Journal articles on the topic 'Caregivers Queensland'

As survival rates and life expectancies of individuals experiencing acquired disabilities such as spinal cord injury improve, greater demands are placed on health, rehabilitation and long-term care services. Further, family caregivers are assuming much of the caring responsibilities. This paper examines family caregiving in relation to individuals with spinal cord injury (SCI) in an Australian context. The paper is based on a descriptive survey conducted with 206 individuals with SCI, referred to a specialist SCI outreach service in Queensland, and 179 family caregivers. The survey collected social and demographic information and details of the type of care provided by family caregivers. It also explored family caregivers' perceptions of the types of services they require to assist them in their caring roles. Family caregiving typically involved physical, practical, and emotional support, and in many cases this occupied in excess of three hours a day, with no additional source of caregiving provided. The most frequently reported service types required by family caregivers included respite, personal support, information services, and health professional services. Mapping caregiver needs in this area establishes a critical basis for service planning and more importantly provides a guide for the development of a range of services dedicated to maintaining the health and well-being of family caregivers of individuals with SCI.

Family caregivers of people with bipolar disorder experience a range of difficulties in understanding and coping with the impact of the disorder. The Family Support Team at the Princess Alexandra Hospital in Brisbane, Queensland, developed an educational supportive program for families of people with bipolar disorder that sought to improve caregiver knowledge of the illness, reduce caregiver distress, and enhance caregiver coping. The program also sought to moderate caregiver attributions of patient behavior in order to build an illness perspective of behavior. The bipolar program was developed trialed, and evaluated Analysis of results shows encouraging improvements for some families in knowledge, distress, attributions, and ways of coping. Practice and research implications include identifying differences with the schizophrenia program, the importance of a problem-solving focus, maintaining a balance between information giving and support, and timing of the intervention.

Objective: As cancer survival rates continue to increase, so will the demand for care from family and friends, particularly in more isolated settings. This study aims to examine the needs of cancer caregivers in regional and remote Australia. Methods: A total of 239 informal (i.e., non-professional) cancer caregivers (e.g., family/friends) from regional and remote Queensland, Australia, completed the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C). The frequencies of individuals reporting specific needs were calculated. Logistic regression analyses assessed the association between unmet needs and demographic characteristics and cancer type. Results: The most frequently endorsed needs were lodging near hospital (77%), information about the disease (74%), and tests and treatment (74%). The most frequent unmet needs were treatment near home (37%), help with economic burden (32%), and concerns about the person being cared for (32%). Younger and female caregivers were significantly more likely to report unmet needs overall (OR = 2.12; OR = 0.58), and unmet healthcare staff needs (OR = 0.35; OR = 1.99, respectively). Unmet family and social support needs were also significantly more likely among younger caregivers (OR = 0.35). Caregivers of breast cancer patients (OR = 0.43) and older caregivers (OR = 0.53) were significantly less likely to report unmet health and psychology needs. Proportions of participants reporting needs were largely similar across demographic groups and cancer type with some exceptions. Conclusions: Caregiver health, practical issues associated with travel, and emotional strain are all areas where regional and remote caregivers require more support. Caregivers’ age and gender, time since diagnosis and patient cancer type should be considered when determining the most appropriate supportive care.

IntroductionThere are personal and societal benefits from caregiving; however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge.Methods and analysisA multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements.Ethics and disseminationParticipants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences.Trial registration numberACTRN12620000060943.

ObjectivesForecasting survival in cancer is a particularly challenging facet of oncological work and can involve complex interactions with patients and their families. While there is considerable research on patient experiences of being provided with, or becoming aware of, their prognosis, there has been much less emphasis placed on the experiences of caregivers. The aim of this paper was to examine caregivers’ experiences of prognosis.DesignThis study used semistructured interviews; transcripts were analysed thematically using the framework approach. These data are part of a larger research project focused on experiences of cancer survivorship.SettingRecruitment was from two metropolitan hospitals in Queensland, Australia.Participants50 caregivers of patients living with cancer and receiving treatment at two metropolitan hospitals (32% male, 68% female) participated in this study.ResultsFour main themes were identified: (1) caregivers’ uncertainty around the meaning and implications of prognosis, (2) caregivers’ sense of exclusion in prognostic conversations, (3) the practice of situating prognosis within a context of hope and (4) the precarious balance between realism, optimism and strategic ‘ignorance’.ConclusionsCaregivers are in many respects the unseen third party of prognostic communication. Developing a better understanding of caregivers’ perceptions of prognosis, including how this may be challenged, accepted or otherwise, is important in engaging caregivers in the process of communicating prognostic information. Facilitating greater participation by caregivers in prognostic conversations could potentially address evident complexities and even improve the experiences of all stakeholders in cancer care settings.

The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured “Statewide Hospital Contacts,” including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; “When to Call” describing symptoms to look out for in a deteriorating child; “Blood Results Table”; and “Information” listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were “Blood Results Table,” “When to Call,” and “Statewide Hospital Contacts,” but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.

IntroductionDental decay is a major problem among Australian children. It can be prevented through good self-care and limiting sugar intake, but many parents/caregivers lack the skills and confidence to help their children adopt these practices. This trial will evaluate the efficacy ofHealthy Habits Triple P - Oral health,a web-based online programme, in improving children’s oral health-related behaviours (toothbrushing, snacking practices and dental visits) and related parenting practices, thereby preventing dental caries.Methods and analysisThis is a cluster, parallel-group, single-blinded, randomised controlled trial of an online intervention for parents/caregivers of children aged 2–6 years. From the City of Gold Coast (Australia), 18 childcare centres will be randomly selected, with equal numbers randomised into intervention and control arms. Intervention arm parents/caregivers will receive access to a web-based parenting intervention while those in the control arm will be directed to oral health-related information published by Australian oral health agencies. After the completion of the study, theHealthy Habits Triple P - Oral healthintervention will be offered to parents/caregivers in the control arm. The primary outcome of this trial is toothbrushing frequency, which will be assessed via Bluetooth supported smart toothbrushes and parent/caregiver report. Data on other outcomes: parenting practices and child behaviour during toothbrushing, consumption of sugar rich foods and parents’ confidence in dealing with children’s demands for sugar rich food, and dental visiting practices, will be collected through a self-administered questionnaire at baseline (before randomisation), and 6 weeks (primary endpoint), 6 months and 12 months after randomisation. Data on dental caries will be collected at baseline, 12 and 18 months post-randomisation.Ethics and disseminationEthical approval has been obtained from Human Research Ethics Committees of Griffith University (2020/700) and the University of Queensland (2020002839). Findings will be submitted for publication in leading international peer-reviewed journals.Trial registration numberACTRN12621000566831.

