This study explores the barriers and facilitators of integrating women into the firefighting workforce, with insights drawn from both women and men firefighters in South Australia. The research focuses on challenges and supports encountered during recruitment and long-term retention of women in this male dominated field. Data were gathered through semi-structured interviews with paid (career) firefighters, with a thematic analysis applied to transcriptions. Key themes identified included occupational challenges (barriers) such as lack of diversity, perception of women as "diversity hires," ill-fitting uniforms and equipment, unconscious bias, and the hypermasculine culture of the workplace. Women also tended to cope with workplace trauma differently than men, seeking psychological support from female colleagues, while men often suppressed emotions. Non-occupational facilitators such as flexible rostering access to fitness programs, and lifestyle benefits including camaraderie within the workforce, were important in retaining both genders. However, the lack of accessible 24-hour childcare emerged as significant barrier for women managing both work and caregiving responsibilities. We concluded that improving equipment fit, trauma support, inclusive recruitment and accessible 24-hour childcare are essential for increasing gender diversity in firefighting. These changes are key to retaining women in first responder roles and enhancing the overall effectiveness of the workforce.

Chronic pain is a substantial health problem with a high prevalence of comorbid depression. To understand the link between chronic pain and depression, cognitive factors including pain catastrophising and pain self-efficacy have been theorised as significant contributing variables. There is relatively strong evidence that pain catastrophising mediates the relationship between pain severity and depression symptoms. There is also emerging evidence that the mediation role of pain catastrophising may vary as a function of pain self-efficacy. However, it is unknown whether this model will apply in a tertiary pain clinic sample. Thus, this study aimed to examine the respective moderating and mediating roles of pain self-efficacy and pain catastrophising on the association between pain severity and depressive symptoms in a large clinical sample of Australian adults living with chronic pain. Participants (n = 1195) completed all questionnaire measures prior to their first appointments at one tertiary pain service. As expected, the PROCESS path analysis showed that pain catastrophising mediated the relationship between pain severity and depressive symptoms. Further, there was support for the moderating effect of pain self-efficacy; as pain self-efficacy decreased, the relationship strengthened between both pain severity and pain catastrophising, as well as pain catastrophising and depressive symptoms. These findings may have important clinical implications including how relationships between these factors may be considered in the provision of care for those with chronic pain. Notably, these measures could be used in triaging processes to inform treatment decisions.

Globally, chronic pain affects more than 30

There is limited research on the psychological wellbeing of female first responders (FRs) and therefore we explore potential indicators of burnout, psychological distress and post-traumatic stress disorder among Australian female FRs. We conducted an online health survey among Australian female FRs (fire, police, para-medical, aeromedical, remote area and other e.g., State Emergency Service). Of the 422 eligible participants who submitted the online survey, 286 completed at least 80% of all survey questions and were used in the final analyses. The main outcomes of interest were moderate burnout (compared to low burnout) and high scores for combined PCL-5/K10 (compared to low scores). Using logistical regression stepwise regression models, we analysed associations between the outcomes of interest and various work-psychosocial factors. Results showed the strongest indicators of moderate burnout to be, 1) returning to work with <12-hour break, 2) exposure to gossip and slander, 3) not enough time to do things, 4) and having experienced rape/sexual assault. The strongest indicators of higher PCL-5/K10 scores were, 1) exposure to unpleasant teasing, 2) pressure at work and home, 3) having experienced physical violence (e.g., beaten/mugged), and 4) someone close to them died unexpectedly. These findings show workforce stressors have more impact on female FRs psychological wellbeing, compared to lifetime traumatic exposures.

