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Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, 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K, Deng X, Denova-Gutiérrez E, Deravi N, Dereje N, Dervenis N, Dervišević E, Des Jarlais DC, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhimal M, Dhingra S, Dhulipala VR, Dias da Silva D, Diaz D, Diaz MJ, Dima A, Ding DD, Ding H, Dinis-Oliveira RJ, Dirac MA, Djalalinia S, Do THP, do Prado CB, Doaei S, Dodangeh M, Dodangeh M, Dohare S, Dokova KG, Dolecek C, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Du M, Dube J, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dwyer-Lindgren L, Dzianach PA, Dziedzic AM, E'mar AR, Eboreime E, Ebrahimi A, Echieh CP, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Effendi DE, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, Elbarazi I, Elema TB, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, El-Huneidi W, Elilo LT, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emeto TI, Engelbert 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Ghahramani S, Ghailan KY, Ghasemi MR, Ghasempour Dabaghi G, Ghasemzadeh A, Ghashghaee A, Ghassemi F, Ghazy RM, Ghimire A, Ghoba S, Gholamalizadeh M, Gholamian A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Ghorbani Vajargah P, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golchin A, Goldust M, Golechha M, Goleij P, Gomes NGM, Gona PN, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Goulart BNG, Goyal A, Grada A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Guimarães RA, Gulati S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta MK, Gupta M, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gurmessa L, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadei M, Hadi NR, Haep N, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halboub ES, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hamilton EB, Han C, Han Q, Hanif A, Hanifi N, 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A, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lam H, Lám J, Landrum KR, Lanfranchi F, Lang JJ, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lassi ZS, Latief K, Latifinaibin K, Lauriola P, Le NHH, Le TTT, Le TDT, Ledda C, Ledesma JR, Lee M, Lee PH, Lee SW, Lee SWH, Lee WC, Lee YH, LeGrand KE, Leigh J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Ligade VS, Likaka ATM, Lim LL, Lim SS, Lindstrom M, Linehan C, Liu C, Liu G, Liu J, Liu R, Liu S, Liu X, Liu X, Llanaj E, Loftus MJ, López-Bueno R, Lopukhov PD, Loreche AM, Lorkowski S, Lotufo PA, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma ZF, Maass KL, Machairas N, Machoy M, Madadizadeh F, Madsen C, Madureira-Carvalho ÁM, Maghazachi AA, Maharaj SB, Mahjoub S, Mahmoud MA, Mahmoudi A, Mahmoudi E, Mahmoudi R, Majeed A, Makhdoom IF, Malakan Rad E, Maled V, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Mansouri P, Mansournia MA, Mantovani LG, Maqsood S, Marasini 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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2100-2132. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
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N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:1989-2056. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Chen HY, Möller H, Senserrick TM, Rogers KD, Cullen P, Ivers RQ. Young drivers' early access to their own car and crash risk into early adulthood: Findings from the DRIVE study. Accid Anal Prev 2024; 199:107516. [PMID: 38401242 DOI: 10.1016/j.aap.2024.107516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/04/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Car ownership at early licensure for young drivers has been identified as a crash risk factor, but for how long this risk persists is unknown. This study examined crash hazard rates between young drivers with their own vehicle and those who shared a family vehicle at early licensure over 13 years. METHODS The DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia was used to link to police crash, hospital and death records up to 2016. The first police-reported crash and crash resulting in hospitalisation/death was modelled via flexible parametric survival analysis by type of vehicle access at baseline (own vs. shared family vehicle). RESULTS After adjusting for covariates, drivers with their own vehicle at early licensure had an almost 30 % increased hazard rate for any crash after one year (95 % CI:1.16-1.42) compared with those who only had access to a family car and this attenuated but remained significantly higher until year 7 (HR: 1.1, 95 % CI: >1.00-1.20). For crashes resulting in hospitalisation or death, an almost 15-times higher hazard (95 % CI: 1.40-158.17) was observed at the start of follow up, remaining 50 % to year 3 (95 % CI:1.01-2.18). CONCLUSIONS Parents and young drivers should be aware of the increased risks involved in car ownership at early licensure. Development of poorer driving habits has been associated with less parental monitoring at this time. Graduated Driving Licensing educators, researchers and stakeholders should seek to address this and to identify improved safety management options.
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Affiliation(s)
- Huei-Yang Chen
- Evidence Directorate, Agency for Clinical Innovation, Sydney, NSW 2065, Australia.
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia.
| | - Teresa M Senserrick
- Western Australian Centre for Road Safety Research, The University of Western Australia, Perth, WA 6009, Australia.
| | - Kris D Rogers
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia; Graduate School of Health, The University of Technology Sydney, Sydney, NSW 2006, Australia.
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia; Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, NSW 2522, Australia.
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia.
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Curtin C, Bandini LG, Forquer M, Cullen P, Rancaño KM, Must A, Schreck K, Bowling AB, Askenazy N, Wei X, Irish C, Stanish HI. A remotely-delivered pilot and feasibility program to promote physical and food literacy in adolescents with intellectual disabilities. J Appl Res Intellect Disabil 2024; 37:e13228. [PMID: 38520166 DOI: 10.1111/jar.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/01/2024] [Accepted: 03/04/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Youth with intellectual disabilities experience disparities in physical activity and diet quality. Physical and food literacy are hypothesised to support adoption of healthy lifestyles; however, few such interventions have been developed for this population. METHOD Participants with intellectual disabilities ages 12-16 years were recruited for a 12-week online sports skills and nutrition education intervention. Feasibility, acceptability, and preliminary efficacy were assessed by attendance, satisfaction, and pre-post measures of motor skills, perceived competence and motivation for physical activity, classifying foods, making healthy choices, and food consumption. RESULTS Six teens participated in the program and attended 87.5% of the sessions. Satisfaction data suggested that the program was well-received by both teens and parents. Trends toward improvements on physical activity and nutrition outcome measures were observed. CONCLUSIONS Preliminary data from this pilot study suggest that physical and food literacy in youth with intellectual disabilities can be improved, which in turn may contribute to the adoption of healthy lifestyles.
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Affiliation(s)
- C Curtin
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - L G Bandini
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - M Forquer
- George Washington University, Washington, DC, USA
| | - P Cullen
- E.K. Shriver Center, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - K M Rancaño
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - A Must
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - K Schreck
- Boston University, Boston, Massachusetts, USA
| | - A B Bowling
- Merrimack College, North Andover, Massachusetts, USA
| | - N Askenazy
- Boston University, Boston, Massachusetts, USA
| | - X Wei
- Boston University, Boston, Massachusetts, USA
| | - C Irish
- Brighton, Massachusetts, USA
| | - H I Stanish
- University of Massachusetts Boston, Boston, Massachusetts, USA
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Reid A, McGhie N, Nguyen THL, Yadav U, Cullen P, Booth L, Bestman A. Exploring the feasibility of a gambling harm screening model in general practice and community service settings in Fairfield: a pilot study. Aust J Prim Health 2024; 30:PY23208. [PMID: 38354727 DOI: 10.1071/py23208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Gambling is a growing public health issue in Australia. However, limited research has examined the role of primary health care and social services in routine screening for gambling harm in Australia. This research aimed to explore the enablers and barriers to implementing a co-designed gambling screening model in Fairfield, New South Wales - an area with high gambling expenditure. METHODS A co-designed gambling screening and referral model for GP and community-based organisations was implemented in Fairfield in 2020. Follow-up interviews were conducted with nine health care professionals who implemented the screening in 130 patients. Thematic analysis generated key barriers and enablers for implementation of this model. RESULTS Key enablers for the screening model implementation included structural factors (alignment of the screening model with current work), process factors and staffing factors (staff empowerment). However, we also noted process factors as a barrier to implementation, particularly the referral pathway following screening. Other barriers included social and structural factors, such as the complexity of gambling harm and project funding. CONCLUSIONS Embedding routine screening in primary and community care settings can play a role in treating, reducing and preventing gambling-related harm, and reducing stigma in Fairfield and beyond. Additionally, screening models such as this provide health systems with clear evidence on the level of gambling harm in their community (particularly important in culturally and linguistically diverse communities who are underrepresented in research). This evidence is important for addressing system-level drivers of harm and advocating for political reform to reduce the impact of gambling on communities.
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6
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Cullen P, Peden AE, Francis KL, Cini KI, Azzopardi P, Möller H, Peden M, Sawyer SM, Nathan S, Joshi R, Patton GC, Ivers RQ. Interpersonal Violence and Gender Inequality in Adolescents: A Systematic Analysis of Global Burden of Disease Data From 1990 to 2019. J Adolesc Health 2024; 74:232-245. [PMID: 37988041 DOI: 10.1016/j.jadohealth.2023.08.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/29/2023] [Accepted: 08/28/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Interpersonal violence is a leading cause of adolescent deaths and disability. This study investigates sex differences in burden of interpersonal violence for adolescents and explores associations with gender inequality. METHOD Using data from the 2019 Global Burden of Disease study, we report numbers, proportions, rates of interpersonal violence deaths and disability adjusted life years (DALYs) for all ages, and rate of change (from 1990 to 2019) in adolescents aged 10-24 years disaggregated by sex and geography. We explored associations with gender inequality using gender inequality index. RESULTS One in four (24.8%) all-age interpersonal violence deaths are in adolescents. In 2019, the rate of deaths in adolescent males was almost six times higher than females (9.3 vs. 1.6 per 100,000); and since 1990, the rate of decline in DALYs for females was double than that for males (-28.9% vs. -12.7%). By contrast, the burden of sexual violence is disproportionately borne by adolescent females, with over double the rate than males (DALYs: 42.8 vs. 17.5 per 100,000). In countries with greater gender inequality, the male-to-female ratio (deaths and DALYs) was increased among older adolescents, pointing to benefits for males in more gender equal settings. DISCUSSION Social identities, relationships, and attitudes to violence are established in adolescence, which is an inflection point marking the emergence of disproportionate burdens of interpersonal violence. Our findings affirm that global agendas must be expanded to address interrelated factors driving multiple forms of interpersonal violence experienced by adolescents and reverberating to the next generation.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia; Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia.
| | - Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia; Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia
| | - Kate L Francis
- Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Karly I Cini
- Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Peter Azzopardi
- Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute Melbourne, Melbourne, Victoria, Australia
| | - Holger Möller
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Maragaret Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia; The George Institute for Global Health UK and School of Public Health, Imperial College London, London, United Kingdom
| | - Susan M Sawyer
- Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sally Nathan
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Rohina Joshi
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia; The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
| | - George C Patton
- Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Rebecca Q Ivers
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia; Centre of Research Excellence: Driving Global Investment in Adolescent Health, Melbourne, Victoria, Australia; The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
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7
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Baffsky R, Ivers R, Cullen P, McGillivray L, Werner-Seidler A, Calear AL, Batterham PJ, Toumbourou JW, Stokes R, Kotselas P, Prendergast T, Torok M. Co-design and Development of Implementation Strategies: Enhancing the PAX Good Behaviour Game in Australian Schools. J Prev (2022) 2023; 44:679-704. [PMID: 37741909 PMCID: PMC10638156 DOI: 10.1007/s10935-023-00749-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 09/25/2023]
Abstract
Effective implementation strategies are important for take-up of programs in schools. However, to date, few implementation strategies have been co-designed with teachers and support staff (including principals) in Australia. The aim of this study was to iteratively co-design multiple implementation strategies to enhance the delivery of mental health prevention program, PAX Good Behaviour Game, in New South Wales primary schools. The secondary aim was to evaluate the acceptability of the implementation strategies from the perspective of school staff. Twenty-nine educational staff (including principals) informed the co-design of the implementation strategies across three phases. Phase 1 involved a rapid review of the literature and stakeholder meetings to agree upon potential evidence-based strategies. Phase 2 involved focus group discussions with educational staff to co-design implementation strategies. Phase 3 involved semi-structured interviews with school staff to assess strategy acceptability after implementation at 6-months post-baseline. Data were analysed using deductive, framework analysis. The final co-designed intervention included nine implementation strategies accessible through a toolkit delivered to the school's leadership team. These strategies were deemed acceptable in school settings that experienced periods of both face-to-face and remote learning due to the changing COVID-19 situation in 2021. This paper contributes to the implementation literature by transparently reporting how educational staff-informed implementation strategies were iteratively co-designed. This will provide a roadmap for other researchers to co-design implementation strategies to further support the delivery of evidence-based prevention programs in schools.