ObjectiveTo investigate primary infant caregiver awareness of the current national public health safe sleep messages and the associations of awareness with care practices.Design and settingA cross-sectional survey in Queensland, Australia. All families with live babies birthed during April–May 2017 were eligible. Questionnaires were distributed when infants were approximately 3 months old.ParticipantsOf the 10 200 eligible families, 3341 (33%) primary caregivers participated.Main outcome measuresParticipants were asked: to recall key safe sleeping messages they were aware of (unprompted); questions about their infant care practices; and to select the current, national six safe sleeping messages (prompted multi-choice).ResultsOverall, the majority of families are aware of sleep-related infant mortality and sudden infant death (3178/3317, 96%); however, approximately one in four caregivers (867/3292, 26%) could not identify the current six messages to promote safer infant sleep in a multi-choice question. Despite being aware of the six key messages, some caregiver practices did not always align with advice (336/2423, 14% were not smoke-free; 349/2423, 14% were not usually supine for sleep; 649/2339, 28% employed practices which may increase risk of head or face covering; 426/2423, 18% were not receiving breastmilk).ConclusionsThere is considerable scope for improvement in parent awareness and ability to recall key safe sleep messages. Awareness of advice does not always translate into safe infant care. Health promotion messaging to encourage safer infant sleep, ultimately aimed at reducing sudden unexpected infant deaths, needs more effective supportive strategies and dissemination if future campaigns are to be successful.

This paper reports on implications for the management of police discretion arising from a Victim—Offender pilot project in Queensland, Australia. The pilot was conducted with juvenile offenders and was highly successful on a range of key outcomes related to restorative justice. However, the project suffered from very low referrals from police, and there were no referrals from the courts, partly because of magistrates' deference to police decisions. As a consequence, many crime victims and young offenders and their caregivers had no opportunity to benefit from reparation. On this basis, a recommendation was made to curtail police discretion severely by building into the case disposition process mandatory consultation regarding mediation with all victims and offenders. This posed a direct challenge to the traditional wide discretionary powers held by police in their gatekeeping role. This research was commissioned by the Queensland Department of Justice. The views expressed are those of the authors, not necessarily those of the Department.

IntroductionThe acceptability and efficacy of existing ready-to-use supplementary and therapeutic foods has been low in Cambodia, thus limiting success in preventing and treating malnutrition among Cambodian children. In that context, UNICEF and IRD have developed a locally produced, multiple micronutrient fortified lipid-based nutrient supplement. This food is innovative, in that it uses fish instead of milk as the animal source food. Very few supplementary foods have non-milk animal source foods, and in addition they have not been widely tested. This trial will assess the novel food’s acceptability to children and caregivers.Methods and analysisThis is a cluster-randomised, incomplete block, 4×4 crossover design with no blinding. It will take place in four sites in a community setting in periurban Phnom Penh. Healthy children aged 9–23 months (n=100) will eat each of four foods for 3 days at a time. The amount they consume will be measured, and at the end of each 3-day set, caregivers will assess how well their child liked the food. After 12 days, caregivers themselves will do a sensory test of the 4 foods and will rank them in terms of preference.Ethics and disseminationEthical clearance was received from the University of Queensland Medical Research Ethics Committee (2014001070) and from Cambodia’s National Ethics Committee for Health Research (03/8 NECHR).RegistrationClinicalTrials.gov, identifier: LNS-CAMB-INFANTS;NCT02257437. Pre-results.

IntroductionChildren and youth with moderate-severe (Gross Motor Function Classification System (GMFCS) levels II–V) cerebral palsy (CP) participate less frequently in physical activities compared with peers without CP and have elevated risk of cardiorespiratory morbidity and mortality in adulthood. Frame Running (RaceRunning) is a new athletics discipline that is an accessible option for physical activity participation for people with moderate-severe CP. There is no high-quality evidence for the effect of Frame Running on cardiovascular disease in children and young people with CP. The primary aim of this study is to conduct a randomised controlled trial of the effect of 12 weeks of Frame Running training on risk factors for cardiovascular disease.Methods and nalysisSixty-two children and youth with CP (age 8–20 years) in GMFCS levels II–V will be recruited across four sites and randomised to receive either 12 weeks of Frame Running training two times weekly for 60 min, or usual care. Outcomes will be measured at baseline, immediately postintervention (primary endpoint) and 12 weeks later for retention of training effects. The primary outcome is cardiorespiratory fitness as measured by distance covered on Six Minute RaceRunner Test with 1 min heart rate recovery. Other outcomes include blood pressure, objectively measured physical activity, body mass index, waist circumference, percentage body fat, gross motor function capacity, community participation, feasibility, tolerability and safety. Adverse events will be monitored, and participants and their caregivers will be interviewed to discern their experiences of participation in Frame Running.Ethics and disseminationThe Children’s Health Queensland Hospital and Health Service and the University of Queensland Human Research Ethics Committees have approved this study. Results will be disseminated in peer-reviewed journals and scientific conferences; through professional and athletic organisations; and to people with CP and their families.Trial registration numberACTRN12621000317897; Australian New Zealand Clinical Trials Registry number.

