Understanding barriers to mental health service utilization for adolescents in rural Australia
- Aisbett, Damon, Boyd, Candice, Francis, Kristy, Newnham, Krystal, Newnham, Karyn
- Authors: Aisbett, Damon , Boyd, Candice , Francis, Kristy , Newnham, Krystal , Newnham, Karyn
- Date: 2007
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 7, no. (2007), p. 1-10
- Full Text:
- Reviewed:
- Description: INTRODUCTION: There is a general paucity of research in the area of rural adolescent mental health in Australia, and in particular a lack of data regarding the experiences of rural adolescents who seek help for mental health problems. This study used a qualitative approach to data collection and analysis in order to assist understanding of the barriers to mental health service utilization for young people in rural communities. METHOD: A series of interviews were conducted with each of the study's participants, who ranged in age from 15 to 17 years. All participants were clients of the Child and Adolescent Mental Health Services in the rural cities of Horsham and Ararat, Victoria, Australia. RESULTS: Participants described how the lack of reliable transport to and from the mental health service affected the utilization of the service by rural young people. They also expressed concern regarding a lack of qualified professionals in their region who specialize in child and adolescent mental health. Participants reported frustration at long waiting lists and the lack of an after-hours service. One participant shared her experiences of deliberate self-harm to in order to gain access. Results also revealed that rural gossip networks and social visibility within rural communities compounded the experience of stigma and social exclusion for these young people. Furthermore, participants explained how these experiences negatively impacted on their utilization of the mental health service and their progress towards recovery. CONCLUSIONS: There are several barriers to mental health service utilization for rural adolescents which affect both their decision to access help as well as their ability to engage effectively with mental health services over time. Clinicians who work with rural adolescents need to be mindful of the influence of rural culture on mental health service utilization by young people. The co-location of mental health services and general health services is suggested as one way to reduce the fear associated with 'being seen' entering a stand-alone mental health service. It is suggested that treatment programs for adolescents in rural areas address the different types of stigma that these young people are likely to encounter. Furthermore, community and school-based interventions aimed at reducing the social stigma of young people with mental illness in rural areas is recommended.
- Description: C1
- Description: 2003005804
- Authors: Aisbett, Damon , Boyd, Candice , Francis, Kristy , Newnham, Krystal , Newnham, Karyn
- Date: 2007
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 7, no. (2007), p. 1-10
- Full Text:
- Reviewed:
- Description: INTRODUCTION: There is a general paucity of research in the area of rural adolescent mental health in Australia, and in particular a lack of data regarding the experiences of rural adolescents who seek help for mental health problems. This study used a qualitative approach to data collection and analysis in order to assist understanding of the barriers to mental health service utilization for young people in rural communities. METHOD: A series of interviews were conducted with each of the study's participants, who ranged in age from 15 to 17 years. All participants were clients of the Child and Adolescent Mental Health Services in the rural cities of Horsham and Ararat, Victoria, Australia. RESULTS: Participants described how the lack of reliable transport to and from the mental health service affected the utilization of the service by rural young people. They also expressed concern regarding a lack of qualified professionals in their region who specialize in child and adolescent mental health. Participants reported frustration at long waiting lists and the lack of an after-hours service. One participant shared her experiences of deliberate self-harm to in order to gain access. Results also revealed that rural gossip networks and social visibility within rural communities compounded the experience of stigma and social exclusion for these young people. Furthermore, participants explained how these experiences negatively impacted on their utilization of the mental health service and their progress towards recovery. CONCLUSIONS: There are several barriers to mental health service utilization for rural adolescents which affect both their decision to access help as well as their ability to engage effectively with mental health services over time. Clinicians who work with rural adolescents need to be mindful of the influence of rural culture on mental health service utilization by young people. The co-location of mental health services and general health services is suggested as one way to reduce the fear associated with 'being seen' entering a stand-alone mental health service. It is suggested that treatment programs for adolescents in rural areas address the different types of stigma that these young people are likely to encounter. Furthermore, community and school-based interventions aimed at reducing the social stigma of young people with mental illness in rural areas is recommended.