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia.
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | | | | | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | - John W Toumbourou
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, Geelong, VIC, Australia
| | - Rhoni Stokes
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Pauline Kotselas
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Traci Prendergast
- Department of Education, New South Wales (NSW), Parramatta, NSW, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Senserrick T, Möller H, Boufous S, Stevenson M, Williamson A, Patton G, McLean R, Chen HY, Cullen P, Woodward M, Ivers R. Learning With a Supervisor Who has Traffic Offences and Young Driver Crashes: The DRIVE Study 13-Year Follow-Up. J Adolesc Health 2023; 73:859-865. [PMID: 37642621 DOI: 10.1016/j.jadohealth.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Young learner drivers commonly must record substantial supervised practice driving before independent licensure. Supervisory driver requirements can be limited or highly regulated, yet research is lacking on the effectiveness of different approaches. The current objective was to explore whether young drivers who were mostly supervised by someone who they perceived had traffic offences versus no offences had different crash records over a period of 13 years postlicensing. METHODS DRIVE is an Australian prospective cohort study of more than 20,000 drivers who were aged 17-24 years and newly licensed during 2003-2004. They completed detailed baseline questionnaires, including whether the person they identified as supervising their learner driving the most had perceived traffic offences in the past 12 months. Responses were linked to their state crash, hospitalization, and death records to 2016. A parametric survival model was created to calculate hazard ratios of time to crash for those reporting that their supervisor had 0 versus 1 and 0 versus 2+ perceived offences, adjusting for the participants' prior crash history and other covariates. RESULTS After adjusting for covariates, 369 participants reporting supervisory drivers with 2+ perceived offences, compared to 15,451 participants reporting no such offences, had up to 1.67 (95% confidence interval 1.10-2.53 at 6 months) times the rate of any crash for the first 2.5 years and up to 2.01 (95% confidence interval 1.26-3.19 at 3.5 years) times the rate of crashes resulting in injury for 5.5 years. DISCUSSION Although overall supervision by a driver with two or more perceived offences was low, further attention is needed to ensure improved supervised driving experiences, with mentoring programs and professional instructor partnerships worthy of exploration.
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Affiliation(s)
- Teresa Senserrick
- Western Australian Centre for Road Safety Research, School of Psychological Science, The University of Western Australia, Western Australia, Australia; Centre for Accident Research and Road Safety - Queensland, School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia.
| | - Holger Möller
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - Soufiane Boufous
- Transport and Road Safety Research, School of Aviation, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - Mark Stevenson
- Transport Health and Urban Design Research Lab, Melbourne School of Design, The University of Melbourne, Parkville, Victoria, Australia; Faculty of Engineering and Information Technology, The University of Melbourne, Parkville, Victoria, Australia
| | - Ann Williamson
- Transport and Road Safety Research, School of Aviation, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - George Patton
- Centre for Adolescent Development, The Royal Children's Hospital, Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Rebecca McLean
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Huei-Yang Chen
- Evidence, Agency for Clinical Innovation, St Leonards, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Rebecca Ivers
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
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Abstract
It is pertinent to examine potentially detrimental impacts of the coronavirus disease 2019 (COVID-19) pandemic on young people. We conducted a review to assess the health impacts of the COVID-19 pandemic on children and adolescents. Databases of MEDLINE, Embase and the Cochrane Library were searched in June 2020, using keywords for 'children', 'adolescents' and 'COVID-19'. English papers discussing young people in context to the COVID-19 pandemic were included. Quality of selected studies was evaluated and scored. Of the 2013 identified articles, 22 met the inclusion criteria, including 11 cohort studies, ten cross-sectional studies and one report. Five main issues emerged: Increased mental health conditions, declines in presentations to paediatric emergency departments, declines in vaccination rates, changes in lifestyle behaviour (mainly decreased physical activity for specific groups of children), and changes in paediatric domestic violence and online child sexual abuse. There are early indications that the COVID-19 pandemic is impacting the health of young people, and this is amplified for those with existing health conditions and vulnerabilities. Despite this, there is limited insight into the protective factors for young people's health and wellbeing, as well as how the impacts of the pandemic can be mitigated in both the short and long term.
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Affiliation(s)
- Tina GA Oostrom
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Sydney, NSW, Australia
| | - Sanne AE Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia
- The George Institute for Global Health, Imperial College London, London, UK
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Cullen P, Mőller H, Baffsky R, Martiniuk A, Senserrick T, Rogers K, Woodward M, Stevenson MR, McLean R, Sawyer S, Patton G, Ivers RQ. Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia. Inj Prev 2023; 29:302-308. [PMID: 36813554 PMCID: PMC10423516 DOI: 10.1136/ip-2022-044807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Self-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood. METHODS We followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors. RESULTS Adolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes. DISCUSSION Our findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Holger Mőller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rachel Baffsky
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Martiniuk
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kris Rogers
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, Sydney, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, UK
| | - Mark R Stevenson
- Transport Health and Urban Design Research Hub, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca McLean
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Susan Sawyer
- Department of Pediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - George Patton
- Department of Pediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
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11
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Peden AE, Cullen P, Bhandari B, Testa L, Wang A, Ma T, Möller H, Peden M, Sawyer SM, Ivers R. A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents. J Safety Res 2023; 85:321-338. [PMID: 37330882 DOI: 10.1016/j.jsr.2023.03.005] [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] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/26/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Globally, injuries are a leading cause of mortality and morbidity for adolescents, which disproportionately affect the disadvantaged. To build an investment case for adolescent injury prevention, evidence is needed as to effective interventions. METHODS A systematic review of peer-reviewed original research published between 2010-2022 was conducted. CINAHL, Cochrane Central, Embase, Medline and PsycINFO databases were searched for studies reporting the effectiveness of unintentional injury prevention interventions for adolescents (10-24 years), with assessment of study quality and equity (e.g., age, gender, ethnicity, socio-economic status). RESULTS Sixty-two studies were included; 59 (95.2%) from high-income countries (HIC). Thirty-eight studies (61.3%) reported no aspect of equity. Thirty-six studies (58.1%) reported prevention of sports injuries (commonly neuromuscular training often focused on soccer-related injuries, rule changes and protective equipment). Twenty-one studies (33.9%) reported prevention of road traffic injury, with legislative approaches, commonly graduated driver licensing schemes, found to be effective in reducing fatal and nonfatal road traffic injury. Seven studies reported interventions for other unintentional injuries (e.g., falls). DISCUSSION Interventions were strongly biased towards HIC, which does not reflect the global distribution of adolescent injury burden. Low consideration of equity in included studies indicates current evidence largely excludes adolescent populations at increased risk of injury. A large proportion of studies evaluated interventions to prevent sports injury, a prevalent yet low severity injury mechanism. Findings highlight the importance of education and enforcement alongside legislative approaches for preventing adolescent transport injuries. Despite drowning being a leading cause of injury-related harm among adolescents, no interventions were identified. CONCLUSION This review provides evidence to support investment in effective adolescent injury prevention interventions. Further evidence of effectiveness is needed, especially for low- and middle-income countries, populations at increased risk of injury who would benefit from greater consideration of equity and for high lethality injury mechanisms like drowning.
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Affiliation(s)
- Amy E Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Queensland, Australia.
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Australia
| | - Buna Bhandari
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; Central Department of Public Health, Tribhuvan University Institute of Medicine, 44600, Nepal; Department of Global Health and Population, Harvard TH Chan School of Public Health, 02115, USA
| | - Luke Testa
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Amy Wang
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Tracey Ma
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia
| | - Holger Möller
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia
| | - Margie Peden
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health UK, Imperial College London, London, United Kingdom
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne; Murdoch Children's Research Institute; and Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Kensington, New South Wales 2052, Australia; The George Institute for Global Health, Newtown, New South Wales 2042, Australia
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12
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Nathan S, Hodgins M, Wirth J, Ramirez J, Walker N, Cullen P. The use of arts-based methodologies and methods with young people with complex psychosocial needs: A systematic narrative review. Health Expect 2023; 26:795-805. [PMID: 36628644 PMCID: PMC10010092 DOI: 10.1111/hex.13705] [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: 09/15/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Arts-based methodologies and methods (ABM) can elicit rich and meaningful data with seldom-heard groups and empower participants in research. Young people with complex psychosocial needs could be better engaged in research using arts-based approaches to overcome communication and literacy issues as well as distrust of those with power, including researchers. A critical review of the use and impact of ABM among this population is timely. The purpose of this review is to synthesize and examine the experience and use of ABM with young people with complex psychosocial needs. METHODS A systematic narrative literature review was conducted with a search of the literature from 2009 to 2021. All abstracts were reviewed independently by two authors and full papers were screened for eligibility against inclusion and exclusion criteria. Data synthesis focused on a descriptive numerical summary and a thematic analysis focused on key patterns across papers relating to the review objectives. RESULTS AND DISCUSSION A total of 25 papers were included. The most common issues of focus were mental health (n = 10) and homelessness (n = 11) and methods using Photovoice (n = 12) and Body Mapping (n = 5). Individual interview data (n = 20) were the most commonly analysed, followed by created works (n = 19). Less than half the studies involved young people in the interpretation of the data collected. Knowledge translation was not described in almost half the studies, with public exhibits (n = 7) and forums with service providers (n = 4) being the most common activities. Key themes across the studies were valued over traditional methods in eliciting data, ABM as an approach to engage these young people in research and the impact of the use of ABM on participants and on key stakeholders through knowledge translation. CONCLUSIONS The growing field of ABM presents opportunities to enhance research with young people with complex psychosocial needs by promoting meaningful exploration of experiences, engaging participants in research and strengthening knowledge translation. The involvement of young people in the interpretation of data and ensuring that knowledge translation occurs are key areas for future attention. PATIENT OR PUBLIC CONTRIBUTION The findings of this review will inform future research to improve the engagement of young people with complex psychosocial needs in research and promote power sharing between researchers and research participants.