IntroductionBronchiectasis is no longer considered rare or irreversible in children, yet it remains relatively under-researched and neglected in respiratory health globally. Bronchiectasis (including chronic suppurative lung disease) causes substantial morbidity for patients and significant impact on caregivers, especially during acute respiratory exacerbations. In other chronic respiratory diseases (eg, asthma), empowering consumers with an individualised plan for management of acute exacerbations improves clinical outcomes. However, in the absence of any such data specific to bronchiectasis, action management plans are rarely currently used in children or adults with bronchiectasis. We hypothesise that providing an individualised bronchiectasis action management plan (BAMP) to children with bronchiectasis reduces non-scheduled doctor consultations, compared with not having a BAMP.Methods and analysisThis multicentre, parallel, double-blind, randomised trial involving three urban Australian hospitals commenced in June 2018 and will include 198 children, aged <19 years with bronchiectasis who had 2 or more exacerbations in the previous 18 months. Children will be randomised to having an individualised BAMP or standard care (a decoy clinic letter). Primary caregivers will then be followed up monthly for 12 months. The primary outcome is the rate of acute non-scheduled doctor visits for respiratory exacerbations by 12 months. The main secondary outcomes are cough-specific quality of life scores at 6 and 12 months, overall exacerbation rate over 12 months, and proportion of children who received timely influenza vaccination by 30 May annually.Ethics and disseminationThe Human Research Ethics Committees of the Northern Territory Department of Health and Menzies School of Heath Research and Queensland Children’s Hospital approved the study. The results of the trial will be submitted for publication and the BAMP made available free online.Trial registration numberAustralia and New Zealand Clinical Trials Register ACTRN12618000604202.

IntroductionAboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysisThe study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and disseminationThe Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC (HREC/QTHS/73789) have approved the study. Dissemination will occur via conferences and peer-reviewed publications. Further dissemination will be determined in partnership with the Aboriginal and Torres Strait Islander Steering Committee, including Youth Representatives and Consultation Network.

Purpose Existing studies of school efficiency primarily specify teacher inputs as the number of teachers and perhaps the student-teacher ratio. As a result, there is no direct qualitative recognition of the learning environment. The purpose of this paper is to incorporate the learning environment directly into the assessment of school efficiency. Design/methodology/approach The authors employ data envelopment analysis to derive efficiency scores and the double-bootstrap truncated regression approach in Simar and Wilson’s (2007) Journal of Econometrics to quantify the sources of efficiency in 430 Queensland state primary schools. In the first stage, the outputs of student National Assessment Program-Literacy and Numeracy scores and the inputs of full-time equivalent teaching staff and cumulative capital expenditure per student are used to measure efficiency. In the second stage, the authors specify an index of community socio-educational advantage, class size, the share of teachers with postgraduate qualifications, funds spent on professional development, and surveyed opinions from parents/caregivers, students, staff and principals on the learning environment to explain these measures of efficiency. Findings Socio-economic background and the teaching environment affect school efficiency. Although not all variables related to teacher contribution are significant, there is evidence to suggest that teachers have a positive influence on student performance hence school efficiency. Teachers ability to clearly explain the requirements of schoolwork tasks and listening to student opinions sets an ideal student engagement environment which can have a profound impact on student learning. Practical implications From a policy perspective, policy makers should target resources at inefficient schools aimed at enhancing student learning through teacher development and, at the same time, providing financial and non-financial educational assistance to students and their families from a low socio-educational background. Originality/value This is the first large-scale primary school efficiency analysis to incorporate the Simar and Wilson (2007) approach to explaining the determinants of efficiency, including teaching environment from the perspective of students, teachers and other stakeholders.

IntroductionNeurodevelopmental disorders (NDD), including cerebral palsy (CP), autism spectrum disorder (ASD) and foetal alcohol spectrum disorder (FASD), are characterised by impaired development of the early central nervous system, impacting cognitive and/or physical function. Early detection of NDD enables infants to be fast-tracked to early intervention services, optimising outcomes. Aboriginal and Torres Strait Islander infants may experience early life factors increasing their risk of neurodevelopmental vulnerability, which persist into later childhood, further compounding the health inequities experienced by First Nations peoples in Australia. The LEAP-CP prospective cohort study will investigate the efficacy of early screening programmes, implemented in Queensland, Australia to earlier identify Aboriginal and Torres Strait Islander infants who are ‘at risk’ of adverse neurodevelopmental outcomes (NDO) or NDD. Diagnostic accuracy and feasibility of early detection tools for identifying infants ‘at risk’ of a later diagnosis of adverse NDO or NDD will be determined.Methods and analysisAboriginal and/or Torres Strait Islander infants born in Queensland, Australia (birth years 2020–2022) will be invited to participate. Infants aged <9 months corrected age (CA) will undergo screening using the (1) General Movements Assessment (GMA); (2) Hammersmith Infant Neurological Examination (HINE); (3) Rapid Neurodevelopmental Assessment (RNDA) and (4) Ages and Stages Questionnaire-Aboriginal adaptation (ASQ-TRAK). Developmental outcomes at 12 months CA will be determined for: (1) neurological (HINE); (2) motor (Peabody Developmental Motor Scales 2); (3) cognitive and communication (Bayley Scales of Infant Development III); (4) functional capabilities (Paediatric Evaluation of Disability Inventory-Computer Adaptive Test) and (5) behaviour (Infant Toddler Social and Emotional Assessment). Infants will be classified as typically developing or ‘at risk’ of an adverse NDO and/or specific NDD based on symptomology using developmental and diagnostic outcomes for (1) CP (2) ASD and (3) FASD. The effects of perinatal, social and environmental factors, caregiver mental health and clinical neuroimaging on NDOs will be investigated.Ethics and disseminationEthics approval has been granted by appropriate Queensland ethics committees; Far North Queensland Health Research Ethics Committee (HREC/2019/QCH/50533 (Sep ver 2)-1370), the Townsville HHS Human Research Ethics Committee (HREC/QTHS/56008), the University of Queensland Medical Research Ethics Committee (2020000185/HREC/2019/QCH/50533) and the Children’s Health Queensland HHS Human Research Ethics Committee (HREC/20/QCHQ/63906) with governance and support from local First Nations communities. Findings from this study will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberACTRN12619000969167.

Fifty-two (52) cases of infant abusive head trauma (IAHT), investigated by the Queensland Police Service over a ten-year period, were examined for information on victim and offender demographics. The study revealed a mean age of 2.6 months for victims of assaults categorised as involving a shaking-type mechanism, indicating that the youngest infants are particularly susceptible to that form of injury. It was further demonstrated that abusive injuries are most likely to be caused by a primary caregiver, such as a biological or step-parent. It is thus hypothesised that to assist in prevention, some form of written caution on the dangers of infant shaking should be provided to all parents immediately prior to their child's departure from the maternity ward.

