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The international tertiary education sector was significantly affected by the COVID-19 pandemic due to the risk of negative learning and psychosocial experiences. Most international students who remained in the host countries demonstrated admirable resilience and adaptability during those challenging times. An integrative review of factors shaping international students’ learning and mental wellbeing during the COVID-19 pandemic was conducted. Five electronic databases—CINAHL, MEDLINE, ProQuest, PsycINFO, and Web of Science—were searched from 2020 to 2023 using the key search terms ‘international students’, ‘tertiary education’, ‘mental health and wellbeing’, and ‘COVID’. A total of 38 studies were included in this review. They revealed six factors across learning and psychosocial experiences. Predisposing factors for maladjustments included the students being younger and possessing poor English proficiency. Precipitating factors were related to online teaching/learning, and lack of accessibility and or insufficient learning and living resources. Perpetuating factors pertained to living arrangements. The protective factor identified was institutional support. This review highlighted that multifaceted factors were associated with international students’ experiences and mental health and wellbeing. In-depth understanding of risk and protective factors can help policymakers to prepare for unprecedented challenges and reduce disruptions to international students’ education and mental health when studying abroad.

Background Mental disorders significantly burden Indigenous communities, worsened by limited culturally appropriate services. Spatial inequalities in access further disadvantage Indigenous peoples, especially in socio-economically challenged areas. This paper measures the spatial accessibility of Indigenous community-controlled mental health services in South East Queensland, Australia and examines its social inequalities across the region. Methods We considered both population and health service providers’ capacity to maximise service coverage in measuring potential access to the services. Using Geographical Information Systems (GIS) technologies, a Gaussian-based two-step floating catchment area (G2SFCA) method was applied to quantify accessibility under four driving time thresholds ranging from 15 to 60 minutes. Bivariate global and local Moran’s I statistics were used to analyse social inequalities in accessibility across various geographical areas. Results Accessibility was higher in urban areas than those towards the peri-urban and rural areas; the overall spatial coverage was relatively limited for service access within the 15- or 30-minute driving time threshold, compared with the 45- or 60-minute driving time threshold. Lower levels of accessibility were identified in areas with a concentration of Indigenous and socio-economically disadvantaged populations. Conclusions This study advances a socially informed spatial inequality assessment framework. Unlike previous research exploring accessibility qualitatively, our framework innovatively integrates spatial analysis, Indigenous-specific population data and culturally sensitive provider capacity metrics within an advanced G2SFCA model. This approach uniquely exposes the compounded socio-spatial barriers to mental health services for Indigenous populations across South East Queensland’s urban-rural continuum. The resulting accessibility and inequality maps, combined with a summary of focus areas and their associated socio-demographic profiles, provide a direct policy lever to prioritise intervention for Indigenous communities experiencing the greatest disadvantage. By bridging spatial analysis with Indigenous cultural contexts, this work offers a replicable model for equitable, community-driven healthcare resource allocation for Indigenous peoples globally.

To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples’ cancer care experiences in the Australian healthcare system from the patient’s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner.

ObjectivesTo compare elective surgeries rates and waiting times between Indigenous and non-Indigenous patients in Queensland.DesignAggregated annual data analysis from July 2013 to December 2022 on elective surgeries and waiting times.SettingPublic hospitals across Queensland.ParticipantsAll patients who had elective surgery in Queensland public hospitals between 2013 and 2022.MeasuresRates and clinically recommended timeframes for elective surgeries.ResultsBetween 2013 and 2022, the overall estimated average rate of elective surgeries for Indigenous patients was 286 per 100 000 population, compared with 221 per 100 000 for non-Indigenous patients. Indigenous patients had higher rates of most elective surgeries except plastic and urological surgeries, where non-Indigenous patients had higher rates. Across all urgency categories, the percentages of elective surgery performed within clinically recommended timeframes were similar between Indigenous and non-Indigenous patients.ConclusionOur findings may point to the efficacy of specific policy and service delivery innovations undertaken in Queensland. Due to the limitations of our aggregated data, this inference warrants careful interpretation. More studies with disaggregated data are needed.

