Self-assessed impact of oral health on the psychological well-being and depressive symptoms of older adults living in Melbourne
- Authors: Mariño, Rodrigo , Enticott, Joanne , Browning, Colette , Elsamman, Mahmoud , Etzion, Rachel , Ferooz, Maryam , Fujihara, Ryuun , Hancock, Hugo , He, Julian , Kendig, Hal
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Public Health Dentistry Vol. 80, no. 3 (2020), p. 177-185
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- Description: Objectives: This study aimed to investigate oral health-related factors affecting the self-assessed psychological well-being (PW) and depressive symptoms of independent-living Australians aged 79 years and over living in the community in metropolitan Melbourne. Methods: The Melbourne Longitudinal Studies on Healthy Aging (MELSHA) program was used as the data source in this study and includes data on the health and well-being of older participants. The MELSHA baseline data collection occurred in 1994, the current study used data from the 2008 data collection and included 201 participants, who remained in the study. Data were analyzed using multiple linear regression (MLR) analysis with a stepwise procedure to identify the variables that accounted for a significant proportion of the variance in the participants' PW scores. Results: Present findings indicate that oral health may play a significant mediating role in PW through maintaining a presentable and acceptable physical appearance. Some 16.4 percent of participants reported feeling concerned about their dental appearance, either “Sometimes,” “Often,” or “Very often.” Multivariate analysis showed significantly influences on PW positive and negative affect scores (P ' 0.0001); and depressive symptoms (P ' 0.0001) by participants' dentition status, enjoyment of meals, self-reported feeling of concern about the appearance of the mouth, social activity and self-assessment of general health. Final models explained 17.8, 20.1, and 24.6 percent of the variance of PW positive, negative affect scores, and depressive symptoms, respectively. Conclusions: Oral health, specifically the appearance of the mouth and dentition, plays a significant role in the PW of older Melbournians. Future cross-sectional and longitudinal studies are indicated to raise awareness on the changes required to improve the quality of life of the older population. © 2020 American Association of Public Health Dentistry
- Description: Funding details: National Health and Medical Research Council, NHMRC, 148625, 219295
Schema : an open-source, distributed mobile platform for deploying mHealth research tools and interventions
- Authors: Shatte, Adrian , Teague, Samantha
- Date: 2020
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 20, no. 1 (2020), p.
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- Description: Background: Mobile applications for health, also known as 'mHealth apps', have experienced increasing popularity over the past ten years. However, most publicly available mHealth apps are not clinically validated, and many do not utilise evidence-based strategies. Health researchers wishing to develop and evaluate mHealth apps may be impeded by cost and technical skillset barriers. As traditionally lab-based methods are translated onto mobile platforms, robust and accessible tools are needed to enable the development of quality, evidence-based programs by clinical experts. Results: This paper introduces schema, an open-source, distributed, app-based platform for researchers to deploy behavior monitoring and health interventions onto mobile devices. The architecture and design features of the platform are discussed, including flexible scheduling, randomisation, a wide variety of survey and media elements, and distributed storage of data. The platform supports a range of research designs, including cross-sectional surveys, ecological momentary assessment, randomised controlled trials, and micro-randomised just-in-time adaptive interventions. Use cases for both researchers and participants are considered to demonstrate the flexibility and usefulness of the platform for mHealth research. Conclusions: The paper concludes by considering the strengths and limitations of the platform, and a call for support from the research community in areas of technical development and evaluation. To get started with schema, please visit the GitHub repository: Https://github.com/schema-app/schema. © 2020 The Author(s).
Non-communicable diseases and cognitive impairment : pathways and shared behavioral risk factors among older Chinese
- Authors: Yiengprugsawan, Vasoontara , Browning, Colette
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 7, no. (Oct 2019), p. 7
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- Description: Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
Current programs and future needs in health literacy for older people : a literature review
- Authors: Lê, Quynh , Terry, Daniel , Woodroffe, Jess
- Date: 2013
- Type: Text , Journal article , Review
- Relation: Journal of Consumer Health on the Internet Vol. 17, no. 4 (2013), p. 369-388
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- Description: Inadequate health literacy occurs more amongst older adults and can result in difficulties synthesising information and communicating with health professionals, increased emergency visits and hospitalizations, poor uptake of preventative interventions, increased mortality, and ultimately greater health care costs. A literature review was conducted that identified 12 articles that discussed and examined health literacy interventions among older adults. It revealed few papers exist which highlight programs that examine health literacy outcomes for older adults. The review identified evidence-based best-practice models of health literacy interventions need to be further developed to meet the health literacy needs of aging population. © 2013 Copyright Quynh Le, Daniel R. Terry, and Jess Woodroffe.
