2024-03-28T09:10:43Z
https://researchonline.jcu.edu.au/cgi/oai2
oai:researchonline.jcu.edu.au:37675
2024-03-01T14:29:46Z
7374617475733D707562
74797065733D61727469636C65
If you knew the end of a story would you still want to hear it? Using research poems to listen to Aboriginal stories
Saunders, Vicki
Usher, Kim
Tsey, Komla
Bainbridge, Roxanne
This paper presents a poem created whilst conducting an inquiry into one of the endings of stories told of, and by, people living with mental illness: this story ending is grouped by a word (and social movement) widely known as Recovery in mental health care. Recovery, however, is not a word commonly used in the places where this Inquiry occurred. Nor is it a category of story ending often told about Australian Aboriginal people living with a diagnosis of chronic mental illness. This inquiry was, and is, thus focussed on how the current endings of stories that surround Australian Aboriginal peoples in mental health care are being/were told and “heard”. This paper is an attempt to use poetry as a therapeutic and storytelling strategy to highlight the difference between hearing and listening, and how that difference relates to the word Recovery as a paradigm shift and story of social change.
Taylor and Francis
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/37675/6/37675%20Saunders%20et%20al%202016.pdf
http://dx.doi.org/10.1080/08893675.2016.1133082
Saunders, Vicki, Usher, Kim, Tsey, Komla, and Bainbridge, Roxanne (2016) If you knew the end of a story would you still want to hear it? Using research poems to listen to Aboriginal stories. Journal of Poetry Therapy, 29 (1). pp. 1-13.
https://researchonline.jcu.edu.au/37675/
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oai:researchonline.jcu.edu.au:39363
2024-03-04T15:11:38Z
7374617475733D707562
74797065733D61727469636C65
A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres
Topp, Stephanie M.
Chipukuma, Julien M.
Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia.
Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding.
Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care.
Conclusion: Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers' trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care.
Oxford University Press
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/39363/6/39363%20Topp%20et%20al%202016.pdf
http://dx.doi.org/10.1093/heapol/czv041
Topp, Stephanie M., and Chipukuma, Julien M. (2016) A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres. Health Policy and Planning, 31 (2). pp. 192-204.
https://researchonline.jcu.edu.au/39363/
open
oai:researchonline.jcu.edu.au:39418
2024-02-29T14:32:13Z
7374617475733D707562
74797065733D61727469636C65
Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial
Seferiadis, Aris
Ohlin, Pernilla
Billhult, Annika
Gunnarsson, Ronny
Purpose: Chronic whiplash-associated disorders (WAD) incur both costs and suffering. Treatments that can relieve chronic WAD are therefore needed. Exercise therapy (ET) has been shown to provide pain relief. Another often used treatment for chronic pain in Scandinavia is basic body awareness therapy (BAT). We compared the effectiveness of 10 weeks of twice-weekly, 90-min sessions of either ET or BAT in a randomized comparative trial.
Method: We recruited 113 patients suffering from chronic WAD grades I–III and several years’ duration of symptoms in a primary health care setting. 57 were allocated to ET and 56 to BAT. Primary outcome measures were Neck Disability Index and SF-36 v.2.
Results: From baseline to post-treatment, the BAT group increased their physical functioning (median 5, IQR = 15) more than the ET group (median = 0, IQR = 15), p = 0.032, effect size −0.54. Three months after the end of treatment, the BAT group had less bodily pain (m = 17.5, 95% CI 6.9–17.6) than the ET group (m = 4.9, 95% CI −0.1 to 9.8), p = 0.044, effect size −0.4. The BAT group had also increased their social functioning (m = 13.3, 95% CI 6.6–19.9) more than the ET group (m = 3.5, 95% CI −3 to 9.9), p = 0.037, effect size −0.41. No statistically significant differences between groups were found for the change of other outcomes. No serious adverse effects were found in either groups.
Conclusions: The present trial indicates that BAT led to greater improvements than ET for the patients with chronic WAD.
Informa Healthcare
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/39418/1/39418_Seferiadis_etal_2016.pdf
http://dx.doi.org/10.3109/09638288.2015.1044036
Seferiadis, Aris, Ohlin, Pernilla, Billhult, Annika, and Gunnarsson, Ronny (2016) Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial. Disability and Rehabilitation, 38 (5). pp. 442-451.
https://researchonline.jcu.edu.au/39418/
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oai:researchonline.jcu.edu.au:39619
2024-03-02T15:19:57Z
7374617475733D707562
74797065733D61727469636C65
Dual benefits of a student-assisted inter-professional men's healthy lifestyle pilot program
Sealey, Rebecca
George, Nadene
Gordon, Susan
Simmons, Lisa
Men are less willing to seek health professional advice than women, and die more often than women from preventable causes. Therefore it is important to increase male engagement with health initiatives. This study reports the outcomes of a student-assisted, inter-professional, 12 week health program for overweight adult males. The program included weekly health education and structured, supervised group exercise sessions. Thirteen males (participants) and eighteen university students (session facilitators) completed the program. Participants were assessed for a range of health and physical activity measures and health and health profession knowledge. Participants demonstrated significant improvement in activity, knowledge and perceptions of physical and mental function, and appreciated the guided, group sessions. Students completed an inter-professional readiness questionnaire and reported significant improvement in the understanding of the benefits of inter-professional education and of their role in health care. This program provides evidence of the dual benefit that occurs from the delivery of a student-assisted, inter-professional men’s health program to at-risk community members.
Sage
2017-07
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/39619/7/39619_Sealey_etal_2015_Accepted_Version.pdf
application/pdf
https://researchonline.jcu.edu.au/39619/2/39619%20Sealey%20et%20al%202017.pdf
http://dx.doi.org/10.1177/1557988315601725
Sealey, Rebecca, George, Nadene, Gordon, Susan, and Simmons, Lisa (2017) Dual benefits of a student-assisted inter-professional men's healthy lifestyle pilot program. American Journal of Men's Health, 11 (4). pp. 1133-1141.
https://researchonline.jcu.edu.au/39619/
open
oai:researchonline.jcu.edu.au:41495
2024-03-03T15:03:25Z
7374617475733D707562
74797065733D61727469636C65
Oxidative stress and abdominal aortic aneurysm: potential treatment targets
Emeto, Theophilus I.
Moxon, Joseph V.
Au, Minnie
Golledge, Jonathan
Abdominal aortic aneurysm (AAA) is a significant cause of mortality in older adults. A key mechanism implicated in AAA pathogenesis is inflammation and the associated production of reactive oxygen species (ROS) and oxidative stress. These have been suggested to promote degradation of the extracellular matrix (ECM) and vascular smooth muscle apoptosis. Experimental and human association studies suggest that ROS can be favourably modified to limit AAA formation and progression. In the present review, we discuss mechanisms potentially linking ROS to AAA pathogenesis and highlight potential treatment strategies targeting ROS. Currently, none of these strategies has been shown to be effective in clinical practice.
Portland Press
2016-01-26
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/41495/1/41495%20Theophilus%20et%20al%202016%20Accepted%20Version.pdf
application/pdf
https://researchonline.jcu.edu.au/41495/2/41495%20Theophilus%20et%20al%202016%20Published%20Version.pdf
http://dx.doi.org/10.1042/CS20150547
Emeto, Theophilus I., Moxon, Joseph V., Au, Minnie, and Golledge, Jonathan (2016) Oxidative stress and abdominal aortic aneurysm: potential treatment targets. Clinical Science, 130 (5). pp. 301-315.
https://researchonline.jcu.edu.au/41495/
open
oai:researchonline.jcu.edu.au:42115
2024-03-04T14:28:43Z
7374617475733D707562
74797065733D61727469636C65
An innovative Australian outreach model of diabetic retinopathy screening in remote communities
Glasson, Nicola M.
Crossland, Lisa J.
Larkins, Sarah L.
Background: Up to 98% of visual loss secondary to diabetic retinopathy (DR) can be prevented with early detection and treatment. Despite this, less than 50% of Australian and American diabetics receive appropriate screening. Diabetic patients living in rural and remote communities are further disadvantaged by limited access to ophthalmology services.
Research Design and Methods: DR screening using a nonmydriatic fundal camera was performed as part of amultidisciplinary diabetes service already visiting remote communities. Images were onforwarded to a distant general practitioner who identified and graded retinopathy, with screenpositive patients referred to ophthalmology. This retrospective, descriptive study aims to compare the proportion of remote diabetic patients receiving appropriate DR screening prior to and following implementation of the service.
Results: Of the 141 patients in 11 communities who underwent DR screening, 16.3% had received appropriate DR screening prior to the implementation of the service. In addition, 36.2% of patients had never been screened. Following the introduction of the service, 66.3% of patients underwent appropriate DR screening (p=0.00025).
Conclusion: This innovative model has greatly improved accessibility to DR screening in remote communities, thereby reducing preventable blindness. It provides a holistic, locally appropriate diabetes service and utilises existing infrastructure and health workforce more efficiently.
Hindawi Publishing Corporation
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42115/1/42115_Larkins_2016.pdf
http://dx.doi.org/10.1155/2016/1267215
Glasson, Nicola M., Crossland, Lisa J. , and Larkins, Sarah L. (2016) An innovative Australian outreach model of diabetic retinopathy screening in remote communities. Journal of Diabetes Research, 2016. 1267215. pp. 1-10.
https://researchonline.jcu.edu.au/42115/
open
oai:researchonline.jcu.edu.au:42116
2016-05-26T05:33:48Z
7374617475733D707562
74797065733D626F6F6B5F73656374696F6E
Case study 1.2: James Cook University School of Medicine, Australia
Larkins, Sarah
Murray, Richard
Sen Gupta, Tarun
Ross, Simone
Preston, Robyn
[Extract] The James Cook University School of Medicine (JCU-SOM) (now the College of Medicine and Dentistry) was established in 2000 as the first new Australian medical school in over 20 years and the only school in the northern half of Australia. Northern Australia's population is dispersed over a huge geographical area, with no settlement larger than 200,000 people, and suffers from a maldistribution of health professionals. For example, in 2012, the ratio of doctors to population varied from one medical practitioner for every 246 people in major cities, to 1:425 in outer regional and remote areas (Australian Institute of Health and Welfare 2014b). Health status is in inverse proportion to this (Australian Institute of Health and Welfare 2014a).
Taylor & Francis
Bin Abdulrahman, Khalid A.
Mennin, Stewart
Harden, Ronald M.
Kennedy, Catherine
2016
Book Chapter
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42116/1/42116_Larkins_etal_2016_CaseStudy_References.pdf
https://www.routledge.com/Routledge-International-Handbook-of-Medical-Education/Abdulrahman-Mennin-Harden-Kennedy/p/book/9780415815734
Larkins, Sarah, Murray, Richard, Sen Gupta, Tarun, Ross, Simone, and Preston, Robyn (2016) Case study 1.2: James Cook University School of Medicine, Australia. In: Bin Abdulrahman, Khalid A., Mennin, Stewart, Harden, Ronald M., and Kennedy, Catherine, (eds.) Routledge International Handbook of Medical Education. Taylor & Francis, New York, NY, USA, pp. 5-7.
https://researchonline.jcu.edu.au/42116/
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oai:researchonline.jcu.edu.au:42351
2024-03-05T14:53:29Z
7374617475733D707562
74797065733D61727469636C65
Responses of Aboriginal and Torres Strait Islander primary health-care services to continuous quality improvement initiatives
Larkins, Sarah
Woods, Cindy E.
Matthews, Veronica
Thompson, Sandra C.
Schierhout, Gill
Mitropoulos, Maxwell
Patrao, Tania
Panzera, Annette
Bailie, Ross Stewart
Background: Indigenous primary health-care (PHC) services participating in continuous quality improvement (CQI) cycles show varying patterns of performance over time. Understanding this variation is essential to scaling up and sustaining quality improvement initiatives. The aim of this study is to examine trends in quality of care for services participating in the ABCD National Research Partnership and describe patterns of change over time and examine health service characteristics associated with positive and negative trends in quality of care.
Setting and participants: PHC services providing care for Indigenous people in urban, rural, and remote northern Australia that had completed at least three annual audits of service delivery for at least one aspect of care (n = 73).
Methods/design: Longitudinal clinical audit data from use of four clinical audit tools (maternal health, child health, preventive health, Type 2 diabetes) between 2005 and 2013 were analyzed. Health center performance was classified into six patterns of change over time: consistent high improvement (positive), sustained high performance (positive), decline (negative), marked variability (negative), consistent low performance (negative), and no specific increase or decrease (neutral). Backwards stepwise multiple logistic regression analyses were used to examine the associations between health service characteristics and positive or negative trends in quality of care.
Results: Trends in quality of care varied widely between health services across the four audit tools. Regression analyses of health service characteristics revealed no consistent statistically significant associations of population size, remoteness, governance model, or accreditation status with positive or negative trends in quality of care.
Conclusion: The variable trends in quality of care as reflected by CQI audit tools do not appear to be related to easily measurable health service characteristics. This points to the need for a deeper or more nuanced understanding of factors that moderate the effect of CQI on health service performance for the purpose of strengthening enablers and overcoming barriers to improvement.
Frontiers Research Foundation
2016-01-21
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42351/1/42351_Larkins_2016.pdf
http://dx.doi.org/10.3389/fpubh.2015.00288
Larkins, Sarah, Woods, Cindy E., Matthews, Veronica, Thompson, Sandra C., Schierhout, Gill, Mitropoulos, Maxwell, Patrao, Tania, Panzera, Annette, and Bailie, Ross Stewart (2016) Responses of Aboriginal and Torres Strait Islander primary health-care services to continuous quality improvement initiatives. Frontiers in Public Health, 3. 288. pp. 1-9.
https://researchonline.jcu.edu.au/42351/
open
oai:researchonline.jcu.edu.au:42352
2024-03-05T14:58:31Z
7374617475733D707562
74797065733D61727469636C65
Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study
Esterman, Adrian J.
Fountaine, Tim
McDermott, Robyn
Objectives: To determine whether certain characteristics of general practices are associated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC).
Research design and methods: Our cross-sectional analysis used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. Practice characteristics were self-reported. Characteristics of the patients that were assessed included glycaemic control (HbA₁(c) level ≤ 53 mmol/mol), age, sex, duration of diabetes, socio-economic disadvantage (SEIFA) score, the complexity of the patient's condition, and whether the patient had completed an ACC for diabetes in the past 18 months. Clustered logistic regression was used to establish predictors of glycaemic control and a completed ACC.
Results: Data were available from 147 general practices and 5455 patients with established type 1 or type 2 diabetes in three Australian states. After adjustment for other patient characteristics, only the patient completing an ACC was statistically significant as a predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having complete an ACC.
Conclusions: Patient characteristics are moderately good predictors of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patients completing an ACC. The ACC is an established indicator of good diabetes management. This is the first study to report a positive association between having completed an ACC and the patient being in glycaemic control.
Australasian Medical Publishing Company
2016-01-18
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42352/1/42352_McDermott_2016.pdf
http://dx.doi.org/10.5694/mja15.00739
Esterman, Adrian J., Fountaine, Tim, and McDermott, Robyn (2016) Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study. Medical Journal of Australia, 204 (1). 23. e1-e6.
https://researchonline.jcu.edu.au/42352/
restricted
oai:researchonline.jcu.edu.au:42353
2024-03-02T15:48:16Z
7374617475733D707562
74797065733D61727469636C65
Community health workers as chronic care coordinators: evaluation of an Australian Indigenous primary health care program
Schmidt, Barbara
Campbell, Sandy
McDermott, Robyn
Objectives: To explore how a client-centred Chronic Care model was implemented by Indigenous Health Workers (IHWs) at participating sites in a trial of IHW-led case management. To understand the experiences of engaging with the model from the perspective of the IHWs, health team members and clients.
Methods: The review was conducted within a cluster randomised trial of the model in six remote Indigenous communities in north Queensland over 18 months. Content analysis was undertaken on 377 project records of health worker activity. Descriptive coding was used to classify issues that were grouped under key themes. Open-ended interviews were conducted with 21 stakeholders and analysed using the key themes.
Results: Implementation of all elements of the intervention was not achieved. Key themes identified that describe the issues affecting the IHWs' capacity to implement the model were: service management, training, client engagement, clarification of IHW role and infrastructure.
Conclusions: Placing skilled and dedicated IHWs to improve care coordination is insufficient to improve chronic disease outcomes. A supportive and systematic service delivery system is also required.
Implications: The PHC model in remote Indigenous communities needs to be re-oriented to actively support the unique contributions of IHWs to chronic care coordination.
Wiley-Blackwell
2016-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42353/6/42353%20Schmidt%20et%20al%202016.pdf
http://dx.doi.org/10.1111/1753-6405.12480
Schmidt, Barbara, Campbell, Sandy, and McDermott, Robyn (2016) Community health workers as chronic care coordinators: evaluation of an Australian Indigenous primary health care program. Australian and New Zealand Journal of Public Health, 40 (S1). S107-S114.
https://researchonline.jcu.edu.au/42353/
open
oai:researchonline.jcu.edu.au:42363
2024-03-05T14:48:39Z
7374617475733D707562
74797065733D61727469636C65
Is there a mismatch between who gets iron supplementation and who needs it? A cross-sectional study of iron supplements, iron deficiency anaemia and socio-economic status in Australia
Callander, Emily J.
Schofield, Deborah J.
Fe deficiency anaemia (IDA) is more prevalent in lower socio-economic groups; however, little is known about who actually receives Fe supplements. This paper aims to determine whether the groups most likely to have IDA are the most likely to be taking Fe supplements. Logistic regression analysis was conducted using the cross-sectional, nationally representative National Nutrition and Physical Activity Survey and National Health Measures Survey. After adjusting for other factors, those whose main language spoken at home was not English had twice the odds of having IDA compared with those whose main language spoken at home was English (95 % CI 1·00, 4·32). Those who were not in the labour force also had twice the odds of having IDA as those who were employed (95 % CI 1·16, 3·41). Those in income quintile 1 had 3·7 times the odds of having IDA compared with those in income quintile 5 (95 % CI 1·42, 9·63). Those whose main language spoken at home was not English were significantly less likely to take Fe supplements (P=0·002) than those whose main language spoken at home was English. There was no significant difference in the likelihood of taking Fe supplements between those who were not in the labour force and those who were employed (P=0·618); between those who were in income quintile 1 and in higher income quintiles; and between males and females (P=0·854), after adjusting for other factors. There is a mismatch between those who are most in need of Fe supplements and those who currently receive them.
Cambridge University Press
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42363/7/42363-Callander-Schofield-2016-Accepted-Version.pdf
application/pdf
https://researchonline.jcu.edu.au/42363/1/Is%20there%20a%20miss-match%20between%20who%20gets%20iron%20supplementation%20and%20who%20needs%20it.pdf
http://dx.doi.org/10.1017/S0007114515004912
Callander, Emily J., and Schofield, Deborah J. (2016) Is there a mismatch between who gets iron supplementation and who needs it? A cross-sectional study of iron supplements, iron deficiency anaemia and socio-economic status in Australia. British Journal of Nutrition, 115 (4). pp. 703-708.
https://researchonline.jcu.edu.au/42363/
open
oai:researchonline.jcu.edu.au:42485
2018-08-31T19:14:45Z
7374617475733D707562
74797065733D61727469636C65
Australian Aboriginal perspectives of attention deficit hyperactivity disorder
Loh, Pek Ru
Hayden, George
Vicary, David
Mancini, Vincent
Martin, Neilson
Piek, Jan P.
[Extract] The diagnosis of attention deficit hyperactivity disorder (ADHD) has been based on a western concept of health, a concern when considering a non-western culture such as Australian Aboriginal and Torres Strait Islander peoples. The lack of statistical data on the extent of ADHD in the Aboriginal community is another concern, a situation similar to many other mental health problems in the Indigenous population. Furthermore, no Australian studies have mentioned specific information on the prevalence of ADHD in Aboriginal communities. The WA Aboriginal Child Health Survey, however, reported that Aboriginal children had a higher risk of hyperactivity problems (15.8%) when compared to 9.7% for non-Aboriginal children (Zubrick et al., 2005).
Informa Healthcare
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42485/1/42485%20Loh%20et%20al%202016.pdf
http://dx.doi.org/10.1177/0004867415624551
Loh, Pek Ru, Hayden, George, Vicary, David, Mancini, Vincent, Martin, Neilson, and Piek, Jan P. (2016) Australian Aboriginal perspectives of attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 50 (4). pp. 309-310.
https://researchonline.jcu.edu.au/42485/
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oai:researchonline.jcu.edu.au:42674
2024-02-29T14:21:26Z
7374617475733D707562
74797065733D61727469636C65
Land use influences mosquito communities and disease risk on remote tropical islands: a case study using a novel sampling technique
Meyer Steiger, Dagmar B.
Ritchie, Scott Alex
Laurance, Susan G.W.
Land use changes, such as deforestation and urbanization, can influence interactions between vectors, hosts, and pathogens. The consequences may result in the appearance and rise of mosquito-borne diseases, especially in remote tropical regions. Tropical regions can be the hotspots for the emergence of diseases due to high biological diversity and complex species interactions. Furthermore, frontier areas are often haphazardly surveyed as a result of inadequate or expensive sampling techniques, which limit early detection and medical intervention. We trialed a novel sampling technique of nonpowered traps and a carbon dioxide attractant derived from yeast and sugar to explore how land use influences mosquito communities on four remote, tropical islands in the Australian Torres Strait. Using this technique, we collected > 11,000 mosquitoes from urban and sylvan habitats. We found that human land use significantly affected mosquito communities. Mosquito abundances and diversity were higher in sylvan habitats compared with urban areas, resulting in significantly different community compositions between the two habitats. An important outcome of our study was determining that there were greater numbers of disease-vectoring species associated with human habitations. On the basis of these findings, we believe that our novel sampling technique is a realistic tool for assessing mosquito communities in remote regions.
American Society of Tropical Medicine and Hygiene
2016-02
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42674/1/42674_Ritchie_2015.pdf
http://dx.doi.org/10.4269/ajtmh.15-0161
Meyer Steiger, Dagmar B., Ritchie, Scott Alex, and Laurance, Susan G.W. (2016) Land use influences mosquito communities and disease risk on remote tropical islands: a case study using a novel sampling technique. American Journal of Tropical Medicine and Hygiene, 94 (2). pp. 314-321.
https://researchonline.jcu.edu.au/42674/
openpub
oai:researchonline.jcu.edu.au:42681
2024-02-29T14:21:26Z
7374617475733D707562
74797065733D61727469636C65
The siren's song: exploitation of female flight tones to passively capture male Aedes aegypti (diptera: culicidae)
Johnson, Brian J.
Ritchie, Scott A.
The need to capture male mosquitoes has intensified recently as a result of a number of male-based sterile insect technique (SIT) and population-modification programs focused on Aedes aegypti (L.) having initiated field releases. Here, we report the results of the successful exploitation of the attraction of male Ae. aegypti to female flight tones to enhance male collections in nonmechanical passive (nonbattery powered) Gravid Aedes Traps (GAT). Prior to field studies, male attraction to female flight tones of 484 and 560 Hz, as well as to a male flight tone of 715 Hz, were assessed in a series of controlled release–recapture and semifield trials. These trials determined that a pure tone of 484 Hz was significantly more attractive to free-flying males than the other flight tones and enabled their collection in sound-baited GATs (ca. 95% capture rate after 2 h; 484 Hz at 65 dB). In contrast, gravid females were unresponsive to male or female flight tones and were evenly distributed among sound-baited and control GATs. Importantly, under normal field conditions sound-baited GATs (484 Hz at 70 dB) captured significantly more male Ae. aegypti per 24-h trap interval (1.3 ± 0.37) than controls (0.2 ± 0.13). Overall, sound-bated GATs captured approximately twice as many Ae. aegypti (male and female; 3.0 ± 0.68 per interval, 30 total) than controls (1.5 ± 0.56 per interval, 15 total). These results reveal that sound-baited GATs are a simple and effective surveillance tool for Ae. aegypti that would allow current male-based SIT and population-modification programs to effectively monitor males in their target populations.