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Affiliation(s)
- Sally Nathan
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Michael Hodgins
- School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jonathan Wirth
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jacqueline Ramirez
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Natasha Walker
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, UNSW Sydney, New South Wales Australia, Newtown, New South Wales, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia
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13
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Mantell R, Hwang YIJ, Radford K, Perkovic S, Cullen P, Withall A. Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants. Front Public Health 2023; 11:1086215. [PMID: 37006541 PMCID: PMC10061143 DOI: 10.3389/fpubh.2023.1086215] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionOlder people experiencing homelessness (PEH) are a rapidly growing population at risk of accelerated aging and the early onset of geriatric conditions. One construct that shows promise in predicting age-related decline is frailty. Better understanding the rates and causes of frailty in PEH may improve understanding of its antecedents, thereby facilitating more targeted health and aged care service interventions. The aim of this study was to conduct a rapid review on the prevalence and determinants of frailty in adult PEH.MethodsWe conducted a rapid review of primary research papers studying PEH and frailty or frailty-related concepts.ResultsFourteen studies were included, which indicate that frailty presents earlier and at higher rates in PEH than community-dwelling cohorts. A notable difficulty for many aging PEH was early-onset cognitive impairment which was associated with a range of negative functional outcomes. Another recurrent theme was the negative impact that drug and alcohol use and dependence can have on the health of PEH. Further, psychosocial and structural determinants such as loneliness, living in an impoverished neighborhood and being female had statistically significant associations with frailty and functional decline in PEH.Discussion and implicationsPEH in their 40s and 50s can be frail and experience geriatric conditions, including cognitive impairment. Factors that have important relationships to frailty and functional decline in PEH include cognitive deficits, drug and alcohol dependence and loneliness, as well as upstream determinants such as gender and ethnicity. More targeted data and research on these factors, including cohort studies to better investigate their potentially causal effects, is important for researchers and practitioners assessing and treating frailty in PEH, particularly those interested in early intervention and prevention.Prospero registration IDCRD42022292549.
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Affiliation(s)
- Rhys Mantell
- School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
- *Correspondence: Rhys Mantell
| | - Ye In Jane Hwang
- School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
- UNSW Ageing Futures Institute, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Kylie Radford
- UNSW Ageing Futures Institute, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Psychology, Faculty of Science, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
| | - Silvija Perkovic
- School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Patricia Cullen
- School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, NSW, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia
| | - Adrienne Withall
- School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
- UNSW Ageing Futures Institute, University of New South Wales (UNSW), Sydney, NSW, Australia
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14
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Baffsky R, Ivers R, Cullen P, Wang J, McGillivray L, Torok M. Strategies for Enhancing the Implementation of Universal Mental Health Prevention Programs in Schools: A Systematic Review. Prev Sci 2023; 24:337-352. [PMID: 36098892 PMCID: PMC9938015 DOI: 10.1007/s11121-022-01434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
A number of school-based mental health prevention programs have been found to be effective in research trials, but little is known about how to support implementation in real-life settings. To address this translational problem, this systematic review aims to identify effective strategies for enhancing the implementation of mental health prevention programs for children in schools. Four electronic databases were searched for empirical, peer-reviewed articles in English from January 2000 to October 2021 reporting the effects of implementation strategies for school-based universal mental health programs. Twenty-one articles were included in the narrative synthesis and assessed for quality using the Mixed Methods Appraisal Tool. Twenty-two strategies were found to be effective at improving program fidelity or adoption. The strategies with the strongest positive evidence base were those that involved monitoring and provision of feedback, engaging principals as program leaders, improving teachers' buy-in and organising school personnel implementation meetings. We recommend school-based practitioners trial strategies with positive findings from this review as part of their continuous quality improvement. This review highlights the pressing need for large-scale, randomised controlled trials to develop and trial more robust strategies to enhance adoption, as the five implementation studies found to measure adoption used qualitative methods limited by small samples sizes and case study designs.
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building F25 Samuel Terry Ave, Kensington, NSW, Australia.
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Samuels Building F25 Samuel Terry Ave, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Samuels Building F25 Samuel Terry Ave, Kensington, NSW, Australia
| | - Jessica Wang
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
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15
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Boufous S, Möller H, Patton G, Woodward M, Stevenson MR, Senserrick T, Mclean R, Cullen P, Wang A, Rogers K, Chen HY, Ivers RQ. Acculturation and risk of traffic crashes in young Asian-born Australian drivers. Inj Prev 2023; 29:74-78. [PMID: 36171076 DOI: 10.1136/ip-2022-044718] [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: 07/28/2022] [Accepted: 09/10/2022] [Indexed: 01/28/2023]
Abstract
The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17-24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.
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Affiliation(s)
- Soufiane Boufous
- Transport and Road Safety Research, School of Aviation, Faculty of Science, University of New South Wales - Kensington Campus, Sydney, New South Wales, Australia
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia
| | - George Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Mark Woodward
- School of Public Health, The George Institute for Global Health, Imperial College London Faculty of Medicine, London, UK
| | - Mark R Stevenson
- Melbourne School of Design
- Faculty of Architecture Building and Planning Melbourne School of Population and Global Health
- Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Rebecca Mclean
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Patricia Cullen
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy Wang
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kris Rogers
- Graduate School of Health and School of Public Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Huei-Yang Chen
- NSW Agency for Clinical Innovation, North Ryde, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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16
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Swist T, Collin P, Nguyen B, Davies C, Cullen P, Medlow S, Skinner SR, Third A, Steinbeck K. Guiding, sustaining and growing the public involvement of young people in an adolescent health research community of practice. Health Expect 2022; 25:3085-3095. [DOI: 10.1111/hex.13616] [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] [Received: 10/17/2021] [Revised: 09/01/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Teresa Swist
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
- Education Futures Studio, Sydney School of Education and Social Work University of Sydney Camperdown New South Wales Australia
| | - Philippa Collin
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
| | - Betty Nguyen
- Young and Resilient Research Centre Western Sydney University Penrith New South Wales Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health University of Sydney Westmead New South Wales Australia
| | - Patricia Cullen
- School of Population Health UNSW Sydney Kensington New South Wales Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute University of Wollongong Wollongong New South Wales Australia
- The George Institute for Global Health UNSW Sydney Newtown New South Wales Australia
| | - Sharon Medlow
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- Academic Department of Adolescent Medicine The Children's Hospital Westmead Westmead New South Wales Australia
| | - S. Rachel Skinner
- Specialty of Child and Adolescent Health, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health University of Sydney Westmead New South Wales Australia
| | - Amanda Third
- Institute for Culture and Society Western Sydney University Penrith New South Wales Australia
| | - Katharine Steinbeck
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- Academic Department of Adolescent Medicine The Children's Hospital Westmead Westmead New South Wales Australia
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17
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Cullen P, Mackean T, Walker N, Coombes J, Bennett-Brook K, Clapham K, Ivers R, Hackett M, Worner F, Longbottom M. Integrating Trauma and Violence Informed Care in Primary Health Care Settings for First Nations Women Experiencing Violence: A Systematic Review. Trauma Violence Abuse 2022; 23:1204-1219. [PMID: 33573523 DOI: 10.1177/1524838020985571] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
It is imperative that access to primary health care services is equitable as health care practitioners are often the first responders to women who experience violence. This is of particular importance for First Nations women who disproportionately experience interpersonal and structural violence when compared to non-First Nations women, as well as the ongoing impact of colonization, racism, and intergenerational trauma. To understand how primary health care services can provide equitable and effective care for First Nations women, we explored how trauma and violence informed care is integrated in primary health care settings through the lens of an equity-oriented framework. A systematic search of electronic databases included Medline (via Ovid), Scopus, Informit, and PubMed and grey literature. Six studies were included in the review and we undertook a narrative synthesis using the equity-oriented framework to draw together the intersection of trauma and violence informed care with culturally safe and contextually tailored care. This review demonstrates how equity-oriented primary health care settings respond to the complex and multiple forms of violence and intergenerational trauma experienced by First Nations women and thus mitigate shame and stigma to encourage disclosure and help seeking. Key attributes include responding to women's individual contexts by centering family, engaging elders, encouraging community ownership, which is driven by a culturally competent workforce that builds trust, reduces retraumatization, and respects confidentiality. This review highlights the importance of strengthening and supporting the workforce, as well as embedding cultural safety within intersectoral partnerships and ensuring adequate resourcing and sustainability of initiatives.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
| | - Tamara Mackean
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Natasha Walker
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
| | | | | | - Kathleen Clapham
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Maree Hackett
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Faye Worner
- Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
- Visiting International Scholar, School of Social Work, University of Hawai'i Manoa, HI, USA
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18
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Baffsky R, Ivers R, Cullen P, Batterham PJ, Toumbourou J, Calear AL, Werner-Seidler A, McGillivray L, Torok M. A cluster randomised effectiveness-implementation trial of an intervention to increase the adoption of PAX Good Behaviour Game, a mental health prevention program, in Australian primary schools: Study protocol. Contemp Clin Trials Commun 2022; 28:100923. [PMID: 35669488 PMCID: PMC9163694 DOI: 10.1016/j.conctc.2022.100923] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/08/2022] [Accepted: 05/21/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
- Corresponding author.
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Philip J. Batterham
- Centre for Mental Health Research, The Australian National University, 62 Mills Road, Acton, ACT, Australia
| | - John Toumbourou
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Alison L. Calear
- Centre for Mental Health Research, The Australian National University, 62 Mills Road, Acton, ACT, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
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19
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Sly N, Soomro M, Withall AL, Cullen P, Turner RM, Flahive SR. Players', parents' and staffs' perceptions of injury prevention exercise programmes in youth rugby union. BMJ Open Sport Exerc Med 2022; 8:e001271. [PMID: 35774618 PMCID: PMC9207903 DOI: 10.1136/bmjsem-2021-001271] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Accepted: 05/27/2022] [Indexed: 11/03/2022] Open
Abstract
Background and aim Despite evidence of their efficacy, there is no widespread adoption of injury prevention exercise programmes (IPEPs) among young players and coaches in community rugby union. The purpose of this study was to (1) analyse the knowledge and perceptions of injury prevention and IPEPs among staff, parents and players in youth rugby union and (2) explore the facilitators and barriers to implementation of IPEPs. With this contextual information, tailored implementation strategies can be created. Methods Participants completed an online survey addressing knowledge and perceptions of injury risk, injury prevention practices and a rugby-specific IPEP. Community rugby union players aged 14-18 years, their parents and staff were invited to participate, including school-based and development squads competing at a national level. Results Surveys were completed by 18 staff members, 72 parents and 56 players. Staff, parents and players believe that the risk of injury in youth rugby union is high and that injury prevention is important. The perceived role in injury prevention and availability of allied health staff, particularly strength and conditioning coaches, was apparent in this sample. Reported barriers to completion of IPEPs related to time, resources, awareness of the programme and end-users' attitudes or motivations. Leadership, the use of role models and the structure and routine provided by an IPEP were considered facilitative. Conclusions These findings inform future implementation strategies for IPEPs in this setting, including the need to provide practical solutions, education and considering the role of allied health staff in facilitating such programmes.
