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

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

Unpaid Professional Work at Home and Work-Life Interference among Employees with Care Responsibilities.

Employees with caregiving responsibilities often experience work-life interference (WLI), particularly when caring for either disabled persons and/or children. This study examines sample of 288 working Australians from the AWALI national survey data, who care for at least one family member or friend with long-term physical or mental illness, disability, or aging-related problems. We investigated the role of unpaid work at home in predicting WLI, based on a model that included indirect association via inferred causes for working unpaid hours at home and a conditional direct relationship based on number of children. The findings supported our prediction that unpaid work at home is positively associated with WLI but its effect is moderated by number of children. There was a conditional direct effect where employees with care responsibilities experienced a stronger relationship between unpaid hours and WLI when having more children. Further, when the perceived reason for unpaid work was excessively demanding work, the relationship with WLI was stronger. Implications for workers with multiple caregiving responsibilities are discussed.

'Very demanding. Extremely rewarding': Exploring the co-occurrence of burnout and engagement in alcohol and other drug workers.

INTRODUCTION: Alcohol and other drug (AOD) work can be highly meaningful and satisfying, but also intense and highly demanding. This combination often creates significant strain for workers. Mirroring this complexity, this study considered the predictors and outcomes of the concurrent experience of burnout and engagement in AOD workers. The Job Demands-Resources model informed the study. METHODS: This study utilised data from a recent Australian AOD workforce survey. The sample comprised 886 workers in direct client service roles. K-means cluster analysis on burnout and engagement measures identified four discrete groups: burnt out (15.6%) (high burnout/low engagement), engaged (36.7%) (low burnout/high engagement), overextended (26.5%) (high burnout/high engagement) and indifferent (21.2%) (low burnout/low engagement). RESULTS: Multinomial logistic regression analysis indicated that workers were more likely to be burnt out or overextended, rather than engaged, if they reported high work intensity, low organisational openness to change and low support. Multivariate analysis of variance showed burnt-out workers had the least favourable and engaged respondents the most favourable outcomes on job satisfaction, turnover intention, health and life quality. Overextended workers were comparable to indifferent workers on these outcomes. DISCUSSION AND CONCLUSION: This study offers a unique and nuanced view of AOD worker wellbeing. For the one-quarter of workers reporting simultaneous burnout and engagement, their enthusiasm and commitment did not protect them from poor personal and organisational outcomes typically linked with burnout. The need for systemic and structural interventions is clearly indicated, including open and supportive organisational cultures, leadership development and adequate staffing.

Why are you asking about gender? Negotiating survey research methods within an industry collaboration.

Objectives: This brief report describes a survey design process undertaken in collaboration with industry stakeholders from government, non-government and other applied fields. This account highlights fundamental and contested issues of knowledge creation in research, situated within the broader contemporary context of social change addressing inequality and inclusion for historically marginalised and vulnerable groups. Study design: The study comprised a non-probability survey of the Australian Alcohol and Other Drugs Workforce. Methods: A reflective account is provided. Results: Significant and unanticipated differences in conceptual frames and perceptions of research ethics between the research team and industry representatives emerged during the collaboration, with major implications for the validity of the research process. Conclusions: The traditional, and largely unquestioned, understanding of quantitative survey research methodology is encountering increasing challenges in light of contemporary considerations of identity, privacy and wellbeing of survey participants. Some of these differences seriously challenged conventional approaches to research methodology, quality and rigour. There is a pressing need for further exploration, discussion and debate regarding the process of knowledge creation, ownership and stewardship. Strategies to better equip the research community and their industry stakeholders to navigate issues of research veracity, integrity and rigour are urgently needed, including training and guidance on negotiate differences in values, priorities and perspectives for upcoming and established researchers.

Older Australians' perceptions of alcohol-related harms and low-risk alcohol guidelines.

