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Agbejule OA, Hart NH, Ekberg S, Chan RJ. Development of a self-management support practice framework for addressing cancer-related fatigue: a modified Delphi study. J Cancer Surviv 2024; 18:972-982. [PMID: 36826459 PMCID: PMC11082027 DOI: 10.1007/s11764-023-01348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Managing cancer-related fatigue requires individuals to adopt a range of self-management behaviours. However, clinicians report the lack of clear guidance on self-management support practices hinders their provision of supportive care. To develop consensus on a framework of core practices required by health professionals to deliver effective self-management support to cancer patients and survivors experiencing cancer-related fatigue. METHODS A preliminary framework of 47 practice items (14 Key Practices, 33 Practice Components) was derived from a systematic review, and a self-management support capability outline for primary care professionals. This preliminary framework was presented for consensus rating and comment in a two-round modified Delphi study conducted with a panel of health professionals, research academics, and cancer consumers. RESULTS Fifty-two panel participants comprising consumers (n = 25), health professionals (n = 19), and researchers (n = 16) were included in Round 1 of the modified Delphi study. Feedback from the panel produced consensus on retaining 27 of 47 original practice items without change. Seventeen items (including 12 modified, and 5 newly created practice items) were sent to the panel for rating in Round 2. Thirty-six experts produced consensus on retaining all 17 practice items in Round 2. The final framework comprised 44 items (13 Key Practices, 31 Practice Components). CONCLUSIONS The practice framework offers an evidence- and consensus-based model of best practice for health professionals providing self-management support for cancer-related fatigue. IMPLICATIONS FOR CANCER SURVIVORS This framework is the first to focus on quality provision of self-management support in managing cancer-related fatigue, one of the most prevalent symptoms experienced by cancer patients and survivors.
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Affiliation(s)
- Oluwaseyifunmi Andi Agbejule
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia.
| | - Nicolas H Hart
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
- Centre for IMPACCT, Faculty of Health, University of Technology, NSW, Sydney, 2007, Australia
| | - Stuart Ekberg
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
| | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
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McLaren H, Hamiduzzaman M, Patmisari E, Jones M, Taylor R. Health and Social Care Outcomes in the Community: Review of Religious Considerations in Interventions with Muslim-Minorities in Australia, Canada, UK, and the USA. J Relig Health 2024; 63:2031-2067. [PMID: 36181633 PMCID: PMC11061054 DOI: 10.1007/s10943-022-01679-2] [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: 09/01/2022] [Indexed: 06/16/2023]
Abstract
The aims of this integrative review included examining the intervention characteristics, religious tailoring, and behavioural outcomes of health and social care interventions with Muslim-minorities in Australia, Canada, UK, and the USA. Nineteen articles were included, and each showed some level of improved health and social care outcomes associated with interventions that were religiously tailored to Islamic teachings, and when notions of health were extended to physical, psychological, spiritual and social domains. Future studies should measure levels of religiosity to understand whether religiously tailored interventions produce a significant intervention effect when compared to non-religiously tailored interventions with Muslims.
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Affiliation(s)
- Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | | | - Emi Patmisari
- College of Education, Psychology and Social Work, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Michelle Jones
- College of Education, Psychology and Social Work, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Renae Taylor
- Community Development, Education & Social Support Australia (CDESSA) Inc., Adelaide, Australia
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3
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Islam A, Shaukat Z, Hussain R, Ricos MG, Dibbens LM, Gregory SL. Aneuploidy is Linked to Neurological Phenotypes Through Oxidative Stress. J Mol Neurosci 2024; 74:50. [PMID: 38693434 PMCID: PMC11062972 DOI: 10.1007/s12031-024-02227-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
Aneuploidy, having an aberrant genome, is gaining increasing attention in neurodegenerative diseases. It gives rise to proteotoxic stress as well as a stereotypical oxidative shift which makes these cells sensitive to internal and environmental stresses. A growing body of research from numerous laboratories suggests that many neurodegenerative disorders, especially Alzheimer's disease and frontotemporal dementia, are characterised by neuronal aneuploidy and the ensuing apoptosis, which may contribute to neuronal loss. Using Drosophila as a model, we investigated the effect of induced aneuploidy in GABAergic neurons. We found an increased proportion of aneuploidy due to Mad2 depletion in the third-instar larval brain and increased cell death. Depletion of Mad2 in GABAergic neurons also gave a defective climbing and seizure phenotype. Feeding animals an antioxidant rescued the climbing and seizure phenotype. These findings suggest that increased aneuploidy leads to higher oxidative stress in GABAergic neurons which causes cell death, climbing defects, and seizure phenotype. Antioxidant feeding represents a potential therapy to reduce the aneuploidy-driven neurological phenotype.
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Affiliation(s)
- Anowarul Islam
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia
- Epilepsy Research Group, Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Zeeshan Shaukat
- Epilepsy Research Group, Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Rashid Hussain
- Epilepsy Research Group, Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Michael G Ricos
- Epilepsy Research Group, Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Leanne M Dibbens
- Epilepsy Research Group, Australian Centre for Precision Health, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Stephen L Gregory
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia.
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4
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Alemu WG, Due C, Muir-Cochrane E, Mwanri L, Azale T, Ziersch A. Quality of life among people living with mental illness and predictors in Africa: a systematic review and meta-analysis. Qual Life Res 2024; 33:1191-1209. [PMID: 37906348 PMCID: PMC11045618 DOI: 10.1007/s11136-023-03525-8] [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] [Accepted: 09/22/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Quality of life (QoL) of patients with mental illness has been examined internationally but to a lesser extent in developing countries, including countries in Africa. Improving QoL is vital to reducing disability among people with mental illness. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of QoL and associated factors among people living with mental illness in Africa. METHODS Using the PICOT approach, Scopus, MEDLINE, PsycINFO, CINAHL, Embase, the Web of Science, and Google Scholar were searched. A structured search was undertaken, comprising terms associated with mental health, mental illness, QoL, and a list of all African countries. The Joanna Briggs Institute Quality Appraisal Checklist is used to evaluate research quality. Subgroup analysis with Country, domains of QoL, and diagnosis was tested using a random-effect model, and bias was assessed using a funnel plot and an inspection of Egger's regression test. A p value, OR, and 95% CI were used to demonstrate an association. RESULTS The pooled prevalence of poor QoL was 45.93% (36.04%, 55.83%), I2 = 98.6%, p < 0.001). Subgroup analysis showed that Ethiopia (48.09%; 95% CI = 33.73, 62.44), Egypt (43.51%; 95% CI = 21.84, 65.18), and Nigeria (43.49%; 95% CI = 12.25, 74.74) had the highest mean poor QoL prevalence of the countries. The pooled prevalence of poor QoL by diagnosis was as follows: bipolar disorder (69.63%; 95% CI = 47.48, 91.77), Schizophrenia (48.53%; 95% CI = 29.97, 67.11), group of mental illnesses (40.32%; 95% CI = 23.98, 56.66), and depressive disorders (38.90%; 95% CI = 22.98, 54.81). Being illiterate (3.63; 95% CI = 2.35, 4.91), having a comorbid medical illness (4.7; 95% CI = 2.75, 6.66), having a low monthly income (3.62; 95% CI = 1.96, 5.27), having positive symptoms (0.32; 95% CI = 0.19, 0.55), and having negative symptoms (0.26; 95% CI = 0.16, 0.43) were predictors of QoL. Thus, some factors are significantly associated with pooled effect estimates of QoL. CONCLUSIONS The current systematic review and meta-analysis showed that almost half of patients with mental illness had poor QoL. Being illiterate, having a comorbid medical condition, having a low monthly income, having positive symptoms, and having negative symptoms of mental illness were independent predictors of poor QoL. This systematic review and meta-analysis emphasize that poor QoL of people with mental illness in Africa needs attention to reduce its negative consequences.
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Affiliation(s)
- Wondale Getinet Alemu
- College of Medicine and Public Health, Flinders University Adelaide, Adelaide, Australia.
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, SA, Australia
| | - Telake Azale
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University Adelaide, Adelaide, Australia
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Kow L, Magdy M. Obituary for Ken Loi (7/7/69-28/10/23). Obes Surg 2024; 34:1393-1394. [PMID: 38446359 PMCID: PMC11031468 DOI: 10.1007/s11695-024-07092-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 03/07/2024]
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Kaambwa B, Woods TJ, Natsky A, Bulamu N, Mpundu-Kaambwa C, Loffler KA, Sweetman A, Catcheside PG, Reynolds AC, Adams R, Eckert DJ. Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review. Pharmacoeconomics 2024; 42:507-526. [PMID: 38340220 PMCID: PMC11039546 DOI: 10.1007/s40273-023-01349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Assessment of quality of life (QoL) in people living with sleep disorders using questionnaires is necessary to compare intervention benefits. Knowledge of the content and concepts covered by specific QoL instruments is essential to determine which instruments are best suited for conducting economic evaluations of sleep-related interventions. OBJECTIVES This review aims to identify the QoL instruments that have been applied in economic evaluations of sleep disorder interventions and compare their conceptual overlap and content coverage using the framework of the International Classification of Functioning, Disability and Health (ICF). METHODS A systematic review of full economic evaluations in sleep published in peer-reviewed journals from conception to 30 May, 2023 was conducted. MEDLINE, PsychInfo, ProQuest, Cochrane, Scopus, CINAHL, Web of Science and Emcare were searched for eligible studies. Studies incorporating either generic or sleep-specific QoL instruments as the primary or secondary measures of effectiveness within a full economic evaluation were included. Quality appraisal against the JBI Critical Appraisal Checklist for Economic Evaluations and EURONHEED checklists and mapping of QoL items to ICF categories were performed by two reviewers, with a third helping settle any potential differences. RESULTS Sixteen instruments were identified as having been used in sleep health economic evaluations. The EQ-5D-3L, Epworth Sleepiness Scale, and Insomnia Severity Index were the most widely used, but the latter two are predominantly diagnostic tools and not specifically designed to guide economic evaluations. Other instruments with broader ICF content coverage have been least used, and these include the Sleep Apnea Quality of Life Index, Functional Outcomes of Sleep Questionnaire, 15 Dimensions, Short-Form 6 Dimensions, 12-item Short Form Survey, 36-item Short Form Survey and the GRID Hamilton Rating Scale for Depression. CONCLUSIONS This study provides an overview of current QoL instruments used in economic evaluations of sleep with respect to their content coverage. A combination of generic and sleep-specific instruments with broader ICF content coverage is recommended for such evaluations.
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Affiliation(s)
- Billingsley Kaambwa
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, SA, 5042, Australia.
| | - Taylor-Jade Woods
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, SA, 5042, Australia
| | - Andrea Natsky
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Norma Bulamu
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Kelly A Loffler
- Health Data and Clinical Trials, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Alexander Sweetman
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Peter G Catcheside
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Robert Adams
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Danny J Eckert
- Flinders Health and Medical Research Institute (Sleep Health)/formerly Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia
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Leske M, Koczwara B, Blunt J, Morris J, Eakin E, Short CE, Daly A, Degner J, Beatty L. Co-designing Healthy Living after Cancer Online: an online nutrition, physical activity, and psychosocial intervention for post-treatment cancer survivors. J Cancer Surviv 2024; 18:606-616. [PMID: 36374435 PMCID: PMC9660094 DOI: 10.1007/s11764-022-01284-y] [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: 05/26/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of the present study was to co-design Healthy Living after Cancer Online (HLaC Online), an online intervention supporting cancer survivors to set and meet their healthy living goals. METHODS Adapted from an initial telephone-delivered Healthy Living after Cancer program, wireframes (PDF black and white mock-ups) of the proposed online program were presented in a series of focus groups and interviews to our stakeholder group, which consisted of cancer survivors, oncology healthcare professionals, and representatives from cancer support organisations. Stakeholders were prompted for feedback on the wireframe and given end-user scenarios to encourage deeper engagement with the co-design process. Transcriptions underwent thematic analysis to determine which features of the program needed change or expansion. RESULTS 27 participants took part in one of 8 focus groups or 10 interviews. Five themes were identified relating to (a) website design elements, (b) promoting and maintaining long-term engagement, (c) relatability and relevance, (d) navigating professional support, and (e) family and peer support. Recommended changes, such as simple activities and guidance videos, were integrated into the HLaC Online prototype. CONCLUSIONS Involving end-users in the co-design process ensured the intervention's relevance and specificity to the needs of cancer survivors. Next steps include feasibility testing the prototype, prior to commencing a national randomised control trial of HLaC Online. IMPLICATIONS FOR CANCER SURVIVORS HLaC Online aims to support cancer survivors to improve their quality of life by making healthy lifestyle changes in their physical activity, healthy eating, weight management, mental health, and fatigue management.
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Affiliation(s)
- Morgan Leske
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia.