- Description: C1
- Description: 2003005804
- Newnham, Krystal, Boyd, Candice, Newnham, Karyn, Aisbett, Damon, Francis, Kristy
- Authors: Newnham, Krystal , Boyd, Candice , Newnham, Karyn , Aisbett, Damon , Francis, Kristy
- Date: 2008
- Type: Text , Journal article
- Relation: Rural Social Work and Community Practice Vol. 13, no. 2 (2008), p. 26-32
- Full Text: false
- Reviewed:
- Description: The purpose of this study was to establish whether socioeconomic status would mediate the relationship between rurality and depression in a sample of Australian adolescents. Participants were 65 rural and 64 urban secondary school students from Years 11 and 12 who completed a survey that included a brief demographic questionnaire and the Centre for Epidemiological Studies - Depression Scale. Schools were selected for their degree of rurality as measured by the Accessibility and Remoteness Index for Australia, and the socioeconomic status of each individual was estimated via postal code using the Socio-Economic Index of Australia. Although a significant relationship between degree of rurality and depression was found, socioeconomic status did not mediate this relationship. These results suggest that the relationship between rurality and depression for young people is not due to simple differences in socioeconomic status between urban and rural areas. Other features of 'place' must be considered in accounting for rural-urban differences in adolescent depression.
- Description: C1
- Description: 2003006059
- Ye, Michelle, Ollington, Nadia, de Salas, Kristy
- Authors: Ye, Michelle , Ollington, Nadia , de Salas, Kristy
- Date: 2016
- Type: Text , Journal article
- Relation: Qualitative Sociology Review Vol. 12, no. 4 (2016), p. 120-137
- Full Text: false
- Reviewed:
- Description: Turner’s Three-Process Theory of Power together with Social Identity Theory (SIT) and Self-Categorization Theory (SCT) have been influential in social psychology to examine power-related behaviors. While positivist experimental and survey methods are common in social psychological studies, these approaches may not adequately consider Turner’s constructs due to a comparative lack of ecological validity. Drawing on a methodology-focused review of the existing research of applying aspects of Turner’s theory of power and SIT/SCT, the interpretivist case study approach by using interviews and other data collections is highlighted as an alternative and useful method to the application of Turner’s framework. The applicability of the interpretive case study approach is further emphasized in comparison with the positivist experiments and surveys. This paper also discusses how this new way of exploration may allow us to understand Turner’s work better. © 2016 QSR.
Issues in rural adolescent mental health in Australia
- Boyd, Candice, Aisbett, Damon, Francis, Kristy, Kelly, Melinda, Newnham, Karyn, Newnham, Krystal
- Authors: Boyd, Candice , Aisbett, Damon , Francis, Kristy , Kelly, Melinda , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Rural and Remote health Vol. 6, no. 501 (2006), p. 1-9
- Full Text:
- Reviewed:
- Description: The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised – including the nature of mental health issues for rural adolescents and barriers to seeking professional help – are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.
- Description: C1
- Description: 2003001815
- Authors: Boyd, Candice , Aisbett, Damon , Francis, Kristy , Kelly, Melinda , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Rural and Remote health Vol. 6, no. 501 (2006), p. 1-9
- Full Text:
- Reviewed:
- Description: The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised – including the nature of mental health issues for rural adolescents and barriers to seeking professional help – are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.
