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This literature review focused on the experience, care, and service requirements of people with younger onset dementia. Systematic searches of 10 relevant bibliographic databases and a rigorous examination of the literature from nonacademic sources were undertaken. Searches identified 304 articles assessed for relevance and level of evidence, of which 74% were academic literature. The review identified the need for (1) more timely and accurate diagnosis and increased support immediately following diagnosis; (2) more individually tailored services addressing life cycle issues; (3) examination of the service needs of those living alone; (4) more systematic evaluation of services and programs; (5) further examination of service utilization, costs of illness, and cost effectiveness; and (6) current Australian clinical surveys to estimate prevalence, incidence, and survival rates. Although previous research has identified important service issues, there is a need for further studies with stronger research designs and consideration of the control of potentially confounding factors.

Abstract. Background: In July 2018, Lifeline Australia launched Australia's first short message service (SMS) crisis support service. Lifeline Text aims to reduce psychological distress and increase coping and social connectedness among help seekers, particularly those who prefer text-based communication. Aims: We aimed to independently evaluate the pilot SMS service over a 240-day period. Method: The service evaluation used operational data, pre and postconversation automated questions, and an online survey to assess outcomes. Results: There were 7,315 contacts during operational hours, of which 5,266 progressed to the queue and 99.2% were answered. Suicide was actively being considered by 1,554 help seekers, and 171 were assessed at imminent risk. Commonly discussed topics were mental health problems, issues relating to the self and identity, and family relationship difficulties. Limitations: This was an evaluation of a pilot service focusing on demand and short-term outcomes. Conclusion: The service succeeded in reaching some under-served groups. On average, help seekers were significantly less distressed, felt more confident in their ability to cope and felt greater connection to others, following the text intervention. The demand for Lifeline Text and the high level of suicidality of help seekers show it is meeting urgent needs in the community.

School garden and kitchen-based activities have potential as health-promoting school initiatives but lack well-designed evaluation frameworks. This article outlines an evaluation of a national kitchen garden program conducted in Australian primary schools. The aim was to evaluate the implementation and impact of a national garden and kitchen program in Australia, including child and health-related impacts of the program, and program implementation factors. The evaluation was undertaken using a multi-component, hierarchical evaluation framework that incorporated a modified case-control design and mixed methods. A cross-section of initiative (N=28) and comparison (N=14) schools was included. The Stephanie Alexander Kitchen Garden model achieved overall improvements in students’ food choices (as reported by students; t=2.26, p=0.024) and kitchen lifestyle behaviours (as reported by parents; t=2.35, p=0.019); female students and students from provincial schools had statistically greater improvements in food choices than other students and girls showed higher scores than boys (t=6.19, p<0.001). The evaluation framework generated data that addressed the evaluation questions. Program integrity was maintained. Factors related to the program's implementation, sustainability, generalisability and return on investment were reported. Factors impacting the evaluation included lack of baseline data, specific data collection methods and time issues. The main conclusion drawn from the study is that structured hierarchical, multi-component evaluation is needed to provide practical insights into effective health promotion initiatives in schools.

Objectives: To identify attributes of rapid response services designed to support people with very severe and extreme responsive behaviours, otherwise known as behavioural and psychological symptoms of dementia, in aged care homes. Methods: A rapid evidence assessment was conducted to inform the evaluation of the Severe Behaviour Response Team (SBRT) service, including a targeted search of peer-reviewed academic literature and an Internet-based search of government, service provider, peak body and university websites. Results: A number of localised rapid response services targeting people with similar clinical profiles were identified, but none operated on the scale of the SBRT. Five operational attributes in common were as follows: clearly defined parameters and processes; provision of clinical expertise and knowledge translation activities; person-centred philosophy; relationship-oriented approach to stakeholders; and generalisable and sustainable outcomes. Conclusions: The five attributes provided a useful framework to guide the evaluation of the SBRT and clarify opportunities for continued service development.