Mary Katsikitis

Background: Fetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23–94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies. Methods: The Yapatjarrathati project (named by the local First Nations community and meaning ‘to get well’) is a mixed-method implementation trial of a tiered assessment process for identifying FASD within a remote Australian community. In collaboration with the community, we co-designed: (a) a culturally sensitive, tiered, neurodevelopmental assessment process for identifying FASD, and (b) training materials that up-skill remote practitioners with varying levels of expertise. Qualitative interviews for primary, secondary and end users will be undertaken to evaluate the implementation strategies. RE-AIM will be used to evaluate the reach, effectiveness, adoption, implementation and maintenance of the assessment and training process. Discussion: Co-designed with the local community, integrated with cultural protocols, and based on implementation science theories, the assessment and training process from this project will have the potential to be scaled-up across other remote locations and trialed in urban settings. The Yapatjarrathati project is an important step towards increasing the availability of neurodevelopmental services across Australia and empowering remote practitioners to contribute to the FASD assessment process.

Purpose: The purpose of this paper is to summarise the initial experiences of Australia’s National Disability Insurance Scheme (NDIS). It highlights some of the main challenges being faced by participants, service providers and government, and demonstrates how research can contribute to the ongoing implementation and success of the scheme. Design/methodology/approach: The historical basis for the need for a new approach to disability funding in Australia is explored. The opportunities that exist and the difficulties that are being encountered by those entering and working within the new scheme are discussed. Findings: Several problems were identified including difficult transitions between existing support frameworks to new “NDIS plans”, and the risk of market failure. Both the problems and their solutions are discussed and it is hoped that collaboration between the Commonwealth Government, service users, their families, service providers and universities can lead to a number of lasting improvements. Practical implications: The new funding framework provides exciting opportunities for increasing the funding of people with intellectual and physical disabilities in Australia. Developments in technology, service provision in rural and remote areas and the opportunity to meet aspirational life goals exist alongside a number of challenges, including the need to ensure that those with multiple and complex disabilities retain existing levels of support. Originality/value: The implementation of the NDIS is still underway, and opportunities exist to implement changes to the scheme where required. Research findings have an important role to play in the national debate regarding how best to improve quality of life for people with a disability in Australia.

People with dementia living in long-term care commonly experience loneliness and lack of meaningful activity. Memory Keeper is a prototype digital application that presents personalised prompts to stimulate reminiscences and meaningful engagement with formal and informal carers. A trial involving three persons with dementia in long-term care and seven family and staff members revealed no negative responses to the device or application. Family members said it was valuable in improving the quality of engagement and made visits more enjoyable. If practical and technical barriers can be overcome, Memory Keeper could become an innovative family engagement tool for dementia management.

The modelling of sub-clinical eating disorders and emotive responses to food between mothers and their early adolescent daughters was investigated. Twenty dyads viewed images of food and rated their levels of happiness, fear and disgust. Results suggest similarities between mothers’ and daughters’ emotive responses, but the exact nature of this relationship differed across food type and response type. Disordered eating was only related to responses to the low-calorie foods. Furthermore, mother’s eating disorders symptoms were related to concerns about shape and weight in the daughters (all ps < .05). These results suggest a transmission of emotive responses to food within the dyad which may inform family-based intervention efforts in the prevention of eating disorders in young women.