Entomological Society of America
2016-01-01
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/42681/1/42681_Ritchie_2016.pdf
http://dx.doi.org/10.1093/jme/tjv165
Johnson, Brian J., and Ritchie, Scott A. (2016) The siren's song: exploitation of female flight tones to passively capture male Aedes aegypti (diptera: culicidae). Journal of Medical Entomology, 53 (1). pp. 245-248.
https://researchonline.jcu.edu.au/42681/
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oai:researchonline.jcu.edu.au:43161
2024-03-03T14:57:04Z
7374617475733D707562
74797065733D61727469636C65
Service level decision-making in rural physiotherapy: development of conceptual models
Adams, Robyn
Jones, Anne
Lefmann, Sophie
Sheppard, Lorraine
Background: Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM.
Method: A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities.
Results: Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict.
Conclusions: Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with clinical decision-making and placing both within the broader healthcare context. The conceptual models provide a way of thinking about decisions informing rural physiotherapy service provision.
Wiley-Blackwell
2016-06
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43161/6/43161_Adams_et_al_2016.pdf
http://dx.doi.org/10.1002/pri.1627
Adams, Robyn, Jones, Anne, Lefmann, Sophie, and Sheppard, Lorraine (2016) Service level decision-making in rural physiotherapy: development of conceptual models. Physiotherapy Research International, 21 (2). pp. 116-126.
https://researchonline.jcu.edu.au/43161/
restricted
oai:researchonline.jcu.edu.au:43237
2024-03-04T15:18:37Z
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Training for general practice: how Australia's programs compare to other countries
Sen Gupta, Tarun
Hays, Richard
Background: General practice in Australia and internationally has undergone a dramatic transformation over the past half century in terms of recognition, academic status, organisation and funding. Training pathways have also evolved in response to this changing environment.
Objectives: This paper compares some of the features of Australian and international general practice training using the educational standards developed by the World Organization of Family Doctors' (WONCA) Working Party on Education as a framework.
Discussion: General practice training in Australia, particularly rural training, is strong by international standards, but more lessons can still be learnt from other settings. Local contextual factors mean there are substantial differences in training across jurisdictions, but there are a number of similarities. There is increasing attention being paid to the many roles of a general practitioner, and the importance of a formalised, structured and well-resourced training program. More needs to be done internationally to ensure high-level primary care is available to all people, particularly the underserved.
Royal Australian College of General Practitioners
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43237/1/43237%20Gupta%20et%20al%202016.pdf
http://www.racgp.org.au/afp/2016/januaryfebruary/training-for-general-practice-how-australia%E2%80%99s-programs-compare-to-other-countries/
Sen Gupta, Tarun, and Hays, Richard (2016) Training for general practice: how Australia's programs compare to other countries. Australian Family Physician, 45 (1-2). pp. 18-21.
https://researchonline.jcu.edu.au/43237/
openpub
oai:researchonline.jcu.edu.au:43337
2024-03-03T14:17:46Z
7374617475733D707562
74797065733D61727469636C65
The reproducibility of acquiring three dimensional gait and plantar pressure data using established protocols in participants with and without type 2 diabetes and foot ulcers
Fernando, Malindu
Crowther, Robert G.
Cunningham, Margaret
Lazzarini, Peter A.
Sangla, Kunwarjit S.
Buttner, Petra
Golledge, Jonathan
Background: Several prospective studies have suggested that gait and plantar pressure abnormalities secondary to diabetic peripheral neuropathy contributes to foot ulceration. There are many different methods by which gait and plantar pressures are assessed and currently there is no agreed standardised approach. This study aimed to describe the methods and reproducibility of three-dimensional gait and plantar pressure assessments in a small subset of participants using pre-existing protocols.
Methods: Fourteen participants were conveniently sampled prior to a planned longitudinal study; four patients with diabetes and plantar foot ulcers, five patients with diabetes but no foot ulcers and five healthy controls. The repeatability of measuring key biomechanical data was assessed including the identification of 16 key anatomical landmarks, the measurement of seven leg dimensions, the processing of 22 three-dimensional gait parameters and the analysis of four different plantar pressures measures at 20 foot regions.
Results: The mean inter-observer differences were within the pre-defined acceptable level (<7 mm) for 100 % (16 of 16) of key anatomical landmarks measured for gait analysis. The intra-observer assessment concordance correlation coefficients were >0.9 for 100 % (7 of 7) of leg dimensions. The coefficients of variations (CVs) were within the pre-defined acceptable level (<10 %) for 100 % (22 of 22) of gait parameters. The CVs were within the pre-defined acceptable level (<30 %) for 95 % (19 of 20) of the contact area measures, 85 % (17 of 20) of mean plantar pressures, 70 % (14 of 20) of pressure time integrals and 55 % (11 of 20) of maximum sensor plantar pressure measures.
Conclusion: Overall, the findings of this study suggest that important gait and plantar pressure measurements can be reliably acquired. Nearly all measures contributing to three-dimensional gait parameter assessments were within predefined acceptable limits. Most plantar pressure measurements were also within predefined acceptable limits; however, reproducibility was not as good for assessment of the maximum sensor pressure. To our knowledge, this is the first study to investigate the reproducibility of several biomechanical methods in a heterogeneous cohort.
BioMed Central Ltd
2016-01-29
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43337/1/43337_Crowther_2016.pdf
http://dx.doi.org/10.1186/s13047-016-0135-8
Fernando, Malindu, Crowther, Robert G., Cunningham, Margaret, Lazzarini, Peter A., Sangla, Kunwarjit S., Buttner, Petra, and Golledge, Jonathan (2016) The reproducibility of acquiring three dimensional gait and plantar pressure data using established protocols in participants with and without type 2 diabetes and foot ulcers. Journal of Foot and Ankle Research, 9 (4). pp. 1-12.
https://researchonline.jcu.edu.au/43337/
open
oai:researchonline.jcu.edu.au:43417
2024-03-05T14:38:45Z
7374617475733D707562
74797065733D61727469636C65
Determinants and gaps in preventive care delivery for Indigenous Australians: a cross-sectional analysis
Bailie, Christopher
Matthews, Veronica
Bailie, Jodie
Burgess, Paul
Copley, Kerry
Kennedy, Catherine
Moore, Liz
Larkins, Sarah
Thompson, Sandra
Bailie, Ross Stewart
Background: Potentially preventable chronic diseases are the greatest contributor to the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Preventive care is important for earlier detection and control of chronic disease, and a number of recent policy initiatives have aimed to enhance delivery of preventive care. We examined documented delivery of recommended preventive services for Indigenous peoples across Australia and investigated the influence of health center and client level factors on adherence to best practice guidelines.
Methods: Clinical audit data from 2012 to 2014 for 3,623 well adult clients (aged 15–54) of 101 health centers from four Australian states and territories were analyzed to determine adherence to delivery of 26 recommended preventive services classified into five different modes of care on the basis of the way in which they are delivered (e.g., basic measurement; laboratory tests and imaging; assessment and brief interventions, eye, ear, and oral checks; follow-up of abnormal findings). Summary statistics were used to describe the delivery of each service item across jurisdictions. Multilevel regression models were used to quantify the variation in service delivery attributable to health center and client level factors and to identify factors associated with higher quality care.
Results: Delivery of recommended preventive care varied widely between service items, with good delivery of most basic measurements but poor follow-up of abnormal findings. Health center characteristics were associated with most variation. Higher quality care was associated with Northern Territory location, urban services, and smaller service population size. Client factors associated with higher quality care included age between 25 and 34 years, female sex, and more regular attendance.
Conclusion: Wide variation in documented preventive care delivery, poor follow-up of abnormal findings, and system factors that influence quality of care should be addressed through continuous quality improvement approaches that engage stakeholders at multiple levels (including, for example, access to care in the community, appropriate decision support for practitioners, and financial incentives and context appropriate guidelines).
Frontiers Research Foundation
2016-03-10
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43417/1/43417_Larkins_2016.pdf
http://dx.doi.org/10.3389/fpubh.2016.00034
Bailie, Christopher, Matthews, Veronica, Bailie, Jodie, Burgess, Paul, Copley, Kerry, Kennedy, Catherine, Moore, Liz, Larkins, Sarah, Thompson, Sandra, and Bailie, Ross Stewart (2016) Determinants and gaps in preventive care delivery for Indigenous Australians: a cross-sectional analysis. Frontiers in Public Health, 4. 34. pp. 1-11.
https://researchonline.jcu.edu.au/43417/
open
oai:researchonline.jcu.edu.au:43421
2024-03-03T14:57:23Z
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Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland
Panzera, Annette June
Murray, Richard
Stewart, Ruth
Mills, Jane
Beaton, Neil
Larkins, Sarah
Creating a stable and sustainable health workforce in regional, rural and remote Australia has long been a challenge to health workforce planners, policy makers and researchers alike. Traditional health workforce planning is often reactive and assumes continuation of current patterns of healthcare utilisation. This demonstration project in Far North Queensland exemplifies how participatory regional health workforce planning processes can accurately model current and projected local workforce requirements. The recent establishment of Primary Health Networks (PHNs) with the intent to commission health services tailored to individual healthcare needs underlines the relevance of such an approach. This study used action research methodology informed by World Health Organization (WHO) systems thinking. Four cyclical stages of health workforce planning were followed: needs assessment; health service model redesign; skills-set assessment and workforce redesign; and development of a workforce and training plan. This study demonstrated that needs-based loco-regional health workforce planning can be achieved successfully through participatory processes with stakeholders. Stronger health systems and workforce training solutions were delivered by facilitating linkages and planning processes based on community need involving healthcare professionals across all disciplines and sectors. By focusing upon extending competencies and skills sets, local health professionals form a stable and sustainable local workforce. Concrete examples of initiatives generated from this process include developing a chronic disease inter-professional teaching clinic in a rural town and renal dialysis being delivered locally to an Aboriginal community. The growing trend of policy makers decentralising health funding, planning and accountability and rising health system costs increase the future utility of this approach. This type of planning can also assist the new PHNs to commission health services that meet the needs of the population and contribute to service and system improvement and innovation.
CSIRO Publishing
2016-02-29
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43421/1/43421_Larkins_2016.pdf
http://dx.doi.org/10.1071/PY15149
Panzera, Annette June, Murray, Richard, Stewart, Ruth, Mills, Jane, Beaton, Neil, and Larkins, Sarah (2016) Regional health workforce planning through action research: lessons for commissioning health services from a case study in Far North Queensland. Australian Journal of Primary Health, 22 (1). PY15149. pp. 63-68.
https://researchonline.jcu.edu.au/43421/
restricted
oai:researchonline.jcu.edu.au:43422
2024-03-04T15:04:36Z
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Geographical access to radiation therapy in North Queensland: a retrospective analysis of patient travel to radiation therapy before and after the opening of an additional radiotherapy facility
Sharma, D.K.
Vangaveti, V.N.
Larkins, S.
Introduction: Access to radiation therapy (RT) underlies optimal care for prostate and breast cancer patients. This study investigates the impact of opening a new RT clinic on distance and road travel time to RT, and overall utilisation for prostate and breast cancer patients over a 3-year period in North Queensland (NQ), Australia.
Methods: The study used retrospective audit of two radiotherapy databases and a geographic information system to illustrate patient origins and distance to the RT clinic used over 3 years. Prostate and female breast cancer patients were selected from the radiation oncology databases of The Townsville Hospital (TTH) and Radiation Oncology Queensland (ROQ) Cairns between 1 July 2010 and 30 June 2013. Distance from a patient's home origin to the RT facility was mapped using a geographic information system (ArcGIS software), and travel time (minutes) and road distance (km) determined by Google Maps road directions.
Results: Overall number of prostate and breast cancer patients treated by RT in Cairns and Townsville clinics increased by 16% in 2011–2012 and by 29% in 2012–2013 from year 1 values. In 2010, 44% of the patients travelled 200–400 km to RT, which reduced to 21% in 2013. By 2013, with a second treatment facility, more than 70% of patients lived within 200 km of an RT facility (p<0.0001). Total median road travel time reduced annually from 201 minutes in 2010–2011 to 66 minutes in 2011–2012 and 56 minutes in 2012–2013 (p<0.0001), corresponding to a decrease in the median distance travelled to an RT facility.
Conclusions: An additional RT facility in NQ has led to an increase in patients treated with RT for prostate and breast cancer and, on average, less travel distance and time to treatment, suggesting improvement in access to RT in NQ.
Australian Rural Health Education Network
2016-03-10
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43422/1/43422_Larkins_2016.pdf
http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3640
Sharma, D.K., Vangaveti, V.N., and Larkins, S. (2016) Geographical access to radiation therapy in North Queensland: a retrospective analysis of patient travel to radiation therapy before and after the opening of an additional radiotherapy facility. Rural and Remote Health, 16. 3640. pp. 1-10.
https://researchonline.jcu.edu.au/43422/
open
oai:researchonline.jcu.edu.au:43428
2024-02-29T15:10:25Z
7374617475733D707562
74797065733D61727469636C65
Anopheles farauti is a homogeneous population that blood feeds early and outdoors in the Solomon Islands
Russell, Tanya L.
Beebe, Nigel W.
Bugoro, Hugo
Apairamo, Allan
Collins, Frank H.
Cooper, Robert D.
Lobo, Neil F.
Burkot, Thomas R.
Background: In the 1970s, Anopheles farauti in the Solomon Island responded to indoor residual spraying with DDT by increasingly feeding more outdoors and earlier in the evening. Although long-lasting insecticidal nets (LLINs) are now the primary malaria vector control intervention in the Solomon Islands, only a small proportion of An. farauti still seek blood meals indoors and late at night where they are vulnerable to being killed by contract with the insecticides in LLINs. The effectiveness of LLINs and indoor residual spraying (IRS) in controlling malaria transmission where the vectors are exophagic and early biting will depend on whether the predominant outdoor or early biting phenotypes are associated with a subpopulation of the vectors present.
Methods: Mark-release-recapture experiments were conducted in the Solomon Islands to determine if individual An. farauti repeat the same behaviours over successive feeding cycles. The two behavioural phenotypes examined were those on which the WHO recommended malaria vector control strategies, LLINs and IRS, depend: indoor and late night biting.
Results: Evidence was found for An. farauti being a single population regarding time (early evening or late night) and location (indoor or outdoor) of blood feeding. Individual An. farauti did not consistently repeat behavioural phenotypes expressed for blood feeding (e.g., while most mosquitoes that fed early and outdoors, and would repeat those behaviours, some fed late at night or indoors in the next feeding cycle).
Conclusions: The finding that An. farauti is a homogeneous population is significant, because during the multiple feeding cycles required to complete the extrinsic incubation period, many individual female anophelines will enter houses late at night and be exposed to the insecticides used in LLINs or IRS. This explains, in part, the control that LLINs and IRS have exerted against a predominantly outdoor feeding vector, such as An. farauti. These findings may be relevant to many of the outdoor feeding vectors that dominate transmission in much of the malaria endemic world and justifies continued use of LLINs. However, the population-level tendency of mosquitoes to feed outdoors and early in the evening does require complementary interventions to accelerate malaria control towards elimination.
BioMed Central
2016-03-09
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43428/1/43428_Burkot_2016.pdf
http://dx.doi.org/10.1186/s12936-016-1194-9
Russell, Tanya L., Beebe, Nigel W., Bugoro, Hugo, Apairamo, Allan, Collins, Frank H., Cooper, Robert D., Lobo, Neil F., and Burkot, Thomas R. (2016) Anopheles farauti is a homogeneous population that blood feeds early and outdoors in the Solomon Islands. Malaria Journal, 15. 151. pp. 1-7.
https://researchonline.jcu.edu.au/43428/
open
oai:researchonline.jcu.edu.au:43471
2024-02-29T15:10:38Z
7374617475733D707562
74797065733D61727469636C65
Frequent blood feeding enables insecticide-treated nets to reduce transmission by mosquitoes that bite predominately outdoors
Russell, Tanya L.
Beebe, Nigel W.
Bugoro, Hugo
Apairamo, Allan
Chow, Weng K.
Cooper, Robert D.
Collins, Frank H.
Lobo, Neil F.
Burkot, Thomas R.
Background: The effectiveness of vector control on malaria transmission by long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) depends on the vectors entering houses to blood feed and rest when people are inside houses. In the Solomon Islands, significant reductions in malaria have been achieved in the past 20 years with insecticide-treated bed nets, IRS, improved diagnosis and treatment with artemisinin combination therapies; despite the preference of the primary vector, Anopheles farauti, to feed outdoors and early in the evening and thereby avoid potential exposure to insecticides. Rational development of tools to complement LLINs and IRS by attacking vectors outdoor requires detailed knowledge of the biology and behaviours of the target species.
Methods: Malaria transmission in Central Province, Solomon Islands was estimated by measuring the components comprising the entomological inoculation rate (EIR) as well as the vectorial capacity of An. farauti. In addition, the daily and seasonal biting behaviour of An. farauti, was examined and the duration of the feeding cycle was estimated with a mark-release-recapture experiment.
Results: Anopheles farauti was highly exophagic with 72 % captured by human landing catches (HLC) outside of houses. Three-quarters (76 %) of blood feeding on humans was estimated to occur before 21.00 h. When the hourly location of humans was considered, the proportion of exposure to mosquito bites on humans occurring indoors (πⁱ) was only 0.130 ± 0.129. Peak densities of host seeking An. farauti occurred between October and January. The annual EIR was estimated to be 2.5 for 2012 and 33.2 for 2013. The length of the feeding cycle was 2.1 days.
Conclusions: The short duration of the feeding cycle by this species offers an explanation for the substantial control of malaria that has been achieved in the Solomon Islands by LLINs and IRS. Anopheles farauti is primarily exophagic and early biting, with 13 % of mosquitoes entering houses to feed late at night during each feeding cycle. The two-day feeding cycle of An. farauti requires females to take 5–6 blood meals before the extrinsic incubation period (EIP) is completed; and this could translate into substantial population-level mortality by LLINs or IRS before females would be infectious to humans with Plasmodium falciparum and Plasmodium vivax. Although An. farauti is primarily exophagic, the indoor vector control tools recommended by the World Health Organization (LLINs and IRS) can still provide an important level of control. Nonetheless, elimination will likely require vector control tools that target other bionomic vulnerabilities to suppress transmission outdoors and that complement the control provided by LLINs and IRS.
BioMed Central
2016-03-10
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43471/1/43471_Russell_2016.pdf
http://dx.doi.org/10.1186/s12936-016-1195-8
Russell, Tanya L., Beebe, Nigel W., Bugoro, Hugo, Apairamo, Allan, Chow, Weng K., Cooper, Robert D., Collins, Frank H., Lobo, Neil F., and Burkot, Thomas R. (2016) Frequent blood feeding enables insecticide-treated nets to reduce transmission by mosquitoes that bite predominately outdoors. Malaria Journal, 15. 156. pp. 1-9.
https://researchonline.jcu.edu.au/43471/
open
oai:researchonline.jcu.edu.au:43473
2024-03-03T14:57:58Z
7374617475733D707562
74797065733D61727469636C65
Larval habitats of the Anopheles farauti and Anopheles lungae complexes in the Solomon Islands
Russell, Tanya L.
Burkot, Thomas R.
Bugoro, Hugo
Apairamo, Allan
Beebe, Nigel W.
Chow, Weng K.
Cooper, Robert D.
Collins, Frank H.
Lobo, Neil F.
Background: There is an urgent need for vector control tools to supplement long-lasting insecticidal nets (LLINs) and indoor residual spraying; particularly in the Solomon Islands where the primary vector, Anopheles farauti, is highly anthropophagic and feeds mainly outdoors and early in the evening. Currently, the only supplementary tool recommended by the World Health Organization is larval source management (LSM). The feasibility and potential effectiveness of LSM requires information on the distribution of anophelines, the productivity of larval habitats and the potential impacts of larval control on adult fitness.
Methods: The distribution of anophelines in Central and Western Provinces in the Solomon Islands was mapped from cross-sectional larval habitat surveys. The composition and micro-distribution of larval instars within a large permanent river-mouth lagoon was examined with a longitudinal survey. Density-dependent regulation of An. farauti larvae was investigated by longitudinally following the development and survival of different densities of first instars in floating cages in a river-mouth lagoon.
Results: Five anopheline species were molecularly identified from a range of fresh and brackish water habitats: An. farauti s.s., An. hinesorum, An. lungae, An. nataliae and An. solomonis. The most common habitats used by the primary malaria vector, An. farauti, were coastal lagoons and swamps. In the detailed study of lagoon micro-productivity, An. farauti was non-uniformly distributed with highest densities found at collections sites most proximal and distal to the mouth of the lagoon. The survival of An. farauti larvae was more than twofold lower when larvae were held at the highest experimental density (1 larva per 3.8 cm²) when compared with the lowest density (1 larva per 38 cm²).
Conclusions: The only documented major malaria vector collected in larval surveys in both Central and Western Provinces was An. farauti. Lagoons and swamps, the most common, largest and (potentially) most productive larval sites of this malaria vector, were "few, fixed and findable" and theoretically, therefore, amenable to successful LSM. However, the immense scale and complexity of these ecosystems in which An. farauti larvae are found raises questions regarding the ability to effectively control the larvae, as incomplete larviciding could trigger density dependent effects resulting in increased larval survivorship. While LSM has the potential to significantly contribute to malaria control of this early and outdoor biting vector, more information on the distribution of larvae within these extensive habitats is required to maximize the effectiveness of LSM.
BioMed Central
2016-03-15
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43473/1/43473%20Russell%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12936-016-1196-7
Russell, Tanya L., Burkot, Thomas R., Bugoro, Hugo, Apairamo, Allan, Beebe, Nigel W., Chow, Weng K., Cooper, Robert D., Collins, Frank H., and Lobo, Neil F. (2016) Larval habitats of the Anopheles farauti and Anopheles lungae complexes in the Solomon Islands. Malaria Journal, 15. 164. pp. 1-9.
https://researchonline.jcu.edu.au/43473/
open
oai:researchonline.jcu.edu.au:43700
2024-03-02T15:16:37Z
7374617475733D707562
74797065733D61727469636C65
The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review
Frier, Amanda
Barnett, Fiona
Devine, Sue
Purpose: This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation.
Method: A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered.
Results: Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible.
Conclusions: Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation.
Informa Healthcare
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43700/11/43700%20Frier%20et%20al%202017.pdf
http://dx.doi.org/10.3109/09638288.2016.1172672
Frier, Amanda, Barnett, Fiona, and Devine, Sue (2017) The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review. Disability and Rehabilitation, 39 (10). pp. 941-948.
https://researchonline.jcu.edu.au/43700/
restricted
oai:researchonline.jcu.edu.au:43872
2024-03-04T15:04:16Z
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Strategies and approaches to vector control in nine malaria-eliminating countries: a cross-case study analysis
Smith Gueye , Cara
Newby, Gretchen
Gosling, Roland D.
Whittaker, Maxine A.
Chandramohan, Daniel
Slutsker, Laurence
Tanner, Marcel
Background: There has been progress towards malaria elimination in the last decade. In response, WHO launched the Global Technical Strategy (GTS), in which vector surveillance and control play important roles. Country experiences in the Eliminating Malaria Case Study Series were reviewed to identify success factors on the road to elimination using a cross-case study analytic approach.
Methods: Reports were included in the analysis if final English language draft reports or publications were available at the time of analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for vector control in malaria elimination was developed, reviewed, formatted as a matrix, and case study data was extracted and entered into the matrix. A workshop was convened during which participants conducted reviews of the case studies and matrices and arrived at a consensus on the evidence and lessons. The framework was revised and a second round of data extraction, synthesis and summary of the case study reports was conducted.
Results: Countries implemented a range of vector control interventions. Most countries aligned with integrated vector management, however its impact was not well articulated. All programmes conducted entomological surveillance, but the response (i.e., stratification and targeting of interventions, outbreak forecasting and strategy) was limited or not described. Indoor residual spraying (IRS) was commonly used by countries. There were several examples of severe reductions or halting of IRS coverage and subsequent resurgence of malaria. Funding and operational constraints and poor implementation had roles. Bed nets were commonly used by most programmes; coverage and effectiveness were either not measured or not articulated. Larval control was an important intervention for several countries, preventing re-introduction, however coverage and impact on incidence were not described. Across all interventions, coverage indicators were incomparable, and the rationale for which tools were used and which were not used appeared to be a function of the availability of funding, operational issues and cost instead of evidence of effectiveness to reduce incidence.
Conclusions: More work is required to fill gaps in programme guidance, clarify the best methods for choosing and targeting vector control interventions, and support to measure cost, cost-effectiveness and cost-benefit of vector surveillance and control interventions.
