A controlled evaluation of social prescribing on loneliness for adults in Queensland: 8-week outcomes.

Introduction: There have been few controlled evaluations of Social Prescribing (SP), in which link workers support lonely individuals to engage with community-based social activities. This study reports early outcomes of a trial comparing General Practitioner treatment-as-usual (TAU) with TAU combined with Social Prescribing (SP) in adults experiencing loneliness in Queensland. Methods: Participants were 114 individuals who were non-randomly assigned to one of two conditions (SP, n = 63; TAU, n = 51) and assessed at baseline and 8 weeks, on primary outcomes (loneliness, well-being, health service use in past 2 months) and secondary outcomes (social anxiety, psychological distress, social trust). Results: Retention was high (79.4%) in the SP condition. Time × condition interaction effects were found for loneliness and social trust, with improvement observed only in SP participants over the 8-week period. SP participants reported significant improvement on all other outcomes with small-to-moderate effect sizes (ULS-8 loneliness, wellbeing, psychological distress, social anxiety). However, interaction effects did not reach significance. Discussion: Social prescribing effects were small to moderate at the 8-week follow up. Group-based activities are available in communities across Australia, however, further research using well-matched control samples and longer-term follow ups are required to provide robust evidence to support a wider roll out.

Medical evidence assisting non-fatal strangulation prosecution: a scoping review.

OBJECTIVES: Non-fatal strangulation (NFS) is a serious form of gendered violence that is fast becoming an offence in many jurisdictions worldwide. However, it often leaves little or no externally visible injuries making prosecution challenging. This review aimed to provide an overview of how health professionals can support the prosecution of criminal charges of NFS as part of regular practice, particularly when externally visible injuries are absent. METHOD: Eleven databases were searched with terms related to NFS and medical evidence in health sciences and legal databases. Eligible articles were English language and peer reviewed, published before 30 June 2021; sample over 18 years that had primarily survived a strangulation attempt and included medical investigations of NFS injuries, clinical documentation of NFS or medical evidence related to NFS prosecution. RESULTS: Searches found 25 articles that were included for review. Alternate light sources appeared to be the most effective tool for finding evidence of intradermal injury among NFS survivors that were not otherwise visible. However, there was only one article that examined the utility of this tool. Other common diagnostic imaging was less effective at detection, but were sought after by prosecutors, particularly MRIs of the head and neck. Recording injuries and other aspects of the assault using standardised tools specific for NFS were suggested for documenting evidence. Other documentation included writing verbatim quotes of the experience of the assault and taking good quality photographs that could assist with corroborating a survivor's story and proving intent, if relevant for the jurisdiction. CONCLUSION: Clinical responses to NFS should include investigation and standardised documentation of internal and external injuries, subjective complaints and the experience of the assault. These records can assist in providing corroborating evidence of the assault, reducing the need for survivor testimony in court proceedings and increasing the likelihood of a guilty plea.

Improving paediatric antimicrobial stewardship in remote and regional Queensland hospitals: development and qualitative evaluation of a tailored intervention for intravenous-to-oral antibiotic switching.

OBJECTIVES: Timely intravenous-to-oral antibiotic switching for children is important for paediatric antimicrobial stewardship (AMS). However, low decision-making confidence and fragmentation of patient care can hamper implementation, with difficulties heightened regionally where AMS programmes for children are lacking. The aim of this study was to develop and evaluate user-led creation and implementation of an intervention package for early intravenous-to-oral switching at regional hospitals in Queensland, Australia. DESIGN: Guided by theory, a four-phase approach was used to: (1) develop multifaceted intervention materials; (2) review materials and their usage through stakeholders; (3) adapt materials based on user-feedback and (4) qualitatively evaluate health workers experiences at 6 months postintervention. SETTING: Seven regional hospitals in Queensland, Australia. PARTICIPANTS: Phase 2 included 15 stakeholders; health workers and patient representatives (patient-guardians and Indigenous liaison officers). Phase 4 included 20 health workers across the seven intervention sites. RESULTS: Content analysis of health worker and parent/guardian reviews identified the 'perceived utility of materials' and 'possible barriers to use'. 'Recommendations and strategies for improvement' provided adjustments for the materials that were able to be tailored to individual practice. Postintervention interviews generated three overarching themes that combined facilitators and barriers to switching: (1) application of materials, (2) education and support, and (3) team dynamics. Overall, despite difficulties with turnover and problems with the medical hierarchy, interventions aided and empowered antibiotic therapy decision-making and enhanced education and self-reflection. CONCLUSIONS: Despite structural barriers to AMS for switching from intravenous-to-oral antibiotics in paediatric patients, offering a tailored multifaceted intervention was reported to provide support and confidence to adjust practice across a diverse set of health workers in regional areas. Future AMS activities should be guided by users and provide opportunities for tailoring tools to practice setting and patients' requirements.