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Affiliation(s)
- Nicole Sly
- The Stadium Sports Medicine Clinic, Sydney, New South Wales, Australia
| | - Mariam Soomro
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Adrienne L Withall
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Robin M Turner
- Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sharron R Flahive
- The Stadium Sports Medicine Clinic, Sydney, New South Wales, Australia
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20
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Walker N, Medlow S, Georges A, Steinbeck K, Ivers R, Perry L, Skinner SR, Kang M, Cullen P. Emergency Department Initiated Mental Health Interventions for Young People: A Systematic Review. Pediatr Emerg Care 2022; 38:342-350. [PMID: 34620805 DOI: 10.1097/pec.0000000000002551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/26/2022]
Abstract
OBJECTIVE Young people (10-24 years old) with mental health concerns are increasingly presenting to hospital emergency departments (EDs). The purpose of this review was to identify the core components and outcomes of mental health interventions for young people that are initiated in the ED, such that they are delivered in the ED and/or by ED health workers. METHODS Six electronic databases were systematically searched. Primary peer-reviewed qualitative or quantitative studies describing an ED-initiated mental health intervention for young people published between 2009 and 2020 were included. RESULTS Nine studies met the inclusion criteria. The included studies demonstrated that compared with traditional ED care, ED-initiated mental health interventions lead to improved efficiency of care and decreased length of stay, and a core component of this care was its delivery by allied health practitioners with mental health expertise. The studies were limited by focusing on service efficiencies rather than patient outcomes. Further limitations were the exclusion of young people with complex mental health needs and/or comorbidities and not measuring long-term positive mental health outcomes, including representations and whether young people were connected with community health services. CONCLUSIONS This systematic review demonstrated that ED-initiated mental health interventions result in improved service outcomes, but further innovation and robust evaluation are required. Future research should determine whether these interventions lead to better clinical outcomes for young people and staff to inform the development of best practice recommendations for ED-initiated mental health care for young people presenting to the ED.
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Affiliation(s)
| | | | | | | | | | - Lin Perry
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo
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21
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Henry A, Yang J, Grattan S, Roberts L, Lainchbury A, Shanthosh J, Cullen P, Everitt L. Effects of the COVID-19 Pandemic and Telehealth on Antenatal Screening and Services, Including for Mental Health and Domestic Violence: An Australian Mixed-Methods Study. Front Glob Womens Health 2022; 3:819953. [PMID: 35814835 PMCID: PMC9257034 DOI: 10.3389/fgwh.2022.819953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Australian antenatal care includes specific screening and service provision for domestic and family violence (DFV) and mental health. However, the COVID-19 pandemic resulted in major care changes, including greatly expanded telehealth. Given difficulties in a safe assessment and management of disclosures via telehealth, DFV and mental health service provision might be substantially impacted. This study therefore aimed to assess COVID-19 effects on DFV and mental health screening, as well as broader service provision from the perspective of local maternity service providers. Methods Mixed-methods study of staff surveys and interviews of staff directly involved in pregnancy care (doctors, midwives, and allied health) in three Sydney (Australia) maternity units, from October 2020 to March 2021. Surveys and interviews interrogated perceived effects of the COVID-19 pandemic on delivery (ensuring required services occurred), timeliness, and quality of (a) overall maternity care and (b) DFV and mental health screening and care; and also advantages and disadvantages of telehealth. Surveys were descriptively analyzed. Interviews were conducted online, recorded, and transcribed verbatim prior to thematic analysis. Results In total, 17 interviews were conducted and 109 survey responses were received. Breakdown of survey respondents was 67% of midwives, 21% of doctors, and 10% of allied health. Over half of survey respondents felt the pandemic had a negative effect on delivery, timeliness, and quality of overall pregnancy care, and DFV and mental health screening and management. Perceived telehealth positives included convenience for women (73%) and reducing women's travel times (69%). Negative features included no physical examination (90%), difficulty regarding non-verbal cues (84%), difficulty if interpreter required (71%), and unsure if safe to ask some questions (62%). About 50% felt telehealth should continue post-pandemic, but for <25% of visits. Those perceived suitable for telehealth were low-risk and multiparous women, whereas those unsuited were high-risk pregnancy, non-English speaking, and/or mental health/psychosocial/DFV concerns. “Change to delivery of care” was the central interview theme, with subthemes of impact on mental health/DFV screening, telehealth (both positive and negative), staff impact (e.g., continuity of care disruption), and perceived impact on women and partners. Discussion While telehealth may have an ongoing, post-pandemic role in Australian maternity care, staff believe that this should be limited in scope, mostly for low-risk pregnancies. Women with high risk due to physical health or mental health, DFV, and/or other social concerns were considered unsuited to telehealth.
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Affiliation(s)
- Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- *Correspondence: Amanda Henry
| | - Jennifer Yang
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales (NSW), Sydney, NSW, Australia
| | - Sarah Grattan
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Lynne Roberts
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- St George and Sutherland Clinical School, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Janani Shanthosh
- The George Institute for Global Health, UNSW Medicine and Health, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Kensington, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Kensington, NSW, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Louise Everitt
- Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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22
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Embry L, Hardy K, Orgel E, Wang Y, Michalski J, Li Y, Cullen P, Colte P, Bass J. QOL-13. Impact of hearing loss on neuropsychological functioning in children treated for medulloblastoma: A report from the Children’s Oncology Group (COG). Neuro Oncol 2022. [PMCID: PMC9164722 DOI: 10.1093/neuonc/noac079.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/OBJECTIVE: We prospectively examined neuropsychological outcomes and ototoxicity in children with average-risk medulloblastoma. METHODS: Eligible patients included those treated on COG protocol ACNS0331 who completed audiograms at end of therapy or one-year off-therapy, and neuropsychological assessments between 2- and 5-years post-diagnosis. Conventional pure-tone audiometric evaluations (0.25-8kHz) were assigned an ototoxicity grade based on the International Society of Pediatric Oncology (SIOP) grading scale. Grade for the better hearing ear was used for analyses. Participants were divided into two groups: SIOP grade≥3 hearing loss (HL) versus SIOP grade<3. Cutoff score of 60 on BASC-2 was used to dichotomize parent-reported anxiety and depression scores as ‘low’ or ‘high’. RESULTS: Data were available for 113 children (66% male; 86% white), aged 3.0-18.5 at diagnosis (Mean=9.1). One-quarter (24.8%, n=28) had at least moderate HL (≥ SIOP grade 2), and 12.3% (n=14) had severe HL (≥ SIOP grade 3). After controlling for radiation exposure and age, children with severe HL showed significantly higher levels of anxiety (OR=5.9, 95%CI 1.3-26.0, p=0.0195) and borderline differences in depression (OR=4.0, 95%CI 1.0-16.5, p=0.0563), but no differences in cognitive functioning when compared to other participants. When moderate and severe HL were combined in exploratory analyses, significantly greater anxiety (OR=9.0, 95%CI 2.1-37.4, p=.0027) and depression (OR=4.6, 95%CI 1.3-15.7, p=.0165) were observed. CONCLUSIONS: Survivors of pediatric medulloblastoma with moderate to severe HL evidenced greater psychosocial, but not neurocognitive, difficulties compared to those with no or mild HL. It may be that modern treatment protocols generally preserve cognitive functioning such that associations between HL and cognitive impairment are no longer significant. It is also possible that neurocognitive risk associated with HL may not manifest until survivors are further from diagnosis. In contrast, survivors with HL may be at greater risk for negative psychosocial adjustment, suggesting that increased monitoring of mental health outcomes is warranted.
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Affiliation(s)
- Leanne Embry
- University of Texas Health Science Center, San Antonio , TX , USA
| | - Kristina Hardy
- Children's National Hospital , Washington, DC , USA
- George Washington University School of Medicine , Washington, DC , USA
| | - Etan Orgel
- Children's Hospital of Los Angeles, Los Angeles , CA , USA
- University of Southern California, Los Angeles , CA , USA
| | - Yu Wang
- St. Jude Children's Research Hospital , Memphis, TN , USA
| | - Jeff Michalski
- Washington University in St. Louis, St. Louis , MO , USA
| | - Yimei Li
- St. Jude Children's Research Hospital , Memphis, TN , USA
| | | | - Paul Colte
- Primary Children's Hospital, Salt Lake City , UT , USA
| | - Johnnie Bass
- St. Jude Children's Research Hospital , Memphis, TN , USA
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23
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Cullen P, Leong RN, Liu B, Walker N, Steinbeck K, Ivers R, Dinh M. Returning to the emergency department: a retrospective analysis of mental health re-presentations among young people in New South Wales, Australia. BMJ Open 2022; 12:e057388. [PMID: 35640990 PMCID: PMC9171221 DOI: 10.1136/bmjopen-2021-057388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study aimed to describe mental health emergency department (ED) presentations among young people aged 8-26 years in New South Wales, Australia, and to identify key characteristics associated with higher risk of ED mental health re-presentation. DESIGN, SETTING AND PARTICIPANTS Retrospective analysis of linked ED data records for mental health presentations between 1 January 2015 and 30 June 2018. MAIN OUTCOME MEASURES The main outcome was the total number of mental health ED re-presentations within 1 year, following initial presentation. Count regression models were fitted to estimate factors associated with higher likelihood of re-presentations. RESULTS Forty thousand two hundred and ninety patients were included in the analyses, and 9713 (~25%) re-presented during the following year; 1831 (20%) presented at least three times. On average, patients re-presented 0.61 times per 365 person-days, with average time until first re-presentation of ~92 days but greatest risk of re-presentation within first 30-60 days. Young people with self-harm or suicidal diagnoses at initial presentation were more likely to re-present. Re-presentations were highest among young people <15 years (IRR 1.18 vs ≥20 years old), female (IRR=1.13 vs male), young people residing outside of major cities (IRR 1.08 vs major cities) and Aboriginal and Torres Strait Islander young people (IRR 1.27 vs non-Indigenous). CONCLUSIONS ED mental health re-presentation is high among young people. We demonstrate factors associated with re-presentation that EDs could target for timely, high-quality care that is youth friendly and culturally safe, with appropriate referral pathways into community-based primary and mental healthcare services.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert Neil Leong
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bette Liu
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Natasha Walker
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Katharine Steinbeck
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Dinh
- NSW Institute of Trauma and Injury Management, NSW Agency for Clinical Innovation, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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24
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Walker N, Beek K, Chen H, Shang J, Stevenson S, Williams K, Herzog H, Ahmed J, Cullen P. The Experiences of Persistent Pain Among Women With a History of Intimate Partner Violence: A Systematic Review. Trauma Violence Abuse 2022; 23:490-505. [PMID: 32945245 DOI: 10.1177/1524838020957989] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Women experience persistent pain at higher rates than men; however, women are less likely to be provided with adequate or appropriate care and more likely to have their pain experiences dismissed. The purpose of this review is to consider the complex interaction of the biopsychosocial factors in the experience of persistent pain in order to inform improved models of care. Given persistent pain is among the most frequently reported health consequences of intimate partner violence (IPV), this review focused on studies exploring the association between persistent pain and IPV. Three reviewers independently and systematically searched seven databases. Qualitative and quantitative studies describing the association between IPV and persistent pain published between January 2000 and June 2018 were included. Twelve studies met the inclusion criteria. The included studies demonstrated that a history of IPV places an additional burden on women who experience persistent pain that cannot be explained by an underlying psychological condition. Health care practitioners should be aware of this phenomena to ensure diagnosis, assessment, and treatment plans are targeted accordingly. Future policy directives and research should account for and seek to elucidate this additional burden.
