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Yisma E, Walsh S, Steen M, Gray R, Dennis S, Gillam M, Parange N, Jones M. Effect of Behavioral Activation for Women with Postnatal Depression: A Systematic Review and Meta-Analysis. Nurs Rep 2024; 14:78-88. [PMID: 38251185 PMCID: PMC10801525 DOI: 10.3390/nursrep14010007] [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: 08/30/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Evidence shows that behavioral activation (BA), a simple form of psychological therapy, is as effective as the more complex psychological therapy-cognitive behavioral therapy (CBT)-in treating general depression. However, it remains unclear whether BA when compared with treatment-as-usual (TAU) has greater contributions in reducing postnatal depression. This systematic review compared the effect of BA versus TAU in reducing depression symptoms among postnatal women. Five databases (MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO) were searched. Risk of bias was assessed using the Cochrane Collaboration's 'risk-of-bias 2 tool'. A random-effects meta-analysis was conducted to examine the effect of BA on postnatal depression. Of 2844 initial studies, only two randomized control trials (RCTs) met the inclusion criteria. The overall quality of evidence of these two RCTs was low. When compared to TAU, meta-analysis showed that BA was associated with reduced depression symptoms in postnatal women (standard mean difference -0.56; 95% confidence interval -0.76 to -0.37). This review suggests that BA might be more effective than TAU for alleviating postnatal depression. However, due to concerns about evidence quality, these findings should be interpreted cautiously.
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Affiliation(s)
- Engida Yisma
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia;
| | - Sandra Walsh
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia;
| | - Mary Steen
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- Department Nursing, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Richard Gray
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Shaun Dennis
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- Flinders and Upper North Local Health Network, Whyalla, SA 5600, Australia
| | - Marianne Gillam
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia;
| | - Nayana Parange
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia;
- Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Martin Jones
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia; (S.W.); (M.S.); (R.G.); (S.D.); (M.G.); (M.J.)
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia;
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Yisma E, Versace VL, Jones M, Walsh S, Jones S, May E, Puah LS, Gillam M. The distribution of registered occupational therapists, physiotherapists, and podiatrists in Australia. PLoS One 2023; 18:e0291962. [PMID: 37733814 PMCID: PMC10513188 DOI: 10.1371/journal.pone.0291962] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND In Australia, the distribution of occupational therapists, physiotherapists, and podiatrists density (per 10,000 population) by measure of location/rurality, usual resident population, and area-level socioeconomic status has not been described. OBJECTIVE To describe the national as well as states-and territories-wide distribution of registered allied health workforce-occupational therapists, physiotherapists, and podiatrists-by measures of rurality and area-level socioeconomic position in Australia. METHODS A linked data study that brings together (1) the location of health practitioners' principal place of practice from the Australian Health Practitioner Regulation Agency, (2) a measure of location/rurality-Modified Monash Model (MMM), and (3) an area-level measure of socioeconomic status-Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD). The provider-to-population ratio (i.e., density) of three Australia's allied health workforce (occupational therapists, physiotherapists, and podiatrists) was calculated according to the MMM classifications (i.e., Modified Monash 1-7) and IRSAD quintiles at state and national level. RESULTS Nationwide, the density of occupational therapists and physiotherapists was highest in metropolitan areas (Modified Monash 1) and decreased with the increasing levels of the MMM categories. The national density of podiatrists was highest in Modified Monash 3 areas. The density of occupational therapists, physiotherapists, and podiatrists was highest in areas with IRSAD quintile 5 (i.e., the highest socioeconomic position) and decreased with the declining levels of the IRSAD quintiles nationwide. Moreover, there were notable disparities in the density of occupational therapists, physiotherapists, and podiatrists across each state and territory in Australia when stratified by the MMM classifications and IRSAD quintiles. CONCLUSIONS There was uneven distribution of registered occupational therapists, physiotherapists, and podiatrists when stratified by measures of location/rurality and area-level socioeconomic status across Australian jurisdictions. The density of these three groups of allied health workforce tended to be more concentrated in metropolitan and most advantaged areas while remote and most disadvantaged areas exhibited less allied health workforce distribution across each state and territory.
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Affiliation(s)
- Engida Yisma
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
| | - Vincent L. Versace
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Martin Jones
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
| | - Sandra Walsh
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
| | - Sara Jones
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
| | - Esther May
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Lee San Puah
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
| | - Marianne Gillam
- Department of Rural Health, Allied Health & Human Performance, University of South Australia, Whyalla and Mount Barker, SA, Australia
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Puah LS, Gillam M, Walsh S, Jones M, Yisma E. Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia? Aust J Rural Health 2023. [PMID: 36852747 DOI: 10.1111/ajr.12974] [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: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. DESIGN Cross-sectional study. PARTICIPANTS Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. MAIN OUTCOME MEASURES Principal place of practice at first and third years after graduation. RESULTS In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. CONCLUSIONS Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.
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Affiliation(s)
- Lee San Puah
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Engida Yisma
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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Muyambi K, Gardiner F, Sollid S, Hyldmo PK, Yisma E, Spring B, Bredmose P, Jones M, Walsh S, Schofield Z, Gillam M. Aeromedical retrieval services characteristics globally: a scoping review. Scand J Trauma Resusc Emerg Med 2022; 30:71. [PMID: 36510297 PMCID: PMC9743498 DOI: 10.1186/s13049-022-01053-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Aeromedical emergency retrieval services play an important role in supporting patients with critical and often life-threatening clinical conditions. Aeromedical retrieval services help to provide fast access to definitive care for critically ill patients in under-served regions. Typically, fixed-wing aeromedical retrieval becomes the most viable transport option compared with rotary-wing aircraft when distances away from centres of definitive care extend beyond 200 kms. To our knowledge, there are no studies that have investigated fixed-wing aeromedical services in the member countries of the organisation for economic cooperation and development (OECD). A description of the global characteristics of aeromedical services will inform international collaboration to optimise clinical outcomes for patients. AIM In this scoping review, we aimed to describe the features of government- and not-for-profit organisation-owned fixed-wing aeromedical retrieval services in some of the member countries of the OECD. METHODS We followed scoping review methodology based on the grey literature search strategy identified in earlier studies. This mostly involved internet-based searches of the websites of fixed-wing aeromedical emergency retrieval services affiliated with the OECD member countries. RESULTS We identified 460 potentially relevant records after searching Google Scholar (n = 24) and Google search engines (n = 436). After removing ineligible and duplicate information, this scoping review identified 86 government-and not-for-profit-operated fixed-wing aeromedical retrieval services as existing in 17 OECD countries. Concentrations of the services were greatest in the USA followed by Australia, Canada, and the UK. The most prevalent business models used across the identified OECD member countries comprised the government, not-for-profit, and hybrid models. Three-quarters of the not-for-profit and two-fifths of the hybrid business models were in the USA compared to other countries studied. The government or state-funded business model was most common in Australia (11/24, 46%), Canada (4/24, 17%), and the UK (4/24, 17%). The frequently used service delivery models adopted for patients of all ages included primary/secondary retrievals, secondary retrievals only, and service specialisation models. Of these service models, primary/secondary retrieval involving the transportation of adults and children from community clinics and primary health care facilities to centres of definitive care comprised the core tasks performed by most of the aeromedical retrieval services studied. The service specialisation model provided an extra layer of specialist health care dedicated to the transportation of neonates and paediatrics. At least eight aeromedical retrieval services catered solely for children from birth to 16 years of age. One aeromedical service, the royal flying doctor service in Australia also provided primary health care and telehealth services in addition to primary retrieval and interhospital transfer of patients. The doctor and registered nurse/paramedic (Franco-German model) and the nurse and/or paramedic (Anglo-American model) configurations were the most common staffing models used across the aeromedical services studied. CONCLUSIONS The development and composition of fixed-wing aeromedical emergency retrieval services operated by not-for-profit organisations and governments in the OECD countries showed diversity in terms of governance arrangements, services provided, and staffing models used. We do not fully understand the impact of these differences on the quality of service provision, including equitable service access, highlighting a need for further research.