OBJECTIVE:This review will scope the literature and map the features of brief introductory group education programs implemented in chronic disease management. INTRODUCTION:Brief introductory group education programs are resource-efficient interventions used in chronic disease management to educate patients about basic disease concepts, self-management strategies, and to introduce specialist services. There is a lack of published research that synthesizes the characteristics, guiding principles, and outcomes reported in brief group education programs in chronic disease management. This scoping review will seek to identify brief introductory group education programs and describe the i) scope of literature available on such programs, ii) characteristics of the programs, iii) guiding self-management principles used and the extent to which programs follow such principles, and iv) types of outcomes reported. INCLUSION CRITERIA:This review will consider studies describing an introductory or brief group patient education program (one to four sessions, no more than eight hours) for the management of chronic disease in adults with ongoing chronic disease. METHODS:MEDLINE, Scopus, CINAHL, Emcare, Web of Science, and PsycINFO will be searched for English-language articles published from 2001 to the present. Titles and abstracts will be screened against inclusion/exclusion criteria, followed by full-text review, independently assessed by two reviewers. Eligible articles will be extracted and charted using a standardized data extraction form. A descriptive review to summarize and contextualize the extracted data will be conducted.

Objective: The objective of this review is to produce a set of integrated findings of quantitative and qualitative evidence regarding workplace recruitment and retention factors (including departure) of female first responders to inform recommendations for policy and practice. Introduction: Historically, first responder workforces such as police officers, firefighters, search and rescue personnel, medical technicians, and paramedics have been largely male dominated. Over the past few decades, however, there has been a steady increase in the number of women entering this field. However, there is minimal research examining factors that influence the recruitment/retention of female first responders. The intention of this review is to identify barriers and facilitators to recruitment and retention of female first responders and to identify any differences between sexes/genders. Inclusion criteria: This review will summarize qualitative and quantitative research examining factors influencing the recruitment/retention of female first responders. Such factors may include job satisfaction, quality of work life, burnout, compassion fatigue, and intent to remain in the workforce. Methods: MEDLINE (PubMed), CINAHL (EBSCO), PsycINFO (APA), PTSDpubs (formerly PILOTS; ProQuest), Embase (Elsevier), and Scopus (Elsevier) will be searched for studies published in English from 2009 to the present. Unpublished studies will be searched in Google Scholar, and ProQuest Dissertations and Theses Global. Both quantitative and qualitative studies will be screened for inclusion and critically appraised for methodological quality by two independent reviewers. Both types of data will be extracted using JBI tools for mixed methods systematic reviews. A convergent integrated approach to synthesis and integration will be used. Systematic review registration number: PROSPERO CRD42020156524

The transition period from military-to-civilian life can be one of the most significant and stressful periods in the military life cycle. We explore the psychosocial factors associated with psychological distress and functional impairment among those who recently transitioned from the Australian Defence Force (ADF) and those currently serving in 2015. Using data from the Transition and Wellbeing Research Programme, multinomial logistic regression models were used to analyze the associations between a combined measure of psychological distress and functional impairment (K10/SDS) with various psychosocial, lifestyle, and physical health factors. There were 10,210 in the final analytic cohort (Transitioned=3,254; Regular 2015 ADF=6,956). Overall, the odds of belonging to the highly distressed/impaired group were greatest among those with insomnia (Odds Ratio 18.53), low resilience (OR 7.67), physical health symptoms (OR 7.16), and alcohol risk (OR 4.67). Other factors included pain (OR 3.36), financial issues (OR 2.38), and social strain (OR 1.98). The associations with insomnia and physical health symptoms were stronger among the Transitioned compared to the Regular 2015 ADF. Results of this research highlights the importance of taking a multi-dimensional perspective of symptoms in military populations, particularly in those recently transitioned from permanent service, as predictors of future risk of disorder.

Physical symptoms are highly comorbid with posttraumatic stress disorder (PTSD). As PTSD is underdiagnosed, this study explored the value of self-reported physical symptoms in screening for 30-day PTSD in military personnel. Two physical symptom scales were constructed using items from a 67-item health symptom checklist, clinical interviews were used as the diagnostic reference standard, and diagnostic utility of physical symptoms was compared with the current gold standard screen, the PTSD checklist (PCL). Receiver operating characteristic analyses showed that both a 9-item and a 10-item physical symptom scale were of value in predicting PTSD (areas under the curve 0.81 and 0.85). Importantly, two thirds of PTSD positive personnel missed by the PCL were captured with physical symptoms scales, and when physical symptoms were added to the PCL, prediction was improved (areas under the curve 0.90 to 0.92). Our findings highlight the value of including assessing physical symptoms in PTSD screening.