INTRODUCTION AND AIMS: Australia has an ageing population. Given the concomitant increase in the numbers and proportion of risky drinkers among older adults, research examining contributory factors is a priority. The current study examined older adults' estimates of the NHMRC low-risk drinking guidelines, consumption patterns and associated harms and self-identification of drinking type. DESIGN AND METHODS: Data from respondents aged 50+ years (N = 11 886) in the 2016 National Drug Strategy Household Survey were subjected to secondary analyses. Estimates of low-risk drinking levels, perceived level of harm from current drinking, self-identification of drinking type and awareness of standard drinks and labelling were included. Data were examined for those aged 50-59 years and 60+. RESULTS: Seventeen percent of older Australians drank at both long-term and short-term risk levels. Approximately 39% of males and 11% of females overestimated the long-term low-risk levels and 54% of males and 20% of females overestimated the short-term low-risk levels. Overestimation was highest among risky drinkers. Most older risky drinkers were aware of standard drinks and labelling; however, less than half perceived their drinking as harmful, instead identifying as social drinkers. DISCUSSION AND CONCLUSIONS: Although substantial gaps are evident in older respondents' estimates of low-risk drinking, additional public awareness campaigns are likely to be of limited use. Older peoples' engagement with the public health system presents 'windows of opportunity' to provide targeted, age-appropriate harm reduction strategies. Appropriate intervention and policy responses are required to direct resources to this emerging area of concern.

"It breaks your soul": An in-depth exploration of workplace injustice in nursing.

AIM(S): To understand nurses' experiences of injustice in the workplace and to identify the impact of injustice on well-being. BACKGROUND: Little is known about how nurses view injustice or its effects on their well-being, although research indicates that such perceptions are central to workplace practices such as performance management and outcomes such as employee well-being. METHOD(S): A qualitative study was conducted with semi-structured interviews for nurses employed in Australian public hospitals. Data were analysed using content analysis. RESULTS: Experiences of injustice and unfairness negatively impacted on performance and the personal health of nurses. Unfair treatment was met with reduced effort and commitment. CONCLUSION(S): This study provides valuable insights into how nurses perceive and experience injustice at work and supports the link between injustice and nurses' decreased well-being and effectiveness. IMPLICATIONS FOR NURSING MANAGEMENT: Implications for nurse managers include the need for managers to engage in regular conversations regarding systemic barriers to performance and implementing performance management as an ongoing dialogue designed for employee voice and relationship management. This process also suggests a need for leadership development in nursing management. Using such steps and strategies would significantly enhance best practice in nursing management.

Seed dispersal of Diospyros virginiana in the past and the present: Evidence for a generalist evolutionary strategy.

Several North American trees are hypothesized to have lost their co-evolved seed disperser during the late-Pleistocene extinction and are therefore considered anachronistic. We tested this hypothesis for the American persimmon (Diospyros virginiana) by studying the effects of gut passage of proposed seed dispersers on seedling survival and growth, natural fruiting characteristics, and modern animal consumption patterns. We tested gut passage effects on persimmon seeds using three native living species, the raccoon (Procyon lotor), Virginia opossum (Didelphis virginiana), and coyote (Canis latrans), and two Pleistocene analogs; the Asian elephant (Elephas maximus) and alpaca (Vicugna pacos). Persimmon seeds excreted by raccoons, coyotes, and elephants survived gut transit. Gut passage did not affect sprouting success, but did tend to decrease time to sprout and increase seedling quality. Under field conditions, persimmon fruits were palatable on the parent tree and on the ground for an equal duration, but most fruits were consumed on the ground. Seven vertebrate species fed upon persimmon fruits, with the white-tailed deer (Odocoileus virginianus)-a species not capable of dispersing persimmon seeds-comprising over 90% of detections. Conversely, potential living seed dispersers were rarely detected. Our results suggest the American persimmon evolved to attract a variety of seed dispersers and thus is not anachronistic. However, human-induced changes in mammal communities could be affecting successful seed dispersal. We argue that changes in the relative abundance of mammals during the Anthropocene may be modifying seed dispersal patterns, leading to potential changes in forest community composition.

Chicken interferome: avian interferon-stimulated genes identified by microarray and RNA-seq of primary chick embryo fibroblasts treated with a chicken type I interferon (IFN-α).