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Affiliation(s)
- Kuda Muyambi
- grid.1026.50000 0000 8994 5086Department of Rural Health, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086IIMPACT in Health, University of South Australia, Adelaide, South Australia Australia
| | - Fergus Gardiner
- Royal Flying Doctor Service, Canberra, Australia ,grid.1001.00000 0001 2180 7477Australian National University, Canberra, Australia
| | - Stephen Sollid
- grid.18883.3a0000 0001 2299 9255University of Stavanger, Stavanger, Norway ,grid.55325.340000 0004 0389 8485Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway
| | - Per Kristian Hyldmo
- grid.18883.3a0000 0001 2299 9255University of Stavanger, Stavanger, Norway ,grid.414311.20000 0004 0414 4503Division of Prehospital Care, Sørlandet Hospital, Sørlandet, Norway
| | - Engida Yisma
- grid.1026.50000 0000 8994 5086Department of Rural Health, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086IIMPACT in Health, University of South Australia, Adelaide, South Australia Australia
| | - Breeanna Spring
- Royal Flying Doctor Service, Canberra, Australia ,grid.1043.60000 0001 2157 559XCharles Darwin University, Casuarina, Australia
| | - Per Bredmose
- grid.55325.340000 0004 0389 8485Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway ,grid.420120.50000 0004 0481 3017Norwegian Air Ambulance Foundation, Oslo, Norway
| | - Martin Jones
- grid.1026.50000 0000 8994 5086Department of Rural Health, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086IIMPACT in Health, University of South Australia, Adelaide, South Australia Australia
| | - Sandra Walsh
- grid.1026.50000 0000 8994 5086Department of Rural Health, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086IIMPACT in Health, University of South Australia, Adelaide, South Australia Australia
| | | | - Marianne Gillam
- grid.1026.50000 0000 8994 5086Department of Rural Health, University of South Australia, Adelaide, Australia ,grid.1026.50000 0000 8994 5086IIMPACT in Health, University of South Australia, Adelaide, South Australia Australia
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Abstract
BACKGROUND Behavioural activation (BA) is an effective treatment for depression; however, it is unclear if it can be used to manage pain. OBJECTIVES To conduct a scoping review of primary research that reported using BA to support people living with chronic pain to understand how BA had been used in relation to pain. In addition, we wanted to understand whether there were any reported changes in that pain, and how and who delivered BA. ELIGIBILITY CRITERIA Primary research published in English. SOURCES OF EVIDENCE We searched seven databases MEDLINE, Ovid Embase, Ovid Emcare, PsycINFO, CINAHL, Scopus and Web of Science, for primary research. No initial date limit was used with the date the searches were conducted used as the end date limit (1 July 2021). CHARTING METHODS A customised data extraction table was developed, piloted and used. RESULTS 551 papers were screened for inclusion, with 15 papers included in our review. Studies were conducted in North America and in Canada. These included three case studies, nine uncontrolled trials and three randomised controlled trials. Only two studies reported pain as the primary outcome. BA was applied across a range of pain related conditions. The dose of BA ranged from 3 to 16 sessions. Duration of treatment was 3 weeks to 12 months. Most studies reported reductions in pain following exposure to BA. CONCLUSION BA has the potential to reduce pain. Caution needs to be exercised in the interpretation of these findings as a high risk of bias was observed in most studies. High-quality research is required to test if BA is an effective intervention for chronic pain.
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Affiliation(s)
- Sandra Walsh
- Department of Rural Health, University of South Australian - Whyalla Campus, Whyalla Norrie, Barngarla Country, South Australia, Australia
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - G Lorimer Moseley
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Richard John Gray
- School of Nursing, La Trobe University, Bundoora, Victoria, Australia
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Marianne Gillam
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Kate M Gunn
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Trevor Barker
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Kham Tran
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Tesfahun Eshetie
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
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Kelly TL, Ward M, Pratt NL, Ramsay E, Gillam M, Roughead EE. The association between exacerbation of chronic obstructive pulmonary disease and timing of paracetamol use: a cohort study in elderly Australians. Respir Res 2022; 23:80. [PMID: 35382818 PMCID: PMC8979782 DOI: 10.1186/s12931-022-02010-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background In elderly populations, paracetamol may be used regularly for conditions such as osteoarthritis. Paracetamol has been associated with respiratory disease through a proposed mechanism of glutathione depletion and oxidative stress. Given that chronic obstructive pulmonary disease (COPD) is frequently co-morbid with osteoarthritis, this study investigated whether the dose and timing of paracetamol exposure may induce COPD exacerbations. Methods The study population was 3523 Australian Government Department of Veterans’ Affairs full entitlement holders who had existing COPD on 1 January 2011, who were dispensed at least one prescription of paracetamol between 1 January 2011 and 30 September 2015, and had no paracetamol dispensed in the 6 months prior to 1 January 2011. The outcome was time to first hospitalisation for COPD exacerbation after initiation of paracetamol. A weighted cumulative exposure approach was used. Results The association between paracetamol exposure and COPD exacerbation was protective or harmful depending on the dose, duration, and recency of exposure. Compared to non-use, current use at the maximum dose of 4 g daily for 7 days was associated with a lower risk (HR = 0.78, 95% CI = 0.67–0.92) and a higher risk after 30 days (HR = 1.27, 95% CI = 1.06–1.52). Risk declined to baseline after 2 months. For past use, there was a short-term increase in risk on discontinuation depending of dose, duration and time since stopping. Conclusions Patients and doctors should be aware of the possible risk of COPD exacerbation with higher dose paracetamol 1 to 6 weeks after initiation or discontinuation, but no increased risk after 2 months. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02010-z.