Background There is a dearth of research comparing why dieting and non-dieting approaches are adopted. A greater understanding of reasons underlying dieting and non-dieting attempts will help to identify target beliefs for interventions to support and motivate adults to attempt whatever approach they are willing and/or able to pursue. We investigated the predictors of dieting and non-dieting approaches in Australian adults using predictors that were identified in a previous qualitative study. Methods We conducted a prospective study, with two waves of data collection occurring 4 weeks apart. At baseline, participants completed a questionnaire assessing constructs drawn from the theory of planned behaviour (attitude, subjective norm, and self-efficacy), past behaviour, non-planning, attributions for dieting failure, weight control beliefs, and dieting and non-dieting intentions. We used path modelling to analyse responses. Results At baseline, 719 adults (52.2% male) aged between 18 and 76 completed the questionnaire. Four weeks later, 64% of participants ( n  = 461) reported on their dieting and non-dieting behaviour in the past month. Past behaviour, attitude, subjective norm, and self-identity significantly predicted dieting intentions. Dieting intentions and past behaviour significantly predicted dieting behaviour, while non-planning and self-efficacy did not. The model explained 74.8% of the variance in intention and 52.9% of the variance in behaviour. While most findings were similar for the non-dieting model, subjective norms and self-identity did not predict intention, while self-efficacy and self-identity both predicted non-dieting behaviour directly. The non-dieting model explained 58.2% of the variance in intention and 37.5% of the variance in behaviour. Conclusions The findings from this study provide support for the application of TPB and identity theory constructs in the context of both dieting and non-dieting behaviour. Self-efficacy and self-identity appear more relevant to non-dieting behaviour than dieting behaviour, while subjective norms was more influential in predicting dieting. Practitioners wishing to encourage either approach in their clients should attempt to modify the constructs that influence each approach.

This study aims to examine the costs associated with a Hospital in the Nursing Home (HiNH) program in Queensland Australia directed at patients from residential aged care facilities (RACFs) with emergency care needs. A cost analysis was undertaken comparing the costs under the HiNH program and the current practice, in parallel with a pre-post controlled study design. The study was conducted in two Queensland public hospitals: the Royal Brisbane and Women's Hospital (intervention hospital) and the Logan Hospital (control hospital). Main outcome measures were the associated incremental costs or savings concerning the HiNH program provision and the acute hospital care utilisation over one year after intervention. The initial deterministic analysis calculated the total induced mean costs associated with providing the HiNH program over one year as AU$488,116, and the total induced savings relating to acute hospital care service utilisation of AU$8,659,788. The total net costs to the health service providers were thus calculated at -AU$8,171,671 per annum. Results from the probabilistic sensitivity analysis (based on 10,000 simulations) showed the mean and median annual net costs associated with the HiNH program implementation were -AU$8,444,512 and-AU$8,202,676, and a standard deviation of 2,955,346. There was 95% certainty that the values of net costs would fall within the range from -AU$15,018,055 to -AU$3,358,820. The costs relating to implementing the HiNH program appear to be much less than the savings in terms of associated decreases in acute hospital service utilisation. The HiNH service model is likely to have the cost-saving potential while improving the emergency care provision for RACF residents.