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Affiliation(s)
- Natasha Walker
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- University of Newcastle, New South Wales, Australia
| | - Kristen Beek
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
| | - Huan Chen
- The George Institute for Global Health, Beijing, China
| | - Jie Shang
- The George Institute for Global Health, Beijing, China
| | - Sally Stevenson
- The Illawarra Women's Health Centre, Warilla, New South Wales, Australia
| | - Karen Williams
- South Coast Private Hospital, Wollongong, New South Wales, Australia
| | - Hayley Herzog
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- Silver School of Social Work, New York University, NY, USA
| | - Jareen Ahmed
- The University of Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, 7800University of New South Wales, Sydney, New South Wales, Australia
- 211065The George Institute for Global Health, Sydney, New South Wales, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
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25
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Möller H, Cullen P, Senserrick T, Rogers K, Boufous S, Ivers RQ. Driving offences and risk of subsequent crash in novice drivers: the DRIVE cohort study 12-year follow-up. Inj Prev 2022; 28:396-404. [PMID: 35361665 PMCID: PMC9510411 DOI: 10.1136/injuryprev-2021-044482] [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: 11/10/2021] [Accepted: 02/26/2022] [Indexed: 11/20/2022]
Abstract
Background Penalties are a key component to improve road user safety, but previous studies suggested that they might not be successful in reducing crashing in offending drivers. However, these studies were not able to consider important crash risk factors in the analysis that might confound the results. Using data from a large prospective cohort study of young drivers in New South Wales, Australia, we explored if novice drivers with driving offences have a higher rates of car crash and if these differences are explained by established crash risk factors. Methods We used data from a 2003/2004 Australian survey of young drivers, linked to police reported offence and crash data, hospital data and deaths data up to 2016. We used Poisson regression models adjusted for confounders to estimate the association between driving offences during 2003–2006 with car crash during 2007–2016. Results The study cohort comprised 20 781 young drivers of whom 7860 drivers (37.8%) had at least one driving offence and 2487 (12.0%) were involved in at least one crash. After adjusting for confounders in the regression model, drivers with three or more driving offences had 2.25 (95% CI 1.98 to 2.57), 2.87 (95% CI 1.60 to 5.17) and 3.28 (95% CI 2.28 to 4.72) times higher rates of any crash, crashes that resulted in hospital admission or death and single vehicle crashes compared with drivers with no driving offences. Conclusion Measures that successfully mitigate the underlying risk factors for both, crashes and offences, have the potential to improve road safety.
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Affiliation(s)
- Holger Möller
- School of Population Health, UNSW, Sydney, New South Wales, Australia .,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Queensland University of Technology (QUT), Brisbane, Queesnland, Australia
| | - Kris Rogers
- School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research, Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
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26
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Baffsky R, Beek K, Wayland S, Shanthosh J, Henry A, Cullen P. "The real pandemic's been there forever": qualitative perspectives of domestic and family violence workforce in Australia during COVID-19. BMC Health Serv Res 2022; 22:337. [PMID: 35287675 PMCID: PMC8920801 DOI: 10.1186/s12913-022-07708-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background In 2020, Australia, like most countries, introduced restrictions related to the global pandemic of coronavirus disease 2019 (COVID-19). Frontline services in the domestic and family violence (DFV) sector had to adapt and innovate to continue supporting clients who were experiencing and/or at risk of DFV. There is a need to understand from the perspective of those on the frontline how DFV service responses in different contexts impacted their working conditions and subsequent wellbeing, and what they want to see continued in ‘the new normal’ to inform future effective practices. We address this by reporting on findings from in-depth interviews conducted with practitioners and managers from the DFV sector in Australia. Methods Between July and September 2020 semi-structured interviews were conducted with 51 DFV practitioners and managers from a range of services and specialisations across legal, housing, health and social care services. The data was analysed using iterative thematic analysis. Results The most common service adaptations reported were shifting to outreach models of care, introducing infection control procedures and adopting telehealth/digital service delivery. Adjacent to these changes, participants described how these adaptations created implementation challenges including increased workload, maintaining quality and safety, and rising costs. Impacts on practitioners were largely attributed to the shift towards remote working with a collision in their work and home life and increased risk of vicarious trauma. Despite these challenges, most expressed a sense of achievement in how their service was responding to COVID-19, with several adaptations that practitioners and managers wanted to see continued in ‘the new normal’, including flexible working and wellbeing initiatives. Conclusions The pandemic has amplified existing challenges for those experiencing DFV as well as those working on the frontline of DFV. Our findings point to the diversity in workforce experiences and has elucidated valuable lessons to shape future service delivery. Given the continuing impacts of the pandemic on DFV, this study provides timely insight and impetus to strengthen the implementation of remote working and telehealth/digital support across the DFV sector and to inform better supports for DFV workforce wellbeing in Australia and other contexts. Trial registration Not a clinical intervention.
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington NSW, Sydney, Australia
| | - Kristen Beek
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington NSW, Sydney, Australia
| | - Sarah Wayland
- Faculty of Medicine and Health, University of New England, Sydney Campus, Sydney, New South Wales, Australia
| | - Janani Shanthosh
- The George Institute for Global Health, UNSW Sydney, 1 King Street Newtown NSW, Sydney, Australia.,Australian Human Rights Institute, UNSW Sydney, Kensington NSW, Sydney, Australia
| | - Amanda Henry
- The George Institute for Global Health, UNSW Sydney, 1 King Street Newtown NSW, Sydney, Australia.,School of Women and Children's Health, UNSW Sydney, Kensington NSW, Sydney, Australia
| | - Patricia Cullen
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington NSW, Sydney, Australia. .,The George Institute for Global Health, UNSW Sydney, 1 King Street Newtown NSW, Sydney, Australia. .,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia.
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27
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Yashadhana A, Howie A, Veber M, Cullen P, Withall A, Lewis E, McCausland R, Macniven R, Andersen M. Experiences and perceptions of ageing among older First Nations Australians: A rapid review. Australas J Ageing 2021; 41:8-19. [PMID: 34905642 DOI: 10.1111/ajag.13031] [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: 05/11/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify and describe articles reporting the experiences and perceptions of ageing among older First Nations Australians. METHODS Following rapid review and PRISMA guidelines, we searched five databases for peer-reviewed articles published prior to October 2019 that reported qualitative accounts of ageing among older (≥ 45 years) First Nations Australians. Data were extracted and synthesised thematically. RESULTS Twenty-one articles were included in the final synthesis. Priorities in ageing highlighted the role of Elders, family, community, culture and connection to ancestral lands. Experiences and perceptions of ageing reflected cultural marginalisation in aged and health care services, and highlighted the importance of cultural identity, resilience and survival as key to ageing well. CONCLUSIONS Our review suggests that mainstream ageing frameworks do not fully reflect the priorities of older First Nations Australians. This has important implications for ageing policy and the design and delivery of culturally safe aged and health care services.
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Affiliation(s)
- Aryati Yashadhana
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Adam Howie
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Madelene Veber
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, New South Wales, Australia.,Ngarruwan Ngadju, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Adrienne Withall
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ebony Lewis
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Ruth McCausland
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia.,Institute for Global Development, University of New South Wales, Sydney, New South Wales, Australia
| | - Rona Macniven
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Andersen
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, New South Wales, Australia
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28
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Möller H, Ivers R, Cullen P, Rogers K, Boufous S, Patton G, Senserrick T. Risky youth to risky adults: Sustained increased risk of crash in the DRIVE study 13 years on. Prev Med 2021; 153:106786. [PMID: 34506819 DOI: 10.1016/j.ypmed.2021.106786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 07/05/2021] [Accepted: 09/04/2021] [Indexed: 11/25/2022]
Abstract
The objective of this study was to investigate if drivers who exhibit risky driving behaviours during youth (aged 17-24 years) have an increased risk of car crash up to 13 years later. We used data from the DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia. The data were linked with police crash, hospital and deaths data up to 2016. We analysed differences in crash associated with 13 items of risky driving behaviours using negative binominal regression models adjusted for driver demographics, driving exposure and known crash risk factors. The items were summarised in one index and grouped into quintiles for the analysis. After adjusting for confounding, drivers of the third (RR 1.16, 95% CI 1.05-1.30), fourth (RR1.22, 95% CI1.09-1.36) and fifth quintile (RR 1.36, 95% CI 1.21-1.53) had higher crash rates compared to the lowest risk-takers. Drivers with the highest scores on the risky driving measure had higher rates of crash related hospital admission or death (RR 1.92, 95% CI 1.13-3.27), crashes in wet conditions (RR 1.35,95% CI 1.05-1.73), crashes in darkness (RR 1.55, 95% CI 1.25-1.93) and head-on crashes (RR 2.14, 95% CI 1.07-4.28), compared with drivers with the lowest scores. Novice adolescent drivers who reported high levels of risky driving when they first obtained a driver licence remained at increased risk of crash well into adulthood. Measures that successfully reduce early risky driving, have the potential to substantially reduce road crashes and transport related injuries and deaths over the lifespan.
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Affiliation(s)
- Holger Möller
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia.
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, Newtown, New South Wales, Australia; University of Technology Sydney (UTS), Graduate School of Health, Sydney, New South Wales, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research, Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - George Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Queensland, Australia
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29
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Affiliation(s)
- Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, Australia.,The George Institute for Global Health and University of New South Wales, Sydney, Australia
| | - Kris Rogers
- The George Institute for Global Health and University of New South Wales, Sydney, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, Australia.,The George Institute for Global Health and University of New South Wales, Sydney, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, Australia.,The George Institute for Global Health and University of New South Wales, Sydney, Australia
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30
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Porykali B, Cullen P, Hunter K, Rogers K, Kang M, Young N, Senserrick T, Clapham K, Ivers R. The road beyond licensing: the impact of a driver licensing support program on employment outcomes for Aboriginal and Torres Strait Islander Australians. BMC Public Health 2021; 21:2146. [PMID: 34814871 PMCID: PMC8611871 DOI: 10.1186/s12889-021-12218-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to 1) examine the impact of a New South Wales (NSW) based driver licensing support program (Driving Change) on client employment outcomes; 2) assess the influence of geographical area of program delivery on driver licence attainment. Methods Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of NSW. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data. Results From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22–5.24, p = 0.011) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27–2.33, p < 0.001) to gain an independent licence than those from urban areas. There was no difference in employment outcomes (OR: 1.2, 95% CI: 0.53–2.52, p = 0.719) for clients from urban compared to regional areas. Conclusion The Driving Change program appears to be effective in improving employment outcomes for those who gained a licence. Clients from regional areas were more likely to gain a licence compared to those in urban settings, and were predominantly young and unemployed, often a hard to reach cohort. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians.
