Supporting LGBTIQ+ students in higher education in Australia : diversity, inclusion and visibility
- Authors: Waling, Andrea , Roffee, James
- Date: 2018
- Type: Text , Journal article
- Relation: Health Education Journal Vol. 77, no. 6 (2018), p. 667-679
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- Description: Objective: Using student narratives of experiences of exclusion and non-inclusion at university, this paper builds an evidence base for, and explores ways in which universities can respond to, the contemporary concerns of lesbian, gay, bisexual, transgender/transsexual, intersex and queer/questioning (LGBTIQ+) undergraduate students. Design: Qualitative exploratory study of undergraduate students who identify as LGBTIQ+ regarding their experiences of exclusion and non-inclusion at university. Setting: Large metropolitan university in Australia. Methods: Sixteen semi-formal interviews with undergraduate students who identify as LGBTIQ+ attending a large Australian university. Data were analysed using phenomenological analysis. Results: Students indicated university-level gaps in service provision and failures to support them in their attempts to access, or create opportunities to access, information regarding sexual and mental health and improve inclusion. They also indicated the importance of queer visibility and its impact in creating a positive experience for LGBTIQ+ members of a campus community. Conclusions: Universities should be aware of the need for formalised diversity and inclusion programmes to tackle contemporary experiences of exclusion. Universities can harness and support student initiatives to better serve the LGBTIQ+ campus community, responding to gaps in knowledge, resources and service needs. These gaps include resources and information regarding sexual health, the provision of gender-neutral toilets and other facilities, and support for peer-led programmes to enhance inclusion. Universities should help increase the visibility of a diverse queer presence on campus to help prevent experiences of exclusion. © The Author(s) 2018.
Supporting regional aged care nursing staff to manage residents’ behavioural and psychological symptoms of dementia, in real time, using the nurses’ behavioural assistant (NBA) : A pilot site 'end-user attitudes’ trial
- Authors: Klein, Britt , Clinnick, Lisa , Chesler, Jessica , Stranieri, Andrew , Bignold, Adam , Dazeley, Richard , McLaren, Suzanne , Lauder, Sue , Balasubramanian, Venki
- Date: 2018
- Type: Text , Conference paper
- Relation: 2017 Global Telehealth Meeting, GT 201; Adelaide, Australia; 22nd-24th November 2017; published in Telehealth for our Ageing Society (part of the Studies in Health Technology and Informatics series) Vol. 246, p. 24-28
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- Description: Background: This regional pilot site ‘end-user attitudes’ study explored nurses’ experiences and impressions of using the Nurses’ Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Methods: Focus groups were conducted, followed by a four-week pilot site ‘end-user attitudes’ trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Results: Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Conclusions: Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.
The efficacy of an iterative “sequence of prevention” approach to injury prevention by a multidisciplinary team in professional rugby union
- Authors: Tee, Jason , Bekker, Sheree , Collins, Rob , Klingbiel, Jannie , van Rooyen, Ivan , van Wyk, David , Till, Kevin , Jones, Ben
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 9 (2018), p. 899-904
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- Description: Objectives: Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union. Design: Observational longitudinal cohort study. Methods: Epidemiological injury data was collected from a professional rugby union team for 5 consecutive seasons. Following each season, these data informed multidisciplinary intervention strategies to reduce injury risk. The effectiveness of these strategies was iteratively assessed to inform future interventions. Specific examples of intervention strategies are provided. Results: Overall team injury burden displayed a likely beneficial decrease (−8%; injury rate ratio (IRR) 0.9, 95%CI 0.9–1.0) from 2012 to 2016. This was achieved through a most likely beneficial improvement in non-contact injury burden (−39%; IRR 0.6, 95%CI 0.6–0.7). Contact injury burden was increased, but to a lesser extent (+18%; IRR 1.2, 95%CI 1.1–1.3, most likely harmful) during the same period. Conclusions: The range of skills required to effectively manage complex injury phenomena in professional collision sport crosses disciplinary boundaries. The evidence presented here points to the effectiveness of a multidisciplinary approach to reducing injury risk. This model will likely be applicable across a range of team and individual sports.
The importance of adequate referrals for chronic kidney disease
- Authors: Wright, Julian , Glenister, Kristen , Thwaites, Rebecca , Terry, Daniel
- Date: 2018
- Type: Text , Journal article
- Relation: Australian journal of general practice Vol. 47, no. 1-2 (2018), p. 58-62
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- Description: DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care.