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Affiliation(s)
- Thu-Lan Kelly
- Clinical and Health Sciences, Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, Australia.
| | - Michael Ward
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Nicole L Pratt
- Clinical and Health Sciences, Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, Australia
| | - Emmae Ramsay
- Clinical and Health Sciences, Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, Australia
| | - Marianne Gillam
- Clinical and Health Sciences, Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, Australia
| | - Elizabeth E Roughead
- Clinical and Health Sciences, Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, Australia
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Yisma E, Gillam M, Versace VL, Jones S, Walsh S, May E, Jones M. Geographical distribution of 3 allied health professions in South Australia: A summary of access and disadvantage. Aust J Rural Health 2021; 29:721-728. [PMID: 34636104 DOI: 10.1111/ajr.12816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the distribution of 3 allied health professionals-occupational therapists, physiotherapists and podiatrists-in South Australia stratified by the Modified Monash Model and the Index of Relative Socio-Economic Disadvantage. DESIGN A descriptive data linkage cross-sectional study. SETTING The state of South Australia, Australia. PARTICIPANTS AND MAIN OUTCOME MEASURES Distribution of the 3 registered allied health professional groups stratified by Modified Monash Model and Index of Relative Socio-Economic Disadvantage. RESULTS The largest proportion of the 3 allied health professional groups (occupational therapists, physiotherapists and podiatrists) were found in areas classified as Modified Monash 1 and Modified Monash 2 (86.5%). The lowest proportion of allied health professionals were found in Modified Monash 7. The largest number of allied health professionals per 10 000 population was found in areas classified as Modified Monash 1 and Modified Monash 2. The lowest number of allied health professionals per 10 000 population was found in Modified Monash 7 areas. The largest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 2, while the lowest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 1. CONCLUSIONS The distribution of allied health professionals according to geographical remoteness, socio-economic disadvantage and per 10 000 population varies widely in South Australia. The number of allied health professionals per 10 000 population was lowest in rural and remote/very remote areas, explaining the typically poor access to allied health services for communities in these areas. The number of allied health professionals per 10 000 population according to Index of Relative Socio-Economic Disadvantage was variable within the context of both urban and rural areas.
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Affiliation(s)
- Engida Yisma
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Marianne Gillam
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Vincent L Versace
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, Vic., Australia
| | - Sara Jones
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Sandra Walsh
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Esther May
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Martin Jones
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
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Leach MJ, Gillam M, Gonzalez-Chica DA, Walsh S, Muyambi K, Jones M. Health care need and health disparities: Findings from the Regional South Australia Health (RESONATE) survey. Health Soc Care Community 2021; 29:905-917. [PMID: 32767700 DOI: 10.1111/hsc.13124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 05/05/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
Regional South Australia has some of the highest rates of psychological distress, chronic disease and multimorbidity of any Australian State or Territory. Yet, the healthcare needs of this population are still not completely understood. To better understand the healthcare needs of regional South Australians, we invited adults living in the region to complete the 44-item consumer utilisation, expectations and experiences of healthcare instrument (CONVERSATIONS), online or in hard-copy. The survey was conducted between April 2017 and March 2018. A multi-modal recruitment campaign was utilised to promote the survey. We examined associations between study outcomes and remoteness area, and drew comparisons between our findings and other surveys reporting pertinent outcomes in the urban SA population. The questionnaire was completed by 3,926 adults (52.5% females; 37.6% aged 60 + years). Among the 264 distinct health conditions reported by participants, the most prevalent were hypertension (31.6%), depression (25.7%), anxiety (23.5%) and hypercholesterolaemia (22.9%). The lifetime prevalence of these conditions among participants exceeded rates reported in urban SA. The largest regional-urban health disparities were observed for eczema/dermatitis, skin cancer, other cancer types and cataracts, where prevalence rates were 2075%, 400%, 373% and 324% higher, respectively, than that reported in urban SA. Participants also reported higher levels of multimorbidity (37.7% higher) relative to urban South Australians. By contrast, participants appeared to be exposed to fewer lifestyle risk behaviours (e.g. smoking, alcohol, inadequate fruit or vegetable intake) than their urban counterparts. In summary, there was a high level of healthcare need, and considerable health disparity among participants when compared with urban settings (particularly for skin and eye conditions). These findings highlight the need for a more targeted approach to delivering health services and health promotion activities in regional areas.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | | | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
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Muyambi K, Gillam M, Dennis S, Gray R, Martinez L, Jones M. Effect of depression awareness and management training on the attitudes of rural primary health care workers. Aust J Rural Health 2021; 29:449-454. [PMID: 34110058 DOI: 10.1111/ajr.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/24/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To measure the effect of depression awareness and management training on the attitudes of rural primary health care workers. DESIGN A repeated measures design in which participants acted as their own controls. SETTING The training program occurred in 6 locations across rural South Australia. PARTICIPANTS The study enrolled primary care workers in general practitioner surgeries, Aboriginal Community Controlled Health Organisations, community health centres, public hospitals, regional health services and non-government organisations. INTERVENTION A six-session training workshop that was informed by the National Institute for Health and Care Excellence guidelines for the treatment and care of people with depression. MAIN OUTCOME MEASURE The 22-item Revised Depression Attitude Questionnaire comprised the main outcome measure. Participants were assessed 12 weeks before the training, again on the day of commencement of the training and after the training. RESULTS Seventy-two primary health workers completed the training program in depression awareness, building therapeutic relationships, working with ambivalence, and goal setting. Between the 2 pre-training assessments mean scores showed no significant difference. There were statistically significant improvements on the overall attitudes and the subscales therapeutic optimism and professional confidence between pre-training and post-training. CONCLUSION Training rural primary health care workers in depression may improve their attitudes to working with people living with depression.
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Affiliation(s)
- Kuda Muyambi
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Marianne Gillam
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Shaun Dennis
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,Flinders and Upper North Local Health Network, Whyalla, SA, Australia
| | - Richard Gray
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | - Lee Martinez
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Martin Jones
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
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10
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Abstract
INTRODUCTION Chronic pain is a distressing condition and often poorly treated and managed. Psychological therapies are considered first-line intervention for people with chronic pain. Common psychological therapies require extensive clinician training and specialist qualifications. One approach that does not need lengthy training nor specialist qualification, but has empirical support in other health domains, is behavioural activation (BA). BA seeks to increase engagement in behaviours that are valued by the person and progress through behaviours that can increase mood and develop skills that build satisfying routines. BA can help people to manage their condition through scheduling behaviours, promoting routine and mastery over their condition. The extent to which BA has been used to support people living with chronic pain is not clear. METHODS AND ANALYSIS This scoping review aims to identify published studies describing the application of BA to support people living with chronic pain. To map the evidence regarding BA and chronic pain, including the study type and the associated evidence, a scoping review was adopted. The search will be conducted in bibliographic databases, clinical trial registries and grey literature. No date limits will be applied to the search strategy. Screening of titles and abstracts, and full-text screening, will be independently undertaken by two investigators using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Data from included publications will be extracted using a customised data extraction tool. ETHICS AND DISSEMINATION The scoping review is an analysis of existing data and therefore ethics approval is not required. The findings of this scoping review will further our understanding of how BA has been used to support people living with chronic pain and inform future training and education programmes in this area.
