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Grigg J, Manning V, Lubman DI. A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial. Med J Aust 2023; 219:560. [PMID: 37985181 DOI: 10.5694/mja2.52161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/12/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
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Graves EJ, Rinehart A, Grapenthin R, Angarita MF, Grigg J. InSAR-observed surface deformation in New Mexico's Permian Basin shows threats and opportunities presented by leaky injection wells. Sci Rep 2023; 13:17308. [PMID: 37828027 PMCID: PMC10570274 DOI: 10.1038/s41598-023-42696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
Knowledge of aquifer dynamics, including groundwater storage changes, is key to effective groundwater resource and reservoir management. Resolving and accurate modeling of these processes requires knowledge of subsurface poroelastic properties and lateral heterogeneity within units of interest. Computationally demanding methods for determining lateral heterogeneity in poroelastic properties exist but remain difficult to practically employ. The InSAR-based detection of uplift over a New Mexico well with a casing breach provides an opportunity to determine poroelastic properties using a tractable 2D analytical plane strain solution for surface uplift created by a pressurized reservoir with overburden. Using a Bayesian inversion framework, we calculate poroelastic properties under deep (depth of well-screen) and shallow (depth of well-breach) conditions. We find that shallow injection is necessary to produce the observed deformation. However, pressure-varying forward solutions for uplift are required to reproduce the temporal evolution of deformation. For this we use realistic shallow poroelastic properties and well dynamics, which reflect the evolving injection conditions at the well breach as the casing further erodes. Analysis of individual interferograms or InSAR time series may provide insights into shallow subsurface heterogeneity or anomalous injection conditions at operating wells more rapidly than scheduled field inspections.
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Affiliation(s)
- E J Graves
- Department of Geosciences, University of Alaska Fairbanks, Fairbanks, AK, USA.
| | - A Rinehart
- Department of Earth and Environmental Sciences, New Mexico Institute of Mining and Technology, Socorro, NM, USA
| | - R Grapenthin
- Department of Geosciences, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - M F Angarita
- Department of Geosciences, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - J Grigg
- Former Subsurface Geologist, New Mexico Bureau of Geology and Mineral Resources, New Mexico Institute of Mining and Technology, Socorro, NM, USA
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Grigg J, Manning V, Lockie D, Giles M, Bell RJ, Stragalinos P, Bernard C, Greenwood CJ, Volpe I, Smith L, Bragge P, Lubman DI. A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial. Med J Aust 2023. [PMID: 37247850 DOI: 10.5694/mja2.51991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. DESIGN Single-site, double-blinded randomised controlled trial. SETTING Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program. PARTICIPANTS Women aged 40 years or more, with or without a history of breast cancer and reporting any alcohol consumption, who attended the clinic for routine mammography during 5 February - 27 August 2021. INTERVENTION Active arm: animation including brief alcohol intervention (four minutes) and lifestyle health promotion (three minutes). CONTROL ARM lifestyle health promotion only. MAJOR OUTCOME MEASURE Change in proportion of women who identified alcohol use as a clear risk factor for breast cancer (scaled response measure). RESULTS The mean age of the 557 participants was 60.3 years (standard deviation, 7.7 years; range, 40-87 years); 455 had recently consumed alcohol (82%). The proportions of participants aware that alcohol use increased the risk of breast cancer were larger at four weeks than at baseline for both the active intervention (65% v 20%; odds ratio [OR], 41; 95% confidence interval [CI], 18-97) and control arms of the study (38% v 20%; OR, 4.9; 95% CI, 2.8-8.8), but the change over time was greater for the active intervention arm (arm × time: P < 0.001). Alcohol literacy also increased to a greater extent in the active than the control arm, but alcohol consumption did not significantly change in either arm. CONCLUSION A tailored brief alcohol intervention for women attending breast screening was effective for improving awareness of the increased breast cancer risk associated with alcohol use and alcohol literacy more broadly. Such interventions are particularly important given the rising prevalence of risky drinking among middle-aged and older women and evidence that even very light alcohol consumption increases breast cancer risk. REGISTRATION ClinicalTrials.gov, NCT04715516 (prospective; 20 January 2021).
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Darren Lockie
- Maroondah BreastScreen, Eastern Health, Melbourne, VIC
| | | | | | - Peta Stragalinos
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Chloe Bernard
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Christopher J Greenwood
- Deakin University, Geelong, VIC
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC
| | - Isabelle Volpe
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Liam Smith
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
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Volpe I, Brien R, Grigg J, Tzanetis S, Crawford S, Lyons T, Lee N, McKinnon G, Hughes C, Eade A, Barratt MJ. Correction: 'We don't live in a harm reduction world, we live in a prohibition world': tensions arising in the design of drug alerts. Harm Reduct J 2023; 20:55. [PMID: 37098592 PMCID: PMC10127480 DOI: 10.1186/s12954-023-00784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Affiliation(s)
- Isabelle Volpe
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
- Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Rita Brien
- Turning Point, Eastern Health Statewide Services, Richmond, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health Statewide Services, Richmond, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | | | - Sione Crawford
- Harm Reduction Victoria (DanceWize), North Melbourne, Australia
| | - Tom Lyons
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Nicole Lee
- , 360Edge, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Ginny McKinnon
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Caitlin Hughes
- Law and Commerce, Flinders University, Adelaide, Australia
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
- Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.
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Brien R, Volpe I, Grigg J, Lyons T, Hughes C, McKinnon G, Tzanetis S, Crawford S, Eade A, Lee N, Barratt MJ. Correction: Co‑designing drug alerts for health and community workers for an emerging early warning system in Victoria, Australia. Harm Reduct J 2023; 20:57. [PMID: 37098601 PMCID: PMC10131409 DOI: 10.1186/s12954-023-00783-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Affiliation(s)
- Rita Brien
- Turning Point, Eastern Health Statewide Services, Richmond, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Isabelle Volpe
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
- Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health Statewide Services, Richmond, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Tom Lyons
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Caitlin Hughes
- Law and Commerce, Flinders University, Adelaide, Australia
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Ginny McKinnon
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Stephanie Tzanetis
- Harm Reduction Victoria (DanceWize), Melbourne, Australia
- CanTEST (Direction Health Services, Pill Testing Australia, Canberra Alliance for Harm Minimisation and Advocacy), Canberra, Australia
| | - Sione Crawford
- Harm Reduction Victoria (DanceWize), Melbourne, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Nicole Lee
- 360Edge, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
- Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.
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Grigg J, Manning V, Cheetham A, Greenwood CJ, Youssef G, Lockie D, Bell R, Stragalinos P, Bernard C, Lubman DI. Risky alcohol consumption among women in Australia attending breast screening services: an exploratory cross-sectional study. Addiction 2023. [PMID: 37057463 DOI: 10.1111/add.16191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/01/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND AND AIMS Alcohol is a major modifiable risk factor for female breast cancer, with breast cancer risk now associated with substantially lower consumption levels than those previously deemed safe. This study sought to measure risky drinking among women attending breast screening services in Australia according to new national alcohol guidelines and to compare daily, weekly and recent (past 12 months) consumption to Australian gender and age population norms. DESIGN, SETTING AND PARTICIPANTS This study was a retrospective analysis of cross-sectional data from the Lifepool Project (collected October 2011-January 2016) in Victoria, Australia, comprising a convenience sample of women attending breast screening services aged 40+ years. MEASUREMENTS Typical and heavy alcohol consumption patterns over the previous 12 months (frequency, quantity), socio-demographic (e.g. age, education) and health-related (e.g. menopause status, breast cancer history) characteristics. Primary outcomes were the proportion of women drinking at a level exceeding new guidelines for weekly and daily alcohol consumption. FINDINGS Of 49 240 women, mean age was 59.94 years (standard deviation = 7.14, range = 40-94 years). Most women had consumed alcohol during the past 12 months [41 628, 85.48%, 95% confidence interval (CI) = 85.16, 85.79]. One in five women (8464, 18.34%, 95% CI = 17.99, 18.69) were drinking at a level exceeding new national guidelines for weekly consumption (i.e. greater than 10 standard drinks per week), and one in six (7446, 15.60%, 95% CI = 15.28, 15.93) were exceeding new guidelines for consumption on a single day (i.e. greater than four standard drinks on any 1 day, more than once per month). The proportion of women in this sample drinking daily (4.21-11.19%), weekly (34.73-50.71%) and in the past 12 months (74.96-90.81%) was significantly greater among nearly all age groups (by decade), compared with Australian gender and age norms [drinking daily (3.4-9.1%), weekly (27.1-37.6%) and in the past 12 months (64.4-81.9%)]. CONCLUSIONS There appears to be a high prevalence of risky alcohol consumption among a large convenience sample of breast screening service clients in Australia using new national alcohol guidelines introduced in December 2020.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Ali Cheetham
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Christopher J Greenwood
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - George Youssef
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Melbourne, Australia
| | - Darren Lockie
- Maroondah BreastScreen, Eastern Health, Melbourne, Australia
| | - Robin Bell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peta Stragalinos
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Chloe Bernard
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
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Lubman DI, Manning V, Arunogiri S, Hall K, Reynolds J, Stragalinos P, Petukhova R, Gerhard R, Tyler J, Bough A, Harris A, Grigg J. A structured, telephone-delivered intervention to reduce methamphetamine use: study protocol for a parallel-group randomised controlled trial. Trials 2023; 24:235. [PMID: 36991490 DOI: 10.1186/s13063-023-07172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Australia has one of the highest rates of methamphetamine (MA) use in the world; however, uptake of in-person psychological treatment remains extremely low due to numerous individual (e.g. stigma, shame) and structural (e.g. service accessibility, geographical location) barriers to accessing care. Telephone-delivered interventions are ideally placed to overcome many of the known barriers to treatment access and delivery. This randomised controlled trial (RCT) will examine the efficacy of a standalone, structured telephone-delivered intervention to reduce MA problem severity and related harms. METHODS This study is a double-blind, parallel-group RCT. We will recruit 196 ± 8 individuals with mild to moderate MA use disorder from across Australia. After eligibility and baseline assessments, participants will be randomly allocated to receive either the Ready2Change-Methamphetamine (R2C-M) intervention (n = 98 ± 4; four to six telephone-delivered intervention sessions, R2C-M workbooks and MA information booklet) or control (n = 98 ± 4; four to six ≤5-min telephone check-ins and MA information booklet including information on accessing further support). Telephone follow-up assessments will occur at 6 weeks and 3, 6 and 12 months post-randomisation. The primary outcome is change in MA problem severity (Drug Use Disorders Identification Test, DUDIT) at 3 months post-randomisation. Secondary outcomes are as follows: MA problem severity (DUDIT) at 6 and 12 months post-randomisation, amount of methamphetamine used, methamphetamine use days, methamphetamine use disorder criteria met, cravings, psychological functioning, psychotic-like experiences, quality of life and other drug use days (at some or all timepoints of 6 weeks and 3, 6 and 12 months post-randomisation). Mixed-methods program evaluation will be performed and cost-effectiveness will be examined. DISCUSSION This study will be the first RCT internationally to assess the efficacy of a telephone-delivered intervention for MA use disorder and related harms. The proposed intervention is expected to provide an effective, low-cost, scalable treatment for individuals otherwise unlikely to seek care, preventing future harms and reducing health service and community costs. TRIAL REGISTRATION ClinicalTrials.gov NCT04713124 . Pre-registered on 19 January 2021.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Victoria, Australia.