- Description: C1
- Description: 2003001815
- Jackson, Kristy, Marques, Francine, Watson, Anna, Palma-Rigo, Keisia, Nguyen-Huu, Thu-Phuc, Morris, Brian, Charchar, Fadi, Davern, Pamela, Head, Geoffrey
- Authors: Jackson, Kristy , Marques, Francine , Watson, Anna , Palma-Rigo, Keisia , Nguyen-Huu, Thu-Phuc , Morris, Brian , Charchar, Fadi , Davern, Pamela , Head, Geoffrey
- Date: 2013
- Type: Text , Journal article
- Relation: Hypertension Vol. 62 , no. 4 (2013), p. 775-781
- Full Text: false
- Reviewed:
- Description: Genetically hypertensive mice (BPH/2J) are hypertensive because of an exaggerated contribution of the sympathetic nervous system to blood pressure. We hypothesize that an additional contribution to elevated blood pressure is via sympathetically mediated activation of the intrarenal renin-angiotensin system. Our aim was to determine the contribution of the renin-angiotensin system and sympathetic nervous system to hypertension in BPH/2J mice. BPH/2J and normotensive BPN/3J mice were preimplanted with radiotelemetry devices to measure blood pressure. Depressor responses to ganglion blocker pentolinium (5 mg/kg i.p.) in mice pretreated with the angiotensin-converting enzyme inhibitor enalaprilat (1.5 mg/kg i.p.) revealed a 2-fold greater sympathetic contribution to blood pressure in BPH/2J mice during the active and inactive period. However, the depressor response to enalaprilat was 4-fold greater in BPH/2J compared with BPN/3J mice, but only during the active period (P=0.01). This was associated with 1.6-fold higher renal renin messenger RNA (mRNA; P=0.02) and 0.8-fold lower abundance of micro-RNA-181a (P=0.03), identified previously as regulating human renin mRNA. Renin mRNA levels correlated positively with depressor responses to pentolinium (r=0.99; P=0.001), and BPH/2J mice had greater renal sympathetic innervation density as identified by tyrosine hydroxylase staining of cortical tubules. Although there is a major sympathetic contribution to hypertension in BPH/2J mice, the renin-angiotensin system also contributes, doing so to a greater extent during the active period and less during the inactive period. This is the opposite of the normal renin-angiotensin system circadian pattern. We suggest that renal hyperinnervation and enhanced sympathetically induced renin synthesis mediated by lower micro-RNA-181a contributes to hypertension in BPH/2J mice.
Preferences and intention of rural adolescents toward seeking help for mental health problems
- Boyd, Candice, Hayes, Louise, Nurse, Sarah, Aisbett, Damon, Francis, Kristy, Newnham, Krystal, Sewell, Jessica
- Authors: Boyd, Candice , Hayes, Louise , Nurse, Sarah , Aisbett, Damon , Francis, Kristy , Newnham, Krystal , Sewell, Jessica
- Date: 2011
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 11, no. 1 (2011), p. 1-13
- Full Text: false
- Reviewed:
- Description: Introduction: In Australia, rural adolescents still face barriers to obtaining professional psychological help due to poor availability and accessibility of services in rural areas when delay in seeking help for mental health problems can lead to poorer treatment outcomes. The aims of this study were to: investigate the preferences and intentions of rural Australian youth towards seeking help for mental health problems; determine predictors of help-seeking intention among rural adolescents; and verify results from previous qualitative research on the barriers to help-seeking in a rural context. Method: Participants were 201 adolescents recruited from 8 rural schools in the state of Victoria, Australia. Participants ranged in age from 11 to 18 years. Using the Accessibility and Remoteness Index of Australia (ARIA+), approximately 149 participants were classified as currently living in an inner regional area of Victoria, whereas 52 participants lived in an outer regional area. Participants completed an open-ended survey of help-seeking intention. Results: Overall, 55.7% of the sample indicated that they would seek help for a mental health problem. The majority of participants, regardless of subgroup, indicated that they would seek help for a mental health problem from a school counsellor as their first choice. Gender differences were observed such that males had a higher preference for seeking help from a psychologist than females. Furthermore, older adolescents were more likely to prefer seeking help from a GP than younger participants. A multivariate analysis of help-seeking intentions revealed that ARIA was the only predictor of help-seeking intention; however, when extreme scores of depression and anxiety were also taken into account, these also predicted help-seeking intention. A content analysis of the barriers to help-seeking nominated by participants revealed that perceived limited availability of professional services in towns, perceived social proximity and fear of rural gossip, and difficulties associated with travelling to obtain help were the most significant concerns for these youth. Conclusions: These findings verify previous research on help-seeking among rural youth and reinforce that these young people face additional barriers to help-seeking by virtue of living in a rural environment. The availability of services for rural youth needs to be improved, as do young people's knowledge of service availability and access (especially travel options). It must be taken into account that rural adolescents of different ages and sex may differ in their help-seeking preferences. Finally, mental health promotion work with rural youth should consider the influence of rural culture on help-seeking intentions.