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Affiliation(s)
- Sandra Walsh
- Department of Rural Health, University of South Australian - Whyalla Campus, Whyalla Norrie, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Richard John Gray
- School of Nursing, La Trobe University, Bundoora, Victoria, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Kate M Gunn
- Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Trevor Barker
- Allied Health & Human Performance, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Tesfahun Eshetie
- Department of Rural Health, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - G Lorimer Moseley
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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11
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Gonzalez-Chica D, Gillam M, Williams S, Sharma P, Leach M, Jones M, Walters L, Gardiner F. Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service. BMC Health Serv Res 2021; 21:390. [PMID: 33902590 PMCID: PMC8077896 DOI: 10.1186/s12913-021-06404-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/14/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics. METHODS Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15-49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20-34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination. RESULTS A total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018-19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018-19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15-19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35-49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively). CONCLUSIONS The proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers.
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Affiliation(s)
- David Gonzalez-Chica
- Adelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA 5005 Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Mt Barker, SA Australia
| | - Susan Williams
- Adelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA 5005 Australia
| | - Pritish Sharma
- Royal Flying Doctor Service of Australia, Canberra, ACT Australia
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Mt Barker, SA Australia
| | - Lucie Walters
- Adelaide Rural Clinical School, The University of Adelaide, Helen Mayo North building, 109 Frome Road, Level 1, Room 106, Adelaide, SA 5005 Australia
| | - Fergus Gardiner
- Royal Flying Doctor Service of Australia, Canberra, ACT Australia
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12
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Gardiner FW, Gillam M, Churilov L, Sharma P, Steere M, Hannan M, Hooper A, Quinlan F. Aeromedical retrieval diagnostic trends during a period of Coronavirus 2019 lockdown. Intern Med J 2021; 50:1457-1467. [PMID: 33040422 PMCID: PMC7675287 DOI: 10.1111/imj.15091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/09/2020] [Revised: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 01/10/2023]
Abstract
Background Little is known on the trends of aeromedical retrieval (AR) during social isolation. Aim To compare the pre, lockdown, and post‐lockdown AR patient characteristics during a period of Coronavirus 2019 (COVID‐19) social isolation. Methods An observational study with retrospective data collection, consisting of AR between 26 January and 23 June 2020. Results There were 16 981 AR consisting of 1983 (11.7%) primary evacuations and 14 998 (88.3%) inter‐hospital transfers, with a population median age of 52 years (interquartile range 29.0–69.0), with 49.0% (n = 8283) of the cohort being male and 38.0% (n = 6399) being female. There were six confirmed and 230 suspected cases of COVID‐19, with the majority of cases (n = 134; 58.3%) in the social isolation period. As compared to pre‐restriction, the odds of retrieval for the restriction and post‐restriction period differed across time between the major diagnostic groups. This included, an increase in cardiovascular retrieval for both restriction and post‐restriction periods (odds ratio (OR) 1.12, 95% confidence interval (CI) 1.02–1.24 and OR 1.18 95%, CI 1.08–1.30 respectively), increases in neoplasm in the post restriction period (OR 1.31, 95% CI 1.04–1.64) and increases for congenital conditions in the restriction period (OR 2.56, 95% CI 1.39–4.71). Cardiovascular and congenital conditions had increased rates of priority 1 patients in the restriction and post restriction periods. There was a decrease in endocrine and metabolic disease retrievals in the restriction period (OR 0.72, 95% CI 0.53–0.98). There were lower odds during the post‐restriction period for retrievals of the respiratory system (OR 0.78, 95% CI 0.67–0.93), and disease of the skin (OR 0.78, 95% CI 0.6–1.0). Distribution between the 2019 and 2020 time periods differed (P < 0.05), with the lockdown period resulting in a significant reduction in activity. Conclusion The lockdown period resulted in increased AR rates of circulatory and congenital conditions.
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Affiliation(s)
- Fergus W Gardiner
- Federation Office, The Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia.,The Rural Clinical School of Western Australia, The University of Western Australia, Perth, Western Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Leonid Churilov
- Department of Medicine (Austin Health) and Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Pritish Sharma
- Federation Office, The Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia
| | - Mardi Steere
- Central Operations, The Royal Flying Doctor Service, Adelaide, South Australia, Australia
| | - Michelle Hannan
- Queensland Section, The Royal Flying Doctor Service, Adelaide, South Australia, Australia
| | - Andrew Hooper
- Western Operations, The Royal Flying Doctor Service, Adelaide, South Australia, Australia
| | - Frank Quinlan
- Federation Office, The Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia
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13
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Gardiner FW, Richardson A, Roxburgh C, Gillam M, Churilov L, McCuaig R, Carter S, Arthur C, Wong C, Morton A, Callaway L, Lust K, Davidson SJ, Foxcroft K, Oates K, Zhang L, Jayawardane S, Coleman M, Peek M. Characteristics and in-hospital outcomes of patients requiring aeromedical retrieval for pregnancy, compared to non-retrieved metropolitan cohorts. Aust N Z J Obstet Gynaecol 2021; 61:519-527. [PMID: 33426679 DOI: 10.1111/ajo.13308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/19/2020] [Revised: 11/23/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Limited access to obstetrics and gynaecology (O&G) services in rural and remote Australia is believed to contribute to suboptimal birth outcomes. AIMS To describe the characteristics of pregnancy aeromedical transfers, in-hospital outcomes, and patient access to O&G services, as compared to whole of Australia data. MATERIALS AND METHODS We conducted a cohort study of women who required aeromedical retrieval for pregnancy-related issues between the 1 January 2015 and 31 December 2017. RESULTS Hospital outcome data were collected on 2171 (65.2%) mothers and 2438 (100.0%) babies. The leading retrieval reason was threatened preterm labour and delivery (n = 883; 40.7%). Most patients were retrieved from rural and remote areas (n = 2224; 93.0%). Retrieved patients were significantly younger (28.0 vs 30.0 years, 95% CI 27.7-28.3), more likely to be overweight or obese (52.2% vs 45.1%, 95% CI 47.5-56.9) and to have smoked during their pregnancy (14.0% vs 9.9%, 95% CI 12.5-15.5) compared to Australian pregnant women overall. Over one-third of transferred women gave birth by Caesarean section (n = 812; 37.4%); the median gestational age at birth was 33.0 (95% CI 32.7-33.3) weeks. Early gestation is associated with low birth weights (median = 2579.5 g; 95% CI 2536.1-2622.9), neonatal resuscitation (35.4%, 95% CI 33.5-37.3), and special care nursery admission (41.2%, 95% CI 39.3-43.2). There were 42 (1.7%, 95% CI 1.2-2.2) stillbirths, which was significantly higher than seen Australia-wide (n = 6441; 0.7%). CONCLUSION This study found that pregnant women retrieved by the Royal Flying Doctor Service were younger, with higher rates of obesity and smoking.
