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Cama E, Beadman K, Beadman M, Smith KA, Christian J, Jackson AC, Tyson B, Anderson C, Smyth L, Heslop J, Gahan G, Tawil V, Sheaves F, Maher L, Page J, Tilley D, Ryan A, Grant K, Donovan B, Stevens A, Slattery T, Pearce K, John-Leader F, Walden A, Lenton J, Crowley M, Treloar C. Correction: Increasing access to screening for blood-borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians: evaluation of the Deadly Liver Mob program's 'cascade of care' across nine sites in New South Wales, Australia. Harm Reduct J 2024; 21:34. [PMID: 38326826 PMCID: PMC10848375 DOI: 10.1186/s12954-024-00927-w] [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: 01/03/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Kim Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Mitch Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Kerri-Anne Smith
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Mount Druitt, NSW, 2770, Australia
| | - Jade Christian
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Aunty Clair Jackson
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Beverley Tyson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Clayton Anderson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Larissa Smyth
- Byron Central Hospital, Mid North Coast and Northern NSW Local Health District, Byron Bay, NSW, 2481, Australia
| | - Jennifer Heslop
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Gary Gahan
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, NSW, 1340, Australia
| | - Victor Tawil
- Centre for Population Health, Ministry of Health, Sydney, NSW, 2065, Australia
| | - Felicity Sheaves
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Louise Maher
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Julie Page
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Donna Tilley
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Sydney, NSW, 2150, Australia
| | - Ann Ryan
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kim Grant
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Annabelle Stevens
- Centre for Population Health, Ministry of Health, Sydney, NSW, 2065, Australia
| | - Trevor Slattery
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kate Pearce
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Mount Druitt, NSW, 2770, Australia
| | - Franklin John-Leader
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Andrew Walden
- Needle and Syringe Program, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Jo Lenton
- Broken Hill Community Centre, Far West Local Health District, Broken Hill, NSW, 2880, Australia
| | - Margaret Crowley
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
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Treloar C, Beadman K, Beadman M, Smith KA, Christian J, Jackson AC, Tyson B, Anderson C, Smyth L, Walker M, Heslop J, Gahan G, Tawil V, Sheaves F, Maher L, Page J, Tilley D, Ryan A, Grant K, Donovan B, Stevens A, Slattery T, Pearce K, John-Leader F, Walden A, Lenton J, Crowley M, Cama E. Evaluating a complex health promotion program to reduce hepatitis C among Aboriginal and Torres Strait Islander peoples in New South Wales, Australia: the Deadly Liver Mob. Harm Reduct J 2023; 20:153. [PMID: 37864234 PMCID: PMC10588051 DOI: 10.1186/s12954-023-00885-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023] Open
Abstract
The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians, and was introduced in response to the disproportionate number of Aboriginal and Torres Strait Islander Australians who are impacted by blood borne viruses (BBVs) and sexually transmitted infections (STIs). The goal of the program is to increase access to BBV and STI education, screening, treatment, and vaccination in recognition and response to the systemic barriers that Aboriginal and Torres Strait Islander peoples face in accessing health care. This commentary introduces a series of papers that report on various aspects of the evaluation of the Deadly Liver Mob (DLM) program. In this paper, we explain what DLM is and how we constructed an evaluation framework for this complex health promotion intervention.
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Affiliation(s)
- Carla Treloar
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia.
| | - Kim Beadman
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia
| | - Mitch Beadman
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia
| | - Kerri-Anne Smith
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Sydney, NSW, 2770, Australia
| | - Jade Christian
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Aunty Clair Jackson
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia
| | - Beverley Tyson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Clayton Anderson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Larissa Smyth
- Byron Central Hospital, Mid North Coast and Northern NSW Local Health District, Byron Bay, NSW, 2481, Australia
| | - Melinda Walker
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia
| | - Jennifer Heslop
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Gary Gahan
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, NSW, 1340, Australia
| | - Victor Tawil
- Centre for Population Health, Ministry of Health, St Leonards, NSW, 2065, Australia
| | - Felicity Sheaves
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Louise Maher
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Julie Page
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Donna Tilley
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, NSW, 2150, Australia
| | - Ann Ryan
- HIV & Related Programs (HARP) Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kim Grant
- HIV & Related Programs (HARP) Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Annabelle Stevens
- Centre for Population Health, Ministry of Health, St Leonards, NSW, 2065, Australia
| | - Trevor Slattery
- HIV & Related Programs (HARP) Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kate Pearce
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Sydney, NSW, 2770, Australia
| | - Franklin John-Leader
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Andrew Walden
- Needle and Syringe Program, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Jo Lenton
- Broken Hill Community Centre, Far West Local Health District, Broken Hill, NSW, 2880, Australia
| | - Margaret Crowley
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Elena Cama
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Kensington, NSW, 2052, Australia
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Cama E, Beadman K, Beadman M, Smith KA, Christian J, Jackson AC, Tyson B, Anderson C, Smyth L, Heslop J, Gahan G, Tawil V, Sheaves F, Maher L, Page J, Tilley D, Ryan A, Grant K, Donovan B, Stevens A, Slattery T, Pearce K, John-Leader F, Walden A, Lenton J, Crowley M, Treloar C. Increasing access to screening for blood-borne viruses and sexually transmissible infections for Aboriginal and Torres Strait Islander Australians: evaluation of the Deadly Liver Mob program's 'cascade of care' across nine sites in New South Wales, Australia. Harm Reduct J 2023; 20:125. [PMID: 37670361 PMCID: PMC10478220 DOI: 10.1186/s12954-023-00850-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians are disproportionately impacted by blood-borne viruses (BBVs) and sexually transmissible infections (STIs). Stigma remains one of the key barriers to testing and treatment for BBVs and STIs, particularly among Aboriginal and Torres Strait Islander people. The Deadly Liver Mob (DLM) is a peer-delivered incentivised health promotion program by and for Aboriginal and Torres Strait Islander Australians. The program aims to increase access to BBV and STI education, screening, treatment, and vaccination for Aboriginal and Torres Strait Islander Australians in recognition of the systemic barriers for First Nations people to primary care, including BBV- and STI-related stigma, and institutional racism. This paper presents routinely collected data across nine sites on the 'cascade of care' progression of Aboriginal and Torres Strait Islander clients through the DLM program: hepatitis C education, screening, returning for results, and recruitment of peers. METHODS Routinely collected data were collated from each of the DLM sites, including date of attendance, basic demographic characteristics, eligibility for the program, recruitment of others, and engagement in the cascade of care. RESULTS Between 2013 and 2020, a total of 1787 Aboriginal and Torres Strait Islander clients were educated as part of DLM, of which 74% went on to be screened and 42% (or 57% of those screened) returned to receive their results. The total monetary investment of the cascade of care progression was approximately $56,220. Data highlight the positive impacts of the DLM program for engagement in screening, highlighting the need for culturally sensitive, and safe programs led by and for Aboriginal and Torres Strait Islander people. However, the data also indicate the points at which clients 'fall off' the cascade, underscoring the need to address any remaining barriers to care. CONCLUSIONS The DLM program shows promise in acting as a 'one stop shop' in addressing the needs of Aboriginal and Torres Strait Islander people in relation to BBVs and STIs. Future implementation could focus on addressing any potential barriers to participation in the program, such as co-location of services and transportation.
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Affiliation(s)
- Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Kim Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Mitch Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Kerri-Anne Smith
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Mount Druitt, NSW, 2770, Australia
| | - Jade Christian
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Aunty Clair Jackson
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Beverley Tyson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Clayton Anderson
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Larissa Smyth
- Byron Central Hospital, Mid North Coast and Northern NSW Local Health District, Byron Bay, NSW, 2481, Australia
| | - Jennifer Heslop
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Gary Gahan
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, NSW, 1340, Australia
| | - Victor Tawil
- Centre for Population Health, Ministry of Health, Sydney, NSW, 2065, Australia
| | - Felicity Sheaves
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Louise Maher
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Julie Page
- Needle and Syringe Program, Nepean Blue Mountains Local Health District, Penrith, NSW, 2747, Australia
| | - Donna Tilley
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Sydney, NSW, 2150, Australia
| | - Ann Ryan
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kim Grant
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Basil Donovan
- Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Annabelle Stevens
- Centre for Population Health, Ministry of Health, Sydney, NSW, 2065, Australia
| | - Trevor Slattery
- HIV & Related Programs Unit, Western and Far West NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Kate Pearce
- Needle and Syringe Program, Mount Druitt Community Health Centre, Western Sydney Local Health District, Mount Druitt, NSW, 2770, Australia
| | - Franklin John-Leader
- HIV & Related Programs, Mid North Coast and Northern NSW Local Health District, Coffs Harbour, NSW, 2450, Australia
| | - Andrew Walden
- Needle and Syringe Program, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Jo Lenton
- Broken Hill Community Centre, Far West Local Health District, Broken Hill, NSW, 2880, Australia
| | - Margaret Crowley
- Dubbo Sexual Health, Western NSW Local Health District, Dubbo, NSW, 2830, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
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Martin AP, Ferri Grazzi E, Mighiu C, Chevli M, Shah F, Maher L, Shaikh A, Sagar A, Hubberstey H, Franks B, Ramos-Goñi JM, Oppe M, Tang D. Health state utilities for beta-thalassemia: a time trade-off study. Eur J Health Econ 2023; 24:27-38. [PMID: 35347553 PMCID: PMC9876862 DOI: 10.1007/s10198-022-01449-7] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Beta-thalassemia (BT) is an inherited blood disorder characterized by reduced levels of functional hemoglobin resulting in phenotypes ranging from clinically asymptomatic to severely anemic. Patients with BT may require lifelong regular blood transfusions supported by appropriate iron chelation therapy (ICT). This study aimed to determine how the UK general population values BT health states associated with differing transfusion burden and ICT. METHODS Composite time trade-off (cTTO) methodology was employed to elicit health state utilities in BT. Relevant BT literature related to symptom and quality-of-life impact, including physical, functional, and emotional well-being, and safety profiles of BT treatments were considered when drafting health state descriptions. Eleven health state descriptions were developed and validated by hematologists and patient advocates for clinical accuracy and completeness. 200 individuals from the UK general population participated in the cTTO interviews. RESULTS The mean age of participants was 41.50 years (SD 16.01, range 18-81); 88 (46.8%) were female. Utility values ranged from 0.78 (SD 0.34) for non-transfusion dependent BT with oral ICT to 0.37 (SD 0.50) for high transfusion burden with subcutaneous ICT in transfusion-dependent BT. CONCLUSIONS This study provides health utilities for a range of BT health states from the UK general population perspective. Importantly, lower transfusion burden and lower burden of anemia were associated with higher utilities. To a lesser extent, differential modes of ICT were found to impact utility valuations in patients with BT. The utilities obtained in this study can be employed as inputs in cost-effectiveness analyses of BT therapies.
