Julie Henderson

Background: Changes to Australian mental health legislation have expanded the role of paramedics in managing mental illness. Paramedics in most Australian states and territories can now temporarily detain and transport people suspected of being mentally ill for further assessment if these people are viewed as being at risk or as posing a risk to others and as lacking capacity for decision making. Aim: This paper examines current mental health legislation from the eight Australian states and territories. We explore the conditions for transport to involuntary care and additional powers granted to paramedics across jurisdictions to identify the differences and implications of legislation in this space. Methods: Current Australian mental health legislation was examined for: how mental illness is defined; how capacity is defined; how the Acts refer to paramedics; and the powers granted to paramedics under each Act. Results: All jurisdictions but Western Australia and Victoria have made legislative changes to authorise paramedics to initiate transport for assessment. Although Victoria has made legislative changes to authorise paramedics to initiate transport for assessment, a subsequent Amendment has paused the introduction of this change. The power to authorise paramedics lies with the head of ambulance services in some states and territories and with senior health officials, e.g., the Chief Psychiatrist in others. Paramedics are required to judge patient capacity and level of risk prior to transport. Conclusion: Legislation has expanded the role of paramedics working with people with mental illness and guides how paramedics conceptualise, interpret and enact their powers in responding to patients with mental illness.

Aim: This study aimed to cross‐culturally adapt and test the psychometric properties of the Chinese version of Missed Nursing Care Infection Prevention and Control (MNCIPC‐CV). Design: A cross‐sectional and psychometric study. Methods: The study adhered to the guidelines for the translation of the original English scale and involved two rounds of correspondence with 16 experts. Data from 483 nurses working at a general hospital were collected and analyzed to evaluate the psychometric properties of the MNCIPC‐CV using classical test theory (CTT) and item response theory (IRT). Results: The MNCIPC‐CV consists of three subscales and tests for Sub‐B/Sub‐C. Its Cronbach’s α was 0.934/0.946. While the majority of scale dimensions and items met the criteria for unidimensionality, stability, and reliability, Items s , r , and v did not meet the fitting index and were removed. Three items, z16, z11, and z10, for gender and four items, s, v , 1, and 20, for education were exited differential item functioning. The final MNCIPC‐CV consisted of 36 items in Sub‐B and 24 items in Sub‐C. Conclusions: This study not only enriches the scientific basis for the revision and application of the MNCIPC‐CV but also underscores the significance of employing diverse methodological frameworks in nursing research to ensure rigor and validity.

This study quantifies the types and frequencies of missed care identified by nurses and measures its impact on their capacity to demonstrate mandatory practice standards as future hospital staff. Considerable literature exists as to the nature of missed care but there is a paucity of findings about how missed care impacts on learning firstly as a student and then as a graduate nurse employed in a hospital setting. Additionally, there is little emphasis as to how staff development for nurses exposed to missed care may be implemented. A non-experimental research design using self-audit data was selected to collect information about the types and frequencies of missed care from nurses engaging in clinical experience. A convenience sample of 471 nursing students completing their undergraduate nursing degree programme was explored. A multi-variate statistical approach was used to apply and then model the consensus scores of undergraduate nurses' beliefs about the frequency of missed care. Implications for their developing competence in critical thinking, therapeutic communication and maintaining capacity for professional practice has been considered. Eight variables directly affect student's total scores underpinning their understanding of missed care and their ability to meet professional standards of practice, given their exposure to care omission. These factors reflect differing nurse attributes, the nature of the clinical venues and shift times, preceptor type, student satisfaction with work teams and staffing adequacy. Modelling outcomes suggest possible changes to hospital staff development learning programme content, learning processes and how it may be better delivered through to minimize episodes of missed care. Staff development needs to note that nursing staff believe missed care occurs across all three-patient acuity domains with patient observation, education, support, and timely medication administration being most frequently omitted. Different clinical venues within the hospital sector and shift times vary in nurses' exposure with missed care. Student nurses' learning and associated development of practice standards is impacted by prior exposure to missed care during clinical placement. Non-native English-speaking nurses require greatest learning support in the presence of missed care. As missed care can be predicted, remedial changes to the nurse staff development program content and learning processes can be orchestrated.

Background: Consumer trust in food systems is essential for consumers, food industry, policy makers and regulators. Yet no comprehensive tool for measuring consumer trust in food systems exists. Similarly, the impact that trust in the food system has on health-related food behaviours is yet to be empirically examined. The aim of this research was to develop a comprehensive instrument to measure trust in the food system (the Dimensions of Trust in Food Systems Scale (DOTIFS scale) and use it to explore whether trust in the food system impacts consumers’ health-related behaviours. Methods: The DOTIFS scale was developed using sociological theories of trust and pre-existing instruments measuring aspects of trust. It was pilot tested and content validity was assessed with 85 participants. A mixed-methods exploration of the health-related behaviours of 18 conveniently sampled Australian consumers with differing trust scores determined by the DOTIFS scale was then conducted. During March–July 2019 shopping- and home-observations were used to assess participants’ food safety practices and exposure to public health fortification programs, while the CSIRO Healthy Diet Score determined their adherence to national dietary guidelines. Results: The DOTIFS scale was found to have high comprehension, ease of use and content validity. Statistical analysis showed scale scores significantly trended as predicted by participants’ stated level of trust. Differences were found in the way individuals with more or less trust in the food system comply with national dietary guidelines, are exposed to public health fortification programs, and adhere to recommended food safety practices. Conclusions: The DOTIFS scale is a comprehensive, sociologically- and empirically- informed assessment of consumer trust in food systems that can be self-administered online to large populations and used to measure changes in consumer trust over time. The differences in health-related behaviours between individuals with varying levels of trust warrant further investigation.