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Affiliation(s)
- Fergus W Gardiner
- Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia.,The Rural Clinical School of Western Australia, The University of Western Australia, Albany, Western Australia, Australia
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carly Roxburgh
- The Rural Clinical School of Western Australia, The University of Western Australia, Albany, Western Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Leonid Churilov
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Ruth McCuaig
- King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Sean Carter
- King Edward Memorial Hospital, Perth, Western Australia, Australia
| | | | - Cynthia Wong
- Townsville University Hospital, Townsville, Queensland, Australia
| | - Adam Morton
- Mater Health Services Public Hospital, Brisbane, Queensland, Australia
| | - Leonie Callaway
- Royal Brisbane Women`s Hospital, Brisbane, Queensland, Australia
| | - Karin Lust
- Royal Brisbane Women`s Hospital, Brisbane, Queensland, Australia
| | - Sarah J Davidson
- Royal Brisbane Women`s Hospital, Brisbane, Queensland, Australia.,Duke University School of Medicine, Durham, North Carolina, USA
| | - Katie Foxcroft
- Royal Brisbane Women`s Hospital, Brisbane, Queensland, Australia
| | - Kiri Oates
- Dubbo Hospital, Dubbo, New South Wales, Australia
| | - Lucy Zhang
- Dubbo Hospital, Dubbo, New South Wales, Australia
| | | | - Mathew Coleman
- The Rural Clinical School of Western Australia, The University of Western Australia, Albany, Western Australia, Australia
| | - Michael Peek
- Australian National University Medical School, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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14
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Nguyen TA, Gilmartin-Thomas J, Tan ECK, Kalisch-Ellett L, Eshetie T, Gillam M, Reeve E. The Impact of Pharmacist Interventions on Quality Use of Medicines, Quality of Life, and Health Outcomes in People with Dementia and/or Cognitive Impairment: A Systematic Review. J Alzheimers Dis 2020; 71:83-96. [PMID: 31356204 DOI: 10.3233/jad-190162] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Medication use in people with dementia and/or cognitive impairment (PWD/CI) is challenging. As medication experts, pharmacists have an important role in improving care of this vulnerable population. OBJECTIVE Systematically review evidence for the effectiveness of pharmacist-led interventions on quality use of medicines, quality of life, and health outcomes of PWD/CI. METHODS A systematic review was conducted using MEDLINE, EMBASE, PsycINFO, Allied and Complementary Medicine (AMED) and Cumulative index to Nursing and Allied Health Literature (CINAHL) databases from conception to 20 March 2017. Full articles published in English were included. Data were synthesized using a narrative approach. RESULTS Nine studies were eligible for inclusion. All studies were from high-income countries and assessed pharmacist-led medication management services. There was great variability in the content and focus of services described and outcomes reported. Pharmacists were found to provide a number of cognitive services including medication reconciliation, medication review, and medication adherence services. These services were generally effective with regards to improving quality use of medicines and health outcomes for PWD/CI and their caregivers, and for saving costs to the healthcare system. Pharmacist-led medication and dementia consultation services may also improve caregiver understanding of dementia and the different aspects of pharmacotherapy, thus improving medication adherence. CONCLUSION Emerging evidence suggests that pharmacist-led medication management services for PWD/CI may improve outcomes. Future research should confirm these findings using more robust study designs and explore additional roles that pharmacists could undertake in the pursuit of supporting PWD/CI.
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Affiliation(s)
- Tuan Anh Nguyen
- Quality Use of Medicines & Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.,Health Strategy and Policy Institute, Ministry of Health of Vietnam
| | - Julia Gilmartin-Thomas
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Parkville, Australia
| | - Edwin Chin Kang Tan
- The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, NSW, Australia.,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia.,Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lisa Kalisch-Ellett
- Quality Use of Medicines & Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Tesfahun Eshetie
- Quality Use of Medicines & Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Marianne Gillam
- Quality Use of Medicines & Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - Emily Reeve
- NHMRC Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Geriatric Medicine Research and College of Pharmacy, Dalhousie University and Nova Scotia Health Authority, NS, Canada.,College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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15
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Leach MJ, Walsh S, Muyambi K, Gillam M, Jones M. Expressed Demand for Health Care Services in Regional South Australia: A Cross-sectional Study. J Rural Health 2020; 37:645-654. [PMID: 32602978 DOI: 10.1111/jrh.12472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Accessibility and availability of health care services/providers is an increasing concern for many regional communities, particularly regional South Australia. Assessing the level of health service/provider utilization within a region (ie, expressed demand) can be useful in determining health care need and health service/workforce demand. METHODS The regional South Australia health (RESONATE) survey aimed to determine the expressed demand for health care services and the health workforce in a regional South Australian population. The study was open to adults living in regional South Australia and was promoted using a comprehensive multimodal recruitment campaign. Data were collected between April 2017 and March 2018 using the consumer utilization, expectations and experiences of healthcare instrument. FINDINGS A total of 3,926 adults completed the questionnaire. Participants reported using 47 different health care providers in the previous 12 months. Whilst almost all (92.9%) participants had seen a general practitioner in the past 12 months, yoga instructors, chiropractors, pharmacists, and physiotherapists were visited most frequently. Proportionally fewer participants in more remote locations received conventional services/treatments, though a significantly greater proportion of those in more remote locations had received complementary medicine services/treatments (relative to inner regional areas). CONCLUSIONS Findings of the RESONATE survey point to a high level of expressed demand for conventional and complementary health care services among study participants, possibly higher than that reported in the general population. Examining the extent to which the health needs of this and other regional populations are met should be the focus of further research to better inform future health workforce/services planning.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, New South Wales, Australia.,Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
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16
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Gadzhanova S, Gillam M, Roughead E. Risk of falls and injuries requiring hospitalisation after first-eye cataract surgery in elderly Australians. Acta Ophthalmol 2020; 98:e495-e498. [PMID: 31654472 DOI: 10.1111/aos.14286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the impact of the type of the intraocular lenses (IOLs) in first-eye cataract surgery in elderly people on the risk of hospitalisation due to falls and injuries. METHODS A retrospective cohort study was conducted using the Australian Government Department Veterans' Affairs claims data. All people aged 65 years and above who had first cataract surgery between January 2007 and July 2017 were identified. Two cohorts were established depending on the type of IOL-monofocal and multifocal. The risk of injuries and falls requiring hospitalisation in the first 3 months post the surgery was assessed using Cox proportional hazard models with age at entry as primary time scale and adjusting for gender, comorbidities and prior history of falls. RESULTS There were 45 728 people across the two cohorts with the majority receiving monofocal lenses (97%), followed by multifocal lenses (3%) at the time of first cataract surgery. The risk of injury and falls was lower (but not significant) in the multifocal cohort compared to monofocal cohort (adjusted hazard ratio (aHR) 0.56, 95% CI 0.26-1.17). The risk was also lower (but not significant) when stratifying by age group at the time of the surgery. CONCLUSIONS Regardless of age, multifocal lenses did not appear to be associated with the higher risk of serious injuries and falls after first-eye cataract surgery compared to monofocal lenses.