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Affiliation(s)
| | | | | | - Manoj Chevli
- Celgene Ltd, a Bristol-Myers Squibb Company, Uxbridge, UK
| | | | - Louise Maher
- Celgene Ltd, a Bristol-Myers Squibb Company, Uxbridge, UK
| | | | | | | | | | - Juan M Ramos-Goñi
- Formerly Axentiva Solutions, Tacoronte, Santa Cruz de Tenerife, Spain
| | - Mark Oppe
- Formerly Axentiva Solutions, Tacoronte, Santa Cruz de Tenerife, Spain
| | - Derek Tang
- Bristol Myers Squibb, Princeton, NJ, USA
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Maher L, Collins V, McCullagh J, McGarrigle A, Vaughan C. Assessment of Newer Radiation Dose Reduction Techniques During Coronary Angiography. Ir Med J 2022; 115:558. [PMID: 35532344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aims To evaluate the impact of Allura Clarity technology on radiation exposure in patients undergoing diagnostic coronary angiography. Methods A retrospective analysis was undertaken of invasive coronary angiograms performed by a single experienced operator in Cork University Hospital (CUH) (Allura Xper FD10 angiography system). In order to reduce operator variability, we also analysed cases performed by the same operator in the Bon Secours Hospital Cork (BSHC) (Allura Clarity FD10 angiography system). Cases were selected consecutively, having excluded those involving percutaneous coronary intervention, graft studies, aortography, ventriculography, right heart studies or fractional flow reserve studies. Results A total of 178 patients were included, equally distributed between the CUH arm (n=89) and the BSHC arm (n=89). Cohorts were very well matched in terms of age, gender, Body Mass Index, and procedural approach. The median radiation dose in CUH was a Dose Area Product (DAP) of 10,460 mGy.cm2 vs. median DAP of 12,795 mGy.cm2 in BSHC (p=0.148). The median fluoroscopy time in CUH was 2.25mins vs. median fluoroscopy time of 2.17mins in BSHC (p=0.675). Conclusion The use of the Allura Clarity system for diagnostic coronary angiography did not result in a significant difference in radiation dose or fluoroscopy time when compared to the reference Allura Xper system. Further research is needed to investigate the benefit of this new image noise reduction technology in diagnostic coronary angiography.
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Affiliation(s)
- L Maher
- Department of Cardiology, Cork University Hospital, Ireland
| | - V Collins
- Department of Radiology, Bon Secours Hospital, Cork, Ireland
| | - J McCullagh
- Department of Medical Physics, Cork University Hospital, Ireland
| | - A McGarrigle
- Cork Radiation Protection Services, Cork, Ireland
| | - C Vaughan
- Department of Cardiology, Cork University Hospital, Ireland
- Department of Cardiology, Bon Secours Hospital, Cork, Ireland
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Noble N, Bryant J, Maher L, Jackman D, Bonevski B, Shakeshaft A, Paul C. Patient self-report versus medical records for smoking status and alcohol consumption at Aboriginal Community Controlled Health Services. Aust N Z J Public Health 2021; 45:277-282. [PMID: 33970509 DOI: 10.1111/1753-6405.13114] [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: 08/01/2020] [Revised: 02/01/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study assessed the level of agreement, and predictors of agreement, between patient self-report and medical records for smoking status and alcohol consumption among patients attending one of four Aboriginal Community Controlled Health Service (ACCHSs). METHODS A convenience sample of 110 ACCHS patients self-reported whether they were current smokers or currently consumed alcohol. ACCHS staff completed a medical record audit for corresponding items for each patient. The level of agreement was evaluated using the kappa statistic. Factors associated with levels of agreement were explored using logistic regression. RESULTS The level of agreement between self-report and medical records was strong for smoking status (kappa=0.85; 95%CI: 0.75-0.96) and moderate for alcohol consumption (kappa=0.74; 95%CI: 0.60-0.88). None of the variables explored were significantly associated with levels of agreement for smoking status or alcohol consumption. CONCLUSIONS Medical records showed good agreement with patient self-report for smoking and alcohol status and are a reliable means of identifying potentially at-risk ACCHS patients. Implications for public health: ACCHS medical records are accurate for identifying smoking and alcohol risk factors for their patients. However, strategies to increase documentation and reduce missing data in the medical records are needed.
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Affiliation(s)
- Natasha Noble
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, New South Wales.,Priority Research Centre for Health Behaviour, University of Newcastle, New South Wales
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, New South Wales.,Priority Research Centre for Health Behaviour, University of Newcastle, New South Wales
| | - Louise Maher
- Centre for Epidemiology and Evidence, NSW Ministry of Health, New South Wales
| | - Daniel Jackman
- Maari Ma Health Aboriginal Corporation, New South Wales.,Outback Division of General Practice, New South Wales
| | - Billie Bonevski
- Hunter Medical Research Institute, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Anthony Shakeshaft
- School of Medicine and Public Health, University of Newcastle, New South Wales.,National Drug and Alcohol Research Centre, University of NSW Sydney, New South Wales
| | - Christine Paul
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, New South Wales.,Priority Research Centre for Health Behaviour, University of Newcastle, New South Wales
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Leader G, Forde J, Naughton K, Maher L, Arndt S, Mannion A. Relationships among gastrointestinal symptoms, sleep problems, challenging behaviour, comorbid psychopathology and autism spectrum disorder symptoms in children and adolescents with 15q duplication syndrome. J Intellect Disabil Res 2021; 65:32-46. [PMID: 33073413 DOI: 10.1111/jir.12789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 08/26/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Comorbidity is the presence of at least two disorders in one person at one time. This study examined the frequency of gastrointestinal (GI) symptoms, sleep problems, comorbid psychopathology, challenging behaviour and autism spectrum disorder (ASD) symptoms in children and adolescents with duplication 15q syndrome (Dup15q), aged 3-17 years. This study also examined whether challenging behaviour in Dup15q is predicted by age, gender, presence of an intellectual disability, sleep problems, GI symptoms and comorbid psychopathology. METHOD Parental measures were completed by 101 parents of children and adolescents with Dup15q. Questionnaires were composed of the Children's Sleep Habits Questionnaire, Behavior Problems Inventory - Short Form, GI Symptom Inventory, Social Communication Questionnaire and the Child Behavior Checklist. RESULTS Sleep problems (94%), GI symptoms (87%) and challenging behaviour (100%) were common comorbidities represented in the sample in this study. Significant relationships were found between challenging behaviour and the presence of co-occurring sleep problems, GI symptoms, comorbid psychopathology and ASD symptoms. Further analysis revealed that these comorbidities also predicted challenging behaviour. CONCLUSION This research demonstrated the importance of studying the relationships between GI symptoms, sleep problems, comorbid psychopathology, ASD symptoms and challenging behaviour in Dup15q and how these conditions can shape the Dup15q phenotype.
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Affiliation(s)
- G Leader
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - J Forde
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - K Naughton
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - L Maher
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - S Arndt
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - A Mannion
- Irish Centre for Autism and Neurodevelopmental Research (ICAN), School of Psychology, National University of Ireland Galway, Galway, Ireland
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Lennox L, Linwood-Amor A, Maher L, Reed J. Making change last? Exploring the value of sustainability approaches in healthcare: a scoping review. Health Res Policy Syst 2020; 18:120. [PMID: 33050921 PMCID: PMC7556957 DOI: 10.1186/s12961-020-00601-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 03/30/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background Numerous models, tools and frameworks have been produced to improve the sustainability of evidence-based interventions. Due to the vast number available, choosing the most appropriate one is increasingly difficult for researchers and practitioners. To understand the value of such approaches, evidence warranting their use is needed. However, there is limited understanding of how sustainability approaches have been used and how they have impacted research or practice. This review aims to consolidate evidence on the application and impact of sustainability approaches in healthcare settings. Methods A systematic scoping review was designed to search for peer-reviewed publications detailing the use of sustainability approaches in practice. A 5-stage framework for scoping reviews directed the search strategy, and quality assessment was performed using the Mixed Method Appraisal Tool. Searches were performed through electronic citation tracking and snowballing of references. Articles were obtained through Web of Science, PubMed and Google Scholar. Six outcome variables for sustainability were explored to ascertain impact of approaches. Results This review includes 68 articles demonstrating the application of sustainability approaches in practice. Results show an increase in the use of sustainability approaches in peer-reviewed studies. Approaches have been applied across a range of healthcare settings, including primary, secondary, tertiary and community healthcare. Approaches are used for five main purposes, namely analysis, evaluation, guidance, assessment and planning. Results outline benefits (e.g. improved conceptualisation of sustainability constructs and improved ability to interpret sustainability data) and challenges (e.g. issues with approach constructs and difficulty in application) associated with using a sustainability approach in practice. Few articles (14/68) reported the sustainability outcome variables explored; therefore, the impact of approaches on sustainability remains unclear. Additional sustainability outcome variables reported in retrieved articles are discussed. Conclusions This review provides practitioners and researchers with a consolidated evidence base on sustainability approaches. Findings highlight the remaining gaps in the literature and emphasise the need for improved rigour and reporting of sustainability approaches in research studies. To guide future assessment and study of sustainability in healthcare settings an updated list of sustainability outcome variables is proposed. Trial Registration This review was registered on the PROSPERO database CRD 42016040081 in June 2016.