Workplace health and safety issues among community nurses : a study regarding the impact on providing care to rural consumers
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
A narrative review of pharmacotherapy treatment for opioid addiction and application in a community-based model in Victoria, Australia
- Authors: Vishwanath, Tejaswini , Cash, Penelope , Penney, Wendy , Cant, Robyn
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Mental Health and Addiction Vol. 18, no. 1 (2020), p. 66-76
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- Description: To review the literature regarding the value and consumer focus of research on opioid replacement therapy (ORT) programs, relevant to the Australian rural context and community pharmacy. We conducted a narrative review of literature published between 1995 and 2015, searching EBSCOhost, PubMed and Google Scholar. Three authors collaborated to screen and synthesise studies. Effectiveness, cost affordability, diversion and retention benefits were reported from pharmacological or prescribers’ or dispensers’ standpoint. Research was fragmented and evaluated contributions of these individual types of stakeholders with less discussion of consumers, or consumers’ everyday experiences of ORT. No studies took into account consumers’ psychosocial aspects or power discourses. We found ORT as a beneficial treatment for opioid dependence is well researched, although overall Australian program evaluation was lacking. A gap within ORT literature should be addressed by making consumer experiences central in designs for future research and for program evaluation. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
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.
Views and perceptions of local council partners concerning a regional-scale health promotion initiative in rural Australia
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2014
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 2, no. 7 (2014), p. 181-188
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- Description: There are a number of risk factors which increasingly impact the health and wellbeing of Australians, particularly in rural communities. To address the health and wellbeing of communities, local governments are taking on a more focused role by supporting healthy community initiatives (HCI). This paper presents local council partners perceptions concerning a regional-scale health promotion initiative that was undertaken in rural Tasmania, Australia. The evaluation provides insight into the future decisions and strategies that may be developed to improve processes, methods and outcomes of health initiatives undertaken by local governments. The study used a mixed methods approach collecting data through a questionnaire, focus group discussions and interviews with stakeholders and participating councils to provide an understanding of the effectiveness and success of, and barriers to, the health promotion initiative. It was found that there was an emphasis by local councils on programs that promoted physical activities, while programs that focused on healthy food and other health promotion topics, such as quit smoking and healthy workplaces were less emphasised. Overall, the health promotion initiative was perceived to be effective; however, there was little measureable evidence as to the outcomes of the various projects within the initiative and there was concern regarding the sustainability of the initiative beyond the funding timeframe. Community based, health promotion interventions are complex. Local government are suitably placed to deliver health promotion initiatives, as they have a greater understanding and can affect the greatest change by investing in projects with the highest priority among those communities within their boundaries. Nevertheless, sustainability of projects beyond funding allocation, while building and improving partnerships among local governments, and service agencies to pool resources and capture specific target groups must be central to ongoing initiatives.
