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Item Open Access Sessional teaching staff experience and motivation in preregistration nursing programs : A qualitative study(Elservier, 2025-12-18)Aim/objective To examine the experiences and motivations of sessional nursing teaching staff and identify the organisational conditions that support sustained engagement in Australian preregistration nursing programs. Background Sessional teaching staff make up a substantial proportion of the nurse education workforce in Australia and play a central role in delivering teaching, simulation, and assessment in preregistration nursing programs. They bring valuable clinical expertise to learning environments; however, many receive limited preparation, feedback, or support for their teaching roles. Variability in onboarding and access to ongoing professional development contributes to uncertainty, reduced job satisfaction, and high turnover. Although sessional staff are critical to sustaining nursing education, little research has explored how they experience these roles and what supports their continued engagement across different university contexts. Design A descriptive qualitative study using reflexive thematic analyses. Methods Four group and seven individual semistructured online interviews were undertaken in November 2024. The interview transcripts were imported into NVivo for coding and theme development. Results A total of three main themes were included: (i) enjoyment of teaching and student engagement, (ii) role flexibility and work-life balance, and (iii) quality of support and working conditions. Conclusion While sessional staff found teaching meaningful and identity-affirming, sustaining their engagement depended on role clarity, collegial inclusion, and ongoing pedagogical support. Regular updates and continued professional development opportunities strengthened confidence and belonging. Organisational support is therefore central to maintaining a stable and capable sessional nursing teaching workforce.Item Open Access Is it a lack of an immunisation workforce or not using the workforce to its potential?(Elservier, 2025-12-17)The National Immunisation Strategy 2025–2030 highlights several important blueprints for Australia to continue to increase immunisation coverage across the community. One of the priority areas includes strengthening the immunisation workforce across all life stages and areas of health care to improve vaccine-preventable diseases immunisation coverage, particularly the National Immunisation Program (NIP) delivery. The NIP covers more than just childhood immunisations as it extends to the Aboriginal and Torres Strait Islander people, culturally and linguistically diverse communities, pregnant women and those with disabilities or other high-risk health conditions. Immunisation coverage has dropped across different age groups and for a multitude of diseases in recent years, including for human papillomavirus (85.3% to 84.2% for girls and 83.1% to 81.8% for boys), meningococcal types A, C, W, and Y (75.9% to 72.8%), influenza (70% to 64.3%) and diphtheria-tetanus-pertussis (86.9% to 85.5%) vaccines. Furthermore, coverage for some non-childhood immunisations is historically very low in coverage in particularly within the high-risk population and Aboriginal and Torres Strait Islander communities including herpes zoster and pneumococcal vaccines. It is crucial that people living in Australia have more opportunities to be exposed to vaccination in various settings, including by better use of our current healthcare workforce, which is already capable of providing immunisation in a broad range of settings.Item Open Access Young children's learning and developmental outcomes : Lessons from the Covid-19 pandemic(Australian Catholic University, 2026-01-20)This thesis investigates the influence of the pandemic on the learning and developmental outcomes of children born in the 36 months prior, or into the Covid-19 pandemic. Spanning more than three years (11th of March 2020 - 5th of May 2023), the Covid-19 pandemic had a global impact across all facets of contemporary society, constituting one of the foremost sociohistorical phenomenon of the 21st century. In Victoria, Australia, prolonged periods of lockdown throughout 2020 – 2021 limited young children’s opportunities to engage in typical early childhood experiences, such as playgroup and other Early Childhood Education and Care (ECEC) services. With the earliest years of a child’s life representing a critical period for neurodevelopment, understanding the influence of disruptions on children during the early childhood years due to pandemic induced lockdowns is necessary to identify effective post-pandemic practices supporting children and their families, and in preparation for possible future pandemics. This research is framed within Bronfenbrenner’s (1979) ecological theory, conceptualising the pandemic as an event of social significance. From an ecological perspective, young children’s developmental trajectories are shaped by events occurring at the chronosystem level of human development. Prolonged disruptions to other levels of the system incurred