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Drug use, Addictive and Anti-social Behaviour Research, Deakin University, Melbourne, Victoria, Australia
| | - John Reynolds
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Peta Stragalinos
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rachel Petukhova
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Robyn Gerhard
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jonathan Tyler
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Anna Bough
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
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Brien R, Volpe I, Grigg J, Lyons T, Hughes C, McKinnon G, Tzanetis S, Crawford S, Eade A, Lee N, Barratt MJ. Co-designing drug alerts for health and community workers for an emerging early warning system in Victoria, Australia. Harm Reduct J 2023; 20:30. [PMID: 36894933 PMCID: PMC9995746 DOI: 10.1186/s12954-023-00761-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Alerts about changes in unregulated drug markets may be useful for supporting health and community workers to anticipate, prevent, and respond to unexpected adverse drug events. This study aimed to establish factors influencing the successful design and implementation of drug alerts for use in clinical and community service settings in Victoria, Australia. METHODS An iterative mixed methods design was used to co-produce drug alert prototypes with practitioners and managers working across various alcohol and other drug services and emergency medicine settings. A quantitative needs-analysis survey (n = 184) informed five qualitative co-design workshops (n = 31). Alert prototypes were drafted based on findings and tested for utility and acceptability. Applicable constructs from the Consolidated Framework for Implementation Research helped to conceptualise factors that impact successful alert system design. RESULTS Timely and reliable alerts about unexpected drug market changes were important to nearly all workers (98%) yet many reported insufficient access to this kind of information (64%). Workers considered themselves 'conduits' for information-sharing and valued alerts for increasing exposure to drug market intelligence; facilitating communication about potential threats and trends; and improving capacity for effective responding to drug-related harm. Alerts should be 'shareable' across a range of clinical and community settings and audiences. To maximise engagement and impact, alerts must command attention, be easily recognisable, be available on multiple platforms (electronic and printable formats) in varying levels of detail, and be disseminated via appropriate notification mechanisms to meet the needs of diverse stakeholder groups. Three drug alert prototypes (SMS prompt, summary flyer, and a detailed poster) were endorsed by workers as useful for supporting their work responding to unexpected drug-related harms. DISCUSSION Alerts informed by coordinated early warning networks that offer close to real-time detection of unexpected substances can provide rapid, evidence-based drug market intelligence to inform preventive and responsive action to drug-related harm. The success of alert systems requires adequate planning and resourcing to support design, implementation, and evaluation, which includes consultation with all relevant audiences to understand how to maximise engagement with information, recommendations, and advice. Our findings about factors impacting successful alert design have utility to inform the development of local early warning systems.
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Affiliation(s)
- Rita Brien
- Turning Point, Eastern Health Statewide Services, Richmond, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Isabelle Volpe
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health Statewide Services, Richmond, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Tom Lyons
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Caitlin Hughes
- Law and Commerce, Flinders University, Adelaide, Australia.,National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Ginny McKinnon
- Department of Health, State Government of Victoria, Melbourne, Australia
| | - Stephanie Tzanetis
- Harm Reduction Victoria (DanceWize), Melbourne, Australia.,CanTEST - Directions Health Services, Canberra, Australia
| | - Sione Crawford
- Harm Reduction Victoria (DanceWize), Melbourne, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia.,Department of Paramedicine, Monash University, Melbourne, Australia
| | - Nicole Lee
- 360Edge, Melbourne, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia. .,National Drug and Alcohol Research Centre, UNSW, Sydney, Australia. .,Digital Ethnography Research Centre, RMIT University, Melbourne, Australia.
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Volpe I, Brien R, Grigg J, Tzanetis S, Crawford S, Lyons T, Lee N, McKinnon G, Hughes C, Eade A, Barratt MJ. 'We don't live in a harm reduction world, we live in a prohibition world': tensions arising in the design of drug alerts. Harm Reduct J 2023; 20:3. [PMID: 36624508 PMCID: PMC9829230 DOI: 10.1186/s12954-022-00716-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/22/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Drug alerts designed for health and community workforces have potential to avert acute harms associated with unpredictable illicit drug markets, by preparing workers to respond to unusual drug-related events, and distribute information to service users. However, the design of such alerts is complicated by diverse needs of individuals, and broader socio-political contexts. Here, we discuss the tensions that arose in the process of co-designing drug alert templates with health and community workers. METHODS We conducted five in-depth digital co-design workshops with 31 workers employed in alcohol and other drug and urgent care settings. Our approach to analysis was informed by Iterative Categorisation and reflexive thematic analysis methods. RESULTS We identified five key tensions. First, there is a need to provide comprehensive information to meet the information needs of a diverse group of workers with varying knowledge levels, while also designing alerts to be clear, concise, and relevant to the work of individuals. Second, it is important that alerts do not create 'information overload'; however, it is also important that information should be available to those who want it. Third, alert design and dissemination must be perceived to be credible, to avoid 'alert scepticism'; however, credibility is challenging to develop in a broader context of criminalisation, stigmatisation, and sensationalism. Fourth, alerts must be carefully designed to achieve 'intended effects' and avoid unintended effects, while acknowledging that it is impossible to control all potential effects. Finally, while alerts may be intended for an audience of health and community workers, people who use drugs are the end-users and must be kept front of mind in the design process. CONCLUSIONS The co-design process revealed complexities in designing drug alerts, particularly in the context of stigmatised illicit drug use, workforce diversity, and dissemination strategies. This study has highlighted the value of developing these important risk communication tools with their target audiences to ensure that they are relevant, useful, and impactful. The findings have informed the development of our drug alert prototypes and provide local context to complement existing best-practice risk-communications literature.
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Affiliation(s)
- Isabelle Volpe
- grid.1017.70000 0001 2163 3550Social and Global Studies Centre, RMIT University, Melbourne, Australia ,grid.1005.40000 0004 4902 0432Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Rita Brien
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health Statewide Services, Richmond, Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- grid.414366.20000 0004 0379 3501Turning Point, Eastern Health Statewide Services, Richmond, Australia ,grid.1002.30000 0004 1936 7857Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | | | - Sione Crawford
- Harm Reduction Victoria (DanceWize), North Melbourne, Australia
| | - Tom Lyons
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Nicole Lee
- 360Edge, Melbourne, Australia ,grid.1032.00000 0004 0375 4078National Drug Research Institute, Curtin University, Perth, Australia
| | - Ginny McKinnon
- Department of Health, Victoria State Government, Melbourne, Australia
| | - Caitlin Hughes
- grid.1014.40000 0004 0367 2697Law and Commerce, Flinders University, Adelaide, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Alan Eade
- Safer Care Victoria, Melbourne, Australia ,grid.1002.30000 0004 1936 7857Department of Paramedicine, Monash University, Melbourne, Australia
| | - Monica J. Barratt
- grid.1017.70000 0001 2163 3550Social and Global Studies Centre, RMIT University, Melbourne, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, UNSW, Sydney, Australia ,grid.1017.70000 0001 2163 3550Digital Ethnography Research Centre, RMIT University, Melbourne, Australia