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Medical Oncology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | | | | | - Elizabeth Eakin
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jon Degner
- Cancer Voices South Australia, Kensington Park, SA, Australia
| | - Lisa Beatty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
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Dutch D, Bell L, Zarnowiecki D, Johnson BJ, Denney-Wilson E, Byrne R, Cheng H, Rossiter C, Manson A, House E, Davidson K, Golley RK. Screening tools used in primary health care settings to identify health behaviours in children (birth-16 years); A systematic review of their effectiveness, feasibility and acceptability. Obes Rev 2024; 25:e13694. [PMID: 38192203 DOI: 10.1111/obr.13694] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/01/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Child health behaviour screening tools have potential to enhance the effectiveness of health promotion and early intervention. This systematic review aimed to examine the effectiveness, acceptability and feasibility of child health behaviour screening tools used in primary health care settings. METHODS A systematic review of studies published in English in five databases (CINAHL, Medline, Scopus, PsycINFO and Web of Science) prior to July 2022 was undertaken. Eligible studies described: 1) screening tools for health behaviours (dietary, physical activity, sedentary or sleep-related behaviours) used in primary health care settings in children birth to 16 years; 2) tool effectiveness for identifying child health behaviours and changing practitioner behaviour; 3) tool acceptability or feasibility from child, caregiver or practitioner perspective and/or 4) implementation of the screening tool. RESULTS Of the 7145 papers identified, 22 studies describing 14 screening tools were included. Only four screening tools measured all four behaviour domains. Fourteen studies reported changes in practitioner self-reported behaviour, knowledge and practice. Practitioners and caregivers identified numerous benefits and challenges to screening. CONCLUSIONS Health behaviour screening can be an acceptable and feasible strategy to assess children's health behaviours in primary health care. Further evaluation is needed to determine effectiveness on child health outcomes.
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Affiliation(s)
- Dimity Dutch
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Lucinda Bell
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Dorota Zarnowiecki
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Brittany J Johnson
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alexandra Manson
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Eve House
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kamila Davidson
- Thriving Queensland Kids Partnership, Brisbane, QLD, Australia
| | - Rebecca K Golley
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Siddiquee NA, Hamiduzzaman M, McLaren H, Patmisari E. Older women's experience with COVID-19 pandemic: A study of risk perception and coping among culturally and linguistically diverse population in South Australia. PLoS One 2024; 19:e0301366. [PMID: 38547238 PMCID: PMC10977767 DOI: 10.1371/journal.pone.0301366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND A global catastrophe-the COVID-19 pandemic-appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia. METHODS A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews. RESULTS Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (P = 0.01). Emergency preparation differed based on the participants' residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services. CONCLUSIONS Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.
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Affiliation(s)
| | - Mohammad Hamiduzzaman
- University Centre for Rural Health, School of Health Sciences, University of Sydney, Lismore, New South Wales, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Emi Patmisari
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
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Zhang D, Li L, Wang L, Sando D, Sharma P, Seidel J. Engineering Domain Variants in 0.7Pb(Mg 1/3Nb 2/3)-0.3PbTiO 3 Single Crystals Using High-Frequency AC Poling. Small Methods 2024:e2301257. [PMID: 38513232 DOI: 10.1002/smtd.202301257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/26/2024] [Indexed: 03/23/2024]
Abstract
Single crystals of (001)-oriented 0.7Pb(Mg1/3Nb2/3)-0.3PbTiO3 (PMN-30PT) with a composition near the morphotropic phase boundary have attracted considerable attention due to their superior dielectric and electromechanical performance. Recently, a new alternating current (electric field) poling approach used for the enhancement of dielectric and piezoelectric properties. However, the microscopic domain variants that govern the performance, especially under high-frequency alternating current (AC) voltages, remain largely unexplored. In this work, the domain microstructure under AC poling reveals the presence of four monoclinic (MA) domain variants using a suite of scanning probe microscopy methods, and X-ray diffraction (XRD) reciprocal space mapping is tuned. It is reported on the emergence of hierarchical fine domains - needle-shaped, and 109° domain walls under applied high-frequency AC poling. Time-resolved Kelvin probe force microscopy (KPFM) reveals the charge dynamics and relaxation behavior of these needle domains and walls. The findings provide new insight and guidance to the domain engineering by high-frequency AC poling for the development of advanced transducer technology.
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Affiliation(s)
- Dawei Zhang
- School of Materials Science and Engineering, UNSW Sydney, Sydney, New South Wales, 2052, Australia
- ARC Centre of Excellence in Future Low-Energy Electronics Technologies, UNSW Sydney, Sydney, New South Wales, 2052, Australia
| | - Linglong Li
- Key Laboratory of Quantum Materials and Devices of Ministry of Education, School of Physics, Southeast University, Nanjing, 211189, China
| | - Lei Wang
- School of Materials Science and Engineering, UNSW Sydney, Sydney, New South Wales, 2052, Australia
| | - Daniel Sando
- School of Materials Science and Engineering, UNSW Sydney, Sydney, New South Wales, 2052, Australia
- ARC Centre of Excellence in Future Low-Energy Electronics Technologies, UNSW Sydney, Sydney, New South Wales, 2052, Australia
- School of Physical and Chemical Sciences, University of Canterbury, Christchurch, 8410, New Zealand
| | - Pankaj Sharma
- College of Science and Engineering, Flinders University, Bedford Park, Adelaide, South Australia, 5042, Australia
| | - Jan Seidel
- School of Materials Science and Engineering, UNSW Sydney, Sydney, New South Wales, 2052, Australia
- ARC Centre of Excellence in Future Low-Energy Electronics Technologies, UNSW Sydney, Sydney, New South Wales, 2052, Australia
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Riley BJ, Lawn S, Crisp BR, Battersby M. Much Ado About Nothing? The Role of Land-Based Gambling Venue Employees in Facilitating Problem Gambling Harm Reduction and Help-Seeking. J Gambl Stud 2024; 40:387-408. [PMID: 37341840 PMCID: PMC10904429 DOI: 10.1007/s10899-023-10226-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/22/2023]
Abstract
Over the past decade, greater emphasis has been placed on the role of the land-based gambling industry to respond to problem gambling behaviour in their venues. Despite this, there is a lack of clear information advising best practice responses by gambling venue employees. This article reviews strategies, practices, and policies employed by land-based gambling venues concerning their employees' role in preventing gambling-related harm and responding to problem gambling behaviours. A systematic search strategy was applied to source peer-reviewed literature which identified 49 articles. The synthesised results were arranged and presented across five categories: (1) the identification of gamblers with potential problems in the venue; (2) gambling venue staff responses to gamblers with potential problems; (3) gamblers' perspectives around venue responsibilities and interactions with gamblers with potential problems; (4) corporate social responsibility programs and the identification of gamblers with problems in the venue; and (5) gambling venue staff needs. The results suggest that most activity performed by venue staff concerning their response to problem gambling is limited to observing and documenting risky behaviours and then discussing this internally with other venue staff. Action which moves beyond this, such as approaching and interacting with identified gamblers of concern, rarely occurs. The results of this review suggest that a focus on the identification and intervention specifically with identified gamblers of concern is a particularly unhelpful aspect of the role of venue staff. The results also indicate that a re-thinking of the role frontline staff play in addressing problem gambling is necessary.
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Affiliation(s)
- Ben J Riley
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Beth R Crisp
- Faculty of Health, School of Health & Soc. Dev., Deakin University, Geelong, VIC, Australia
| | - Malcolm Battersby
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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12
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Mangoni AA, Zinellu A. A systematic review and meta-analysis of circulating adhesion molecules in rheumatoid arthritis. Inflamm Res 2024; 73:305-327. [PMID: 38240792 PMCID: PMC10894129 DOI: 10.1007/s00011-023-01837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/18/2023] [Accepted: 12/12/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The availability of robust biomarkers of endothelial activation might enhance the identification of subclinical atherosclerosis in rheumatoid arthritis (RA). We investigated this issue by conducting a systematic review and meta-analysis of cell adhesion molecules in RA patients. METHODS We searched electronic databases from inception to 31 July 2023 for case-control studies assessing the circulating concentrations of immunoglobulin-like adhesion molecules (vascular cell, VCAM-1, intercellular, ICAM-1, and platelet endothelial cell, PECAM-1, adhesion molecule-1) and selectins (E, L, and P selectin) in RA patients and healthy controls. Risk of bias and certainty of evidence were assessed using the JBI checklist and GRADE, respectively. RESULTS In 39 studies, compared to controls, RA patients had significantly higher concentrations of ICAM-1 (standard mean difference, SMD = 0.81, 95% CI 0.62-1.00, p < 0.001; I2 = 83.0%, p < 0.001), VCAM-1 (SMD = 1.17, 95% CI 0.73-1.61, p < 0.001; I2 = 95.8%, p < 0.001), PECAM-1 (SMD = 0.82, 95% CI 0.57-1.08, p < 0.001; I2 = 0.0%, p = 0.90), E-selectin (SMD = 0.64, 95% CI 0.42-0.86, p < 0.001; I2 = 75.0%, p < 0.001), and P-selectin (SMD = 1.06, 95% CI 0.50-1.60, p < 0.001; I2 = 84.8%, p < 0.001), but not L-selectin. In meta-regression and subgroup analysis, significant associations were observed between the effect size and use of glucocorticoids (ICAM-1), erythrocyte sedimentation rate (VCAM-1), study continent (VCAM-1, E-selectin, and P-selectin), and matrix assessed (P-selectin). CONCLUSIONS The results of our study support a significant role of cell adhesion molecules in mediating the interplay between RA and atherosclerosis. Further studies are warranted to determine whether the routine use of these biomarkers can facilitate the detection and management of early atherosclerosis in this patient group. PROSPERO Registration Number: CRD42023466662.
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Affiliation(s)
- Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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13
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Sharma P, Brown S, Sokoya EM. Re-evaluation of dietary interventions in rheumatoid arthritis: can we improve patient conversations around food choices? Rheumatol Int 2024:10.1007/s00296-024-05541-4. [PMID: 38376558 DOI: 10.1007/s00296-024-05541-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
Rheumatoid arthritis (RA) is one of over 100 different types of autoimmune conditions. In RA, the cells of the immune system attack the tissue lining the joints, triggering inflammation. A large body of research suggests that the underlying trigger(s) of RA are unique to an individual. For example, increased risk of RA can be driven by smoking tobacco in one individual and mercury exposure in another. Due to the development of next-generation sequencing technology, the critical role of the microbiota in shaping RA risk has been elucidated. Therefore, it is surprising that diet, arguably the most important lever in shaping the gut microbiota, is ineffective in the treatment of RA, even in a sub-set of patients. To attempt to rationalise this apparent paradox, we conducted an umbrella review to address the question as to whether diet can affect outcomes in RA.
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Affiliation(s)
- Prakriti Sharma
- College of Medicine and Public Health, Flinders University, Flinders Health and Medical Research Institute, Adelaide, SA, Australia
| | - Shannon Brown
- Flinders University Library, Adelaide, SA, Australia
| | - Elke M Sokoya
- College of Medicine and Public Health, Flinders University, Flinders Health and Medical Research Institute, Adelaide, SA, Australia.
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14
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Bulamu NB, Chen G, McGrane E, Cock C, Young GP, Symonds EL. Health utility assessments in individuals undergoing diagnostic and surveillance colonoscopy: improved discrimination with a cancer-specific scale. Cancer Causes Control 2024; 35:347-357. [PMID: 37747615 PMCID: PMC10787680 DOI: 10.1007/s10552-023-01789-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE To compare the sensitivity and discriminant validity of generic and cancer-specific measures for assessing health-related quality of life (HRQoL) for individuals undergoing diagnostic or surveillance colonoscopy for colorectal cancer. METHODS HRQoL was assessed using EQ-5D-5L (generic), and EORTC QLQ-C30 (cancer-specific) scales, 14 days after (baseline) and one-year following colonoscopy (follow-up). Utility scores were calculated by mapping EORTC-QLQ-C30 onto QLU-C10D. Differences between participants with different indications for colonoscopy (positive faecal occult blood test (FOBT), surveillance, or symptoms) and colonoscopy findings (no polyps, polyps, or cancer) were tested using Wilcoxon-Mann-Whitney and Kruskal-Wallis H tests. Sensitivity was assessed by calculating the ceiling effects (proportion reporting the best possible level). RESULTS 246 adults completed the survey, including those undergoing colonoscopy for symptoms (n = 87), positive FOBT (n = 92) or surveillance (n = 67). Those with symptoms had the lowest HRQoL at both baseline and follow-up, with differences observed within the HRQoL domains/areas of role function, appetite loss and bowel function on the QLU-C10D. No differences were found in HRQoL when stratified by findings at colonoscopy with both measures or when comparing baseline and follow-up responses. Participants reporting full health with EQ-5D-5L (21% at baseline and 16% at follow-up) still had problems on the QLU-C10D, with fatigue and sleep at baseline and with role function and fatigue at follow-up. CONCLUSION Patients undergoing colonoscopy for symptoms had lower HRQoL compared to surveillance or positive FOBT. The cancer-specific QLU-C10D was more sensitive and had greater discriminant ability between patients undergoing colonoscopy for different indications.
