Flying the coop : why is the move out of home proving unsustainable?

Changing social trends indicate that more young Australians are electing to live at home longer. Residing in the parental home is the most common mode of living for those aged in their 20s, with recent data indicating more than 30 per cent decisively remain in this arrangement with their parents.While there are obviously still those who decide to move out, this housing arrangement seems to be proving unsustainable; many young adults are returning home to reside with their parents after time spent on their own in a trend increasingly referred to as the &lsquo;boomerang&rsquo; effect.This paper reviews the available literature on young adults&rsquo; living arrangements, identifying those factors implicated both in the leaving home process and the likelihood a young adult will return home after previously moving out. In highlighting how much of this earlier research has relied on the use of statistical methods, the paper aims to justify the need for the proposed study- a contemporary exploration of generation Y Australians&rsquo; experiences of home returning.The study, guided by an ecological theoretical perspective, will utilise a qualitative methodology to investigate the reasons why young adults are experiencing difficulty sustaining their move to independent living. In-depth interviews will be conducted in Melbourne with young adults aged between 20 and 30 years who currently reside in the parental home after living independently for four months or more. It is anticipated the study sample will include both males and females who are currently engaged in, or have previously completed, tertiary study.These interviews will be analysed and through the emergent themes, will provide a clearer insight into the &lsquo;boomerang&rsquo; generation- a group of young adults who will become increasingly more common in light of the current uncertainty surrounding finances, employment and housing markets. The implications of this research will therefore be significant for those concerned with the future housing decisions of Australian society.<br /

Using a qualitative approach to research to build trust between a non-Aboriginal researcher and Aboriginal participants (Australia)

This article focuses on the qualitative methodologies employed in a research project developed in collaboration with Aboriginal advisors and gaining an in-depth understanding of Aboriginal Victorian peoples\u27 connection to their ancestral lands. It outlines why qualitative methodologies were used and highlights the ethical dimensions of working with Aboriginal Victorian communities. A research partnership was developed between Aboriginal Victorian communities and the non-Aboriginal researcher and this process was emphasised because in the past Australian Indigenous people have been grossly exploited in health research. The methods of semi-structured interviews and focus groups were used to gain a better understanding of this topic. The novel point of this article is that it provides an honest reflection of the benefits and limitations of this qualitative research process from the perspectives of a non-Aboriginal researcher and an Aboriginal participant, when emphasis is placed on a collaborative approach. The paper outlines what a successful qualitative research project looks like in Victorian Aboriginal communities. This can be used as a blueprint not only for working with Victorian Aboriginal communities, who have been marginalised within Australian society, but may also be relevant to other culturally diverse communities throughout the world

Cultivating health and wellbeing : members\u27 perceptions of the health benefits of a Port Melbourne community garden

This paper reports on a research project undertaken with members of a community garden in Port Melbourne, Australia, to investigate the ways in which such a facility contributes to the enhancement of health, wellbeing and contact with nature for urban dwellers. Ten members from an urban community garden were interviewed using qualitative semi-structured questions exploring perceptions of health and wellbeing benefits associated with membership. The garden was felt by members to be a sanctuary where people could come together and escape daily pressures, a source of advice and social support, and a place which gave them a sense of worth and involvement. Members also identified spiritual, fitness and nutritional benefits arising from participation in the community garden. It is evident even from this small qualitative study that community gardening offers many health and wellbeing benefits to members. This study provides a basis for the benefits of community gardens in Australia to be taken into account by policy-makers and practitioners to enhance urban community health and wellbeing. <br /

Health empowerment scripts : simplifying social/green prescriptions

Social prescriptions are one term commonly used to describe non-pharmaceutical approaches to healthcare and are gaining popularity in the community, with evidence highlighting psychological benefits of reduced anxiety, depression and improved mood and physiological benefits of reduced risk of cardiovascular disease and reduced hypertension. The relationship between human health benefits and planetary health benefits is also noted. There are, however, numerous barriers, such as duration and frequencies to participate in activities, access, suitability, volition and a range of unpredictable variables (such as inclement weather, shifting interests and relocating home amongst others) impeding a comprehensive approach to their use on a wider scale. From a multidisciplinary perspective, this commentary incorporates a salutogenic and nature-based approach to health, we also provide a range of recommendations that can be undertaken at the patient level to assist in shifting the acknowledged systemic barriers currently occurring. These include using simple language to explain the purpose of health empowerment scripts, ensuing personal commitment to a minimum timeframe, enabling ease of access, co-designing a script program, providing ongoing motivational support and incorporating mindfulness to counter unexpected disruptions. Copyright © 2022 Lawson, Wissing, Henderson-Wilson, Snell, Chambers, McNeil and Nuttman

Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter

This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter) who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health

Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT

Background: Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients. Primary objective: Time to developing a new PU of category ≥ 2 in patients using an alternating pressure mattress (APM) compared with a high-specification foam mattress (HSFM). Design: A multicentre, Phase III, open, prospective, planned as an adaptive double-triangular group sequential, parallel-group, randomised controlled trial with an a priori sample size of 2954 participants. Randomisation used minimisation (incorporating a random element). Setting: The trial was set in 42 secondary and community inpatient facilities in the UK. Participants: Adult inpatients with evidence of acute illness and at a high risk of PU development. Interventions and follow-up: APM or HSFM – the treatment phase lasted a maximum of 60 days; the final 30 days were post-treatment follow-up. Main outcome measures: Time to event. Results: From August 2013 to November 2016, 2029 participants were randomised to receive either APM (n = 1016) or HSFM (n = 1013). Primary end point – 30-day final follow-up: of the 2029 participants in the intention-to-treat population, 160 (7.9%) developed a new PU of category ≥ 2. There was insufficient evidence of a difference between groups for time to new PU of category ≥ 2 [Fine and Gray model HR 0.76, 95% confidence interval (CI) 0.56 to 1.04; exact p-value of 0.0890 and 2% absolute difference]. Treatment phase sensitivity analysis: 132 (6.5%) participants developed a new PU of category ≥ 2 between randomisation and end of treatment phase. There was a statistically significant difference in the treatment phase time-to-event sensitivity analysis (Fine and Gray model HR 0.66, 95% CI 0.46 to 0.93; p = 0.0176 and 2.6% absolute difference). Secondary end points – 30-day final follow-up: new PUs of category ≥ 1 developed in 350 (17.2%) participants, with no evidence of a difference between mattress groups in time to PU development, (Fine and Gray model HR 0.83, 95% CI 0.67 to 1.02; p-value = 0.0733 and absolute difference 3.1%). New PUs of category ≥ 3 developed in 32 (1.6%) participants with insufficient evidence of a difference between mattress groups in time to PU development (Fine and Gray model HR 0.81, 95% CI 0.40 to 1.62; p = 0.5530 and absolute difference 0.4%). Of the 145 pre-existing PUs of category 2, 89 (61.4%) healed – there was insufficient evidence of a difference in time to healing (Fine and Gray model HR 1.12, 95% CI 0.74 to 1.68; p = 0.6122 and absolute difference 2.9%). Health economics – the within-trial and long-term analysis showed APM to be cost-effective compared with HSFM; however, the difference in costs models are small and the quality-adjusted life-year gains are very small. There were no safety concerns. Blinded photography substudy – the reliability of central blinded review compared with clinical assessment for PUs of category ≥ 2 was ‘very good’ (kappa statistic 0.82, prevalence- and bias-adjusted kappa 0.82). Quality-of-life substudy – the Pressure Ulcer Quality of Life – Prevention (PU-QoL-P) instrument meets the established criteria for reliability, construct validity and responsiveness. Limitations: A lower than anticipated event rate. Conclusions: In acutely ill inpatients who are bedfast/chairfast and/or have a category 1 PU and/or localised skin pain, APMs confer a small treatment phase benefit that is diminished over time. Overall, the APM patient compliance, very low PU incidence rate observed and small differences between mattresses indicate the need for improved indicators for targeting of APMs and individualised decision-making. Decisions should take into account skin status, patient preferences (movement ability and rehabilitation needs) and the presence of factors that may be potentially modifiable through APM allocation, including being completely immobile, having nutritional deficits, lacking capacity and/or having altered skin/category 1 PU. Future work: Explore the relationship between mental capacity, levels of independent movement, repositioning and PU development. Explore ‘what works for whom and in what circumstances’. Trial registration: Current Controlled Trials ISRCTN01151335. Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 52. See the NIHR Journals Library website for further project information

Perceived health benefits and willingness to pay for parks by park users: quantitative and qualitative research

Whilst a growing body of evidence demonstrates people derive a range of health and wellbeing benefits from visiting parks, only a limited number of attempts have been made to provide a complementary economic assessment of parks. The aim of this exploratory study was to directly estimate the perceived health and wellbeing benefits attained from parks and the economic value assigned to parks by park users in Victoria, Australia. The research employed a mixed methods approach (survey and interviews) to collect primary data from a selection of 140 park users: 100 from two metropolitan parks in Melbourne and 40 from a park on the urban fringe of Melbourne, Victoria. Our findings suggest that park users derive a range of perceived physical, mental/spiritual, and social health benefits, but park use was predominantly associated with physical health benefits. Overall, our exploratory study findings suggest that park users are willing to pay for parks, as they highly value them as places for exercising, socialising, and relaxing. Importantly, most people would miss parks if they did not exist. The findings aim to provide park managers, public health advocates, and urban policy makers with evidence about the perceived health and wellbeing benefits of park usage and the economic value park visitors place on parks