Viruses that infect birds pose major threats-to the global supply of chicken, the major, universally-acceptable meat, and as zoonotic agents (e.g. avian influenza viruses H5N1 and H7N9). Controlling these viruses in birds as well as understanding their emergence into, and transmission amongst, humans will require considerable ingenuity and understanding of how different species defend themselves. The type I interferon-coordinated response constitutes the major antiviral innate defence. Although interferon was discovered in chicken cells, details of the response, particularly the identity of hundreds of stimulated genes, are far better described in mammals. Viruses induce interferon-stimulated genes but they also regulate the expression of many hundreds of cellular metabolic and structural genes to facilitate their replication. This study focusses on the potentially anti-viral genes by identifying those induced just by interferon in primary chick embryo fibroblasts. Three transcriptomic technologies were exploited: RNA-seq, a classical 3'-biased chicken microarray and a high density, "sense target", whole transcriptome chicken microarray, with each recognising 120-150 regulated genes (curated for duplication and incorrect assignment of some microarray probesets). Overall, the results are considered robust because 128 of the compiled, curated list of 193 regulated genes were detected by two, or more, of the technologies.

Drivers and barriers to heat stress resilience.

Heatwaves are the most dangerous natural hazard to health in Australia. The frequency and intensity of heatwaves will increase due to climate change and urban heat island effects in cities, aggravating the negative impacts of heatwaves. Two approaches exist to develop population heat stress resilience. Firstly, the most vulnerable social groups can be identified and public health services can prepare for the increased morbidity. Secondly, the population level of adaptation and the heat stress resistance of the built environment can be increased. The evaluation of these measures and their efficiencies has been fragmented across research disciplines. This study explored the relationships between the elements of heat stress resilience and their potential demographic and housing drivers and barriers. The responses of a representative online survey (N=393) about heat stress resilience at home and work from Adelaide, South Australia were analysed. The empirical findings demonstrate that heat stress resistant buildings increased adaptation capacity and decreased the number of health problems. Air-conditioning increased dependence upon it, limited passive adaptation and only people living in homes with whole-house air-conditioning had less health problems during heatwaves. Tenants and respondents with pre-existing health conditions were the most vulnerable, particularly as those with health conditions were not aware of their vulnerability. The introduction of an Energy Performance Certificate is proposed and discussed as an effective incentive to increase the heat stress resistance of and the general knowledge about the built environment.

A work-life perspective on sleep and fatigue--looking beyond shift workers.

This study examines sleep and fatigue through a work-life lens. Whilst most often thought of as an issue for shift workers, this study observed that self-reported insufficient sleep and fatigue were prevalent for workers on standard daytime schedules. Using a representative sample of 573 daytime workers (51.3% men; 70.7% aged 25-54 yr) from one Australian state, it was observed that 26.4% of daytime workers never or rarely get the seven hours of sleep a night that is recommended for good health. Those with parenting responsibilites (29.4%) or working long (45+) hours (37.4%) were most likely to report insufficient sleep. Whereas mothers in full-time work were most likely to report frequent fatigue (42.5%). This study highlights the common experience of insufficient sleep and fatigue in a daytime workforce, with significant implications for health and safety at work and outside of work. Stronger and more effective legislation addressing safe and 'decent' working time is clearly needed, along with greater awareness and acceptance within workplace cultures of the need to support reasonable workloads and working hours.

Alcohol consumption patterns of shiftworkers compared with dayworkers.

The detrimental effects of excessive alcohol consumption are well documented. There is some evidence that shiftworkers consume more alcohol than dayworkers as a sleep aid to compensate for sleep difficulties associated with work schedules. This study investigated drinking patterns between shiftworkers and dayworkers using the 2006 and 2007 waves from the Household Income and Labour Dynamics Survey. A subset of workers who were not in full-time study and had a single job were selected; participants who did not drink alcohol (n = 2090) were excluded. Using the 2001 Australian Government alcohol guidelines, alcohol consumption for risk of short-term harm (7+ standard drinks for men, 5+ for women) was investigated. The number of workers who drank alcohol "nearly every day" or "every day" was also examined. Some 13% of shiftworkers and 10% of those on standard schedules reported consuming alcohol at levels risky for short-term harm. Having a child less than 17 yrs (odds ratio [OR] = .39, 95% confidence interval [CI] = .22-.69), higher job demands (OR = .71, 95% CI = .58-.86), being female (OR = .45, 95% CI=. 26-.79), and being older (OR = .89, 95% CI = .87-.92) significantly reduced, whereas being a shiftworker (OR = 2.10, 95% CI = 1.08-4.12) significantly increased, the odds of drinking alcohol in short-term risky levels. Nearly 10% of shiftworkers and 8% of those on standard schedules reported consuming alcohol in short-term risky levels at least weekly. Having a child less than 17 yrs (OR = .40, 95% CI = .22-.74), higher job demands (OR = .69, 95% CI = .56-.86), being female (OR = .28, 95% CI = .15-.53), and being older (OR = .92, 95% CI = .89-.94) were associated with a significant reduction in the odds of consuming alcohol at risky levels at least weekly. Being a shiftworker was not associated with a significant increase in the odds of consuming alcohol at such risky levels at least weekly, but a trend was evident (OR = 1.47, 95% CI = .73-3.00). Some 13.5% of shiftworkers and 21% of those on standard schedules reported consuming alcohol in any amount "near daily" or "daily." Working more hours than preferred (OR = 1.80, 95% CI = 1.12-2.89) and being older (OR = 1.10, 95% CI = 1.07-1.13) were associated with a significant increase, and being female (OR = .18, 95% CI = .10-.33), and being a shiftworker (OR = .20, 95% CI = .09-.45) were associated with a significant decrease in the odds of consuming alcohol "daily" or "near daily." Overall, the results suggest that shiftworkers may be more likely to consume alcohol at levels considered to be risky for health in the short term. In contrast, they appear less likely to drink alcohol daily. This pattern is suggestive of "binge drinking" behavior.