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Affiliation(s)
- L Lennox
- National Institute for Health Research, Applied Research Collaboration North West London. Imperial College London, 369 Fulham Road, SW10 9NH, London, United Kingdom.
| | - A Linwood-Amor
- Ministry of Health, Environment, Culture and Housing, George Town, Grand Cayman KY1-9000, Cayman Islands
| | - L Maher
- Ko Awatea Health System Innovation and Improvement, Middlemore Hospital, 100 Hospital Road, Otahuhu, New Zealand
| | - J Reed
- Julie Reed Consultancy, 27 Molasses House, London, SW113TN, United Kingdom
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Robinson R, Maher L, Jenkins R. Introduction of new needleless valve devices across a Local Health District. Infect Dis Health 2019. [DOI: 10.1016/j.idh.2019.09.036] [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: 11/28/2022]
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10
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Gadsden T, Wilson G, Totterdell J, Willis J, Gupta A, Chong A, Clarke A, Winters M, Donahue K, Posenelli S, Maher L, Stewart J, Gardiner H, Passmore E, Cashmore A, Milat A. Can a continuous quality improvement program create culturally safe emergency departments for Aboriginal people in Australia? A multiple baseline study. BMC Health Serv Res 2019; 19:222. [PMID: 30975155 PMCID: PMC6458761 DOI: 10.1186/s12913-019-4049-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 05/01/2018] [Accepted: 03/28/2019] [Indexed: 11/23/2022] Open
Abstract
Background Providing culturally safe health care can contribute to improved health among Aboriginal people. However, little is known about how to make hospitals culturally safe for Aboriginal people. This study assessed the impact of an emergency department (ED)-based continuous quality improvement program on: the accuracy of recording of Aboriginal status in ED information systems; incomplete ED visits among Aboriginal patients; and the cultural appropriateness of ED systems and environments. Methods Between 2012 and 2014, the Aboriginal Identification in Hospitals Quality Improvement Program (AIHQIP) was implemented in eight EDs in NSW, Australia. A multiple baseline design and analysis of linked administrative data were used to assess program impact on the proportion of Aboriginal patients correctly identified as Aboriginal in ED information systems and incomplete ED visits in Aboriginal patients. Key informant interviews and document review were used to explore organisational changes. Results In all EDs combined, the AIHQIP was not associated with a reduction in incomplete ED visits in Aboriginal people, nor did it influence the proportion of ED visits made by Aboriginal people that had an accurate recording of Aboriginal status. However, in two EDs it was associated with an increase in the trend of accurate recording of Aboriginality from baseline to the intervention period (odds ratio (OR) 1.31, p < 0.001 in ED 4 and OR 1.15, p = 0.020 in ED 5). In other words, the accuracy of recording of Aboriginality increased from 61.4 to 70% in ED 4 and from 72.6 to 73.9% in ED 5. If the program were not implemented, only a marginal increase would have occurred in ED 4 (from 61.4 to 64%) and, in ED 5, the accuracy of reporting would have decreased (from 72.6 to 71.1%). Organisational changes were achieved across EDs, including modifications to waiting areas and improved processes for identifying Aboriginal patients and managing incomplete visits. Conclusions The AIHQIP did not have an overall effect on the accuracy of recording of Aboriginal status or on levels of incomplete ED visits in Aboriginal patients. However, important organisational changes were achieved. Further research investigating the effectiveness of interventions to improve Aboriginal cultural safety is warranted. Electronic supplementary material The online version of this article (10.1186/s12913-019-4049-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thomas Gadsden
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
| | - Gai Wilson
- University of Melbourne, Parkville, VIC, 3010, Australia
| | - James Totterdell
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
| | - John Willis
- St Vincent's Health Australia, Level 5, 340 Albert Street, Melbourne, VIC, 3002, Australia
| | - Ashima Gupta
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Alwin Chong
- Positive Futures Research Collaboration, Division of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - Angela Clarke
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Michelle Winters
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Kym Donahue
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Sonia Posenelli
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Louise Maher
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
| | - Jessica Stewart
- NSW Department of Family and Community Services, 223-239 Liverpool Road, Ashfield, NSW, 2131, Australia
| | - Helen Gardiner
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
| | - Erin Passmore
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
| | - Aaron Cashmore
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia. .,School of Public Health and Community Medicine, UNSW, Sydney, NSW, 2052, Australia.
| | - Andrew Milat
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia
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11
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Passmore E, Donato-Hunt C, Maher L, Havrlant R, Hennessey K, Milat A, Farrell L. Evaluation of a pilot school-based physical activity challenge for primary students. Health Promot J Austr 2019; 28:103-109. [PMID: 27923111 DOI: 10.1071/he16021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/19/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed Physical inactivity and sedentary behaviour among children are growing public health concerns. The Culture Health Communities Activity Challenge (hereafter known as the Challenge) is a school-based pedometer program in which classes compete to achieve the highest class average daily steps in an 8-week period. The Challenge aims to encourage physical activity in primary school students, with a focus on engaging Aboriginal students. The program was piloted in 15 classes in New South Wales in 2014. Methods The evaluation aimed to explore students' and teachers' experiences of the Challenge, and assess its impact on the students' physical activity levels. Data sources were a pre- and post-intervention survey of students' physical activity levels and sedentary time (n=209), qualitative interviews with teachers (n=11) and discussions with 10 classes. Results Fifteen Year 5 and 6 classes comprising 318 students participated. Fifty percent of participants were girls, the average age was 11 years and the majority (57%) were Aboriginal students. Participation in the Challenge was associated with a slight but statistically significant increase in students' physical activity levels (P<0.05), and a significant decrease in weekend screen time (P<0.05). However, when stratified by Aboriginality these changes were not statistically significant for Aboriginal students. Qualitative feedback from teachers and students indicated high levels of engagement and satisfaction with the Challenge. Teachers and students reported positive impacts, including increased motivation to be physically active, and improved student attendance and engagement in class activities and teamwork. Conclusions Participation in the Challenge was associated with increased physical activity and decreased screen time for some students. Students and teachers also reported a range of positive social and educational outcomes. So what? The findings highlight the importance of primary schools as a setting for health promotion activities, and demonstrate that school-based physical activity programs can be engaging and appropriate for classes with high proportions of Aboriginal students.
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Affiliation(s)
- E Passmore
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia
| | - C Donato-Hunt
- Cultural and Indigenous Research Centre Australia, Level 1, 93 Norton Street, Leichhardt, NSW 2040, Australia
| | - L Maher
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia
| | - R Havrlant
- NSW Agency for Clinical Innovation, 67 Albert Avenue, Chatswood, NSW 2067, Australia
| | - K Hennessey
- NSW Agency for Clinical Innovation, 67 Albert Avenue, Chatswood, NSW 2067, Australia
| | - A Milat
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia
| | - L Farrell
- NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia
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12
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Jayakody A, Passmore E, Oldmeadow C, Bryant J, Carey M, Simons E, Cashmore A, Maher L, Hennessey K, Bunfield J, Terare M, Milat A, Sanson-Fisher R. The impact of telephone follow up on adverse events for Aboriginal people with chronic disease in new South Wales, Australia: a retrospective cohort study. Int J Equity Health 2018; 17:60. [PMID: 29776360 PMCID: PMC5960116 DOI: 10.1186/s12939-018-0776-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic diseases are more prevalent and occur at a much younger age in Aboriginal people in Australia compared with non-Aboriginal people. Aboriginal people also have higher rates of unplanned hospital readmissions and emergency department presentations. There is a paucity of research on the effectiveness of follow up programs after discharge from hospital in Aboriginal populations. This study aimed to assess the impact of a telephone follow up program, 48 Hour Follow Up, on rates of unplanned hospital readmissions, unplanned emergency department presentations and mortality within 28 days of discharge among Aboriginal people with chronic disease. METHODS A retrospective cohort of eligible Aboriginal people with chronic diseases was obtained through linkage of routinely-collected health datasets for the period May 2009 to December 2014. The primary outcome was unplanned hospital readmissions within 28 days of separation from any acute New South Wales public hospital. Secondary outcomes were mortality, unplanned emergency department presentations, and at least one adverse event (unplanned hospital readmission, unplanned emergency department presentation or mortality) within 28 days of separation. Logistic regression models were used to assess outcomes among Aboriginal patients who received 48 Hour Follow Up compared with eligible Aboriginal patients who did not receive 48 Hour Follow Up. RESULTS The final study cohort included 18,659 patients with 49,721 separations, of which 8469 separations (17.0, 95% confidence interval (CI): 16.7-17.4) were recorded as having received 48 Hour Follow Up. After adjusting for potential confounders, there were no significant differences in rates of unplanned readmission or mortality within 28 days between people who received or did not receive 48 Hour Follow Up. Conversely, the odds of an unplanned emergency department presentation (Odds ratio (OR) = 0.92; 95% CI: 0.85, 0.99; P = 0.0312) and at least one adverse event (OR = 0.91; 95% CI: 0.85,0.98; P = 0.0136) within 28 days were significantly lower for separations where the patient received 48 Hour Follow Up compared with those that did not receive follow up. CONCLUSIONS Receipt of 48 Hour Follow Up was associated with both a reduction in emergency department presentations and at least one adverse event within 28 days of discharge, suggesting there may be merit in providing post-discharge telephone follow up to Aboriginal people with chronic disease.
