used for the integration of community health nursing (CHN) practice, education, and research within a Nursing Centre (NC) model. BACKGROUND: New forms of training and support are needed to equip nurses to manage the complex and costly challenges facing health care systems. The NC model provides scope to address these challenges by integrating nursing practice, education, and research. However, there is little information about how these constructs are integrated or how education is constituted within the model. METHODS: This study used an embedded single case study design across three Nursing Centres (NCs) in West Java Indonesia. Semi-structured interviews and a review of relevant documents were conducted. Interview participants were recruited purposively to select stakeholders with rich information, including clients, nurses, nursing students and lecturers who have been using the NC model, as well as the head of the co-located Community Health Centres. Data was analysed using thematic analysis, pattern matching and cross-unit synthesis. FINDINGS: Four components relevant to integration in the NC were identified, namely (1) client-centred care as the shared common ground for integration in the NC; (2) nursing education using a service learning approach; (3) the NC as a model for reviving CHN services; and (4) service improvement through research and community service activities. The service learning approach was identified as appropriate because it links services with the learning process and this serves to address the interests of both practice and education institutions. The conceptual framework identified in this study can be used to improve the functionality of NCs in Indonesia and be considered for use internationally.

Raising the Awareness of Undergraduate Nurses to the Psychosocial Impact of Living with Cancer: A Consumer Engagement in Teaching Initiative.

This article reflects on the development and implementation of a consumer engagement in teaching initiative by the authors. The authors highlight the challenges of engaging undergraduate nursing students on the psychosocial aspects of living with cancer and other chronic illnesses when students have very limited personal and professional experiences to draw on. The authors discuss how they have responded to these challenges by integrating the voices of consumers into their classrooms. Speakers from consumer advocacy organization, Cancer Voices SA, participated in a series of tutorials in a 1st year topic in the Undergraduate Nursing Program at the School of Nursing and Midwifery, Flinders University. Student feedback from the implementation of the initiative indicated that students found consumers' stories and experiences of living with cancer, "moving and powerful" and that they encouraged students to question their assumptions about the psychosocial impacts of cancer on individuals and families. The importance of good communication in reducing patient distress was identified by students as an important element of consumers' experiences of the health care system as was the need for transparency and information sharing between health care providers across the health care system. For many students, consumers' stories and experiences had reinforced students' commitment to studying nursing and pursuing a career in nursing. The article concludes that involving consumers in the education of health care professionals encourages a much deeper understanding of and empathy for how patients experience disease, which is integral to the provision of patient-centered and holistic care.

Corrigendum: Gender Differences in the Physical and Psychological Manifestation of Childhood Trauma and/or Adversity in People with Psychosis.

[This corrects the article on p. 1768 in vol. 6, PMID: 26635676.].

Gender Differences in the Physical and Psychological Manifestation of Childhood Trauma and/or Adversity in People with Psychosis.

The link between childhood trauma and/or adversity and risk of psychosis is well known. Our aim was to determine the prevalence of childhood trauma and/or adversity in people who have psychotic disorders and to investigate the association between childhood trauma and/or adversity and a range of social and health measures. Participants (n = 391, 42% male) were specifically asked about any experience of childhood trauma and/or adversity. Respondents provided information about education, employment, physical health, and health service utilization. Univariate analyses revealed that childhood trauma and/or adversity was associated with poorer levels of self-reported physical health and social problems. This includes the experience of chronic pain, headaches, arthritis, asthma, and victimization/stigma in men. Participants with a childhood trauma and/or adversity history indicated higher rates of lifetime suicide attempts with women reporting more lifetime depressive symptoms. Multivariate analyses revealed differing profiles in relation to physical and psychological health variable between males and females. Males with the experience of childhood trauma and/or adversity were significantly more likely to report cardiovascular/stroke issues, migraines and anhedonia. Females with the experience of childhood trauma and/or adversity were more likely to report a lifetime history of elevated mood and to be married or in a de facto relationship. There has been very little research into the assessment and treatment of the effects of childhood trauma and/or adversity in adults with psychosis. Childhood trauma and/or adversity may contribute to higher rates of self-reported poor health in men and is associated with increased depression in women. Our findings suggest that interventions to address the effects of past trauma are urgently needed.

Psychosis, Socioeconomic Disadvantage, and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis.

The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses, such as psychosis, are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper, thus, examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health, and health service utilization in a community sample of 402 participants diagnosed with psychosis. The paper utilizes quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, SA, Australia. Participants (42% female) provided information about socioeconomic status, education, employment, physical health, contact with family and friends, and health service utilization. The paper highlights that socioeconomic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact, and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by this disadvantage be an important focus for mental health services. Such health policy would provide accessible treatment programs and linked pathways to illness recovery and diminish the pressure on the delivery of health services. Consequently, the development of policy and practice that seeks to redress the socioeconomic and health inequalities created by disadvantage should be an important focus for the improvement of mental health services.

" . . . There is no war here; it is only the relationship that makes us scared": factors having an impact on domestic violence in Liberian refugee communities in South Australia.

This article explores the factors that have an impact on domestic violence in African refugee communities, with specific reference to the Liberian community in South Australia. Seventeen focus group discussions were undertaken with women participants of the Liberian Women's Gathering. The nested ecological model (Dutton, 2001; Heise, 1998) is used to conceptualize the factors having an impact on domestic violence. The findings suggest that disruption to traditional gender roles has an impact on domestic violence at the cultural, socioeconomic, familial, and individual levels and that women's experience of domestic violence must be understood in relation to the acute and prolonged stressors of war, loss, and displacement.