via the chronosystem level, such as the Covid-19 pandemic, have cascading influence on children’s learning and developmental outcomes. Through a pragmatic approach, this study employed an explanatory sequential design comprising two related Phases. Mixed methodologies were employed, with Phase One conducted as a systematic review of the literature and Phase Two conducted as a semi-structured interviews with nine caregivers of young children having lived experiences of pandemic induced lockdowns across Victoria, Australia. The research suggested disruption across the ecological systems of young children during the Covid-19 pandemic to influence their learning and developmental outcomes, predominantly in the domains of socioemotional development and psychological wellbeing. Notably, differences were identified between Phase One findings, which emphasised influence of disruption at the microsystem level, and Phase Two, which revealed disruption at the meso , and exosystem levels as influencing the learning and developmental outcomes of young children. The thesis makes a new contribution to knowledge regarding the influence of the pandemic on young children’s learning and development. Insights for policy based on the findings suggest post-pandemic practices as a formative response to the Covid-19 pandemic, and the necessity of preparing supports for young children and their families in the event of future pandemics.Item Open Access Understanding the effects of screen time on children and adolescents’ socio-emotional wellbeing(Australian Catholic University, 2026-01-15)Children and adolescents increasingly engage with screens for entertainment, schoolwork, and socialisation. Parents and policymakers debate whether screens cause socio-emotional problems, or if children with these problems are simply drawn to screens. This thesis aimed to explore the longitudinal relationship between screen use and socio-emotional problems, focusing on the direction of these associations. Secondarily, this thesis aimed to investigate the underlying mechanisms shaping this relationship, including screen use content and context, socio-demographic influences, environmental factors, and psychological variables. Study 1 (Chapter 3) was a meta-analysis of 132 longitudinal studies involving more than 290,000 children worldwide. Findings revealed a bidirectional relationship: increased screen use predicts socio-emotional problems, and vice versa. These associations were particularly strong for gaming interactions, and varied by age, gender and level of exposure to screens. For example, reciprocal effects were stronger among children who exceeded screen time guidelines. Study 2 (Chapter 4) was a longitudinal research using wearable cameras to access children’s screen behaviour. Contrary to the meta-analysis results, total screen time was not linked to significantly higher socio-emotional problems. However, gaming was linked to increased socio-emotional problems, particularly in boys. Social screen use was associated with greater socio-emotional difficulties, especially in girls. Solitary screen use appeared to be particularly harmful, whereas socially interactive screen use—especially when involving co-participation—reduced risks. Study 3 (Chapter 5) explored how environmental (i.e., need-supportive vs. need-thwarting environments) and psychological factors (i.e., intrinsic vs. extrinsic life aspirations) shape the relationship between screen use (i.e., gaming and social media use) and socio-emotional problems in adolescents. Findings showed that gaming interactions enhance wellbeing in need-supportive environments but become a coping mechanism in need-thwarting ones, leading to a cycle between problematic gaming and socio-emotional difficulties. Social media effects followed a similar pattern. Adolescents driven by extrinsic life goals seemed more vulnerable to both problematic use and socio-emotional challenges. Overall, findings suggest that screen use and socio-emotional problems fuel each other over time. Simply reducing screen time may be ineffective for those already struggling with emotional or social challenges. Instead, fostering healthier coping strategies and balancing screen use with activities that promote wellbeing seems to be the key to building resilience and emotional growth in children and adolescents in the digital era.Item Open Access Systemic strategies to improve mental health outcomes for children and young people in Australian out-of-home care who have experienced multi-type maltreatment(Australian Catholic University, 2026)Child maltreatment, either physical abuse, sexual abuse, emotional abuse, neglect, or exposure to domestic violence, is a key risk factor for both out-of-home care (OOHC) placement and mental health issues. Research also shows that a high proportion of individuals who experience child maltreatment suffer more than one type (multi-type maltreatment), a pattern strongly linked to adverse outcomes across all aspects of wellbeing, especially mental health. In Australia, statutory OOHC serves as a last‑resort child protection intervention. When a child or young person is placed in statutory OOHC, the state assumes