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Affiliation(s)
- Amanda Jayakody
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, 2308, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, 2305, NSW, Australia. .,Evidence and Evaluation, Centre for Epidemiology and Evidence, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia.
| | - Erin Passmore
- Evidence and Evaluation, Centre for Epidemiology and Evidence, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, 2305, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, 2305, NSW, Australia
| | - Mariko Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, 2305, NSW, Australia
| | - Eunice Simons
- NSW Agency for Clinical Innovation, Level 4, Sage Building, 67 Albert Ave, Chatswood, Sydney, NSW, 2067, Australia
| | - Aaron Cashmore
- Evidence and Evaluation, Centre for Epidemiology and Evidence, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia.,School of Public Health and Community Medicine, University of NSW, Sydney, 2033, Australia
| | - Louise Maher
- Evidence and Evaluation, Centre for Epidemiology and Evidence, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia
| | - Kiel Hennessey
- NSW Agency for Clinical Innovation, Level 4, Sage Building, 67 Albert Ave, Chatswood, Sydney, NSW, 2067, Australia
| | - Jacinta Bunfield
- Centre for Aboriginal Health, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia
| | - Maurice Terare
- Centre for Aboriginal Health, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia
| | - Andrew Milat
- Evidence and Evaluation, Centre for Epidemiology and Evidence, NSW Ministry of Health LMB 961, North Sydney, Sydney, NSW, 2059, Australia.,Sydney Medical School, University of Sydney, Edward Ford Building A27, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, 2305, NSW, Australia
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13
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Bui H, Zablotska-Manos I, Hammoud M, Jin F, Lea T, Bourne A, Iversen J, Bath N, Grierson J, Degenhardt L, Prestage G, Maher L. Prevalence and correlates of recent injecting drug use among gay and bisexual men in Australia: Results from the FLUX study. International Journal of Drug Policy 2018; 55:222-230. [DOI: 10.1016/j.drugpo.2018.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/12/2018] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
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14
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Lennox L, Maher L, Reed J. Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implement Sci 2018; 13:27. [PMID: 29426341 PMCID: PMC5810192 DOI: 10.1186/s13012-017-0707-4] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/29/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Improvement initiatives offer a valuable mechanism for delivering and testing innovations in healthcare settings. Many of these initiatives deliver meaningful and necessary changes to patient care and outcomes. However, many improvement initiatives fail to sustain to a point where their full benefits can be realised. This has led many researchers and healthcare practitioners to develop frameworks, models and tools to support and monitor sustainability. This work aimed to identify what approaches are available to assess and influence sustainability in healthcare and to describe the different perspectives, applications and constructs within these approaches to guide their future use. METHODS A systematic review was carried out following PRISMA guidelines to identify publications that reported approaches to support or influence sustainability in healthcare. Eligibility criteria were defined through an iterative process in which two reviewers independently assessed 20% of articles to test the objectivity of the selection criteria. Data were extracted from the identified articles, and a template analysis was undertaken to identify and assess the sustainability constructs within each reported approach. RESULTS The search strategy identified 1748 publications with 227 articles retrieved in full text for full documentary analysis. In total, 62 publications identifying a sustainability approach were included in this review (32 frameworks, 16 models, 8 tools, 4 strategies, 1 checklist and 1 process). Constructs across approaches were compared and 40 individual constructs for sustainability were found. Comparison across approaches demonstrated consistent constructs were seen regardless of proposed interventions, setting or level of application with 6 constructs included in 75% of the approaches. Although similarities were found, no approaches contained the same combination of the constructs nor did any single approach capture all identified constructs. From these results, a consolidated framework for sustainability constructs in healthcare was developed. CONCLUSIONS Choosing a sustainability method can pose a challenge because of the diverse approaches reported in the literature. This review provides a valuable resource to researchers, healthcare professionals and improvement practitioners by providing a summary of available sustainability approaches and their characteristics. TRIAL REGISTRATION This review was registered on the PROSPERO database: CRD42016040081 in June 2016.
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Affiliation(s)
- L. Lennox
- NIHR CLAHRC North West London, 369 Fulham Road, London, SW10 9NH United Kingdom
- Department of Primary Care and Public Health, Imperial College London, 369 Fulham Road, London, United Kingdom
| | - L. Maher
- Ko Awatea I Health System Innovation and Improvement, Middlemore Hospital, 100 Hospital Road, Otahuhu, New Zealand
| | - J. Reed
- NIHR CLAHRC North West London, 369 Fulham Road, London, SW10 9NH United Kingdom
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15
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Passmore E, Shepherd B, Milat A, Maher L, Hennessey K, Havrlant R, Maxwell M, Hodge W, Christian F, Richards J, Mitchell J. The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: the New South Wales Knockout Health Challenge. BMC Public Health 2017; 17:951. [PMID: 29237437 PMCID: PMC5729464 DOI: 10.1186/s12889-017-4955-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/28/2017] [Indexed: 12/26/2022] Open
Abstract
Background Aboriginal people in Australia experience significant health burden from chronic disease. There has been limited research to identify effective healthy lifestyle programs to address risk factors for chronic disease among Aboriginal people. Methods The Knockout Health Challenge is a community-led healthy lifestyle program for Aboriginal communities across New South Wales, Australia. An evaluation of the 2013 Knockout Health Challenge was undertaken. Participants’ self-reported physical activity and diet were measured at four time points - at the start and end of the Challenge (via paper form), and 5 and 9 months after the Challenge (via telephone survey). Participants’ weight was measured objectively at the start and end of the Challenge, and self-reported (via telephone survey) 5 and 9 months after the Challenge. Changes in body composition, physical activity and diet between time points were analysed using linear mixed models. As part of the telephone survey participants were also asked to identify other impacts of the Challenge; these were analysed descriptively (quantitative items) and thematically (qualitative items). Results A total of 586 people registered in 22 teams to participate in the Challenge. The mean weight at the start was 98.54kg (SD 22.4), and 94% of participants were overweight or obese. Among participants who provided data at all four time points (n=122), the mean weight loss from the start to the end of the Challenge was 2.3kg (95%CI -3.0 to -1.9, p<0.001), and from the start to 9 months after the Challenge was 2.3kg (95%CI -3.3 to -1.3, p<0.001). Body mass index decreased by an average of 0.9kg/m2 (95%CI -1.0 to -0.7, p<0.001) from the start to the end of the Challenge, and 0.8kg/m2 (95%CI -1.2 to -0.4, p<0.001) 9 months after. At the end of the Challenge, participants reported they were more physically active and had increased fruit and vegetable consumption compared with the start of the Challenge, and identified a range of other positive impacts. Conclusions The Challenge was effective in reducing weight and promoting healthy lifestyles among Aboriginal people across New South Wales, and has potential to contribute to closing the health gap between Aboriginal and non-Aboriginal people.
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Affiliation(s)
- Erin Passmore
- NSW Ministry of Health, North Sydney, NSW, Australia.
| | | | - Andrew Milat
- NSW Ministry of Health, North Sydney, NSW, Australia.,Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Louise Maher
- NSW Ministry of Health, North Sydney, NSW, Australia
| | - Kiel Hennessey
- NSW Agency for Clinical Innovation, Chatswood, NSW, Australia
| | | | | | - Wendy Hodge
- ARTD Consultants, Level 4/352 Kent Street, Sydney, NSW, Australia
| | - Fiona Christian
- ARTD Consultants, Level 4/352 Kent Street, Sydney, NSW, Australia
| | - Justin Richards
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Jo Mitchell
- NSW Ministry of Health, North Sydney, NSW, Australia
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Abstract
Risky paternal alcohol use is associated with maternal alcohol use during pregnancy, poor fetal and infant outcomes, domestic violence and depression. This study developed 30 SMS text messages about alcohol for fathers who drink at risky levels. The text messages were developed using two motivational styles: messages presented in a second person voice and the same messages presented in a child's voice. Fifty-one fathers were recruited through social media to complete an online survey rating the SMS text messages for message importance and likelihood of seeking further information and measuring risky alcohol use and psychosocial distress. Seventeen participants then participated in a semi-structured qualitative interview. Fathers rated the text messages presented in the child's voice as more important than messages presented in the second person. Qualitative data supported survey results that motivational SMS text messages could provide an acceptable way to raise awareness of risky alcohol consumption for future fathers.