BioMed Central
2016-01-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43872/1/43872%20Smith%20Gueye%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12936-015-z
Smith Gueye , Cara, Newby, Gretchen, Gosling, Roland D., Whittaker, Maxine A., Chandramohan, Daniel, Slutsker, Laurence, and Tanner, Marcel (2016) Strategies and approaches to vector control in nine malaria-eliminating countries: a cross-case study analysis. Malaria Journal, 15. 2. pp. 1-14.
https://researchonline.jcu.edu.au/43872/
open
oai:researchonline.jcu.edu.au:43875
2024-03-04T15:02:24Z
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74797065733D61727469636C65
Health information systems and disability in the Lao PDR: a qualitative study
Durham, Jo
Sychareun, Vanphanom
Rodney, Anna
Gouda, Hebe N.
Richards, Nicola
Rampatige, Rasika
Whittaker, Maxine
The Convention on the Rights of Persons with Disabilities provides an opportunity to strengthen disability-related health information. This study analysed the health information system in Lao PDR and sought evidence of interventions to improve disability-related health information. The study was based on a literature review and key informant interviews (N = 17) informed by the Health Metrics Network's Framework and Standards and the Performance of Routine Information System Management framework. The Lao health information system is in an embryonic stage with health data often incomplete, inaccurate and poorly used. Indicators related to disability or functioning are not included, and capacity to diagnose the health condition of disability is limited. No studies of health information interventions were found. As a State Party to the CRPD, the Lao PDR has a legal obligation to collect health-related information on people with disabilities. Given the nascent stage of development of the health information system in the Lao PDR and diagnostic capacity, indicators related to basic functioning and access to services should be integrated into household level surveys. As the health information system further develops, small, incremental changes in the type of disability information and rehabilitation and the way it is collected can be implemented.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/43875/6/43875%20Durham%20et%20al%202016.pdf
http://dx.doi.org/10.1002/hpm.2319
Durham, Jo, Sychareun, Vanphanom, Rodney, Anna, Gouda, Hebe N., Richards, Nicola, Rampatige, Rasika , and Whittaker, Maxine (2016) Health information systems and disability in the Lao PDR: a qualitative study. International Journal of Health Planning and Management, 31 (4). pp. 446-458.
https://researchonline.jcu.edu.au/43875/
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oai:researchonline.jcu.edu.au:44021
2024-03-01T14:40:25Z
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Supporting Australia's new veterans
Gill, Gerard F.
Bain, Roderick
Seidl, Isaac
Background: The recent period of instability and conflict in parts of the world has exposed a new generation of Australian service members to conflict and its associated traumas.
Objective: The aim of this article is to assist general practitioners (GPs) in engaging with younger veterans who have served in the Australian Defence Force (ADF) since 1990 and acquired health problems as a result of this service. It provides abbreviated advice on the resources available from the Department of Veterans' Affairs (DVA), particularly for mental health problems, and how to efficiently access DVA-funded services for newer veterans.
Discussion: Early detection of and attention to health problems (especially mental ill health) arising from military service, particularly from conflict or peacekeeping missions, has been found to improve veterans' health, their functioning and family happiness. GPs are ideally situated to arrange and coordinate this care.
Royal Australian College of General Practitioners
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44021/1/44021%20Gill%20et%20al%202016.pdf
http://www.racgp.org.au/afp/2016/march/supporting-australia%E2%80%99s-new-veterans/
Gill, Gerard F., Bain, Roderick, and Seidl, Isaac (2016) Supporting Australia's new veterans. Australian Family Physician, 45 (3). pp. 102-106.
https://researchonline.jcu.edu.au/44021/
openpub
oai:researchonline.jcu.edu.au:44024
2024-03-01T14:40:39Z
7374617475733D707562
74797065733D61727469636C65
A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people
Pighills, Alison
Ballinger, Claire
Pickering, Ruth
Chari, Satyan
Introduction: The potential of environmental assessment and modification to reduce falls has recently received attention within the gerontology literature. Research investigating the clinical effectiveness of this intervention in falls prevention reports conflicting results. Discrepancies are due to variation in the risk profile of study participants and the health care background of the person providing the environmental intervention or the intensity of the intervention provided.
Method: The purpose of this paper is to compare and contrast two systematic reviews, which include meta-analyses, of environmental interventions for falls prevention in community dwelling older people, using the critical appraisal skills programme tool for systematic reviews.
Findings: Both reviews found that: environmental assessment and modification was effective in falls prevention; intervention was effective with high but not low risk participants; and that high intensity environmental assessment was effective, whereas low intensity intervention was not. Environmental interventions which were delivered by occupational therapists were deemed high intensity, probably because their underpinning theoretical frameworks focus on the impact of the environment on function.
Conclusion: We discuss possible reasons why occupational therapist led environmental assessment and modification is clinically effective in falls prevention, for people at high risk of falls, whereas non occupational therapist led intervention is not.
College of Occupational Therapists
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44024/1/44024_Pighills%20et%20al_2016.pdf
http://dx.doi.org/10.1177/0308022615600181
Pighills, Alison, Ballinger, Claire, Pickering, Ruth, and Chari, Satyan (2016) A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people. British Journal of Occupational Therapy, 79 (3). pp. 133-143.
https://researchonline.jcu.edu.au/44024/
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oai:researchonline.jcu.edu.au:44028
2024-03-03T14:18:37Z
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Commissioning for healthcare: a case study of the general practitioners After Hours Program
Carlisle, Karen
Fleming, Rhonda
Berrigan, Alison
A strong primary healthcare system that is effective and efficient is a priority for health reform in Australia. Commissioning to support primary healthcare delivery has received increasing attention as part of healthcare reform in Australia and beyond. The aim of this paper is to present a case study of transitioning to an activity-based model for the provision of GP after-hours services in Australia. The GP After-Hours Program utilised a commissioning model that comprised of needs assessment, service development, provider engagement and evaluation. Evaluation of the new model showed a 17% increase in after-hours services, with service providers indicating that they were satisfied with the new process. Examination of the experience of implementation suggests that the commissioning model provided a useful framework for guiding activity-based funding for after-hours services. However, relational factors, such as engagement with the community, knowledge of the wider context and legitimacy of the commissioning body, can affect the implementation process.
CSIRO Publishing
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44028/1/44028%20Carlise%20et%20al%202016.pdf
http://dx.doi.org/10.1071/PY15036
Carlisle, Karen, Fleming, Rhonda, and Berrigan, Alison (2016) Commissioning for healthcare: a case study of the general practitioners After Hours Program. Australian Journal of Primary Health, 22 (1). pp. 22-25.
https://researchonline.jcu.edu.au/44028/
restricted
oai:researchonline.jcu.edu.au:44120
2024-03-02T15:18:57Z
7374617475733D707562
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'It's the simple things you do first that start the process of help': undergraduate nursing and midwifery students' experiences of the Mental Health First Aid Course
Kelly, Jenny
Birks, Melanie
Background: Mental Health First Aid (MHFA) is the initial help offered to a person developing a mental health problem or experiencing a mental health crisis. The MHFA course is a twelve hour evidence-based course which teaches members of the general public to provide first aid assistance until the crisis resolves or the individual receives professional help. While the MHFA program does not teach people to provide a diagnosis or treat mental health conditions, it has been established as an effective tool in improving mental health literacy, reducing stigma and increasing helping behaviours.
Aim: The aim of the study was to explore the experiences of students who completed a tailored 13-hour version of this MHFA course specifically developed for undergraduate nursing and midwifery students.
Method: Sixty-six students, the majority of whom were female and aged 17-55 years, completed an online survey. The survey sought to explore the perspectives of students in respect of both undertaking the course as well as its value in retrospect. Areas explored in the survey included: relevance and value of content; strengths and weaknesses of the course; if and how they had applied any of the skills learnt and overall perceptions of the course.
Results: Findings showed that the vast majority of students (86%) regarded the course as appropriate for nursing and midwifery students with 89% stating they would recommend the course to other university students.
Conclusion: Data indicates that the course had application and impact following completion beyond what had been anticipated by the students. Responses to the open ended questions suggest widespread support for the routine offering of this course for beginning nursing and midwifery students nationwide.
Elsevier
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44120/1/44120%20Kelly%20et%20al%202017.pdf
http://dx.doi.org/10.1016/j.colegn.2016.04.004
Kelly, Jenny, and Birks, Melanie (2017) 'It's the simple things you do first that start the process of help': undergraduate nursing and midwifery students' experiences of the Mental Health First Aid Course. Collegian, 24 (3). pp. 275-280.
https://researchonline.jcu.edu.au/44120/
restricted
oai:researchonline.jcu.edu.au:44159
2016-12-14T14:24:05Z
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Executive function deficits in psychiatric outpatients in Australia
Oei, T.P.S.
Shaw, S.
Healy, K.L.
This study compared deficits in executive functioning in psychiatric outpatients with anxiety and depression to neurologically impaired patients and a community sample using a cross-sectional design. Anxious, depressed and neurologically impaired patients were compared for executive dysfunction using the revised Dysexecutive Questionnaire. A large sample of 663 community individuals, 39 mood disordered, 121 anxiety disordered and 120 neurologically impaired outpatients participated. Anxious and depressed patients exhibited significantly greater executive dysfunction than neurological patients and healthy controls. Anxiety patients reported the greatest executive dysfunction than all other groups including greater total problems and specific deficits in inhibiting responses and in acting with volition. Problems with inhibition reflect difficulties of anxiety patients in preventing automatic responses. Problems with volition reported by anxiety patients were attributed to comorbid depression, consistent with anxiety patients reporting the highest levels of depressive as well as anxious symptomology. Depressed patients reported greater problems with volition than community members, reflecting problems with planning and motivation. Neurologically impaired individuals reported a comparable level of executive dysfunction to the general community. This was attributed mainly to the poor ability of neurologically impaired individuals to report their own deficits. We discuss the relevance of executive functioning to anxiety and depression, and the implications of using the DEX-R with clinical samples.
Springer
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44159/6/44159%20oei%20et%20al%202016.pdf
http://dx.doi.org/10.1007/s11469-016-9634-x
Oei, T.P.S., Shaw, S., and Healy, K.L. (2016) Executive function deficits in psychiatric outpatients in Australia. International Journal of Mental Health and Addiction, 14 (3). pp. 337-349.
https://researchonline.jcu.edu.au/44159/
restricted
oai:researchonline.jcu.edu.au:44170
2024-03-03T14:57:25Z
7374617475733D707562
74797065733D61727469636C65
Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach
Topp, Stephanie M.
Moonga, Clement N.
Luo, Nkandu
Kaingu, Michael
Chileshe, Chisela
Magwende, George
Heymann, S. Jody
Henostroza, German
Background: Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting.
Methods: We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 34 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems.
Results: A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare.
Conclusions: This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems and more comprehensive pre-service health education for prison officers.
Oxford University Press
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44170/11/44170%20Topp%20et%20al%202016.pdf
http://dx.doi.org/10.1093/heapol/czw059
Topp, Stephanie M., Moonga, Clement N., Luo, Nkandu, Kaingu, Michael, Chileshe, Chisela, Magwende, George, Heymann, S. Jody, and Henostroza, German (2016) Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach. Health Policy and Planning, 31 (9). pp. 1250-1261.
https://researchonline.jcu.edu.au/44170/
open
oai:researchonline.jcu.edu.au:44181
2024-03-02T15:19:00Z
7374617475733D707562
74797065733D61727469636C65
Associations between bride price obligations and women's anger, symptoms of mental distress, poverty, spouse and family conflict and preoccupations with injustice in conflict-affected Timor-Leste
Rees, Susan
Mohsin, Mohammed
Tay, Alvin Kuowei
Thorpe, Rosamund
Murray, Samantha
Savio, Elisa
Fonseca, Mira
Tol, Wietse
Silove, Derrick
,
Objectives: Bride price is a widespread custom in many parts of the world, including in most countries in sub-Saharan Africa and parts of Asia. We hypothesised that problems relating to the obligatory ongoing remittances made by the husband and his family to the bride's family may be a source of mental disturbance (in the form of explosive anger and severe mental distress) among women. In addition, we postulated that problems arising with bride price would be associated with conflict with the spouse and family, poverty and women's preoccupations with injustice.
Design: A mixed-methods study comprising a total community household survey and semistructured qualitative interviews.
Setting: Two villages, one urban, the other rural, in Timor-Leste.
Participants: 1193 married women participated in the household survey and a structured subsample of 77 women participated in qualitative interviews.
Results: Problems with bride price showed a consistent dose–effect relationship with sudden episodes of explosive anger, excessive anger and severe psychological distress. Women with the most severe problems with bride price had twice the poverty scores as those with no problems with the custom. Women with the most severe problems with bride price also reported a threefold increase in conflict with their spouse and a fivefold increase in conflict with family. They also reported heightened preoccupations with injustice.
Conclusions: Our study is the first to show consistent associations between problems with bride price obligations and mental distress, poverty, conflict with spouse and family and preoccupations with injustice among women in a low-income, postconflict country.
BMJ Publishing Group
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44181/1/BMJ%20article.pdf
http://dx.doi.org/10.1136/bmjgh-2015-000025
Rees, Susan, Mohsin, Mohammed, Tay, Alvin Kuowei, Thorpe, Rosamund, Murray, Samantha, Savio, Elisa, Fonseca, Mira, Tol, Wietse, Silove, Derrick, and UNSPECIFIED (2016) Associations between bride price obligations and women's anger, symptoms of mental distress, poverty, spouse and family conflict and preoccupations with injustice in conflict-affected Timor-Leste. BMJ Global Health, 1 (1). e000025.
https://researchonline.jcu.edu.au/44181/
open
oai:researchonline.jcu.edu.au:44192
2024-03-03T14:22:27Z
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74797065733D61727469636C65
Psychosocial characteristics and predictors of health-care use in families of young children with cystic fibrosis in Western Australia
Douglas, Tonia
Green, Jennifer
Park, Judy
Turkovic, Lidija
Massie, John
Shields, Linda
Objective: Early childhood psychosocial experiences determine future health and health-care use. Identifying psychosocial predictors in cystic fibrosis may inform intervention strategies that can reduce health-care utilization.
Design: The study was designed as a prospective cohort study.
Setting: The study was set in the only cystic fibrosis clinic in Western Australia.
Patients: The patients were children up to 6 years diagnosed with cystic fibrosis in Western Australia between 2005 and 2011.
Main outcome measures: Psychosocial data collected for each year of life were compared with Australian population data and analysed as predictors of annual hospital, emergency and outpatient visits.
Results: Compared with the Australian population, cystic fibrosis families demonstrated lower socio-economic status and labour supply (P < 0.001), increased residential mobility (P < 0.001) and trends towards increased rates of parental separation (P = 0.066). Marital discord and maternal and child psychological stress significantly predicted increased hospital admissions, emergency and outpatient visits.
Conclusions: Social gradients may exist for families of young children with cystic fibrosis in Western Australia with potential implications for child health. Family psychological and relationship stress predicted increased child cystic fibrosis-related health-care use.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44192/1/44192_Douglas%20et%20al_2016.pdf
http://dx.doi.org/10.1111/jpc.13011
Douglas, Tonia, Green, Jennifer, Park, Judy, Turkovic, Lidija, Massie, John, and Shields, Linda (2016) Psychosocial characteristics and predictors of health-care use in families of young children with cystic fibrosis in Western Australia. Journal of Paediatrics and Child Health, 52 (1). pp. 34-39.
https://researchonline.jcu.edu.au/44192/
restricted
oai:researchonline.jcu.edu.au:44201
2024-03-03T14:28:37Z
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Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription
Orda, Ulrich
Mitra, Biswadev
Orda, Sabine
Fitzgerald, Mark
Gunnarsson, Ronny
Rofe, Geoff
Dargan, Anna
Objective: History, clinical examination and throat culture may be inadequate to rule in or out the presence of group A streptococci (GAS) infection in patients with sore throat in a remote location. We correlated the diagnostic accuracy for guiding antibiotic prescription of clinical decision and physiological scoring systems to a rapid diagnostic point of care (POC) test result in paediatric patients presenting with sore throat.
Methods: Prospective diagnostic accuracy study conducted between 30 June 2014 and 27 February 2015 in a remote Australian ED using a convenience sample. Among paediatric patients presenting with sore throat, the Centor criteria and clinical decision were documented. Simultaneously, patients without sore throat or respiratory tract infection were tested to determine the number of carriers. A throat swab on all patients was tested using a POC test (Alere TestPack + Plus Strep A with on board control), considered as reference standard to detect GAS infection.
Results: A total of 101 patients with sore throat were tested with 26 (25.7%) positive for GAS. One hundred and forty-seven patients without sore throat were tested with one positive POC test result (specificity 99%; 95% CI 96-100). Positive predictive value for clinician decision-making for a positive GAS swab (bacterial infection) was 29% (95% CI 17-43), negative predictive value 78% (95% CI 63-88). Area under ROC for the Centor score was 0.70 (95% CI 0.58-0.81).
Conclusion: Clinician judgement and Centor score are inadequate tools for clinical decision-making for children presenting with sore throat. Adjunctive POC testing provides sufficient accuracy to guide antibiotic prescription on first presentation.
Blackwell Publishing Ltd
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44201/6/44201%20Orda%20et%20al%202016.pdf
http://dx.doi.org/10.1111/1742-6723.12567
Orda, Ulrich, Mitra, Biswadev, Orda, Sabine, Fitzgerald, Mark, Gunnarsson, Ronny, Rofe, Geoff, and Dargan, Anna (2016) Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription. Emergency Medicine Australasia, 28 (2). pp. 199-204.
https://researchonline.jcu.edu.au/44201/
open
oai:researchonline.jcu.edu.au:44242
2024-03-03T14:59:07Z
7374617475733D707562
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Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific
Wen, Shawn
Harvard, Kelly E.
Smith Gueye, Cara
Canavati, Sara E.
Chancellor, Arna
Ahmed, Be-Nazir
Leaburi, John
Lek, Desoley
Namgay, Rinzin
Surya, Asik
Thakur, Garib D.
Whittaker, Maxine Anne
Gosling, Roly D.
Background: Significant progress has been made in reducing the malaria burden in the Asia Pacific region, which is aggressively pursuing a 2030 regional elimination goal. Moving from malaria control to elimination requires National Malaria Control Programmes (NMCPs) to target interventions at populations at higher risk, who are often not reached by health services, highly mobile and difficult to test, treat, and track with routine measures, and if undiagnosed, can maintain parasite reservoirs and contribute to ongoing transmission.
Methods: A qualitative, free-text questionnaire was developed and disseminated among 17 of the 18 partner countries of the Asia Pacific Malaria Elimination Network (APMEN).
Results: All 14 countries that responded to the survey identified key populations at higher risk of malaria in their respective countries. Thirteen countries engage in the dissemination of malaria-related Information, Education, and Communication (IEC) materials. Eight countries engage in diagnostic screening, including of mobile and migrant workers, military staff, and/or overseas workers. Ten countries reported distributing or recommending the use of long-lasting insecticide-treated nets (LLINs) among populations at higher risk with fewer countries engaging in other prevention measures such as indoor residual spraying (IRS) (two countries), spatial repellents (four countries), chemoprophylaxis (five countries), and mass drug administration (MDA) (three countries). Though not specifically tailored to populations at higher risk, 11 countries reported using mass blood surveys as a surveillance tool and ten countries map case data. Most NMCPs lack a monitoring and evaluation structure.
Conclusion: Countries in the Asia Pacific have identified populations at higher risk and targeted interventions to these groups but there is limited information on the effectiveness of these interventions. Platforms like APMEN offer the opportunity for the sharing of protocols and lessons learned related to finding, targeting and successfully clearing malaria from populations at higher risk. The sharing of programme data across borders may further strengthen national and regional efforts to eliminate malaria. This exchange of real-life experience is invaluable to NMCPs when scarce scientific evidence on the topic exists to aid decision-making and can further support NMCPs to develop strategies that will deliver a malaria-free Asia Pacific by 2030.
BioMed Central
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44242/1/44242%20Wen%20et%20al%202015.pdf
http://dx.doi.org/10.1186/s12936-016-1319-1
Wen, Shawn, Harvard, Kelly E., Smith Gueye, Cara, Canavati, Sara E., Chancellor, Arna, Ahmed, Be-Nazir, Leaburi, John, Lek, Desoley, Namgay, Rinzin, Surya, Asik, Thakur, Garib D., Whittaker, Maxine Anne, and Gosling, Roly D. (2016) Targeting populations at higher risk for malaria: a survey of national malaria elimination programmes in the Asia Pacific. Malaria Journal, 15. 271. pp. 1-14.
https://researchonline.jcu.edu.au/44242/
openpub
oai:researchonline.jcu.edu.au:44243
2024-03-03T14:59:08Z
7374617475733D707562
74797065733D61727469636C65
Village malaria worker performance key to the elimination of artemisinin-resistant malaria: a Western Cambodia health system assessment
Canavati, Sara E.
Lawpoolsri, Saranth
Quintero, Cesia E.
Nguon, Chea
Ly, Po
Pukrittayakamee, Sasithon
Sintasath, David
Singhasivanon, Pratap
Grietens, Koen Peeters
Whittaker, Maxine Anne
Background: Village malaria workers (VMWs) and mobile malaria workers (MMWs) are a critical component of Cambodia's national strategy to eliminate Plasmodium falciparum malaria by 2025. Since 2004, VMWs have been providing malaria diagnosis through the use of rapid diagnostic tests and free-of-charge artemisinin-based combination therapy in villages more than 5 km away from the closest health facility. They have also played a key role in the delivery of behaviour change communication interventions to this target population. This study aimed to assess the job performance of VMWs/MMWs, and identify challenges they face, which may impede elimination efforts.
Methods: A mixed-methods assessment was conducted in five provinces of western Cambodia. One hundred and eighty five VMW/MMW participants were surveyed using a structured questionnaire. Qualitative data was gathered through a total of 60 focus group discussions and 65 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis.
Results: Overall, VMWs/MMWs met or exceeded the expected performance levels (80 %). Nevertheless, some performance gaps were identified. Misconceptions regarding malaria transmission and prevention were found among workers. The recommended approach for malaria treatment, directly-observed treatment (DOT), had low implementation rates. Stock-outs, difficulties in reaching out to migrant and mobile populations, insufficient means of transportation and dwindling worker satisfaction also affected job performance.
Discussion: VMW/MMW job performance must be increased from 80 to 100 % in order to achieve elimination. In order to do this, it is recommended for the national malaria programme to eliminate worker malaria knowledge gaps. Barriers to DOT implementation and health system failures also need to be addressed. The VMW programme should be expanded on several fronts in order to tackle remaining performance gaps. Findings from this evaluation are useful to inform the planning of future activities of the programme and to improve the effectiveness of interventions in a context where artemisinin drug resistance is a significant public health issue.
BioMed Central
2016-04-20
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44243/1/44243%20Canavati%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12936-016-1322-6
Canavati, Sara E., Lawpoolsri, Saranth, Quintero, Cesia E., Nguon, Chea, Ly, Po, Pukrittayakamee, Sasithon, Sintasath, David, Singhasivanon, Pratap, Grietens, Koen Peeters, and Whittaker, Maxine Anne (2016) Village malaria worker performance key to the elimination of artemisinin-resistant malaria: a Western Cambodia health system assessment. Malaria Journal, 15. 282. pp. 1-15.
https://researchonline.jcu.edu.au/44243/
open
oai:researchonline.jcu.edu.au:44321
2019-03-04T19:31:07Z
7374617475733D707562
74797065733D626F6F6B
Disasters and Social Resilience: a bioecological approach
Boon, Helen J.
Cottrell, Alison
King, David
The interconnectedness of communities, organisations, governing bodies, policy and individuals in the field of disaster studies has never been accurately examined or comprehensively modelled. This kind of study is vital for planning policy and emergency responses and assessing individual and community vulnerability, resilience and sustainability as well as mitigation and adaptation to climate change impacts; it therefore deserves attention.
Disasters and Social Resilience fills this gap by introducing to the field of disaster studies a fresh methodology and a model for examining and measuring impacts and responses to disasters. Urie Bronfenbrenner's bioecological systems theory, which is used to look at communities holistically, is outlined and illustrated through a series of chapters, guiding the reader from the theory's underpinnings through research illustrations and applications focused on each level of Bronfenbrenner's ecosystems, culminating in an integration chapter. The final chapter provides policy recommendations for local and national government bodies and emergency providers to help individuals and communities prepare and withstand the effects of a range of disasters.
