Bond University

Psychological distress is common among intensive care unit (ICU) patients, yet current pharmacological approaches carry risks. The aim of this study was to survey ICU clinicians' perceptions of psychological stressors affecting patients, their coping strategies, and the perceived feasibility, benefits, and challenges of implementing virtual reality (VR) interventions in ICU settings. A dual-method cross-sectional survey was distributed to ICU clinicians in Australia and New Zealand between March and May 2025. The survey comprised 5-point Likert-scale and open-ended questions exploring three domains: (i) perceived psychological stressors in ICU patients; (ii) current practices and perceived effectiveness of psychological support interventions, including VR; and (iii) perceived barriers and design recommendations for VR implementation in the ICU. Quantitative data were analysed descriptively; qualitative responses underwent thematic analysis using the NVivo software. Among 143 valid respondents (125 completed), 56.6% were female; 48.3 % were nurses, 46.9% doctors, and 4.8% allied health professionals. Lack of sleep (median: 5 [4-5]), isolation (median: 4 [3-4]), temporal disorientation (median: 4 [3.5-4]), and sensory overload (median: 4 [4-5]) were rated as key stressors. Pharmacological, family communication, and maintaining a calm environment were the most implemented and effective interventions (median: 4 [4-4]). Engagement activities were infrequent, but structured communication with family was rated important (median: 4 [4-5]). The interventions listening to music, watching family videos, and viewing nature scenes (median: 4 [3-4.5]) closely followed. VR was seen as moderately familiar (median: 3 [2-3]) and moderately beneficial (median: 3 [3-4]) but difficult to implement (median: 3 [3-4]). ICU clinicians recommended that the VR content should be personalised, simple, safe, and supporting both patients' emotional needs and ICU workflow integration. ICU clinicians acknowledge the perceived psychological burden of ICU environments and engagement activities were infrequent in ICU patients. They express cautious optimism towards VR as a supportive tool. However, successful implementation requires addressing significant logistical, clinical, and educational barriers.

Health workforce challenges negatively impact health service delivery. In Aotearoa New Zealand, instability in the physiotherapy workforce, including poor retention, a shortage of experienced clinicians, and under-representation of physiotherapists from priority populations, is potentially compromising the quality and continuity of patient care. This study aimed to describe the composition, working patterns, and turnover intentions of the public health physiotherapy workforce, i.e., those employed by Health New Zealand – Te Whatu Ora, providing baseline data to inform retention and diversity strategies, as well as future research. Data were collected via a national e-survey distributed through unions and open to all physiotherapists employed by Health New Zealand – Te Whatu Ora. The response rate was 47.9% (n = 578), representing approximately 46.6% of the workforce. Of the participants, 5.9% were Māori, 2.4% Pacific, and 10.2% identified as disabled people. A majority (59.3%) had over 10 years of career experience, 60.7% worked full-time, 51.7% worked overtime, 56.6% supervised students, and 49.3% contributed to the out-of-hours rota. Using survey weighting, it is estimated that 39.6% of the Health New Zealand – Te Whatu Ora workforce have intentions to leave their job and 19.4% often or always consider leaving the profession. These findings reveal a workforce with complex roles and responsibilities. The high proportion of intention to leave signals a workforce under pressure and in need of urgent attention. Future research is needed to explore physiotherapists’ experiences of the current practice environment and determine what factors influence turnover intention.

Paramedicine students experience disproportionately high rates of anxiety, depression, stress, and insomnia compared to the general population, placing them at risk of post-traumatic stress disorder and long-term psychological distress. Breathwork has emerged as a promising self-regulation intervention that may enhance resilience and wellbeing while reducing symptoms of mental illness. This randomised controlled trial (RCT) evaluated the effectiveness of the A52 Breath Method, a structured breathwork protocol, in improving mental health and resilience among student paramedics. A single-blind parallel-group mixed-methods RCT was conducted with 98 student paramedics from two Australian universities, randomised to either a 12-week breathwork intervention or control, with results interpreted in light of differential attrition. The intervention involved twice-daily practice of slow, diaphragmatic breathing (5-s inhale, 5-s exhale, 2-s hold) with video and guided audio instruction. Outcomes included changes in anxiety, depression, stress (DASS-21), insomnia (ISI), resilience (RS-14), and psychological wellbeing (RPWB-18), between baseline and post-intervention. Analyses included 2 × 2 mixed factorial ANOVA, ANCOVA for baseline differences, and correlation analyses. At post-intervention, participants in the breathwork group reported significantly lower stress, anxiety, and depression scores, and higher resilience compared to controls (all p < 0.05), with medium to large effect sizes. Insomnia and psychological wellbeing showed non-significant changes. Qualitative feedback highlighted perceived benefits for self-regulation, including emotional regulation and perceived psychological safety and control-although challenges to practice engagement was noted. The A52 Breath Method significantly reduced reported symptoms of psychological distress and enhanced resilience in student paramedics, even during exam stress. Breathwork shows promise as a scalable, upstream intervention to support mental health in paramedic student training. TRIAL REGISTRATION: Registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12625000101482 on 30/01/2025. Available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=388884&showOriginal=true&isReview=true.