Aim The aim was to translate and validate the Missed Nursing Care in Infection Prevention and Control Survey for its use in the Lithuanian context. Methods A convenience sample of 331 nurses was surveyed. The study instrument explored missed care in the context of infection prevention and control practices. Rasch analysis was undertaken using Winsteps(R) Rasch measurement computer program and the generalized item response modelling software. Results The Missed Nursing Care in Infection Prevention and Control Survey in the Lithuanian language demonstrated unidimensionality and provided evidence of item fit to the modified instrument. The reliability of both sub-scales was 0.78 and 0.98, respectively. Differing consensus between the nurses based on their perceived frequencies and reasons of missed care was demonstrated. Conclusions The final Lithuanian version of the Missed Nursing Care in Infection Prevention and Control Survey consists of 29 items that assess type and frequency of missed care and 17 items that identify reasons for missed care. Implications for Nursing Management Unit managers will be able to use the modified scales to generate evidence as to the sources of missed infection control practices in their clinical areas and the rationale for the breaks in the hierarchy of mandatory infection prevention.

Purpose: Consumers’ trust in food systems is essential to their functioning and to consumers’ well-being. However, the literature exploring how food safety incidents impact consumer trust is theoretically underdeveloped. This study explores the relationship between consumers’ expectations of the food system and its actors (regulators, food industry and the media) and how these influence trust-related judgements that consumers make during a food safety incident.Design/methodology/approach: In this study, two groups of purposefully sampled Australian participants (n = 15) spent one day engaged in qualitative public deliberation to discuss unfolding food incident scenarios. Group discussion was audio recorded and transcribed for the analysis. Facilitated group discussion included participants' expected behaviour in response to the scenario and their perceptions of actors' actions described within the scenario, particularly their trust responses (an increase, decrease or no change in their trust in the food system) and justification for these.Findings: The findings of the study indicated that food incident features and unique consumer characteristics, particularly their expectations of the food system, interacted to form each participant's individual trust response to the scenario. Consumer expectations were delineated into “fundamental” and “anticipatory” expectations. Whether fundamental and anticipatory expectations were in alignment was central to the trust response. Experiences with the food system and its actors during business as usual contributed to forming anticipatory expectations.Originality/value: To ensure that food incidents do not undermine consumer trust in food systems, food system actors must not only demonstrate competent management of the incident but also prioritise trustworthiness during business as usual to ensure that anticipatory expectations held by consumers are positive.

Introduction: Social support, particularly support from an intimate partner, is both a significant protective factor for trauma-exposed Veterans and critical for recovery in mental health, yet we know little about the experiences and support needs of their partners, particularly in the Australian context. This study examined the multidimensional nature of experiences of being an intimate partner of a contemporary Veteran with posttraumatic stress disorder (PTSD). Methods: The authors used a qualitative phenomenological approach to conduct an inductive thematic analysis of data collected through individual interviews with a purposive sample of 10 partners of contemporary Veterans living in Australia. Interviewees were recruited through a range of community support organizations. Results: Analysis revealed intimate partners are crucial participants in supporting the recovery journey for traumatized Veterans, effectively managing day-to-day care, encouraging autonomy and instilling hope. However, descriptions highlighted that lack of understanding of partners’ daily lives, and particularly their commitment to maintaining their intimate relationship, by health care providers and government results in a sense of invisibility and is the key barrier to receiving the support they need in order to support recovery in their Veteran partners. Discussion: The findings underscore the importance of recognizing the role of intimate relationships in trauma recovery and of responding to the support needs of intimate partners. In particular, the findings have clear implications for improving the engagement by health care providers of partners of Veterans with PTSD in Veteran clinical treatment. More formal recognition of the indirect impact of PTSD on partners of Veterans is also needed within organizational policies and procedures. Finally, there is clearly a need for continuing education of health care providers, government staff and the general community about the nature of PTSD and its impacts on relationships, particularly the intimate type.

This study examined the multidimensional nature of experiences of being an intimate partner of an Australian veteran or emergency service first responder (ESFR) with posttraumatic stress disorder (PTSD). Using a qualitative phenomenological approach, inductive thematic analysis was undertaken on data collected in 2017–2018 through individual interviews with a purposive sample of 22 partners of veterans, paramedics, fire and police officers living in Australia. Analysis revealed that the key concern of the participants was to protect their family unit and the intimate relationship, highlighting the ways in which they adapted, managed and coped with the changes that PTSD brought to the relationship. However, lack of understanding by healthcare providers, government, military and emergency service organizations of their daily lives, and of the strength of commitment to their relationship, resulted in a sense of invisibility and was revealed as the key barrier to the support they crave. The findings underscore the importance of recognizing the significance of the intimate relationship in trauma recovery and of responding to the support needs of the intimate partner.