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Affiliation(s)
- Svetla Gadzhanova
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Marianne Gillam
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Elizabeth Roughead
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
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17
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Leach MJ, Gillam M, Walsh S, Jones M, Muyambi K. Community pulse—Conversations in health. Aust J Rural Health 2020; 28:159-160. [DOI: 10.1111/ajr.12611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 01/29/2020] [Accepted: 02/25/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Matthew J. Leach
- Department of Rural Health University of South Australia Adelaide SA Australia
| | - Marianne Gillam
- Department of Rural Health University of South Australia Adelaide SA Australia
| | - Sandra Walsh
- Department of Rural Health University of South Australia Whyalla Norrie SA Australia
| | - Martin Jones
- Department of Rural Health University of South Australia Whyalla Norrie SA Australia
| | - Kuda Muyambi
- Department of Rural Health University of South Australia Tanunda SA Australia
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18
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Leach MJ, Jones M, Bressington D, Jones A, Nolan F, Muyambi K, Gillam M, Gray R. The association between community mental health nursing and hospital admissions for people with serious mental illness: a systematic review. Syst Rev 2020; 9:35. [PMID: 32066507 PMCID: PMC7027066 DOI: 10.1186/s13643-020-01292-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 02/06/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Relapse prevention is an important objective in the management of serious mental illness (SMI). While community mental health nurses (CMHN) might be well-placed to support people with SMI in averting relapse, no systematic reviews have examined this association. AIM To review the evidence from studies reporting an association between CMHN exposure and hospitalisation of persons living with SMI (a proxy for relapse). METHODS Searches were undertaken in ten bibliographic databases and two clinical trial registries. We included studies of patients with SMI, where CMHN was the exposure, and the outcome was relapse (i.e. readmission to a psychiatric inpatient facility). Quality assessment of included studies was completed using two risk-of-bias measures. RESULTS Two studies met the inclusion criteria. Studies were rated as being of low-moderate methodological quality. There was insufficient evidence to conclude that community mental health nursing reduced the risk of admission to psychiatric inpatient facilities. CONCLUSIONS The review found no evidence that CMHN was associated with higher or lower odds of admission to psychiatric inpatient facilities among patients with SMI. The findings of the review point to a need for further research to investigate the impact of CMHN exposure and relapse in people with SMI. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017058694.
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Affiliation(s)
- Matthew J Leach
- Department of Rural Health, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - Martin Jones
- Department of Rural Health, University of South Australia, 111 Nicholson Avenue, Whyalla Norrie, South Australia, 5608, Australia
| | - Dan Bressington
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, SAR, China
| | - Adrian Jones
- Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Wrexham, Wales, LL167TD, UK
| | - Fiona Nolan
- Florence Nightingale Foundation, School of Health and Human Science, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, 111 Nicholson Avenue, Whyalla Norrie, South Australia, 5608, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, 3086, Australia
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19
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Gillam M, Leach M, Muller J, Gonzalez-Chica D, Jones M, Muyambi K, Walsh S, May E. Availability and quality of publicly available health workforce data sources in Australia: a scoping review protocol. BMJ Open 2020; 10:e034400. [PMID: 31969370 PMCID: PMC7044942 DOI: 10.1136/bmjopen-2019-034400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The health workforce is an integral component of the healthcare system. Comprehensive, high-quality data on the health workforce are essential to identifying gaps in health service provision, as well as informing future health workforce and health services planning, and health policy. While many data sources are used in Australia for these purposes, the quality of the data sources with respect to relevance, accessibility and accuracy is not clear. METHODS AND ANALYSIS This scoping review aims to identify and appraise publicly available data sources describing the Australian health workforce. The review will include any data source (eg, registry, administrative database and survey) or document reporting a data source (eg, journal article, report) on the Australian health workforce, which is publicly available and describes the characteristics of the workforce. The search will be conducted in 10 bibliographic databases and the grey literature using an iterative process. Screening of titles and abstracts will be undertaken by two investigators, independently, using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Documents/data sources identified as potentially eligible will be retrieved in full text and reviewed following the same process. Data will be extracted using a customised data extraction tool. A customised appraisal tool will be used to assess the relevance, accessibility and accuracy of included data sources. ETHICS AND DISSEMINATION The scoping review is a secondary analysis of existing, publicly available data sources and does not require ethics approval. The findings of this scoping review will further our understanding of the quality and availability of data sources used for health workforce and health services planning in Australia. The results will be submitted for publication in peer-reviewed journals and presented at conferences targeted at health workforce and public health topics.
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Affiliation(s)
- Marianne Gillam
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Matthew Leach
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Jessica Muller
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Esther May
- Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Ratay M, Dubin J, Wilson M, Davis-Allen P, Gillam M, Izzo J, Maloy K, Davis J, Goyal M. 50 Multi-Center Implementation of Automated Age-Adjusted D-Dimer Cutoffs Reduces Unnecessary CTPE Imaging. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.053] [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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Nguyen TA, Gilmartin-Thomas J, Tan EC, Ellett LK, Eshetie T, Gillam M, Reeve E. P3-502: THE IMPACT OF PHARMACIST INTERVENTIONS ON QUALITY USE OF MEDICINES, QUALITY OF LIFE AND HEALTH OUTCOMES IN PEOPLE WITH DEMENTIA AND COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | - Emily Reeve
- Kolling Institute of Medical Research, Northern Clinical School Faculty of Medicine; The University of Sydney; Sydney Australia
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22
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Nguyen TA, Pham T, Vu HTT, Nguyen TX, Vu TT, Nguyen BTT, Nguyen NQ, Nguyen BT, Nguyen BT, Nguyen TN, Phan SV, Nguyen AT, Pham TL, Dang HT, Kalisch-Ellett L, Gillam M, Pratt N, Qiang S, Wang H, Kanjanarach T, Hassali MAA, Babar ZUD, Razak AA, Chinwong D, Roughead EE. Use of Potentially Inappropriate Medications in People With Dementia in Vietnam and Its Associated Factors. Am J Alzheimers Dis Other Demen 2018; 33:423-432. [PMID: 29642720 PMCID: PMC10852524 DOI: 10.1177/1533317518768999] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This study examined the use of potentially inappropriate medicines that may affect cognition (PIMcog) in people with dementia and its associated factors. Medical records of all outpatients with dementia attending a tertiary hospital in Vietnam between January 1, 2015, and December 31, 2016, were examined. Medicine use was assessed against a list of PIMcog. Variables associated with having a PIMcog were assessed using a multiple logistic regression. Of the 128 patients, 41% used a PIMcog, 39.1% used cholinesterase inhibitors (CEIs) concomitantly with anticholinergics, and 18% used antipsychotics. The number of hospital visits (adjusted odds ratio [OR]: 1.08; 95% confidence interval [CI]: 1.02-1.16) and number of treating specialists (adjusted OR: 0.61; 95% CI: 0.45-0.83) were associated with PIMcog use. This study highlights a high-level use of medicines that can further impair cognition or reduce the effectiveness of CEIs in people with dementia. Efforts to improve quality use of medicines for this population are warranted.