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Affiliation(s)
- Norma B Bulamu
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
| | - Gang Chen
- Monash Business School, Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | - Ellen McGrane
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Charles Cock
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Gastroenterology Department, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Graeme P Young
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Erin L Symonds
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Gastroenterology Department, Flinders Medical Centre, Adelaide, South Australia, Australia
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15
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Mangoni AA, Zinellu A. The diagnostic role of the systemic inflammation index in patients with immunological diseases: a systematic review and meta-analysis. Clin Exp Med 2024; 24:27. [PMID: 38285324 PMCID: PMC10824868 DOI: 10.1007/s10238-024-01294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
The identification of novel, easily measurable biomarkers of inflammation might enhance the diagnosis and management of immunological diseases (IDs). We conducted a systematic review and meta-analysis to investigate an emerging biomarker derived from the full blood count, the systemic inflammation index (SII), in patients with IDs and healthy controls. We searched Scopus, PubMed, and Web of Science from inception to 12 December 2023 for relevant articles and evaluated the risk of bias and the certainty of evidence using the Joanna Briggs Checklist and the Grades of Recommendation, Assessment, Development, and Evaluation Working Group system, respectively. In 16 eligible studies, patients with IDs had a significantly higher SII when compared to controls (standard mean difference, SMD = 1.08, 95% CI 0.75 to 1.41, p < 0.001; I2 = 96.2%, p < 0.001; moderate certainty of evidence). The pooled area under the curve (AUC) for diagnostic accuracy was 0.85 (95% CI 0.82-0.88). In subgroup analysis, the effect size was significant across different types of ID, barring systemic lupus erythematosus (p = 0.20). In further analyses, the SII was significantly higher in ID patients with active disease vs. those in remission (SMD = 0.81, 95% CI 0.34-1.27, p < 0.001; I2 = 93.6%, p < 0.001; moderate certainty of evidence). The pooled AUC was 0.74 (95% CI 0.70-0.78). Our study suggests that the SII can effectively discriminate between subjects with and without IDs and between ID patients with and without active disease. Prospective studies are warranted to determine whether the SII can enhance the diagnosis of IDs in routine practice. (PROSPERO registration number: CRD42023493142).
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Affiliation(s)
- Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Bedford ParkAdelaide, SA, 5042, Australia.
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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16
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Bulto LN, Roseleur J, Noonan S, Pinero de Plaza MA, Champion S, Dafny HA, Pearson V, Nesbitt K, Gebremichael LG, Beleigoli A, Gulyani A, Schultz T, Hines S, Clark RA, Hendriks JM. Effectiveness of nurse-led interventions versus usual care to manage hypertension and lifestyle behaviour: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2024; 23:21-32. [PMID: 37130339 DOI: 10.1093/eurjcn/zvad040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023]
Abstract
AIMS This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients' knowledge of hypertension and associated risk factors. METHODS A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. RESULTS A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference -4.66; 95% CI -6.69, -2.64; I2 = 83.32; 31 RCTs; low certainty evidence) and diastolic blood pressure (mean difference -1.91; 95% CI -3.06, -0.76; I2 = 79.35; 29 RCTs; low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. CONCLUSION This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. REGISTRATION PROSPERO: CRD42021274900.
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Affiliation(s)
- Lemma N Bulto
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jacqueline Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Sara Noonan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Stephanie Champion
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Hila Ariela Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Vincent Pearson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Katie Nesbitt
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Lemlem G Gebremichael
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Alline Beleigoli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Aarti Gulyani
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Timothy Schultz
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, 5005, SA, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Flinders Rural and Remote Health, NT. College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
| | - Robyn A Clark
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, 5042, SA, Australia
- Mparntwe Centre for Evidence in Health, A JBI Centre of Excellence, Flinders University, 5 Skinner Street, East Wing, 4066, Alice Springs, Northern Territory, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, 5001, SA, Australia
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17
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Pinczel AJ, Woods CM, Catcheside PG, Woodman RJ, Carney AS, Chai-Coetzer CL, Chia M, Cistulli PA, Hodge JC, Jones A, Lam ME, Lewis R, McArdle N, Ooi EH, Rea SC, Rees G, Singh B, Stow N, Yeo A, Antic N, McEvoy RD, Weaver EM, MacKay SG. Sleep apnea multi-level surgery trial: long-term observational outcomes. Sleep 2024; 47:zsad218. [PMID: 37607039 DOI: 10.1093/sleep/zsad218] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 08/02/2023] [Indexed: 08/24/2023] Open
Abstract
STUDY OBJECTIVES The sleep apnea multi-level surgery (SAMS) randomized clinical trial showed surgery improved outcomes at 6 months compared to ongoing medical management in patients with moderate or severe obstructive sleep apnea (OSA) who failed continuous positive airway pressure therapy. This study reports the long-term outcomes of the multi-level surgery as a case series. METHODS Surgical participants were reassessed >2 years postoperatively with the same outcomes reported in the main SAMS trial. Primary outcomes were apnea-hypopnea index (AHI) and Epworth sleepiness scale (ESS), with secondary outcomes including other polysomnography measures, symptoms, quality of life, and adverse events. Long-term effectiveness (baseline to long-term follow-up [LTFU]) and interval changes (6 month to LTFU) were assessed using mixed effects regression models. Control participants were also reassessed for rate of subsequent surgery and outcomes. RESULTS 36/48 (75%) of surgical participants were reevaluated (mean (standard deviation)) 3.5 (1.0) years following surgery, with 29 undergoing polysomnography. AHI was 41/h (23) at preoperative baseline and 21/h (18) at follow-up, representing persistent improvement of -24/h (95% CI -32, -17; p < 0.001). ESS was 12.3 (3.5) at baseline and 5.5 (3.9) at follow-up, representing persistent improvement of -6.8 (95% CI -8.3, -5.4; p < 0.001). Secondary outcomes were improved long term, and adverse events were minor. Interval change analysis suggests stability of outcomes. 36/43 (84%) of the control participants were reevaluated, with 25 (69%) reporting subsequent surgery, with symptom and quality of life improvements. CONCLUSION Multi-level upper airway surgery improves OSA burden with long-term maintenance of treatment effect in adults with moderate or severe OSA in whom conventional therapy failed. CLINICAL TRIAL Multi-level airway surgery in patients with moderate-severe obstructive sleep apnea (OSA) who have failed medical management to assess change in OSA events and daytime sleepiness; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366019&isReview=true; ACTRN12614000338662.
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Affiliation(s)
- Alison J Pinczel
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Charmaine M Woods
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Peter G Catcheside
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Richard J Woodman
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Andrew Simon Carney
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Southern ENT and Adelaide Sinus Centre, Flinders Private Hospital, Adelaide, SA, Australia
| | - Ching Li Chai-Coetzer
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
- Respiratory and Sleep Service, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Michael Chia
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Peter A Cistulli
- Charles Perkins Centre, Faculty for Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
| | - John-Charles Hodge
- Ear Nose and Throat Department, Royal Adelaide Hospital, Adelaide, SA, Australia
- ICON Cancer Centre, Adelaide, SA, Australia
- Department of Surgery, University of Adelaide, Adelaide, SA, Australia
| | - Andrew Jones
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- Illawarra Sleep Medicine Centre, Wollongong, NSW, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Matthew E Lam
- Illawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia
| | - Richard Lewis
- Head and Neck Surgery, Hollywood Medical Centre, Perth, WA, Australia
- Department of Otolaryngology, Royal Perth Hospital, Perth, WA, Australia
| | - Nigel McArdle
- West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Eng H Ooi
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, SA, Australia
- Adelaide ENT Surgery, Flinders Private Hospital, Adelaide, SA, Australia
| | - Siobhan Clare Rea
- West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia
| | - Guy Rees
- ENT Surgeons, Memorial Hospital, North Adelaide, SA, Australia
- Department of Surgery, University of Adelaide, Adelaide, SA, Australia
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Faculty of Human Sciences, University of Western Australia, Perth, WA, Australia
| | - Nicholas Stow
- Sydney Centre for Ear, Nose and Throat, Sydney, NSW, Australia
- Sleep Clinic, The Woolcock Clinic, Glebe, NSW, Australia
| | - Aeneas Yeo
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Nick Antic
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
| | - Ronald Doug McEvoy
- Adelaide Institute for Sleep Health, FHMRI Sleep Health, Flinders University, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Edward M Weaver
- Department of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle, WA, USA
- Surgery Service, Seattle Veterans Affairs Medical Center, Seattle, WA, USA
| | - Stuart G MacKay
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- Illawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia
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18
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Manners J, Kemps E, Guyett A, Stuart N, Lechat B, Catcheside P, Scott H. Estimating vigilance from the pre-work shift sleep using an under-mattress sleep sensor. J Sleep Res 2024:e14138. [PMID: 38185773 DOI: 10.1111/jsr.14138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
Predicting vigilance impairment in high-risk shift work occupations is critical to help to reduce workplace errors and accidents. Current methods rely on multi-night, often manually entered, sleep data. This study developed a machine learning model for predicting vigilance errors based on a single prior sleep period, derived from an under-mattress sensor. Twenty-four healthy volunteers (mean [SD] age = 27.6 [9.5] years, 12 male) attended the laboratory on two separate occasions, 1 month apart, to compare wake performance and sleep under two different lighting conditions. Each condition occurred over an 8 day protocol comprising a baseline sleep opportunity from 10 p.m. to 7 a.m., a 27 h wake period, then daytime sleep opportunities from 10 a.m. to 7 p.m. on days 3-7. From 12 a.m. to 8 a.m. on each of days 4-7, participants completed simulated night shifts that included six 10 min psychomotor vigilance task (PVT) trials per shift. Sleep was assessed using an under-mattress sensor. Using extra-trees machine learning models, PVT performance (reaction times <500 ms, reaction, and lapses) during each night shift was predicted based on the preceding daytime sleep. The final extra-trees model demonstrated moderate accuracy for predicting PVT performance, with standard errors (RMSE) of 19.9 ms (reaction time, 359 [41.6]ms), 0.42 reactions/s (reaction speed, 2.5 [0.6] reactions/s), and 7.2 (lapses, 10.5 [12.3]). The model also correctly classified 84% of trials containing ≥5 lapses (Matthews correlation coefficient = 0.59, F1 = 0.83). Model performance is comparable to current fatigue prediction models that rely upon self-report or manually entered data. This efficient approach may help to manage fatigue and safety in non-standard work schedules.
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Affiliation(s)
- Jack Manners
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia
| | - Eva Kemps
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia
| | - Alisha Guyett
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Nicole Stuart
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia
| | - Bastien Lechat
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
| | - Peter Catcheside
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
| | - Hannah Scott
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, Australia
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McCaffrey N, Ratcliffe J, Currow D, Engel L, Hutchinson C. What Aspects of Quality of Life are Important from Palliative Care Patients' Perspectives? A Framework Analysis to Inform Preference-Based Measures for Palliative and End-of-Life Settings. Patient 2024; 17:39-52. [PMID: 37975965 DOI: 10.1007/s40271-023-00651-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Preference-based outcome measures are commonly applied in economic analyses to inform healthcare resource allocation decisions. Few preference-based outcome measures have been specifically developed for palliative and end-of-life settings. This study aimed to identify which quality-of-life domains are most important to Australians receiving specialised palliative care services to help determine if the development of a new condition-specific preference-based outcome measure is warranted. METHODS In-depth face-to-face interviews were conducted with 18 participants recruited from palliative care services in South Australia. Data were analysed using a framework analysis drawing on findings from a systematic review of international qualitative studies investigating the quality-of-life preferences of patients receiving palliation (domains identified included cognitive, emotional, healthcare, personal autonomy, physical, preparatory, social, spiritual). Participants identified missing or irrelevant domains in the EQ-5D and QLU-C10D questionnaires and ranked the importance of domains. RESULTS A priori domains were refined into cognitive, environmental, financial, independence, physical, psychological, social and spiritual. The confirmation of the eight important quality-of-life domains across multiple international studies suggests there is a relatively high degree of convergence on the perspectives of patients in different countries. Four domains derived from the interviews are not covered by the EQ-5D and QLU-C10D (cognitive, environmental, financial, spiritual), including one of the most important (spiritual). CONCLUSIONS Existing, popular, preference-based outcome measures such as the EQ-5D do not incorporate the most important, patient-valued, quality-of-life domains in the palliative and end-of-life settings. Development of a new, more relevant and comprehensive preference-based outcome measure could improve the allocation of resources to patient-valued services and have wide applicability internationally.