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Grigg J, Manning V, Lockie D, Giles M, Bell R, Stragalinos P, Bernard C, Volpe I, Greenwood CJ, Smith L, Bragge P, Lubman DI. A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol use Among Women Attending an Australian Breast Screening Service (Health4Her): Protocol for a Hybrid Effectiveness-Implementation Trial (Preprint). JMIR Res Protoc 2022; 12:e44867. [PMID: 36995739 PMCID: PMC10131813 DOI: 10.2196/44867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption. A breast screening service is a novel health care setting for brief alcohol intervention, with the potential for extensive reach. OBJECTIVE This study aimed to conduct a formative evaluation with breast screening service consumers to understand the need for, and acceptability of, brief alcohol intervention in the breast screening setting and collaboratively design a brief alcohol intervention (Health4Her); to test the effectiveness of Health4Her in improving knowledge of alcohol as a breast cancer risk factor (primary outcome), improving alcohol literacy, and reducing consumption among women attending a breast screening service; and to examine the implementation strategy through process evaluation. METHODS This was a hybrid type II effectiveness-implementation trial comprising a randomized controlled trial (RCT) alongside a mixed methods program evaluation guided by applicable elements of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and Consolidated Framework for Implementation Research. Formative evaluation comprised a retrospective analysis of alcohol consumption data (n=49,240), a web-based survey (n=391), and focus groups and interviews (n=31) with breast screening service consumers. Women attending routine mammography, drinking at any level, were recruited to the single-site, double-blind RCT (n=558), and completed a baseline assessment before randomization (1:1) to receive Health4Her (alcohol brief intervention + lifestyle information) or control (lifestyle information) via animation on an iPad. Follow-up assessments were performed 4 and 12 weeks after randomization. The process evaluation included evaluation of trial administrative data, participant quantitative (n=497) and qualitative feedback (n=30), and site staff qualitative feedback (n=11). RESULTS This research was funded in March and May 2019. Data collection for the formative evaluation and trial recruitment occurred between January and April 2020 and February and August 2021, respectively, with finalization of follow-up data collection in December 2021. Quantitative process evaluation data were collected during trial implementation, and collection of participant and staff feedback was finalized in December 2021. Results of the retrospective analysis of alcohol consumption data from breast screening service consumers is anticipated to be published in March 2023 and the results of the RCT to be published in March 2023. CONCLUSIONS This study is anticipated to generate new substantial knowledge on the alcohol consumption and literacy needs of women attending breast screening and the extent to which these can be addressed using a novel, tailored brief alcohol intervention. The study design permits the evaluation of the effectiveness and implementation of Health4Her to predict and facilitate uptake in breast screening services. TRIAL REGISTRATION ClinicalTrials.gov NCT04715516; https://clinicaltrials.gov/ct2/show/NCT04715516. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/44867.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Darren Lockie
- Maroondah BreastScreen, Eastern Health, Melbourne, Australia
| | - Michelle Giles
- Maroondah BreastScreen, Eastern Health, Melbourne, Australia
| | - Robin Bell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | | | - Christopher J Greenwood
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Liam Smith
- BehaviourWorks Australia, Monash University, Melbourne, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
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11
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Grigg J, Manning V, Cheetham A, Youssef G, Hall K, Baker AL, Staiger PK, Volpe I, Stragalinos P, Lubman DI. A Latent Class Analysis of Perceived Barriers to Help-seeking Among People with Alcohol Use Problems Presenting for Telephone-delivered Treatment. Alcohol Alcohol 2022; 58:68-75. [PMID: 36448844 PMCID: PMC9830485 DOI: 10.1093/alcalc/agac063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/18/2022] [Accepted: 10/26/2022] [Indexed: 12/05/2022] Open
Abstract
AIMS Despite the magnitude of alcohol use problems globally, treatment uptake remains low. This study sought to determine the proportion of people presenting to telephone-delivered alcohol treatment who are first-time help-seekers, and explored perceived barriers to help-seeking to understand the barriers this format of treatment may help to address. METHODS Secondary analysis of baseline data from a randomized controlled trial of a telephone-delivered intervention for alcohol use problems. Latent class analysis (LCA) identified participant profiles according to self-reported barriers to alcohol treatment. RESULTS Participants' (344) mean age was 39.86 years (SD = 11.36, 18-73 years); 51.45% were male. Despite high alcohol problem severity (Alcohol Use Disorder Identification Test: mean = 21.54, SD = 6.30; 63.37% probable dependence), multiple barriers to accessing treatment were endorsed (mean = 5.64, SD = 2.41), and fewer than one-third (29.36%) had previously accessed treatment. LCA revealed a two-class model: a 'low problem recognition' class (43.32%) endorsed readiness-for-change and attitudinal barriers; a 'complex barriers' class (56.68%) endorsed stigma, structural, attitudinal and readiness-to-change barriers, with complex barrier class membership predicted by female sex (adjusted OR = 0.45, 95% CI 0.28, 0.72) and higher psychological distress (adjusted OR = 1.13, 95% CI 1.08, 1.18). CONCLUSION The majority of people accessing this telephone-delivered intervention were new to treatment, yet had high alcohol problem severity. Two distinct profiles emerged, for which telephone interventions may overcome barriers to care and tailored approaches should be explored (e.g. increasing problem awareness, reducing psychological distress). Public health strategies to address stigma, and raise awareness about the low levels of drinking that constitute problem alcohol use, are needed to increase help-seeking.
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Affiliation(s)
- Jasmin Grigg
- Corresponding author: 110 Church St Richmond, VIC 3121, Australia. Tel.: +61 8413 8723; E-mail
| | - Victoria Manning
- Turning Point, Eastern Health, Church St Richmond, 3121, Australia,Monash Addiction Research Centre, Eastern Health Clinical School, Moorooduc Hwy Melbourne, 3199, Australia
| | - Ali Cheetham
- Turning Point, Eastern Health, Church St Richmond, 3121, Australia,Monash Addiction Research Centre, Eastern Health Clinical School, Moorooduc Hwy Melbourne, 3199, Australia
| | - George Youssef
- School of Psychology, Deakin University, Pigdons Rd Geelong, 3216, Australia,Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Burwood Hwy Melbourne, 3125, Australia,Centre for Adolescent Health, Murdoch Children’s Research Institute, Flemington Rd Melbourne, 3052, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Pigdons Rd Geelong, 3216, Australia,Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Burwood Hwy Melbourne, 3125, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, University Drv Callaghan, 2308, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, Pigdons Rd Geelong, 3216, Australia,Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Burwood Hwy Melbourne, 3125, Australia
| | - Isabelle Volpe
- Turning Point, Eastern Health, Church St Richmond, 3121, Australia,Monash Addiction Research Centre, Eastern Health Clinical School, Moorooduc Hwy Melbourne, 3199, Australia
| | - Peta Stragalinos
- Turning Point, Eastern Health, Church St Richmond, 3121, Australia,Monash Addiction Research Centre, Eastern Health Clinical School, Moorooduc Hwy Melbourne, 3199, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Church St Richmond, 3121, Australia,Monash Addiction Research Centre, Eastern Health Clinical School, Moorooduc Hwy Melbourne, 3199, Australia
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12
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Lubman DI, Grigg J, Reynolds J, Hall K, Baker AL, Staiger PK, Tyler J, Volpe I, Stragalinos P, Harris A, Best D, Manning V. Effectiveness of a Stand-alone Telephone-Delivered Intervention for Reducing Problem Alcohol Use: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:1055-1064. [PMID: 36129698 PMCID: PMC9494267 DOI: 10.1001/jamapsychiatry.2022.2779] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/26/2022] [Indexed: 11/14/2022]
Abstract
Importance Despite the magnitude of alcohol use problems globally, treatment uptake remains low. Telephone-delivered interventions have potential to overcome many structural and individual barriers to help seeking, yet their effectiveness as a stand-alone treatment for problem alcohol use has not been established. Objective To examine the effectiveness of the Ready2Change telephone-delivered intervention in reducing alcohol problem severity up to 3 months among a general population sample. Design, Setting, and Participants This double-blind, randomized clinical trial recruited participants with an Alcohol Use Disorders Identification Test (AUDIT) score of greater than 6 (for female participants) and 7 (for male participants) from across Australia during the period of May 25, 2018, to October 2, 2019. Telephone assessments occurred at baseline and 3 months after baseline (84.9% retention). Data collection was finalized September 2020. Interventions The telephone-based cognitive and behavioral intervention comprised 4 to 6 telephone sessions with a psychologist. The active control condition comprised four 5-minute telephone check-ins from a researcher and alcohol and stress management pamphlets. Main Outcomes and Measures The primary outcome was change in alcohol problem severity, measured with the AUDIT total score. Drinking patterns were measured with the Timeline Followback (TLFB) instrument. Results This study included a total of 344 participants (mean [SD] age, 39.9 [11.4] years; range, 18-73 years; 177 male participants [51.5%]); 173 participants (50.3%) composed the intervention group, and 171 participants (49.7%) composed the active control group. Less than one-third of participants (101 [29.4%]) had previously sought alcohol treatment, despite a high mean (SD) baseline AUDIT score of 21.5 (6.3) and 218 (63.4%) scoring in the probable dependence range. For the primary intention-to-treat analyses, there was a significant decrease in AUDIT total score from baseline to 3 months in both groups (intervention group decrease, 8.22; 95% CI, 7.11-9.32; P < .001; control group decrease, 7.13; 95% CI, 6.10-8.17; P < .001), but change over time was not different between groups (difference, 1.08; 95% CI, -0.43 to 2.59; P = .16). In secondary analyses, the intervention group showed a significantly greater reduction in the AUDIT hazardous use domain relative to the control group at 3 months (difference, 0.58; 95% CI, 0.02-1.14; P = .04). A greater reduction in AUDIT total score was observed for the intervention group relative to the control group when adjusting for exposure to 2 or more sessions (difference, 3.40; 95% CI, 0.36-6.44; P = .03) but not 1 or more sessions (per-protocol analysis). Conclusions and Relevance Based on the primary outcome, AUDIT total score, this randomized clinical trial did not find superior effectiveness of this telephone-based cognitive and behavioral intervention compared with active control. However, the intervention was effective in reducing hazardous alcohol use and reduced alcohol problem severity when 2 or more sessions were delivered. Trial outcomes demonstrate the potential benefits of this highly scalable and accessible model of alcohol treatment. Trial Registration ANZCTR Identifier: ACTRN12618000828224.