The intergenerational transmission of problem gambling : the mediating role of offspring gambling expectancies and motives
- Authors: Dowling, Nicki , Oldenhof, Erin , Shandley, Kerrie , Youssef, George , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Addictive Behaviors Vol. 77, no. (2018), p. 16-20
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- Description: Introduction The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's expectancies and motives relating to gambling explain, at least in part, the intergenerational transmission of problem gambling. Methods Participants (N = 524; 56.5% male) were recruited from educational institutions, and retrospectively reported on parental problem gambling. Problem gambling was measured using the Problem Gambling Severity Index and a range of positive and negative expectancies and gambling motives were explored as potential mediators of the relationship between parent-and-participant problem gambling. Results The relationship between parent-and-participant problem gambling was significant, and remained so after controlling for sociodemographic factors and administration method. Significant mediators of this relationship included self-enhancement expectancies (feeling in control), money expectancies (financial gain), over-involvement (preoccupation with gambling) and emotional impact expectancies (guilt, shame, and loss), as well as enhancement motives (gambling to increase positive feelings) and coping motives (gambling to reduce or avoid negative emotions). All mediators remained significant when entered into the same model. Conclusions The findings highlight that gambling expectancies and motives present unique pathways to the development of problem gambling in the offspring of problem gambling parents, and suggest that gambling cognitions may be potential candidates for targeted interventions for the offspring of problem gamblers. © 2017 Elsevier Ltd **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
UPPS-P facets of impulsivity and alcohol use patterns in college and noncollege emerging adults
- Authors: Tran, Joanna , Teese, Robert , Gill, Peter
- Date: 2018
- Type: Text , Journal article
- Relation: American Journal of Drug and Alcohol Abuse Vol. 44, no. 6 (2018), p. 695-704
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- Description: Background: Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults. Objectives: To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested. Methods: A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (Mage = 23.71, SD = 2.81). Results: Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults. Conclusion: These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.
Use of a tibial accelerometer to measure ground reaction force in running : A reliability and validity comparison with force plates
- Authors: Raper, Damian , Witchalls, Jeremy , Philips, Elissa , Knight, Emma , Drew, Michael , Waddington, Gordon
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 1 (2018), p. 84-88
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- Description: Objectives: The use of microsensor technologies to conduct research and implement interventions in sports and exercise medicine has increased recently. The objective of this paper was to determine the validity and reliability of the ViPerform as a measure of load compared to vertical ground reaction force (GRF) as measured by force plates. Design: Absolute reliability assessment, with concurrent validity. Methods: 10 professional triathletes ran 10 trials over force plates with the ViPerform mounted on the mid portion of the medial tibia. Calculated vertical ground reaction force data from the ViPerform was matched to the same stride on the force plate. Bland–Altman (BA) plot of comparative measure of agreement was used to assess the relationship between the calculated load from the accelerometer and the force plates. Reliability was calculated by intra-class correlation coefficients (ICC) with 95% confidence intervals. Results: BA plot indicates minimal agreement between the measures derived from the force plate and ViPerform, with variation at an individual participant plot level. Reliability was excellent (ICC = 0.877; 95% CI = 0.825–0.917) in calculating the same vertical GRF in a repeated trial. Standard error of measure (SEM) equalled 99.83 units (95% CI = 82.10–119.09), which, in turn, gave a minimum detectable change (MDC) value of 276.72 units (95% CI = 227.32–330.07). Conclusions: The ViPerform does not calculate absolute values of vertical GRF similar to those measured by a force plate. It does provide a valid and reliable calculation of an athlete’s lower limb load at constant velocity.