The incarceration of a mother usually brings considerable dislocation to the offending woman's children and family. This paper examines current policies for the inmate mother, for her children and for the caregiver(s) of her children on the outside and argues for reform with respect to these policies. To this end, it reports on the Australian component of a comparative policy study, Incarcerated Mothers and Children: Impact of Prison Environments (IMCIPE), which investigated the impact of the prison environment on incarcerated mothers and their young children (including both mothers whose children live with them in custody and mothers who are separated from their children), in Queensland, New South Wales, Victoria and England. The paper draws on data from policy analyses; interviews with policy-makers, with inmate mothers, and with custodial and non-custodial staff; and observations within six women's prisons and their respective correctional authorities in the three Australian states. The study found that while inmate mothers need support from “significant others” within and outside the prison to cope with the dual roles of prisoner and mother, the custodial environment with its philosophy of incarceration, its mode of containment and the prison rules and regulations runs counter to such needs.

ObjectiveTo compare the effectiveness of two acute burn dressings, Burnaid hydrogel dressing and plasticised polyvinylchloride film, on reducing acute pain scores in paediatric burn patients following appropriate first aid.DesignSingle-centre, superiority, two-arm, parallel-group, prospective randomised controlled trial.Participants and settingPaediatric patients (aged ≤16) presenting to the Emergency Department at the Queensland Children’s Hospital, Brisbane, Australia, with an acute thermal burn were approached for participation in the trial from September 2017–September 2018.InterventionsPatients were randomised to receive either (1) Burnaid hydrogel dressing (intervention) or (2) plasticised polyvinylchloride film (Control) as an acute burn dressing.Primary and secondary outcomesObservational pain scores from nursing staff assessed 5 min post application of the randomised dressing, measured using the Face Legs Activity Cry and Consolability Scale was the primary outcome. Repeated measures of pain, stress and re-epithelialisation were also collected at follow-up dressing changes until 95% wound re-epithelialisation occurred.ResultsSeventy-two children were recruited and randomised (n=37 intervention; n=35 control). No significant between-group differences in nursing (mean difference: −0.1, 95% CI −0.7 to 0.5, p=0.72) or caregiver (MD: 1, 95% CI −8 to 11, p=0.78) observational pain scores were identified. Moreover, no significant differences in child self-report pain (MD: 0.3, 95% CI −1.7 to 2.2, p=0.78), heart rate (MD: −3, 95% CI −11 to 5, p=0.41), temperature (MD: 0.6, 95% CI −0.13 to 0.24, p=0.53), stress (geometric mean ratio: 1.53, 95% CI 0.93 to 2.53, p=0.10), or re-epithelialisation rates (MD: −1, 95% CI −3 to 1, p=0.26) were identified between the two groups.ConclusionsA clear benefit of Burnaid hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burns was not identified in this investigation.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617001274369).

Background An aging population, accompanied by the prevalence of age-related diseases, presents a significant burden to health systems. This is exacerbated by an increasing shortage of aged care staff due to the existing workforce entering their retirement and fewer young people being attracted to work in aged care. In line with consumer preferences and potential cost-efficiencies, government and aged care providers are increasingly seeking options to move care and support to the community or home as opposed to residential care facilities. However, compared to residential care, home environments may provide limited opportunity for monitoring patients’ progression/decline in functioning and therefore limited opportunity to provide timely intervention. To address this, the Smarter Safer Homes (SSH) platform was designed to enable self-monitoring and/or management, and to provide aged care providers with support to deliver their services. The platform uses open Internet of Things communication protocols to easily incorporate commercially available sensors into the system. Objective Our research aims to detail the benefits of utilizing the SSH platform as a service in its own right as well as a complementary service to more traditional/historical service offerings in aged care. This work is anticipated to validate the capacity and benefits of the SSH platform to enable older people to self-manage and aged care service providers to support their clients to live functionally and independently in their own homes for as long as possible. Methods This study was designed as a single-blinded, stratified, 12-month randomized controlled trial with participants recruited from three aged care providers in Queensland, Australia. The study aimed to recruit 200 people, including 145 people from metropolitan areas and 55 from regional areas. Participants were randomized to the intervention group (having the SSH platform installed in their homes to assist age care service providers in monitoring and providing timely support) and the control group (receiving their usual aged care services from providers). Data on community care, health and social-related quality of life, health service utilization, caregiver burden, and user experience of both groups were collected at the start, middle (6 months), and end of the trial (12 months). Results The trial recruited its first participant in April 2019 and data collection of the last participant was completed in November 2020. The trial eventually recruited 195 participants, with 98 participants allocated to the intervention group and 97 participants allocated to the control group. The study also received participants’ health service data from government data resources in June 2021. Conclusions A crisis is looming to support the aging population. Digital solutions such as the SSH platform have the potential to address this crisis and support aged care in the home and community. The outcomes of this study could improve and support the delivery of aged care services and provide better quality of life to older Australians in various geographical locations. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000829213; https://tinyurl.com/2n6a75em International Registered Report Identifier (IRRID) DERR1-10.2196/31970

Purpose Active school travel (AST) programmes aim to change commuting behaviour to improve children's physical and mental health. However, very limited health education programmes for children use segmentation to create tailored solutions that understand the specific characteristics of each group of children and their caregivers in order to yield better results. The aim of this study is to use a statistical segmentation analysis (two-step cluster analysis) to gain insights on the examination of specific groups to design future health education interventions and campaigns that can improve children's health. Design/methodology/approach Guided by the Ecological and Cognitive Active Commuting (ECAC) framework, a market segmentation analysis was performed. An online survey was designed to collect data from caregivers of children between 5 and 12 years attending school and responsible for taking the child to and/or from school in Victoria and Queensland, Australia. Using 3,082 responses collected from Australian caregivers of primary school children, a two-step cluster analysis was performed. Findings Analysis revealed the most important variables for group formation were previous child walking behaviour, distance from school and caregiver income. Perceived risk of the physical environment was the most important psychographic segmentation variable for group formation, followed by social norms. Four distinct groups with different characteristics were identified from the analysis. Originality/value This is the first study that applies the ECAC framework to perform market segmentation in the AST context. Results revealed four market segments that demand different tailored solutions. Findings shed light on how to better design AST interventions and campaigns to promote children's health using segmentation techniques.