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Affiliation(s)
- Dan I. Lubman
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - John Reynolds
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug, Addictive and Anti-social Behaviour Research, Deakin University, Melbourne, Victoria, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Petra K. Staiger
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug, Addictive and Anti-social Behaviour Research, Deakin University, Melbourne, Victoria, Australia
| | - Jonathan Tyler
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Isabelle Volpe
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peta Stragalinos
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - David Best
- Department of Criminology, University of Derby, Derby, United Kingdom
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
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13
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Affiliation(s)
- Rowan P Ogeil
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School and Monash Addiction Research Centre Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School and Monash Addiction Research Centre Monash University, Melbourne, Australia
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14
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Grigg J, Volpe I, Tyler J, Hall K, McPherson B, Lubman DI, Manning V. Ready2Change: Preliminary effectiveness of a telephone-delivered intervention program for alcohol, methamphetamine and cannabis use problems. Drug Alcohol Rev 2021; 41:517-527. [PMID: 34343370 DOI: 10.1111/dar.13363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Telehealth has considerable potential to overcome many of the barriers to accessing care for substance use problems, thereby increasing the opportunity for earlier intervention. The Ready2Change program is a multiple-session outbound telephone-delivered cognitive and behavioural intervention for mild-to-moderate substance use disorders, embedded within a long-established 24/7 alcohol and drug helpline. We sought to analyse routinely collected program data in a preliminary study to examine the effectiveness of Ready2Change in reducing substance use problem severity and psychological distress. METHODS A retrospective analysis of program data from December 2013 to June 2018 was performed. Analysed cases were 249 clients living in Victoria, Australia with alcohol (n = 191), methamphetamine (n = 40) or cannabis (n = 18) as their primary drug of concern. A within-subjects design was used to examine pre- and post-intervention substance use problem severity and psychological distress. RESULTS For alcohol cases, there was a statistically significant decrease in alcohol problem severity [AUDIT, mean difference = -12.7, 95% confidence interval (CI) -14.0, -11.5]. Statistically significant reductions in drug problem severity (DUDIT) were observed for methamphetamine (mean difference = -17.3, 95% CI -20.9, -13.7) and cannabis (mean difference = -15.9, 95% CI -22.3, -9.6) cases. All groups showed reductions in problem severity for other substances used (P < 0.05) and psychological distress (P < 0.001). DISCUSSION AND CONCLUSIONS Results suggest Ready2Change benefits clients with alcohol, methamphetamine and cannabis use problems, with the potential to improve treatment access for health inequity groups including those living in remote areas. These findings warrant further investigation into the effectiveness of this program.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Isabelle Volpe
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | | | - Kate Hall
- School of Psychology, Deakin University, Geelong, Australia.,Centre of Drug, Addictive and Anti-social Behaviour Research, Deakin University, Melbourne, Australia
| | | | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
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15
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Soh HJ, Grigg J, Gurvich C, Gavrilidis E, Kulkarni J. Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners. J Interpers Violence 2021; 36:NP2391-NP2409. [PMID: 29580196 DOI: 10.1177/0886260518760609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Family violence is threatening behavior carried out by a person to coerce or control another member of the family or causes the family member to be fearful. Health practitioners are well placed to play a pivotal role in identifying and responding to family violence; however, their perceived capacity to respond to patients experiencing family violence is not well understood. We aim to explore Australian health practitioners' current perspectives, practices, and perceived barriers in working with family violence, including perceived confidence in responding effectively to cases of family violence encountered during their work with patients. A total of 1,707 health practitioners primarily practicing in the wider Melbourne region were identified, and 114 health practitioners participated in the study between March 2016 and August 2016 by completing an investigator-developed questionnaire. Descriptive, qualitative, and thematic analyses were performed. The majority of participants recognized family violence to be a health issue and that family violence would impact the mental health of afflicted persons. Despite this, only a fifth of participants felt they were very confident in screening, supporting, and referring patients with family violence experiences. Perceived barriers to inquire about family violence included time constraints and greater importance placed on screening for other health issues. Health practitioners reported that additional training on screening, supporting, and referring patients would be beneficial. Australian health practitioners need to be upskilled. Recently, in Australia, state-relevant toolkits have been developed to provide succinct information about responding to initial patient presentations of family violence, how to inquire about family violence, and how to handle disclosures (and nondisclosures) by patients. Further resources could be developed to aid health practitioners in providing assistance to their patients as indicated. These initiatives would be a step toward addressing the concerns with regard to the lack of training and could possibly optimize outcomes for patients experiencing family violence.
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Affiliation(s)
- Han Jie Soh
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Emmy Gavrilidis
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
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Valiulis A, Bousquet J, Veryga A, Suprun U, Sergeenko D, Cebotari S, Borelli D, Pietikainen S, Banys J, Agache I, Billo NE, Bush A, Chkhaidze I, Dubey L, Fokkens WJ, Grigg J, Haahtela T, Julge K, Katilov O, Khaltaev N, Odemyr M, Palkonen S, Savli R, Utkus A, Vilc V, Alasevicius T, Bedbrook A, Bewick M, Chorostowska-Wynimko J, Danila E, Hadjipanayis A, Karseladze R, Kvedariene V, Lesinskas E, Münter L, Samolinski B, Sargsyan S, Sitkauskiene B, Somekh D, Vaideliene L, Valiulis A, Hellings PW. Correction to: Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases. Clin Transl Allergy 2020; 10:49. [PMID: 33292544 PMCID: PMC7672866 DOI: 10.1186/s13601-020-00357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Arunas Valiulis
- Department of Public Health, Institute of Health Sciences, and Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. .,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France. .,UMR‑S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France. .,Euforea, Brussels, Belgium. .,Charité, Berlin, Germany.
| | - A Veryga
- Minister of Health, Vilnius, Lithuania
| | - U Suprun
- Minister of Health, Kiev, Ukraine
| | - D Sergeenko
- Minister of Labour, Health and Social Affairs, Tbilisi, Georgia
| | - S Cebotari
- Minister of Health, Labour and Social Protection, Chișinău, Moldova
| | | | | | - J Banys
- Lithuianian Academy of Sciences, Vilnius, Lithuania
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - N E Billo
- Global Alliance Against Chronic Respiratory Diseases (GARD), Joensuu, Finland
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | - I Chkhaidze
- Department of Pediatrics, and Iashvili Central Children's Hospital, Tbilisi State Medical University, Tbilisi, Georgia
| | - L Dubey
- Faculty of Postgraduate Education, Lviv National Medical University by Danylo Halytsky, Lviv, Ukraine
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - J Grigg
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - K Julge
- Children's Clinic, Tartu University Institute of Clinical Medicine, Tartu, Estonia
| | - O Katilov
- Vinnytsa National Medical University by Mykola Pyrogov, Vinnytsa, Ukraine
| | - N Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Geneva, Switzerland
| | - M Odemyr
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - R Savli
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - A Utkus
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Association of Medical Schools in Europe, Berlin, Germany
| | - V Vilc
- State Institute of Phtysiopulmonology by Chiril Draganiuk, Chisinau, Moldova
| | - T Alasevicius
- Department of Public Health, Institute of Health Sciences, and Clinic of Children's Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - A Bedbrook
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - J Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - E Danila
- Clinic of Chest Diseases, Immunology and Allergology, Centre of Pulmonology and Allergology, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - A Hadjipanayis
- Medical School, European University of Cyprus, Nicosia, Cyprus
| | - R Karseladze
- Tbilisi State University Faculty of Medicine, Tbilisi, Georgia
| | - V Kvedariene
- Clinic of Infectious Chest Diseases, Dermatology and Allergology, Institute of Biomedical Sciences, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - E Lesinskas
- Clinic of ENT and Eye Diseases, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - L Münter
- Danish Commitee for Health Education, Copenhagen East, Denmark
| | - B Samolinski
- Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - S Sargsyan
- Institute of Child and Adolescent Health at Arabkir Medical Centre, Yerevan State Medical University, Yerevan, Armenia
| | - B Sitkauskiene
- Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Somekh
- European Health Futures Forum (EHFF), Dromahair, Ireland
| | - L Vaideliene
- Clinic of Children's Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Algirdas Valiulis
- Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - P W Hellings