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Affiliation(s)
- Maryanne Robinson
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- 12 Alfred Street, Newcastle East, New South Wales 2300 Australia
| | - R. B. Wilkinson
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Fletcher
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Bruno
- School of Medicine, University of Tasmania, Hobart, Australia
| | - A. L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - L. Maher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales Australia
| | - J. Wroe
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - A. J. Dunlop
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, New Lambton, New South Wales Australia
- Centre for Brain and Mental Health, University of Newcastle, Callaghan, New South Wales Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
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17
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Iversen J, Grebely J, Catlett B, Cunningham P, Dore G, Maher L. O9 Progress towards elimination: rapid uptake of HCV treatment among people who inject drugs following broad access to DAA therapies. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30892-x] [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: 10/23/2022] Open
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18
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Bajis S, Lamoury F, Applegate T, Maher L, Treloar C, Mowat Y, Schulz M, Hajarizadeh B, Marshall A, Cunningham E, Cock V, Ezard N, Gorton C, Hayllar J, Smith J, Dore G, Grebely J. P4 Acceptability of point of care finger-stick and venepuncture hepatitis C virus testing among people who inject drugs and homeless people. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30745-7] [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: 11/28/2022] Open
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19
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Keoshkerian E, Hunter M, Cameron B, Nguyen N, Sugden P, Bull R, Zekry A, Maher L, Seddiki N, Zaunders J, Kelleher A, Lloyd AR. Hepatitis C-specific effector and regulatory CD4 T-cell responses are associated with the outcomes of primary infection. J Viral Hepat 2016; 23:985-993. [PMID: 27558465 DOI: 10.1111/jvh.12576] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/29/2016] [Indexed: 12/31/2022]
Abstract
Clearance of primary hepatitis C virus (HCV) infection has been associated with strong and broadly targeted cellular immune responses. This study aimed to characterize HCV-specific CD4+ effector and regulatory T-cell numbers and cytokine production during primary infection. Antigen-specific CD4+ T-cell responses were investigated in a longitudinal cohort of subjects from pre-infection to postoutcome, including subjects who cleared [n=12] or became chronically infected [n=17]. A cross-sectional cohort with previously cleared, or chronic infection [n=15 for each], was also studied. Peripheral blood mononuclear cells were incubated with HCV antigens and surface stained for T-effector (CD4+CD25high CD134+CD39-) and T-regulatory (CD4+CD25high CD134+CD39+) markers, and culture supernatants assayed for cytokine production. Contrary to expectations, the breadth and magnitude of the HCV-specific CD4+ T-cell responses were higher in subjects who became chronically infected. Subjects who cleared the virus had HCV-specific CD4+ T-cell responses dominated by effector T cells and produced higher levels of IFN-γ, in contrast to HCV-specific CD4+ T-cell responses dominated by regulatory T cells and more IL-10 production in those who became chronically infected. Better understanding of the role of antigen-specific CD4+ T-cell responses in primary HCV will further define pathogenesis and help guide development of a preventative vaccine.
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Affiliation(s)
- E Keoshkerian
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
| | - M Hunter
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - B Cameron
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - N Nguyen
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - P Sugden
- UNSW Australia, SOMS (Infection and Immunology Research Centre, IIRC), Kensington, NSW, Australia
| | - R Bull
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
| | - A Zekry
- UNSW Australia, St George and Sutherland Clinical School, Sydney, NSW, Australia
| | - L Maher
- UNSW Australia, Kirby Institute (Viral Hepatitis Epidemiology and Prevention Program VHEPP), Kensington, NSW, Australia
| | - N Seddiki
- The Vaccine Research Institute (VRI), INSERM, Créteil, France
| | - J Zaunders
- UNSW Australia, Kirby Institute (Immunovirology and Pathogenesis Program, IVPP), Kensington, NSW, Australia
| | - A Kelleher
- UNSW Australia, Kirby Institute (Immunovirology and Pathogenesis Program, IVPP), Kensington, NSW, Australia
| | - A R Lloyd
- UNSW Australia, Kirby Institute (Viral Immunology Systems Program, VISP) and School of Medical Sciences (SOMS), Kensington, NSW, Australia
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20
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Natoli L, Coburn T, Maher L, Shephard M, Hengel B, Badman S, Causer L, Tangey A, Kaldor J, Ward J, Anderson D, Guy R. P13.04 “I do feel like a scientist at time yeah…” acceptability of point-of-care testing for chlamydia and gonorrhoea to health service providers in remote primary care. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.502] [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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21
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Spelman T, Morris MD, Zang G, Rice T, Page K, Maher L, Lloyd A, Grebely J, Dore GJ, Kim AY, Shoukry NH, Hellard M, Bruneau J. A longitudinal study of hepatitis C virus testing and infection status notification on behaviour change in people who inject drugs. J Epidemiol Community Health 2015; 69:745-52. [PMID: 25814695 PMCID: PMC4515217 DOI: 10.1136/jech-2014-205224] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/26/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) testing and counselling have the potential to impact individual behaviour and transmission dynamics at the population level. Evidence of the impact of an HCV-positive status notification on injection risk reduction is limited. The objective of our study was to (1) assess drug and alcohol use and injection risk behaviours following notification; (2) to compare behaviour change in people who inject drugs (PWID) who received a positive test result and those who remained negative; and (3) to assess the effect of age on risk behaviour. METHODS Data from the International Collaboration of Incident HIV and HCV Infection in Injecting Cohorts (InC3 Study) were analysed. Participants who were initially HCV seronegative were followed prospectively with periodic HCV blood testing and post-test disclosure and interview-administered questionnaires assessing drug use and injection behaviours. Multivariable generalised estimating equations were used to assess behavioural changes over time. RESULTS Notification of an HCV-positive test was independently associated with a small increase in alcohol use relative to notification of a negative test. No significant differences in postnotification injection drug use, receptive sharing of ancillary injecting equipment and syringe borrowing postnotification were observed between diagnosis groups. Younger PWID receiving a positive HCV test notification demonstrated a significant increase in subsequent alcohol use compared with younger HCV negative. CONCLUSIONS The proportion of PWID reporting alcohol use increased among those receiving an HCV-positive notification, increased the frequency of alcohol use postnotification, while no reduction in injection drug use behaviours was observed between notification groups. These findings underscore the need to develop novel communication strategies during post-test notification to improve their impact on subsequent alcohol use and risk behaviours.
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Affiliation(s)
- T Spelman
- Centre of Population Health, Burnet Institute, Melbourne, Victoria, Australia
| | - M D Morris
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - G Zang
- Centre Hospitalier de l'Université de Montréal Research Center (CRCHUM), Université de Montréal, Montréal, Canada
| | - T Rice
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - K Page
- Department of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center
| | - L Maher
- Kirby Institute, UNSW Australia, Sydney, Australia
| | - A Lloyd
- UNSW Australia, Sydney, Australia
| | - J Grebely
- Kirby Institute, UNSW Australia, Sydney, Australia
| | - G J Dore
- Kirby Institute, UNSW Australia, Sydney, Australia
| | - A Y Kim
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - N H Shoukry
- Centre Hospitalier de l'Université de Montréal Research Center (CRCHUM), Université de Montréal, Montréal, Canada
| | - M Hellard
- Centre of Population Health, Burnet Institute, Melbourne, Victoria, Australia
| | - J Bruneau
- Centre Hospitalier de l'Université de Montréal Research Center (CRCHUM), Université de Montréal, Montréal, Canada
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Natoli L, Guy RJ, Shephard M, Whiley D, Tabrizi SN, Ward J, Regan DG, Badman SG, Anderson DA, Kaldor J, Maher L. Public health implications of molecular point-of-care testing for chlamydia and gonorrhoea in remote primary care services in Australia: a qualitative study. BMJ Open 2015; 5:e006922. [PMID: 25922100 PMCID: PMC4420950 DOI: 10.1136/bmjopen-2014-006922] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES With accurate molecular tests now available for diagnosis of chlamydia and gonorrhoea (Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG)) at the point-of-care (POC), we aimed to explore the public health implications (benefits and barriers) of their integration into remote primary care in Australia. METHODS Qualitative interviews were conducted with a purposively selected group of 18 key informants reflecting sexual health, primary care, remote Aboriginal health and laboratory expertise. RESULTS Participants believed that POC testing may decrease community prevalence of sexually transmitted infections (STIs), and associated morbidity by reducing the time to treatment and infectious period and expediting partner notification. Also, POC testing could improve acceptability of STI testing, increase testing coverage and result in more targeted prescribing, thereby minimising the risk of antibiotic resistance. Conversely, some felt the immediacy of diagnosis could deter certain young people from being tested. Participants also noted that POC testing may reduce the completeness of communicable disease surveillance data given the current dependence on reporting from pathology laboratories. Others expressed concern about the need to maintain and improve the flow of NG antibiotic sensitivity data, already compromised by the shift to nucleic acid-based testing. This is particularly relevant to remote areas where culture viability is problematic. CONCLUSIONS Results indicate a high level of support from clinicians and public health practitioners for wider access to CT/NG POC tests citing potential benefits, including earlier, more accurate treatment decisions and reductions in ongoing transmission. However, the data also highlight the need for new systems to avoid adverse impact on disease surveillance. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry: ACTRN12613000808741.