Abstract Background There is limited best- practice evidence to address behavioral and psychiatric symptoms for those with dementia in Australian rural nursing homes. This study aims to evaluate the outcomes of a person-centered, non-pharmacological dementia care model, ‘Harmony in the Bush’, based on the Progressively Lowered Stress Threshold principles and person-centered music in rural Australia. Methods A quasi-experimental (nonrandomized, pre-post) intervention study was conducted in five rural nursing homes in Queensland and South Australia. Seventy-four residents with dementia participated in this intervention study, which yielded a sample power of 80%. Eighty-seven staff completed the Caregiver Stress Inventory at pre-post four-weeks of intervention. Staff training workshops focused on the theory of the Progressively Lowered Stress Threshold principles and delivery of person-centered care plan with integrated music intervention. We used reported changes in agitation of the residents, measured using Cohen- Mansfield Agitation Inventory, and staff’s caregiving stress, using Caregivers Stress Inventory. This study adheres to the CONSORT guidelines. Results Mean age of residents with dementia was 82.4 (7.7) years and 69% were females. The mean age of admission was 80.1(8.4) years. Baseline measures indicated that 32.7% had mild- severe pain and 30.5% reported mild-severe sadness. The results showed statistically significant decline in aggressive behaviors, physically non-aggressive behaviors, verbally agitated behavior and hiding and hoarding. There was similar reduction in staff stress in the domains of aggressive behaviors, inappropriate behaviors, resident safety, and resource deficiency. Conclusions The Harmony in the Bush model is effective in reducing agitation among dementia residents with significant reduction in staff stress levels in nursing homes in rural Australia. Trial registration Australian and New Zealand Clinical Trials Registry (ANZCTR) on 20/2/2018 (Registration No: ACTRN12618000263291p). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374458

Abstract Background The Compassionate Access Scheme (CAS) being delivered through the Queensland Children’s Hospital is designed to allow access to an investigational purified Cannabidiol oral solution to paediatric patients with severe refractory epilepsy. The objectives of this study were to conduct semi-structured interviews to: 1. Understand families’ expectations and attitudes about the use of an investigational cannabinoid product for their child’s seizures; 2. Understand families’ perceptions of Cannabidiol’s efficacy for their child’s seizures; and other aspects of their child’s behaviour, quality of life and/or cognition. Methods Children aged 2-18 years had been enrolled in, or were enrolled in a compassionate access scheme for Cannabidiol at the time of the study. Semi-structured interviews (n = 19) with parents or caregivers (n = 23) of children diagnosed with refractory epilepsy were voice-recorded, transcribed and analysed to generate common themes. Results Key themes emerged relating to seizure activity, family and school engagement, drug safety and legal access, efficacy, clinical support, social acceptance of the medication and program delivery. The use of Cannabidiol was perceived to have benefits in relation to reducing the severity and frequency of seizure activity for almost a third of patients experiencing refractory epilepsy. Participants described other benefits including improved social engagement, wakefulness and a reduction of side effects related to a reduction of conventional medication dosage. Conclusion This study provided unique perspectives of families’ experiences managing untreatable epilepsy, their experiences with conventional and experimental pharmacological treatments and health services. Whilst families’ perceptions showed the use of Cannabidiol did not provide a therapeutic reduction in the seizure activity for all patients diagnosed with refractory epilepsy, it’s use as an additional pharmacological agent was perceived to provide other benefits by some patient families.

Abstract Background Our study aims to explore the experience of having a central venous access device (CVAD) from the perspective of the child and family and how movements within and outside of hospital environments influence this experience. Methods A mixed-methods study was conducted across Children’s Health Queensland (Australia), including inpatient and home-care settings. Children less than 18 years with CVADs were eligible and followed for 3 months or CVAD removal. A subgroup of primary caregivers participated in semi-structured interviews. Quantitative and qualitative measures of child and family CVAD experiences were explored. Results In total, 163 patients with 200 CVADs were recruited and followed for 6993 catheter days (3329 [48%] inpatients; 3147 [45%] outpatients; 517 [7%] home). Seventeen participants were interviewed. Experiences of having a CVAD were complex but predominantly positive primarily related to personalized CVAD care, healthcare quality, and general wellbeing. Their experience was shaped by their movements through hospital and home environments, including care variation and distress with procedures. Device selection and insertion location further influenced experience, including safety, impairments in activities of daily living, school, and recreation. Conclusions CVAD experiences were influenced by nonmodifiable (e.g., diagnosis) and modifiable factors (e.g., education; care variation). Clinical approaches and policies that account for family and child considerations should be explored. Impact Variation in decision making and management for pediatric CVADs is accepted by many clinicians, but the influence this variation has on the health experience of children and their families is less well explored. This is the first study to draw from a broad range of children requiring CVADs to determine their experience within and outside of healthcare facilities. Interdisciplinary clinicians and researchers need to work collaboratively with children and their families to provide resources and support services to ensure they have positive experiences with CVADs, no matter where they are managed, or who they are managed by.

Intergenerational playgroups purposively bring older people, young children and their caregivers together to engage in play and develop reciprocal relationships. Intergenerational research focuses on the benefits for participants, with much less known about how these programmes sustain. This paper discusses and explores programme sustainability through the examination of two playgroups established through Playgroup Queensland’s Ageless Play programme. Through qualitative interviewing with playgroup practitioners and participants we aimed to understand how each of these playgroups had sustained beyond 3 years. The findings included the importance of mutual benefit for stakeholders, knowledge and skills of the playgroup facilitator and use of strategies to ensure ongoing interaction and engagement within the group. These findings are important for ensuring the continuation of intergenerational playgroup programmes.