- Euforea, Brussels, Belgium.,Department of Otorhinolaryngology, University Hospital Leuven, Leuven, Belgium.,Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Grigg J, Killian JJ, Matthews S, Scott D, Arunogiri S, Manning V, Taylor DA, Crossin R, Smith K, Lubman DI. The impact of legislation on acute synthetic cannabinoid harms resulting in ambulance attendance. Int J Drug Policy 2020; 79:102720. [PMID: 32279004 DOI: 10.1016/j.drugpo.2020.102720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Synthetic cannabinoid receptor agonists (SCRAs) have been challenging current drug policy due to the rapid emergence of new variants, and their propensity for acute harm. In Australia, as in other parts of the world, multiple regulatory changes have occurred in response to these new psychoactive compounds, and population surveys indicate use is declining. This suggests that related harms would also be declining. We examined the impact of drug legislative changes on acute SCRA-related harms resulting in ambulance attendance. Secondary aims were to describe patient and attendance characteristics. METHODS A retrospective analysis of coded ambulance attendance data from Victoria, Australia (January 2014-December 2018). Interrupted time-series was used to analyse the trajectories of SCRA-related attendances relative to legislative changes. RESULTS During the study period, 3727 SCRA-related ambulance attendances were identified. There was an upward trend in attendances following legislation scheduling specific SCRAs in Victoria in October 2016 (slope = 1.31, 95% CI 1.17, 1.45). A downward trend in attendances followed 'blanket' legislation targeting all new psychoactive substances, implemented in Victoria in November 2017 (slope = -1.87, 95% CI -2.27, -1.46). Patient median age was 33 years, 80.5% were male, co-occurring substance use was identified in 30.4% cases, and 15.2% had >1 SCRA-related attendance. Overall, 69.4% cases were transported to hospital, with the odds of transport to hospital increasing each year from 2016. CONCLUSION This study represents a population-level examination of the impact of drug policy on acute SCRA-related harms resulting in ambulance attendance. Scheduling of specific SCRAs was associated with a spike in attendances, likely due to the introduction of more harmful variants in the drug market. Blanket legislation was associated with a reduction in SCRA-related attendances, however, a corresponding increase in cases transported to hospital indicates a greater severity of harm that may have been inadvertently promoted by this policy.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
| | - Jessica J Killian
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Sharon Matthews
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Debbie Scott
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | | | - Rose Crossin
- Turning Point, Eastern Health, Melbourne, Australia
| | - Karen Smith
- Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
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Grigg J, Arunogiri S, Manning V, Phan V, Campbell S, Frei M, Lubman DI. The Drug and Alcohol Clinical Advisory Service: A model of telephone-delivered addiction specialist support. Drug Alcohol Rev 2020; 39:238-245. [PMID: 31972876 DOI: 10.1111/dar.13035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 11/06/2019] [Accepted: 12/23/2019] [Indexed: 01/26/2023]
Abstract
INTRODUCTION AND AIMS People with substance use problems frequently present to mainstream health services with a variety of health issues. However, many medical and allied health-care providers feel under-equipped to respond to this population. We describe the Drug and Alcohol Clinical Advisory Service (DACAS), an established 24/7 telephone-delivered model of addiction specialist consultation, and examine recent call data to identify drug use issues for which health practitioners seek support. DESIGN AND METHODS Methods of DACAS service provision and call data collection are provided. A retrospective review of routinely collected call data between July 2013 and June 2018 was performed, extracting information on call and caller characteristics, and consultation details. RESULTS During 2013-2018, DACAS responded to 6565 calls, providing access to specialist alcohol and other drug support for more than 1200 practitioners across Victoria, Tasmania and the Northern Territory annually. Higher rates of service use were found among practitioners located in regional and remote areas, relative to those in metropolitan areas. Opioid agonist treatment was the most common drug class for which practitioners sought consultation (39.5%), followed by other opioids (19.4%). Advice-seeking patterns differed according to caller profession, service setting and location. DISCUSSION AND CONCLUSIONS DACAS is providing a multistate-level response to the challenges of accessing specialist addiction treatment, particularly for opioid agonist treatment and other opioid issues, with demonstrated uptake in regional and remote areas. This telephone-delivered service provides an opportunity to expand access to treatment for opioid use disorder and other substance use problems, particularly in areas with less equitable access to specialist addiction care.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Vicky Phan
- Turning Point, Eastern Health, Melbourne, Australia
| | | | - Matthew Frei
- Turning Point, Eastern Health, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia.,Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia
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Affiliation(s)
- E Jauniaux
- EGA Institute for Women’s Health Faculty of Population Health Sciences University College London London UK
| | - J Grigg
- Centre for Genomics and Child Health Queen Mary University of London London UK
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Thomas B, Javadzadeh S, Robinson E, Ahmed R, Begum R, Rahman S, Khanam H, Kelsell D, Grigg J, O’Toole E. 163 Eczema: Relationships between the environment, severity and the risk of admission to hospital. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Lubman DI, Grigg J, Manning V, Hall K, Volpe I, Dias S, Baker A, K Staiger P, Reynolds J, Harris A, Tyler J, Best D. A structured telephone-delivered intervention to reduce problem alcohol use (Ready2Change): study protocol for a parallel group randomised controlled trial. Trials 2019; 20:515. [PMID: 31426835 PMCID: PMC6701125 DOI: 10.1186/s13063-019-3462-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Current population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder. However, only a minority seek professional help due to individual and structural barriers, such as low health literacy, stigma, geography, service operating hours and wait lists. Telephone-delivered interventions are readily accessible and ideally placed to overcome these barriers. We will conduct a randomised controlled trial (RCT) to examine the efficacy of a standalone, structured telephone-delivered intervention to reduce alcohol consumption, problem severity and related psychological distress among individuals with problem alcohol use. Methods/design This is a single site, parallel group, two-arm superiority RCT. We will recruit 344 participants from across Australia with problem alcohol use. After completing a baseline assessment, participants will be randomly allocated to receive either the Ready2Change (R2C) intervention (n = 172, four to six sessions of structured telephone-delivered intervention, R2C self-help resource, guidelines for alcohol consumption and stress management pamphlets) or the control condition (n = 172, four phone check-ins < 5 min, guidelines for alcohol consumption and stress management pamphlets). Telephone follow-up assessments will occur at 4–6 weeks, 3 months, 6 months and 12 months post-baseline. The primary outcome is the Alcohol Use Disorders Identification Test (AUDIT) score administered at 3 months post-baseline. Secondary outcomes include change in AUDIT score (6 and 12 months post-baseline), change in number of past-month heavy drinking days, psychological distress, health and wellbeing, quality of life, client treatment evaluation and cost effectiveness. Discussion This study will be one of the first RCTs conducted internationally to examine the impact of a standalone, structured telephone-delivered intervention to address problem alcohol use and associated psychological morbidity. The proposed intervention is expected to contribute to the health and wellbeing of individuals who are otherwise unlikely to seek treatment through mainstream service models, to reduce the burden on specialist services and primary care providers and to provide an accessible and proportionate response, with resulting cost savings for the health system and broader community. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12618000828224. Pre-registered on 16 May 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3462-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, Australia. .,Turning Point, Eastern Health, Richmond, Australia.
| | - Jasmin Grigg
- Eastern Health Clinical School, Monash University, Box Hill, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Monash University, Box Hill, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Australia.,Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Melbourne, Australia
| | | | | | - Amanda Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, Geelong, Australia.,Centre of Drug, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Melbourne, Australia
| | - John Reynolds
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash University, Clayton, Australia
| | | | - David Best
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, UK
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Abstract
OBJECTIVE Synthetic cannabinoid use disorder is emerging as a significant clinical issue. This article provides the general psychiatrist with an overview of the physical and psychiatric adverse effects of chronic synthetic cannabinoid use, as well as specific clinical responses. METHOD We performed electronic searches of Ovid MEDLINE and Ovid Embase to identify key articles, of all methodological designs, published up to June 2018. RESULTS The available evidence suggests that, compared to cannabis, use of synthetic cannabinoids is associated with the more rapid development of dependence, increased psychiatric risks and complex withdrawal, and serious physical adverse effects that include seizures, cardiotoxicity and death, denoting a potential need for more intensive management. CONCLUSION When synthetic cannabinoid use is identified, along with management of acute physical and psychiatric adverse effects, psychotherapeutic strategies to reduce use and/or harm are recommended.
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Affiliation(s)
- Jasmin Grigg
- Research Fellow, Turning Point, Eastern Health, Richmond, VIC, and; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Victoria Manning
- Associate Professor, Turning Point, Eastern Health, Richmond, VIC, and; Eastern Health Clinical School, Monash University, Melbourne, VIC, and Australia
| | - Shalini Arunogiri
- Addiction Psychiatrist, Turning Point, Eastern Health, Richmond, VIC, and; Senior Lecturer, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Dan I Lubman
- Director, Turning Point, Eastern Health, Richmond, VIC, and; Professor of Addiction Studies and Services, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
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23
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Valiulis A, Bousquet J, Veryga A, Suprun U, Sergeenko D, Cebotari S, Borelli D, Pietikainen S, Banys J, Agache I, Billo NE, Bush A, Chkhaidze I, Dubey L, Fokkens WJ, Grigg J, Haahtela T, Julge K, Katilov O, Khaltaev N, Odemyr M, Palkonen S, Savli R, Utkus A, Vilc V, Alasevicius T, Bedbrook A, Bewick M, Chorostowska-Wynimko J, Danila E, Hadjipanayis A, Karseladze R, Kvedariene V, Lesinskas E, Münter L, Samolinski B, Sargsyan S, Sitkauskiene B, Somekh D, Vaideliene L, Valiulis A, Hellings PW. Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases. Clin Transl Allergy 2019; 9:7. [PMID: 30705747 PMCID: PMC6348633 DOI: 10.1186/s13601-019-0242-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/04/2019] [Indexed: 01/18/2023] Open
Abstract
Background Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable. A meeting was held in Vilnius, Lithuania (March 23, 2018) under the patronage of the Ministry of Health and several scientific societies to propose multisectoral care pathways embedding guided self-management, mHealth and air pollution in selected chronic respiratory diseases (rhinitis, chronic rhinosinusitis, asthma and COPD). The meeting resulted in the Vilnius Declaration that was developed by the participants of the EU Summit on chronic respiratory diseases under the leadership of Euforea. Conclusion The Vilnius Declaration represents an important step for the fight against air pollution in chronic respiratory diseases globally and has a clear strategic relevance with regard to the EU Health Strategy as it will bring added value to the existing public health knowledge.