A Cultural Competence Organizational Review for community health services : Insights from a participatory approach
- Authors: Truong, Mandy , Gibbs, Lisa , Pradel, Veronika , Morris, Michal , Gwatirisa, Pauline , Tadic, Maryanne , De Silva, Andrea , Hall, Martin , Young, Dana , Riggs, Elisha , Calache, Hanny , Gussy, Mark , Watt, Richard , Gondal, Iqbal , Waters, Elizabeth
- Date: 2017
- Type: Text , Journal article
- Relation: Health Promotion Practice Vol. 18, no. 3 (2017), p. 466-475
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- Description: Cultural competence is an important aspect of health service access and delivery in health promotion and community health. Although a number of frameworks and tools are available to assist health service organizations improve their services to diverse communities, there are few published studies describing organizational cultural competence assessments and the extent to which these tools facilitate cultural competence. This article addresses this gap by describing the development of a cultural competence assessment, intervention, and evaluation tool called the Cultural Competence Organizational Review (CORe) and its implementation in three community sector organizations. Baseline and follow-up staff surveys and document audits were conducted at each participating organization. Process data and organizational documentation were used to evaluate and monitor the experience of CORe within the organizations. Results at follow-up indicated an overall positive trend in organizational cultural competence at each organization in terms of both policy and practice. Organizations that are able to embed actions to improve organizational cultural competence within broader organizational plans increase the likelihood of sustainable changes to policies, procedures, and practice within the organization. The benefits and lessons learned from the implementation of CORe are discussed. © 2017, Society for Public Health Education.
A multifactorial evaluation of illness risk factors in athletes preparing for the Summer Olympic Games
- Authors: Drew, Michael , Vlahovich, Nicole , Hughes, David , Appaneal, Renee , Peterson, Kirsten , Burke, Louise , Lundy, Bronwen , Toomey, Mary , Watts, David , Lovell, Gregory , Praet, Stephan , Halson, Shona , Colbey, Candice , Manzanero, Silvia , Welvaert, Marijke , West, Nic , Pyne, David , Waddington, Gordon
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 20, no. 8 (2017), p. 745-750
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- Description: Objectives Illness can disrupt training and competition performance of athletes. Few studies have quantified the relative contribution of the known medical, behavioural and lifestyle risk factors. Design Cross-sectional. Methods Olympic athletes from 11 sports (n = 221) were invited to complete questionnaires administered nine months before the Rio 2016 Olympic Games. These included the Depression, Anxiety and Stress Questionnaire (DASS-21), Perceived Stress Scale (PSS), Dispositional Resilience Scale (DRS), Recovery-Stress Questionnaire (REST-Q-52 item), Low Energy in Females Questionnaire (LEAF-Q), a modified Personal and Household Hygiene questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and custom-made questionnaires on probiotic usage and travel. An illness (case) was defined as an event which limited training or competition for greater hours in the prior month. Odds ratios and attributable fractions in the population (AFP) were utilised for categorical variables with independent t-tests or Wilcoxon rank-sum for continuous variables. Results Eighty-one athletes responded (male, n = 26; female, n = 55). There were 16 illness cases and 65 controls. Female athletes were at higher odds of illness (OR = 9.4, 95%CI 1.3–410, p = 0.01, AFP = 0.84). Low energy availability (LEAF-Q score ≥8: OR = 7.4, 95%CI 0.78–352, p = 0.04, AFP = 0.76), depression symptoms (DASS-21: depression score >4, OR = 8.4, 95%CI 1.1–59, p < 0.01; AFP = 0.39) and higher perceived stress (PSS: 10-item, p = 0.04) were significantly associated with illness. Conclusions Female sex, low energy availability, and mental health are associated with sports incapacity (time loss) due to illness. Low energy availability had high attributable fractions in the population and stands out as a primary association with illness. © 2017
An exploration of emergency nurses’ perceptions, attitudes and experience of teamwork in the emergency department
- Authors: Grover, Elise , Porter, Joanne , Morphet, Julia
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 20, no. 2 (2017), p. 92-97
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- Description: Background Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. Method A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Results Three major themes emerged from the data. The first theme ‘when teamwork works’ supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme ‘team support’ revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme ‘no time for teamwork’ centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Discussion Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. © 2017 College of Emergency Nursing Australasia
Assessing the anthelmintic activity of pyrazole-5-carboxamide derivatives against Haemonchus contortus
- Authors: Jiao, Yaqing , Preston, Sarah , Song, Hongjian , Jabbar, Abdul , Liu, Yuxiu , Baell, Jonathan , Hofmann, Andreas , Hutchinson, Dana , Wang, Tao , Koehler, Anson , Fisher, Gillian , Andrews, Katherine , Laleu, Benoit , Palmer, Michael , Burrows, Jeremy , Wells, Timothy , Wang, Qingmin , Gasser, Robin
- Date: 2017
- Type: Text , Journal article
- Relation: Parasites and Vectors Vol. 10, no. 1 (2017), p. 1-7
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- Description: Background: In this study, we tested five series of pyrazole-5-carboxamide compounds (n = 55) for activity against parasitic stages of the nematode Haemonchus contortus (barber’s pole worm), one of the most pathogenic parasites of ruminants. Methods: In an optimised, whole-organism screening assay, using exsheathed third-stage (xL3) and fourth-stage (L4) larvae, we measured the inhibition of larval motility and development of H. contortus. Results: Amongst the 55 compounds, we identified two compounds (designated a-15 and a-17) that reproducibly inhibit xL3 motility as well as L4 motility and development, with IC50 values ranging between ~3.4 and 55.6 μM. We studied the effect of these two ‘hit’ compounds on mitochondrial function by measuring oxygen consumption. This assessment showed that xL3s exposed to each of these compounds consumed significantly less oxygen and had less mitochondrial activity than untreated xL3s, which was consistent with specific inhibition of complex I of the respiratory electron transport chain in arthropods. Conclusions: The present findings provide a sound basis for future work, aimed at identifying the targets of compounds a-15 and a-17 and establishing the modes of action of these chemicals in H. contortus. © 2017 The Author(s).