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Affiliation(s)
- Tuan Anh Nguyen
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Thang Pham
- National Geriatric Hospital of Vietnam, Hanoi, Vietnam
| | | | | | - Trinh Thi Vu
- National Geriatric Hospital of Vietnam, Hanoi, Vietnam
| | | | | | | | | | | | | | | | - Tuan Le Pham
- Hanoi Medical University and Ministry of Health of Vietnam, Hanoi, Vietnam
| | - Ha Thu Dang
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Lisa Kalisch-Ellett
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Nicole Pratt
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Sun Qiang
- Center for Health Management and Policy, School of Health Care Management, Shandong University, Jinan, China
| | - Haipeng Wang
- Center for Health Management and Policy, School of Health Care Management, Shandong University, Jinan, China
| | | | | | | | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Dujrudee Chinwong
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Elizabeth E. Roughead
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
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Muyambi K, McPhail R, Cronin K, Gillam M, Martinez L, Dennis S, Bressington D, Gray R, Jones M. What do mental health workers in the bush think about mental health nurse prescribing? A cross-sectional study. Aust J Rural Health 2018; 26:429-435. [PMID: 29864200 DOI: 10.1111/ajr.12435] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Relatively few psychiatrists live and work in rural South Australia. The rural GP is an essential component of support for people with mental health problems. However, considerable GP maldistribution between rural and metropolitan Australia still exists. Thus, accessing health services, including medication, becomes challenging for rural communities. Extending mental health nurse prescribing could be a strategy to build additional capacity to complement the GPs and psychiatrists who practice in rural South Australia. Until now, no studies have examined mental health workers' attitudes towards nurse prescribing in rural Australia. OBJECTIVE To examine the attitudes of rural and remote South Australian mental health workers about mental health nurse prescribing. DESIGN/METHOD A cross-sectional survey assessing mental health workers' attitudes to mental health nurse prescribing. SETTING The study was conducted across South Australia, excluding metropolitan Adelaide. PARTICIPANTS Mental health workers employed by the Country Health South Australia Local Health Network for Mental Health. RESULTS Of the 289 potential participants, 93 (32%) responded and were included in this study. All the respondents reported positive attitudes towards mental health nurse prescribing. However, they expressed concerns about safety, educational preparation and supervision structures. CONCLUSION The attitudes of rural South Australian mental health workers are not a barrier to mental health nurse prescribing. The implementation and sustainability of mental health nurse prescribing will require additional staff training in psychopharmacology and a governance framework to assure quality and safety. Policy-makers need to focus their attention on the uptake of mental health nurse prescribing in parts of Australia that struggle to attract and retain psychiatrists.
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Affiliation(s)
- Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
| | - Ruth McPhail
- Country Health SA Local Health Network for Mental Health, Adelaide, South Australia, Australia
| | - Kathryn Cronin
- Country Health SA Local Health Network for Mental Health, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
| | - Lee Martinez
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
| | - Shaun Dennis
- Country Health SA Local Health Network for Mental Health, Adelaide, South Australia, Australia
| | - Daniel Bressington
- The Hong Kong Polytechnic University, Hong Kong, Hong Kong.,La Trobe University, Melbourne, Victoria, Australia
| | - Richard Gray
- La Trobe University, Melbourne, Victoria, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
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Abstract
INTRODUCTION Access to quality healthcare services is considered a moral right. However, for people living in regional locations, timely access to the services that they need may not always be possible because of structural and attitudinal barriers. This suggests that people living in regional areas may have unmet healthcare needs. The aim of this research will be to examine the healthcare needs, expectations and experiences of regional South Australians. METHODS AND ANALYSIS The Regional South Australia Health (RESONATE) survey is a cross-sectional study of adult health consumers living in any private or non-private dwelling, in any regional, rural, remote or very remote area of South Australia and with an understanding of written English. Data will be collected using a 45-item, multidimensional, self-administered instrument, designed to measure healthcare need, barriers to healthcare access and health service utilisation, attitudes, experiences and satisfaction. The instrument has demonstrated acceptable psychometric properties, including good content validity and internal reliability, good test-retest reliability and a high level of acceptability. The survey will be administered online and in hard-copy, with at least 1832 survey participants to be recruited over a 12-month period, using a comprehensive, multimodal recruitment campaign. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Human Research Ethics Committee of the University of South Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities.
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Affiliation(s)
- Matthew J Leach
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - Esther May
- Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Leach MJ, Jones M, Bressington D, Nolan F, Jones A, Muyambi K, Gillam M, Gray R. The association between mental health nursing and hospital admissions for people with serious mental illness: a protocol for a systematic review. Syst Rev 2018; 7:2. [PMID: 29316979 PMCID: PMC5759359 DOI: 10.1186/s13643-017-0658-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 12/05/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Relapse in individuals with severe mental illness (SMI) is a frequent occurrence and can add considerably to the burden of disease. As such, relapse prevention is an essential therapeutic outcome for people with SMI. Mental health nurses (MHNs) are well placed to support individuals with SMI and to prevent relapse; notwithstanding, there has been no synthesis of the evidence to date to determine whether MHNs prevent relapse in this population. METHODS Electronic databases will be systemically searched for observational studies and clinical trials that report the association between mental health nursing and the hospitalisation of persons living with an SMI. The search will be supplemented by reference checking and a search of the grey literature. The primary outcome of interest will be hospital admission rate. Screening of articles, data extraction and critical appraisal will be undertaken by two reviewers, independently, with a third reviewer consulted should disagreement occur between reviewers. The quality of studies will be assessed using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane Collaboration risk of bias tool. Depending on the number of studies and level of heterogeneity, the evidence may be synthesised using meta-analysis or narrative synthesis. DISCUSSION This review will explore for the first time the clinical potential of mental health nursing in preventing relapse in persons with SMI. The findings of this review will serve to inform future research and education in this area. The evidence may also help inform future policy, including decisions regarding future mental health workforce development and planning. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017058694 .