Teaching law to non-law students : The use of problem solving models in legal teaching
- Richardson, Kristy, Butler, Jennifer, Holm, Eric
- Authors: Richardson, Kristy , Butler, Jennifer , Holm, Eric
- Date: 2009
- Type: Text , Journal article
- Relation: Studies in Learning, Evaluation, Innovation and Development Vol. 6, no. 2 (2009), p. 29-41
- Full Text:
- Reviewed:
- Description: The use of problem solving models has been successfully applied and subject to evaluation in law school courses. However, the models have not been evaluated in terms of their application to law courses in which non-law (i.e., business) students are involved. This paper discusses the usefulness of such legal problem solving methods for non-law students from a technology use and acceptance framework, presenting data obtained from a pilot study which was the subject of a teaching and learning grant from CQUniversity Australia.
- Description: 2003007346
- Authors: Richardson, Kristy , Butler, Jennifer , Holm, Eric
- Date: 2009
- Type: Text , Journal article
- Relation: Studies in Learning, Evaluation, Innovation and Development Vol. 6, no. 2 (2009), p. 29-41
- Full Text:
- Reviewed:
- Description: The use of problem solving models has been successfully applied and subject to evaluation in law school courses. However, the models have not been evaluated in terms of their application to law courses in which non-law (i.e., business) students are involved. This paper discusses the usefulness of such legal problem solving methods for non-law students from a technology use and acceptance framework, presenting data obtained from a pilot study which was the subject of a teaching and learning grant from CQUniversity Australia.
- Description: 2003007346
Rural adolescents' attitudes to seeking help for mental health problems
- Francis, Kristy, Boyd, Candice, Aisbett, Damon, Newnham, Karyn, Newnham, Krystal
- Authors: Francis, Kristy , Boyd, Candice , Aisbett, Damon , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Youth Studies Australia Vol. 25 , no. 4 (2006), p. 42-49
- Full Text:
- Reviewed:
- Description: Little research has been undertaken into the barriers facing rural adolescents seeking help and support for mental health problems. This study presented students from rural secondary schools in Victoria with hypothetical scenarios of an adolescent living in a rural area with a mental disorder and posed questions inorder to create group discussion. The results revealed a range of perceived barriers to help-seeking that could be considered unique to rural settings. However, adolescents also expressed positive attitudes and identified a range of professional help sources available to them. The findings support recent moves towards providing school-based mental health services to young people in rural areas.
- Description: C1
- Description: 2003001811
- Authors: Francis, Kristy , Boyd, Candice , Aisbett, Damon , Newnham, Karyn , Newnham, Krystal
- Date: 2006
- Type: Text , Journal article
- Relation: Youth Studies Australia Vol. 25 , no. 4 (2006), p. 42-49
- Full Text:
- Reviewed:
- Description: Little research has been undertaken into the barriers facing rural adolescents seeking help and support for mental health problems. This study presented students from rural secondary schools in Victoria with hypothetical scenarios of an adolescent living in a rural area with a mental disorder and posed questions inorder to create group discussion. The results revealed a range of perceived barriers to help-seeking that could be considered unique to rural settings. However, adolescents also expressed positive attitudes and identified a range of professional help sources available to them. The findings support recent moves towards providing school-based mental health services to young people in rural areas.