This book will be of great interest to scholars and students of disaster and emergency management, disaster readiness and risk reduction (DRR), and to scholars and students of more general climate change and sustainability studies.
Taylor & Francis
2016
Book
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44321/1/44321_Boon_etal_2016_FrontPages.pdf
https://www.routledge.com/Disasters-and-Social-Resilience-A-bioecological-approach/Boon-Cottrell-King/p/book/9781138933125
Boon, Helen J., Cottrell, Alison, and King, David (2016) Disasters and Social Resilience: a bioecological approach. Routledge Explorations in Environmental Studies . Taylor & Francis, London, UK.
https://researchonline.jcu.edu.au/44321/
open
oai:researchonline.jcu.edu.au:44339
2017-01-30T01:27:18Z
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The public health challenge of dengue fever in Papua New Guinea
Kitau, Russel
Samiak, Louis
Guldan, Georgia S.
Machine, Edwin
Dengue Fever (DF) is a mosquito-borne disease of public health concern in both tropical and subtropical countries, especially influenced by rainfall, temperature and unplanned rapid urbanization [1]. World Health Organization (WHO) member states have reported on average 2.4 million cases of DF annually over the past 5 years [1]. Even with these figures, other data suggests the number of dengue infections could be as high as 390 million annually, of which up to 96 million show clinical manifestation[1]. Global reporting has therefore not been good, and Papua New Guinea (PNG) is one of the countries that have not yet reported national DF surveillance data. DF does not feature among the leading burden of diseases reported in PNG’s National Health Plan 2011-2020, and it is not clear whether lack of reliable reporting was the reason. In 2015, DF was reported as being only rarely diagnosed and possibly having a low index of clinical suspicion in PNG. That same report further stated that dengue haemorrhagic fever (DHF) has not been reported in PNG for over a decade [2]. Three reports of the DF situation in the Western Pacific region from 2010 to 2012 state that there was no DF-specific surveillance in PNG [3-5]. However, DF's presence was verified from case importation to Queensland for which surveillance in Queensland is actively conducted [6]. DF surveillance in PNG is challenged by geographical isolation of its remote, mountainous, coastal, and island sparsely distributed and diverse rural communities [7]. This situation limits access, provision and coverage of health services. These challenges only add to those posed by DF itself, resulting in a paucity of information about its presence in PNG.
University of Papua New Guinea
2016-05
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44339/1/44339%20Kitau%20et%20al%202016.pdf
http://www.pacjmedsci.com/pjmsvol16no1may2016.htm
Kitau, Russel, Samiak, Louis, Guldan, Georgia S., and Machine, Edwin (2016) The public health challenge of dengue fever in Papua New Guinea. Pacific Journal of Medical Sciences, 16 (1). pp. 20-26.
https://researchonline.jcu.edu.au/44339/
restricted
oai:researchonline.jcu.edu.au:44456
2024-03-04T15:02:48Z
7374617475733D707562
74797065733D61727469636C65
Towards understanding the availability of physiotherapy services in rural Australia
Adams, R.
Jones, A.
Lefmann, S,
Sheppard, L.
Introduction: A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services.
Methods: A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews were recorded and transcribed verbatim, with transcripts provided to participants for review. Open-ended survey questions and interview transcripts were analysed thematically.
Results: Surveys were received from 11/25 (44%) of facilities in the investigation area, with a response rate of 29.4% (16/54) from public sector physiotherapists. A further 18 surveys were received: five from principals of private physiotherapy practices and 13 from colleagues and managers. Nineteen interviews were conducted: with 14 physiotherapists (nine public, five private), four other decision makers and one colleague. Three decision makers declined an interview. The variation in physiotherapy service availability between the 11 communities of this study prompted the researchers to consider how such variation could be reflected. The influential factors that emerged from participant comments included rurality and population, size and funding model of public hospitals, the number of public sector physiotherapists and private practices, and the availability of specialised paediatric and rehabilitation services. The factors described by participants were used to develop a conceptual framework or index of rural physiotherapy availability.
Conclusions: It is important to make explicit the link between workforce maldistribution, the resultant rural workforce shortages and the implications for local service availability. This study sought to do so by investigating physiotherapy service provision within the rural communities of the investigation area. In doing so, varying levels of availability emerged within local communities. A conceptual framework combining key influencing factors is offered as a way to reflect the availability of physiotherapy services.
Australian Rural Health Education Network
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44456/1/availablity%20of%20physio%20rural.pdf
http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=3686
Adams, R., Jones, A., Lefmann, S,, and Sheppard, L. (2016) Towards understanding the availability of physiotherapy services in rural Australia. Rural and Remote Health, 16. 3686.
https://researchonline.jcu.edu.au/44456/
open
oai:researchonline.jcu.edu.au:44526
2024-03-03T14:30:41Z
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The role of parents, parenting and the family environment in children's post-disaster mental health
Cobham, Vanessa E.
McDermott, Brett
Haslam, Divna
Sanders, Matthew R.
There is widespread support for the hypothesis that, post-disaster, children's mental health is impacted—at least in part—via the impact on parents, parenting, parent-child interactions, and the family environment. To some degree, the enthusiasm with which this hypothesis is held outstrips the evidence examining it. The current paper critically evaluates the empirical evidence for this hypothesis and concludes that although limited (both in terms of number of existing studies and methodological flaws), the extant literature indicates some parent-related variables, as well as some aspects of the family environment are likely to constitute risk or protective factors for children. Given that parenting is modifiable, it is proposed that the identified parent- and family-related factors represent important therapeutic targets, and a universal post-disaster parenting intervention (Disaster Recovery Triple P) is described.
Springer
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44526/3/44526%20%20Cobham%20et%20al%202016.pdf
http://dx.doi.org/10.1007/s11920-016-0691-4
Cobham, Vanessa E., McDermott, Brett, Haslam, Divna, and Sanders, Matthew R. (2016) The role of parents, parenting and the family environment in children's post-disaster mental health. Current Psychiatry Reports, 18 (6). 53.
https://researchonline.jcu.edu.au/44526/
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oai:researchonline.jcu.edu.au:44605
2024-03-03T14:57:50Z
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Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial
Heal, C.F.
Charles, D.
Hardy, A.
Delpachitra, M.
Banks, J.
Wohlfahrt, M.
Saednia, Sabine
Buettner, P.
Introduction: Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions.
Methods and analysis: The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance.
Ethics and dissemination: The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media.
Discussion: RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence.
BMJ Group
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44605/2/44605%20Heal%20et%20al%202016.pdf
https://doi.org/10.1136/bmjopen-2016-011604
Heal, C.F., Charles, D., Hardy, A., Delpachitra, M., Banks, J., Wohlfahrt, M., Saednia, Sabine, and Buettner, P. (2016) Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial. BMJ Open, 6 (7). e011614.
https://researchonline.jcu.edu.au/44605/
open
oai:researchonline.jcu.edu.au:44624
2024-03-01T15:01:45Z
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Primary health networks and Aboriginal and Torres Strait Islander health
Couzos, Sophia
Delaney-Thiele, Dea
Page, Priscilla
•The Australian Government has established that the health of Aboriginal and Torres Strait Islander peoples is a priority for the newly established 31 Primary Health Networks (PHNs). Efforts to reduce the high hospitalisation rates of Aboriginal people will require PHNs to build formal participatory structures with Aboriginal health organisations to support best practice service models.
•There are precedents as to how PHNs can build formal partnerships with Aboriginal community controlled health services (ACCHSs), establish an Aboriginal and Torres Strait Islander steering committee to guide strategic plan development, and work towards optimising comprehensive primary care.
•All health services within PHN boundaries can be supported to systematically and strategically improve their responsiveness to Aboriginal and Torres Strait Islander people by assessing systems of care, adopting best practice models, embedding quality assurance activity, and participating in performance reporting.
•PHNs can be guided to adopt an Aboriginal and Torres Strait Islander-specific quality improvement framework, agree to local performance measures, review specialist and other outreach services to better integrate with primary health care, enhance the cultural competence of services, and measure and respond to progress in reducing potentially preventable hospitalisations.
•Through collaborations and capacity building, PHNs can transition certain health services towards greater Aboriginal community control.
•These proposals may assist policy makers to develop organisational performance reporting on PHN efforts to close the gap in Aboriginal health disparity.
Australasian Medical Publishing Company
2016-04-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44624/1/44624_Couzos_2016.pdf
http://dx.doi.org/10.5694/mja15.00975
Couzos, Sophia, Delaney-Thiele, Dea, and Page, Priscilla (2016) Primary health networks and Aboriginal and Torres Strait Islander health. Medical Journal of Australia, 204 (6). 234-237.e1.
https://researchonline.jcu.edu.au/44624/
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oai:researchonline.jcu.edu.au:44659
2024-03-03T14:58:07Z
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Mosquito communities and disease risk influenced by land use change and seasonality in the Australian tropics
Meyer Steiger, Dagmar B.
Ritchie, Scott A.
Laurance, Susan G.W.
Background: Anthropogenic land use changes have contributed considerably to the rise of emerging and re-emerging mosquito-borne diseases. These diseases appear to be increasing as a result of the novel juxtapositions of habitats and species that can result in new interchanges of vectors, diseases and hosts. We studied whether the mosquito community structure varied between habitats and seasons and whether known disease vectors displayed habitat preferences in tropical Australia.
Methods: Using CDC model 512 traps, adult mosquitoes were sampled across an anthropogenic disturbance gradient of grassland, rainforest edge and rainforest interior habitats, in both the wet and dry seasons. Nonmetric multidimensional scaling (NMS) ordinations were applied to examine major gradients in the composition of mosquito and vector communities.
Results: We captured ~13,000 mosquitoes from 288 trap nights across four study sites. A community analysis identified 29 species from 7 genera. Even though mosquito abundance and richness were similar between the three habitats, the community composition varied significantly in response to habitat type. The mosquito community in rainforest interiors was distinctly different to the community in grasslands, whereas forest edges acted as an ecotone with shared communities from both forest interiors and grasslands. We found two community patterns that will influence disease risk at out study sites, first, that disease vectoring mosquito species occurred all year round. Secondly, that anthropogenic grasslands adjacent to rainforests may increase the probability of novel disease transmission through changes to the vector community on rainforest edges, as most disease transmitting species predominantly occurred in grasslands.
Conclusion: Our results indicate that the strong influence of anthropogenic land use change on mosquito communities could have potential implications for pathogen transmission to humans and wildlife.
BioMed Central
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44659/1/Meyer%20Steiger%20et%20al%202016%20Land%20use%20change%20and%20mosquito%20communities%20Parasites%20%26%20Vectors.pdf
http://dx.doi.org/10.1186/s13071-016-1675-2
Meyer Steiger, Dagmar B., Ritchie, Scott A., and Laurance, Susan G.W. (2016) Mosquito communities and disease risk influenced by land use change and seasonality in the Australian tropics. Parasites & Vectors, 9. pp. 387-400.
https://researchonline.jcu.edu.au/44659/
open
oai:researchonline.jcu.edu.au:44680
2024-03-03T14:59:40Z
7374617475733D707562
74797065733D61727469636C65
General practitioners' perspectives on the management of gout: a qualitative study
Jeyaruban, Andrew
Soden, Muriel
Larkins, Sarah
Background: Many quantitative studies globally have identified suboptimal management of gout.
Purpose: To explore management of gout from the perspective of general practitioners (GPs), while identifying the barriers and possible strategies for improvement.
Study design: This descriptive qualitative study used semistructured interviews with 14 purposely selected GPs from four separate general practices in Townsville. The questions focused on management strategies, practicalities in managing gout, barriers and possible strategies to improve management.
Results: Indomethacin was commonly reported to be used in acute gout with progression to allopurinol after the acute stage had subsided. There were differences with the initial allopurinol dose and follow-up periods. GPs reported lack of patient adherence to allopurinol and lifestyle modifications, mainly due to lack of education. Most suggested the need for allied health input and improved patient education.
Conclusions: Tailor-made plan in terms of education and lifestyle advice could help adherence to gout management.
BMJ Group
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44680/6/44680_Jeyaruban_etal_2016.pdf
http://dx.doi.org/10.1136/postgradmedj-2015-133920
Jeyaruban, Andrew, Soden, Muriel, and Larkins, Sarah (2016) General practitioners' perspectives on the management of gout: a qualitative study. Postgraduate Medical Journal, 92 (1092). pp. 603-607.
https://researchonline.jcu.edu.au/44680/
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oai:researchonline.jcu.edu.au:44699
2020-04-17T19:07:28Z
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The global distribution of comorbid depression and anxiety in people with diabetes mellitus: risk-adjusted estimates
Hasan, Syed Shahzad
Clavarino, Alexandra M.
Mamun, Abdulla Al
Doi, Suhail A.R.
Kairuz, Therese
Background: Previous reports suffer from the problem that they simply pooled data using aggregate means or standard meta-analytic method. The aim of the current study was to re-estimate the point prevalence of comorbid depression and anxiety in people with diabetes.
Methods: The estimates were calculated using recently introduced directly standardized effect estimate method, which gives corrected risk-adjusted estimates for the population of interests. Reported are global and regional burden of prevalence, presented as risk-adjusted prevalence estimates with 95% confidence intervals.
Results: Globally, the burden of comorbid depression was higher than the burden of anxiety (23.36% vs. 17.58%) symptoms and/or disorder in people with diabetes. There was a higher burden of comorbid depression in people living in developing regions (26.32%), in women (15.41%), and when assessed by self-report scales (SRS) (22.66%). The burden of anxiety was higher in developed regions in people with Type 2 diabetes mellitus (20.15%) and when assessed by SRS (20.75%). No statistically significant differences were observed due to gross heterogeneity across countries.
Conclusions: There are wide-ranging differences in studies in developed and developing regions, regarding the burden of comorbid depression and of anxiety among people with diabetes and both conditions affect approximately a fifth of the diabetic population.
Wolters Kluwer
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44699/1/ArchPharmaPract_2016_7_3_80_186172.pdf
http://dx.doi.org/10.4103/2045-080X.186172
Hasan, Syed Shahzad, Clavarino, Alexandra M., Mamun, Abdulla Al, Doi, Suhail A.R., and Kairuz, Therese (2016) The global distribution of comorbid depression and anxiety in people with diabetes mellitus: risk-adjusted estimates. Archives of Pharmacy Practice, 7 (3). pp. 80-86.
https://researchonline.jcu.edu.au/44699/
open
oai:researchonline.jcu.edu.au:44745
2018-03-02T18:54:21Z
7374617475733D707562
74797065733D61727469636C65
Goitre studies revisited, as a marker for schizophrenia, link diets with inadequate seafood, seaweed and protein to schizophrenia
Laupu, W.
Gaining an understanding of the aetiology of schizophrenia may influence the growing number of children being prescribed antipsychotic drugs. Urbanization features foremost in the literature, however historical documents point to malnourishment. A unique set of data has been uncovered, with the potential to broadly answer this question. Goitre studies, preceding treatment with antipsychotic drugs, acted as a marker for schizophrenia. A review of these studies enabled environmental, public health and dietary variables to be compared between populations in mental hospitals (control) and the rest of New Zealand. Mineral deficiencies in soils enter the food chain through vegetables. In areas of depleted soil mineralization, inadequate diets were present amongst some New Zealanders; relative to those in mental hospitals. Dietary minerals are imperative for enabling the antioxidant defence system to counter stress and maintain neuronal health. The highest concentrations of these minerals, which are required for thyroid hormone production and antioxidant defences, are present in seafood, seaweed, proteins. Here we discuss the relevance of this finding to neuropathology at onset, first episode of psychosis, the prevalence and incidence of schizophrenia and affective disorders. Further work educating stakeholders of the need to eat for brain health would be beneficial for our children.
British Journal of Medical and Health Research
2016-06
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44745/1/44745_Laupu_2016.pdf
http://www.bjmhr.com/show_script.php?volume=3&issue=6&month=June#
Laupu, W. (2016) Goitre studies revisited, as a marker for schizophrenia, link diets with inadequate seafood, seaweed and protein to schizophrenia. British Journal Of Medical and Health Research, 3 (6). pp. 35-49.
https://researchonline.jcu.edu.au/44745/
openpub
oai:researchonline.jcu.edu.au:44767
2024-03-02T15:15:47Z
7374617475733D707562
74797065733D61727469636C65
Mapping the Zambian prison health system: an analysis of key structural determinants
Topp, Stephanie M.
Moonga, Clement N.
Luo, Nkandu
Kaingu, Michael
Chileshe, Chisela
Magwende, George
Henostroza, German
Health and health service access in Zambian prisons are in a state of 'chronic emergency'. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n = 7), memos generated during workshops (n = 4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.
Taylor & Francis Group
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44767/1/44767_Topp%20et%20al_2017.pdf
http://dx.doi.org/10.1080/17441692.2016.1202298
Topp, Stephanie M., Moonga, Clement N., Luo, Nkandu, Kaingu, Michael, Chileshe, Chisela, Magwende, George, and Henostroza, German (2017) Mapping the Zambian prison health system: an analysis of key structural determinants. Global Public Health, 12 (7). pp. 858-475.
https://researchonline.jcu.edu.au/44767/
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oai:researchonline.jcu.edu.au:44856
2024-03-03T14:59:43Z
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Systematic review of youth mental health service integration research
Kinchin, Irina
Tsey, Komla
Heyeres, Marion
Cadet-James, Yvonne
Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998-2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12-25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.
CSIRO Publishing
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44856/6/44856%20Kinchin%20et%20al%202016.pdf
http://dx.doi.org/10.1071/PY15114
Kinchin, Irina, Tsey, Komla, Heyeres, Marion, and Cadet-James, Yvonne (2016) Systematic review of youth mental health service integration research. Australian Journal of Primary Health, 22 (4). pp. 304-315.
https://researchonline.jcu.edu.au/44856/
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oai:researchonline.jcu.edu.au:44862
2020-04-17T19:07:52Z
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74797065733D61727469636C65
Seeking to understand: using generic qualitative research to explore access to medicines and pharmacy services among resettled refugees
Bellamy, Kim
Ostini, Remo
Martini, Nataly
Kairuz, Therese
Introduction: There are challenges associated with selecting a qualitative research approach. In a field abundant with terminology and theories, it may be difficult for a pharmacist to know where and how to begin a qualitative research journey. The purpose of this paper is to provide insight into generic qualitative research and to describe the journey of data collection of a novice qualitative researcher in the quest to answer her research question: 'What are the barriers to accessing medicines and pharmacy services for resettled refugees in Queensland, Australia?'
Methodology: Generic qualitative research draws on the strengths of one or more qualitative approaches. The aim is to draw out participants' ideas about things that are 'outside themselves'; rather than focussing on their inner feelings the research seeks to understand a phenomenon, a process, or the perspectives of participants. Sampling is designed to obtain a broad range of opinions about events and experiences and data collection includes interviews, questionnaires or surveys; thematic analysis is often used to analyse data.
When to use: Generic qualitative research provides an opportunity to develop research designs that fit researchers' epistemological stance and discipline, with research choices, including methodology and methods, being informed by the research question.
Limitations: Generic qualitative research is one of many methodologies that may be used to answer a research question and there is a paucity of literature about how to do it well. There is also debate about its validity as a qualitative methodology.
Springer
2016-06
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44862/1/Bellamy%20et%20al_2016_%20Seeking%20to%20understadn%20IJCP_38_3_671-5.pdf
http://dx.doi.org/10.1007/s11096-016-0261-1
Bellamy, Kim, Ostini, Remo, Martini, Nataly, and Kairuz, Therese (2016) Seeking to understand: using generic qualitative research to explore access to medicines and pharmacy services among resettled refugees. International Journal of Clinical Pharmacy, 38 (3). pp. 671-675.
https://researchonline.jcu.edu.au/44862/
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oai:researchonline.jcu.edu.au:44865
2024-02-28T14:44:30Z
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Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes
Hasan, Syed
Thiruchelvam, Kaeshaelya
Ahmed, Syed Imran
Clavarino, Alexandra M.
Mamun, Abdulla A.
Kairuz, Therese
Anxiety and depression are more common among females and those experiencing diabetes and menopause. Menopausal symptoms experienced by women can vary tremendously from population to population; therefore, there is a need to investigate these symptoms and associated risk factors in different communities. This study investigated the differences in psychological health and menopause-specific quality of life (MENQOL) between women with and without diabetes type 2 (T2DM) in Malaysia. Women with T2DM (n = 320) were matched by age range to controls without T2DM (n = 320). Data were collected from March 2012 to January 2013. Delusions Symptoms States Inventory (DSSI) instrument was used to identify symptoms of depression and anxiety. Women with diabetes had higher depressive (11.8% versus 8.4%) and anxiety (8.4% versus 6.6%) symptoms compared to women without diabetes. In both groups, the most common menopausal symptom was aches (muscles and joints). Women without diabetes had significantly higher scores for the sexual domain compared to women with diabetes (4.20 versus 3.21, p = 0.001). The odds that a postmenopausal woman with diabetes was depressed or anxious on the DSSI scale increased significantly when the MENQOL score on the physical, vasomotor, and psychosocial domains increased by one unit. Both diabetes and psychological problems have negative impact on MENQOL. Our findings support the view of screening postmenopausal women with diabetes for depressive and anxiety, to improve overall quality of life.
Elsevier
2016-10
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44865/1/Hasan_Psychological%20health_menopause_QOL_Asian%20J%20Psych_2016.pdf
http://dx.doi.org/10.1016/j.ajp.2016.07.005
Hasan, Syed, Thiruchelvam, Kaeshaelya, Ahmed, Syed Imran, Clavarino, Alexandra M., Mamun, Abdulla A., and Kairuz, Therese (2016) Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes. Asian Journal of Psychiatry, 23. pp. 56-63.
https://researchonline.jcu.edu.au/44865/
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oai:researchonline.jcu.edu.au:44882
2024-03-03T14:59:43Z
7374617475733D707562
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Getting over the shock: taking action on Indigenous maternal smoking
Gould, Gillian S.
Cadet-James, Yvonne
Clough, Alan R.
Smoking rates are slow to decline among pregnant Indigenous women. One in two pregnant Indigenous Australian women is a tobacco smoker compared with one in eight in the non-Indigenous population. The National Close the Gap strategy ambitiously aims to reduce Indigenous smoking prevalence to half by 2018, but this goal is unlikely to be achieved. Evidence is growing to better inform targeted strategies for Indigenous pregnant women based on national and international studies. It is proposed to be an appropriate time to refine translational approaches for anti-tobacco messages and cessation support in this population, rather than waiting for further empirical research before making these essential changes. Systemic barriers to Indigenous pregnant women receiving equitable primary health care have been identified, are remediable, and urgently require addressing. These barriers include: (1) lack of subsidised access to suitable oral forms of nicotine replacement therapy; (2) lack of clinician training in the complex area of management of maternal Indigenous smoking; and (3) lack of targeted health promotion programs addressing the psychosocial challenges that Indigenous women face. In the interim, translational strategies to target tobacco control and cessation in pregnant Indigenous women need to be based on current evidence.
CSIRO Publishing
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44882/6/44882%20Gould%20et%20al%202016.pdf
http://dx.doi.org/10.1071/PY15066
Gould, Gillian S., Cadet-James, Yvonne, and Clough, Alan R. (2016) Getting over the shock: taking action on Indigenous maternal smoking. Australian Journal of Primary Health, 22 (4). pp. 276-282.
https://researchonline.jcu.edu.au/44882/
open
oai:researchonline.jcu.edu.au:44914
2024-03-02T15:17:15Z
7374617475733D707562
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Depression and diabetes in the remote Torres Strait Islands
Taylor, Sean
McDermott, Robyn
Thompson, Fintan
Usher, Kim
Issue addressed: Diabetes is associated with significant depression, which can result in poorer clinical outcomes, including increased mortality. Little is known about the prevalence of depression among Torres Strait Islander adults with diabetes.
Methods: Self-reported depression was measured using the Patient Health Questionnaire (PHQ)-9 translated into Torres Strait Creole, and associations with socioeconomic, behavioural and clinical indicators in Torres Strait Islander adults with diabetes in five remote Torres Strait Islands were examined.