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Affiliation(s)
- Bobby Porykali
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia. .,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.
| | - Patricia Cullen
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Kate Hunter
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Kris Rogers
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia
| | - Melissa Kang
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - Nareen Young
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - Teresa Senserrick
- Queensland University of Technology, 130 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Kathleen Clapham
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Rebecca Ivers
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia
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Abstract
BACKGROUND Intimate partner violence (IPV) is a significant problem with several negative health outcomes. Disasters are linked to increased IPV, but little is known about reporting of and strategies to address IPV during the COVID-19 pandemic. This review maps the IPV reporting during the pandemic and interventions to prevent and respond to IPV in 11 Western and Southern European countries. METHODS Government websites, news articles and pre-prints were searched using the terms 'domestic violence' or 'violence' in combination with 'Covid' or 'Corona'. Embase, PubMed, Scopus and Google Scholar were searched using the terms 'domestic violence' and 'partner violence' and 'interventions'. RESULTS Six countries showed an increase in domestic violence reports (Austria, Belgium, France, Ireland, Spain and UK), two countries a drop (Italy and Portugal), two countries showed no change (The Netherlands and Switzerland) and one country did not provide comparative data (Germany). Common measures to address IPV were starting a campaign (nine countries), creating online support (seven), more funding for alternative accommodation (seven) and support (eight) and use of a code word (four). CONCLUSIONS IPV reports or helpline calls in Western and Southern European countries in the first weeks of COVID-19 measures increased in six countries, remained the same in two countries and showed a decrease in two countries. While this review cannot ascertain the impact of the measures taken by the countries during the pandemic and beyond, this mapping provides a foundation for future research, and an opportunity to trace the efficacy of these strategies.
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Affiliation(s)
- Julia Brink
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, Australia
| | - Kristen Beek
- School of Population Health, UNSW, Sydney, Australia
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- The George Institute for Global Health, UNSW, Sydney, Australia
- The George Institute for Global Health, Imperial College London, London, UK
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32
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Smyth C, Cullen P, Breckenridge J, Cortis N, valentine K. COVID-19 lockdowns, intimate partner violence and coercive control. Aust J Soc Issues 2021; 56:359-373. [PMID: 34188336 PMCID: PMC8222883 DOI: 10.1002/ajs4.162] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 05/07/2023]
Abstract
2020 was a year like no other, with the COVID-19 virus upending life as we know it. When governments around the world imposed lockdown measures to curb the spread of COVID-19, advocates in the domestic and family violence (DFV) sector recognised that these measures were likely to result in increases in violence against women, particularly intimate partner violence (IPV). IPV can take many forms, including physical, emotional, psychological, financial, coercive controlling behaviours, surveillance and isolation tactics. Lockdown conditions provide fertile ground for the exercise of coercive control by encouraging people to stay at home, limiting social interactions to household members, reducing mobility and enabling perpetrators to closely monitor their partner's movements. However, media reports and awareness of IPV are generally dominated by a focus on physical violence and lethality, which are easily defined and measured. By contrast, coercive control as a concept is difficult to operationalise, measure and action in law, policy and frontline interventions. This paper discusses the challenges inherent in measuring coercive control and engages with current debates around the criminalisation of coercive control in NSW. Such reflection is timely as the conditions of COVID-19 lockdowns are likely to lead to an increase in coercive controlling behaviours.
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Affiliation(s)
- Ciara Smyth
- Social Policy Research Centre (SPRCUNSW SydneySydneyNSWAustralia
| | - Patricia Cullen
- School of Population Health UNSW SydneyUNSW SydneySydneyNSWAustralia
- The George Institute for Global Health UNSW SydneyUniversity of WollongongWollongongNSWAustralia
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research CentreUniversity of WollongongWollongongNSWAustralia
| | | | - Natasha Cortis
- Social Policy Research Centre (SPRCUNSW SydneySydneyNSWAustralia
| | - kylie valentine
- Social Policy Research Centre (SPRCUNSW SydneySydneyNSWAustralia
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33
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Cortis N, Smyth C, valentine K, Breckenridge J, Cullen P. Adapting Service Delivery during COVID-19: Experiences of Domestic Violence Practitioners. Br J Soc Work 2021; 51:1779-1798. [PMID: 34393655 PMCID: PMC8344860 DOI: 10.1093/bjsw/bcab105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 05/07/2023]
Abstract
COVID-19 rapidly altered patterns of domestic and family violence, increasing the complexity of women's needs, and presenting new barriers to service use. This article examines service responses in Australia, exploring practitioners' accounts of adapting service delivery models in the early months of the pandemic. Data from a qualitatively enriched online survey of practitioners (n = 100) show the ways services rapidly shifted to engage with clients via remote, technology-mediated modes, as physical distancing requirements triggered rapid expansion in the use of phone, email, video calls and messaging, and many face-to-face interventions temporarily ceased. Many practitioners and service managers found that remote service delivery improved accessibility and efficiency. Others expressed concerns about their capacity to assess risk without face-to-face contact, and were unsure whether new service modalities would meet the needs of all client groups and reflect best practice. Findings attest to practitioners' mixed experiences during this period of rapid service innovation and change, and underline the importance of monitoring emerging approaches to establish which service adaptations are effective for different groups of people, and to determine good practice for combining remote and face-to-face service options in the longer term.
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Affiliation(s)
- Natasha Cortis
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence to Associate Professor Natasha Cortis, Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia. E-mail:
| | - Ciara Smyth
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kylie valentine
- Social Policy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jan Breckenridge
- School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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34
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Cullen P, Möller H, Woodward M, Senserrick T, Boufous S, Rogers K, Brown J, Ivers R. Are there sex differences in crash and crash-related injury between men and women? A 13-year cohort study of young drivers in Australia. SSM Popul Health 2021; 14:100816. [PMID: 34041353 PMCID: PMC8141461 DOI: 10.1016/j.ssmph.2021.100816] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Young men have long been known to be disproportionately impacted by road crash and crash-related injury compared to young women and older drivers. However, there is limited insight into how sex differences in crash and crash-related injury changes over time as men and women get older and gain more driving experience. To explore sex differences in crash and crash-related injury, we undertook a sex disaggregated analysis in a large longitudinal cohort of over 20,000 young drivers in New South Wales, Australia, for up to 13 years after they first attained their independent car driver licence. METHODS DRIVE Study survey data from 2003-04 were linked with police, hospital and deaths data up to 2016. Sex differences were analysed using cumulative incidence curves investigating time to first crash and in negative binominal regression models adjusted for driver demographics and crash risk factors. RESULTS After adjusting for demographics and driving exposure, compared with women, men had 1.25 (95% CI 1.18-1.33), 2.07 (1.75-2.45), 1.28 (95% CI 1.13-1.46), 1.32 (95% CI 1.17-1.50) and 1.59 (95% CI 1.43-1.78) times higher rates of any crash, single vehicle crash, crash on streets with a speed limit of 80 km/h or above, crash in wet conditions and crash in the dark, respectively. By contrast, men were less likely to be involved in crashes that resulted in hospitalisation compared to women 0.73 (95% CI 0.55-0.96). CONCLUSIONS Young men are at increased risk of crash, and this risk persists as they get older and gain more driving experience. Despite lower risk of crash, women are at higher risk of crash related injury requiring hospitalisation. These differences in men's and women's risk of crash and injury signal the need for better understanding of how sex and/or gender may contribute to risk of crash and injury across the life-course.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, NSW, Australia
| | - Holger Möller
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Mark Woodward
- The George Institute for Global Health, Imperial College, London, UK
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety – Queensland, Kelvin Grove, QLD, 4059, Australia
| | - Soufiane Boufous
- Transport and Road Safety (TARS) Research, UNSW, Sydney, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, Australia
- Graduate School of Health, The University of Technology Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
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35
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Mőller H, Rogers K, Cullen P, Senserrick T, Boufous S, Ivers R. Socioeconomic status during youth and risk of car crash during adulthood. Findings from the DRIVE cohort study. J Epidemiol Community Health 2021; 75:755-763. [PMID: 33687994 DOI: 10.1136/jech-2020-214083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 11/16/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Young drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women. METHODS We used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers' demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants' SES, with car crash. RESULTS After adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups. CONCLUSION Young drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.
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Affiliation(s)
- Holger Mőller
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia .,School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Brisbane, Queensland, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research,Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia
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36
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Cullen P, Dawson M, Price J, Rowlands J. Intersectionality and Invisible Victims: Reflections on Data Challenges and Vicarious Trauma in Femicide, Family and Intimate Partner Homicide Research. J Fam Violence 2021; 36:619-628. [PMID: 33551548 PMCID: PMC7854328 DOI: 10.1007/s10896-020-00243-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 05/23/2023]
Abstract
Rigorous, comprehensive and timely research are the cornerstone of social and transformative change. For researchers responding to femicide, family and intimate partner homicide, there are substantial challenges around accessing robust data that is complete and fully representative of the experiences and social identities of those affected. This raises questions of how certain social identities are privileged and how the lens of intersectionality may be constrained or enabled through research. Further, there is limited insight into the emotional labour and safety for researchers, and how they experience and mitigate vicarious trauma. We examine these issues through a shared critical reflection and conclude with key recommendations to address the challenges and issues identified. Four researchers examining and responding to femicide, family and intimate partner homicide in Australia, Canada and the United Kingdom shared and evaluated their critical reflection. We drew on our experiences and offer insights into processes, impacts and unintended consequences of fatality reviews and research initiatives. There are substantial limitations in accessibility and completeness of data, which has unintended consequences for the construction of social identities of those affected, including how multiple forms of exclusion and structural oppression are represented. Our experiences as researchers are complex and have driven us to implement strategies to mitigate vicarious trauma. We assert that these issues can be addressed by reconceptualizing the goals of data collection and fostering collaborative discussions among those involved in data collection and violence prevention to strengthen research, prevention efforts and safety for all involved.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, Samuels Building, UNSW, NSW 2052 Sydney, Australia
- The George Institute for Global Health, UNSW, NSW 2042 Newtown, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, NSW 2500 Wollongong, Australia
| | - Myrna Dawson
- Department of Sociology & Anthropology, College of Social and Applied Human Sciences, University of Guelph, Guelph, Ontario N1G 2W1 Canada
| | - Jenna Price
- Crawford School, Australian National University, ACT 2600 Canberra, Australia
| | - James Rowlands
- Department of Sociology, School of Law, Politics and Sociology, University of Sussex, Brighton, BN1 9QE UK
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37
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Michalski J, Li Y, Northcott P, Vezina G, Billups C, Burger P, Cullen P, Gajjar A, Fouladi M, Perkins S, Pomeroy S, Smith K, Merchant T, Fitzgerald T, Booth T, Hadley J, Kumar R, Tarbell N, Packer R, Janss A. Impact of Molecular Subgroups on Outcomes Following Radiation Treatment Randomizations for Average Risk Medulloblastoma: A Planned Analysis of Children’s Oncology Group (COG) ACNS0331. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Walker N, Mackean T, Longbottom M, Coombes J, Bennett-Brook K, Clapham K, Ivers R, Hackett M, Redfern J, Cullen P. Responses to the primary health care needs of Aboriginal and Torres Strait Islander women experiencing violence: A scoping review of policy and practice guidelines. Health Promot J Austr 2020; 32 Suppl 2:40-53. [PMID: 32894883 DOI: 10.1002/hpja.417] [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: 09/11/2019] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED It is demonstrated that primary health care (PHC) providers are sought out by women who experience violence. Given the disproportionate burden of violence experienced by Aboriginal and Torres Strait Islander women, it is essential there is equitable access to appropriate PHC services. This review aimed to analyse whether Australian PHC policy accounts for the complex needs of Aboriginal and Torres Strait Islander women experiencing violence and the importance of PHC providers responding to violence in culturally safe ways. METHODS Using the Arskey and O'Malley framework, an iterative scoping review determined the policies for analysis. The selected policies were analysed against concepts identified as key components in responding to the needs of Aboriginal and Torres Strait Islander women experiencing violence. The key components are Family Violence, Violence against Aboriginal and Torres Strait Islander Women, Social Determinants of Aboriginal and Torres Strait Islander Health and Wellbeing, Cultural Safety, Holistic Health, Trauma, Patient-Centred Care and Trauma-and-Violence-Informed Care. RESULTS Following a search of Australian government websites, seven policies were selected for analysis. Principally, no policy embedded or described best practice across all key components. CONCLUSION The review demonstrates the need for a specific National framework supporting Aboriginal and Torres Strait Islander women who seek support from PHC services, as well as further policy analysis and review. SO WHAT?: Aboriginal and Torres Strait Islander women disproportionately experience more severe violence, with complex impact, than other Australian women. PHC policy and practice frameworks must account for this, together with the intersection of contemporary manifestations of colonialism and historical and intergenerational trauma.