From data to evidence, to action: findings from a systematic review of hospital screening studies for high risk alcohol consumption.

OBJECTIVE: To conduct a systematic review of hospital alcohol screening studies to identify effective and efficient evidence-based strategies. METHOD: Sixty-five studies (N=100,980) of alcohol problem prevalence amongst hospital patients were reviewed. RESULTS: Prevalence of positive alcohol screens varied according to hospital location, screening tool and patient characteristics. BAC measures (26%) were nearly twice as likely (OR=1.92, p<.001) to reveal positive screens in the ED than self-reports (16%). No difference was found in prevalence of self-report positive screens between ED (16%) and ward settings (17%). Males were two to four times more likely than females to screen positive (BAC: OR=2.37, p<.001, ED self-report: OR=3.07, p<.001, ward self-report: OR=4.30, p<.001). ED patients aged 20-40 years and ward patients aged 30-50 years had the highest prevalence of positive screens. CONCLUSIONS: Prevalence of risky or problematic drinking among hospital patients is high and warrants systematic screening and intervention. Many hospitals lack sufficient resources to undertake widespread screening programs. For optimum return on resources, it is recommended to screen males in the ED using BAC measures. Established protocols applying priority criteria and staff training can increase screening accuracy and effectiveness.

The general practitioner pharmacotherapy prescribing workforce: examining sustainability from a systems perspective.

As prescribers of opioid pharmacotherapies, general practitioners (GPs) are pivotal to the sustainability of opioid pharmacotherapy treatment services. The goal of this study was to examine the nature and sustainability of the Australian GP prescriber workforce in order to inform future programmes and policy development in this area. Data were collected from four Australian states: South Australia, Queensland, Victoria and New South Wales. Key features of the available data were: a heavy client load carried by a small number of prescribers, a high proportion of trained but inactive prescribers, and a high proportion (one-third to two-thirds) of medical practitioners who undertake training but do not take up prescribing, i.e. a high attrition rate. Available data indicate significant shortfalls in the number of prescribers available in each state to service this patient population. Across all states a relatively small number of prescribers were providing services for the majority of methadone clients. In order to achieve sustainable, high quality prescriber service provision, workforce development strategies are needed which focus on recruitment of new prescribers, and the support and retention of existing and inactive prescribers. Establishment of systematic and detailed data collection systems should also be considered a priority.

The dynamics of threat and challenge appraisals prior to stressful achievement events.

Research on cognitive appraisal of stressful achievement events has emphasized threat appraisals and anxiety. The present research also focused on challenge and positive emotion. Study 1 used hypothetical scenarios of stressful events. Study 2 explored temporal pattems of appraisal and emotion prior to an exam. Compared with threat appraisals, trait and state challenge appraisals were associated with more confident coping expectancies, lower perceptions of threat, higher positive emotion, and more beneficial perceptions of the effects of appraisal and emotion on performance. Beneficial perceptions of state appraisals were associated with higher exam performance. These findings were interpreted in the context of theoretical perspectives on the cognitive appraisal of stressful events and the adaptive functions of challenge and positive emotion.