Asthma hospitalisation trends from 2010 to 2015 : variation among rural and metropolitan Australians
- Authors: Terry, Daniel , Robins, Shalley , Gardiner, Samantha , Wyett, Ruby , Islam, Md Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 17, no. 1 (2017), p.
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- Description: Background: Asthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993-94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010-2015 results with asthma data prior to 2010. Methods: Hospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables. Results: During the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0-14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0-14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas. Conclusions: We demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient's age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour. © 2017 The Author(s).
Development of a suicidal ideation detection tool for primary Healthcare settings : Using open access online psychosocial data
- Authors: Meyer, Denny , Abbott, Jo-Anne , Rehm, Imogen , Bhar, Sunil , Barak, Azy , Deng, Gary , Wallace, Klaire , Ogden, Edward , Klein, Britt
- Date: 2017
- Type: Text , Journal article
- Relation: Telemedicine and e-Health Vol. 23, no. 4 (2017), p. 273-281
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- Description: Background: Suicidal patients often visit healthcare professionals in their last month before suicide, but medical practitioners are unlikely to raise the issue of suicide with patients because of time constraints and uncertainty regarding an appropriate approach. Introduction: A brief tool called the e-PASS Suicidal Ideation Detector (eSID) was developed for medical practitioners to help detect the presence of suicidal ideation (SI) in their clients. If SI is detected, the system alerts medical practitioners to address this issue with a client. The eSID tool was developed due to the absence of an easy-to-use, evidence-based SI detection tool for general practice. Material and Methods: The tool was developed using binary logistic regression analyses of data provided by clients accessing an online psychological assessment function. Ten primary healthcare professionals provided advice regarding the use of the tool. Results: The analysis identified eleven factors in addition to the Kessler-6 for inclusion in the model used to predict the probability of recent SI. The model performed well across gender and age groups 18-64 (AUR 0.834, 95% CI 0.828-0.841, N = 16,703). Healthcare professionals were interviewed; they recommended that the tool be incorporated into existing medical software systems and that additional resources be supplied, tailored to the level of risk identified. Conclusion: The eSID is expected to trigger risk assessments by healthcare professionals when this is necessary. Initial reactions of healthcare professionals to the tool were favorable, but further testing and in situ development are required. © 2017, Mary Ann Liebert, Inc.