Background: While numerous studies have explored the patient experience of dialysis or other end-stage kidney disease (ESKD) treatments, few have explored the process of transitioning between dialysis modalities. This study aimed to develop an in-depth understanding of patient and caregiver perceptions and experiences of the transition from peritoneal to haemodialysis (HD) and to identify ways in which transitions can be optimised. Methods: Fifty-four in-depth, semi-structured interviews were undertaken at six study sites across the West Midlands, UK ( n = 23), and Queensland, Australia ( n = 31). Thirty-nine participants were patients with ESKD; the remainder were family members. An inductive analytical approach was employed, with findings synthesised across sites to identify themes that transcended country differences. Results: Of the 39 patient transitions, only 4 patients reported a wholly negative transition experience. Three cross-cutting themes identified common transition experiences and areas perceived to make a difference to the treatment transition: resistance to change and fear of HD; transition experience shared with family; and bodily adjustment and sense of self. Conclusion: Although each transition is unique to the individual and their circumstances, kidney care services could optimise the process by recognising these patient-led themes and developing strategies that engage with them. Kidney care services should consider ways to keep patients aware of potential future treatment options and present them objectively. There is potential value in integrating expert support before and during treatment transitions to identify and address patient and family concerns.

Introduction The recipe is more than just a list of ingredients and the instructions on how to prepare a particular dish. Recipes also are, as Janet Floyd and Laurel Foster argue, a form of narrative that tells a myriad of stories, “of family sagas and community, of historical and cultural moments and also of personal histories and narratives of self” (Floyd and Forster 2). Among the most intimate and personal sources of recipes are manuscript cookbooks. These typically contained original handwritten recipes created by the author as well as those shared by family and friends; some recipes were copied from published cookbooks or clipped out of newspapers and magazines. However, these books are more than a mere collection of recipes and domestic instructions, they also paint a unique and vivid picture of the life of their authors. These manuscript cookbooks were a common sight in many Australian colonial kitchens, yet they are a rarely examined and rich archival source that provides a valuable insight into foodways, material culture, and the lives and social relationships of the women who created them. This article will examine the manuscript cookbook created by Phillis Clark in the Darling Downs during the 1860s. Through a close examination of Clark’s manuscript cookbook, this article will explore colonial domestic habits and the cultural context in which they were formed. It will also highlight the historical value of manuscript cookbooks as social texts that chronicle daily life, both inside and outside the kitchen, in colonial Australia. A Colonial Woman Phillis Clark was born in Tasmania in 1836. She was the daughter of Charles Seal, the pioneer of the whaling industry in that state. In 1858 she married Charles George Clark, the eldest son of a well-known Tasmanian family. Both the Seal and Clark families were at the centre of social and political life in Tasmania. In 1861, the couple moved to Talgai, twenty two kilometres north-west of Warwick in the Darling Downs region of Queensland. Here, Charles Clark established himself as a storekeeper and became a partner in the Ellinthorp Steam Flour Mills, the first successful flour mill in Queensland (Waterson 3). He also represented Warwick in the Queensland Legislative assembly between 1871 and 1873. Clark’s brother, George Clark, also settled in the area together with his wife and family. In 1868, both families set up home in adjoining properties known as East Talgai and West Talgai. This joint property, with its well manicured gardens, English trees, and fruit orchard, has been described as a small oasis “in an empty, brown and dusty summer landscape” (Waterson, Squatter 19). The Manuscript Sometime during this period Clark began to compile her very own manuscript cookbook. The front of Clark’s manuscript is dated 1866, yet there is ample evidence to suggest that she began work on this manuscript some years earlier. Clark was scrupulous in acknowledging the sources of her recipes, a habit common to many manuscript cookbook authors (Newlyn 35). She also initialled her own creations, firstly with P.S., for her maiden name Phillis Seal, and later P.S.C. for Phillis Seal Clark, her married name. By 1866 Clarke had been married for eight years so it can be assumed that she commenced her manuscript some time before 1858. A number of the recipes that appear in the manuscript appear to be credited to people living in Tasmania. Furthermore, a number of the newspaper clippings found in her manuscript can be dated to before 1866, including one for 1861. The manuscript itself is a hard bound and lined notebook, sturdy enough to withstand the rigours of daily use in the kitchen. The majority of recipes are handwritten but there are also a number of recipes clipped from newspapers interspaced within the manuscript. The handwritten recipes are in a neat copperplate style and all appear to be written in the same hand. The recipes are not found in distinct sections, although there are some small clusters of particular types of recipes, highlighting the fact that they were added to the manuscript over a period of time. At the front of the manuscript there is a detailed index noting the page number on which each recipe is to be found. The recipes themselves follow the standard conventions of the period. The Sources The sources from which Clark gathered some of the recipes in her manuscript indicate the variety of texts that were available to her. There are a number of newspaper clippings pasted in the pages of her manuscript for a range of both recipes for foods as well as the so-called domestic remedies (medicines) and receipts for household products. Amongst the food recipes there are to be found instructions in the making of cream cheese in the Irish manner and a recipe for stewed shoulder of mutton as well as two different methods for preparing kangaroo. While it is impossible to fully know what newspapers all these clippings have been taken from, at least one of them came from the Darling Downs Gazette and General Advertiser and it is likely that some of them might also have come from a number of the local Warwick papers (one which was founded by her brother-in-law George Clark) that were in publication during Clark’s residence in the area. Clark also utilised a number of published cookbooks as sources for some of the recipes in her own manuscripts. Like most Australians until the last few decades of the nineteenth century, Clark would have mainly resorted to the British cookbooks that were available. The two most commonly acknowledged cookbooks in her manuscript were Enquire Within Upon Everything and Eliza Acton’s. Enquire Within Upon Everything was an immensely popular general household guide amassing eighty-nine editions in a little over forty years in print. It contained information on a plethora of subjects (over three thousand individual entries) including such topics as etiquette, first aid, domestic hints, and recipes. It first appeared on the British market in 