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Affiliation(s)
- Natasha Walker
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Tamara Mackean
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Julieann Coombes
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | | | - Kathleen Clapham
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Maree Hackett
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Faculty of Medicine, UNSW, Sydney, NSW, Australia.,School of Sport and Health Services, The University of Central Lancashire, Preston, UK
| | - Julie Redfern
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia
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39
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Möller H, Senserrick T, Rogers K, Sakashita C, de Rome L, Boufous S, Davey C, Cullen P, Ivers R. Crash risk factors for novice motorcycle riders. J Safety Res 2020; 73:93-101. [PMID: 32563413 DOI: 10.1016/j.jsr.2020.02.003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 12/08/2019] [Accepted: 02/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities. METHODS We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models. RESULTS In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11-2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07-1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14-2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%. CONCLUSION Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to include on-road components.
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Affiliation(s)
- Holger Möller
- The George Institute for Global Health, Sydney, NSW, Australia; School of Public Health & Community Medicine, UNSW, Sydney, NSW, Australia.
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kris Rogers
- The George Institute for Global Health, Sydney, NSW, Australia; University of Technology Sydney (UTS), Graduate School of Health, Sydney, NSW, Australia
| | - Chika Sakashita
- The George Institute for Global Health, Sydney, NSW, Australia; Global Road Safety Solutions (GRSS) Pty Ltd, NSW, Australia
| | - Liz de Rome
- Deakin University Institute for Frontier Materials, Geelong, Victoria, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research, Faculty of Science, UNSW, Sydney, NSW, Australia
| | - Carine Davey
- The George Institute for Global Health, Sydney, NSW, Australia; School of Public Health & Community Medicine, UNSW, Sydney, NSW, Australia
| | - Patricia Cullen
- The George Institute for Global Health, Sydney, NSW, Australia; School of Public Health & Community Medicine, UNSW, Sydney, NSW, Australia; Ngarruwan Ngadju, Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, Sydney, NSW, Australia; School of Public Health & Community Medicine, UNSW, Sydney, NSW, Australia
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Sullivan EA, Kendall S, Chang S, Baldry E, Zeki R, Gilles M, Wilson M, Butler T, Levy M, Wayland S, Cullen P, Jones J, Sherwood J. Aboriginal mothers in prison in Australia: a study of social, emotional and physical wellbeing. Aust N Z J Public Health 2019; 43:241-247. [PMID: 30994971 DOI: 10.1111/1753-6405.12892] [Citation(s) in RCA: 5] [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] [Received: 10/01/2018] [Revised: 12/01/2018] [Accepted: 02/01/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. METHODS Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. RESULTS Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). CONCLUSIONS Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.
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Affiliation(s)
- Elizabeth A Sullivan
- Faculty of Health and Medicine, University of Newcastle, New South Wales.,The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Sacha Kendall
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Sungwon Chang
- IMPACCT, Faculty of Health, University of Technology Sydney, New South Wales
| | - Eileen Baldry
- School of Social Sciences, UNSW Sydney, New South Wales
| | - Reem Zeki
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Marisa Gilles
- WA Country Health Service - Midwest, Western Australia
| | - Mandy Wilson
- National Drug Research Institute, Curtin University, Western Australia
| | - Tony Butler
- The Kirby Institute, UNSW Sydney, New South Wales
| | - Michael Levy
- Medical School, Australian National University, Canberra
| | - Sarah Wayland
- Faculty of Health Sciences, The University of Sydney, New South Wales
| | - Patricia Cullen
- School of Public Health and Community Medicine, UNSW Sydney, New South Wales
| | - Jocelyn Jones
- Faculty of Health and Medical Sciences, The University of Western Australia, Western Australia
| | - Juanita Sherwood
- Faculty of Medicine and Health, The University of Sydney, New South Wales
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Jagnoor J, Rahman A, Cullen P, Chowdhury FK, Lukaszyk C, Baset KU, Ivers R. Exploring the impact, response and preparedness to water-related natural disasters in the Barisal division of Bangladesh: a mixed methods study. BMJ Open 2019; 9:e026459. [PMID: 30948605 PMCID: PMC6500363 DOI: 10.1136/bmjopen-2018-026459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate the impact of natural disasters on communities in the Barisal division of Bangladesh, exploring community approaches to disaster preparedness and mitigation. SETTING Communities in all districts of the Barisal division of Bangladesh. PARTICIPANTS Quantitative data were collected through a cross-sectional household survey (n=9263 households; n=38 981 individuals). Qualitative data were collected through in-depth interviews (n=7) and focus group discussions (n=23) with key informants. OUTCOME MEASURES Quantitative research recorded features of natural disaster events from the previous 5 years, documenting risk factors that increase vulnerability to disaster, use of disaster warning systems and evacuation processes. Qualitative research investigated disaster risk perceptions, experiences during and following disaster, and disaster preparedness practices. RESULTS The survey response rate was 94.7%. Exposure to disaster in the last 5 years was high (82%) with flooding and cyclones considered the greatest threats. Awareness of evacuation processes was low; and only 19% of respondents evacuated their homes at the time of disaster. Drowning during disaster was the primary concern (87%), followed by debt, livestock and crop loss (78%). The qualitative findings indicated prevailing fatalistic perceptions towards natural disasters among community. The consequences of disasters included significant loss of livelihoods and exposure to infections due to poor sanitation. There was also insufficient support for the most vulnerable, particularly women, children and the elderly. Although several community preparedness and practices existed, there was a lack of response to early warning systems. Barriers to disaster response and resilience included financial insecurities, loss of livelihoods and cultural concerns regarding women's privacy. CONCLUSIONS Critical to achieving disaster resilience is increased government investment in infrastructure and systems-level responses that empower communities. Further research can support this by addressing community challenges to promoting disaster resilience and how to leverage existing community strengths to implement locally owned solutions.
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Affiliation(s)
- Jagnoor Jagnoor
- Injury Division, The George Institute for Global Health, Sydney, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, New Delhi, New Delhi, India
| | - Aminur Rahman
- International Drowning Research Centre, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Patricia Cullen
- Injury Division, The George Institute for Global Health, Sydney, Australia
| | - Fazlul Kader Chowdhury
- International Drowning Research Centre, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Caroline Lukaszyk
- Injury Division, The George Institute for Global Health, Sydney, Australia
| | - Kamran ul Baset
- International Drowning Research Centre, Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh
| | - Rebecca Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Flinders University, Adelaide, South Australia, Australia
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Cullen P, Hunter K, Clapham K, Senserrick T, Rogers K, Harrison JE, Ivers RQ. Road user behaviour, attitudes and crashes: a survey of Aboriginal and Torres Strait Islander people in Australia. Inj Prev 2019; 26:123-128. [PMID: 30837328 DOI: 10.1136/injuryprev-2018-043011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to describe road user behaviour, attitudes and crashes in Aboriginal and Torres Strait Islander people in four urban, regional and remote communities located in New South Wales (NSW) and South Australia (SA). METHODS Face-to-face surveys were administered to clients (n=625) in Aboriginal Community Controlled Health Services (ACCHS). All Aboriginal and Torres Strait Islander clients attending the ACCHS for any reason were approached to participate over a 2-week period. Surveys included questions on sociodemographic factors, crash involvement, road behaviours and road safety attitudes drawn from tools used in national surveys. RESULTS The participation rate was high (69%-75%). Seat belt wearing rates were very high, particularly in the front of a car, although rear seat belt wearing rates in SA (77%) were substantially lower than in NSW (93%). Among drivers, 11% reported always or mostly driving 10 km/hour over the speed limit, and this was higher among drivers in SA (13.4%). Drivers aged 55 years and over and/or women were more likely to report that they do not drink at any time or restricted what they drank when driving. These results enable comparison with the Community Attitude to Road Safety survey conducted Australia-wide in 2013. CONCLUSIONS This study confirms that Aboriginal and Torres Strait Islander people are inclined to report attitudes or road safety behaviours similar to the rest of the population; however, rear restraint use was lower and self-reported speeding was higher. These issues are likely attributable to transport options and geography in remote communities, which can contribute to overcrowding and unsafe driving practices.
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Affiliation(s)
- Patricia Cullen
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kate Hunter
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Transport and Road Safety Research, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - James E Harrison
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia .,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Southgate Institute, Flinders University, Adelaide, South Australia, Australia
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Little M, Pereira P, Mulcahy R, Cullen P, Carrette T, Seymour J. Severe Cardiac Failure Associated with Presumed Jellyfish Sting. Irukandji Syndrome? Anaesth Intensive Care 2019; 31:642-7. [PMID: 14719425 DOI: 10.1177/0310057x0303100605] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present a retrospective review of twelve cases of Irukandji syndrome associated with pulmonary oedema. This is a life-threatening envenoming due to a presumed jellyfish sting throughout Northern Australia, although only one case occurred outside North Queensland. Patients presented with significant and ongoing pain, tachycardia and hypertension. Half the patients became hypotensive requiring inotropic support. Cardiac echocardiography revealed significant cardiac dysfunction. Six patients required ventilatory support. There was no death reported due to pulmonary oedema, but one patient died of intracerebral haemorrhage. We believe patients may develop a toxin associated cardiomyopathy, and jellyfish other than Carukia barnesi may be responsible. As there is confusion with nomenclature, Carukia barnesi should be known as the Barnes jellyfish, and the diagnosis of cardiotoxic marine envenoming is suggested for any patient who has been stung by a jellyfish, develops no or minimal skin markings, and develops cardiogenic pulmonary oedema associated with Irukandji syndrome.