e-TC : Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer
- Authors: Heiniger, Louise , Smith, Allan , Olver, Ian , Grimison, Peter , Klein, Britt , Wootten, Addie , Abbott, Jo-Anne , Price, Melanie , McJannett, Margaret , Tran, Ben , Stockler, Martin , Gurney, Howard , Butow, Phyllis
- Date: 2017
- Type: Text , Journal article
- Relation: European Journal of Cancer Care Vol. 26, no. 6 (2017), p. 1-10
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- Description: e-TC is an online intervention designed to address common psychosocial concerns of testicular cancer survivors. It aims to reduce anxiety, depression and fear of cancer recurrence by providing evidence-based information and psychological intervention. This paper details the development and pilot testing of e-TC. During pilot testing, 25 men (with varying psychological profiles) who had completed treatment for testicular cancer, 6 months to 5 years ago (which had not recurred), used e-TC over a 10-week period and provided quantitative and qualitative feedback on the feasibility and acceptability of the programme. Six men also completed a qualitative interview to provide detailed feedback on their experiences using e-TC. Fourteen men (56%) completed at least 80% of the programme. Participants reported a high level of satisfaction with the programme. Men's limited time was a barrier to programme use and completion, and participants suggested that men with a more recent diagnosis and a higher level of distress may be more likely to engage with the programme. e-TC appears to be a feasible and acceptable online intervention for survivors of testicular cancer. Findings from this study are currently being used to refine e-TC and guide the design of a larger efficacy study. © 2017 John Wiley & Sons Ltd
Effect of a mass media campaign on ambulance use for chest pain
- Authors: Nehme, Zlad , Cameron, Peter , Akram, Muhammad , Patsamanis, Harry , Bray, Janet , Meredith, Ian , Smith, Karen
- Date: 2017
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 206, no. 1 (2017), p. 30-35
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- Description: Objectives: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. Design, setting and participants: A retrospective analysis of 253 428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 e December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use. Main outcome measure: Monthly ambulance attendances. Results: The median number of monthly ambulance attendances for chest pain was 3609 (IQR, 3011e3891), but was higher in campaign months than in non-campaign months (3880 v 3234, P < 0.001). After adjustments, campaign activity was associated with a 10.7% increase (95% CI, 6.5e14.9%; P < 0.001) in monthly ambulance use for chest pain, and a 15.4% increase (95% CI, 10.1e20.9%; P < 0.001) when the two-month lag periods were included. Clinical presentations for suspected acute coronary syndromes, as determined by paramedics, increased by 11.3% (95% CI, 6.9e15.9%; P < 0.001) during campaigns. Although the number of patients transported to hospital by ambulance increased by 10.0% (95% CI, 6.1e14.2%; P < 0.001) during campaign months, the number of patients not transported to hospital also increased, by 13.9% (95% CI, 8.3e19.8%; P < 0.001). Conclusion: A public awareness campaign about responding to prodromal acute myocardial infarction symptoms was associated with an increase in EMS use by people with chest pain and suspected acute coronary syndromes. Campaign activity may also lead to increased EMS use in low risk populations. © 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.
Health justice partnerships: Initial insights into the delivery of an integrated health and legal service for youth in regional Victoria
- Authors: Ollerenshaw, Alison , Camilleri, Marg
- Date: 2017
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 17, no. 2 (2017), p. 1-6
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- Description: Introduction: This article presents interim findings from research examining the implementation of a health justice partnership (HJP) focusing on the legal and health needs of regional young people. HJPs provide an innovative service model offering an integrated health and legal service for the community. HJPs are a relatively new service model for Australia, yet the program is well suited to meet the needs of particular population cohorts, including young people and those in regional locations experiencing complex legal issues. Methods: Funded by the Victorian Legal Services Board and Commissioner, an HJP in partnership with three organisations was established in a large regional area in Victoria, Australia. Research is being conducted alongside the program to examine its impact on young people, and the implications on practice for staff in the partner organisations. Results: Findings provide preliminary support for the HJP model with a number of young people - from predominantly disadvantaged backgrounds and with varying legal issues - having been referred to the program in the first 6 months. Referrals were received from both partner agencies and external agencies. Initial client and staff survey responses indicate that the legal problem of the young people was affecting how they feel. Conclusions: While these findings provide preliminary support for the HJP further research will offer longer term insights about HJPs within the Australian context, particularly rural and regional settings. © A Ollerenshaw, M Camilleri, 2017.