Social prescribing link workers-A qualitative Australian perspective.

Social prescribing (or community referral) is a model of healthcare designed to address social needs that contribute to poor health. At the heart of social prescribing programs is the link worker, who liaises between clients, health professionals and community organisations. Social prescribing is newly emerging in Australia but there are already calls for a large-scale roll out. This research, therefore, aimed to understand Australian link workers' role and skills required, to determine where such a workforce could be drawn from in Australia, and to identify what training and resources are needed to support this potential new workforce. To explore these questions, interviews were conducted with 15 link workers in Queensland, New South Wales and Victoria, and the transcripts were analysed using thematic analysis. Participants were predominantly female (87%); and primarily had qualifications in social work (47%) or nursing (27%). Three overarching themes were identified: (1) skills of successful social prescribing, identifying that link work requires multifaceted social and emotional skills; (2) workforce issues, presenting that link workers experienced challenges such as a lack of available support and training, lack of public awareness of social prescribing and a lack of sustained funding; and (3) job fulfilment, related to link workers' sense of reward and accomplishment from the job. We suggest that fostering job fulfilment in conjunction with the provision of increased support, training and security will reduce feelings of overwork and burnout among link workers and likely lead to longevity in the role. Social prescribing has the potential to be hugely beneficial to clients and the community and fulfilling for link workers, provided that sufficient advocacy and resources are put in place.

Reproductive coercion and abuse among pregnancy counselling clients in Australia: trends and directions.

BACKGROUND: Reproductive coercion and abuse (RCA) interferes with a person's reproductive autonomy and can be classified into behaviours that are pregnancy promoting or pregnancy preventing (including coerced abortion). However, prevalence data are lacking, and little is known about whether particular forms of RCA are more or less common. The aims of our study were to explore how frequently people seeking pregnancy counselling reported RCA, the proportions reporting the different forms of RCA, and whether there were different trends based on a range of demographic factors. METHODS: Data were collected from 5107 clients seeking counselling support for their pregnancy between January 2018 and December 2020 from two leading providers of pregnancy counselling and sexual and reproductive health services in Australia, Marie Stopes Australia and Children by Choice. Counsellors identified and recorded the presence of RCA and whether the behaviour was pregnancy promoting and/or pregnancy preventing. Demographic factors included age, and whether the person identified as being from a migrant or refugee community or as an Aboriginal and/or Torres Strait Islander person. RESULTS: RCA was identified in 15.4% of clients, with similar proportions disclosing RCA towards pregnancy (6%) and towards pregnancy prevention or abortion (7.5%), and 1.9% experiencing RCA towards pregnancy and abortion concurrently. There were no differences based on age or whether the person identified as being from a migrant or refugee background, though people who identified as Aboriginal and/or Torres Strait Islander experienced RCA that was significantly more likely to be pregnancy promoting. CONCLUSIONS: RCA is commonly disclosed by people seeking support in a pregnancy counselling context, and coercion and abuse is equally likely to be towards pregnancy promotion or pregnancy prevention/abortion. Given the prevalence and negative impacts of RCA, regardless of age and background, we recommend sensitive and culturally respectful enquiry around experiences of RCA be embedded in healthcare, health education, and health research.