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Affiliation(s)
- M Little
- Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia
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Cullen P, Clapham K, Lo S, Rogers K, Hunter K, Treacy R, Porykali B, Keay L, Senserrick T, Ivers R. Communities driving change: evaluation of an Aboriginal driver licensing programme in Australia. Health Promot Int 2018; 33:925-937. [PMID: 29106515 DOI: 10.1093/heapro/dax036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Driving Change programme was developed to facilitate access to licensing in Aboriginal communities in Australia. This process evaluation aimed to explore whether Driving Change was implemented as intended and was addressing the needs of the communities. A mixed methods approach was used, with triangulation of client data (n = 984), semi-structured interviews (n = 18) and client discussion groups (n = 21). Descriptive and regression analyses of quantitative and thematic analysis of qualitative data were drawn together to develop an integrated understanding of implementation barriers and facilitators. The programme reached 984 clients, with the majority from the target age group 16-24 years (56-89%). In multivariate analysis, clients who had supervised driving practice were 2.4 times more likely to attain a licence (95% CI: 1.9-3.1) and clients who received a high level of case management were 1.8 times more likely to progress to attain a licence than those who received low levels of case management (95% CI: 1.3-2.6). Implementation was facilitated by community partnerships and this was attributed to local delivery, Aboriginal leadership, connections with community networks and community ownership of solutions. Driving Change is engaging communities and reaching clients with a high level of need for licensing support. The programme is working with communities, benefiting from the input of cultural values and sharing ownership of local solutions. Community partnerships were critical to successfully supporting clients to overcome challenging barriers to participation. The learnings from this programme are relevant to complex community programme implementation and evaluation, particularly with diverse or hard to reach populations.
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Affiliation(s)
- Patricia Cullen
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Serigne Lo
- Melanoma Institute Australia, Wolstencraft, Australia
| | - Kris Rogers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,The Poche Centre for Indigenous Health, The University of Sydney, Camperdown, Australia
| | - Rebekah Treacy
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Bobby Porykali
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Teresa Senserrick
- Transport and Road Safety Research, University of New South Wales, Sydney, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Flinders University, Adelaide, South Australia
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Packer R, Li Y, Hardy K, Janss A, Billups C, Embry L, Han Y, Cullen P, Merchant T, Tarbell N, Pollack I, Gajjar A, Leary S, Fouladi M, Michalski J. MBCL-07. 5-YEAR EVENT-FREE SURVIVAL (EFS) AND NEUROCOGNITIVE OUTCOME IN CHILDREN WITH MEDULLOBLASTOMA (MB) BETWEEN 3 AND 5 YEARS OF AGE: RESULTS OF CHILDREN’S ONCOLOGY GROUP STUDY ACNS0331. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.405] [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: 11/13/2022] Open
Affiliation(s)
- Roger Packer
- Children’s National Health System, Washington DC, USA
| | - Yimei Li
- St. Jude’s Children’s Hospital, Memphis, TN, USA
- Children’s Oncology Group, Arcadia, CA, USA
| | | | - Anna Janss
- Emory Children’s Hospital, Atlanta, GA, USA
| | - Catherine Billups
- St. Jude’s Children’s Hospital, Memphis, TN, USA
- Children’s Oncology Group, Arcadia, CA, USA
| | | | - Yuanyuan Han
- St. Jude’s Children’s Hospital, Memphis, TN, USA
- Children’s Oncology Group, Arcadia, CA, USA
| | | | | | | | - Ian Pollack
- Pittsburgh Children’s Hospital, Pittsburgh, PA, USA
| | - Amar Gajjar
- St. Jude’s Children’s Hospital, Memphis, TN, USA
| | - Sarah Leary
- Seattle Children’s Hospital, Seattle, WA, USA
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Embry L, Gioia A, Li Y, Han Y, Cullen P, Janss A, Michalski J, Billups C, Noll R, Hardy K. NCOG-15. LONG-TERM IMPACT OF RADIATION DOSE AND VOLUME ON INTELLECTUAL FUNCTIONING (IQ) FOR CHILDREN DIAGNOSED WITH MEDULLOBLASTOMA: A REPORT FROM THE CHILDREN’S ONCOLOGY GROUP (COG). Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.576] [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: 11/12/2022] Open
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Schulte F, Russell KB, Cullen P, Embry L, Fay-McClymont T, Johnston D, Rosenberg AR, Sung L. Systematic review and meta-analysis of health-related quality of life in pediatric CNS tumor survivors. Pediatr Blood Cancer 2017; 64. [PMID: 28266804 DOI: 10.1002/pbc.26442] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/10/2016] [Accepted: 12/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pediatric central nervous system (CNS) tumor survivors are at high risk for numerous late effects including decreased health-related quality of life (HRQOL). Our objective was to summarize studies describing HRQOL in pediatric CNS tumor survivors and compare HRQOL outcomes in studies that included a comparison group. PROCEDURE EMBASE, MEDLINE, and PsychINFO were used to identify relevant articles published until August, 2016. Eligible studies reported outcomes for pediatric CNS tumor survivors diagnosed before age 21, at least 5 years from diagnosis and/or 2 years off therapy and used a standardized measure of HRQOL. All data were abstracted by two reviewers. Random-effects meta-analyses were performed using Review Manager 5.0. RESULTS Of 1,912 unique articles identified, 74 were included in this review. Papers described 29 different HRQOL tools. Meta-analyses compared pediatric CNS tumor survivors to healthy comparisons and other pediatric cancer survivors separately. HRQOL was significantly lower for CNS (n = 797) than healthy comparisons (n = 1,397) (mean difference = -0.54, 95% confidence interval [CI] = -0.72 to -0.35, P < 0.001, I2 = 35%). HRQOL was also significantly lower for CNS (n = 244) than non-CNS survivors (n = 414) (mean difference = -0.56, 95% CI = -0.73 to -0.38, P < 0.00001, I2 = 0%). CONCLUSIONS Pediatric CNS tumor survivors experience worse HRQOL than healthy comparisons and non-CNS cancer survivors. Future HRQOL work should be longitudinal, and/or multisite studies that examine HRQOL by diagnosis and treatment modalities.
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Affiliation(s)
- Fiona Schulte
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Haematology, Oncology and Transplant Program, Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - K Brooke Russell
- Haematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.,Departments of Oncology and Psychology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Patricia Cullen
- Loretto Heights School of Nursing, Regis University, Denver, Colorado
| | - Leanne Embry
- Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Taryn Fay-McClymont
- Departments of Oncology and Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna Johnston
- Department of Haematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Abby R Rosenberg
- Department of Hematology/Oncology, Seattle Children's Hospital, Seattle, Washington
| | - Lillian Sung
- Department of Haematology/Oncology, SickKids Hospital, Toronto, Ontario, Canada
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Clapham K, Hunter K, Cullen P, Helps Y, Senserrick T, Byrne J, Harrison JE, Ivers RQ. Addressing the barriers to driver licensing for Aboriginal people in New South Wales and South Australia. Aust N Z J Public Health 2017; 41:280-286. [PMID: 28245515 DOI: 10.1111/1753-6405.12654] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/01/2016] [Accepted: 11/01/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Low rates of driver licensing have been linked to increased risk of transport-related injury, and reduced access to health services, employment and educational opportunities in the Aboriginal population. This paper reports on how barriers to obtaining a driver licence are being addressed in four Aboriginal communities in New South Wales and South Australia. METHODS Qualitative data were collected over a four-month period in 2013. Interviews with Aboriginal and non-Aboriginal stakeholders (n=31) and 11 focus groups with Aboriginal participants (n=46) were analysed thematically using a framework approach. RESULTS Factors facilitating licensing included: family support, professional lessons, alternative testing and programs that assist with literacy, fines management, financial assistance and access to a supervising driver. Stakeholders recommended raising awareness of existing services and funding community-based service provision to promote access to licensing. DISCUSSION Facilitating licence participation requires systemic change and long-term investment to ensure interagency collaboration, service use and sustainability of relevant programs, including job search agencies. Implications for public health: The disadvantage faced by Aboriginal people in driver licensing is a fundamental barrier to participation and a social determinant of health. Understanding the factors that promote licensing is crucial to improving access for under-serviced populations; recommendations provide pragmatic solutions to address licensing disadvantage.
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Affiliation(s)
- Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, New South Wales
| | - Kate Hunter
- The George Institute for Global Health, University of Sydney, New South Wales.,The Poche Centre for Indigenous Health, University of Sydney, New South Wales
| | - Patricia Cullen
- The George Institute for Global Health, University of Sydney, New South Wales
| | | | - Teresa Senserrick
- Transport and Road Safety Research, University of New South Wales, New South Wales
| | - Jake Byrne
- The George Institute for Global Health, University of Sydney, New South Wales
| | | | - Rebecca Q Ivers
- The George Institute for Global Health, University of Sydney, New South Wales.,Flinders University, South Australia
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McNamara C, Cullen P, Rackauskas M, Kelly R, O'Sullivan KE, Galvin J, Eaton D. Left cardiac sympathetic denervation: case series and technical report. Ir J Med Sci 2017; 186:607-613. [PMID: 28238200 DOI: 10.1007/s11845-017-1577-0] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay. LCSD provides a valuable treatment option for patients with life-threatening channelopathies and cardiomyopathies. AIMS AND METHODS This case series reports the preliminary paediatric and adult experience in the Republic of Ireland with LCSD and describes five cases recently treated in addition to an outline of the operative procedure employed. Of the five cases included, two were paediatric cases and three were adult cases. RESULTS One of the paediatric patients had a diagnosis of the rare catecholaminergic polymorphic ventricular tachycardia (CPVT) and the other a diagnosis of long-QT syndrome. Both paediatric patients experienced excellent outcomes. Of the three adult patients, two benefitted greatly and remain well at follow-up (one inappropriate sinus tachycardia and one CPVT). One patient with idiopathic ventricular fibrillation unfortunately passed away from intractable VF despite all attempts at resuscitation. CONCLUSION In this case series, we highlight that LCSD provides a critical adjunct to existing medical therapies and should be considered for all patients with life-threatening refractory arrhythmias especially those patients on maximal medical therapy.
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Affiliation(s)
- C McNamara
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - P Cullen
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - M Rackauskas
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - R Kelly
- Department of Cardiothoracic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - K E O'Sullivan
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland
| | - J Galvin
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - D Eaton
- Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
- Department of Cardiothoracic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
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Cullen P, Chevalier A, Byrne J, Hunter K, Gadsden T, Ivers R. 520 Summative process evaluation of a driver licensing support program in remote aboriginal communities. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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