A review of code blue activations in a single regional Australian healthcare service : a retrospective descriptive study of RISKMAN data
- Authors: Porter, Joanne , Peck, Blake , McNabb, Tiffinee , Missen, Karen
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 1-2 (2020), p. 221-227
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- Description: Background: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. Aims and objectives: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. Methods: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). Findings: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. Conclusion: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. Relevance to clinical practice: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events. © 2019 John Wiley & Sons Ltd
Type 2 diabetes mellitus management : a retrospective study in rural general practice
- Authors: Wyett, Ruby , Peck, Blake , Terry, Daniel
- Type: Text , Journal article
- Relation: Advances in Diabetes and Metabolism Vol. 7, no. 1 (), p. 1-7
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- Description: Type 2 Diabetes Mellitus (T2DM) is a chronic, progressive metabolic disease that is an international epidemic. General Practitioners (GPs) are the cornerstones of T2DM management. The aim of this study was to determine the scope of care and management of patients with T2DM within General Practice, while highlighting domains of success and areas where improvement can be made. Demographic and laboratory cross sectional data were collected by examining electronic patient records at one rural General Practice to address the aims of the study. Data included key management parameters of Hemoglobin A1c (HbA1c), estimated Glomerular Filtration Rate (eGFR), microalbuminuria, blood pressure and cholesterol levels, in addition to age, sex, and residential postcode. Further, data regarding the use of insulin, antihypertensive medications and lipid-lowering medications were collected and analyzed. Descriptive and inferential statistics were used and significance was determined at p
The development of a competency assessment standard for general practitioners in China
- Authors: Rao, Xin , Lai, Jinming , Wu, Hua , Li, Yang , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 8, no. (2020), p.
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- Description: This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs. © Copyright © 2020 Rao, Lai, Wu, Li, Xu, Browning and Thomas.
Behind every active and sporting population, there is an Epidemiologist
- Authors: Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 3-4
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- Description: This Round Table on The Epidemiology of Fitness, Sport and Physical Recreation makes for compelling reading. Australia has long been regarded as a sports-mad nation and one that has achieved major international sporting achievements because of its long-term investment in sports medicine and sports science research. Sports spectatorship is also a major pastime in Australia, underpinning the value of using sport to promote a range of health promotion messages (e.g. in relation to tobacco, alcohol, social tolerance and most recently violence prevention). People of all ages now enjoy participating in a wide range of activities from general physical activity to fitness training to cycling to team ball sports such as Australian football to combat sports. All of these feature in papers in this issue.
ED-HOME : Improving educator confidence and patient education in the Emergency Department
- Authors: Coombs, Nicole , Porter, Joanne , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Australasian Emergency Nursing Journal Vol. 19, no. 3 (2016), p. 133-137
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- Description: Background Barriers to effective patient communication in the emergency department (ED) are well recognised; time, resources and staff and consumer expectations. This project aimed to improve the quality of health education provided in the ED by increasing nurses’ confidence as educators. Method By providing a staff information package including the introduction of a new structured education tool; ED-HOME, and by assessing the confidence and self-efficacy of the nurses in the process, we hoped to determine if an improvement in practice and confidence was achieved. A quantitative, pre and post-test questionnaire comparison study was undertaken before and after a four week implementation period. The project examined the attitudes and practices of registered emergency nurses and was conducted in one metropolitan emergency department. Results Results indicated that nurse confidence and self-efficacy improved by using the new structured ED-HOME format and both staff satisfaction and education competence increased. Participants positively responded to the new tool and recommended future use in the ED. Conclusion This project demonstrates that if emergency nurses feel more confident with their educating practices and by using a structured format, patients will benefit from better quality patient education provided in the ED. © 2016 College of Emergency Nursing Australasia
Nurse expertise : a critical resource in the covid-19 pandemic response
- Authors: Schwerdtl, Patricia , Connell, Clifford , Lee, Susan , Plummer, Virginia , Russo, Philip , Endacott, Ruth , Kuhn, Lisa
- Date: 2020
- Type: Text , Journal article
- Relation: Annals of Global Health Vol. 86, no. 1 (2020), p.
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Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure
- Authors: Toukhsati, Samia , Mathews, Stephanie , Sheed, A. , Freijah, Isabella , Moncur, L. , Cropper, P , Ha, F. , Hare, David
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Cardiovascular Nursing Vol. 19, no. 2 (2020), p.165-171
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- Description: Background: Low confidence to exercise is a barrier to engaging in exercise in heart failure patients. Participating in low to moderate intensity exercise, such as the six-minute walk test, may increase exercise confidence. Aim: To compare the effects of a six-minute walk test with an educational control condition on exercise confidence in heart failure patients. Methods: This was a prospective, quasi-experimental design whereby consecutive adult patients attending an out-patient heart failure clinic completed the Exercise Confidence Scale prior to and following involvement in the six-minute walk test or an educational control condition. Results: Using a matched pairs, mixed model design (n=60; 87% male; Mage=58.87±13.16), we identified a significantly greater improvement in Total exercise confidence (F(1,54)=4.63, p=0.036, partial η2=0.079) and Running confidence (F(1,57)=4.21, p=0. 045, partial η2=0.069) following the six-minute walk test compared to the educational control condition. These benefits were also observed after adjustment for age, gender, functional class and depression. Conclusion: Heart failure patients who completed a six-minute walk test reported greater improvement in exercise confidence than those who read an educational booklet for 10 min. The findings suggest that the six-minute walk test may be used as a clinical tool to improve exercise confidence. Future research should test these results under randomized conditions and examine whether improvements in exercise confidence translate to greater engagement in exercise behavior. © The European Society of Cardiology 2019.