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Affiliation(s)
- A Valiulis
- 1Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Bousquet
- 3MACVIA-France, Fondation partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.,INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,5UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium.,7Charité, Berlin, Germany
| | - A Veryga
- Minister of Health, Vilnius, Lithuania
| | - U Suprun
- Minister of Health, Kiev, Ukraine
| | - D Sergeenko
- Minister of Labour, Health and Social Affairs, Tbilisi, Georgia
| | - S Cebotari
- Minister of Health, Labour and Social Protection, Chișinău, Moldova
| | | | | | - J Banys
- Lithuianian Academy of Sciences, Vilnius, Lithuania
| | - I Agache
- 15Faculty of Medicine, Transylvania University, Brasov, Romania
| | - N E Billo
- Global Alliance Against Chronic Respiratory Diseases (GARD), Joensuu, Finland
| | - A Bush
- 17Imperial College and Royal Brompton Hospital, London, UK
| | - I Chkhaidze
- 18Department of Pediatrics, and Iashvili Central Children's Hospital, Tbilisi State Medical University, Tbilisi, Georgia
| | - L Dubey
- 19Faculty of Postgraduate Education, Lviv National Medical University by Danylo Halytsky, Lviv, Ukraine
| | - W J Fokkens
- 20Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - J Grigg
- 21Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - T Haahtela
- 22Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - K Julge
- 23Children's Clinic, Tartu University Institute of Clinical Medicine, Tartu, Estonia
| | - O Katilov
- Vinnytsa National Medical University by Mykola Pyrogov, Vinnytsa, Ukraine
| | - N Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Geneva, Switzerland
| | - M Odemyr
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - S Palkonen
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - R Savli
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - A Utkus
- 27Department of Human and Medical Genetics, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Association of Medical Schools in Europe, Berlin, Germany
| | - V Vilc
- State Institute of Phtysiopulmonology by Chiril Draganiuk, Chisinau, Moldova
| | - T Alasevicius
- 1Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - A Bedbrook
- 3MACVIA-France, Fondation partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - J Chorostowska-Wynimko
- 31Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - E Danila
- 32Clinic of Chest Diseases, Immunology and Allergology, Centre of Pulmonology and Allergology, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - A Hadjipanayis
- 33Medical School, European University of Cyprus, Nicosia, Cyprus
| | - R Karseladze
- 34Tbilisi State University Faculty of Medicine, Tbilisi, Georgia
| | - V Kvedariene
- 35Clinic of Infectious Chest Diseases, Dermatology and Allergology, Institute of Biomedical Sciences, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - E Lesinskas
- 36Clinic of ENT and Eye Diseases, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - L Münter
- Danish Commitee for Health Education, Copenhagen East, Denmark
| | - B Samolinski
- 38Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - S Sargsyan
- 39Institute of Child and Adolescent Health at Arabkir Medical Centre, Yerevan State Medical University, Yerevan, Armenia
| | - B Sitkauskiene
- 40Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Somekh
- European Health Futures Forum (EHFF), Dromahair, Ireland
| | - L Vaideliene
- 42Clinic of Children's Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Valiulis
- 43Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - P W Hellings
- Euforea, Brussels, Belgium.,44Department of Otorhinolaryngology, University Hospital Leuven, Leuven, Belgium.,45Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Zhu XM, Zheng W, Li XH, Cai DB, Yang XH, Ungvari GS, Ng CH, Wang XP, Kulkarni J, Grigg J, Ning YP, Xiang YT. Adjunctive raloxifene for postmenopausal women with schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials. Schizophr Res 2018; 197:288-293. [PMID: 29395611 DOI: 10.1016/j.schres.2018.01.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 11/26/2017] [Accepted: 01/17/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Raloxifene, a selective estrogen receptor modulator, has been used in treating postmenopausal women with schizophrenia with inconsistent results. This meta-analysis of randomized, double-blind, placebo-controlled trials (RCTs) examined its efficacy and safety for postmenopausal women with schizophrenia. METHOD Standardized mean differences (SMDs) and risk ratio (RR) together with their 95% confidence intervals (CIs) were calculated using the random effects model. RESULTS The meta-analysis included 5 RCTs (n = 240) comparing raloxifene (n = 125, 60 or 120 mg/day) with placebo (n = 115). Adjunctive raloxifene outperformed placebo with regard to the Positive and Negative Syndrome Scale (PANSS) total psychopathology [n = 240, SMD:-0.64 (95%CI:-0.90, -0.37), P < 0.00001; I2 = 0%], positive symptoms [n = 240, SMD:-0.49 (95%CI:-0.81, -0.16), P = 0.003; I2 = 29%], negative symptoms [n = 240, SMD:-0.43 (95%CI:-0.68, -0.17), P = 0.001; I2 = 0%], and general psychopathology scores [n = 240, SMD:-0.66 (95%CI:-0.92, -0.39), P < 0.00001; I2 = 0%]. Both groups had similar rates of adverse events and discontinuation (n = 159, RR: 1.32 (95%CI: 0.65, 2.70), P = 0.44, I2 = 0%). CONCLUSION Adjunctive raloxifene appears to be effective and safe in improving psychotic symptoms for postmenopausal women with schizophrenia. Review registration: CRD 42017059946.
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Affiliation(s)
- Xiao-Min Zhu
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Dong-Bin Cai
- Clinics of Chinese Medicine, The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin-Hu Yang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Graylands Hospital, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Xiao-Ping Wang
- Mental Health Institute of the Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry & Key Laboratory of Psychiatry, Mental Health of Hunan Province, Central South University, China
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Hospital, Melbourne, Australia; Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Monash Alfred Psychiatry Research Centre, Alfred Hospital, Melbourne, Australia; Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Yu-Ping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Morris O, Fairclough M, Grigg J, Prenant C, McMahon A. A review of approaches to 18
F radiolabelling affinity peptides and proteins. J Labelled Comp Radiopharm 2018; 62:4-23. [DOI: 10.1002/jlcr.3634] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 04/23/2018] [Accepted: 04/23/2018] [Indexed: 12/15/2022]
Affiliation(s)
- O. Morris
- Wolfson Molecular Imaging Centre; The University of Manchester; UK
- CRUK/EPSRC Imaging Centre in Cambridge & Manchester; The University of Manchester; UK
| | - M. Fairclough
- Wolfson Molecular Imaging Centre; The University of Manchester; UK
- CRUK/EPSRC Imaging Centre in Cambridge & Manchester; The University of Manchester; UK
| | | | - C. Prenant
- Wolfson Molecular Imaging Centre; The University of Manchester; UK
- CRUK/EPSRC Imaging Centre in Cambridge & Manchester; The University of Manchester; UK
| | - A. McMahon
- Wolfson Molecular Imaging Centre; The University of Manchester; UK
- CRUK/EPSRC Imaging Centre in Cambridge & Manchester; The University of Manchester; UK
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Abstract
OBJECTIVE This review examines the existing evidence for the relationship between borderline personality disorder and polycystic ovary syndrome, and to identify commonalities in etiological mechanisms of borderline personality disorder and polycystic ovary syndrome that might explain the relationship between these seemingly disparate disorders. METHODS A search of Medline, EMBASE and Cochrane Central was undertaken on 5 December 2016 to identify studies investigating women with borderline personality disorder and polycystic ovary syndrome (or symptoms and markers specific to polycystic ovary syndrome). RESULTS Nine studies were identified, including three cross-sectional studies investigating symptoms of polycystic ovary syndrome in women with borderline personality disorder, two cross-sectional and one cohort study examining the prevalence of psychiatric diagnoses in women with polycystic ovary syndrome and three case reports of comorbid borderline personality disorder and polycystic ovary syndrome. CONCLUSION Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries, which can be key features of polycystic ovary syndrome. However, this research is still in its infancy, which limits our understanding of this potential comorbid phenomenon. Given the emerging anecdotal and empirical evidence to date, a theoretical discussion of the potential psychoneuroendocrinological mechanism underlying the borderline personality disorder and polycystic ovary syndrome comorbidity is provided. Further rigorous studies using standardized diagnostic criteria for polycystic ovary syndrome are warranted. Specifically, the use of prospective controlled cohort studies may be able to determine the causality and temporality of observed comorbid borderline personality disorder and polycystic ovary syndrome.
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Affiliation(s)
- Raelene Ym Tan
- 1 Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC, Australia.,2 Monash University, Melbourne, VIC, Australia
| | - Jasmin Grigg
- 1 Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- 1 Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC, Australia
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Kulkarni J, Thomas N, Hudaib AR, Gavrilidis E, Grigg J, Tan R, Cheng J, Arnold A, Gurvich C. Effect of the Glutamate NMDA Receptor Antagonist Memantine as Adjunctive Treatment in Borderline Personality Disorder: An Exploratory, Randomised, Double-Blind, Placebo-Controlled Trial. CNS Drugs 2018; 32:179-187. [PMID: 29549516 DOI: 10.1007/s40263-018-0506-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a complex, severe and highly stigmatised psychiatric illness. Several lines of evidence highlight the causal link between chronic stress, glucocorticoid response to stress and glutamatergic overactivity as a key event in the pathophysiology of BPD. Therefore, molecular mechanisms capable of regulating glutamate excitotoxicity represent novel and potentially promising treatment targets. Memantine-HCl is a voltage-dependent N-methyl-D-aspartate (NMDA) receptor 'channel blocker' that selectively blocks pathological glutamate overactivity. OBJECTIVE The aim of the current study was to determine if memantine can improve BPD symptoms. METHOD An 8-week, double-blind, placebo-controlled trial of adjunctive memantine to treatment as usual was conducted. Treatment as usual comprised antidepressants (selective serotonin reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, noradrenergic and specific serotonin antagonists and serotonin noradrenaline reuptake inhibitors), mood stabilisers and antipsychotics, as well as psychotherapy and other psychosocial interventions. Sixteen participants received oral placebo while 17 participants received daily oral memantine 10 mg for 7 days, with subsequent titration to daily oral memantine 20 mg. Eligibility criteria included men and women aged between 16-65 years, with a diagnosis of BPD according to the Diagnostic Interview for Borderline Patients. Primary outcome measures included the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), assessed fortnightly. Secondary measures included an adverse effect questionnaire administered fortnightly to assess adverse effects known to be related to memantine use. RESULTS According to intention-to-treat, latent growth curve analyses, a significant change in total score of ZAN-BPD symptom severity was observed in the memantine group at 20 mg/daily across time, compared with placebo (p = 0.02). No adverse effects were significantly more frequent among participants receiving active memantine than among those receiving placebo. CONCLUSION Memantine at a 20-mg daily dose is a well tolerated drug that can improve BPD symptomatology and may be a promising novel therapeutic for its treatment. Further studies are needed to explore the efficacy of memantine versus placebo, as well as in comparison with other potential treatments for BPD. ClinicalTrials.gov identifier: NCT02097706.
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Affiliation(s)
- Jayashri Kulkarni
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia.
| | - Natalie Thomas
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Abdul-Rahman Hudaib
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Emorfia Gavrilidis
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Jasmin Grigg
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Raelene Tan
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Jacinta Cheng
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Amelia Arnold
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Caroline Gurvich
- The Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Level 4 607 St Kilda Rd, Melbourne, VIC, 3004, Australia
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Grigg J, Worsley R, Thew C, Gurvich C, Thomas N, Kulkarni J. Antipsychotic-induced hyperprolactinemia: synthesis of world-wide guidelines and integrated recommendations for assessment, management and future research. Psychopharmacology (Berl) 2017; 234:3279-3297. [PMID: 28889207 DOI: 10.1007/s00213-017-4730-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/22/2017] [Indexed: 01/25/2023]
Abstract
RATIONALE Hyperprolactinemia is a highly prevalent adverse effect of many antipsychotic agents, with potentially serious health consequences. Several guidelines have been developed for the management of this condition; yet, their concordance has not been evaluated. OBJECTIVES The objectives of this paper were (1) to review current clinical guidelines; (2) to review key systematic evidence for management; and (3) based on our findings, to develop an integrated management recommendation specific to male and female patients who are otherwise clinically stabilised on antipsychotics. METHODS We performed searches of Medline and EMBASE, supplemented with guideline-specific database and general web searches, to identify clinical guidelines containing specific recommendations for antipsychotic-induced hyperprolactinemia, produced/updated 01/01/2010-15/09/2016. A separate systematic search was performed to identify emerging management approaches described in reviews and meta-analyses published ≥ 2010. RESULTS There is some consensus among guidelines relating to baseline PRL screening (8/12 guidelines), screening for differential diagnosis (7/12) and discontinuing/switching PRL-raising agent (7/12). Guidelines otherwise diverge substantially regarding most aspects of screening, monitoring and management (e.g. treatment with dopamine agonists). There is an omission of clear sex-specific recommendations. Systematic literature on management approaches is promising; more research is needed. An integrated management recommendation is presented to guide sex-specific clinical response to antipsychotic-induced hyperprolactinemia. Key aspects include asymptomatic hyperprolactinemia monitoring and fertility considerations with PRL normalisation. CONCLUSION Further empirical work is key to shaping robust guidelines for antipsychotic-induced hyperprolactinemia. The integrated management recommendation can assist clinician and patient decision-making, with the goal of balancing effective psychiatric treatment while minimising PRL-related adverse health effects in male and female patients.
