Background: International studies have shown that some 60% of paramedics have experienced physical violence in the workplace, and between 21-78% have experienced verbal abuse. To date, there is no Australian literature describing Australian paramedics' experience of workplace violence. Objective: To identify the percentage of paramedics who had experienced six different forms of workplace violence. Methods: A questionnaire was developed to explore paramedics' experience of workplace violence. Six forms of violence were included: verbal abuse, property damage or theft, intimidation, physical abuse, sexual harassment, and sexual assault. The questionnaire also included a series of demographic questions. The questionnaire was piloted using a reference group and changes made accordingly. The questionnaire was distributed to 500 rural Victorian paramedics and 430 metropolitan South Australian paramedics. Ethics approval was granted for this study. Results: The overall response rate was 28%, with 75% being male and 25% female. The median age of respondents was 40.7 years, range 21-62 years. The median number of years experience as a paramedic was 14.3 years, range 6 months to 39 years. There were 87.5% of paramedics exposed to workplace violence. Verbal abuse was the most prevalent form of workplace violence (82%), with intimidation (55%), physical abuse (38%), sexual harassment (17%), and sexual assault (4%). Conclusion: This study lays the foundation for further studies investigating paramedic experience of workplace violence. This study demonstrates that workplace violence is prevalent for paramedics and highlights the need for prevention and education within the profession.

The results contribute to a growing body of evidence demonstrating favourable outcomes of AS in terms of engagement and challenging behaviour in people with ID. Surprising results are presented for choice and perceived support needs, warranting further investigation.

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Occupational violence and aggression are common in general practice. This study examined occupational violence and aggression against GPs in terms of prevalence and predictive factors, such as sex of GP, and practice location. Over half of the GPs sampled had experienced at least one form of violence and aggression; more female than male GPs experienced sexual harassment; and there was no difference in the number of metropolitan and rural GPs who had experienced violence and aggression. Predictors emerged for verbal abuse, intimidation, physical abuse, and sexual harassment.

This is the second of two articles that explore the general practitioner (GP)-specialist relationship. In this article, we explore the nature of the referral process, beginning with referrals frequently made by GPs in Australia and reasons for referral to specialists. In Australia, GPs commonly refer patients to specialists, particularly orthopaedic surgeons, ophthalmologists, surgeons and gynaecologists for a variety of reasons, including diagnosis or investigation, treatment and reassurance (reassurance for themselves as well as reassurance for the patient). GPs will choose a specialist after considering a variety of factors, such as the specialist's medical skill, their previous experience with the specialist, the quality of communication between them, office location and patient preferences. The referral is generally made by telephone or by letter, the latter of which is known to vary significantly in content and quality. The specialist, GP and patient expectations of the referral and the consultation process are also described. Specialists expect the GP to provide information about the problem to be addressed and adequate patient history, GPs expect a clear response regarding diagnosis and management as well as justification for the course of action, and patients expect clear communication and explanation of the diagnosis, treatment and follow-up requirements. When these expectations remain unmet, GPs, specialists and patients end up dissatisfied with the referral process.