Results: Seventy-three men and 115 women completed interviews. The median PHQ-9 score was 5.5 (IQR 0–7); 42% of respondents scored 0–4 (none–minimal), 46% scored 5–9 (mild) and 12% scored 10+ (moderate–severe). Mean HbA1c was 8.3% (67.4 mmol). HbA1c was not related to PHQ-9 scores (β = 0.20, P = 0.323), however exercise in hours (β = –0.34, P < 0.001) and screen time in hours (β = 0.11, P < 0.001) were significant predictors of depression after adjusting for other study variables.
Conclusions: This sample of remote living Torres Strait Islanders reported relatively low rates of depression compared with national samples, and depression was not related to glycaemic control. Exercise and screen time were the strongest predictors of depression based on PHQ-9 scores. This represents an opportunity for health promotion.
So what?: These findings provide an indication of the health impact of physical activity in rural and remote communities. Local health and education services, councils and sporting bodies should work collaboratively to promote sustainable physical activity programs.
CSIRO Publishing
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/44914/1/44914_Taylor%20et%20al_2017.pdf
http://dx.doi.org/10.1071/HE15118
Taylor, Sean, McDermott, Robyn, Thompson, Fintan, and Usher, Kim (2017) Depression and diabetes in the remote Torres Strait Islands. Health Promotion Journal of Australia, 28. pp. 59-66.
https://researchonline.jcu.edu.au/44914/
restricted
oai:researchonline.jcu.edu.au:45048
2024-03-03T15:00:57Z
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74797065733D61727469636C65
Etiologic predictive value of a rapid immunoassay for the detection of group A Streptococcus antigen from throat swabs in patients presenting with a sore throat
Orda, Ulrich
Gunnarsson, Ronny
Orda, Sabine
Fitzgerald, Mark
Rofe, Geoff
Dargan, Anna
Background: Clinical reasoning utilizing certain symptoms and scores has not proven to be a reliable decision-making tool to determine whether or not to suspect a group A Streptococcus (GAS) infection in the patient presenting with a sore throat. Culture as the so-called 'gold standard' is impracticable because it takes 1 to 2 days (and even longer in remote locations) for a result, and thus treatment decisions will be made without the result available. Rapid diagnostic antigen tests have demonstrated sufficient sensitivities and specificities in detecting GAS antigens to identify GAS throat infections.
Methods: Throat swab samples were collected from patients attending the Mount Isa Hospital emergency department for a sore throat; these samples were compared to swab samples collected from healthy controls who did not have a sore throat. Both groups were aged 3–15 years. All swab samples were analyzed with a point-of-care test (Alere Test Pack +Plus with OBC Strep A). The etiologic predictive value (EPV) of the throat swab was calculated.
Results: The 95% confidence interval for positive EPV was 88–100% and for negative EPV was 97–99%, depending on assumptions made.
Conclusion: This study demonstrates that the point-of-care test Alere Test Pack +Plus Strep A has a high positive predictive value and is able to rule in GAS infection as long as the proportion of carriers is low. Also the negative predictive value for ruling out GAS as the etiologic agent is very high irrespective of the carrier rate. Hence, this test is always useful to rule out GAS infection.
Elsevier
2016-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45048/1/2016%20---%20Orda%20-%20EPV.pdf
http://dx.doi.org/10.1016/j.ijid.2016.02.002
Orda, Ulrich, Gunnarsson, Ronny, Orda, Sabine, Fitzgerald, Mark, Rofe, Geoff, and Dargan, Anna (2016) Etiologic predictive value of a rapid immunoassay for the detection of group A Streptococcus antigen from throat swabs in patients presenting with a sore throat. International Journal of Infectious Diseases, 45. pp. 32-35.
https://researchonline.jcu.edu.au/45048/
open
oai:researchonline.jcu.edu.au:45171
2024-03-03T14:31:08Z
7374617475733D707562
74797065733D61727469636C65
Breaking bad news in ethnic settings: perspectives of patients and families in Northern Sri Lanka
Rajasooriyar, Chrishanthi
Kelly, Jenny
Sivakumar, Thanikai
Navanesan, Gowcikan
Nadarasa, Shahini
Sriskandarajah, Madona Hashanthy
Sabesan, Sabe
Purpose: The discussion of a cancer diagnosis and prognosis often is difficult. This study explored the expectations of Tamil-speaking patients with cancer and their families with respect to receiving their cancer diagnosis in northern Sri Lanka.
Methods: This exploratory, descriptive, qualitative study used semistructured interviews.
Results: Thematic analysis identified two major themes: communication and information seeking. The findings illustrate a discrepancy between patient preference for direct disclosure of the diagnosis and that of families. Ninety-five percent of patients wanted medical staff to disclose their cancer diagnosis, whereas only 45% of family members believed that the diagnosis should be disclosed to the patient rather than to the family.
Conclusion: Although patients and their family members' views and expectations of the disclosure of diagnosis and prognosis differ, a majority of patients want to be told directly about their diagnosis rather than to learn of it from a relative. The findings are similar to the literature on other ethnic groups from Sri Lanka and studies from English-speaking developed countries. Therefore, the main questions are how to educate families and physicians about the benefits of open disclosure to patients and how to change culture. Results of this study along with a previous study call for the development of strategies and guidelines to improve societal views, educate patients and families, and train health professionals in the area of breaking bad news and discussing prognosis in the Sri Lankan setting.
American Society of Clinical Oncology
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45171/1/45171%20Rajasooriyar%20et%20al%202017.pdf
http://dx.doi.org/10.1200/JGO.2016.005355
Rajasooriyar, Chrishanthi, Kelly, Jenny, Sivakumar, Thanikai, Navanesan, Gowcikan, Nadarasa, Shahini, Sriskandarajah, Madona Hashanthy, and Sabesan, Sabe (2017) Breaking bad news in ethnic settings: perspectives of patients and families in Northern Sri Lanka. Journal of Global Oncology, 3 (3). pp. 250-256.
https://researchonline.jcu.edu.au/45171/
open
oai:researchonline.jcu.edu.au:45188
2024-02-27T15:08:12Z
7374617475733D707562
74797065733D61727469636C65
Quality assurance of the university medical education, hospital services and traditional pharmaceutical products of the Bhutanese So-wa-rig-pa health care system
Wangchuk, Phurpa
Tashi,
Background: The Bhutanese So-wa-rig-pa medicine (BSM) was integrated with the allopathic (modern) health care system in 1967. Ever since the health care integration policy was implemented, the BSM has gone through many phases of quality improvement and changes including the establishment of one university-based institute, 58 hospitals and Basic Health Units (BHU)-based health care services, and one traditional medicine factory. The BSM provides primary health care services to more than 20–30 % of patients who visit hospitals and BHU on a daily basis. However, there has been no study covering the quality assurance system of BSM. Our paper addresses this information gap.
Methods: This study was an observational ethnographic study supported by phenomenological understanding and content analysis of the data. The information was triangulated through consultation with the BSM practitioners (discussion (N = 8)) and personalized in-depth question-answer sessions using electronic protocols (N = 5). These participants comprised BSM educationists, clinical physicians, researchers, production and the quality assurance staff who were selected using convenience and purposive sampling method. The relevant So-wa-rig-pa information and literature were obtained from the government policy documents, official websites, scientific papers and the traditional medical texts. This study is enhanced by our practical observations and first-hand experience with BSM while working as the researchers at the Ministry of Health in Bhutan. In addition, the information in this paper is crosschecked and authenticated by five So-wa-rig-pa practitioners of Bhutan.
Results: The study highlights the following: a) The BSM receives both the government and people's support, b) The quality assurance system have been developed by integrating the traditional empirical knowledge and modern scientific protocols, c) There exist three administrative and functional organizations responsible for providing the quality BSM health care services in Bhutan, d) Extensive standard treatment guidelines and Quality documentation system exist for BSM as required by the regulatory bodies in Bhutan. The paper also recommends appropriate future directions for BSM.
Conclusions: The BSM plays significant role in the primary health care system of the country. Consequently, the quality, safety and efficacy of BSM has been given priority by the Bhutan government. Many scientific protocols were integrated with the traditional quality approaches and further scientific studies are still required to improve its quality.
BioMed Central
2016-08-12
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45188/1/45188_Wangchuk_2016.pdf
http://dx.doi.org/10.1186/s12906-016-1270-2
Wangchuk, Phurpa, and Tashi, (2016) Quality assurance of the university medical education, hospital services and traditional pharmaceutical products of the Bhutanese So-wa-rig-pa health care system. BMC Complementary and Alternative Medicine, 16. 283. pp. 1-18.
https://researchonline.jcu.edu.au/45188/
open
oai:researchonline.jcu.edu.au:45257
2018-02-13T02:20:05Z
7374617475733D707562
74797065733D61727469636C65
Emerging therapeutic potential of nanoparticles in pancreatic cancer: a systematic review of clinical trials
Au, Minnie
Emeto, Theophilus I.
Power, Jacinta
Vangaveti, Venkat N.
Lai, Hock C.
Pancreatic cancer is an aggressive disease with a five year survival rate of less than 5%, which is associated with late presentation. In recent years, research into nanomedicine and the use of nanoparticles as therapeutic agents for cancers has increased. This article describes the latest developments in the use of nanoparticles, and evaluates the risks and benefits of nanoparticles as an emerging therapy for pancreatic cancer. The Preferred Reporting Items of Systematic Reviews and Meta-Analyses checklist was used. Studies were extracted by searching the Embase, MEDLINE, SCOPUS, Web of Science, and Cochrane Library databases from inception to 18 March 2016 with no language restrictions. Clinical trials involving the use of nanoparticles as a therapeutic or prognostic option in patients with pancreatic cancer were considered. Selected studies were evaluated using the Jadad score for randomised control trials and the Therapy CA Worksheet for intervention studies. Of the 210 articles found, 10 clinical trials including one randomised control trial and nine phase I/II clinical trials met the inclusion criteria and were analysed. These studies demonstrated that nanoparticles can be used in conjunction with chemotherapeutic agents increasing their efficacy whilst reducing their toxicity. Increased efficacy of treatment with nanoparticles may improve the clinical outcomes and quality of life in patients with pancreatic cancer, although the long-term side effects are yet to be defined. The study registration number is CRD42015020009.
MDPI
2016-08-19
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45257/2/biomedicines-04-00020-1.pdf
http://www.mdpi.com/2227-9059/4/3/20
Au, Minnie, Emeto, Theophilus I., Power, Jacinta, Vangaveti, Venkat N., and Lai, Hock C. (2016) Emerging therapeutic potential of nanoparticles in pancreatic cancer: a systematic review of clinical trials. Biomedicines, 4 (3). 20. pp. 1-20.
https://researchonline.jcu.edu.au/45257/
open
oai:researchonline.jcu.edu.au:45275
2024-03-02T15:17:52Z
7374617475733D707562
74797065733D61727469636C65
Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland
Evans, Rebecca
Larkins, Sarah
Cheffins, Tracy
Fleming, Rhonda
Johnston, Karen
Tennant, Marc
Australia has seen a significant increase in people aged over 65 years accessing general practice services over the last decade. Although people aged 65 years and over comprise 14% of the total population, this age demographic accounts for the largest proportion of general practitioner (GP)–patient encounters. Access to general practice is important for older Australians as the burden of chronic disease increases with age. A geographic information system, ArcGIS, was used to assess geographic access to general practice for older people residing in the regional Queensland towns of Mackay, Townsville and Cairns. Geographic units with high proportions of over 65-year-old people were spatially analysed in relation to proximity to geomapped general practices with a 2-km buffer zone. Modelling of changes in access was performed with the strategic location of a new general practice where gaps existed. Geographic access to general practice for the older population was poorest in Cairns despite a high population density. Addition of a single, strategically placed general practice in Cairns markedly improved access. Socioeconomic analysis suggested that general practices were appropriately located in areas of greatest need. Geographic information systems provide a means to map population characteristics against service locations to assist in strategic development and location of future health services.
CSIRO Publishing
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45275/6/45275_Evans%20et%20al_2016_accepted%20version_final.pdf
application/pdf
https://researchonline.jcu.edu.au/45275/1/45275_Evans%20et%20al_2016.pdf
http://dx.doi.org/10.1071/PY15175
Evans, Rebecca, Larkins, Sarah, Cheffins, Tracy, Fleming, Rhonda, Johnston, Karen, and Tennant, Marc (2017) Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland. Australian Journal of Primary Health, 23 (2). pp. 114-122.
https://researchonline.jcu.edu.au/45275/
open
oai:researchonline.jcu.edu.au:45283
2024-03-03T14:57:32Z
7374617475733D707562
74797065733D61727469636C65
Defining, describing, and categorizing public health infrastructure priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters
Ryan, Benjamin J.
Franklin, Richard C.
Burkle, Frederick M.
Watt, Kerrianne
Aitken, Peter
Smith, Erin C.
Leggat, Peter
Objectives: The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters.
Methods: Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of individual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency.
Results: Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surveillance.
Conclusions: This review identified workforce as the most important of the 13 thematic areas related to PHI and disasters. If its functionality fails, workforce has the greatest impact on the performance of health services. If addressed post-disaster, the remaining forms of PHI will then be progressively addressed. These findings are a step toward providing an evidence base to inform PHI priorities in the disaster setting.
Cambridge University Press
2016-08
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45283/1/45283_Watt_2016.pdf
http://dx.doi.org/10.1017/dmp.2016.3
Ryan, Benjamin J., Franklin, Richard C., Burkle, Frederick M., Watt, Kerrianne, Aitken, Peter, Smith, Erin C., and Leggat, Peter (2016) Defining, describing, and categorizing public health infrastructure priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters. Disaster Medicine and Public Health Preparedness, 10 (4). pp. 598-610.
https://researchonline.jcu.edu.au/45283/
restricted
oai:researchonline.jcu.edu.au:45360
2024-03-02T15:18:39Z
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74797065733D61727469636C65
Adherence to secondary prophylaxis for acute rheumatic fever and rheumatic heart disease: a systematic review
Kevat, Priya Minaxi
Reeves, Benjamin M.
Ruben, Alan R.
Gunnarsson, Ronny
Background: Optimal delivery of regular benzathine penicillin G (BPG) injections prescribed as secondary prophylaxis for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) is vital to preventing disease morbidity and cardiac sequelae in affected pediatric and young adult populations. However, poor uptake of secondary prophylaxis remains a significant challenge to ARF/RHD control programs.
Objective: In order to facilitate better understanding of this challenge and thereby identify means to improve service delivery, this systematic literature review explored rates of adherence and factors associated with adherence to secondary prophylaxis for ARF and RHD worldwide.
Methods: MEDLINE was searched for relevant primary studies published in the English language from 1994-2014, and a search of reference lists of eligible articles was performed. The methodological quality of included studies was evaluated using a modified assessment tool. Results: Twenty studies were included in the review. There was a range of adherence to varying regimens of secondary prophylaxis reported globally, and a number of patient demographic, clinical, socio-cultural and health care service delivery factors associated with adherence to secondary prophylaxis were identified.
Conclusion: Insights into factors associated with lower and higher adherence to secondary prophylaxis may be utilized to facilitate improved delivery of secondary prophylaxis for ARF and RHD. Strategies may include ensuring an effective active recall system, providing holistic care, involving community health workers and delivering ARF/RHD health education.
Bentham Science
2017-07
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45360/1/45360_Kevat%20et%20al_2017_accepted.pdf
http://dx.doi.org/10.2174/1573403X13666170116120828
Kevat, Priya Minaxi, Reeves, Benjamin M., Ruben, Alan R., and Gunnarsson, Ronny (2017) Adherence to secondary prophylaxis for acute rheumatic fever and rheumatic heart disease: a systematic review. Current Cardiology Reviews, 13 (2). pp. 155-166.
https://researchonline.jcu.edu.au/45360/
open
oai:researchonline.jcu.edu.au:45520
2024-03-01T14:40:17Z
7374617475733D707562
74797065733D61727469636C65
Facing the times: a young onset dementia support group: Facebook™ style
Craig, Denise
Strivens, Edward
Young onset dementia accounts for up to 1 in 10 dementia diagnoses. Those diagnosed face premature transition into the realm of aged care services and adjustment to an illness of ageing prior to age 65. To help elicit communication of the perceived psychosocial needs of this group, provide a platform to gain peer support and advocate for increased awareness, the Young Onset Dementia Support Group was established on the social networking site, Facebook™. Followers post comments, read educational or otherwise interesting news feeds, share inspirational quotes and access others living with dementia worldwide. Facebook provides a means of rapid global reach in a way that allows people with dementia to increase their communications and potentially reduce isolation. This paper was authored by the page administrators. We aim to highlight the promising utility of a social network platform just entering its stride amongst health communication initiatives.
Wiley-Blackwell
2016-03
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45520/1/45520-Craig-and-Strivens-2016.pdf
http://dx.doi.org/10.1111/ajag.12264
Craig, Denise, and Strivens, Edward (2016) Facing the times: a young onset dementia support group: Facebook™ style. Australasian Journal on Ageing, 35 (1). pp. 48-53.
https://researchonline.jcu.edu.au/45520/
restricted
oai:researchonline.jcu.edu.au:45523
2024-03-03T14:16:11Z
7374617475733D707562
74797065733D61727469636C65
Living through a volcanic eruption: understanding the experience of survivors as a phenomenological existential phenomenon
Warsini, Sri
Mills, Jane
West, Caryn
Usher, Kim
Mount Merapi in Indonesia is the most active volcano in the world with its 4-6-year eruption cycle. The mountain and surrounding areas are populated by hundreds of thousands of people who live near the volcano despite the danger posed to their wellbeing. The aim of this study was to explore the lived experience of people who survived the most recent eruption of Mount Merapi, which took place in 2010. Investigators conducted interviews with 20 participants to generate textual data that were coded and themed. Three themes linked to the phenomenological existential experience (temporality and relationality) of living through a volcanic eruption emerged from the data. These themes were: connectivity, disconnection and reconnection. Results indicate that the close relationship individuals have with Mount Merapi and others in their neighbourhood outweighs the risk of living in the shadow of an active volcano. This is the first study to analyze the phenomenological existential elements of living through a volcanic eruption.
Wiley-Blackwell
2016-06
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45523/1/45523_West_2016.pdf
http://dx.doi.org/10.1111/inm.12212
Warsini, Sri, Mills, Jane, West, Caryn, and Usher, Kim (2016) Living through a volcanic eruption: understanding the experience of survivors as a phenomenological existential phenomenon. International Journal of Mental Health Nursing, 25 (3). pp. 206-213.
https://researchonline.jcu.edu.au/45523/
restricted
oai:researchonline.jcu.edu.au:45558
2024-03-04T15:18:34Z
7374617475733D707562
74797065733D61727469636C65
Barriers around access to abortion experienced by rural women in New South Wales, Australia
Doran, F.M.
Hornibrook, J.
Introduction: Little is known about Australian rural women's overall experiences of accessing an abortion service and the barriers they encounter. Approximately one in three Australian women access an abortion at some time in their lives. Most abortions are undertaken during the first trimester of pregnancy in private clinics. Although both medical and surgical abortions are uncomplicated medical procedures, abortion remains a contentious area of women's health. Whilst it is clear that rural women experience disparities in relation to access to health care, there is a gap in the evidence on rural women's experiences of accessing an abortion. The aim of the present study was to identify factors that women in rural New South Wales (NSW) experience in accessing abortion services and suggestions about how rural women could be better supported when seeking access to an abortion service.
Methods: In-depth qualitative interviews were undertaken with rural women living in NSW who had had an abortion in the previous 1 5 years. Participants self-selected for a phone or face-to-face interview, in response to promotion of the study through women's services, community flyers and press releases.
Results: Rural women in this study experienced many barriers to accessing an abortion. Women travelled 1-9 hours one way to access an abortion in clinics. Several women borrowed money for the abortion fee. Five themes were identified: finding information about the provider; stigma, shame and secrecy; logistics involved in accessing the clinic related to travel, money and support; medical and surgical abortion; and ways rural women could be better supported in this process. Suggestions to improve rural women's access to abortion services included more affordable services that were 'closer to home' as a way to reduce travel and cost, and to normalise abortion as a women's health rights issue.
Conclusions: Despite welcome legal and pharmaceutical reform in Australia, results from this small study indicate that there is a long way to go remove barriers on issues rural women experience in their process of accessing reproductive care, including the pervasiveness of abortion stigma. Services closer to home may help reduce inequities in access to health care experienced by rural women. Strategies such as broader use of tele-health and willingness of general practitioners to become authorised prescribers for medical abortions could help to reduce long distances to travel to services and the financial burden experienced by rural women.
Deakin University Press
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45558/1/45558%20Doran%20and%20Hornibrook%202016.pdf
http://www.rrh.org.au/articles/showarticlenew.asp?ArticleID=3538
Doran, F.M., and Hornibrook, J. (2016) Barriers around access to abortion experienced by rural women in New South Wales, Australia. Rural and Remote Health, 16 (1). pp. 1-12.
https://researchonline.jcu.edu.au/45558/
open
oai:researchonline.jcu.edu.au:45652
2024-03-03T14:27:06Z
7374617475733D707562
74797065733D61727469636C65
The supportive care needs of parents with a child with a rare disease: results of an online survey
Pelentsov, Lemuel J.
Fielder, Andrea L.
Laws, Thomas A.
Esterman, Adrian J.
Background: Parents caring for a child affected by a rare disease have unmet needs, the origins of which are complex and varied. Our aim was to determine the supportive care needs of parents caring for a child with a rare disease.
Methods: An online survey was developed consisting of 45 questions (108 items) and separated into six domains. The survey included questions about perceived level of satisfaction with receiving care, experiences and needs of providing daily care, the impacts of disease on relationships, the emotional and psychological burdens of disease, and parents overall satisfaction with the support received.
Results: Three-hundred and one parents from Australia and New Zealand completed the survey; 91 % (n = 275/301) were mothers, with 132 distinct rare diseases being reported. Fifty-four percent (n = 140/259) of parents were dissatisfied with health professionals' level of knowledge and awareness of disease; 71 % (n = 130/183) of parents felt they received less support compared to other parents. Information regarding present (60 %, n = 146/240) and future services (72 %, n = 174/240) available for their child were considered important. Almost half of parents (45 %, n = 106/236) struggled financially, 38 % (n = 99/236) reduced their working hours and 34 % (n = 79/236) ceased paid employment. Forty-two percent (n = 99/223) of parents had no access to a disease specific support group, and 58 % (n = 134/230) stated that their number of friends had reduced since the birth of their child; 75 % (n = 173/230) had no contact with other parents with a child with a similar disease, and 46 % (n = 106/230) reported feeling socially isolated and desperately lonely. Most frequent emotions expressed by parents in the week prior to completing the survey were anxiety and fear (53 %, n = 119/223), anger and frustration (46 %, n = 103/223) and uncertainty (39 %, n = 88/223).
Conclusion: This study is the first to develop an online survey specifically for use with parents to investigate their supportive care needs across a large and diverse group of rare diseases. The findings highlight that parents with a child with a rare disease have common unmet needs regardless of what disease their child has. Such information may allow health providers to improve child outcomes through improving parental supportive care.
BioMed Central
2016-07-21
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45652/1/45652_Esterman_2016.pdf
http://dx.doi.org/10.1186/s12875-016-0488-x
Pelentsov, Lemuel J., Fielder, Andrea L., Laws, Thomas A., and Esterman, Adrian J. (2016) The supportive care needs of parents with a child with a rare disease: results of an online survey. BMC Family Practice, 17 (88). pp. 1-13.
https://researchonline.jcu.edu.au/45652/
open
oai:researchonline.jcu.edu.au:45772
2024-03-03T14:59:53Z
7374617475733D707562
74797065733D61727469636C65
Assessment of local mosquito species incriminates Aedes aegypti as the potential vector of zika virus in Australia
Hall-Mendelin, Sonja
Pyke, Alyssa T.
Moore, Peter R.
Mackay, Ian M.
McMahon, Jamie L.
Ritchie, Scott A.
Taylor, Carmel T.
Moore, Frederick A.J.
van den Hurk, Andrew F.
Background: Within the last 10 years Zika virus (ZIKV) has caused unprecedented epidemics of human disease in the nations and territories of the western Pacific and South America, and continues to escalate in both endemic and non-endemic regions. We evaluated the vector competence of Australian mosquitoes for ZIKV to assess their potential role in virus transmission.
