Community‐based models of alcohol and other drug support for First Nations peoples in Australia : a systematic review

The transgenerational impacts of colonisation—inclusive of dispossession, intergenerational trauma, racism, social and economic exclusion and marginalisation—places First Nations peoples in Australia at significant risk of alcohol and other drug (AOD) use and its associated harms. However, knowledge and evidence supporting community‐based AOD treatment for First Nations adults is limited. Therefore, this review aimed to examine the impact and acceptability of community‐based models of AOD support for First Nations adults in Australia. Approach: A systematic search of the empirical literature from the past 20 years was conducted. Key Findings: Seventeen studies were included. Nine studies evaluated the program's impact on substance use and 10 studies assessed program acceptability (two studies evaluated both). Only three out of nine studies yielded a statistically significant reduction in substance use. Acceptable components included cultural safety, First Nations AOD workers, inclusion of family and kin, outreach and group support. Areas for improvement included greater focus on holistic wrap‐around psychosocial support, increased local community participation and engagement, funding and breaking down silos. Implications: Culturally safe, holistic and integrated AOD outreach support led by First Nations peoples and organisations that involves local community members may support First Nations peoples experiencing AOD concerns. These findings may inform the (re)design and (re)development of community‐based AOD services for First Nations peoples. Conclusion: There is a limited evidence‐base for community‐based AOD programs for First Nations peoples. First Nations‐led research that is controlled by and co‐produced with First Nations peoples is necessary to extend our understanding of community‐based programs within First Nations communities

The impact of community mental health programs for Australian youth : a systematic review

Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n = 16), case management (n = 9), integrated ‘one-stop-shop’ (n = 6) and lifestyle (n = 6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory

A mixed-method evaluation of Cradle to Kinder : an Australian intensive home visitation program for families experiencing significant disadvantage

Cradle to Kinder is an Australian intensive, long-term, home visitation program that supports young families experiencing multiple stressors, including poverty, family violence, mental illness, substance use, childhood trauma, intellectual disability, child projection involvement, teenage pregnancy, or social isolation, which places them at high risk of child removal. The program adopts a multidisciplinary, whole-of-family and trauma-informed approach to provide families with long-term case management, practical support and evidence-based therapeutic parenting interventions from pregnancy for up to four years to address these underlying risk factors. The aim of this study was to evaluate: (1) the extent to which families experienced improvements in family, caregiver and infant wellbeing outcomes after 24 months engagement; and (2) caregivers’ experiences of the program. A mixed-method evaluation was employed, which included two components: (1) uncontrolled pre-post quantitative assessment for 57 families using the North Carolina Family Assessment Scale and Brigance Early Child Development Assessment, completed every six months; and (2) qualitative interviews with 14 caregivers engaged in the program. The quantitative findings showed significant improvements in key domains of family functioning, parenting capabilities, infant development, and family preservation. The qualitative results validated these findings as caregivers reported favourable outcomes via participation in the program, including improved parenting skills and confidence, personal wellbeing, and child development. Suggestions for program development included greater support for fathers, increased cultural awareness, and consistency in workers. This mixed-methods study provides support for Cradle to Kinder as a promising model of family support that can improve family functioning, caregiver and child wellbeing, and prevent child removal among families experiencing significant disadvantage. These findings support the ongoing delivery of Cradle to Kinder in Australia to ensure families at greatest risk receive the support they urgently need

Network Analysis of Skeletal Muscle During Spaceflight in Male Mice

Context: The unloading associated with spaceflight results in the rapid loss of bone and muscle tissue thereby affecting functionality. These are two of the most concerning physiologic changes that occur in space and could limit long-term occupation in space. Thus, a better understanding of the mechanisms of changes to bone and muscle could lead to development of improved therapies to counteract both spaceflight and terrestrial-based bone and muscle dysfunction.Methods: Here we used a non-biased, stringent, deep sequencing (96 million paired end reads targeting 100 bp read length) assay to examine genomic networks altered by spaceflight in the quadriceps (n=4/group). Specifically, 9 week old C57BL/6 male mice were housed on the International Space Station or at Kennedy Space Center for approximately four weeks (n=10/group). Results: 14,228 genes (70% of whole mouse genome) met the cut-off criteria and the data sets were mapped to an average of ~76% of the whole mouse genome. Of these, 840 genes met the t-test criteria, p\u3c0.05. Canonical networks linked to EIF2 signaling, calcium ion signaling, and oxidative stress response were significantly enriched by the differentially expressed genes. A comprehensive energy deprivation was indicated as functions related to protein synthesis and degradation, lipid synthesis and oxidation, and ATP hydrolysis were inhibited, and mitochondrial dysfunction was activated.Conclusions: This is the first time that skeletal muscle changes have been studied in male mice during spaceflight, and these data add important new findings to changes that occur to the musculoskeletal system in male mice during spaceflight. In orthopaedic trauma, many patients spend prolonged periods non-weight bearing and can experience significant muscle atrophy as a result. The networks analyzed in this work may prove to be targets for future therapies to counter this atrophy

The impact of transition interventions for young people leaving care : a review of the Australian evidence