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Affiliation(s)
- Nikki McCaffrey
- Institute for Health Transformation, Deakin Health Economics, SHSD, Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - David Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Claire Hutchinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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20
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McMillen A, Chew Y. Neural mechanisms of dopamine function in learning and memory in Caenorhabditis elegans. Neuronal Signal 2024; 8:NS20230057. [PMID: 38572143 PMCID: PMC10987485 DOI: 10.1042/ns20230057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 04/05/2024] Open
Abstract
Research into learning and memory over the past decades has revealed key neurotransmitters that regulate these processes, many of which are evolutionarily conserved across diverse species. The monoamine neurotransmitter dopamine is one example of this, with countless studies demonstrating its importance in regulating behavioural plasticity. However, dopaminergic neural networks in the mammalian brain consist of hundreds or thousands of neurons, and thus cannot be studied at the level of single neurons acting within defined neural circuits. The nematode Caenorhabditis elegans (C. elegans) has an experimentally tractable nervous system with a completely characterized synaptic connectome. This makes it an advantageous system to undertake mechanistic studies into how dopamine encodes lasting yet flexible behavioural plasticity in the nervous system. In this review, we synthesize the research to date exploring the importance of dopaminergic signalling in learning, memory formation, and forgetting, focusing on research in C. elegans. We also explore the potential for dopamine-specific fluorescent biosensors in C. elegans to visualize dopaminergic neural circuits during learning and memory formation in real-time. We propose that the use of these sensors in C. elegans, in combination with optogenetic and other light-based approaches, will further illuminate the detailed spatiotemporal requirements for encoding behavioural plasticity in an accessible experimental system. Understanding the key molecules and circuit mechanisms that regulate learning and forgetting in more compact invertebrate nervous systems may reveal new druggable targets for enhancing memory storage and delaying memory loss in bigger brains.
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Affiliation(s)
- Anna McMillen
- College of Medicine and Public Health and Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
| | - Yee Lian Chew
- College of Medicine and Public Health and Flinders Health and Medical Research Institute, Flinders University, Bedford Park, 5042, South Australia, Australia
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21
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Milte R, Crocker M, Lay K, Ratcliffe J, Mulhern B, Norman R, Viney R, Khadka J. Feasibility of self-reported health related quality of life assessment with older people in residential care: insights from the application of eye tracking technology. Qual Life Res 2023; 32:3557-3569. [PMID: 37474850 PMCID: PMC10624716 DOI: 10.1007/s11136-023-03488-w] [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] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging individuals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment. METHODS Residents (n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated. RESULTS For all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally. CONCLUSIONS This exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent.
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Affiliation(s)
- Rachel Milte
- Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Matthew Crocker
- Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Kiri Lay
- Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Richard Norman
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jyoti Khadka
- Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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22
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Milte R, Jemere D, Lay K, Hutchinson C, Thomas J, Murray J, Ratcliffe J. A scoping review of the use of visual tools and adapted easy-read approaches in Quality-of-Life instruments for adults. Qual Life Res 2023; 32:3291-3308. [PMID: 37344727 PMCID: PMC10624740 DOI: 10.1007/s11136-023-03450-w] [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] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Self-Reporting using traditional text-based Quality-of-Life (QoL) instruments can be difficult for people living with sensory impairments, communication challenges or changes to their cognitive capacity. Adapted communication techniques, such as Easy-Read techniques, or use of pictures could remove barriers to participation for a wide range of people. This review aimed to identify published studies reporting adapted communication approaches for measuring QoL, the methodology used in their development and validation among adult populations. METHODS A scoping review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist was undertaken. RESULTS The initial search strategy identified 13,275 articles for screening, with 264 articles identified for full text review. Of these 243 articles were excluded resulting in 21 studies for inclusion. The majority focused on the development of an instrument (12 studies) or a combination of development with some aspect of validation or psychometric testing (7 studies). Nineteen different instruments were identified by the review, thirteen were developed from previously developed generic or condition-specific quality of life instruments, predominantly aphasia (7 studies) and disability (4 studies). Most modified instruments included adaptations to both the original questions, as well as the response categories. CONCLUSIONS Studies identified in this scoping review demonstrate that several methods have been successfully applied e.g. with people living with aphasia post-stroke and people living with a disability, which potentially could be adapted for application with more diverse populations. A cohesive and interdisciplinary approach to the development and validation of communication accessible versions of QOL instruments, is needed to support widespread application, thereby reducing reliance on proxy assessors and promoting self-assessment of QOL across multiple consumer groups and sectors.
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Affiliation(s)
- Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Digisie Jemere
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Kiri Lay
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Claire Hutchinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Jolene Thomas
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Joanne Murray
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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Abstract
The vaping industry has been found to employ similar tactics to tobacco industry actors to seek credibility and distort the scientific evidence base around the health harms of nicotine vaping products. As vaping industry interests undermine vaping control efforts, safeguards are necessary to protect against this influence. We aimed to examine health organizations' policies on vaping industry participation in their activities in Australia. A descriptive approach integrating policy analysis and key informant surveys was used to obtain vaping industry participation information from health research stakeholders. Descriptive statistics on organization type, policy document type, policy document industry focus (tobacco or vaping) and respondent role and responsibility were collected. We used framework analysis to identify themes describing organizational allowances, constraints, and rationale for vaping industry research participation. Relevant health organizations were identified within Australia for policy searching (n = 156), which identified 47 unique policy documents. After contacting 267 key stakeholders from eligible organizations, 31 survey responses were analysed. Research organizations and universities were highly represented in both the policy and survey data. Most health research stakeholders recognized that vaping industry interests counteract public health priorities and opposed vaping industry participation. However, many organizations lacked clear, vaping industry-specific participation policies. To protect the integrity of the emerging evidence base around vaping harms which inform vaping policy, health organizations require strong, comprehensive policies to resist vaping industry participation in research.
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Affiliation(s)
- Isabelle Haklar
- College of Medicine & Public Health, Flinders University, Kaurna (Bedford Park), South Australia 5042, Australia
| | - Jacqueline Stephens
- College of Medicine & Public Health, Flinders University, Kaurna (Bedford Park), South Australia 5042, Australia
- Flinders Health and Medical Research Institute, Kaurna (Bedford Park), South Australia 5042, Australia
| | - Jacqueline Bowden
- College of Medicine & Public Health, Flinders University, Kaurna (Bedford Park), South Australia 5042, Australia
- National Centre for Education and Training on Addiction, Flinders University, Kaurna (Bedford Park), South Australia 5042, Australia
| | - Joshua Trigg
- College of Medicine & Public Health, Flinders University, Kaurna (Bedford Park), South Australia 5042, Australia
- Flinders Health and Medical Research Institute, Kaurna (Bedford Park), South Australia 5042, Australia
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24
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Riley BJ, Li L, Plevin D, Baigent M. Betting on Australian Rules Football: Can Expert Tipsters beat Randomness? J Gambl Stud 2023; 39:1537-1546. [PMID: 37544961 PMCID: PMC10627876 DOI: 10.1007/s10899-023-10244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/08/2023]
Abstract
Betting on the various codes of football in Australia accounts for the majority of sports betting, with Australian rules football (AFL) by far the most popular sport in Australia. Several studies have revealed the heavy presence of gambling advertising during AFL broadcasts, and a frequently used advertising strategy involves the use of well-known AFL commentators outlining their tips and betting suggestions. To date, no research has examined the hypotheses that skill may help in predicting AFL matches and monetary outcomes from AFL betting. Rather than merely discounting such ideas, it is important to test them empirically. The aims of this study were therefore, to examine if (1) expert AFL tipsters made better predictions than random picks, (2) expert AFL tipsters gained greater monetary reward than random selection, and (3) expert tipsters' prediction accuracy improved with betting experience. To this end, six seasons of AFL matches, odds data, and expert tipster data were analysed retrospectively, totalling 1141 matches. Random selections were calculated for each match using an inbuilt random number generator within Microsoft Excel and a $2 simulated wager was applied for each AFL match. The results of mixed-effects modelling showed that experts picked more correct outcomes than random selection; experts' correct predictions were partially mediated by home-game selections; no difference in monetary outcome was observed for experts compared to random selection; experts' predictions did not improve over time. The results of this study may be used to inform both psychological interventions that target gamblers' illusions of control, and public health gambling harm prevention messaging.
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Affiliation(s)
- Ben J Riley
- College of Medicine and Public Health, Flinders University, South, Australia.
| | - Lee Li
- College of Medicine and Public Health, Flinders University, South, Australia
| | - David Plevin
- Adelaide Medical School Discipline of Psychiatry Adelaide University, South, Australia
| | - Michael Baigent
- College of Medicine and Public Health, Flinders University, South, Australia
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25
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Karunakaran M, Roulin D, Ullah S, Shrikhande SV, De Boer HD, Demartines N, Barreto SG. Global Perceptions on ERAS ® in Pancreatoduodenectomy. World J Surg 2023; 47:2977-2989. [PMID: 37787776 PMCID: PMC10694106 DOI: 10.1007/s00268-023-07198-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Uptake of ERAS® pathways for pancreatic surgery have been slow and impacted by low compliance. OBJECTIVE To explore global awareness, perceptions and practice of ERAS® peri-pancreatoduodenectomy (PD). METHODS A structured, web-based survey (EPSILON) was administered through the ERAS® society and IHPBA membership. RESULTS The 140 respondents included predominantly males (86.4%), from Europe (45%), practicing surgery (95%) at academic/teaching hospitals (63.6%) over a period of 10-20 years (38.6%). Most respondents identified themselves as general surgeons (68.6%) with 40.7% reporting an annual PD volume of 20-50 cases, practicing post-PD clinical pathways (37.9%), with 31.4% of respondents auditing their outcomes annually. Reduced medical complications, cost and hospital length of stay, and improved patient satisfaction were perceived benefits of compliance to enhancing-recovery. Multidisciplinary co-ordination was considered the most important factor in the implementation and sustainability of peri-PD ERAS® pathways, while reluctance to change among health care practitioners, difficulties in data collection and audit, lack of administrative support, and recruitment of an ERAS® dedicated nurse were reported to be important barriers. CONCLUSIONS The EPSILON survey highlighted global clinician perceptions regarding the benefits of compliance to peri-PD ERAS®, the importance of individual components, perceived facilitators and barriers, to the implementation and sustainability of these pathways.
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Affiliation(s)
- Monish Karunakaran
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, 500 032, India
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Didier Roulin
- Department of Visceral Surgery, Lausanne University Hospital CHUV and University of Lausanne UNIL, 1011, Lausanne, Switzerland
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Shailesh V Shrikhande
- Department of Gastrointestinal and HPB Surgical Oncology, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai, 400085, India
| | - Hans D De Boer
- Department of Anesthesiology, Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital Groningen, Groningen, The Netherlands
| | - Nicolas Demartines
- Department of Visceral Surgery, Lausanne University Hospital CHUV and University of Lausanne UNIL, 1011, Lausanne, Switzerland.
| | - Savio George Barreto
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, 500 032, India.
- Division of Surgery and Perioperative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, 5042, Australia.
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26
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Roseleur J, Edney LC, Jung J, Karnon J. Prevalence of unmet supportive care needs reported by individuals ever diagnosed with cancer in Australia: a systematic review to support service prioritisation. Support Care Cancer 2023; 31:676. [PMID: 37934313 PMCID: PMC10630245 DOI: 10.1007/s00520-023-08146-y] [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: 07/08/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Improved health outcomes for individuals ever diagnosed with cancer require comprehensive, coordinated care that addresses their supportive care needs. Implementing interventions to address these is confounded by a lack of evidence on population needs and a large pool of potential interventions. This systematic review estimates the point prevalence of different supportive care needs stratified by the tool used to measure needs and cancer type in Australia. METHODS We searched MEDLINE, Embase, and Scopus from 2010 to April 2023 to identify relevant studies published on the prevalence of supportive care needs in Australia. RESULTS We identified 35 studies that met the inclusion criteria. The highest prevalent unmet need across all cancers was 'fear of cancer spreading' (20.7%) from the Supportive Care Needs Survey Short-Form 34 (SCNS-SF34), ranging from 9.4% for individuals ever diagnosed with haematological cancer to 36.3% for individuals ever diagnosed with gynaecological cancer, and 'concerns about cancer coming back' (17.9%) from the Cancer Survivors' Unmet Needs (CaSUN), ranging from 9.7% for individuals ever diagnosed with prostate cancer to 37.8% for individuals ever diagnosed with breast cancer. Two studies assessed needs in Aboriginal and Torres Strait Islander populations, reporting the highest needs for financial worries (21.1%). CONCLUSIONS Point prevalence estimates presented here, combined with estimates of the costs and effects of potential interventions, can be used within economic evaluations to inform evidence-based local service provision to address the supportive care needs of individuals ever diagnosed with cancer. IMPLICATIONS FOR CANCER SURVIVORS Local health services can use local evidence to prioritise the implementation of interventions targeted at unmet needs.