1856, under the editorship of Robert Kemp Philp, and became available in Australia in the same year. Booksellers in the Darling Downs advertised copies of the book for the price of three shillings and six pence. Eliza Acton, for her part, was one of Britain’s leading cookbook authors. Her books were widely available throughout the colonies with copies advertised for sale by J. Walch and Sons booksellers in Hobart (‘Advertising’ 1). Extracts from her cookbook Modern Cookery for Private Families began to appear in Australian newspapers only months after it first was published in Britain in 1845 (‘Bullion’ 4). Although Modern Cookery did not provide any recipes directly catering for Australian conditions, its simple and straightforward approach to cookery made it an invaluable resource in the colonial kitchen. Such was the popularity and reputation of Acton’s work that in the preface to Australia’s first cookbook, The English and Australian Cookery Book, the author, Tasmanian born Edward Abbott, stated that he hoped that his cook book would posses “all the advantages of Mrs. Acton’s work” (Abbott vi). The range of printed sources contained within Clark’s manuscript indicate that women in colonial households were far from isolated from the culinary trends occurring in other parts of Australia and the wider British empire. The Recipes Like many Australian women of her class and generation, Phillis Clark reproduced the predominant British food culture in her kitchen. The great majority of recipes contained in her manuscript are for typically English dishes, particularly those for sweet dishes such as biscuits, cakes, and puddings. Plum pudding, trifle, and custard pudding are all featured in her book. As well, many of the savoury dishes such as curry, roast beef, and Yorkshire pudding similarly reflect the British palate. In There is No Taste like Home: The Food of Empire, Adele Wessell argues that the maintenance of British food habits in Australia was a device to reaffirm “cultural and historical bonds and sustain a shared sense of British identity” (811). However, as in many other rural kitchens, native ingredients also found a place. Her manuscript included a number of recipes for the preparation of kangaroo and detailed instructions for the butchering of the animal. Clark’s recipe for “Jugged Hare or Kangaroo” bares a close resemblance to the one that appears in Edward Abbott’s cookbook. Clark’s father and Abbott were from the same, small social milieu in colonial Hobart and were both active in the same political causes. This raises the intriguing possibility that Phillis also knew Abbott and came into contact with some of his culinary ideas. Australians consumed all manners of native ingredients, not only as a matter of necessity but also as a matter of choice. The inclusion of freshly killed native game in Clark’s kitchen would have served to alleviate the monotony of the salted beef and mutton that were common staples during this period. The distinct Australian flavour that began to appear in manuscript cookbooks like Clark’s would later be replicated in their printed counterparts. Australian cookbooks published in the last decades of the nineteenth century demonstrate the importance of native ingredients in colonial kitchens (Singley 37). The Darling Downs region had been a popular destination for German migrants from the 1850s and Clark’s manuscript contained a number of recipes for German dishes. This included one for the traditional German Christmas cake Lebkuchen as well as for various German puddings and biscuits. Clark also included an elaborate recipe for making ham or bacon in the traditional Westphalian fashion. This was a laborious process that involved vigorously rubbing salt, sugar, and beer into the leg of ham every day for a fortnight after which it is then hung to dry for a couple of days and then smoked. Katie Hume, a fellow Darling Downs resident and a close friend of the extended Clark family described feeling like a “gute verstandige Hausfrau” (a good sensible housewife) after salting 112 pounds of pork she had purchased from a neighbour (152). While, unlike their counterparts in the Barossa valley in South Australia, the Germans who lived in the Darling Downs area did not leave a significant mark on the local culinary landscape, the inclusion of German recipes in Clark’s manuscript indicates that there was not only some cross-cultural transmission of culinary knowledge, but also some willingness to go beyond traditional British fare. Many, more mundane recipes also populate Clark’s manuscript. “Toad in a Hole”, “Mutton Pie” and “Stewed Sirloin” all merit an entry. Yet, even with such simple dishes, Clark demonstrated a keen eye for detail. This is attested by her method for the preparation of a simple dish of roasted pumpkin: “Cut into slices 1 inch thick and about 5 inches long, have ready a baking dish with boiling fat—lay the slices in it so that the fat will cover them and bake for 20 minutes (by fat I mean good dripping) Half an hour will not bake them too much. They ought to be brown” (Clark 13). Whilst Clark’s manuscript is not indicative of the foodways of all classes across Queensland society, it does provide some insight as to what was consumed at the table of a well-heeled rural household. As the wife of a prominent businessman and a local dignitary, Phillis Clark would have also undoubtedly been called upon to play the role of hostess and to entertain her husband’s commercial and political acquaintances. Her manuscript also reflects the overwhelmingly British nature of colonial Australian foodways despite the intrusion of some foreign dishes. As Anne Murcott argues, the preparation and consumption of food provides a way through which individuals can express the more abstract significance of cultural values and social systems (204). The Clark household also showed some interest in producing a broad range of products in the home. There are, for example, a number of recipes for beverages including those for non-alcoholic ginger beers and flavoured cordials. They were also far from abstemious, with recipes for wine, mead, and ale included in the manuscript. This last recipe was given to her by her brother Alfred who, according to Clark, “understands brewing and therefore I think it can be depended upon” (Clark 43). Clark also bottled her own fruit, made a wide range of jams, including grape and mock melon, as well as making her own butter, confectionery, and vinegar. The production of goods like these within the home indicates the level of self-reliance in many colonial households, particularly those finding themselves far from the convenience of shops and markets. Many culinary historians argue that there exists a significant time lag between the initial appearance and consumption of a particular dish in a society and its subsequent appearance in the pages of a cookbook. This time lag can be between forty and 150 years long (Mennell 44; Mason 23). However, manuscript cookbooks reflect the immediacy of eating practices. The very personal nature of manuscript cookbooks would suggest that the recipes included within their pages were ones that the author intended to use in her own kitchen. Moreover, from the reciprocal nature of recipe sharing that is evident from these types of cookbooks it can be concluded that the recipes in Clark’s manuscript were ones that, at least in her own social milieu, were in common usage. In her manuscript Clark clearly noted those recipes which she especially liked or otherwise found useful. Many recipes throughout the manuscript have been marked as “proved” indicating that Clark had used and tested them at some stage. A number