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Affiliation(s)
- L Natoli
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | - R J Guy
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - M Shephard
- Flinders University International Centre for Point of-Care Testing, Flinders University, Adelaide, South Australia, Australia
| | - D Whiley
- Queensland Paediatric Infectious Diseases (QPID) Laboratory, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - S N Tabrizi
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - J Ward
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - D G Regan
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - S G Badman
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - D A Anderson
- Burnet Institute, Melbourne, Victoria, Australia
| | - J Kaldor
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - L Maher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Treloar C, Newland J, Maher L. A qualitative study trialling the acceptability of new hepatitis C prevention messages for people who inject drugs: symbiotic messages, pleasure and conditional interpretations. Harm Reduct J 2015; 12:5. [PMID: 25884357 PMCID: PMC4355982 DOI: 10.1186/s12954-015-0042-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 02/11/2015] [Indexed: 02/01/2023] Open
Abstract
AIM Prevention of hepatitis C (HCV) remains a public health challenge. A new body of work is emerging seeking to explore and exploit "symbiotic goals" of people who inject drugs (PWID). That is, strategies used by PWID to achieve other goals may be doubly useful in facilitating the same behaviours (use of sterile injecting equipment) required to prevent HCV. This project developed and trialled new HCV prevention messages based on the notion of symbiotic messages. METHOD New HCV prevention messages were developed in a series of 12 posters after consultation with staff from needle and syringe programs (NSPs) and a drug user organisation. Two posters were displayed each week for a 6-week period within one NSP. NSP staff and clients were invited to focus groups to discuss their responses to the posters. RESULTS A total of four focus groups were conducted; one group of seven staff members and three groups of clients with a total of 21 participants. Responses to each of the posters were mixed. Staff and clients interpreted messages in literal ways rather than as dependent on context, with staff concerned that not all HCV prevention information was included in any one message; while clients felt that some messages were misleading in relation to the expectations of pleasure. Clients appreciated the efforts to use bright imagery and messages that included acknowledgement of pleasure. Clients were not aware of some harm reduction information contained in the messages (such as "shoot to the heart"), and this generated potential for misunderstanding of the intended message. Clients felt that any message provided by the NSP could be trusted and did not require visible endorsement by health departments. CONCLUSIONS While the logic of symbiotic messages is appealing, it is challenging to produce eye-catching, brief messages that provide sufficient information to cover the breadth of HCV prevention. Incorporation of symbiotic messages in conversations or activities between staff and clients may provide opportunities for these messages to be related to the clients' needs and priorities and for staff to provide HCV prevention information in accord with their professional ethos.
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Affiliation(s)
- Carla Treloar
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW, Australia.
| | - Jamee Newland
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW, Australia.
| | - Louise Maher
- Population Health Services, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.
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Maher L, Dawson A, Wiley K, Hope K, Torvaldsen S, Lawrence G, Conaty S. Influenza vaccination during pregnancy: a qualitative study of the knowledge, attitudes, beliefs, and practices of general practitioners in Central and South-Western Sydney. BMC Fam Pract 2014; 15:102. [PMID: 24884996 PMCID: PMC4038848 DOI: 10.1186/1471-2296-15-102] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 05/08/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pregnant women have an increased risk of influenza complications. Influenza vaccination during pregnancy is safe and effective, however coverage in Australia is less than 40%. Pregnant women who receive a recommendation for influenza vaccination from a health care provider are more likely to receive it, however the perspectives of Australian general practitioners has not previously been reported. The aim of the study was to investigate the knowledge, attitudes, beliefs, and practices of general practitioners practicing in South-Western Sydney, Australia towards influenza vaccination during pregnancy. METHODS A qualitative descriptive study was conducted, with semi-structured interviews completed with seventeen general practitioners in October 2012. A thematic analysis was undertaken by four researchers, and transcripts were analysed using N-Vivo software according to agreed codes. RESULTS One-third of the general practitioners interviewed did not consider influenza during pregnancy to be a serious risk for the mother or the baby. The majority of the general practitioners were aware of the government recommendations for influenza vaccination during pregnancy, but few general practitioners were confident of their knowledge about the vaccine and most felt they needed more information. More than half the general practitioners had significant concerns about the safety of influenza vaccination during pregnancy. Their practices in the provision of the vaccine were related to their perception of risk of influenza during pregnancy and their confidence about the safety of the vaccine. While two-thirds reported that they are recommending influenza vaccination to their pregnant patients, many were adopting principles of patient-informed choice in their approach and encouraged women to decide for themselves whether they would receive the vaccine. CONCLUSIONS General practitioners have varied knowledge, attitudes, and beliefs about influenza vaccination during pregnancy, which influence their practices. Addressing these could have a significant impact on improving vaccine uptake during pregnancy.
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Affiliation(s)
- Louise Maher
- NSW Public Health Officer Training Program, NSW Ministry of Health, 73 Miller St, North Sydney, NSW 2060, Australia.
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Iversen J, Grebely J, Topp L, Wand H, Dore G, Maher L. Uptake of hepatitis C treatment among people who inject drugs attending Needle and Syringe Programs in Australia, 1999-2011. J Viral Hepat 2014; 21:198-207. [PMID: 24438681 DOI: 10.1111/jvh.12129] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [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: 03/27/2013] [Accepted: 04/21/2013] [Indexed: 01/16/2023]
Abstract
The majority of new and existing cases of hepatitis C virus (HCV) infection occur among people who inject drugs (PWID). Despite safe and efficacious HCV antiviral therapy, uptake remains low in this population. This study examined trends in HCV treatment uptake among a large national sample of PWID attending Australian Needle and Syringe Programs between 1999 and 2011. Annual cross-sectional sero-surveys conducted among PWID since 1995 involve completion of a self-administered questionnaire and provision of a dried blood spot for HCV antibody testing. Multivariate logistic regression identified variables independently associated with HCV treatment uptake among 9478 participants with both self-reported and serologically confirmed prior HCV infection. Between 1999 and 2011, the proportion currently receiving treatment increased from 1.1% to 2.1% (P < 0.001), while the proportion having ever received treatment increased from 3.4% to 8.6% (P < 0.001). Men were significantly more likely than women to have undertaken HCV treatment (P = 0.002). Among men, independent predictors of HCV treatment uptake were homosexual identity and older age; among women, independent predictors included homosexual identity and an incarceration history. Despite increases in HCV treatment among Australian PWID between 1999 and 2011, uptake remains low. Strategies are required to increase the proportion of PWID assessed and treated for HCV infection to address the increasing burden of disease. Specific approaches that target women may also be warranted. Continued surveillance of HCV treatment uptake among PWID will be important to monitor the roll-out of simple, safe and more effective HCV treatments expected to be available in the future.
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Affiliation(s)
- J Iversen
- Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute University of New South Wales, Sydney, NSW, Australia
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26
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Voss J, Maher L, Jones C, Lever N. AV junction ablation audit - Auckland City Hospital. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.04.239] [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: 10/25/2022]
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Randall DA, Reinten T, Maher L, Lujic S, Stewart J, Keay L, Leyland AH, Jorm LR. Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia. Clin Exp Ophthalmol 2013; 42:629-36. [PMID: 24299196 PMCID: PMC4233999 DOI: 10.1111/ceo.12274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 08/19/2013] [Accepted: 11/12/2013] [Indexed: 11/27/2022]
Abstract
Background To investigate variation in rates of cataract surgery in New South Wales, Australia by area of residence for Aboriginal and non-Aboriginal adults. Design Observational data linkage study of hospital admissions. Participants Two hundred eighty-nine thousand six hundred forty-six New South Wales residents aged 30 years and over admitted to New South Wales hospitals for 444 551 cataract surgery procedures between 2001 and 2008. Methods Analysis of linked routinely collected hospital data using direct standardization and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas. Main Outcome Measures Age-standardized cataract surgery rates and adjusted rate ratios. Results Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same Statistical Local Area (adjusted rate ratio 0.71, 95% confidence interval 0.68–0.75). There was significant variation in cataract surgery rates across Statistical Local Areas for both Aboriginal and non-Aboriginal people, with the disparity greater in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most Statistical Local Areas, but in a few, the rates were similar or higher for Aboriginal people. Conclusions Aboriginal people in New South Wales received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations.
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Affiliation(s)
- Deborah A Randall
- Centre for Health Research, School of Medicine, University of Western Sydney, Penrith, Australia
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Maher L, Hope K, Torvaldsen S, Lawrence G, Dawson A, Wiley K, Thomson D, Hayen A, Conaty S. Influenza vaccination during pregnancy: coverage rates and influencing factors in two urban districts in Sydney. Vaccine 2013; 31:5557-64. [PMID: 24076176 DOI: 10.1016/j.vaccine.2013.08.081] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 08/18/2013] [Accepted: 08/27/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pregnant women have an increased risk of complications from influenza. Influenza vaccination during pregnancy is considered effective and safe; however estimates of vaccine coverage are low. This study aimed to determine influenza vaccination coverage and factors associated with vaccine uptake in pregnant women in two Sydney-based health districts. METHODS A random sample of women who delivered a baby in a public hospital in Sydney and South-Western Sydney Local Health Districts between June and September 2012 were surveyed using a computer assisted telephone interviewing service. RESULTS Of the 462 participants (participation rate 92%), 116 (25%) reported receiving the influenza vaccine during their pregnancy. In univariate analysis, vaccination coverage varied significantly depending on antenatal care type, hospital of birth, and parity (p<0.05), but not for age category, highest level of education, country of birth, language spoken at home, or Aboriginal status. Women who received antenatal care through a general practitioner (GP) had 2.3 (95% CI 1.4-3.6) times the odds (unadjusted) of receiving the influenza vaccination than those who received their antenatal care through a public hospital. The main reason cited for vaccination was GP recommendation (37%), while non-recommendation (33%) and lack of knowledge (26%) were cited as main reasons for not receiving the vaccination. 30% of women recalled receiving a provider recommendation for the vaccination and these women had 33.0 times the odds (unadjusted) of receiving the vaccination than women who had not received a recommendation. In a multivariate model a provider recommendation was the only variable that was significantly associated with vaccination (OR 41.9; 95% CI 20.7-84.9). CONCLUSION Rates of influenza vaccination during pregnancy are low. There is a significant relationship between healthcare provider recommendation for the vaccination and vaccine uptake. Increasing provider recommendation rates has the potential to increase coverage rates of influenza vaccination in pregnant women.