a parental role, responsible not only for ensuring their immediate safety but also for supporting their broader wellbeing. In this population, where exposure to maltreatment is common, promoting positive wellbeing requires addressing the immediate effects of maltreatment while also actively working to reduce the likelihood of future mental health issues that may arise as a result of exposure to maltreatment. To achieve these objectives, OOHC systems must adopt a coordinated and standardised trauma-informed approach that recognises the frequent association between multi-type maltreatment and enduring mental health challenges, while also recognising that trajectories can vary across individuals. Despite playing a crucial role in mitigating the impacts of child maltreatment, the effectiveness of Australian OOHC systems has been widely debated. Over the past decade, numerous inquiries and reforms have sought to assess and improve the service system, reflecting ongoing concerns about its utility. International and Australian data consistently indicate that mental health issues persist among care-experienced individuals – both those currently in statutory OOHC and those who have a history of OOHC placement. This evidence represents a clear indicator of systemic shortcomings. With over 45,000 children and young people in care across Australia, this thesis focuses on the current reality that children and young people in OOHC are highly likely to have experienced multi-type maltreatment, placing them at heightened risk of poor mental health outcomes. OOHC systems across the country must urgently strengthen their ability to facilitate positive mental health outcomes to meet their ethical and legislative responsibilities to these children and young people. This leads me to pose the fundamental research question that drives this thesis: What systemic strategies does the OOHC sector need to implement or enhance, to facilitate improved mental health outcomes for children and young people in the system, given their exposure to multi-type maltreatment? Throughout this thesis I aim to build on the current evidence base, guiding the OOHC sector in answering this question. Grounded in ecological systems macro-theory and underpinned by biopsychosocial and developmental models, as well as social work and public health principles, I conducted five interconnected studies to contribute to this evidence base. In the first three studies, I quantitatively examined the prevalence and patterns of child maltreatment and mental health disorders among care-experienced Australians using data from the Australian Child Maltreatment Study. Exploring descriptive statistics, I established that care-experienced adults report higher rates of maltreatment and mental health disorders than the general population including post-traumatic stress disorder, major depression disorder, generalised anxiety disorder and severe alcohol use disorder. The second study subsequently compared maltreated groups (care-experienced and non-care-experienced) on the intensity of their maltreatment experiences. The results of that study revealed a significant difference between the two groups, with care-experienced individuals enduring more intense maltreatment than those never placed in care. In the final quantitative study, I applied propensity score matching and logistic regression analyses to show that, when maltreatment intensity is accounted for, the apparent effects of OOHC experience on mental health diminish. This suggests that the intensity of maltreatment, rather than OOHC per se, is a more influential factor in shaping later mental health outcomes, though the relationship remains complex and may be moderated by other contextual conditions. In the final two studies of this thesis, I used qualitative methods to pull the disparate evidence together on the practical changes the OOHC sector can implement to improve mental health outcomes for children and young people. In Study 4, I reviewed the literature to identify key practices, approaches, systems, and services within the OOHC sector's control, that could drive systemic improvements. I thematically analysed 47 publications and, using a bioecological perspective, identified 11 enablers of improvement positioned across all ecological levels. In the final study, I applied a phenomenological approach to interviews with 27 OOHC practitioners from across Australia. Their insights validated the 11 enablers found within the literature and revealed five additional ones. After refining themes, I mapped a total of 15 critical enabling factors—both within and beyond the OOHC sector's control—that are essential for systematically enhancing mental health outcomes for children and young people in OOHC. Together these studies present nationally representative data illuminating the context of maltreatment and mental health issues within the care-experienced population in Australia. They also establish a foundation for developing a comprehensive, evidence-informed approach that OOHC sectors can use to integrate effective mental health care strategies for children and young people.
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