Implementation and evaluation of community-based drop-in centres for breastfeeding support in Victoria, Australia
- Authors: Cramer, Rhian , McLachlan, Helen , Shafiei, Touran , Amir, Lisa , Cullinane, Meabh , Small, Rhonda , Forster, Della
- Date: 2017
- Type: Text , Journal article
- Relation: International Breastfeeding Journal Vol. 12, no. 1 (2017), p.1-15
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- Description: Background: While Australia has high breastfeeding initiation, there is a sharp decline in the first weeks postpartum and this continues throughout the first year. Supporting breastfeeding In Local Communities (SILC) was a three-arm cluster randomised controlled trial to determine whether early home-based breastfeeding support by a maternal and child health nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving any breast milk at three, four and six months. The trial was conducted in ten Local Government Areas (LGAs) in Victoria, Australia. The primary aim of this paper is to describe the three drop-in centres established during the trial; and the profile of women who accessed them. The secondary aim is to explore the views and experiences of the drop-in centre staff, and the challenges faced in establishing and maintaining a breastfeeding drop-in centre in the community. Methods: Evaluation of the three LGAs with drop-in centres was multifaceted and included observational visits and field notes; data collected from attendance log books from each drop-in centre; a written survey and focus groups with maternal and child health (MCH) nurses who ran the drop-in centres; and semi-structured interviews with MCH coordinators of the participating LGAs. Results: The three LGAs developed and ran different models of breastfeeding drop-in centres. They reported challenges in finding convenient, accessible locations. Overall, attendance was lower than expected, with an average of only one attendee per session. Two global themes were identified regarding staff views: implementation challenges, encompassing finding accessible, available space, recruiting volunteers to provide peer support, and frustration when women did not attend; and the work of SILC-MCHNs, including themes of satisfying and rewarding work, juggling roles, and benefits to women, babies and the community. Conclusion: Providing community-based breastfeeding support was satisfying for the drop-in centre staff but proved difficult to implement, reflected by the lower than anticipated attendances at all of the drop-in centres. Interventions to increase breastfeeding in complex community settings require sufficient time to build partnerships with the existing services and the target population; to understand when and how to offer interventions for optimum benefit. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12611000898954.
Is prior aspirin use associated with reduced severity in patients with acute pancreatitis?
- Authors: Lim, Alvin , Iyengar, Vasudha , Terry, Daniel , Islam, Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 5, no. 4 (2017), p. 151-156
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- Description: Clinical severity of Acute Pancreatitis (AP) following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.
Knowing, performing and holding queerness : LGBTIQ+ student experiences in Australian tertiary education
- Authors: Waling, Andrea , Roffee, James
- Date: 2017
- Type: Text , Journal article
- Relation: Sex Education Vol. 17, no. 3 (2017), p. 302-318
- Full Text: false
- Reviewed:
- Description: This paper explores LGBTIQ+ students’ experiences of knowing, performing and holding queerness in a tertiary educational environment. Through interviews conducted with LGBTIQ+ students at a large Australian metropolitan university, we examine the students’ engagement with other LGBTIQ+ students in the tertiary educational space. Although originally intending to explore LGBTIQ+ students’ experience of violence, harassment and abuse on campus, the study identified a number of themes concerning the normalisation of a set of beliefs, practices, presentations and performances. Drawing on frameworks of hetero/homo and trans-normativity, we explore how LGBTIQ+ students articulated concerns in knowing, performing and holding ‘authentic’ queerness. We find LGBTIQ students experienced barred access to knowledge, hostility and dismissal by other LGBTIQ+ students when they were either perceived as too queer, or not queer enough. Behind these interactions and at the heart of these tensions is the notion of an authentic queer identity in a post-gay era and the continuous challenges all LGBTIQ+ students face within a heteronormative society. New insights into how LGBTIQ+ students negotiate, manage and shape their interactions in a higher educational settings are provided, and the implications for tertiary educational institutions, in particular the need to support a diverse LGBTIQ+ community, are discussed. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
Methicillin-resistant Staphylococcus aureus in Papua New Guinea : A community nasal colonization prevalence study
- Authors: Laman, Moses , Greenhill, Andrew , Coombs, Geoffrey , Robinson, Owen , Pearson, Julie , Davis, Timothy , Manning, Laurens
- Date: 2017
- Type: Text , Journal article
- Relation: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 111, no. 8 (2017), p. 360-362
- Full Text: false
- Reviewed:
- Description: Background: There are few epidemiological data available to inform a national response to communityacquired methicillin-resistant Staphylococcus aureus (MRSA) in Papua New Guinea (PNG). Methods: We performed a cross-sectional survey to determine the pattern of MRSA nasal colonization and the diversity of circulating MRSA clones among adults and adolescents in Madang Province, PNG. Results: S. aureus nasal colonization was confirmed in 44 (17.1%) of 257 participants. Four (9.1%) isolates were methicillin resistant. Resistance to other antimicrobial agents was uncommon. Detailed molecular typing of three MRSA isolates demonstrated multiple MRSA clones in this community, of which two carried the Panton-Valentin leukocidin-associated virulence genes. Conclusions: MRSA is likely to account for a clinically important proportion of staphylococcal disease in PNG. There are multiple MRSA clones in PNG. Ongoing surveillance of community and invasive isolates is a critical component of an effective response to the challenge of community-acquired MRSA in this and many other resource-limited contexts.