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Affiliation(s)
- Jackie Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Laura Catherine Edney
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jayda Jung
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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27
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Dubowsky M, Theunissen F, Carr JM, Rogers ML. The Molecular Link Between TDP-43, Endogenous Retroviruses and Inflammatory Neurodegeneration in Amyotrophic Lateral Sclerosis: a Potential Target for Triumeq, an Antiretroviral Therapy. Mol Neurobiol 2023; 60:6330-6345. [PMID: 37450244 PMCID: PMC10533598 DOI: 10.1007/s12035-023-03472-y] [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: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is a progressive neurological disorder, characterised by the death of upper and lower motor neurons. The aetiology of ALS remains unknown, and treatment options are limited. Endogenous retroviruses (ERVs), specifically human endogenous retrovirus type K (HERV-K), have been proposed to be involved in the propagation of neurodegeneration in ALS. ERVs are genomic remnants of ancient viral infection events, with most being inactive and not retaining the capacity to encode a fully infectious virus. However, some ERVs retain the ability to be activated and transcribed, and ERV transcripts have been found to be elevated within the brain tissue of MND patients. A hallmark of ALS pathology is altered localisation of the transactive response (TAR) DNA binding protein 43 kDa (TDP-43), which is normally found within the nucleus of neuronal and glial cells and is involved in RNA regulation. In ALS, TDP-43 aggregates within the cytoplasm and facilitates neurodegeneration. The involvement of ERVs in ALS pathology is thought to occur through TDP-43 and neuroinflammatory mediators. In this review, the proposed involvement of TDP-43, HERV-K and immune regulators on the onset and progression of ALS will be discussed. Furthermore, the evidence supporting a therapy based on targeting ERVs in ALS will be reviewed.
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Affiliation(s)
- Megan Dubowsky
- College of Medicine and Public Health and Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia.
| | - Frances Theunissen
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, WA, Australia
| | - Jillian M Carr
- College of Medicine and Public Health and Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Mary-Louise Rogers
- College of Medicine and Public Health and Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
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28
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Khanna D, Khadka J, Mpundu-Kaambwa C, Ratcliffe J. Child-Parent Agreement in the Assessment of Health-Related Quality of Life Using the CHU9D and the PedsQL TM. Appl Health Econ Health Policy 2023; 21:937-947. [PMID: 37773319 PMCID: PMC10627990 DOI: 10.1007/s40258-023-00831-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE This study examined the inter-rater agreement between child-self and parental proxy health-related quality of life (HRQoL) ratings (overall and domain level) using two different generic child-specific measures, the Child Health Utility 9D (CHU9D) and the Pediatric Quality of Life Inventory (PedsQLTM), in a community-based sample of Australian children. A secondary objective was to investigate the impact of age on child-parent agreement across the dimensions of the two measures. METHODS A total of 85 child-parent dyads (children aged 6-12 years) recruited from the community completed the self and proxy versions of the CHU9D and the PedsQLTM, respectively. The inter-rater agreement was estimated using Concordance Correlation Coefficients (CCC) and Gwet's Agreement Coefficient (AC1) for the overall sample and across age-groups. RESULTS Agreement was low for overall HRQoL for both the CHU9D (CCC = 0.28) and the PedsQLTM (CCC = 0.39). Across the CHU9D dimensions, agreement was the highest for 'sad' (AC1 = 0.83) and lowest for 'tired' (AC1 = 0.31). The PedsQLTM demonstrated stronger agreement (AC1 = 0.41-0.6) for the physical health dimension but weaker for the psychosocial dimensions (AC1 < 0.4). Except for the 'tired' dimension, agreement was consistent across age-groups with the CHU9D, whilst the PedsQLTM showed poor agreement for most of the psychosocial health items among the older age-groups only (8-10 and 11-12 years). CONCLUSION This study highlights that the agreement between child and parent proxy reported HRQoL may be influenced by both the measure used and the age of the child. These findings may have implications for the economic evaluation of healthcare interventions and services in child populations when both child and proxy perspectives are considered in the assessment of child HRQoL.
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Affiliation(s)
- Diana Khanna
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
| | - Jyoti Khadka
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Registry of Senior Australians, Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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29
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Woodman RJ, Mangoni AA. A comprehensive review of machine learning algorithms and their application in geriatric medicine: present and future. Aging Clin Exp Res 2023; 35:2363-2397. [PMID: 37682491 PMCID: PMC10627901 DOI: 10.1007/s40520-023-02552-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 06/13/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
The increasing access to health data worldwide is driving a resurgence in machine learning research, including data-hungry deep learning algorithms. More computationally efficient algorithms now offer unique opportunities to enhance diagnosis, risk stratification, and individualised approaches to patient management. Such opportunities are particularly relevant for the management of older patients, a group that is characterised by complex multimorbidity patterns and significant interindividual variability in homeostatic capacity, organ function, and response to treatment. Clinical tools that utilise machine learning algorithms to determine the optimal choice of treatment are slowly gaining the necessary approval from governing bodies and being implemented into healthcare, with significant implications for virtually all medical disciplines during the next phase of digital medicine. Beyond obtaining regulatory approval, a crucial element in implementing these tools is the trust and support of the people that use them. In this context, an increased understanding by clinicians of artificial intelligence and machine learning algorithms provides an appreciation of the possible benefits, risks, and uncertainties, and improves the chances for successful adoption. This review provides a broad taxonomy of machine learning algorithms, followed by a more detailed description of each algorithm class, their purpose and capabilities, and examples of their applications, particularly in geriatric medicine. Additional focus is given on the clinical implications and challenges involved in relying on devices with reduced interpretability and the progress made in counteracting the latter via the development of explainable machine learning.
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Affiliation(s)
- Richard J Woodman
- Centre of Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, SA, Australia
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Barnett MI, Wassie MM, Cock C, Bampton PA, Symonds EL. Low Incidence of Colorectal Advanced Neoplasia During Surveillance in Individuals with a Family History of Colorectal Cancer. Dig Dis Sci 2023; 68:4243-4251. [PMID: 37682374 PMCID: PMC10570165 DOI: 10.1007/s10620-023-08053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/21/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Family history of colorectal cancer (CRC) is used to stratify individuals into risk categories which determine timing of initial screening and ongoing CRC surveillance. Evidence for long-term CRC risk following a normal index colonoscopy in family history populations is limited. AIMS To assess the incidence of advanced neoplasia and associated risk factors in a population undergoing surveillance colonoscopies due to family history of CRC. METHODS Surveillance colonoscopy findings were examined in 425 individuals with a family history of CRC, a normal index colonoscopy and a minimum of 10 years of follow-up colonoscopies. Advanced neoplasia risk was determined for three CRC family history categories (near-average, medium and high-risk), accounting for demographics and time after the first colonoscopy. RESULTS The median follow-up was 13.5 years (IQR 11.5-16.0), with an incidence of advanced neoplasia of 14.35% (61/425). The number of affected relatives and age of CRC diagnosis in the youngest relative did not predict the risk of advanced neoplasia (p > 0.05), with no significant differences in advanced neoplasia incidence between the family history categories (p = 0.16). Patients ≥ 60 years showed a fourfold (HR 4.14, 95% CI 1.33-12.89) higher advanced neoplasia risk during surveillance than those < 40 years at index colonoscopy. With each subsequent negative colonoscopy, the risk of advanced neoplasia at ongoing surveillance was reduced. CONCLUSIONS The incidence of advanced neoplasia was low (14.35%), regardless of the family history risk category, with older age being the main risk for advanced neoplasia. Delaying onset of colonoscopy or lengthening surveillance intervals could be a more efficient use of resources in this population.
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Affiliation(s)
| | - Molla M Wassie
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Charles Cock
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, SA, 5042, Australia
| | - Peter A Bampton
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Erin L Symonds
- Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
- Bowel Health Service, Flinders Medical Centre, Bedford Park, SA, 5042, Australia
- Level 3, Flinders Centre for Innovation in Cancer, Bedford Park, SA, 5042, Australia
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Lay K, Crocker M, Engel L, Ratcliffe J, Charlton S, Hutchinson C. How do older adults receiving aged care services understand and respond to the EQ-5D-5L? A think-aloud study in residential care. Qual Life Res 2023; 32:3161-3170. [PMID: 37386266 PMCID: PMC10522713 DOI: 10.1007/s11136-023-03466-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE The EQ-5D-5L is a preference-based instrument for measuring and valuing health-related quality of life (HRQoL). The EQ-5D-5L has been used extensively in economic evaluation, including in aged care. However, older adults' understanding of the EQ-5D-5L has not been comprehensively investigated to date. This research aimed to assess older adults' understanding of the EQ-5D-5L using a think-aloud protocol with two cognition groups: no cognitive impairment and mild/moderate cognitive impairment. METHODS Participants' cognition was assessed using the Standardised Mini-Mental State Examination (SMMSE). Face-to face interviews were conducted with concurrent and retrospective think-aloud encouraged through verbal probing. Audio recordings were transcribed, and qualitative analysis, informed by the Tourangeau four-stage Response Model (comprehension, retrieval, decision process, response process) was conducted in NVivo. RESULTS In total, 46 older adults (age 65 +) were recruited from 10 residential care facilities across South Australia (n = 25 no cognitive impairment, n = 21 mild/moderate cognitive impairment). Comprehension, retrieval, judgement and response mapping issues were common across all cognition levels and EQ-5D-5L dimensions. The two dimensions resulting in the most response issues were usual activities and personal care. CONCLUSION Older adults may bring a different understanding to the EQ-5D-5L descriptive system than that expected given testing with general population samples. Dimension descriptors that are more relevant to this population may facilitate responses that better align with the underlying EQ-5D-5L concept model.
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Affiliation(s)
- Kiri Lay
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Matthew Crocker
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Lidia Engel
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | | | - Claire Hutchinson
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
- Health Economics Division, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Kahn M, Irwin C, Pillion M, Whittall H, Fitton J, Sprajcer M, Gradisar M. Sleepless on the road: Are mothers of infants with insomnia at risk for impaired driving? J Sleep Res 2023:e14083. [PMID: 37904304 DOI: 10.1111/jsr.14083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/18/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
Infant sleep problems have been associated with a myriad of adverse child and parent outcomes, yet whether these problems may pose a risk for parents on the road has received little research attention. This study sought to test whether mothers of infants with insomnia are at an elevated risk for vehicular crashes, by comparing their objectively measured driving performance with that of mothers of well-sleeping infants and with that of women without children. Fifty-four women from these three groups completed a simulated driving task. Outcome measures included standard deviation of lateral position, number of lane crossings, standard deviation of speed, average speed and maximum speed. Women additionally reported on their driving behaviour using the Driving Behaviour Questionnaire, and on sleep, sleepiness and insomnia symptoms using 7-day sleep diaries and questionnaires. Mothers of infants with insomnia demonstrated greater lane deviation (Wald = 9.53, p = 0.009), higher maximum speed (Wald = 6.10, p = 0.04) and poorer self-rated driving behaviour (Wald = 7.44, p = 0.02) compared with control groups. Analyses also indicated that driving performance in mothers of infants with insomnia tended to be poorer relative to control groups with the progression of time on task. While further research is needed to assess the scope of these effects, our findings suggest that parents, healthcare providers and policymakers should be aware of the potential consequences of infant sleep problems on road safety, and collaborate to establish strategies to mitigate these risks.
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Affiliation(s)
- Michal Kahn
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Hannah Whittall
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Josh Fitton
- Flinders University, College of Education, Psychology and Social Work, Adelaide, Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University, Adelaide, Australia
| | - Michael Gradisar
- Wink Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
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Lawless MT, Archibald MM, Ambagtsheer RC, Pinero de Plaza MA, Kitson AL. My Wellbeing Journal: Development of a communication and goal-setting tool to improve care for older adults with chronic conditions and multimorbidity. Health Expect 2023; 27:e13890. [PMID: 37830439 PMCID: PMC10726145 DOI: 10.1111/hex.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Chronic conditions and multimorbidity, the presence of two or more chronic conditions, are increasingly common in older adults. Effective management of chronic conditions and multimorbidity in older adults requires a collaborative and person-centred approach that considers the individual's goals, preferences and priorities. However, ensuring high-quality personalised care for older adults with multimorbidity can be challenging due to the complexity of their care needs, limited time and a lack of patient preparation to discuss their personal goals and preferences with their healthcare team. OBJECTIVE To codesign a communication and goal-setting tool, My Wellbeing Journal, to support personalised care planning for older adults with chronic conditions and multimorbidity. DESIGN We drew on an experience-based codesign approach to develop My Wellbeing Journal. This article reports on the final end-user feedback, which was collected via an online survey with older adults and their carers. SETTING AND PARTICIPANTS Older adults with chronic conditions, multimorbidity and informal carers living in Australia. Personalised care planning was considered in the context of primary care. RESULTS A total of 88 participants completed the online survey. The survey focused on participants' feedback on the tool in terms of effectiveness, efficiency, satisfaction and errors encountered. This feedback resulted in modifications to My Wellbeing Journal, which can be used during clinical encounters to facilitate communication, goal setting and progress tracking. DISCUSSION AND CONCLUSIONS Clinicians and carers can use the tool to guide discussions with older adults about their care planning and help them set realistic goals that are meaningful to them. The findings of this study could be used to inform the development of recommendations for healthcare providers to implement person-centred, goal-oriented care for older adults with chronic conditions and multimorbidity. PATIENT OR PUBLIC CONTRIBUTION Older adults living with chronic conditions and multimorbidity and their carers have contributed to the development of a tool that has the potential to significantly enhance the experience of personalised care planning. Their direct involvement as collaborators has ensured that the tool is optimised to meet the standards of effectiveness and usability.