of them have also been favourably annotated as being “delicious”, “very nice”, “the best”, and “very good”. Amongst the number of recipes for “Soda Cake” that feature in the manuscript Clarke clearly indicates that “Number 1 is the best”. However, she was not averse to commenting on recipes and altering them to suit her taste. In a recipe for “A nice light Cake”, for example, Clark noted that the addition of a “little peel and currants is an improvement” (89). This form of marginal intrusion was a common practice amongst many women and it can even be seen in the margins of many published cookbooks (Theophano 186). These annotations, according to Sandra Sherman, are not transgressive, since the manuscripts are not authored “by” anyone (Sherman 121). In fact, annotations personalise the recipe and confirm the compiler’s confidence in it (Sherman 121). Not Just Food: ‘Domestic Receipts’ As noted above, Clark’s manuscript contained more than just recipes for food and drink. Many of them are “Domestic Receipts” that reflect the complex nature of running a household in rural Australia. Some of Clark’s domestic receipts are in the form of newspaper clippings and are general instructions for the manufacture of simple household products such as a “ready to use glue” and a home-made tooth powder. Others are handwritten and copied from other domestic advice books or were given to Clark by family and friends. A recipe for manufacturing “blacking for stoves”, essential in the maintenance of cast iron stoves, was, for example, culled from Enquire Within Upon Everything. Here, with some authorial intrusion, Clark includes her own list of measured ingredients to prepare the mixture. An intriguing method for the “artificial preparation of ice” involving the use of ammonium nitrate and bicarbonate of soda was given to Clark by Mrs. McKeachie, the wife of Charles Clark’s business partner. Clark also showed an interest in beekeeping and in raising turkeys, with instructions for both these tasks included in her manuscript. The wide range of miscellaneous receipts featured in Clark’s book highlights the breadth of activities that were carried out in many homes in rural Australia. A hint of Clark’s artistic side is also in evidence, with detailed instructions on how to create delicate fern impressions on paper also included in her book. As with many other women in colonial Australia, Clark was expected to take on the role of caregiver when members of her family fell ill or were injured. Her manuscript included a number of recipes for “domestic remedies”, another common trope in books of this kind as well as in their printed counterparts. These remedies included recipes for a cough mixture composed of linseed, liquorice, and water and a liniment to treat rheumatism which was made by mixing rape seed oil and turpentine with a hefty dose of laudanum. Clark used olive oil in a number of medical recipes to treat burns and scalds. As well, treatments for diphtheria, cholera, and diarrhoea feature prominently in her manuscript. The Darling Downs had been subject to a number of outbreaks of dysentery and cholera during Clark’s residency in the area (Waterson, Squatter 71). For “a pain in the chest” Clark recommended the following: “a piece of brown paper spread with tallow and placed on the chest” (69).The inclusion of these domestic remedies and Clark’s obvious concerns for her family’s health is particularly poignant given her personal history. Her family was plagued by misfortune and illness and she lost three of her ten children in a six-year period including two within just months of each other. Clark herself would die during childbirth in 1874. Sharing and Caring The word “recipe” has its origins in the Latin recipere meaning to “receive”. In order to receive there has to be, by implication, someone doing the giving. A recipe signifies an exchange and a connection between individuals. The sharing of recipes was a common activity for many women in nineteenth century Australia. Wilhelmina Rawson, Queensland’s first published cookbook author, was keenly aware of the manner in which women shared recipes and culinary knowledge. This act of reciprocity, she argued, not only helped to ease the isolation of bush living but also allowed each individual to be “benefited by the cleverness of the whole number” (14). For many, food often has a deeply private and personal component, being prepared and consumed within the realm of the home. However, food is also a communal experience and is openly shared through rituals, feasts, the contexts in which it is bought and sold, and, most importantly, reciprocal exchange. In her manuscript, Clark acknowledged a number of different individuals as the source for the recipes she included within its pages. The convention of acknowledging the sources of recipes in manuscript cookbooks functions as a way to assert the recipe’s authority and to ensure that they are proven (Sherman 122). This act of acknowledgement also locates Clark within a social network of women who not only shared recipes but also, one can imagine, many of the vicissitudes of domestic life in a remote rural setting. In her study of women’s manuscript cookbooks, entitled Eat My Words: Reading Women’s Lives Through the Cookbooks They Wrote, Janet Theophano describes these texts as “the maps of the social and cultural life they inhabited” (13). This circulation of recipes allowed women to share their knowledge, skills, and creativity. Those who received and used these recipes not only engaged in a conversation with the writer of these recipes but also formed a connection with a broader community that allowed them to learn more about themselves and the world. Conclusion The manuscript cookbook created by Phillis Clark is a fascinating prism through which to explore domestic life in colonial Australia. The recipes contained in Clark’s manuscript reflect the eating habits of her own family and those of a particular social class in Queensland. They not only demonstrate the tenacity of British foodways in Australia but also show the degree of culinary adventurism that existed in some homes. The personal, almost autobiographical nature of manuscript cookbooks also provides an intimate view in the life of its creator. In the splattered pages of Phillis Clark’s book we can read the many travails, joys, and tragedies of her life. References Abbott, Edward. The English and Australian Cookery Book: Cookery for the Many, as Well as for the Upper Ten Thousand. London: Sampson Low, Son, and Marston, 1864. ‘Advertising’. Launceston Examiner 9 Mar. 1858: 1. ‘Boullion, The Common Soup of France’. The Sydney Morning Herald 22 Aug. 1845: 4. 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Australian Enquiry Book of Household and General Information: A Practical Guide for the Cottage, Villa and Bush Home. Melbourne: Pater and Knapton, 1894. Sherman, S. “‘The Whole Art and Mystery of Cooking’: What Cookbooks Taught Readers in the Eighteenth Century”. Eighteenth-Century Life 28.1 (2004): 115–35. Singley, Blake. “‘Hardly Anything Fit for Man to Eat’: Food and Colonialism in Australia.” History Australia 9.3 (2012): 27–42. Theophano, Janet. Eat My Words: Reading Women’s Lives Through the Cookbooks They Wrote. New York, N.Y: Palgrave, 2002. Waterson, D. B. “A Darling Downs Quartet”. Queensland Heritage 1.7 (1967): 3–14. Waterson, D. B. Squatter, Selector and Storekeeper: A History of the Darling Downs, 1859-93. Sydney: Sydney UP, 1968. Wessell, Adele. “There’s No Taste Like Home: The Food of Empire”. Exploring the British World: Identity, Cultural Production, Institutions. Ed. Kate Darian-Smith and Patricia Grimshaw. Melbourne: RMIT, 2004.