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Affiliation(s)
- Jasmin Grigg
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia
| | - Roisin Worsley
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia
| | - Caroline Thew
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia
| | - Caroline Gurvich
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia
| | - Natalie Thomas
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia
| | - Jayashri Kulkarni
- The Monash Alfred Psychiatry Research Centre, Monash University, Level 4, 607 St Kilda Rd, Melbourne, 3004, Victoria, Australia.
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Morris O, Elsawy MA, Fairclough M, Williams KJ, Mcmahon A, Grigg J, Forster D, Miller AF, Saiani A, Prenant C. In vivo characterisation of a therapeutically relevant self-assembling 18 F-labelled β-sheet forming peptide and its hydrogel using positron emission tomography. J Labelled Comp Radiopharm 2017. [PMID: 28623878 PMCID: PMC5601235 DOI: 10.1002/jlcr.3534] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Positron emission tomography (PET) and fluorescence labelling have been used to assess the pharmacokinetics, biodistribution and eventual fate of a hydrogel‐forming nonapeptide, FEFKFEFKK (F9), in healthy mice, using 18F‐labelled and fluorescein isothiocyanate (FITC)‐labelled F9 analogues. F9 was site‐specifically radiolabelled with 2‐[18F]fluoro‐3‐pyridinecarboxaldehyde ([18F]FPCA) via oxime bond formation. [18F]FPCA‐F9 in vivo fate was evaluated both as a solution, following intravenous administration, and as a hydrogel when subcutaneously injected. The behaviour of FITC‐F9 hydrogel was assessed following subcutaneous injection. [18F]FPCA‐F9 demonstrated high plasma stability and primarily renal excretion; [18F]FPCA‐F9 when in solution and injected into the bloodstream displayed prompt bladder uptake (53.4 ± 16.6 SUV at 20 minutes postinjection) and rapid renal excretion, whereas [18F]FPCA‐F9 hydrogel, formed by co‐assembly of [18F]FPCA‐F9 monomer with unfunctionalised F9 peptide and injected subcutaneously, showed gradual bladder accumulation of hydrogel fragments (3.8 ± 0.4 SUV at 20 minutes postinjection), resulting in slower renal excretion. Gradual disaggregation of the F9 hydrogel from the site of injection was monitored using FITC‐F9 hydrogel in healthy mice (60 ± 3 over 96 hours), indicating a biological half‐life between 1 and 4 days. The in vivo characterisation of F9, both as a gel and a solution, highlights its potential as a biomaterial.
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Affiliation(s)
- O Morris
- Wolfson Molecular Imaging Centre, The University of Manchester, UK.,CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK
| | - M A Elsawy
- School of Materials, The University of Manchester, UK.,Manchester Institute of Biotechnology, The University of Manchester, UK.,School of Pharmacy and Biomedical Sciences, University of Central Lancashire, UK
| | - M Fairclough
- Wolfson Molecular Imaging Centre, The University of Manchester, UK.,CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK
| | - K J Williams
- CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK.,Manchester Pharmacy School, The University of Manchester, UK
| | - A Mcmahon
- Wolfson Molecular Imaging Centre, The University of Manchester, UK.,CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK
| | - J Grigg
- GE Healthcare, Little Chalfont, UK
| | - D Forster
- Wolfson Molecular Imaging Centre, The University of Manchester, UK.,CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK
| | - A F Miller
- Manchester Institute of Biotechnology, The University of Manchester, UK.,School of Chemical Engineering and Analytical Science, The University of Manchester, UK
| | - A Saiani
- School of Materials, The University of Manchester, UK.,Manchester Institute of Biotechnology, The University of Manchester, UK.,School of Chemical Engineering and Analytical Science, The University of Manchester, UK
| | - C Prenant
- Wolfson Molecular Imaging Centre, The University of Manchester, UK.,CRUK/EPSRC Imaging Centre in Cambridge & Manchester, The University of Manchester, UK
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Affiliation(s)
- Jasmin Grigg
- The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Caroline Thew
- The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
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Rivera-Ramos M, Plasencia E, DeVos E, Grigg J. Transforming Medical Student International Engagement to a Focus on
Educational Programs. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Saffron (Crocus savitus) is a Middle-Eastern herb with strong antioxidant properties. Its major constituents, safranal, crocin, and crocetin, are also antioxidants and bear structural similarities to other well-known natural antixodant substances, such as zeaxanthin. Given the role of oxidative stress in many diseases, considerable interest has been shown into the potential role of saffron supplementation as a treatment for a range of diseases. In vitro and animal studies have provided evidence that saffron and its constituents may be potent therapies for a range of pathologies, including Alzheimer's disease, age-related macular degeneration (AMD) and cardiac ischemia. Whether these findings translate into clinical efficacy, however, has as of yet been incompletely assessed. This makes assessing the role of saffron supplementation in these diseases difficult. Here, we review the current human clinical evidence supporting saffron supplementation as a treatment for a range of pathologies and the underlying science supporting its use.
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Affiliation(s)
- G K Broadhead
- a Save Sight Institute, The University of Sydney , Sydney , Australia
| | - A Chang
- a Save Sight Institute, The University of Sydney , Sydney , Australia
| | - J Grigg
- a Save Sight Institute, The University of Sydney , Sydney , Australia
| | - P McCluskey
- a Save Sight Institute, The University of Sydney , Sydney , Australia
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Affiliation(s)
- Jasmin Grigg
- 1 The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Roisin Worsley
- 1 The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia.,2 Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- 1 The Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
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Griffiths CJ, Mudway I, Wood H, Marlin N, Dundas I, Walton R, Grigg J, Sheikh A, Lee T, Kelly F. P180 Impact of the london low emission zone on children’s respiratory health: a sequential yearly cross sectional study 2008–2014. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Kulkarni J, Gavrilidis E, Gwini SM, Worsley R, Grigg J, Warren A, Gurvich C, Gilbert H, Berk M, Davis SR. Effect of Adjunctive Raloxifene Therapy on Severity of Refractory Schizophrenia in Women: A Randomized Clinical Trial. JAMA Psychiatry 2016; 73:947-54. [PMID: 27438995 DOI: 10.1001/jamapsychiatry.2016.1383] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE A substantial proportion of women with schizophrenia experience debilitating treatment-refractory symptoms. The efficacy of estrogen in modulating brain function in schizophrenia has to be balanced against excess exposure of peripheral tissue. Raloxifene hydrochloride is a selective estrogen receptor modulator (mixed estrogen agonist/antagonist) with potential psychoprotective effects and fewer estrogenic adverse effects. OBJECTIVE To determine whether adjunctive raloxifene therapy reduces illness severity in women with refractory schizophrenia. DESIGN, SETTING, AND PARTICIPANTS This 12-week, double-blind, placebo-controlled, randomized clinical trial with fortnightly assessments was performed at an urban tertiary referral center and a regional center from January 1, 2006, to December 31, 2014. Participants included 56 women with schizophrenia or schizoaffective disorder and marked symptom severity despite substantial and stable antipsychotic doses. Data were analyzed using intention to treat as the basis. INTERVENTIONS Adjunctive raloxifene hydrochloride, 120 mg/d, or placebo for 12 weeks. MAIN OUTCOMES AND MEASURES The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score. Clinical response (defined as a ≥20% decrease in PANSS total score from baseline) and change in PANSS subscale scores, mood, cognition, reproductive hormone levels, and adverse events were also assessed. RESULTS Of the 56 participants (mean [SD] age, 53 [7.7] years; age range, 40-70 years; mean [SD] duration of psychotic illness, 24 [11] years), 26 were randomized to raloxifene and 30 were randomized to placebo. Raloxifene produced a greater reduction in the PANSS total score relative to placebo (β = -6.37; 95% CI, -11.64 to -1.10; P = .02) and resulted in an increased probability of a clinical response (hazard ratio, 5.79; 95% CI, 1.46 to 22.97; P = .01). A significant reduction was found in the PANSS general symptom scores for the raloxifene compared with the placebo (β = -3.72; 95% CI, -6.83 to -0.61; P = .02) groups. For patients who completed the full 12-week trial, there was not a statistically significant treatment effect on PANSS positive symptom scores (β for change in raloxifene vs placebo, -1.92; 95% CI, -3.83 to 0.00; P = .05). Change in mood, cognition, and reproductive hormone levels and the rate of adverse events did not differ between groups. CONCLUSIONS AND RELEVANCE Raloxifene hydrochloride, 120 mg/d, reduces illness severity and increases the probability of a clinical response in women with refractory schizophrenia. This large trial of raloxifene in this patient population offers a promising, well-tolerated agent that has potential application in clinical practice. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00361543.