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Affiliation(s)
- Louise Maher
- NSW Public Health Officer Training Program, NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia; School of Public Health and Community Medicine, University of New South Wales, UNSW, Sydney 2052, Australia.
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Maher L, Phelan C, Lawrence G, Torvaldsen S, Dawson A, Wright C. The Early Childhood Oral Health Program: promoting prevention and timely intervention of early childhood caries in NSW through shared care. Health Promot J Austr 2013; 23:171-6. [PMID: 23540315 DOI: 10.1071/he12171] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ISSUE ADDRESSED Early childhood caries (ECC) continues to have high prevalence worldwide, despite being largely preventable. The Early Childhood Oral Health (ECOH) Program was established in New South Wales (NSW) using a model of shared responsibility for oral health, which involves a partnership between child health professionals, oral health professionals and parents of young children, to facilitate the primary prevention, early identification and early intervention of ECC. METHODS An evaluation of the ECOH program was conducted, using mixed methods. Data were obtained through document review, surveys and interviews with program implementers, and analysis of the Information System for Oral Health (ISOH) database for public oral health services activity in NSW. RESULTS Key achievements of the ECOH program include the establishment of governance mechanisms, policy, structures and responsibilities for implementation, support mechanisms for child health professionals, referral processes, communications resources, and the delivery of training. Parents receive oral health information, education and support through written resources and contact with child health professionals. Child and family health nurses interviewed reported routinely incorporating oral health promotion and early identification for ECC into their practices. The referral rate to public oral health services for children under five years of age by community health professionals has increased steadily since the program began, with the rate in 2009 five times higher than in 2007. CONCLUSIONS Models of shared responsibility for oral health between parents, child health professionals and oral health professionals can facilitate primary prevention and early intervention for ECC.
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Affiliation(s)
- Louise Maher
- School of Public Health and Community Medicine University of New South Wales, Australia.
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Maher L, Wand H. Hepatitis C Virus Transmission in People Who Inject Drugs: Swabs May Not Be the Main Culprit. J Infect Dis 2012; 205:1892; author reply 1892-3. [DOI: 10.1093/infdis/jis286] [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: 11/14/2022] Open
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Maher L, Turnour C, Stewart J. Reporting of Aboriginal people in health data collections in NSW. N S W Public Health Bull 2012; 23:61-62. [PMID: 22697100 DOI: 10.1071/nb12067f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Louise Maher
- Centre for Aboriginal Health, NSW Ministry of Health
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Maher L, Brown AM, Torvaldsen S, Dawson AJ, Patterson JA, Lawrence G. Eye health services for Aboriginal people in the western region of NSW, 2010. N S W Public Health Bull 2012; 23:81-86. [PMID: 22697105 DOI: 10.1071/nb11050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM To assess the availability, accessibility and uptake of eye health services for Aboriginal people in western NSW in 2010. METHODS The use of document review, observational visits, key stakeholder consultation and service data reviews, including number of cataract operations performed, to determine regional service availability and use. RESULTS Aboriginal people in western NSW have a lower uptake of tertiary eye health services, with cataract surgery rates of 1750 per million for Aboriginal people and 9702 per million for non-Aboriginal people. Public ophthalmology clinics increase access to tertiary services for Aboriginal people. CONCLUSION Eye health services are not equally available and accessible for Aboriginal people in western NSW. Increasing the availability of culturally competent public ophthalmology clinics may increase access to tertiary ophthalmology services for Aboriginal people. The report of the review was published online, and outlines a list of recommendations.
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Affiliation(s)
- Louise Maher
- NSW Public Health Officer Training Program, NSW Ministry of Health.
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Stewart J, Parter C, Maher L. Building a strategic approach to improve Aboriginal health research and evaluation in NSW. N S W Public Health Bull 2012; 23:87-91. [PMID: 22697106 DOI: 10.1071/nb11055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 5-year strategic plan for Aboriginal health research and evaluation has been developed to support the NSW Ministry of Health in its efforts to create the evidence for what works in addressing the health disparity between Aboriginal and non-Aboriginal people. The plan has the following objectives: that all Aboriginal health policies and programs are evidence informed; that programs and strategies are rigorously evaluated and contribute to building the evidence for improving Aboriginal health outcomes; that new research evidence is generated for improving Aboriginal health outcomes; and that robust monitoring and accountability mechanisms in Aboriginal health are in place, with improved data quality. This paper describes the development of the NSW Ministry of Health's Aboriginal Health Research and Evaluation Strategic Plan 2011-15, including a review of the evidence and policy documents, facilitated planning sessions, and consultation with staff within the Population and Public Health Division of the Ministry.
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Affiliation(s)
- Jessica Stewart
- Centre for Epidemiology and Evidence, NSW Ministry of Health.
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Ramke J, Brian G, Maher L, Qalo Qoqonokana M, Szetu J. Prevalence and causes of blindness and low vision among adults in Fiji. Clin Exp Ophthalmol 2012; 40:490-6. [DOI: 10.1111/j.1442-9071.2011.02749.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ramke J, Maher L, Lee L, Hobday K, Brian G. Diabetes and its ocular complications: awareness among adults aged 40 years and older in Timor-Leste. Clin Exp Optom 2012; 95:377-81. [PMID: 22248299 DOI: 10.1111/j.1444-0938.2011.00681.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim was to assess awareness of diabetes mellitus and its ocular complications among Timorese aged 40 years and older. METHODS An interview-based questionnaire was administered to a subset of five urban and five rural clusters of 45 people aged 40 years and older as part of a population-based cross-sectional survey. RESULTS The participation rate was 96.2 per cent and data were analysed for 413 respondents. Correct nomination of at least one symptom, risk factor, prevention or treatment of diabetes was made by 6.1 per cent of participants. When explicitly asked, 6.8 per cent thought that diabetes caused problems with the body and 3.6 per cent thought diabetes caused eye problems. CONCLUSION There is little awareness of diabetes and its ocular complications in Timor-Leste. Given the predicted urbanisation and economic development in the coming decades, as other health challenges are addressed and resources become available, consideration of diabetes might be prudent. Improving knowledge among the population will be an important component of any strategy developed.
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Mac Ananey O, Mellotte G, Maher L, Dunne M, Maher A, Maher V. P1.05 SEDENTARY LIFESTYLE IS ASSOCIATED WITH INDICES OF ARTERIAL STIFFNESS, DIASTOLIC DYSFUNCTION AND OBESITY. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.042] [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: 10/27/2022] Open
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Maher L, Taylor HR, Barton J. Bug breakfast in the bulletin: trachoma. N S W Public Health Bull 2011; 22:209. [PMID: 22060059 DOI: 10.1071/nb10080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Louise Maher
- NSW Public Health Officer Training Program, NSW Department of Health
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Coombes RC, Von Minckwitz G, Hicks J, Klare P, Evans AA, Schmidt M, Makris A, Grieve R, Loibl S, Maher L, Mousa K, Buchsenscuhtz K, A'Hern R, Bliss JM. A phase III, multicenter, double-blind, randomized trial of celecoxib versus placebo in primary breast cancer patients: Randomized European Celecoxib Trial (REACT). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Maher L, Phlong P, Mooney-Somers J, Keo S, Stein E, Couture MC, Page K. Amphetamine-type stimulant use and HIV/STI risk behaviour among young female sex workers in Phnom Penh, Cambodia. Int J Drug Policy 2011; 22:203-9. [PMID: 21316935 DOI: 10.1016/j.drugpo.2011.01.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 12/17/2010] [Accepted: 01/14/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Use of amphetamine-type substances (ATS) has been linked to increased risk of HIV and other sexually transmitted infections (STI) worldwide. In Cambodia, recent ATS use is independently associated with incident STI infection among young female sex workers (FSWs). METHODS We conducted 33 in-depth interviews with women (15-29 years old) engaged in sex work to explore ATS use and vulnerability to HIV/STI. RESULTS Participants reported that ATS, primarily methamphetamine in pill and crystalline forms (yama), were cheap, widely available and commonly used. Yama was described as a "power drug" (thnam kamlang) which enabled women to work long hours and serve more customers. Use of ATS by clients was also common, with some providing drugs for women and/or encouraging their use, often resulting in prolonged sexual activity. Requests for unprotected sex were also more common among alternatives intoxicated clients and strategies typically employed to negotiate condom use were less effective. CONCLUSION ATS use was highly functional for young women engaged in sex work, facilitating a sense of power and agency and highlighting the occupational significance and normalization of ATS in this setting. This highly gendered dynamic supports the limited but emerging literature on women's use of ATS, which to date has been heavily focused on men. Results indicate an urgent need to increase awareness of the risks associated with ATS use, to provide women with sustainable alternatives for income generation, to better regulate the conditions of sex work, and to work with FSWs and their clients to develop and promote culturally appropriate harm reduction interventions.
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Affiliation(s)
- L Maher
- National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.