Current paradigms regarding the effects of traumatic exposures on military personnel do not consider physical symptoms unrelated to injury or illness as independent outcomes of trauma exposure, characteristically dealing with these symptoms as comorbidities of psychological disorders. Our objective was to ascertain the proportions of deployed military personnel who experienced predominantly physical symptoms, predominantly psychological symptoms, and comorbidity of the two and to examine the association between traumatic deployment exposures (TDEs) and these symptomatic profiles. Data were taken from a cross-sectional study of Australian Defence Force personnel who were deployed to the Middle East during 2001-2009 (N = 14,032). Four groups were created based on distributional splits of physical and psychological symptom scales: low-symptom, psychological, physical, and comorbid. Multinomial logistic regression models assessed the probability of symptom group membership, compared with low-symptom, as predicted by self-reported TDEs. Group proportions were: low-symptom, 78.3%; physical, 5.0%; psychological, 9.3%; and comorbid, 7.5%. TDEs were significant predictors of all symptom profiles. For subjective, objective, and human death and degradation exposures, respectively, the largest relative risk ratios (RRRs) were for the comorbid profile, RRRs = 1.47, 1.19, 1.48; followed by the physical profile, RRRs = 1.27, 1.15, 1.40; and the psychological profile, RRRs = 1.22, 1.07, 1.22. Almost half of participants with physical symptoms did not have comorbid psychological symptoms, suggesting that physical symptoms can occur as a discrete outcome trauma exposure. The similar dose-response association between TDEs and the physical and psychological profiles suggests trauma is similarly associated with both outcomes.

While meta-analytic reviews of universal school-based social and emotional interventions indicate overall effectiveness, outcome effect sizes are often small. We report an evaluation of a high school-based Personal Leadership Program, designed to promote positive social, emotional, and motivational outcomes. Program and comparison group participants (n=102) from South Australian high schools completed pre- and post-program measures of positive functioning: positive emotion, behavioral engagement, positive relations, meaning, and accomplishment, as well as self-esteem and goal setting. Additionally, teacher-reported student engagement was assessed. Program participants demonstrated greater improvement than the comparison group on all variables. Mixed between-within subjects ANOVAs, showed statistically significant time-by-group interactions for six out of nine variables, the exceptions being relationship with parents, relationship with classmates, and accomplishment. There were medium effect sizes for student- and teacher-rated engagement, and large effect sizes for positive emotion, meaning, self-esteem and goal setting. With findings demonstrating improvements in positive functioning across a range of measures of wellbeing this approach to building wellbeing in adolescents, drawing on Cognitive Behavioral Therapy and goal setting theory should be further investigated using randomized control trials.

OBJECTIVES:This study aimed to investigate sleep patterns in adolescent males over a 12-week period (a 10-week school term and pre and post term holidays). DESIGN:Intensive longitudinal design, with sleep data collected daily via actigraphy for 81 consecutive days. SETTING:Five Secondary Schools in Adelaide, South Australia. PARTICIPANTS:Convenience sample of 47 adolescent males aged 14 to 17 years. MEASUREMENTS:Daily sleep duration, bedtimes, rise times, and sleep efficiency were collected via actigraphy with all (except sleep efficiency) also measured by sleep diary. Mood was measured weekly with Depression Anxiety Stress Scale-21 (DASS-21) and weekly wellbeing with the Satisfaction with Life Scale (SWLS). Age, body mass index, self-reported mood, life satisfaction, and chronotype preference assessed at baseline (pre-term holiday week) were included as covariates. RESULTS:Dynamic Structural Equation Modeling indicated significant but small fixed-effect and random-effect auto-regressions for all sleep variables. Collectively, these findings demonstrate day-to-day fluctuations in sleep patterns, the magnitude of which varied between individuals. Age, morningness, and mood predicted some of the temporal dynamics in sleep over time but other factors (BMI, life satisfaction) were not associated with sleep dynamics. CONCLUSIONS:Using intensive longitudinal data, this study demonstrated inter-individual and intra-individual variation in sleep patterns over 81 consecutive days. These findings provide important and novel insights into the nature of adolescent sleep and require further examination in future studies.