Background Equity in access to disability support services is critical for addressing health disparities faced by Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as Indigenous Australians) in Australia. Since its rollout in 2016, the National Disability Insurance Scheme (NDIS) has faced criticism for limited access among Indigenous Australians. While systemic barriers have been identified, the extent of disparities and factors influencing access and funding remain unclear. We examined NDIS psychosocial support access and utilisation among Indigenous Australians in South East Queensland (SEQ), focusing on disparities and determinants of access and budget allocation. Methods This study analysed Australian Bureau of Statistics Personal Level Integrated Data Asset, 2021 Census, 2021 NDIS and Medicare datasets. We examined the sociodemographic and service-related factors that were associated with access rates and budget allocation for NDIS support for psychosocial disability as primary disability among Indigenous Australians with mental health needs. Multivariate logistic regression and linear regression were used to assess associations with access and budget allocation, respectively. Results Indigenous Australians in SEQ accessed NDIS psychosocial support at higher rates than non-Indigenous Australians (1.75% versus 0.88%, p  < 0.001), though budget allocations were comparable ($94,310.90 versus $86,371.78 per capita, p  = 0.062). Access varied within Indigenous Australians based on sociodemographic factors, health service regions, and levels of need. Stable housing, lower income, and higher mental health needs were associated with greater access, whereas post-secondary education and chronic conditions were associated with lower access. Budget allocation was higher for those in group/lone households and those with greater functional impairment. However, 88% of individual level utilisation data were missing, and only 69.57% of Indigenous participants were correctly identified as Indigenous in NDIS data. Conclusions In SEQ, Indigenous Australians demonstrated higher access to NDIS psychosocial support. Differences in access to and budget allocation of NDIS psychosocial support benefit those most in need. Nonetheless, systemic challenges remain including under-identification of Indigenous status, missing data on utilisation, and barriers associated with housing instability. Addressing these issues and strengthening culturally safe processes are critical to improving access to psychosocial disability support for Indigenous Australians.

Universities are providing short-term overseas study programs for healthcare students to increase their cultural competence (i.e., capacity to work effectively in cross-cultural situations). However, there is limited empirical research evaluating the effects of these programs using well-controlled research designs. In the present research study, undergraduate healthcare students in an Australian university were selected as participants. Group 1 (n = 32) participated in a short-term overseas study program in Asia (i.e., China, Vietnam, Singapore, and Taiwan), whereas Group 2 (n = 46) stayed in Australia to continue their university education as usual. All participants completed a self-developed demographic questionnaire, Cultural Intelligence Scale, and Multicultural Personality Questionnaire. Cultural competence was surveyed pre- and post-short-term overseas programs. After controlling for prior overseas experiences and the open-mindedness trait, an ANCOVA indicated that Group 1 had a significantly higher scores than Group 2 in cultural knowledge (p < 0.05), but not in cultural awareness, attitude, or skills. It is suggested that short-term overseas study programs may increase healthcare students’ cultural knowledge, a component of competence, and that more needs to be accomplished to improve other areas of cultural competence.

Background There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). Methods A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Results Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p  = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p  < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p  = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p  < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p  < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p  = 0.196). Conclusions Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

Following surgery, over 50% of cardiac surgery patients report anxiety, stress and/or depression, with at least 10% meeting clinical diagnoses, which can persist for more than a year. Psychological distress predicts post-surgery health outcomes for cardiac patients. Therefore, post-operative distress represents a critical recovery challenge affecting both physical and psychological health. Despite some research identifying key personal, social, and health service correlates of patient distress, a review or synthesis of this evidence remains unavailable. Understanding these factors can facilitate the identification of high-risk patients, develop tailored support resources and interventions to support optimum recovery. This narrative review synthesises evidence from 39 studies that investigate personal, social, and health service predictors of post-surgery psychological distress among cardiac patients. The following factors predicted lower post-operative distress: participation in pre-operative education, cardiac rehabilitation, having a partner, happier marriages, increased physical activity, and greater social interaction. Conversely, increased pain and functional impairment predicted greater distress. The role of age, and sex in predicting distress is inconclusive. Understanding several factors is limited by the inability to carry out experimental manipulations for ethical reasons (e.g., pain). Future research would profit from addressing key methodological limitations and exploring the role of self-efficacy, pre-operative distress, and pre-operative physical activity. It is recommended that cardiac patients be educated pre-surgery and attend cardiac rehabilitation to decrease distress.