Methodology/Principal Findings: Mosquitoes were exposed to infectious blood meals containing the prototype African ZIKV strain. After 14 days incubation at 28°C and high relative humidity, infection, dissemination and transmission rates were assessed. Infection in Culex annulirostris and Cx. sitiens could not be detected. 8% of Cx. quinquefasciatus were infected, but the virus did not disseminate in this species. Despite having infection rates > 50%, Aedes notoscriptus and Ae. vigilax did not transmit ZIKV. In contrast, Ae. aegypti had infection and transmission rates of 57% and 27%, respectively. In susceptibility trials, the virus dose required to infect 50% (ID₅₀) of Ae. aegypti was10⁶.⁴ tissue culture infectious dose₅₀ (TCID₅₀)/mL. Additionally, a threshold viral load within the mosquito of at least 10⁵.¹ TCID₅₀ equivalents/mL had to be reached before virus transmission occurred.
Conclusions/Significance: We confirmed Ae. aegypti to be the most likely mosquito vector of ZIKV in Australia, although the restricted distribution of this species will limit the receptive zone to northern Queensland where this species occurs. Importantly, the role in ZIKV transmission of Culex and other Aedes spp. tested will be negligible. Despite being the implicated vector, the relatively high ID₅₀ and need for a high titer disseminated infection in Ae. aegypti suggest that high mosquito population densities will be required to facilitate epidemic ZIKV transmission among the currently immunologically naïve human population in Australia.
Public Library of Science
2016-09-19
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45772/1/45772_Ritchie_2016.pdf
http://dx.doi.org/10.1371/journal.pntd.0004959
Hall-Mendelin, Sonja, Pyke, Alyssa T., Moore, Peter R., Mackay, Ian M., McMahon, Jamie L., Ritchie, Scott A., Taylor, Carmel T., Moore, Frederick A.J., and van den Hurk, Andrew F. (2016) Assessment of local mosquito species incriminates Aedes aegypti as the potential vector of zika virus in Australia. PLoS Neglected Tropical Diseases, 10 (9). e0004959. pp. 1-14.
https://researchonline.jcu.edu.au/45772/
open
oai:researchonline.jcu.edu.au:45774
2024-03-03T14:59:56Z
7374617475733D707562
74797065733D61727469636C65
Public health responses to and challenges for the control of dengue transmission in high-income countries: four case studies
Viennet, Elvina
Ritchie, Scott A.
Williams, Craig R.
Faddy, Helen M.
Harley, David
Dengue has a negative impact in low- and lower middle-income countries, but also affects upper middle- and high-income countries. Despite the efforts at controlling this disease, it is unclear why dengue remains an issue in affluent countries. A better understanding of dengue epidemiology and its burden, and those of chikungunya virus and Zika virus which share vectors with dengue, is required to prevent the emergence of these diseases in high-income countries in the future. The purpose of this review was to assess the relative burden of dengue in four high-income countries and to appraise the similarities and differences in dengue transmission. We searched PubMed, ISI Web of Science, and Google Scholar using specific keywords for articles published up to 05 May 2016. We found that outbreaks rarely occur where only Aedes albopictus is present. The main similarities between countries uncovered by our review are the proximity to dengue-endemic countries, the presence of a competent mosquito vector, a largely nonimmune population, and a lack of citizens’ engagement in control of mosquito breeding. We identified important epidemiological and environmental issues including the increase of local transmission despite control efforts, population growth, difficulty locating larval sites, and increased human mobility from neighboring endemic countries. Budget cuts in health and lack of practical vaccines contribute to an increased risk. To be successful, dengue-control programs for high-income countries must consider the epidemiology of dengue in other countries and use this information to minimize virus importation, improve the control of the cryptic larval habitat, and engage the community in reducing vector breeding. Finally, the presence of a communicable disease center is critical for managing and reducing future disease risks.
Public Library of Science
2016-09-19
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45774/1/45774_Ritchie_2016.pdf
http://dx.doi.org/10.1371/journal.pntd.0004943
Viennet, Elvina, Ritchie, Scott A., Williams, Craig R., Faddy, Helen M., and Harley, David (2016) Public health responses to and challenges for the control of dengue transmission in high-income countries: four case studies. PLoS Neglected Tropical Diseases, 10 (9). e0004943. pp. 1-33.
https://researchonline.jcu.edu.au/45774/
open
oai:researchonline.jcu.edu.au:45783
2024-03-01T15:04:20Z
7374617475733D707562
74797065733D61727469636C65
Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods
Schadewaldt, Verena
McInnes, Elizabeth
Hiller, Janet E.
Gardner, Anne
Background: In 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models.
Methods: A multiple case study of five primary healthcare sites was undertaken, applying mixed methods research. Six nurse practitioners, 13 medical practitioners and three practice managers participated in the study. Data were collected through direct observations, documents and semi-structured interviews as well as questionnaires including validated scales to measure the level of collaboration, satisfaction with collaboration and beliefs in the benefits of collaboration. Thematic analysis was undertaken for qualitative data from interviews, observations and documents, followed by deductive analysis whereby thematic categories were compared to two theoretical models of collaboration. Questionnaire responses were summarised using descriptive statistics.
Results: Using the scale measurements, nurse practitioners and medical practitioners reported high levels of collaboration, were highly satisfied with their collaborative relationship and strongly believed that collaboration benefited the patient. The three themes developed from qualitative data showed a more complex and nuanced picture: 1) Structures such as government policy requirements and local infrastructure disadvantaged nurse practitioners financially and professionally in collaborative practice models; 2) Participants experienced the influence and consequences of individual role enactment through the co-existence of overlapping, complementary, traditional and emerging roles, which blurred perceptions of legal liability and reimbursement for shared patient care; 3) Nurse practitioners' and medical practitioners' adjustment to new routines and facilitating the collaborative work relied on the willingness and personal commitment of individuals.
Conclusions: Findings of this study suggest that the willingness of practitioners and their individual relationships partially overcame the effect of system restrictions. However, strategic support from healthcare reform decision makers is needed to strengthen nurse practitioner positions and ensure the sustainability of collaborative practice models in primary healthcare.
BioMed Central
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45783/1/45783%20Schadewaldt%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12875-016-0503-2
Schadewaldt, Verena, McInnes, Elizabeth, Hiller, Janet E., and Gardner, Anne (2016) Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods. BMC Family Practice, 17. 99. pp. 1-16.
https://researchonline.jcu.edu.au/45783/
open
oai:researchonline.jcu.edu.au:45803
2024-03-02T15:18:53Z
7374617475733D707562
74797065733D61727469636C65
Building a sustainable workforce in a rural and remote health service: a comprehensive and innovative Rural Generalist training approach
Orda, Ulrich
Orda, Sabine
Sen Gupta, Tarun
Knight, Sabina
Background: Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff.
Concept: The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars.
Achievements: Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience – for staff at all levels.
Results: Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position.
Conclusions: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU.
Wiley-Blackwell
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45803/1/45803_Orda%20et%20al_2017.pdf
http://dx.doi.org/10.1111/ajr.12306
Orda, Ulrich, Orda, Sabine, Sen Gupta, Tarun, and Knight, Sabina (2017) Building a sustainable workforce in a rural and remote health service: a comprehensive and innovative Rural Generalist training approach. Australian Journal of Rural Health, 25. pp. 116-119.
https://researchonline.jcu.edu.au/45803/
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oai:researchonline.jcu.edu.au:45851
2024-03-03T14:47:33Z
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High glycaemia and low uptake of insulin treatment among remote Torres Strait Islanders with diabetes: implications for service delivery
Taylor, Sean
McDermott, Robyn
[Extract] Torres Strait Islanders have the highest prevalence of Type 2 Diabetes in Australia.[1] Between 2005/06 and 2009/10, there were on average 123 diabetes separations per year in the Torres Strait and Northern Peninsula Hospital and Health Service. A review in 2005 noted that newer diabetes cases were younger, more obese and had poorer glycaemic control compared to 6 years previously.[2]
Here we briefly report all diabetes cases in five of the most remote outer islands of the Torres Strait conducted in 2013 who were recruited into a cohort study. These very remote islands are serviced by local primary care workers, nurses and only intermittently visited by specialist outreach teams and general practitioners.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45851/6/45851%20Taylor_et_al-2016-Australian_Journal_of_Rural_Health.pdf
http://dx.doi.org/10.1111/ajr.12322
Taylor, Sean, and McDermott, Robyn (2016) High glycaemia and low uptake of insulin treatment among remote Torres Strait Islanders with diabetes: implications for service delivery. Australian Journal of Rural Health, 24 (6). pp. 422-423.
https://researchonline.jcu.edu.au/45851/
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oai:researchonline.jcu.edu.au:45852
2024-03-03T14:47:34Z
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74797065733D61727469636C65
Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes
Taylor, Sean
Thompson, Fintan
McDermott, Robyn
Objective: To explore self reported knowledge and attitudes to insulin treatment among a group of adults with poorly controlled diabetes in the Torres Strait islands.
Design:Cross-sectional survey in 2014, interviews with 29 adults with HbA1c ≥ 8.5% (69 mmol mol⁻¹) and not taking insulin, using Insulin Treatment Appraisal Scale (ITAS) and Barriers to Insulin Treatment Questionnaire (BITQ) scores.
Setting: Five remote Torres Strait Island communities in the Torres Strait region.
Participants: Poorly controlled insulin-naïve type 2 diabetics.
Main outcome measures: BITQ and ITAS scores on items related to knowledge and attitudes to insulin treatment, clinical and demographic measures.
Results: Overall, 34% of the cohort had poor glycaemic control. Compared to those with HbA1c ≥ 8.5% and taking insulin (n = 37), the 29 insulin-naïve participants were more obese, more likely to smoke and drink alcohol, have lower mean HbA1c and fewer years with diabetes. Among the insulin-naïve group, those reporting higher 'barriers' (BITQ scores) were older and with lower formal education than those reporting fewer barriers. Torres participants consistently scored low on 'knowledge' items in the ITAS, especially those which would guide insulin initiation (insulin improves glucose control and prevents complications).
Conclusion: Compared to other published studies, the Torres participants had higher scores for BITQ 'barrier' items and lower 'knowledge' scores. This suggests better education around glycaemic control with medication and discussion of perceptions and exchange of experiences with peers who are taking insulin might improve the uptake of insulin in this high-risk group.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45852/6/45852%20Taylor_et_al-2016-Australian_Journal_of_Rural_Health-1.pdf
http://dx.doi.org/10.1111/ajr.12315
Taylor, Sean, Thompson, Fintan, and McDermott, Robyn (2016) Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes. Australian Journal of Rural Health, 24 (6). pp. 363-370.
https://researchonline.jcu.edu.au/45852/
open
oai:researchonline.jcu.edu.au:45909
2024-03-02T15:18:56Z
7374617475733D707562
74797065733D61727469636C65
Attitudes to lesbian, gay, bisexual and transgender parents seeking health care for their children in two early parenting services in Australia
Bennett, Elaine
Berry, Karen
Emeto, Theophilus I.
Burmeister, Oliver K.
Young, Jeanine
Shields, Linda
Aim: To examine the attitudes to and knowledge and beliefs about homosexuality, of nurses and allied professionals in two early parenting services in Australia.
Background: Early parenting services employ nurses and allied professionals. Access and inclusion policies are important in community health and early childhood service settings. However, little is known about the perceptions of professionals who work within early parenting services in relation to lesbian, gay, bisexual and transgender families.
Design: This is the final in a series of studies and was undertaken in two early parenting services in two states in Australia using a cross-sectional design with quantitative and qualitative approaches.
Methods: Validated questionnaires were completed by 51 nurses and allied professionals and tested with Chi-squared test of independence (or Fisher's exact test), Mann–Whitney U-test, Kruskal–Wallis one-way analysis of variance, or Spearman's rank correlation. Thematic analysis examined qualitative data collected in a box for free comments.
Results: Of the constructs measured by the questionnaires, no significant relationships were found in knowledge, attitude and gay affirmative practice scores by sociodemographic variables or professional group. However, attitude to lesbians and to gay men scores were significantly negatively affected by conservative political affiliation (p=0.038), held religious beliefs (p=0.011), and frequency of praying (p=0.018). Six overall themes were found: respect, parenting role, implications for the child, management, disclosure, resources and training.
Conclusions: The study provided an in-depth analysis of the attitudes, knowledge and beliefs of professionals in two early parenting services, showing that work is needed to promote acceptance of diversity and the inclusion of LGBT families in planning, developing, evaluating and accessing early parenting services.
Wiley-Blackwell
2016-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45909/1/45909%20Bennet%20et%20al%202017.pdf
http://dx.doi.org/10.1111/jocn.13595
Bennett, Elaine, Berry, Karen, Emeto, Theophilus I., Burmeister, Oliver K., Young, Jeanine, and Shields, Linda (2016) Attitudes to lesbian, gay, bisexual and transgender parents seeking health care for their children in two early parenting services in Australia. Journal of Clinical Nursing, 26 (7-8). pp. 1021-1030.
https://researchonline.jcu.edu.au/45909/
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oai:researchonline.jcu.edu.au:45934
2024-03-01T15:05:28Z
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High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project
Canavati, Sara E.
Quintero, Cesia E.
Lawford, Harriet L.S.
Yok, Sovann
Lek, Dysoley
Richards, Jack S.
Whittaker, Maxine Anne
Background: During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11.
Methods: A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis.
Results: High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact.
Conclusions: There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population.
BioMed Central
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45934/1/45934%20Canavati%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12936-016-1491-3
Canavati, Sara E., Quintero, Cesia E., Lawford, Harriet L.S., Yok, Sovann, Lek, Dysoley, Richards, Jack S., and Whittaker, Maxine Anne (2016) High mobility, low access thwarts interventions among seasonal workers in the Greater Mekong Sub-region: lessons from the malaria containment project. Malaria Journal, 15. 434. pp. 1-13.
https://researchonline.jcu.edu.au/45934/
open
oai:researchonline.jcu.edu.au:45953
2024-03-01T15:04:42Z
7374617475733D707562
74797065733D61727469636C65
Parent and adolescent reports in assessing adolescent sleep problems: results from a large population study
Fatima, Yaqoot
Doi, Suhail A.R.
O'Callaghan, Michael
Williams, Gail
Najman, Jake M.
Al Mamun, Abdullah
Aim: To compare parent and adolescent reports in exploring adolescent sleep problems and to identify the factors associated with adolescent sleep problem disclosures.
Methods: Parent (n = 5185) and adolescent reports (n = 5171, age=13.9 0.3 years), from a birth cohort were used to explore adolescent sleep problems. Kappa coefficients were used to assess the agreement, whereas, conditional agreement and disagreement ratios were used to identify the optimal informant. Logistic regression analysis was used to determine the factors affecting adolescent sleep problem disclosure.
Results: Parental reports identified only about one-third of the sleep problems reported by adolescents. Whereas adolescent reports identified up to two-thirds of the sleep problems reported by parents. Combined reports of parents and adolescent did not show any considerable difference from the adolescent report. Adolescent and parent health, maternal depression, and family communication were significantly associated with adolescents sleep problem disclosures.
Conclusion: Adolescent reports could be used as the preferred source to explore adolescent sleep problems. Parental reports should be used when parents as observers are more reliable reporters, or where adolescents are cognitively unable to report sleep problems. Additionally, the impact of poor health, maternal depression and family communication on sleep problems disclosure should be considered for adolescent sleep problem diagnosis.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/45953/1/45953%20Fatima_et_al-2016.pdf
http://dx.doi.org/10.1111/apa.13404
Fatima, Yaqoot, Doi, Suhail A.R., O'Callaghan, Michael, Williams, Gail, Najman, Jake M., and Al Mamun, Abdullah (2016) Parent and adolescent reports in assessing adolescent sleep problems: results from a large population study. Acta Paediatrica, 105 (9). e433-e439.
https://researchonline.jcu.edu.au/45953/
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oai:researchonline.jcu.edu.au:46008
2024-03-03T14:59:35Z
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Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum
Herdiana, Herdiana
Cotter, Chris
Coutrier, Farah N.
Zarlinda, Iska
Zelman, Brittany W.
Tirta, Yusrifar
Greenhouse, Bryan
Gosling, Roly D.
Baker, Peter
Whittaker, Maxine
Hsiang, Michelle S.
Background: As malaria transmission declines, it becomes more geographically focused and more likely due to asymptomatic and non-falciparum infections. To inform malaria elimination planning in the context of this changing epidemiology, local assessments on the risk factors for malaria infection are necessary, yet challenging due to the low number of malaria cases.
Methods: A population-based, cross-sectional study was performed using passive and active surveillance data collected in Aceh Besar District, Indonesia from 2014 to 2015. Malaria infection was defined as symptomatic polymerase chain reaction (PCR)-confirmed infection in index cases reported from health facilities, and asymptomatic or symptomatic PCR-confirmed infection identified in reactive case detection (RACD). Potential risk factors for any infection, species-specific infection, or secondary-case detection in RACD were assessed through questionnaires and evaluated for associations.
Results: Nineteen Plasmodium knowlesi, 12 Plasmodium vivax and six Plasmodium falciparum cases were identified passively, and 1495 community members screened in RACD, of which six secondary cases were detected (one P. knowlesi, three P. vivax, and two P. falciparum, with four being asymptomatic). Compared to non-infected subjects screened in RACD, cases identified through passive or active surveillance were more likely to be male (AOR 12.5, 95 % CI 3.0–52.1), adult (AOR 14.0, 95 % CI 2.2–89.6 for age 16–45 years compared to <15 years), have visited the forest in the previous month for any reason (AOR 5.6, 95 % CI 1.3–24.2), and have a workplace near or in the forest and requiring overnight stays (AOR 7.9, 95 % CI 1.6–39.7 compared to workplace not near or in the forest). Comparing subjects with infections of different species, differences were observed in sub-district of residence and other demographic and behavioural factors. Among subjects screened in RACD, cases compared to non-cases were more likely to be febrile and reside within 100 m of the index case.
Conclusion: In this setting, risk of malaria infection in index and RACD identified cases was associated with forest exposure, particularly overnights in the forest for work. In low-transmission settings, utilization of data available through routine passive and active surveillance can support efforts to target individuals at high risk
BioMed Central
2016-09
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46008/1/46008%20Herdiana%20et%20al%202016.pdf
http://dx.doi.org/10.1186/s12936-016-1523-z
Herdiana, Herdiana, Cotter, Chris, Coutrier, Farah N., Zarlinda, Iska, Zelman, Brittany W., Tirta, Yusrifar, Greenhouse, Bryan, Gosling, Roly D., Baker, Peter, Whittaker, Maxine, and Hsiang, Michelle S. (2016) Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum. Malaria Journal, 15. 468. pp. 1-15.
https://researchonline.jcu.edu.au/46008/
open
oai:researchonline.jcu.edu.au:46098
2024-03-01T15:02:21Z
7374617475733D707562
74797065733D61727469636C65
The ethics of medical practitioner migration from low-resourced countries to the developed world: a call for action by health systems and individual doctors
Mpofu, Charles
Sen Gupta, Tarun
Hays, Richard
Medical migration appears to be an increasing global phenomenon, with complex contributing factors. Although it is acknowledged that such movements are inevitable, given the current globalized economy, the movement of health professionals from their country of training raises questions about equity of access and quality of care. Concerns arise if migration occurs from low- and middle-income countries (LMICs) to high-income countries (HICs). The actions of HICs receiving medical practitioners from LMICs are examined through the global justice theories of John Rawls and Immanuel Kant. These theories were initially proposed by Pogge (1988) and Tan (1997) and, in this work, are extended to the issue of medical migration. Global justice theories propose that instead of looking at health needs and workforce issues within their national boundaries, HICs should be guided by principles of justice relevant to the needs of health systems on a global scale. Issues of individual justice are also considered within the framework of rights and social responsibilities of individual medical practitioners. Local and international policy changes are suggested based on both global justice theories and the ideals of individual justice.
Springer
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46098/1/46098%20Mpofu%20et%20al%202016.pdf
http://dx.doi.org/10.1007/s11673-016-9726-0
Mpofu, Charles, Sen Gupta, Tarun, and Hays, Richard (2016) The ethics of medical practitioner migration from low-resourced countries to the developed world: a call for action by health systems and individual doctors. Journal of Bioethical Inquiry, 13 (3). pp. 395-406.
https://researchonline.jcu.edu.au/46098/
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oai:researchonline.jcu.edu.au:46152
2024-03-02T15:15:44Z
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Strengthening health information systems for disability-related rehabilitation in LMICs
McPherson, Anna
Durham, Jo
Richards, Nicola
Gouda, Hebe
Rampatige, Rasika
Whittaker, Maxine
The purpose of this study was to describe the state of rehabilitation health information systems (HIS) in different settings, and identify key processes and actions which contribute to the development of HIS which can effectively support low- and middle-income countries (LMICs) allocate resources to health-related rehabilitation to people with disabilities. Nine case studies were conducted across different disability and developmental settings using documentary review and semi-structured key informant interviews (N = 41). Results were analysed against the six building blocks of a HIS, based on the Health Metrics Network Framework and Standards for Country Health Information Systems and existing HIS capacity. Key barriers or enablers to good disability data collection and use, were documented for each HIS component. Research results suggest there is no gold standard HIS for rehabilitation. There was broad consensus however, that effective health related disability planning requires reliable data on disability prevalence, functional status, access to rehabilitation services and functional outcomes of rehabilitation. For low-resource settings, and where routine HIS are already challenged, planning to include disability and rehabilitation foci starting with a minimum dataset on functioning, and progressively improving the system for increased utility and harmonization, is likely to be most effective and minimize the potential for overburdening fragile systems. The recommendations from this study are based on the successes and challenges of countries with established information systems, and will assist LMICs to prioritize strategic measures to strengthen the collection and use of data for rehabilitation, and progressively realize the rights of people with disabilities.
Oxford University Press
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46152/1/46152_McPherson%20et%20al_2017.pdf
http://dx.doi.org/10.1093/heapol/czw140
McPherson, Anna, Durham, Jo, Richards, Nicola, Gouda, Hebe, Rampatige, Rasika, and Whittaker, Maxine (2017) Strengthening health information systems for disability-related rehabilitation in LMICs. Health Policy and Planning, 32. pp. 384-394.
https://researchonline.jcu.edu.au/46152/
open
oai:researchonline.jcu.edu.au:46153
2024-03-04T14:56:42Z
7374617475733D707562
74797065733D61727469636C65
Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland
Segal, Leonie
Nguyen, Ha
Schmidt, Barbara
Wenitong, Mark
McDermott, Robyn A.
Objective: To conduct an economic evaluation of intensive management by Indigenous health workers (IHWs) of Indigenous adults with poorly controlled type 2 diabetes in rural and remote north Queensland.
Design: Cost–consequence analysis alongside a cluster randomised controlled trial of an intervention delivered between 1 March 2012 and 5 September 2013.
Setting: Twelve primary health care services in rural and remote north Queensland communities with predominantly Indigenous populations.
Participants: Indigenous adults with poorly controlled type 2 diabetes (HbA₁(c) ≥ 69 mmol/mol) and at least one comorbidity (87 people in six IHW-supported communities (IHW-S); 106 in six usual care (UC) communities).
Main outcome measures: Per person cost of the intervention; differential changes in mean HbA₁(c) levels, percentage with extremely poor HbA₁(c) level control, quality of life, disease progression, and number of hospitalisations.
Results: The mean cost of the 18-month intervention trial was $10 060 per person ($6706 per year). The intervention was associated with a non-significantly greater reduction in mean HbA₁(c) levels in the IHW-S group (–10.1 mmol/mol v –5.4 mmol/mol in the UC group; P = 0.17), a significant reduction in the proportion with extremely poor diabetes control (HbA₁(c) ≥ 102 mmol/mol; P = 0.002), and a sub-significant differential reduction in hospitalisation rates for type 2 diabetes as primary diagnosis (–0.09 admissions/person/year; P = 0.06), with a net reduction in mean annual hospital costs of $646/person (P = 0.07). Quality of life utility scores declined in both groups (between-group difference, P = 0.62). Rates of disease progression were high in both groups (between-group difference, P = 0.73).
Conclusion: Relative to the high cost of the intervention, the IHW-S model as implemented is probably a poor investment. Incremental cost-effectiveness might be improved by a higher caseload per IHW, a longer evaluation time frame, and improved service integration. Further approaches to improving chronic disease outcomes in this very unwell population need to be explored, including holistic approaches that address the complex psychosocial, pathophysiological and environmental problems of highly disadvantaged populations.