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Affiliation(s)
- Matthew J Leach
- Department of Rural Health, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - Dan Bressington
- Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, Special Administrative Region of China
| | - Fiona Nolan
- School of Health and Human Science, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Adrian Jones
- Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, LL167TD, Wrexham, UK
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, 111 Nicholson Avenue, Whyalla Norrie, South Australia, 5608, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Richard Gray
- Department of Rural Health, University of South Australia, 111 Nicholson Avenue, Whyalla Norrie, South Australia, 5608, Australia.,La Trobe University, Bundoora, Victoria, 3086, Australia
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Gramlich L, Martin L, Atkins M, Gillam M, Sheppard C, Buhler S, Basualdo Hammond C, Nelson G. SUN-LB320: The Impact of Enhanced Recovery after Surgery on Nutrition Care. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30643-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: 10/18/2022]
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Leong D, Shakib S, Gillam M, Ryan P, Salter A, Gericke C. Prediction of Outcome for Hospitalised Heart Failure Patients: A Competing Risks Analysis. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.851] [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: 10/19/2022]
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Gillam M, Noto A, Zahradka P, Taylor CG. Improved n-3 fatty acid status does not modulate insulin resistance in fa/fa Zucker rats. Prostaglandins Leukot Essent Fatty Acids 2009; 81:331-9. [PMID: 19864121 DOI: 10.1016/j.plefa.2009.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 09/23/2009] [Accepted: 09/30/2009] [Indexed: 01/13/2023]
Abstract
The objective was to examine the effect of polyunsaturated fatty acid type (plant vs fish oil-derived n-3, compared to n-6 fatty acids in the presence of constant proportions of saturated, monounsaturated and polyunsaturated fatty acids) on obesity, insulin resistance and tissue fatty acid composition in genetically obese rats. Six-week-old fa/fa and lean Zucker rats were fed with a 10% (w/w) mixed fat diet containing predominantly flax-seed, menhaden or safflower oils for 9 weeks. There was no effect of dietary lipid on obesity, oral glucose tolerance (except t=60min insulin), pancreatic function or molecular markers related to insulin, glucose and lipid metabolism, despite increased n-3 fatty acids in muscle and adipose tissue. The menhaden oil diet reduced fasting serum free fatty acids in both fa/fa and lean rats. These data suggest that n-3 composition does not alter obesity and insulin resistance in the fa/fa Zucker rat model when dietary lipid classes are balanced.
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Affiliation(s)
- M Gillam
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada R2H 2A6
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Wachs JP, Stern HI, Edan Y, Gillam M, Handler J, Feied C, Smith M. A Gesture-based Tool for Sterile Browsing of Radiology Images. J Am Med Inform Assoc 2008. [DOI: 10.1197/jamia.m2410] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gillam M. 12 The Health Smart Library: An Open Source Model for Rapid Clinical Resource Management. Acad Emerg Med 2003. [DOI: 10.1197/aemj.10.8.918-a] [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: 11/10/2022]
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Camargo R, Limbert E, Gillam M, Henriques MM, Fernandes C, Catarino AL, Soares J, Alves VA, Kopp P, Medeiros-Neto G. Aggressive metastatic follicular thyroid carcinoma with anaplastic transformation arising from a long-standing goiter in a patient with Pendred's syndrome. Thyroid 2001; 11:981-8. [PMID: 11716048 DOI: 10.1089/105072501753211073] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this article we describe detailed pathological and molecular genetics studies in a consanguineous kindred with Pendred's syndrome. The index patient was a 53-year-old female patient with congenital deafness and goiter. Her parents were first-degree cousins. She had a large goiter (150 g) that had been present since childhood. One of her sisters and a niece are also deaf and have goiter as well. The presence of Pendred's syndrome was confirmed by a positive perchlorate test and the demonstration of a Mondini malformation. Thyroid function tests (under levothyroxine [LT4] therapy) were in the euthyroid range with a thyrotropin [TSH] level of 2.8 microU/mL (0.2-3.2), a serum total thyroxine (T4) of 90 nmol/L (54-142), and a serum total triiodothyronine (T3) of 2.7 nmol/L (0.8-2.4). Total thyroidectomy was performed, and the mass in the right lobe was found to have invaded adjacent tissues. The histopathological findings were consistent with a follicular carcinoma with areas of anaplastic transformation and lung metastasis. The patient was treated twice with 100 mCi 131iodine (3,700 MBq) and received suppressive doses of LT4. Postoperatively, the serum thyroglobulin (Tg) levels remained markedly elevated (2,352 to 41,336 ng/mL). The patient died of a sudden severe episode of hemoptysis. Sequence analysis of the PDS gene performed with DNA from the two relatives with Pendred's syndrome revealed the presence of a deletion of thymidine 279 in exon 3, a point mutation that results in a frameshift and a premature stop codon at codon 96 in the pendrin molecule. We concluded that prolonged TSH stimulation because of iodine deficiency or dyshormonogenesis in combination with mutations of oncogenes and/or tumor suppressor genes, may result in the development of follicular thyroid carcinomas that undergo transformation into anaplastic cancers. It is likely that these pathogenetic mechanisms have been involved in the development of aggressive metastatic thyroid cancer in this unusual patient with Pendred's syndrome.
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Affiliation(s)
- R Camargo
- Thyroid Unit, Hospital das Clinicas FMUSP, São Paulo, Brazil
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Abstract
The findings of a consensus committee created to address the definition, measurement, and identification of error in emergency medicine (EM) are presented. The literature of error measurement in medicine is also reviewed and analyzed. The consensus committee recommended adopting a standard set of terms found in the medical error literature. Issues surrounding error identification are discussed. The pros and cons of mandatory reporting, voluntary reporting, and surveillance systems are addressed, as is error reporting at the clinician, hospital, and oversight group levels. Committee recommendations are made regarding the initial steps EM should take to address error. The establishment of patient safety boards at each institution is also recommended.
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Affiliation(s)
- J A Handler
- Division of Emergency Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
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Abstract
UNLABELLED Although the Internet has been described as "ubiquitous," little is known about the extent to which physicians have access to the Internet while providing clinical care. OBJECTIVE To assess the extent of Internet connectivity within the clinical area of every ED within the state of Illinois. METHODS This was a prospective observational study. Each Illinois ED listed in a published directory was called by telephone, and a responsible party was identified to provide information regarding the type and size of the ED, patient demographics, the types of personal computers (PCs) available in the ED (if any), the types of operating systems used, the availability of access to the World Wide Web (Web), and the highest speed at which an Internet connection could be established. Responses regarding the presence and types of PCs and the types of operating systems used were assessed using one-factor chi-square. Univariate and multivariate predictors of the type of PC used, the presence or absence of Web access, and the highest speed of Internet access were evaluated using optimal discriminant analysis and nonlinear classification tree analysis, respectively. RESULTS One hundred ninety-eight of the 199 EDs in the state of Illinois (99.5%) completed the survey. Of the responding EDs, 50.5% had PCs, but only 17.6% had Web access. When Web access was available, it was most often available through a high-speed Internet connection that was faster than a dial-up modem. Most departments (68.1%) with PCs used the Windows 95 or Windows 98 operating systems. A majority (62.5%) used the Netscape browser exclusively. Larger EDs (more than six ED beds) in rural or suburban areas were more likely to have a PC compared with smaller EDs (six or fewer beds). Large EDs (more than 12 ED beds) in private tertiary care or academic hospitals were most likely to have Web access. CONCLUSIONS Although half of Illinois EDs have PCs, only one in six has access to the Internet; thus, most emergency physicians do not have ready access to the Web from the site where they deliver clinical care.
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Affiliation(s)
- J A Handler
- Division of Emergency Medicine, Northwestern University, Chicago, IL, USA.
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