Whilst advancing outcomes for young people transitioning from out-of-home care is a national priority, no synthesis of Australian interventions that support their transition from care and into independence currently exists. The aim of this systematic scoping review was to examine the characteristics of such interventions delivered in Australia and to evaluate their impact. Papers were included if they assessed the extent to which transitional support interventions, delivered in Australia, improved housing, employment, education, financial, health, or social functioning outcomes. Eleven studies were included. Interventions primarily adopted a case management approach to support care-leavers' transition. Interventions facilitated improvements in care-leavers' independent living outcomes (e.g., housing, education, and financial stability), but less so in health outcomes. This synthesis provides guidance for how research organizations in partnership with community service organizations and statutory services should develop and deliver interventions to support young Australians transitioning from care

Comparative analysis of authorship trends in the Journal of Hand Surgery European and American volumes: A bibliometric analysis

Background The purpose of this study was to better understand the authorship publishing trends in the field of hand surgery. To accomplish this, a comparative analysis was completed between the European and American volumes of the Journal of Hand Surgery (JHSE and JHSA) over the past three decades. Well-established bibliometric methods were used to examine one representative year from each of the past three decades. The focus of the study was to examine changes in author gender over time as well as to compare authorship trends across the two volumes. Materials and methods All JHSA and JHSE publications from 1985, 1995, 2005, and 2015 were placed into a Microsoft Excel spreadsheet. Data was collected for each publication including the gender of first and corresponding authors, corresponding author position, corresponding author country of origin, number of credited institutions, authors, printed pages, and references. Countries were grouped by regions. Results A total of 450 and 763 manuscripts from JHSE and JHSA, respectively, met inclusion criteria. JHSE and JHSA both showed increases in most variables analyzed over time. Both journals showed an increase in female first and corresponding authors. JHSE and JHSA displayed a rise in collaboration between institutions and countries. Conclusions Both JHSE and JHSA display increasing female inclusion in the hand surgery literature, which has traditionally been a male dominated field. The observed increase in collaboration between institutions and countries is likely linked to advances in technology that allow sharing of information more conveniently and reliably than was previously possible. As further advances are made socially and technologically, hopefully these trends will continue, leading to faster and higher quality research being generated in the field of hand surgery

Skeletal adaptations in young male mice after 4 weeks aboard the International Space Station

Gravity has an important role in both the development and maintenance of bone mass. This is most evident in the rapid and intense bone loss observed in both humans and animals exposed to extended periods of microgravity in spaceflight. Here, cohabitating 9-week-old male C57BL/6 mice resided in spaceflight for ~4 weeks. A skeletal survey of these mice was compared to both habitat matched ground controls to determine the effects of microgravity and baseline samples in order to determine the effects of skeletal maturation on the resulting phenotype. We hypothesized that weight-bearing bones would experience an accelerated loss of bone mass compared to non-weight-bearing bones, and that spaceflight would also inhibit skeletal maturation in male mice. As expected, spaceflight had major negative effects on trabecular bone mass of the following weight-bearing bones: femur, tibia, and vertebrae. Interestingly, as opposed to the bone loss traditionally characterized for most weight-bearing skeletal compartments, the effects of spaceflight on the ribs and sternum resembled a failure to accumulate bone mass. Our study further adds to the insight that gravity has site-specific influences on the skeleton

The Use of Social Media for Preconception Information and Pregnancy Planning among Young Women

Young women of reproductive age (18–25 years) often seek and engage with health-related information via social media. However, the extent to which this population group seek preconception and pregnancy-related information has not been explored. Therefore, this study aimed to: (1) examine the proportion, type, and frequency of social media use to seek general health, preconception, and pregnancy-related information or advice among young women; and (2) explore the relationship between age, education status, relationship status, and planning a pregnancy on social media use for preconception and pregnancy-related health information. Ninety-one Australian women aged 18–25 years completed an online survey about their patterns and preferences of social media use for this information. Forty percent of women used social media for general health information (most often daily), 32% for preconception health advice (most commonly weekly), and 20% for pregnancy-related information (most often weekly), with Facebook the most frequently used platform. Planning a pregnancy within the next 5 years and younger age were associated with greater likelihood of using social media for such information. It is necessary that social media platforms are leveraged to disseminate preconception and pregnancy planning health advice, support, and education to provide better health promotion and preventive care to young women

Mapping community-based youth mental health services in Tasmania, Australia

Background: Tasmania has the most rurally and remotely dispersed population of young people in Australia with high rates of youth experiencing mental ill health and socioeconomic disadvantage. Standard descriptions of mental healthcare provision are necessary for evidence-informed mental healthcare policy, planning and implementation. This systematic scoping study aimed to: (1) map and describe the characteristics of community-based youth mental health services (including substance-use) for young people in Tasmania, Australia and (2) identify gaps in service accessibility and provision. Methods: A list of eligible services was developed through a systematic search and consultation with key stakeholders. Data were collected from a representative from each eligible service via an interview or online survey. A standardised framework was used to classify, describe and map services. Thematic analysis was used to analyse service providers' perceived gaps to service access and provision. Results: Twenty-eight community-based mental health services for youth were identified, predominantly located in the major city of Tasmania's three service regions. Service gaps include the 'missing middle', lack of integrated supports and limited service capacity. Conclusions: The findings highlight the limited availability, accessibility and capacity of youth mental health services across Tasmania. Recommendations focus on increasing accessibility of rural/regional supports, provision of assertive outreach, psychosocial support, integrated care and strengthening the rural mental health workforce. These findings may inform the (re)design/(re)development of community-based youth mental health services in Tasmania. The findings may also guide evidence-informed mental health service planning, decision-making, development and implementation of integrated models of youth mental health care across Australia