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Affiliation(s)
- Michael T. Lawless
- Caring Futures Institute, College of Nursing and Health SciencesFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Mandy M. Archibald
- Caring Futures Institute, College of Nursing and Health SciencesFlinders UniversityBedford ParkSouth AustraliaAustralia
- Helen Glass Centre for NursingCollege of NursingWinnipegManitobaCanada
| | | | | | - Alison L. Kitson
- Caring Futures Institute, College of Nursing and Health SciencesFlinders UniversityBedford ParkSouth AustraliaAustralia
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Han J, Allison S, Looi JCL, Chan SKW, Bastiampillai T. A systematic review of the role of clozapine for severe borderline personality disorder. Psychopharmacology (Berl) 2023; 240:2015-2031. [PMID: 37572113 PMCID: PMC10506937 DOI: 10.1007/s00213-023-06431-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/21/2023] [Indexed: 08/14/2023]
Abstract
RATIONALE Clozapine is a unique medication with a potential role in the treatment of severe borderline personality disorder (BPD). OBJECTIVES The review examines the effectiveness of clozapine as a medication for management for severe BPD with high risk of suicide, violence or imprisonment, and aims to help guide clinical practice in managing severe BPD. METHODS A database search of the terms "Clozapine" AND "BPD"; "Antipsychotics" AND "BPD"; "Clozapine" AND "Borderline Personality Disorder"; and "Antipsychotics" AND "Borderline Personality Disorder" were performed in CINAHL, Cochrane Library, Embase, Medline, PsychINFO, PubMed, and Web of Science. Full-text articles of clinical clozapine use for BPD were included for review. RESULTS A total of 24 articles consisting of 1 randomised control trial, 10 non-controlled trials, and 13 case reports were identified. Most of the studies reported benefits from clozapine when used for severe BPD. Many of the studies focused on clozapine use in BPD patients at high risk of suicide. Results from these non-controlled and case reports support the use of clozapine in patients with severe BPD at high risk of suicide. CONCLUSION There may be a role for clozapine in treating severe treatment refractory BPD, especially for those patients at high risk of suicide and frequent hospitalisations.
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Affiliation(s)
- Joshua Han
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
| | - Stephen Allison
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Consortrium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), ACT, Canberra, Australia
| | - Jeffrey C L Looi
- Consortrium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), ACT, Canberra, Australia
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT, Australia
| | - Sherry Kit Wa Chan
- Department of Psychiatry, the School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Tarun Bastiampillai
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Discipline of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Psychiatry, Monash University, Wellington Road, Clayton, Victoria, Australia
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Karunakaran M, Marshall-Webb M, Ullah S, Barreto SG. Impact of Unplanned Intra-Operative Conversions on Outcomes in Minimally Invasive Pancreatoduodenectomy. World J Surg 2023; 47:2507-2518. [PMID: 37436469 PMCID: PMC10473988 DOI: 10.1007/s00268-023-07114-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Minimally-invasive pancreatoduodenectomy (MIPD) is fraught with the risk of complication-related deaths (LEOPARD-2), a significant volume-outcome relationship and a long learning curve. With rates of conversion for MIPD approaching 40%, the impact of these on overall patient outcomes, especially, when unplanned, are yet to be fully elucidated. This study aimed to compare peri-operative outcomes of (unplanned) converted MIPD against both successfully completed MIPD and upfront open PD. METHODS A systematic review of major reference databases was undertaken. The primary outcome of interest was 30-day mortality. Newcastle-Ottawa scale was used to judge the quality of the studies. Meta-analysis was performed using pooled estimates, derived using random effects model. RESULTS Six studies involving 20,267 patients were included in the review. Pooled analysis demonstrated (unplanned) converted MIPD were associated with an increased 30-day (RR 2.83, CI 1.62- 4.93, p = 0.0002, I2 = 0%) and 90-day (RR 1.81, CI 1.16- 2.82, p = 0.009, I2 = 28%) mortality and overall morbidity (RR 1.41, CI 1.09; 1.82, p = 0.0087, I2 = 82%) compared to successfully completed MIPD. Patients undergoing (unplanned) converted MIPD experienced significantly higher 30-day mortality (RR 3.97, CI 2.07; 7.65, p < 0.0001, I2 = 0%), pancreatic fistula (RR 1.65, CI 1.22- 2.23, p = 0.001, I2 = 0%) and re-exploration rates (RR 1.96, CI 1.17- 3.28, p = 0.01, I2 = 37%) compared upfront open PD. CONCLUSIONS Patient outcomes are significantly compromised following unplanned intraoperative conversions of MIPD when compared to successfully completed MIPD and upfront open PD. These findings stress the need for objective evidence-based guidelines for patient selection for MIPD.
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Affiliation(s)
- Monish Karunakaran
- Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Matthew Marshall-Webb
- Division of Surgery and Peri-Operative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, 5042, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Savio George Barreto
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
- Division of Surgery and Peri-Operative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, 5042, Australia.
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Matthews SR, Elizabeth M, Roberts LN, Kaambwa B, Wade TD, Nixon RDV. Assessing the validity and responsiveness of a generic preference quality of life measure in the context of posttraumatic stress disorder. Qual Life Res 2023; 32:2817-2827. [PMID: 37179519 PMCID: PMC10474197 DOI: 10.1007/s11136-023-03432-y] [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] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE There is limited research exploring the usefulness of generic preference-based quality of life (GPQoL) measures used to facilitate economic evaluation in the context of posttraumatic stress disorder (PTSD). The aim of the current study was to explore the validity and responsiveness of a common GPQoL measure (Assessment of Quality of Life 8 Dimension [AQoL-8D]) in relation to a PTSD condition-specific outcome measure (Posttraumatic Stress Disorder Checklist for the DSM-5 [PCL-5]). METHOD This aim was investigated in a sample of individuals (N = 147) who received trauma-focused cognitive-behavioural therapies for posttraumatic stress disorder. Convergent validity was investigated using spearman's correlations, and the level of agreement was investigated using Bland-Altman plots. Responsiveness was investigated by exploring the standardised response means (SRM) from pre-post-treatment across the two measures, which allow the comparison of the magnitude of change between the measures over time. RESULTS Correlations between the AQoL-8D (dimensions, utility and summary total scores) and the PCL-5 total score ranged from small to large and agreement between the measures was considered moderate to good. While SRMs were large for the AQoL-8D and PCL-5 total scores, the SRM for the PCL-5 was nearly double that of the AQoL-8D. CONCLUSION Our findings demonstrate that the AQoL-8D has good construct validity but present preliminary evidence that economic evaluations using only GPQoL measures may not fully capture the effectiveness of PTSD treatments.
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Affiliation(s)
- Sheradyn R. Matthews
- College of Education, Psychology and Social Work, Flinders University, P.O. Box 2100, Adelaide, SA 5001 Australia
| | - Marja Elizabeth
- College of Education, Psychology and Social Work, Flinders University, P.O. Box 2100, Adelaide, SA 5001 Australia
| | - Larissa N. Roberts
- College of Education, Psychology and Social Work, Flinders University, P.O. Box 2100, Adelaide, SA 5001 Australia
| | - Billingsley Kaambwa
- College of Medicine and Public Health, Flinders University, P.O Box 2100, Adelaide, SA 5001 Australia
| | - Tracey D. Wade
- Flinders University Institute for Mental Health and Wellbeing, P.O Box 2100, Adelaide, SA 5001 Australia
- College of Education, Psychology and Social Work, Flinders University, P.O. Box 2100, Adelaide, SA 5001 Australia
| | - Reginald D. V. Nixon
- Flinders University Institute for Mental Health and Wellbeing, P.O Box 2100, Adelaide, SA 5001 Australia
- College of Education, Psychology and Social Work, Flinders University, P.O. Box 2100, Adelaide, SA 5001 Australia
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Nguyen T, Ullah S, Looi JCL, Allison S, Mulder R, Bastiampillai T. Indigenous suicide rates in the United States, Australia and New Zealand between 2006 and 2019. Aust N Z J Psychiatry 2023; 57:1324-1330. [PMID: 37092737 PMCID: PMC10517587 DOI: 10.1177/00048674231167327] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVE Indigenous suicide prevention is an important focus for national health policies. Indigenous suicide rates in formerly colonial English-speaking countries such as the United States, Australia and New Zealand are considerably higher than the general population, particularly in young males. Given the similarities in their sociocultural history, a time series analysis was conducted to assess recent sex and age trends of suicide in the Indigenous and general populations in the United States, Australia and New Zealand. METHODS Using the number of deaths by intentional self-harm and estimated resident population, suicide incidence rates were calculated for the years 2006-2019 and stratified by Indigenous status, year, time period, sex and age group (above 15 years). Incidence rates were plotted. Using the Poisson regression model, calculated suicide incidence rate ratios were used to make comparisons for sex and age. RESULTS Across all countries studied, Indigenous suicide rates have increased over time, with Indigenous males having higher suicide rates than Indigenous females. However, the increase in Indigenous female suicides was greater than that for Indigenous males in Australia and New Zealand. Indigenous males aged 15-44 years have the highest suicide rates across all countries. CONCLUSION Indigenous suicide rates have remained consistently high in the United States, Australia and New Zealand, with Indigenous males aged 15-44 years showing the highest rate. However, suicide rates for Indigenous females in Australia and New Zealand are increasing more rapidly than males. Given this, it is critical that further research is dedicated to understanding and addressing the issues driving this problem, particularly in youth.
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Affiliation(s)
- Teresa Nguyen
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jeffrey CL Looi
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University, Canberra Hospital, Canberra, ACT, Australia
| | - Stephen Allison
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Roger Mulder
- Department of Psychological Medicine (Christchurch), University of Otago, Dunedin, New Zealand
| | - Tarun Bastiampillai
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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Chen Y, Prichard R, Mason M, Tower M, Zimmerman PA, Sparke V, Layh J, Mehdi AM, Lin FF. Barriers and facilitators to COVID-19 vaccine uptake among Australian health professional students during the pandemic: a nationwide study. J Public Health Policy 2023; 44:400-414. [PMID: 37330562 PMCID: PMC10485127 DOI: 10.1057/s41271-023-00422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/19/2023]
Abstract
Using a cross-sectional online survey we investigated knowledge, attitudes, and risk perception about COVID-19 vaccination and identified factors influencing vaccine uptake among Australian health professional students from October 2021 to January 2022. We analysed data from 1114 health professional students from 17 Australian universities. Most participants were enrolled in nursing programs (n = 958, 86.8%), and 91.6% (n = 858) of the participants received COVID-19 vaccination. Approximately 27% believed COVID-19 was no more serious than seasonal influenza and that they had a low risk of acquiring COVID-19. Nearly 20% disagreed that COVID-19 vaccines in Australia were safe and perceived they were at higher-risk of acquiring COVID infection than the general population. Higher-risk perception viewing vaccination as their professional responsibility, and vaccine mandate strongly predicted vaccination behaviour. Participants consider COVID-19 information from health professionals, government websites, and World Health Organization as the most trusted information sources. The findings highlight that healthcare decision-makers and university administrators need to monitor students' hesitancy with vaccination to improve students' promotion of the vaccination to the general population.
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Affiliation(s)
- Yingyan Chen
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia
| | - Roslyn Prichard
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Matt Mason
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Marion Tower
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
| | | | - Vanessa Sparke
- Nursing and Midwifery, College of Healthcare Sciences, James Cook University, Cairns, Australia
| | - Janice Layh
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Ahmed M Mehdi
- QCIF Bioinformatics, Queensland Cyber Infrastructure Foundation Ltd, Brisbane, Australia
| | - Frances Fengzhi Lin
- School of Health, University of the Sunshine Coast, Sunshine Coast, Australia.
- Sunshine Coast Health Institute, Sunshine Coast, Australia.
- College of Nursing and Health Sciences, Flinders University, Level 1, Room N103, Sturt North Sturt Road, Bedford Park, South Australia, 5042, Australia.
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Bacchi S, Tan S, Slee M. Toward a common clinical lexicon of consciousness. Intern Emerg Med 2023; 18:1851-1853. [PMID: 37422543 PMCID: PMC10504159 DOI: 10.1007/s11739-023-03359-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Stephen Bacchi
- Department of Neurology, Flinders Medical Centre, SA Health, Flinders Drive, Bedford Park, SA, 5042, Australia.
- College of Medicine and Public Health, Flinders University of South, Adelaide, Australia.