Australasian Medical Publishing Company
2016-03-21
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46153/1/46153_McDermott_2016.pdf
http://dx.doi.org/10.5694/mja15.00598
Segal, Leonie, Nguyen, Ha, Schmidt, Barbara, Wenitong, Mark, and McDermott, Robyn A. (2016) Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland. Medical Journal of Australia, 204 (5). 196. e1-e9.
https://researchonline.jcu.edu.au/46153/
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oai:researchonline.jcu.edu.au:46156
2024-03-03T14:47:34Z
7374617475733D707562
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When chronic conditions become emergencies: a report from regional Queensland
Harriss, Linton R.
Thompson, Fintan
Dey, Arindam
Mills, Jane
Watt, Kerrianne
McDermott, Robyn
Objective: To describe chronic conditions and injuries as a proportion of total emergency presentations to a large public hospital in regional Queensland, and to investigate differences in presentation rates associated with Indigenous status.
Design: Cross-sectional analysis using Emergency Department Information System data between 1 July 2012 and 30 June 2014.
Setting: Regional Queensland, Australia.
Participants: A total of 95 238 emergency presentations were generated by 50 083 local residents living in the 10 statistical local areas (SLAs) immediately around the hospital.
Main outcome measures: Emergency presentations for chronic conditions and injuries identified from discharge ICD-10-AM principal diagnosis. Age-standardised presentation rates were calculated using the Australian 2001 reference population.
Results: Approximately half of all presentations were for chronic conditions (20.2%) and injuries (28.8%). Two-thirds of all chronic condition presentations were for mental and behavioural disorders (34.6%) and circulatory diseases (33.2%). Head injuries accounted for the highest proportion of injuries (18.9%). Age-standardised rates for major diagnostic groups were consistently higher for Indigenous residents, whose presentations were lower in mean age (95% CI) by 7.7 (7.3–8.1) years, 23% less likely to be potentially avoidable GP-type presentations [RR (95% CI) = 0.77 (0.75–0.80)], 30% more likely to arrive by ambulance [1.31 (1.28–1.33)] and 11% more likely to require hospital admission [1.11 (1.08–1.13)].
Conclusions: Opportunities exist to enhance current coordinated hospital avoidance and primary health services in regional Queensland targeting common mental and circulatory disorders, especially for Indigenous Australians.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46156/6/46156%20Harriss%20et%20al%202016.pdf
http://dx.doi.org/10.1111/ajr.12320
Harriss, Linton R., Thompson, Fintan, Dey, Arindam, Mills, Jane, Watt, Kerrianne, and McDermott, Robyn (2016) When chronic conditions become emergencies: a report from regional Queensland. Australian Journal of Rural Health, 24 (6). pp. 392-401.
https://researchonline.jcu.edu.au/46156/
open
oai:researchonline.jcu.edu.au:46158
2024-03-05T14:38:51Z
7374617475733D707562
74797065733D61727469636C65
The complexity of health service integration: a review of reviews
Heyeres, Marion
McCalman, Janya
Tsey, Komla
Kinchin, Irina
Background: The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research.
Method: The review was developed by systematically searching nine electronic data-bases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized.
Results: Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low.
Conclusion: There is no "one size fits all" approach to health service integration. Instead, this literature review highlighted the complexity of service integration, which in most primary studies involved a range of strategies. Rigorous assessments of cost-effectiveness and reporting on consumer involvement are required in future research.
Frontiers Research Foundation
2016-10
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46158/1/Complexity_of_health_service_integration.pdf
http://dx.doi.org/10.3389/fpubh.2016.00223
Heyeres, Marion, McCalman, Janya, Tsey, Komla, and Kinchin, Irina (2016) The complexity of health service integration: a review of reviews. Frontiers in Public Health, 4. 223. pp. 1-8.
https://researchonline.jcu.edu.au/46158/
open
oai:researchonline.jcu.edu.au:46165
2024-03-02T15:59:53Z
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Diarrheal diseases and climate change in Cambodia: environmental epidemiology and opportunities for adaptation
McIver, Lachlan J.
Imai, Chisato
Buettner, Petra G.
Gager, Paul
Chan, Vibol S.
Hashizume, Masahiro
Iddings, Steven N.
Kol, Hero
Raingsey, Piseth R.
Lyne, K.
The DRIP-SWICCH (Developing Research and Innovative Policies Specific to the Water-related Impacts of Climate Change on Health) project aimed to increase the resilience of Cambodian communities to the health risks posed by climate change–related impacts on water. This article follows a review of climate change and water-related diseases in Cambodia and presents the results of a time series analysis of monthly weather and diarrheal disease data for 11 provinces. In addition, correlations of diarrheal disease incidence with selected demographic, socioeconomic, and water and sanitation indicators are described, with results suggesting education and literacy may be most protective against disease. The potential impact of climate change on the burden of diarrheal disease in Cambodia is considered, along with the implications of these findings for health systems adaptation.
Sage Publications
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46165/1/46165_Buettner_2016.pdf
http://dx.doi.org/10.1177/1010539516660190
McIver, Lachlan J., Imai, Chisato, Buettner, Petra G., Gager, Paul, Chan, Vibol S., Hashizume, Masahiro, Iddings, Steven N., Kol, Hero, Raingsey, Piseth R., and Lyne, K. (2016) Diarrheal diseases and climate change in Cambodia: environmental epidemiology and opportunities for adaptation. Asia-Pacific Journal of Public Health, 28 (7). pp. 576-585.
https://researchonline.jcu.edu.au/46165/
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oai:researchonline.jcu.edu.au:46168
2024-03-02T15:14:41Z
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Cognitive-behavioural therapy for inflammatory bowel disease: 24-month data from a randomised controlled trial
Mikocka-Walus, Antonina
Bampton, Peter
Hetzel, David
Hughes, Patrick
Esterman, Adrian
Andrews, Jane M.
Purpose: There is ongoing controversy on the effectiveness of psychotherapy in inflammatory bowel disease (IBD). In the few small studies, cognitive-behavioural therapy (CBT) has been shown to alleviate symptoms of anxiety or depression. However, there is little research on the impact of CBT on physical outcomes in IBD and no studies on long-term effectiveness of CBT.
Methods: The present two-arm pragmatic randomised controlled trial aimed to establish the impact of CBT on disease course after 24 months of observation. The study compared standard care plus CBT (+CBT) with standard care alone (SC). CBT was delivered over 10 weeks, face-to-face (F2F) or online (cCBT). The data were analysed using linear mixed-effects models.
Results: CBT did not significantly influence disease activity as measured by disease activity indices at 24 months (Crohn's Disease Activity Index (CDAI), p = 0.92; Simple Clinical Colitis Activity Index (SCCAI), p = 0.88) or blood parameters (C-reactive protein (CRP), p < 0.62; haemoglobin (Hb), p = 0.77; platelet, p = 0.64; white cell count (WCC), p = 0.59) nor did CBT significantly affect mental health, coping or quality of life (all p > 0.05).
Conclusions: Therefore, we conclude that CBT does not influence the course of IBD over 24 months. Given the high rate of attrition, particularly in the CBT group, future trials should consider a personalised approach to psychotherapy, perhaps combining online and one-to-one therapist time.
Springer
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46168/1/46168_Mikocka-Walus%20et%20al_2017.pdf
http://dx.doi.org/10.1007/s12529-016-9580-9
Mikocka-Walus, Antonina, Bampton, Peter, Hetzel, David, Hughes, Patrick, Esterman, Adrian, and Andrews, Jane M. (2017) Cognitive-behavioural therapy for inflammatory bowel disease: 24-month data from a randomised controlled trial. International Journal of Behavioral Medicine, 24. pp. 127-135.
https://researchonline.jcu.edu.au/46168/
restricted
oai:researchonline.jcu.edu.au:46169
2024-03-04T14:57:03Z
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Pre-registration paid employment practices of undergraduate nursing students: a scoping review
Phillips, Craig
Kenny, Amanda
Esterman, Adrian
Objectives: This article presents findings from a scoping review that sought to highlight what is known about pre-registration paid employment practices of undergraduate nursing students.
Background: Researchers have identified large numbers of undergraduate nursing students engaging in paid employment. This review was prompted by our interest in the different employment choices that students make and whether these choices have any impact on transition to practice.
Design: A scoping review was designed to map the existing evidence base on undergraduate student nurse employment practices. Scoping reviews support the identification of a broad range of literature, which encompasses all types of study design.
Data sources: Utilising key search terms, databases searched included MEDLINE, CINAHL, Psych INFO, EMBASE, SCOPUS, SCIRUS, Joanna Briggs Institute, Web of Science, Informit Health and the Cochrane database.
Review method: We utilised Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting the results. Based on the research question, relevant literature was selected which was reported in accordance with Arksey and O'Malley's framework.
Results: The scoping review identified 40 articles that explored the nature of undergraduate student nurse paid employment activity. Highlighted themes included: reasons for engaging in paid employment; specific paid employment models; paid employment and academic performance, and paid employment choice and transition to graduate practice.
Conclusion: The review highlighted a lack of studies detailing the relationship between paid employment and transition to graduate nurse practice, particularly those studies situated within the hospitality sector.
Elsevier
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46169/1/46169_Esterman_2016.pdf
http://dx.doi.org/10.1016/j.colegn.2014.09.012
Phillips, Craig, Kenny, Amanda, and Esterman, Adrian (2016) Pre-registration paid employment practices of undergraduate nursing students: a scoping review. Collegian, 23 (1). pp. 115-127.
https://researchonline.jcu.edu.au/46169/
restricted
oai:researchonline.jcu.edu.au:46171
2024-03-04T14:57:08Z
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Predictors of radiation-induced gastrointestinal morbidity: a prospective, longitudinal study following radiotherapy for carcinoma of the prostate
Yeoh, Eric K.
Krol, Robin
Dhillon, Varinderpal S.
Botten, Rochelle
Di Matteo, Addolorata
Butters, Julie
Brock, Aleisha R.
Esterman, Adrian
Salisbury, Carolyn
Fenech, Michael
Background: Chronic gastrointestinal (GI) morbidity occurs in ≥50% of patients after external beam radiotherapy (EBRT) for carcinoma of prostate (CaP). This prospective, longitudinal study examines which baseline measurements of: 1) homocysteine and micronutrients in plasma; 2) chromosome damage/misrepair biomarkers; and 3) anal and rectal dose volume metrics predict GI morbidity after EBRT.
Patients and methods: In total, 106 patients with CaP had evaluations of GI symptoms (modified LENT-SOMA questionnaires) before EBRT and at one month, one, two and three years after its completion. Other variables measured before EBRT were: 1) plasma concentrations of homocysteine and micronutrients including caroteinoids and selenium; 2) chromosome damage/DNA misrepair (micronuclei/nucleoplasmic bridge) indices; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy. Univariate and multivariate analyzes examined the relationships among: 1) plasma levels of homocysteine and micronutrients; 2) indices of chromosome damage/DNA misrepair; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy and total GI symptom scores from one month to three years after EBRT.
Results: Increased frequency and urgency of defecation, rectal mucous discharge and bleeding after EBRT resulted in sustained rises in total GI symptom scores above baseline at three years. On univariate analysis, total GI symptom scores were significantly associated with: 1) plasma selenium and α tocopherol; 2) micronuclei indices of DNA damage; 3) mean anal and rectal wall doses; and 4) volumes of anal and rectal wall receiving ≥40 Gy and ≥60 Gy (p = 0.08–<0.001). On multivariate analysis, only volume of anal wall receiving ≥40 Gy was significant for increased GI symptoms after EBRT (p < 0.001).
Conclusion: The volume of anal wall receiving ≥40 Gy predicts chronic GI morbidity after EBRT for CaP.
Taylor & Francis Group
2016-04
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46171/1/46171_Esterman_2016.pdf
http://dx.doi.org/10.3109/0284186X.2015.1118658
Yeoh, Eric K., Krol, Robin, Dhillon, Varinderpal S., Botten, Rochelle, Di Matteo, Addolorata, Butters, Julie, Brock, Aleisha R., Esterman, Adrian, Salisbury, Carolyn, and Fenech, Michael (2016) Predictors of radiation-induced gastrointestinal morbidity: a prospective, longitudinal study following radiotherapy for carcinoma of the prostate. Acta Oncologica, 55 (5). pp. 604-610.
https://researchonline.jcu.edu.au/46171/
openpub
oai:researchonline.jcu.edu.au:46174
2024-03-03T14:58:06Z
7374617475733D707562
74797065733D61727469636C65
The supportive care needs of parents with a child with a rare disease: a qualitative descriptive study
Pelentsov, Lemuel J.
Fielder, Andrea L.
Esterman, Adrian J.
There are few studies that exist which focus specifically on parents with a child with a rare disease. The purpose of this study was to better understand the lived experiences and supportive care needs (SCN) of parents caring for a child across a spectrum of rare diseases. A qualitative descriptive approach was used to guide the research, and four semi-structured focus group interviews were conducted with 23 parents (17 mothers and 6 fathers). Participants described 'feeling boxed-in outside the box' due to a number of limitations unique to their child's disease, daily practical challenges in providing care and the various relational impacts of caring for a child with a rare disease were discussed. The results from this study help to give clearer direction for health professionals on where to focus future efforts in better meeting the supportive care needs of parents and their child with a rare disease.
Elsevier
2016-05
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46174/1/46174_Estermn_2016.pdf
http://dx.doi.org/10.1016/j.pedn.2015.10.022
Pelentsov, Lemuel J., Fielder, Andrea L., and Esterman, Adrian J. (2016) The supportive care needs of parents with a child with a rare disease: a qualitative descriptive study. Journal of Pediatric Nursing, 31 (3). e207-e218.
https://researchonline.jcu.edu.au/46174/
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oai:researchonline.jcu.edu.au:46211
2024-03-04T14:56:21Z
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Trauma-focused cognitive behavior therapy: narratives of children and adolescents
Westerman, Nancy K.
Cobham, Vanessa E.
McDermott, Brett
Repeated retelling of trauma narratives within Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) assists participants to habituate to experiences that have precipitated symptoms of post-traumatic stress. In this study, the narratives produced by children and adolescents, who developed post-traumatic stress disorder following a natural disaster, and who were treated with a manualized TF-CBT intervention, were examined. The first author developed a coding system utilizing three major concepts (coherence, elaboration, and evaluation) to identify changes in the narratives as they were retold at each therapeutic session. Analysis using this coding system identified that the internal logic of the stories was maintained as the detail diminished, and that the level of evaluation increased. Compression emerged as a major pattern, alongside the reduction in participant distress over the course of the treatment. Although requiring replication, these trial concepts, developed by the coding system, have potential analyzing trauma narratives and enhancing clinician observations.
Sage Publications
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46211/6/46211%20Westerman%20et%20al%202017.pdf
http://dx.doi.org/10.1177/1049732315627795
Westerman, Nancy K., Cobham, Vanessa E., and McDermott, Brett (2016) Trauma-focused cognitive behavior therapy: narratives of children and adolescents. Qualitative Health Research, 27 (2). pp. 226-235.
https://researchonline.jcu.edu.au/46211/
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oai:researchonline.jcu.edu.au:46244
2024-03-02T15:15:46Z
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The impact of socially-accountable health professional education: a systematic review of the literature
Reeve, Carole
Woolley, Torres
Ross, Simone J.
Mohammadi, Leila
Halili, Servando "Ben"
Cristobal, Fortunato
Siega-Sur, Jusie Lydia J.
Neusy, A-J.
This literature review describes the impact of health professional schools with a social accountability mandate by identifying characteristics of medical education found to impact positively on medical students, health workforce, and health outcomes of disadvantaged communities. A critical appraisal tool was used to identify the strengths and weaknesses of the published articles. Data are presented as a narrative synthesis due to the variety of methodologies in the studies, and characterized using a logic model. Health professional schools aiming to improve health outcomes for their disadvantaged local communities described collaborative partnerships with communities, equitable selection criteria, and community-engaged placements in underserved areas as positively impacting the learning and attitudes of students. Students of socially accountable schools were more likely to stay in rural areas and serve disadvantaged communities, and were often more skilled than students from more traditional schools to meet the needs of underserved communities. However, published literature on the impact of socially accountable health professional education on communities and health outcomes is limited, with only one study investigating health outcomes. The findings of this literature review guide schools on the inputs likely to maximize their socially accountability outputs and increase their impact on students, local health workforce and local communities.
Informa Healthcare
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46244/6/46244-Reeve-et-al-2017.pdf
http://dx.doi.org/10.1080/0142159X.2016.1231914
Reeve, Carole, Woolley, Torres, Ross, Simone J., Mohammadi, Leila, Halili, Servando "Ben", Cristobal, Fortunato, Siega-Sur, Jusie Lydia J., and Neusy, A-J. (2017) The impact of socially-accountable health professional education: a systematic review of the literature. Medical Teacher, 39 (1). pp. 67-73.
https://researchonline.jcu.edu.au/46244/
open
oai:researchonline.jcu.edu.au:46311
2024-03-03T14:57:06Z
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74797065733D61727469636C65
Topical antibiotics for preventing surgical site infection in wounds healing by primary intention
Heal, Clare F.
Banks, Jennifer L.
Lepper, Phoebe D.
Kontopantelis, Evangelos
van Driel, Mieke L.
Background: Surgical site infections (SSI) can delay wound healing, impair cosmetic outcome and increase healthcare costs. Topical antibiotics are sometimes used to reduce microbial contaminant exposure following surgical procedures, with the aim of reducing SSIs.
Objectives: The primary objective of this review was to determine whether the application of topical antibiotics to surgical wounds that are healing by primary intention reduces the incidence of SSI and whether it increases th e incidence of adverse outcomes (allergic contact dermatitis,
infections with patterns of antibiotic resistance and anaphylaxis).
Search methods: In May 2015 we searche d: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL;the Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL. We also searched clinical trial registries for ongoing studies, and bibliographies of relevant publications to identify further eligible trials. There was no restriction of language, date of study or setting. The search was repeated in May 2016 to ensure currencyof included studies.
Selection criteria: All randomized controlled trials (RCTs) and quasi-randomised trials that assessed the effects of topical antibiotics (any formulation,including impregnated dressings) in people with surgical wounds healing by primary intention were eligible for inclusion.
Data collection and analysis: Two review authors independently selected studies and independently extracted data. Two authors then assessed the studies for risk of bias. Risk ratios were calculated for dichotomous variables, and when a sufficient number of comparable trials were available, trials were pooled in a meta-analysis.
Main results: A total of 10 RCTs and four quasi-randomised trials with 6466 participants met the inclusion criteria. Six studies involved minor procedures conducted in an outpatient or emergency department setting; eight studies involved major surgery conducted in theatre. Nine different topical antibiotics were included. We included two three-arm trials, two four-arm trials and 10 two-arm trials. The control groups comprised; an alternative topical antibiotic (two studies), topical antiseptic (six studies) and no topical antibiotic (10 studies), which comprised inert ointment (five studies) no treatment (four studies) and one study with one arm of each. The risk of bias of the 14 studies varied. Seven studies were at high risk of bias, five at unclear risk of bias and two at low risk of bias. Most risk of bias concerned risk of se lection bias. Twelve of the studies (6259 participants) reported infection rates, although we could not extract the data for this outcome from one study. Four studies (3334 participants) measured allergic contact dermatitis as an outcome. Four studies measured positive wound swabs for patterns of antimicrobial resistance, for which there were no outcomes reported. No episodes of anaphylaxis were reported.
Topical antibiotic versus no topical antibiotic: We pooled the results of eight trials (5427 participants) for the outcome of SSI. Topical antibiotics probably reduce the risk of SSI in people with surgical wounds healing by primary intention compared with no topical antibiotic (RR 0.61, 95% CI 0.42 to 0.87; moderate-quality evidence downgraded once for risk of bias). This equates to 20 fewer SSIs per 1000 patients treated with topical antibiotics (95% CI 7 to 29) and a number needed to treat for one additional beneficial outcome (NNTB) (i.e. prevention of one SSI) of 50.
We pooled the results of three trials (3012 participants) for the outcome of allergic contact dermatitis, however this comparison was underpowered, and it is unclear whether topical antibiotics affect the risk of allergic contact dermatitis (RR 3.94, 95% CI 0.46 to 34.00; very low-quality evidence, downgraded twice for risk of bias, once for imprecision).
Topical antibiotic versus antiseptic: We pooled the results of five trials (1299 participants) for the outcome of SSI. Topical antibiotics probably reduce the risk of SSI in people with surgical wounds healing by primary intention compared with using topical antiseptics (RR 0.49, 95% CI 0.30 to 0.80; moderate-quality evidence downgraded once for risk of bias). This equates to 43 fewer SSIs per 1000 patients treated with topical antibiotics instead of antiseptics (95% CI 17 to 59) and an NNTB of 24.
We pooled the results of two trials (541 participants) for the outcome of allergic contact dermatitis; there was no clear difference in the risk of dermatitis between topical antibiotics and antiseptics, however this comparison was underpowered and a difference cannot be ruled out (RR 0.97, 95% CI 0.52 to 1.82; very low-quality evidence, downgraded twice for risk of bias and once for imprecision).
Topical antibiotic versus topical antibiotic: One study (99 participants) compared mupirocin ointment with a combination ointment of neomycin/polymyxin B/bacitracin zinc for the outcome of SSI. There was no clear difference in the risk of SSI, however this comparison was underpowered (very low-quality evidence downgraded twice for risk of bias, once for imprecision).
A four-arm trial involved two antibiotic arms (neomycin sulfate/bacitracin zinc/polymyxin B sulphate combination ointment versus bacitracin zinc, 219 participants). There was no clear difference in risk of SSI between the combination ointment and the bacitracin zinc ointment. The quality of evidence for this outcome was low, downgraded once for risk of bias, and once for imprecision.
Authors' conclusions: Topical antibiotics applied to surgical wounds healing by primary intention probably reduce the risk of SSI relative to no antibiotic, and relative to topical antiseptics (moderate quality evidence). We are unable to draw conclusions regarding the effects of topical antibiotics on adverse outcomes such as allergic contact dermatitis due to lack of statistical power (small sample sizes). We are also unable to draw conclusions regarding the impact of increasing topical antibiotic use on antibiotic resistance. The relative effects of different topical antibiotics are unclear.
Wiley-Blackwell
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46311/1/Heal_et_al-2016-The_Cochrane_Library.pdf
http://dx.doi.org/10.1002/14651858.CD011426.pub2
Heal, Clare F., Banks, Jennifer L., Lepper, Phoebe D., Kontopantelis, Evangelos, and van Driel, Mieke L. (2016) Topical antibiotics for preventing surgical site infection in wounds healing by primary intention. Cochrane Database of Systematic Reviews , 2016 (11). CD011426. pp. 1-71.
https://researchonline.jcu.edu.au/46311/
openpub
oai:researchonline.jcu.edu.au:46447
2024-03-05T14:57:10Z
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Exploring the contemporary stage and scripts for the enactment of dying roles: a narrative review of literature
Lowrie, Daniel
Ray, Robin
Plummer, David
Yau, Matthew
This narrative review explores the literature regarding the drama of dying from several academic perspectives. Three key themes were identified including ‘‘The impact of blurred boundaries on roles and transitions,’’ ‘‘The orchestration of death and dying through time,’’ and ‘‘Contemporary dying and new machinery of control.’’ This review reveals the manner in which tightly scripted dying roles serve the needs of the living to a greater extent than those of the dying, by ensuring the depiction of both dying and death as phenomena which have been brought under the control of the living, thereby countering death anxiety. An incongruence between the actual experience of dying and contemporary dying scripts is also highlighted. The authors argue that this incongruence is hidden from the broader societal audience through the maintenance of a dying role that demands serenity and acceptance, thus downplaying or even hiding the actual end-of-life experiences of the dying themselves.
Baywood Publishing
2018
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46447/7/JCU_46447_Lowrie_et_al_2018_accepted.pdf
application/pdf
https://researchonline.jcu.edu.au/46447/1/46447_Lowrie%20et%20al_2018.pdf
https://doi.org/10.1177/0030222817696541
Lowrie, Daniel, Ray, Robin, Plummer, David, and Yau, Matthew (2018) Exploring the contemporary stage and scripts for the enactment of dying roles: a narrative review of literature. Omega: Journal of Death and Dying, 76 (4). pp. 328-350.
https://researchonline.jcu.edu.au/46447/
open
oai:researchonline.jcu.edu.au:46470
2019-07-05T19:09:17Z
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The economic cost of suicide and non-fatal suicidal behaviour in the Australian construction industry
Doran, Christopher M.