High-intensity interval training improves cardiorespiratory fitness in cancer patients and survivors : a meta-analysis
- Authors: Wallen, Matthew , Hennessy, Declan , Brown, Stephen , Evans, Luke , Rawstorn, Jonathan , Wong Shee, Anna , Hall, Adrian
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Cancer Care Vol. 29, no. 4 (2020), p.
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- Description: Objective: The primary objective of this systematic review and meta-analysis was to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) and usual care (UC) on cardiorespiratory fitness (peak V̇O2) in cancer patients and survivors. Secondary objectives were to compare the effects of HIIT versus MICT and UC on other cardiopulmonary exercise testing (CPET) indices. Safety and adherence to HIIT were also evaluated. Methods: A systematic review and meta-analysis of controlled trials were undertaken using eligible studies from electronic database searching (inception—December 2019). Mean differences (MD) with 95% confidence intervals (CI) were compared and heterogeneity assessed using Cochran's Q and I2 statistic. Results: Twelve eligible studies included 516 participants with post-intervention CPET data. No serious adverse events occurred. Adherence to HIIT ranged between 71.2% and 95.6%. HIIT had significantly higher peak V̇O2 compared with UC (MD = 2.11 ml kg−1 min−1, 95% CI 0.75–3.47, p =.002). No significant difference was found between HIIT and MICT (MD = 2.03 ml kg−1 min−1, 95%CI −0.75–4.83, p =.15). HIIT was more effective than UC to improve peak oxygen pulse (MD = 1.59 ml/beat, 95%CI 0.06–3.12, p =.04). Conclusions: Quantitative assessment of HIIT studies indicates good compliance, with a significant effect on peak V̇O2 and peak oxygen pulse compared with UC in cancer patients and survivors. HIIT demonstrates a comparable effect with MICT to improve peak V̇O2. © 2020 John Wiley & Sons Ltd
- Description: Western Alliance Academic Health Science Centre , WA-739501
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).
Satisfaction amid professional challenges : international medical graduates in rural Tasmania
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
The shortage-surplus paradox : a literature review of primary health care accessibility
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
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- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
In search of the optimum structural model for internet gaming disorder
- Authors: Stavropoulos, Vasileios , Gomez, Rapson , Griffiths, Mark
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 21, no. 1 (2021), p.
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- Description: Background: Internet gaming Disorder (IGD) constitutes a recently proposed clinical disorder (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2013). The present study examined if IGD is best conceptualized as categorical (present/absent), or dimensional (severity ranging from low to high), or both (i.e., hybrid of categorical/dimensional). Methods: Ratings of the nine DSM-5 IGD symptoms, as presented in the Internet Gaming Disorder Scale 9-Short Form (Pontes & Griffiths, Comput Hum Behav 45:137-143, 2015), from 738 gamers, aged 17 to 72 years, were collected. Confirmatory factor analysis (CFA), latent class analysis (LCA), and factor mixture modelling analysis (FMMA) procedures were applied to determine the optimum IGD model. Results: Although the findings showed most support for a FFMA model with two classes and one factor, there was also good statistical and substantive support for the one-factor CFA model, and the LCA model with three classes. Conclusion: It was concluded that while the optimum structure of IGD is most likely to be a hybrid model (i.e., concurrently categorical and dimensional), a uni-dimensional model and/or a three-class categorical model are also plausible. © 2021, The Author(s).