Reproductive coercion and abuse (RCA) is behaviour that interferes with a person's decision to become pregnant or to continue a pregnancy. We classified RCA into behaviours that attempt to promote pregnancy or to prevent/end a pregnancy. Drawing on data collected from 5107 people seeking counselling support for their pregnancy from two Australian services, this research explored how common the different types of RCA are. The research also looked at whether a person's age or whether the person identified as being from a migrant or refugee community or as an Aboriginal and/or Torres Strait Islander person made any difference to the type of RCA they experienced. We found that 15.4% of people reported RCA, with similar proportions reporting behaviours attempting to promote pregnancy and prevent/end pregnancy. Around 2% reported experiencing both forms of RCA. We found that there were no differences in frequency of RCA based on age or whether the person identified as being from a migrant or refugee background, although we found that people who identified as Aboriginal and/or Torres Strait Islander were proportionally more likely to experience RCA that was pregnancy promoting. Given how common RCA is, regardless of age and background, we recommend sensitive and culturally respectful enquiry around experiences of RCA be included in any conversations around sexual and reproductive health care and education.

Experiences of Reproductive Coercion in Queensland Women.

Reproductive coercion is any interference with a person's reproductive autonomy that seeks to control if and when they become pregnant, and whether the pregnancy is maintained or terminated. It includes sabotage of contraceptive methods and intervention in a woman's access to health care. Our study sought to explore the prevalence and associations with reproductive coercion within Queensland, Australia, where legislation addressing domestic violence and abortion are largely state based and undergoing a period of law reform. The study was a retrospective analysis of 3,117 Queensland women who contacted a telephone counseling and information service regarding an unplanned pregnancy. All data were collected by experienced counselors regarding circumstances within a current pregnancy between January 2015 and July 2017. Overall, experience of current domestic violence was significantly more likely to co-occur with reproductive coercion (21.1%) compared with reproductive coercion identified in the absence of other domestic violence (3.1%). Furthermore, significantly more mental health issues were reported by 36.6% of women affected by reproductive coercion, compared with 14.1% of women with no reproductive coercion present. Disclosure for reproductive coercion, violence, and mental health issues was much higher among women who made a repeat contact to the counselors about their pregnancy (17.8%) compared with those who disclosed at first contact (5.9%). These findings demonstrate the importance for health services to ensure that appropriate screening (and re-screening) for reproductive coercion is completed as a distinct part of screening for violence during a health care relationship.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms.

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation. Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts. Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment. Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.

The effects of social group interventions for depression: Systematic review.

BACKGROUND: There is a growing prevalence of prolonged antidepressant use globally. Social group interventions may be an effective way to manage mild to moderate depression, especially with patients seeking to discontinue antidepressant use. This systematic review evaluates studies that used social group interventions to manage depression. METHODS: Studies published up to June 2019 in nine bibliographic databases were identified using search terms related to depression, social interventions, and social participation. Formal therapies for depression (cognitive behaviour therapy, music therapy) were excluded as they have been reviewed elsewhere. RESULTS: 24 studies met inclusion criteria; 14 RCTs, 6 non-randomised controlled trials and 4 pre-post evaluations. In total, 28 social group programs were evaluated, 10 arts-based groups, 13 exercise groups and 5 others. Programs ranged in 'dose' from 5 to 150 hours (M = 31 hours) across 4 to 75 weeks (M = 15 weeks) and produced effect sizes on depression in the small to very large range (Hedge's g = .18 to 3.19, M = 1.14). A regression analysis revealed no participant variables, study variables or intervention variables were related to effect size on depression. LIMITATIONS: Risks of bias were found, primarily in the non-randomised studies, which means the findings must be regarded as preliminary until replicated. CONCLUSION: These findings indicate that social group interventions are an effective way to manage mild to moderate depression symptoms in a variety of populations. This approach may also help to prevent relapse among patients tapering off antidepressant medication.

Using crying to cope: Physiological responses to stress following tears of sadness.