- University of Adelaide, Adelaide, SA, 5000, Australia.
| | - Sheryn Tan
- University of Adelaide, Adelaide, SA, 5000, Australia
| | - Mark Slee
- Department of Neurology, Flinders Medical Centre, SA Health, Flinders Drive, Bedford Park, SA, 5042, Australia
- College of Medicine and Public Health, Flinders University of South, Adelaide, Australia
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40
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Winter JM, Cornthwaite KJ, Young GP, Wilson C, Chen G, Woodman R, Coats M, Fraser R, Cock C, Bampton P, Symonds EL. FIT for purpose: study protocol for a randomized controlled trial to personalize surveillance colonoscopy for individuals at elevated risk of colorectal cancer. Int J Colorectal Dis 2023; 38:201. [PMID: 37490150 PMCID: PMC10368549 DOI: 10.1007/s00384-023-04493-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE There is increasing demand for colorectal cancer (CRC) surveillance, but healthcare capacity is limited. The burden on colonoscopy resources could be reduced by personalizing surveillance frequency using the fecal immunochemical test (FIT). This study will determine the safety, cost-effectiveness, and patient acceptance of using FIT to extend surveillance colonoscopy intervals for individuals at elevated risk of CRC. METHODS This multicenter, prospective, randomized controlled trial will invite participants who are scheduled for surveillance colonoscopy (due to a personal history of adenomas or a family history of CRC) and who have returned a low fecal hemoglobin (< 2 μg Hb/g feces; F-Hb) using a two-sample FIT (OC Sensor, Eiken Chemical Company) in the prior 3 years. A total of 1344 individuals will be randomized to either surveillance colonoscopy as scheduled or delayed by 1 or 2 years for individuals originally recommended a 3- or 5-year surveillance interval, respectively. The primary endpoint is incidence of advanced neoplasia (advanced adenoma and/or CRC). Secondary endpoints include cost-effectiveness and consumer acceptability of extending surveillance intervals, determined using surveys and discrete choice experiments. CONCLUSION This study will establish the safety, cost-effectiveness, and acceptability of utilizing a low FIT Hb result to extend colonoscopy surveillance intervals in a cohort at elevated risk for CRC. This personalized approach to CRC surveillance will lead to a reduction in unnecessary colonoscopies, increases in healthcare savings, and a better patient experience. TRIAL REGISTRATION: Registration was approved on December 9, 2019 with the Australian New Zealand Clinical Trials Registry ANZCTR 12619001743156.
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Affiliation(s)
- Jean M Winter
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
| | - Kathryn J Cornthwaite
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Graeme P Young
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Carlene Wilson
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
| | - Richard Woodman
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Michelle Coats
- Department of Gastroenterology & Hepatology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Robert Fraser
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Gastroenterology & Hepatology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Charles Cock
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Gastroenterology & Hepatology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Peter Bampton
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Gastroenterology & Hepatology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Erin L Symonds
- Cancer Research, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Department of Gastroenterology & Hepatology, Flinders Medical Centre, Bedford Park, SA, Australia
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Oswald TK, Azadi L, Sinclair S, Lawn S, Redpath P, Beecroft L, Ranogajec M, Yoo J, Venning A. "Somebody was standing in my corner": a mixed methods exploration of survivor, coach, and hospital staff perspectives and outcomes in an Australian cancer survivorship program. Support Care Cancer 2023; 31:478. [PMID: 37477703 PMCID: PMC10361845 DOI: 10.1007/s00520-023-07908-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/16/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Cancer survivorship in Australia continues to increase due to new methods for early detection and treatment. Cancer survivors face challenges in the survivorship phase and require ongoing support. A telephone-delivered cancer survivorship program (CSP), including health and mental health coaches, was developed, piloted, and evaluated in Eastern Australia. METHODS Cancer survivors' (n = 7), coaches' (n = 7), and hospital staff (n = 3) experiences of the CSP were explored through semi-structured interviews. Quantitative data routinely collected throughout the pilot of the CSP was described (N = 25). RESULTS Three syntheses and 11 themes were generated through thematic analysis. The first synthesis centred around operational factors and highlighted a need to streamline communication from the point of recruitment, through to program delivery, emphasising that the program could be beneficial when timed right and tailored correctly. The second synthesis indicated that the CSP focused on appropriate information, filled a gap in support, and met the needs of cancer survivors by empowering them. The third synthesis focussed on the value of mental health support in the CSP, but also highlighted challenges coaches faced in providing this support. Descriptive analysis of quantitative data indicated improvements in self-management, weekly physical activity, and meeting previously unmet needs. CONCLUSIONS Cancer survivors expressed appreciation for the support they received through the CSP and, in line with other cancer survivorship research, predominantly valued just having somebody in their corner. IMPLICATIONS FOR CANCER SURVIVORS Recommendations are made for improving cancer survivorship programs in the future.
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Affiliation(s)
- Tassia Kate Oswald
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford, South Australia, 5042, Australia
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AB, UK
| | - Leva Azadi
- Remedy Healthcare Group, 271 Spring Street, Melbourne, VIC, 3000, Australia
| | - Sue Sinclair
- Ramsay Health, Level 3, 5 Talavera Rd, Macquarie Park, New South Wales, 2113, Australia
| | - Sharon Lawn
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford, South Australia, 5042, Australia
| | - Paula Redpath
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford, South Australia, 5042, Australia
| | - Liam Beecroft
- Remedy Healthcare Group, 271 Spring Street, Melbourne, VIC, 3000, Australia
| | - Miles Ranogajec
- Remedy Healthcare Group, 271 Spring Street, Melbourne, VIC, 3000, Australia
| | - Jeannie Yoo
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford, South Australia, 5042, Australia
- Remedy Healthcare Group, 271 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Venning
- Discipline of Behavioural Health, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford, South Australia, 5042, Australia.
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Tsai D, Zam BB, Tongs C, Chiong F, Sajiv C, Pawar B, Ashok A, Cooper BP, Tong SYC, Janson S, Wallis SC, Roberts JA, Parker SL. Validating a novel three-times-weekly post-hemodialysis ceftriaxone regimen in infected Indigenous Australian patients-a population pharmacokinetic study. J Antimicrob Chemother 2023:dkad190. [PMID: 37367723 PMCID: PMC10393936 DOI: 10.1093/jac/dkad190] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVES To describe the total and unbound population pharmacokinetics of a 2 g three-times-weekly post-dialysis ceftriaxone regimen in Indigenous Australian patients requiring hemodialysis. METHODS A pharmacokinetic study was carried out in the dialysis unit of a remote Australian hospital. Adult Indigenous patients on intermittent hemodialysis (using a high-flux dialyzer) and treated with a 2 g three-times-weekly ceftriaxone regimen were recruited. Plasma samples were serially collected over two dosing intervals and assayed using validated methodology. Population pharmacokinetic analysis and Monte Carlo simulations were performed using Pmetrics in R. The probability of pharmacokinetic/pharmacodynamic target attainment (unbound trough concentrations ≥1 mg/L) and toxicity [trough concentrations (total) ≥100 mg/L] were simulated for various dosing strategies. RESULTS Total and unbound concentrations were measured in 122 plasma samples collected from 16 patients (13 female) with median age 57 years. A two-compartment model including protein-binding adequately described the data, with serum bilirubin concentrations associated (inversely) with ceftriaxone clearance. The 2 g three-times-weekly regimen achieved 98% probability to maintain unbound ceftriaxone concentrations ≥1 mg/L for a serum bilirubin of 5 µmol/L. Incremental accumulation of ceftriaxone was observed in those with bilirubin concentrations >5 µmol/L. Three-times-weekly regimens were less probable to achieve toxic exposures compared with once-daily regimens. Ceftriaxone clearance was increased by >10-fold during dialysis. CONCLUSIONS A novel 2 g three-times-weekly post-dialysis ceftriaxone regimen can be recommended for a bacterial infection with an MIC ≤1 mg/L. A 1 g three-times-weekly post-dialysis regimen is recommended for those with serum bilirubin ≥10 µmol/L. Administration of ceftriaxone during dialysis is not recommended.
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Affiliation(s)
- Danny Tsai
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
- Pharmacy Department, Alice Springs Hospital, Alice Springs, NT, Australia
| | - Betty B Zam
- Pharmacy Department, Alfred Health, Melbourne, VIC, Australia
| | - Carleigh Tongs
- Northern Territory Medical Program, College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | - Fabian Chiong
- Department of Medicine, Alice Springs Hospital, Alice Springs, NT, Australia
| | - Cherian Sajiv
- Department of Nephrology, Alice Springs Hospital, Alice Springs, NT, Australia
| | - Basant Pawar
- Department of Nephrology, Alice Springs Hospital, Alice Springs, NT, Australia
| | - Aadith Ashok
- Department of Infectious Diseases, Alfred Health, Melbourne, VIC, Australia
| | - Brynley P Cooper
- Pharmacy Department, Alice Springs Hospital, Alice Springs, NT, Australia
| | - Steven Y C Tong
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Sonja Janson
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia
| | - Steven C Wallis
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
| | - Jason A Roberts
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, QLD, Australia
- Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Suzanne L Parker
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
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Balfour D, Melton PE, McVeigh JA, Huang R, Eastwood PR, Wanstall S, Reynolds AC, Cohen‐Woods S. Childhood sleep health and epigenetic age acceleration in late adolescence: Cross-sectional and longitudinal analyses. Acta Paediatr 2023; 112:1001-1010. [PMID: 36808764 PMCID: PMC10952569 DOI: 10.1111/apa.16719] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/14/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
AIM Investigate if childhood measures of sleep health are associated with epigenetic age acceleration in late adolescence. METHODS Parent-reported sleep trajectories from age 5 to 17, self-reported sleep problems at age 17, and six measures of epigenetic age acceleration at age 17 were studied in 1192 young Australians from the Raine Study Gen2. RESULTS There was no evidence for a relationship between the parent-reported sleep trajectories and epigenetic age acceleration (p ≥ 0.17). There was a positive cross-sectional relationship between self-reported sleep problem score and intrinsic epigenetic age acceleration at age 17 (b = 0.14, p = 0.04), which was attenuated after controlling for depressive symptom score at the same age (b = 0.08, p = 0.34). Follow-up analyses suggested this finding may represent greater overtiredness and intrinsic epigenetic age acceleration in adolescents with higher depressive symptoms. CONCLUSION There was no evidence for a relationship between self- or parent-reported sleep health and epigenetic age acceleration in late adolescence after adjusting for depressive symptoms. Mental health should be considered as a potential confounding variable in future research on sleep and epigenetic age acceleration, particularly if subjective measures of sleep are used.
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Affiliation(s)
- David Balfour
- College of Education, Psychology, and Social WorkFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Phillip E. Melton
- Menzies Institute for Medical Research, College of Health and MedicineUniversity of TasmaniaHobartTasmaniaAustralia
- School of Population and Global HealthThe University of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Joanne A. McVeigh
- Curtin School of Allied HealthCurtin UniversityPerthWestern AustraliaAustralia
- Movement Physiology Laboratory, School of PhysiologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Rae‐Chi Huang
- Nutrition and Health Innovation Research Institute (NHIRI)Edith Cowan UniversityPerthWestern AustraliaAustralia
| | - Peter R. Eastwood
- Flinders Health and Medical Research Institute (Sleep Health)Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Sian Wanstall
- Flinders Health and Medical Research Institute (Sleep Health)Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Amy C. Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Sarah Cohen‐Woods
- College of Education, Psychology, and Social WorkFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders University Institute for Mental Health and WellbeingFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders Centre for Innovation in CancerFlinders UniversityAdelaideSouth AustraliaAustralia
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Pillen H, Withall L, Tonkin E, Ward PR, Meyer SB, Henderson J, McCullum D, Coveney J, Wilson AM. Understanding how healthcare providers build consumer trust in the Australian food system: A qualitative study. Nutr Diet 2023. [PMID: 37056202 DOI: 10.1111/1747-0080.12809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 04/15/2023]
Abstract
AIM This study aimed to identify how dietitians and other healthcare providers work to build trust in food systems in the course of providing dietary education. METHODS Qualitative semi-structured interviews were conducted with 15 purposefully sampled dietitians (n = 5), general practitioners (n = 5), and complementary and alternative medicine practitioners (n = 5) within metropolitan South Australia. Interview data were then interpreted using an inductive thematic analysis approach, involving the construction of themes representing trust-enhancing roles around which beliefs about professional roles, the 'patient', and food and health were clustered. RESULTS Healthcare providers communicate beliefs regarding (dis)trust in food systems through: (i) responding to patient queries and concerns following a food incident or scare; (ii) helping patients to identify (un)trustworthy elements of food supply systems; and (iii) encouraging consumption of locally produced and minimally processed food. Importantly, the expression of these roles differed according to participant beliefs about food and health (medico-scientific versus alternative medicine) and their adoption of professional projects that sought to promote medico-scientific ways of thinking about health and diet or manage the failures of Western medicine. CONCLUSION The development and consolidation of trust-enhancing roles amongst healthcare providers likely requires disciplinary reflection on professional values and the processes by which practitioners apply these values to understanding food systems.