Climate change exposure is predicted to contribute to significant mental health problems for younger people; however, little research has examined this stressor in the context of other psychosocial stressors experienced by this age group. In the immediate aftermath of Australia's severe bushfire season of 2019/2020 and at the onset of the COVID-19 pandemic, 712 Australian youth (Mage = 21.07, range 16-25 years) completed standardised clinical screening measures of psychological distress, adjustment disorder, and substance misuse. Objective exposure to extreme drought, bushfire, and bushfire smoke (air quality index) was quantified using data from the NSW Department of Primary Industries and Energy. Subjective exposure was quantified by responses to questions about direct exposure to drought, bushfire, and bushfire smoke. In contrast to expectations, neither subjective nor objective exposure to climate extremes meaningfully contributed to mental health outcomes, with little variance explained. However, common psychosocial stressors did account for significant amounts of variance in psychological distress (range: 2%-6%), adjustment disorder (range: 1%-3%), and substance misuse (range: 1%-2%) symptom endorsement. These results indicate-for the first time-that although extreme climate events may cause significant distress in some young people, other stressful events may have more of an impact on overall mental health.

Virtual reality (VR) devices are increasingly being utilized within operating theaters and intensive care units where appropriate sanitation is vital to ensure that patients do not unnecessarily acquire hospital‐associated infections. The morphology of VR devices in conjunction with the variety of materials and internal components provides challenges to their repurposing. This study aimed to evaluate the microorganisms remaining on VR headsets following sanitation by laboratory staff in a medical education anatomy teaching facility. The external components and internal facial interface were swabbed and separately cultured on four AGAR plates (Horse Blood, Nutrient, bile Esculin, and Mannitol Salt). Colonies were counted, sampled, pooled and subsequently processed for shotgun metagenomic sequencing. A higher number of colonies were present on surfaces closest to the eyes and facial interface compared to the external components. Metagenomic analysis identified 27 pathogenic bacteria including 4 “ESKAPE” pathogens (Enterobacter sp., Staphylococcus aureus, Klebsiella spp. and, Escherichia coli) and numerous organisms associated with ocular infections. A broad range of antimicrobial resistance genes were identified conveying resistance to Methicillin, Aminoglycosides, Macrolides, Tetracyclines, and Polymixins. Further research is required to ensure that current sanitization practices of VR head mounted displays are appropriate within high‐risk hospital settings.

Evaluation is essential for assessing whether policy and program outcomes align with their intended goals. A key critique of Western evaluation approaches is their failure to incorporate Indigenous ways of knowing, being and doing. Developing an Indigenist evaluation concept can enhance evaluation quality by recognising Indigenous perspectives. This study draws on Indigenous Lifeworlds as a theoretical basis to explore the idea of ‘collective capability’, asserting Indigenous societies operate at the ‘collective’ level over the individual and focus on ‘capability’ as a way of realising potential through collective effort. We conducted 20 in-depth interviews with Aboriginal and Torres Strait Islander Knowledge holders involved in evaluation to identify attributes of collective capability. Through manifest and latent content analysis, we defined collective capability and its key components. Our definition describes it as people coming together in a relational, collaborative environment to pursue a common goal, where cultural values are prioritised, knowledge is shared and the process is as important as the outcome . The two main elements of collective capability are relationality and knowledge sharing, each with several sub-elements. The next phase of the research will focus on integrating these elements into the context of Indigenist evaluation, developing criteria and processes for their operationalisation.

BackgroundLaw enforcement officers are required to wear and carry loads as part of their occupation. Research detailing differences in loads carried across occupational subgroups in law enforcement is limited.ObjectiveThe aim of this study was to profile the loads carried by an Australian State police agency and investigate whether any occupational subgroup, or sex-based, differences existed.MethodsData from 88 officers across five different stations from the same agency were collected. Officers were weighed in their uniforms without, and with, their duty load. Duty load was calculated as both absolute and relative values. Independent samples t-tests were used to investigate differences between sexes. An ANOVA was used to compare loads between occupational subgroups. Alpha levels were set at 0.05.ResultsFemale officers were significantly shorter and lighter than male officers, carried significantly lighter absolute loads but similar relative loads. General Duties (9.47 ± 1.67 kg) and Bicycle officers (10.38 ± 0.37 kg) carried and wore significantly heavier absolute loads than plain clothes officers (6.71 ± 2.26 kg), while specialist police carried significantly heavier loads than all subgroups (15.72 ± 2.13 kg). A similar trend was found in relative loads (General Duties = 11.1 ± 2.1%, specialist police = 17.0 ± 3.6%) except for Bicycle officer relative loads (10.9 ± 1.6%) which were not significantly heavier than those of plain clothes officers (7.9 ± 2.9%).ConclusionDifferent subgroups of officers carry and wear different loads. These differences warrant consideration especially when considering the chronic impacts of wearing these loads across a career. Optimised load fit and physical conditioning are recommended to mitigate the occupational impacts of carrying these loads.