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Brian G, Ramke J, Maher L, Page A, Fischer-Harder K, Sikivou B. Body mass index among Melanesian and Indian Fijians aged ≥ 40 years living in Fiji. Asia Pac J Public Health 2011; 23:34-43. [PMID: 21169598 DOI: 10.1177/1010539510390665] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To determine the distribution and sociodemographic associations of body mass index (BMI; kg/m(2)) among Melanesian and Indian Fijians aged ≥40 years living in Fiji, a population-based cross-sectional survey with multistage random sampling was conducted in 2009. Melanesians were more likely to have BMI ≥25 (odds ratio [OR] = 4.73; 95% confidence interval [CI] = 3.57-6.28; P < .001) and BMI ≥30 (OR = 3.84; 95% CI = 2.94-5.03; P < .001). Among Melanesians, gender and educational attainment were predictive of BMI ≥25 on multivariate analysis. Women were more likely to be overweight (OR = 2.03; 95% CI = 1.34-3.06) or obese (OR = 1.92; 95% CI = 1.43-2.59). Among Indians, gender and age were predictive of BMI ≥25. Again, women were more likely to be overweight (OR = 2.51; 95% CI = 1.69-3.73) or obese (OR = 3.71; 95% CI = 2.19-6.29). Gender-age-domicile-adjusted, and extrapolating across Fiji, 0.3%, 84.5%, and 51.7% of Melanesians aged ≥40 years had BMI <18.5, ≥25, and ≥30, respectively. Among Indians, these values were 5.8%, 54.2%, and 21.2%, respectively.
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Affiliation(s)
- Garry Brian
- The Fred Hollows Foundation New Zealand, Newmarket, Auckland, New Zealand.
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Brian G, Ramke J, Maher L, Page A, Szetu J. The prevalence of diabetes among adults aged 40 years and over in Fiji. N Z Med J 2010; 123:68-75. [PMID: 21358785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM To estimate the prevalence of diabetes among adults aged ≥40 years in Fiji, and determine the demographic characteristics associated with this diagnosis. METHOD During a population-based survey, participant glycosylated haemoglobin (HbA1c) was determined and physician diagnosis of diabetes self-reported. HbA1c ≥6.5% or claimed previous diagnosis, independent of HbA1c, defined presence of diabetes. Results were extrapolated to the whole population. Predictors of risk for diabetes were investigated using logistic regression models. RESULTS Of those enumerated, 1381 participated (73.0%). For 1353 with either a history of diabetes or valid HbA1c, prevalence of diabetes was 44.8% (95%CI 42.2-47.5). Adjusting for age and domicile, Indians had significantly higher risk of diabetes than Melanesians among males (OR 2.02, 95%CI 1.37-2.97, p<0.001) and females (OR 1.99, 95%CI 1.44-2.73, p<0.001). Females were at greater risk than males among Melanesians (OR 1.75, 95%CI 1.30-2.36, p<0.001) and Indians (OR 1.94, 95%CI 1.33-2.84, p<0.001). Risk increased with age for both genders and ethnicities, adjusting for ethnicity and domicile, then gender and domicile. The ethnicity-gender-age-domicile adjusted prevalence of diabetes among adults aged ≥40 years in Fiji was 41.0% (95%CI 38.4-43.6): 99,000 people. CONCLUSION As identified in 1970, diabetes continues to be a substantial population health problem in Fiji.
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Affiliation(s)
- Garry Brian
- The Fred Hollows Foundation New Zealand, Private Bag 99909, Newmarket, Auckland 1023, New Zealand.
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Pertl M, Hevey D, Thomas K, Craig A, Chuinneagáin SN, Maher L. Differential effects of self-efficacy and perceived control on intention to perform skin cancer-related health behaviours. Health Educ Res 2010; 25:769-779. [PMID: 20439349 DOI: 10.1093/her/cyq031] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Previous research using the Theory of Planned Behaviour (TPB) for predicting skin cancer-related health behaviours has not adequately incorporated empirical advances in the conceptualization of the perceived behavioural control (PBC) component of the theory. This study examined the role of self-efficacy and controllability for predicting sunscreen and sunbed use intentions. Five hundred and ninety young adults completed a questionnaire on beliefs and intentions regarding sunscreen and sunbed use. Analysis using confirmatory factor analysis and multiple regression supported a conceptual distinction between two PBC subcomponents: controllability and self-efficacy. While self-efficacy--but not controllability--emerged as a significant predictor of intentions to use sunscreen, the opposite pattern was observed for the prediction of intentions to use sunbeds, whereby lower controllability beliefs were associated with higher intentions. Campaigns aimed at influencing health behaviours should consider the differential effects of the components of perceived control.
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Affiliation(s)
- M Pertl
- School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
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Contractor KB, Challapalli A, Sharma R, Kenny LM, Maher L, Winkler M, Hellawell G, Al-Nahhas A, Aboagye E, Mangar S. Determination of pelvic node status in patients with high-risk localized or locally advanced prostate cancer by [ 11c]choline PET-CT. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e13546] [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: 11/20/2022] Open
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Hevey D, Pertl M, Thomas K, Maher L, Craig A, Ni Chuinneagain S. Body Consciousness Moderates the Effect of Message Framing on Intentions to Use Sunscreen. J Health Psychol 2010; 15:553-9. [DOI: 10.1177/1359105309355335] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to investigate the impact of messages differing in focus (health vs appearance) and frame (gain vs loss) on intentions for sunscreen use and sunbed use, and the potential moderating role of body consciousness. Questionnaire data from 390 young adults were analysed using factorial ANOVA. Results showed a significant interaction between message frame and body consciousness, such that gain-framed health or appearance messages had the strongest effect on sunscreen use intentions for those high in body consciousness, compared to those low in body consciousness. We conclude that message framing effects on precautionary sun behaviour intentions are moderated by body consciousness.
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Affiliation(s)
- D. Hevey
- Trinity College Dublin, Ireland,
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Hevey D, Pertl M, Thomas K, Maher L, Craig A, Ni Chuinneagain S. Consideration of future consequences scale: Confirmatory Factor Analysis. Personality and Individual Differences 2010. [DOI: 10.1016/j.paid.2010.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dwyer R, Topp L, Maher L, Power R, Hellard M, Walsh N, Jauncey M, Conroy A, Lewis J, Aitken C. Prevalences and correlates of non-viral injecting-related injuries and diseases in a convenience sample of Australian injecting drug users. Drug Alcohol Depend 2009; 100:9-16. [PMID: 19013725 DOI: 10.1016/j.drugalcdep.2008.08.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [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] [Received: 03/17/2008] [Revised: 08/25/2008] [Accepted: 08/25/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The prevalences and correlates of non-viral injecting-related injuries and diseases (IRIDs) in Australian injecting drug users (IDUs) remain unknown. METHODS A cross-sectional survey of IDUs was conducted in six sites across Australia's eastern states to investigate IRID experience among Australian IDU. Correlates of IRIDs were explored using logistic and negative binomial regression analyses. RESULTS 393 IDUs were recruited. Lifetime experience of non-serious IRIDs was common (e.g., 'dirty hit' 68%); potentially serious and serious IRIDs were less commonly experienced (e.g., abscess 16%; gangrene <1%). Factors independently associated with potentially serious or serious IRIDs in the previous 12 months were: injecting in sites other than arms (Adjusted Odds Ratio 3.0, 95% confidence interval 1.7-5.4), injecting non-powder drug forms (5.0, 2.2-11.2), unstable accommodation (2.0, 1.1-3.5), being aged 25 years or older (4.3, 1.7-10.6) and not always washing hands before injection (9.3, 2.1-41.8). Factors independently associated with multiple IRIDs in the preceding 12 months were using three or more injecting sites (Adjusted Incidence Rate Ratio 1.5, 95% CI 1.1-2.0), injecting in sites other than arms (1.7, 1.3-2.2), using non-powder drug forms (1.9, 1.4-2.5), injecting daily or more often (1.7, 1.3-2.2), current pharmacotherapy experience (1.5, 1.1-1.9), and not always washing hands before injecting (1.9, 1.2-2.9). DISCUSSION Some IRIDs are widespread among Australian IDUs. Observed associations, particularly the protective effect of handwashing, have useful public health implications.
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Affiliation(s)
- R Dwyer
- Centre for Epidemiology and Population Health Research, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne 3001, Australia
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Kearney N, Miller M, Maguire R, Dolan S, MacDonald R, McLeod J, Maher L, Sinclair L, Norrie J, Wengström Y. WISECARE+: Results of a European study of a nursing intervention for the management of chemotherapy-related symptoms. Eur J Oncol Nurs 2008; 12:443-8. [DOI: 10.1016/j.ejon.2008.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 07/04/2008] [Accepted: 07/07/2008] [Indexed: 10/21/2022]
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Day CA, White B, Thein HH, Doab A, Dore GJ, Bates A, Holden J, Maher L. Experience of hepatitis C testing among injecting drug users in Sydney, Australia. AIDS Care 2008; 20:116-23. [DOI: 10.1080/09540120701426524] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- C. A Day
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - B. White
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - H. H Thein
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - A. Doab
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - G. J Dore
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - A. Bates
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - J. Holden
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
| | - L. Maher
- a National Centre in HIV Epidemiology and Clinical Research , University of New South Wales , Australia
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Abstract
The current study aimed to compare self-reported injecting and sexual risk behaviour among Needle and Syringe Program (NSP) attendees who self-completed a questionnaire to that of those who received assistance in completing the questionnaire. Information on demographic, injecting and sexual risk behaviour was collected via a self-completed questionnaire for an annual cross-sectional survey of injecting drug users (IDUs) recruited from sentinel NSPs around Australia. Assistance was provided when necessary and recorded. Of 2,035 participants, 1,452 (71%) reported completing the questionnaire without assistance. Being male and nominating a language other than English spoken at home was independently associated with receiving assistance with questionnaire completion. Participants who reported heroin as the drug last injected were also more likely to receive assistance. Multivariate analyses revealed those who received assistance with questionnaire completion were less likely to report re-using a syringe after someone else and less likely to report sex work in the past month. The current findings suggest self-completion of risk behaviour questionnaires should be considered as an alternative to interviewer administered questionnaires to maximise accuracy of self-reports.
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Affiliation(s)
- B White
- Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, SYDNEY, NSW, Australia.
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