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Affiliation(s)
- Heath Pillen
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Liz Withall
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Emma Tonkin
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Paul R Ward
- Torrens University Australia, Adelaide Campus, Australia
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Julie Henderson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Dean McCullum
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Annabelle M Wilson
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Amarasooriya M, Jerome TJ, Tourret L. Current Concepts in Scapholunate Instability Without Arthritic Changes. Indian J Orthop 2023; 57:515-526. [PMID: 37006727 PMCID: PMC10050294 DOI: 10.1007/s43465-023-00839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/29/2023] [Indexed: 04/04/2023]
Abstract
Scapholunate instability (SLI) is the most common carpal instability described. SLI leads to a degenerative arthritic pattern known as scapholunate advanced collapse (SLAC). Diagnosis of SLI can be challenging in pre-dynamic and dynamic stages. CT arthrogram, MR arthrogram and dynamic fluoroscopy are helpful in diagnosis while arthroscopy remains the gold standard. SLI is a multi-ligament injury, which involves not only the scapholunate interosseous ligament (SLIL) but also the extrinsic carpal ligaments. Hence, it is better described as an injury compromising the 'dorsal scapholunate(dSLL) complex'. A repair can be attempted for acute SLI presenting within 6 weeks of injury. Reconstruction is the mainstay of treatment for chronic SLI without degenerative changes. Multiple repair techniques have been described which include capsulodesis and tenodesis procedures. The clinical outcomes of the techniques have improved over the years. However, a common problem of all these techniques is the lack of long-term data on the outcomes and deteriorating radiological parameters over time. SLI staging is an important factor to be considered in choosing the reconstruction techniques for a better outcome. Currently, there is a trend towards more biological and less invasive techniques. Regardless of the technique, it is important to preserve the nerve supply of the dorsal capsuloligamentous structures of the wrist. Arthroscopic techniques being minimally invasive have the advantage of less collateral damage to the capsuloligamentous structures. Rehabilitation involves a team approach where a protected dart thrower's motion is allowed after a period of immobilization. Strengthening SL-friendly muscles and inhibiting SL-unfriendly muscles is a key principle in rehabilitation.
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Affiliation(s)
- Melanie Amarasooriya
- Department of Orthopedic and Trauma Surgery, Flinders Medical Centre and Flinders University, Bedford Park, South Australia 5042 Australia
- Orthopedic Surgeon, Ministry of Health, Colombo, Sri Lanka
| | - Terrence Jose Jerome
- Hand and Reconstructive Microsurgery, Olympia Hospital and Research Centre , Trichy, India
| | - Lisa Tourret
- Hand and Upper Limb Surgeon, Brighton and Sussex University Hospitals, NHS Trust, Brighton, UK
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Yew WP, Humenick A, Chen BN, Wattchow DA, Costa M, Dinning PG, Brookes SJH. Electrophysiological and morphological features of myenteric neurons of human colon revealed by intracellular recording and dye fills. Neurogastroenterol Motil 2023; 35:e14538. [PMID: 36740821 DOI: 10.1111/nmo.14538] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/27/2022] [Accepted: 01/11/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ex vivo intracellular recordings and dye fills, combined with immunohistochemistry, are a powerful way to analyze the enteric nervous system of laboratory animals. METHODS Myenteric neurons were recorded in isolated specimens of human colon. A key determinant of successful recording was near-complete removal of circular muscle from the surface of ganglia. KEY RESULTS Treatment with a collagenase/neutral protease mix before dissection significantly improved recording success and reduced damage to the plexus. Carboxyfluorescein in microelectrodes allowed recorded neurons to be routinely labeled, analyzed, and subjected to multi-layer immunohistochemistry. Carboxyfluorescein revealed morphological details that were not detected by immunohistochemical methods. Of 54 dye-filled myenteric neurons (n = 22), 45 were uni-axonal and eight were multi-axonal. There was a significant bias toward recordings from large neural somata. The close association between morphology and electrophysiology (long after-hyperpolarizations and fast EPSPs) seen in mice and guinea pigs did not hold for human myenteric neuron recordings. No slow EPSPs were recorded; however, disruption to the myenteric plexus during dissection may have led the proportion of cells receiving synaptic potentials to be underestimated. Neurons immunoreactive for nitric oxide synthase were more excitable than non-immunoreactive neurons. Distinctive grooves were observed on the serosal and/or mucosal faces of myenteric neurons in 3D reconstructions. These had varicose axons running through them and may represent a preferential site of synaptic inputs. CONCLUSIONS Human enteric neurons share many features with laboratory animals, but the combinations of features in individual cells appear more variable.
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Affiliation(s)
- Wai Ping Yew
- Human Physiology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Adam Humenick
- Human Physiology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Bao Nan Chen
- Human Physiology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - David A Wattchow
- Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Marcello Costa
- Human Physiology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Phil G Dinning
- Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Simon J H Brookes
- Human Physiology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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Bitton S, Chatburn A, Immink MA. The Influence of Focused Attention and Open Monitoring Mindfulness Meditation States on True and False Memory. J Cogn Enhanc 2023; 7:1-16. [PMID: 37363054 PMCID: PMC10061380 DOI: 10.1007/s41465-023-00259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Previous investigations into the effect of mindfulness meditation on false memory have reported mixed findings. One potential issue is that mindfulness meditation involves different styles that establish distinct cognitive control states. The present work aimed to address this issue by comparing the effects of single-session focused attention (FAM) and open monitoring (OMM) mindfulness meditation styles on true and false memory recall. Strengthened cognitive control states associated with FAM were predicted to increase true memory recall and decrease false memory recall. Conversely, weakened cognitive control established by OMM was predicted to increase false memory recall. Thirty-four meditation-naïve participants (23 females, mean age = 23.4 years, range = 18-33) first completed pre-meditation learning and recall phases of the Deese-Roediger-McDermott (DRM) task. Participants then completed a single session of FAM or OMM prior to a second, post-meditation, round of DRM task learning and recall phases with a novel word list. Finally, participants completed a recognition test with true and false memory, and distractor words. Both FAM and OMM groups demonstrated significant increase in false memory recall between pre- and post-meditation recall tests but these groups did not differ with respect to true and false memory recall and recognition. The present findings are consistent with previous reports of increased false memory arising from mindfulness meditation. Distinct cognitive control states associated with FAM and OMM states do not result in distinct true and false memory formation, at least in meditation-naïve adults.
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Affiliation(s)
- Sara Bitton
- University of South Australia, Adelaide, Australia
| | | | - Maarten A. Immink
- University of South Australia, Adelaide, Australia
- Flinders University, Adelaide, Australia
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Barnes A, Ooi SYJ, Lynch KD, Parthasarathy N, Bishara M, Gounder M, Grafton R, Leach P, Bampton P, Sechi A, Ng W, Connor S, van Langenberg D, Mountifield R, Andrews JM. Proactive Metabolite Testing in Patients on Thiopurine May Yield Long-Term Clinical Benefits in Inflammatory Bowel Disease. Dig Dis Sci 2023; 68:889-896. [PMID: 35687221 PMCID: PMC10011286 DOI: 10.1007/s10620-022-07556-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/04/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The thiopurine medications are well established in the treatment of inflammatory bowel disease (IBD). There is significant variation in levels of toxic and therapeutic metabolites. Current data from small or short-term studies support therapeutic drug monitoring (TDM) in assessing azathioprine (AZA) and 6-mercaptopurine (6MP). TDM of thiopurines involves measurement and interpretation of metabolites 6-TGN and 6-MMPR. AIMS This study aimed to assess long-cterm outcomes of patients on thiopurines following therapeutic drug monitoring. METHODS A multicenter retrospective observational study of outcomes post thiopurine TDM was conducted. Demographics, disease characteristics, physician global assessment, IBD therapy at baseline TDM and again at 12 months were collected. Clinical outcomes were analyzed according to TDM result, and indication for TDM including proactive and other indications. RESULTS The study included 541 patients. Only 39% of patients had appropriate dosing of thiopurines. AZA/6MP TDM informed a management change in 61.9%, and enabled 88.8% of the cohort to continue AZA/6MP following TDM. At 12 months following TDM the majority (74.1%) of the cohort remained on AZA/6MP. Clinical remission was higher at 12-months following thiopurines TDM (68%) compared to baseline (37%), including proactive TDM. Post TDM, 13.0% of patients were identified as shunters and commenced on thiopurine-allopurinol co-therapy. CONCLUSION Thiopurine TDM resulted in a change in management for the majority of patients. Post TDM significantly more patients were in remission. TDM allowed the identification of non-adherence and shunters who, without intervention, would not reach therapeutic drug levels. Proactive TDM allowed identification and management of inappropriate dosing, and was associated with increased levels of clinical remission.
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Affiliation(s)
- Alex Barnes
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital Adelaide, Adelaide, Australia.
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia.
- College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Soong-Yuan J Ooi
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital Adelaide, Adelaide, Australia
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Kate D Lynch
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital Adelaide, Adelaide, Australia
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Nina Parthasarathy
- Department of Gastroenterology and Hepatology, Eastern Health, Melbourne, Australia
| | - Maria Bishara
- Department of Gastroenterology and Hepatology, Eastern Health, Melbourne, Australia
| | - Michael Gounder
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Sydney, Australia
| | - Rachel Grafton
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital Adelaide, Adelaide, Australia
| | - Peta Leach
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia
| | - Peter Bampton
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia
| | - Alexandra Sechi
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia
| | - Watson Ng
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Sydney, Australia
| | - Susan Connor
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia
- South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Sydney, Australia
| | - Daniel van Langenberg
- Department of Gastroenterology and Hepatology, Eastern Health, Melbourne, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Réme Mountifield
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA, 5042, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jane M Andrews
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital Adelaide, Adelaide, Australia
- School of Medicine, University of Adelaide, Adelaide, Australia
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49
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Calabro R, Kemps E, Prichard I, Tiggemann M. Vending machine backgrounds: nudging healthier beverage choices. Curr Psychol 2023:1-10. [PMID: 37359624 PMCID: PMC9971671 DOI: 10.1007/s12144-023-04420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/06/2023]
Abstract
Soft drink overconsumption is a growing public health concern. The present research investigated whether priming nudges could decrease soft drink choices from a vending machine. We compared the effect of six vending machine wraps (Mount Franklin ™ logo, Coca-Cola™ logo, picture of water, picture of soft drink, blue, red) on beverage choice against a black (control) computerised vending machine display. In two studies, young adult participants (17 - 25 years) were recruited from [removed for blind review] (Study 1, n = 142, Study 2, n = 232). Participants were randomly allocated to choose a beverage from one of the wrap conditions. They also rated how much the beverage was liked and how often it was consumed (Study 1), or rated the refreshing value, healthiness, taste, and energy of each beverage in the vending machine (Study 2). We predicted that wraps referencing water would produce healthier choices and those referencing soft drink would result in unhealthier choices. Contrary to these predictions, the type of vending machine wrap did not significantly influence beverage choice in Study 1. However, viewing the black vending machine wrap resulted in significantly more caffeine-based selections in Study 2. Other significant predictors of the choice of beverage were how often the beverages were consumed and how much they were liked (Study 1), as well as their perceptions of the taste, healthiness and refreshing value (Study 2). The finding that the black vending machine produced more caffeine-based beverage choices demonstrates, in principle, that color-based priming nudges could influence beverage choices.
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Affiliation(s)
- Ryan Calabro
- Psychology, College of Education, Psychology and Social Work, School of Psychology, Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
| | - Eva Kemps
- Psychology, College of Education, Psychology and Social Work, School of Psychology, Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
| | - Ivanka Prichard
- Health & Exercise Sciences, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Marika Tiggemann
- Psychology, College of Education, Psychology and Social Work, School of Psychology, Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
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50
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Hunter SC, Mauch CE, Ridley K, Shipman J, Riggs DW, Coveney J, Feo R, Golley RK. Family Life During and Beyond COVID-19: The Impact of Relationship Quality on Caregivers’ Management of Paid Work, Caregiving, and Self-Care. J Fam Issues 2023. [PMCID: PMC9908515 DOI: 10.1177/0192513x231155668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This multi-method project examined how Australian caregivers navigated family life during the COVID-19 pandemic in 2020 and subsequent impact on family health behaviours. Participants were invited to complete all three phases. In phase 1, 115 caregivers completed an online survey, focussed on 2020 experiences of COVID-19. In phase 2, 96 of the participants completed a use-of-time recall and 80 completed a dietary recall examining participants’ health behaviours including how they spent their time, their physical activity, and diet quality. Phase 3 involved 24 of the participants completing an online story completion task, focussed on understanding participants’ sense-making of COVID-19. Through triangulating analyses of the three phases, this project identified how poor relationship quality negatively affected families’ experiences of significant disruptions and transitions. This project provides a nuanced picture of how COVID-19 in 2020 impacted family life and highlights the importance of caregiver relationship quality for family health and wellbeing.
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Affiliation(s)
- Sarah C. Hunter
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Sarah C. Hunter, Caring Futures Institute, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia.
| | - Chelsea E. Mauch
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, SA, Australia
| | - Kate Ridley
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Jessica Shipman
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Damien W. Riggs
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - John Coveney
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Rebecca Feo
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Rebecca K. Golley
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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