Ling, Rod
Milner, Alison
Kinchin, Irina
Objective: Suicide has gained recognition worldwide as a significant public health problem. This paper quantifies the economic cost of suicide and non-fatal suicide behaviour (NFSB) in the Australian Construction Industry (CI).
Methods: Suicide data were obtained from the National Coronial Information System and occupational information was coded according to Australian standards with CI workers falling into three major groups: technicians and trades worker; machine operators; and, drivers and labourers. The analysis used a costing methodology endorsed by the National Occupational Health and Safety Commission. Costs were derived for the year 2012 using an incidence-based approach with future costs discounted to 2012 dollars.
Results: In 2012, a total 169 male CI workers lost their life to suicide with an average age of 37 years. For those states where age standardised rates of suicide could be calculated, rates of suicide in the CI was higher than the state and national average with the exception of QLD where the CI had comparable rates to the state average. The economic cost is estimated at $1.57 billion cost. The cost of non-fatal suicidal behaviour resulting in full incapacity comprised the majority of these costs (76.5%) with loss of earnings the key cost driver.
Conclusion: The high economic cost of suicide and non-fatal suicide behaviour in the Australian CI warrants an appropriate response. There are a number of workforce strategies available to address mental health issues. We hope our up-to-date estimates of the burden on the Australian CI will fuel the national call to action.
SciTechnol
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46470/1/46470%20Doran%20et%20al%202016.pdf
http://dx.doi.org/10.4172/2471-4372.1000130
Doran, Christopher M., Ling, Rod, Milner, Alison, and Kinchin, Irina (2016) The economic cost of suicide and non-fatal suicidal behaviour in the Australian construction industry. International Journal of Mental Health & Psychiatry, 2 (4). pp. 1-6.
https://researchonline.jcu.edu.au/46470/
restricted
oai:researchonline.jcu.edu.au:46616
2024-03-03T14:24:52Z
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74797065733D61727469636C65
What do beginning students, in a rurally focused medical course, think about rural practice?
Young, Louise
Lindsay, Daniel B.
Ray, Robin A.
Background: Medical schools may select students for their attitudes towards rural medical practice, yet the rural–urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies.
Methods: Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project.
Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests.
Results: No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were found for positive views of the rural doctor role and negative views of rural practice. Participants from a capital city background reported a significantly higher percentage of responses related to negative views of rural practice than their regional and rural counterparts. Students from capital city areas had significantly more negative views about the rural doctor role, especially related to workload, limited resources and isolation than students from rural and regional areas.
Conclusion: Students entering medical school already have both positive and negative views about the life and work of a rural doctor. Those students from capital city areas have significantly more negative views despite being selected to enter a medical course with a rural focus based on their expressed rural perceptions. Further work is required to refine selection criteria and the year level experiences and learning opportunities which may positively influence student perceptions about rural medical practice to overcome early negative perceptions at the beginning of medical school.
BioMed Central
2016-12-07
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46616/1/What%20do%20beginning%20%20students%20in%20a%20rurally%20focused%20course.pdf
http://dx.doi.org/10.1186/s12909-016-0829-4
Young, Louise, Lindsay, Daniel B., and Ray, Robin A. (2016) What do beginning students, in a rurally focused medical course, think about rural practice? BMC Medical Education, 16. 310. pp. 1-7.
https://researchonline.jcu.edu.au/46616/
open
oai:researchonline.jcu.edu.au:46632
2024-03-04T14:56:54Z
7374617475733D707562
74797065733D61727469636C65
Mosquito bite immunization with radiation-attenuated Plasmodium falciparum sporozoites: safety, tolerability, protective efficacy and humoral immunogenicity
Hickey, Bradley W.
Lumsden, Joanne M.
Reyes, Sharina
Sedegah, Martha
Hollingdale, Michael R.
Freilich, Daniel A.
Luke, Thomas C.
Charoenvit, Yupin
Goh, Lucy M.
Berzins, Mara P.
Bebris, Lolita
Sacci Jr., John B.
De La Vega, Patricia
Wang, Ruobing
Ganeshan, Harini
Abot, Esteban N.
Carucci, Daniel J.
Doolan, Denise L.
Brice, Gary T.
Kumar, Anita
Aguiar, Joao
Nutman, Thomas B.
Leitman, Susan F.
Hoffman, Stephen L.
Epstein, Judith E.
Richie, Thomas L.
Background: In this phase 1 clinical trial, healthy adult, malaria-naïve subjects were immunized with radiation-attenuated Plasmodium falciparum sporozoites (PfRAS) by mosquito bite and then underwent controlled human malaria infection (CHMI). The PfRAS model for immunization against malaria had previously induced >90 % sterile protection against homologous CHMI. This study was to further explore the safety, tolerability and protective efficacy of the PfRAS model and to provide biological specimens to characterize protective immune responses and identify protective antigens in support of malaria vaccine development.
Methods: Fifty-seven subjects were screened, 41 enrolled and 30 received at least one immunization. The true-immunized subjects received PfRAS via mosquito bite and the mock-immunized subjects received mosquito bites from irradiated uninfected mosquitoes. Sera and peripheral blood mononuclear cells (PBMCs) were collected before and after PfRAS immunizations.
Results: Immunization with PfRAS was generally safe and well tolerated, and repeated immunization via mosquito bite did not appear to increase the risk or severity of AEs. Local adverse events (AEs) of true-immunized and mock-immunized groups consisted of erythaema, papules, swelling, and induration and were consistent with reactions from mosquito bites seen in nature. Two subjects, one true- and one mock-immunized, developed large local reactions that completely resolved, were likely a result of mosquito salivary antigens, and were withdrawn from further participation as a safety precaution. Systemic AEs were generally rare and mild, consisting of headache, myalgia, nausea, and low-grade fevers. Two true-immunized subjects experienced fever, malaise, myalgia, nausea, and rigours approximately 16 h after immunization. These symptoms likely resulted from pre-formed antibodies interacting with mosquito salivary antigens. Ten subjects immunized with PfRAS underwent CHMI and five subjects (50 %) were sterilely protected and there was a significant delay to parasitaemia in the other five subjects. All ten subjects developed humoral immune responses to whole sporozoites and to the circumsporozoite protein prior to CHMI, although the differences between protected and non-protected subjects were not statistically significant for this small sample size.
Conclusions: The protective efficacy of this clinical trial (50 %) was notably less than previously reported (>90 %). This may be related to differences in host genetics or the inherent variability in mosquito biting behavior and numbers of sporozoites injected. Differences in trial procedures, such as the use of leukapheresis prior to CHMI and of a longer interval between the final immunization and CHMI in these subjects compared to earlier trials, may also have reduced protective efficacy. This trial has been retrospectively registered at ISRCTN ID 17372582, May 31, 2016.
BioMed Central
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46632/1/46632_Doolan_2016.pdf
http://dx.doi.org/10.1186/s12936-016-1435-y
Hickey, Bradley W., Lumsden, Joanne M., Reyes, Sharina, Sedegah, Martha, Hollingdale, Michael R., Freilich, Daniel A., Luke, Thomas C., Charoenvit, Yupin, Goh, Lucy M., Berzins, Mara P., Bebris, Lolita, Sacci Jr., John B., De La Vega, Patricia, Wang, Ruobing, Ganeshan, Harini, Abot, Esteban N., Carucci, Daniel J., Doolan, Denise L., Brice, Gary T., Kumar, Anita, Aguiar, Joao, Nutman, Thomas B., Leitman, Susan F., Hoffman, Stephen L., Epstein, Judith E., and Richie, Thomas L. (2016) Mosquito bite immunization with radiation-attenuated Plasmodium falciparum sporozoites: safety, tolerability, protective efficacy and humoral immunogenicity. Malaria Journal, 15 (377). pp. 1-18.
https://researchonline.jcu.edu.au/46632/
open
oai:researchonline.jcu.edu.au:46676
2024-03-01T15:02:57Z
7374617475733D707562
74797065733D61727469636C65
Psychosocial impact of dental esthetics regulates motivation to seek orthodontic treatment
Lin, Feiou
Ren, Manman
Yao, Linjie
He, Yan
Guo, Jing
Ye, Qingsong
Introduction: The aim of this study was to evaluate the psychosocial impact of dental esthetics for adults seeking orthodontic treatment.
Methods: The Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered to 393 adults, aged 18 to 30 years. The participants were divided into 2 groups: an intervention group (received orthodontic treatment) and a control group (rejected orthodontic treatment). Baseline malocclusion severity was assessed using the Index of Orthodontic Treatment Need (IOTN).
Results: The Wilcoxon signed rank test showed no statistically significant difference between the groups for the dental health component (DHC) of the IOTN (P = 0.134). Total and subscale PIDAQ scores of the intervention group were higher than those of the control group and differed significantly in each group among the 4 IOTN-DHC grades; self-confidence scores in the control group (F = 1.802; P>0.05) were the exception. Correlations between the PIDAQ scores and the IOTN-DHC grades were strong in each group. DHC grades, psychological impact, social impact, and aesthetic concern had significant impacts on patients accepting orthodontic treatment.
Conclusions: The psychosocial impact of dental esthetics played an important role in the decision-making process of adults seeking orthodontic treatment. Importantly, participants with low self-awareness of the potential psychosocial impact rejected orthodontic treatment, despite the need for severe normative treatment.
Mosby
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46676/1/46676_Lin%20et%20al_2016.pdf
http://dx.doi.org/10.1016/j.ajodo.2016.02.024
Lin, Feiou, Ren, Manman, Yao, Linjie, He, Yan, Guo, Jing, and Ye, Qingsong (2016) Psychosocial impact of dental esthetics regulates motivation to seek orthodontic treatment. American Journal of Orthodontics and Dentofacial Orthopedics, 150 (3). pp. 476-482.
https://researchonline.jcu.edu.au/46676/
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oai:researchonline.jcu.edu.au:46682
2024-03-01T14:40:52Z
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An acute bout of exercise improves the cognitive performance of older adults
Johnson, Liam
Addamo, Patricia K.
Raj, Isaac Selva
Borkoles, Erika
Wyckelsma, Victoria
Cyarto, Elizabeth
Polman, Remco C.
There is evidence that an acute bout of exercise confers cognitive benefits, but it is largely unknown what the optimal mode and duration of exercise is and how cognitive performance changes over time after exercise. We compared the cognitive performance of 31 older adults using the Stroop test before, immediately after, and at 30 and 60 min after a 10 and 30 min aerobic or resistance exercise session. Heart rate and feelings of arousal were also measured before, during, and after exercise. We found that, independent of mode or duration of exercise, the participants improved in the Stroop Inhibition task immediately postexercise. We did not find that exercise influenced the performance of the Stroop Color or Stroop Word Interference tasks. Our findings suggest that an acute bout of exercise can improve cognitive performance and, in particular, the more complex executive functioning of older adults.
Human Kinetics
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46682/1/46682_Johnson%20et%20al_2016.pdf
http://dx.doi.org/10.1123/japa.2015-0097
Johnson, Liam, Addamo, Patricia K., Raj, Isaac Selva, Borkoles, Erika, Wyckelsma, Victoria, Cyarto, Elizabeth, and Polman, Remco C. (2016) An acute bout of exercise improves the cognitive performance of older adults. Journal of Aging and Physical Activity, 24 (4). pp. 591-598.
https://researchonline.jcu.edu.au/46682/
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oai:researchonline.jcu.edu.au:46736
2024-02-28T14:45:09Z
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How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis
Topp, Stephanie M.
Chipukuma, Julien
Background: In sub-Saharan Africa, large amounts of funding continue to be directed towards HIV-specific care and treatment, often with claims of ‘health system strengthening’ effect. Such claims rarely account for the impact on human relationships and decisions that are core to functional health systems. This research examined how establishment of externally funded HIV services influenced trusting relationships in Zambian health centres.
Methods: An in-depth, multicase study included four health centres selected for urban, peri-urban and rural characteristics. Case data included healthcare worker (HCW) interviews (60); patient interviews (180); direct observation of facility operations (2 weeks/centre) and key informant interviews (14) which were recorded and transcribed verbatim. Thematic analysis adopted inductive and deductive coding guided by a framework incorporating concepts of workplace trust, patient–provider trust, intrinsic and extrinsic motivation.
Results: HIV service scale-up impacted trust in positive and negative ways. Investment in HIV-specific infrastructure, supplies and quality assurance mechanisms strengthened workplace trust, HCW motivation and patient–provider trust in HIV departments in the short-term. In the health centres more broadly and over time, however, non-governmental organisation-led investment and support of HIV departments reinforced HCW's perceptions of the government as uninterested or unable to provide a quality work environment. Exacerbating existing perceptions of systemic workplace inequity and nepotism, uneven distribution of personal and professional opportunities related to HIV service establishment contributed to interdepartmental antagonism and reinforced workplace practices designed to protect individual HCW's interests.
Conclusions: Findings illustrate long-term negative effects of the vertical HIV resourcing and support structures which failed to address and sometimes exacerbated HCW (dis)trust with their own government and supervisors. The short-term and long-term effects of weakened workplace trust on HCWs' motivation and performance signal the importance of understanding how such relationships play a role in generating virtuous or perverse cycles of actor interactions, with implications for service outcomes.
BMJ Publishing Group
2016-12-16
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/46736/7/46736_Topp%20and%20Chipukuma_2016.pdf
http://dx.doi.org/10.1136/bmjgh-2016-000179
Topp, Stephanie M., and Chipukuma, Julien (2016) How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis. BMJ Global Health, 1 (4). e000179. pp. 1-13.
https://researchonline.jcu.edu.au/46736/
open
oai:researchonline.jcu.edu.au:47129
2024-02-28T15:05:04Z
7374617475733D707562
74797065733D61727469636C65
Pilot evaluation of the informant AD8 as a case-finding instrument for cognitive impairment in general practitioner clinics of Singapore: a brief report
Wan, Esther Yee Shuang
Shaik, Muhammad Amin
Adhha, Amir
Ng, Richard Mong Hoo
Thompson, Claire
Ong, Ivana
Xu, Jing
Chen, Christopher Li-Hsian
Dong, Yanhong
Background: Case-finding services using a composite total risk score (TRS) and the informant AD8 have been previously recommended to detect cognitive impairment (CI) in government subsidized primary health care centers of Singapore (ie, polyclinics).
Objective: We compared the feasibility of implementing the services recommended for government-subsidized primary health care in private, primary health care service providers such as general practitioner (GP) clinics.
Method: 123 patients >= 60 years of age were recruited from 2 GP clinics within Singapore. Trained research personnel administered the AD8 to informants. Patients of the present study were compared against a random sample of 123 patients selected from polyclinics.
Results: Significantly higher positive screening rates (AD8 >= 3) were found among patients in polyclinics than GP clinics (P < .001). Patients attending polyclinics reported more comorbid medical issues such as subjective cognitive complaint (P < .001) and heart disease (P < .001). The TRS of patients attending polyclinics was significantly higher than those attending GP clinics (P < .001), indicating a higher proportion of patients at risk of CI in polyclinics. Therefore, patients attending polyclinics were found to have higher AD8 scores compared with patients in GP clinics (P < .001).
Conclusion: Compared with GP clinics, polyclinics may be more suited to provide case-finding services for the detection of CI in primary health care. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Elsevier
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47129/1/47129_Wan%20et%20al_2016.pdf
http://dx.doi.org/10.1016/j.jamda.2016.07.031
Wan, Esther Yee Shuang, Shaik, Muhammad Amin, Adhha, Amir, Ng, Richard Mong Hoo, Thompson, Claire, Ong, Ivana, Xu, Jing, Chen, Christopher Li-Hsian, and Dong, Yanhong (2016) Pilot evaluation of the informant AD8 as a case-finding instrument for cognitive impairment in general practitioner clinics of Singapore: a brief report. The Journal of the American Medical Directors Association, 17 (12). pp. 1147-1150.
https://researchonline.jcu.edu.au/47129/
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oai:researchonline.jcu.edu.au:47281
2024-02-28T15:07:56Z
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"We expect older adults to be able to prepare and recover from a cyclone as well as younger members of this community": emergency management's expectations of older adults residing in aging, remote hamlets on Australia's cyclone prone coastline
Astill, Sandra
Miller, Evonne
To investigate the extent to which older residents feel they can remain “self-reliant” during future natural disasters and to compare the findings with the viewpoints of local policy-makers and with those charged with caring for the elderly both on a day-to-day basis and in times of crisis.
This study used an array of non-probability snowballing techniques to seek the participation of senior citizens over the age of 65 years, emergency services officers, community health carers, and local government disaster managers located in aging, remote, coastal Australian communities vulnerable to cyclones and storm surges. All respondents participated in either a face-to-face personal interview or a focus group, with senior citizens also completing a self-administered questionnaire.
This research found a discrepancy between policy expectations and the experiences of both the elderly and those who care for them, as well as a lack of understanding with regard to the term “self-reliant.”
These results highlight the inability of older adults in aging, remote, coastal Australian communities to remain “self-reliant” in the future, impacting both disaster management policies and the future capacity of these communities to remain resilient. (Disaster Med Public Health Preparedness. 2017;page 1 of 5)
Cambridge University Press
2018
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47281/1/47281%20Astill%20and%20Miller%202018.pdf
http://dx.doi.org/10.1017/dmp.2017.33
Astill, Sandra, and Miller, Evonne (2018) "We expect older adults to be able to prepare and recover from a cyclone as well as younger members of this community": emergency management's expectations of older adults residing in aging, remote hamlets on Australia's cyclone prone coastline. Disaster Medicine and Public Health Preparedness, 12 (1). pp. 14-18.
https://researchonline.jcu.edu.au/47281/
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oai:researchonline.jcu.edu.au:47405
2024-02-28T15:06:53Z
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A cross-platform solution for light field based 3D telemedicine
Wang, Gengkun
Xiang, Wei
Pickering, Mark
Current telehealth services are dominated by conventional 2D video conferencing systems, which are limited in their capabilities in providing a satisfactory communication experience due to the lack of realism. The "immersiveness" provided by 3D technologies has the potential to promote telehealth services to a wider range of applications. However, conventional stereoscopic 3D technologies are deficient in many aspects, including low resolution and the requirement for complicated multi-camera setup and calibration, and special glasses. The advent of light field (LF) photography enables us to record light rays in a single shot and provide glasses-free 3D display with continuous motion parallax in a wide viewing zone, which is ideally suited for 3D telehealth applications. As far as our literature review suggests, there have been no reports of 3D telemedicine systems using LF technology. In this paper, we propose a cross-platform solution for a LF-based 3D telemedicine system. Firstly, a novel system architecture based on LF technology is established, which is able to capture the LF of a patient, and provide an immersive 3D display at the doctor site. For 3D modeling, we further propose an algorithm which is able to convert the captured LF to a 3D model with a high level of detail. For the software implementation on different platforms (i.e., desktop, web-based and mobile phone platforms), a cross-platform solution is proposed. Demo applications have been developed for 2D/3D video conferencing, 3D model display and edit, blood pressure and heart rate monitoring, and patient data viewing functions. The demo software can be extended to multi-discipline telehealth applications, such as tele-dentistry, tele-wound and tele-psychiatry. The proposed 3D telemedicine solution has the potential to revolutionize next-generation telemedicine technologies by providing a high quality immersive tele-consultation experience.
Elsevier
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47405/1/47405%20Wang%20et%20al%202016.pdf
http://dx.doi.org/10.1016/j.cmpb.2015.11.002
Wang, Gengkun, Xiang, Wei, and Pickering, Mark (2016) A cross-platform solution for light field based 3D telemedicine. Computer Methods and Programs in Biomedicine, 125. pp. 103-116.
https://researchonline.jcu.edu.au/47405/
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oai:researchonline.jcu.edu.au:47442
2024-03-01T14:42:24Z
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The implementation and evaluation health promotion services and programs to improve cultural competency: a systematic scoping review
Jongen, Crystal Sky
McCalman, Janya
Bainbridge, Roxanne Gwendalyn
Background: Cultural competency is a multifaceted intervention approach which needs to be implemented at various levels of healthcare systems to improve quality of care for culturally and ethnically diverse populations. One level of healthcare where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience healthcare and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes.
Methods: This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature.
Results: The review identified three overarching strategies utilised in health promotion services and programs to improve cultural competency: community focused strategies, culturally focused strategies, and language focused strategies. Studies took different approaches to delivering culturally competent health interventions; with the majority incorporating multiple strategies from each overarching category. There were various intermediate healthcare and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts.
Discussion: Examined together, these intervention strategies and outcomes provide a framework which can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.
Frontiers Research Foundation
2017
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47442/1/Implementation_and_evaluation.pdf
https://doi.org/10.3389/fpubh.2017.00024
Jongen, Crystal Sky, McCalman, Janya, and Bainbridge, Roxanne Gwendalyn (2017) The implementation and evaluation health promotion services and programs to improve cultural competency: a systematic scoping review. Frontiers in Public Health, 5. 24.
https://researchonline.jcu.edu.au/47442/
open
oai:researchonline.jcu.edu.au:47471
2024-03-02T15:08:04Z
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Improving community health using an outcome-oriented CQI approach to community-engaged health professions education
Clithero, Amy
Ross, Simone Jacquelyn
Middleton, Lyn
Reeve, Carole
Neusy, Andre-Jacques
Health professionals providing health-care services must have the relevant competencies and clinical experiences needed to improve population health outcomes in different contexts. Current models of health profession education often fail to produce a fit-for-purpose workforce ready and willing to provide relevant, quality care to underserved communities. Evidence is emerging that community-engaged and socially accountable health workforce education, i.e., aligned with priority health needs, produces a workforce ready and willing to work in partnership with underserved regions. This model of education fosters greater affiliation between education and service delivery systems and requires institutions to measure graduate outcomes and institutional impact. The Training for Health Equity Network (THEnet), a partnership of socially accountable health workforce education institutions, has developed and tested a Social Accountability Framework for Health Workforce Education (the Framework) and toolkit to improve alignment of health workforce education with outcomes to assess how well education institutions meet the needs of the communities they serve. The Framework links education and service delivery creating a continuous quality improvement feedback loop to ensure that education addresses needs and maximizes impact on the quality of service delivery. The Framework also provides a unifying set of guidelines for health workforce policy and planning, accreditation, education, research, and service delivery. A key element to ensuring consistent high quality service delivery is an appropriately trained and equitably distributed workforce. An effective and comprehensive mechanism for evaluation is the method of CQI which links the design, implementation, accreditation, and evaluation of health workforce education with health service delivery and health outcomes measurement.
Frontiers Research Foundation
2017-02-27
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47471/1/47471_Ross_2017.pdf
http://dx.doi.org/10.3389/fpubh.2017.00026
Clithero, Amy, Ross, Simone Jacquelyn, Middleton, Lyn, Reeve, Carole, and Neusy, Andre-Jacques (2017) Improving community health using an outcome-oriented CQI approach to community-engaged health professions education. Frontiers in Public Health, 5. 26. pp. 1-6.
https://researchonline.jcu.edu.au/47471/
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2017-03-01T19:30:03Z
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Aboriginal peoples participation in their health care: a patient right and an obligation for health care providers
Couzos, Sophie
Thiele, Dea Delaney
[Extract] Health professionals may be experts about disease, but patients are experts about their lives. That's because patients live with their illness and disease every day. The best health care providers know that the factors that influence people’s lives also influences their health outcomes. They treat the patient and not just the disease. This is called patient-centered care. Aboriginal peoples started delivering patient-centred care 45years ago when they established Aboriginal Community Controlled Health Services (ACCHSs). These services gave patients a voice in their health care decisions when this had been historically denied to them 2.Through these services, and there are now more than 150 of them. Aboriginal peoples can meaningfully participate in the healthcare system. ACCHSs now form part of a national system of primary health care services that specialise in providing comprehensive and quality care to Aboriginal peoples and Torres Strait Islanders. So, what is it about these services that demonstrate consumer engagement or participation? First, let's explore what this means.
Aboriginal and Islander Health Worker
2016
Article
PeerReviewed
application/pdf
https://researchonline.jcu.edu.au/47473/6/47473_Couzos_2016.pdf
Couzos, Sophie, and Thiele, Dea Delaney (2016) Aboriginal peoples participation in their health care: a patient right and an obligation for health care providers. Aboriginal and Islander Health Worker Journal, 40. pp. 6-7.
https://researchonline.jcu.edu.au/47473/
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