This research tested the hypothesis that emotional crying facilitates coping and recovery, specifically through physiological changes that occur during crying. Female undergraduate students (N = 197) were randomly assigned to either a sad or neutral condition using short videos. Sad videos were selected for their extreme emotion elicitation. We predicted that compared to those who did not cry to the stimuli and those who were exposed to neutral videos, people who cried would (a) be able to withstand a stressful task for longer; (b) show lower levels of cortisol following crying and exposure to the stressor; and (c) have faster recovery (i.e., return to baseline levels of affect). The final groups consisted of the neutral group (n = 65), sad criers (n = 71), and sad noncriers (n = 61). After a 5-min baseline period, participants watched either the sad or neutral videos for 17 min and then completed a physical stressor (cold pressor test). Heart rate and respiration were continuously recorded, whereas salivary samples for cortisol were taken at 4 separate time points during testing. Analyses revealed no differences between the 3 groups in time withstanding the stressor or cortisol changes. Respiration rate, however, increased in the neutral group and noncriers while watching the videos, with criers' respiration remaining stable. Furthermore, heart rate was found to decelerate just before crying, with a return to baseline during the first crying period. These results suggest that crying may assist in generally maintaining biological homeostasis, perhaps consciously through self-soothing via purposeful breathing and unconsciously through regulation of heart rate. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Relationship of Gender Roles and Beliefs to Crying in an International Sample.

This study aimed to (1) investigate the variation in self ascription to gender roles and attitudes toward gender roles across countries and its associations with crying behaviors, emotion change, and beliefs about crying and (2) understand how the presence of others affects our evaluations of emotion following crying. This was a large international survey design study (N = 893) conducted in Australia, Croatia, the Netherlands, Thailand, and the United Kingdom. Analyses revealed that, across countries, gender, self-ascribed gender roles, and gender role attitudes (GRA) were related to behavioral crying responses, but not related to emotion change following crying. How a person evaluates crying, instead, appeared to be highly related to one's beliefs about the helpfulness of crying, irrespective of gender. Results regarding crying when others were present showed that people are more likely both to cry and to feel that they received help around a person that they know, compared to a stranger. Furthermore, closeness to persons present during crying did not affect whether help was provided. When a crier reported that they were helped, they also tended to report feeling better following crying than those who cried around others but did not receive help. Few cross-country differences emerged, suggesting that a person's responses to crying are quite consistent among the countries investigated here, with regard to its relationship with a person's gender role, crying beliefs, and reactions to the presence of others.

Does crying help? Development of the beliefs about crying scale (BACS).

Crying is often considered to be a positive experience that benefits the crier, yet there is little empirical evidence to support this. Indeed, it seems that people hold a range of appraisals about their crying, and these are likely to influence the effects of crying on their emotional state. This paper reports on the development and psychometric validation of the Beliefs about Crying Scale (BACS), a new measure assessing beliefs about whether crying leads to positive or negative emotional outcomes in individual and interpersonal contexts. Using 40 preliminary items drawn from a qualitative study, an exploratory factor analysis with 202 participants (50% female; aged 18-84 years) yielded three subscales: Helpful Beliefs, Unhelpful-Individual Beliefs, and Unhelpful-Social Beliefs, explaining 60% of the variance in the data. Confirmatory factor analysis on the 14-item scale with 210 participants (71% female; aged 17-48 years) showed a good fit to the three factors. The subscales showed differential relationships with measures of personality traits, crying proneness, emotion regulation and expressivity, and emotional identification (alexithymia). The BACS provides a nuanced understanding of beliefs about crying in different contexts and helps to explain why crying behaviour may not always represent positive emotion regulation for the crier.

Associations Between Unintended Pregnancy, Domestic Violence, and Sexual Assault in a Population of Queensland Women.

This study aimed to establish the proportion of women seeking information regarding unintended pregnancy in the context of domestic violence (DV) and/or sexual assault (SA) experiences in Queensland. Mental health, sociodemographic variables, and gestation at first and repeated contacts were examined for 6249 women primarily seeking information regarding abortion options during an unintended pregnancy over the 5-year period from July 2012 to June 2017. Reports of DV and SA and associations with mental health issues increased significantly across the 5 years. First contact rates of disclosure were 12.2% for DV and 3% for SA, and higher among repeat contacts (38.1% for DV and 14.1% for SA), with recurring contact facilitating violence disclosure. Restricting access to abortions in the context of violence impedes a woman's agency in attempts to separate from violence and highlights the need for safe, supportive, and accessible services, to assist in screening and assisting with violence.