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Affiliation(s)
- Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Emorfia Gavrilidis
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Stella M Gwini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Roisin Worsley
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Annabelle Warren
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Heather Gilbert
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Michael Berk
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Susan R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Morris O, Gregory J, Kadirvel M, Henderson F, Blykers A, McMahon A, Taylor M, Allsop D, Allan S, Grigg J, Boutin H, Prenant C. Development & automation of a novel [(18)F]F prosthetic group, 2-[(18)F]-fluoro-3-pyridinecarboxaldehyde, and its application to an amino(oxy)-functionalised Aβ peptide. Appl Radiat Isot 2016; 116:120-7. [PMID: 27518217 PMCID: PMC5034901 DOI: 10.1016/j.apradiso.2016.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/07/2016] [Accepted: 07/26/2016] [Indexed: 12/15/2022]
Abstract
2-[(18)F]-Fluoro-3-pyridinecarboxaldehyde ([(18)F]FPCA) is a novel, water-soluble prosthetic group. It's radiochemistry has been developed and fully-automated for application in chemoselective radiolabelling of amino(oxy)-derivatised RI-OR2-TAT peptide, (Aoa-k)-RI-OR2-TAT, using a GE TRACERlab FX-FN. RI-OR2-TAT is a brain-penetrant, retro-inverso peptide that binds to amyloid species associated with Alzheimer's Disease. Radiolabelled (Aoa-k)-RI-OR2-TAT was reproducibly synthesised and the product of the reaction with FPCA has been fully characterised. In-vivo biodistribution of [(18)F]RI-OR2-TAT has been measured in Wistar rats.
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Affiliation(s)
- Olivia Morris
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK.
| | - J Gregory
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
| | - M Kadirvel
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
| | - Fiona Henderson
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
| | - A Blykers
- In-Vivo Cellular and Molecular Imaging Lab, Vrije Universiteit Brussel, Belgium
| | - Adam McMahon
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
| | - Mark Taylor
- Division of Biomedical and Life Sciences, The University of Lancaster, UK
| | - David Allsop
- Division of Biomedical and Life Sciences, The University of Lancaster, UK
| | | | - J Grigg
- GE Healthcare, Life Sciences, Imaging R&D, The Grove Centre, Amersham, Bucks, UK
| | - Herve Boutin
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
| | - Christian Prenant
- Wolfson Molecular Imaging Centre, CRUK/EPSRC Imaging Centre of Cambridge & Manchester, The University of Manchester, UK
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Brugha R, Mushtaq N, McCarthy NE, Stagg AJ, Grigg J. Respiratory tract dendritic cells in paediatric asthma. Clin Exp Allergy 2015; 45:624-31. [PMID: 25411998 DOI: 10.1111/cea.12457] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/06/2014] [Accepted: 10/08/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Airway dendritic cells (DC) are critical mediators of lung inflammation in asthma, but the characteristics of DC in the airways of healthy children, and children with asthma, are currently unknown. OBJECTIVE We sought to identify changes in DC subset distribution and activation profile in paediatric asthma using flow cytometry to analyse induced sputum samples obtained from healthy and asthmatic children. METHODS Lung function and atopic status were determined by spirometry and skin prick testing. Induced sputum samples were analysed using 7-colour flow cytometry to identify airway DC populations (lineage(-) HLA-DR(+) sputum cells expressing either CD11c as conventional DC or CD123 as plasmacytoid DC). RESULTS Sputum samples containing lower airway plugs were obtained from 10 healthy children and 8 children with asthma. Lineage(-) HLA-DR(+) DC were successfully identified in all samples, and DC comprised a significantly higher proportion of sputum cells in children with asthma compared with age-matched healthy controls (1.29% vs. 0.67%, P = 0.02). DC expression of the costimulatory marker CD86 was significantly reduced in asthmatic children (73.4% vs. 59.7%, P = 0.04). Sputum DC also included numerous CD1c(+) cells (mean 57% of the total DC population) and low frequencies of cells expressing the subset markers CD141 or CD123, although the proportions of these did not differ between groups. CONCLUSIONS Airway DC can be identified and characterized non-invasively using flow cytometry to analyse paediatric sputum samples. Our data reveal that children with steroid-treated asthma exhibit increased frequency of airway DC with reduced expression of the costimulatory marker CD86, suggesting altered trafficking and/or maturation of these cells either due to asthma or steroid therapies.
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Affiliation(s)
- R Brugha
- Asthma UK Centre for Applied Research, Centre for Paediatrics, Blizard Institute, Queen Mary, University of London, London, UK
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Brugha R, Mushtaq N, Dundas I, Sanak M, Grigg J. S65 Urinary Prostaglandins As Inflammatory Markers For Childhood Asthma Exacerbations. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Whitehouse A, Brugha R, Mushtaq N, Dundas I, Grigg J. S64 Eosinophil Cationic Protein And Cytokine Analysis In Exhaled Breath Condensate In Paediatric Asthma. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kulkarni J, Gavrilidis E, Lee S, Van Rheenen TE, Grigg J, Hayes E, Lee A, Ong R, Seeary A, Andersen S, Worsley R, Keppich-Arnold S, Stafrace S. Establishing female-only areas in psychiatry wards to improve safety and quality of care for women. Australas Psychiatry 2014; 22:551-6. [PMID: 25358653 DOI: 10.1177/1039856214556322] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Our aim was to assess the impact of creating a female-only area within a mixed-gender inpatient psychiatry service, on female patient safety and experience of care. METHOD The Alfred hospital reconfigured one of its two psychiatry wards to include a female-only area. Documented incidents compromising the safety of women on each ward in the 6 months following the refurbishment were compared. Further, a questionnaire assessing perceived safety and experience of care was administered to female inpatients on both wards, and staff feedback was also obtained. RESULTS The occurrence of documented incidents compromising females' safety was found to be significantly lower on the ward containing a female-only area. Women staying on this ward rated their perceived safety and experience of care significantly more positively than women staying where no such gender segregation was available. Further, the female-only area was identified by the majority of surveyed staff to provide a safer environment for female patients. CONCLUSIONS Establishing female-only areas in psychiatry wards is an effective way to improve the safety and experience of care for female patients.
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Affiliation(s)
- Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Emmy Gavrilidis
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Stuart Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Jasmin Grigg
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Emily Hayes
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Adeline Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Roy Ong
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Amy Seeary
- Department of Psychiatry, The Alfred Hospital, Melbourne, VIC, Australia
| | - Shelley Andersen
- Department of Psychiatry, The Alfred Hospital, Melbourne, VIC, Australia
| | - Rosie Worsley
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, VIC, Australia
| | | | - Simon Stafrace
- Department of Psychiatry, The Alfred Hospital, Melbourne, VIC, Australia
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Martineau A, MacLaughlin B, Hooper R, Barnes N, Jolliffe D, Choudhury A, Rajakulasingam R, Bhowmik A, Simcock D, Grigg J, Corrigan C, Hawrylowicz C, Griffiths C. S95 Double-blind Multi-centre Randomised Controlled Trial Of Vitamin D3 Supplementation In Adults With Inhaled Corticosteroid-treated Asthma (vidias). Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Grigg J, Iyer S, Goss E, Patel A, Murakami N, Luepp T, Fung-Chaw G, Paccione G. A case-based approach to village health worker supervisor continuing
education. Ann Glob Health 2014. [DOI: 10.1016/j.aogh.2014.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Grigg J, Cassandra S, Ellis K, Rowe C, Desmond P, Masters C, Ames D. P2‐182: AiblWHAP: Methodology and baseline characteristics of a population‐based sample recruited for a longitudinal study of risk factors and later‐life cognitive decline. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jasmin Grigg
- Mental Health Research InstituteParkvilleAustralia
| | | | | | | | - Patricia Desmond
- University of Melbourne and Royal Melbourne HospitalMelbourneAustralia
| | - Colin Masters
- University of Melbourne and Mental Health Research InstituteMelbourneVictoriaAustralia
| | - David Ames
- University of Melbourne and National Ageing Research Institute (NARI)ParkvilleAustralia
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Abstract
There is now convincing evidence that air pollution, especially the particulate matter (PM) fraction, adversely affects children's health. In general, the health effects of traffic-derived PM are well described in children living in high-income countries. Conversely, studies into the health effects of PM from biomass and solid fuels are limited to children in lower-income countries. As PM from different combustion sources have components in common (e.g. elemental black carbon) - are we able to extrapolate from the research performed in different countries under different exposure conditions? Using lung function growth and vulnerability to infection as examples of health effects of global significance to children, this review addresses the question whether high-income-country research into air pollution can inform effects of pollution in low-income countries and vice versa.
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Affiliation(s)
- J Grigg
- Centre for Paediatrics, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK.
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Sonnappa S, Bastardo CM, Aurora P, Whyatt D, Kelly FJ, Beevers SD, Grigg J. Residential proximity to main roads and lung function in healthy young children. Eur Respir J 2011; 37:1525-6. [DOI: 10.1183/09031936.00181910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Fung AT, Azar D, Fraser-Bell S, McCluskey P, Grigg J. Ockham's razor revisited: decreased visual acuity secondary to keratoconus in a patient with intracranial hypertension. Case Reports 2011; 2011:2011/feb17_1/bcr0520103030. [DOI: 10.1136/bcr.05.2010.3030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lenney W, Boner AL, Bont L, Bush A, Carlsen KH, Eber E, Fauroux B, Gotz M, Greenough A, Grigg J, Hull J, Kimpen J, Sanchez Luna M, de Benedictis FM. Medicines used in respiratory diseases only seen in children. Eur Respir J 2009; 34:531-51. [DOI: 10.1183/09031936.00166508] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Brand PLP, Baraldi E, Bisgaard H, Boner AL, Castro-Rodriguez JA, Custovic A, de Blic J, de Jongste JC, Eber E, Everard ML, Frey U, Gappa M, Garcia-Marcos L, Grigg J, Lenney W, Le Souëf P, McKenzie S, Merkus PJFM, Midulla F, Paton JY, Piacentini G, Pohunek P, Rossi GA, Seddon P, Silverman M, Sly PD, Stick S, Valiulis A, van Aalderen WMC, Wildhaber JH, Wennergren G, Wilson N, Zivkovic Z, Bush A. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J 2009; 32:1096-110. [PMID: 18827155 DOI: 10.1183/09031936.00002108] [Citation(s) in RCA: 493] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis. Based on the limited evidence available, inhaled short-acting beta(2)-agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop. Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes.
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Affiliation(s)
- P L P Brand
- Princess Amalia Children's Clinic, Isala klinieken, Zwolle, The Netherlands.
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