- Description: C1
- Description: 2003001811
- Jackson, Kristy, Gueguen, Cindy, Lim, Kyungjoon, Eikelis, Nina, Stevenson, Emily, Charchar, Fadi, Lambert, Gavin, Burke, Sandra, Paterson, Madeleine, Marques, Francine, Head, Geoffrey
- Authors: Jackson, Kristy , Gueguen, Cindy , Lim, Kyungjoon , Eikelis, Nina , Stevenson, Emily , Charchar, Fadi , Lambert, Gavin , Burke, Sandra , Paterson, Madeleine , Marques, Francine , Head, Geoffrey
- Date: 2020
- Type: Text , Journal article
- Relation: Hypertension Research Vol. 43, no. 11 (2020), p. 1152-1164
- Full Text: false
- Reviewed:
- Description: BPH/2J mice are a genetic model of hypertension with overactivity of the sympathetic nervous system (SNS) and renin–angiotensin system (RAS). BPH/2J display higher renal renin mRNA and low levels of its negative regulator microRNA-181a (miR-181a). We hypothesise that high renal SNS activity may reduce miR-181a expression, which contributes to elevated RAS activity and hypertension in BPH/2J. Our aim was to determine whether in vivo administration of a renal-specific miR-181a mimic or whether renal denervation could increase renal miR-181a abundance to reduce renal renin mRNA, RAS activity and hypertension in BPH/2J mice. Blood pressure (BP) in BPH/2J and normotensive BPN/3J mice was measured via radiotelemetry probes. Mice were administered miR-181a mimic or a negative control (1–25 nmol, i.v., n = 6–10) with BP measured for 48 h after each dose or they underwent renal denervation or sham surgery (n = 7–9). Injection of 5–25 nmol miR-181a mimic reduced BP in BPH/2J mice after 36–48 h (−5.3 ± 1.8, −6.1 ± 1.9 mmHg, respectively, P < 0.016). Treatment resulted in lower renal renin and inflammatory marker (TLR4) mRNA levels in BPH/2J. The mimic abolished the hypotensive effect of blocking the RAS with enalaprilat (P < 0.01). No differences between mimic or vehicle were observed in BPN/3J mice except for a higher level of renal angiotensinogen in the mimic-treated mice. Renal miR-181a levels that were lower in sham BPH/2J mice were greater following renal denervation and were thus similar to those of BPN/3J. Our findings suggest that the reduced renal miR-181a may partially contribute to the elevated BP in BPH/2J mice, through an interaction between the renal sympathetic nerves and miR-181a regulation of the RAS. © 2020, The Japanese Society of Hypertension.
- Description: This work was supported by a grant from the National Health & Medical Research Council of Australia (NHMRC, Project grant 1065714) and in part by the Victorian Government’s OIS Program. Investigators were supported by NHMRC/National Heart Foundation (NHF) Postdoctoral Fellowships (NHMRC APP1091688 to KLJ, NHMRC APP1052659 and NHF PF12M6785 and 101185 to FZM) and NHMRC Research Fellowships (APP1042492 to GWL and APP1002186 to GAH).
Mothering ideology : a qualitative exploration of mothers’ perceptions of navigating motherhood pressures and partner relationships
- Williamson, Tricia, Wagstaff, Danielle, Goodwin, Jane, Smith, Naomi
- Authors: Williamson, Tricia , Wagstaff, Danielle , Goodwin, Jane , Smith, Naomi
- Date: 2023
- Type: Text , Journal article
- Relation: Sex Roles Vol. 88, no. 1-2 (2023), p. 101-117
- Full Text:
- Reviewed:
- Description: Good mother ideology refers to beliefs that women are only ‘good’ mothers if they adhere to the tenets of dominant parenting discourse, such as intensive mothering ideology, which prioritizes children’s needs and child-raising above all else. Undergirded by this ideology, mothers’ attempts to navigate the transition to motherhood are fraught with pressures, and the transition is associated with negative health outcomes for mothers and children; yet existing research gives little attention to the quality or dynamics of the partner relationship as part of this transition. The current study examined motherhood pressure and the impact on partner relationships through individual, semi-structured interviews with 19 mothers living in Australia who were 18 years or older in a heterosexual relationship with at least one child under the age of five. Thematic analysis revealed four key themes: discourses on motherhood: criticisms of mothers and internalised guilt; transformation of identity; entrenchment of gender roles through childrearing; and positive relationship dynamics: supportive fathers and challenging gender roles. This study contributes to the larger body of literature highlighting the complexity of dominant mothering ideology and its entanglement with and impact on partner relationships. Further, this study includes mothers’ perceptions of how they navigate these pressures within the relationship with their partner and the family unit. These findings have implications for programs to support mothers and other caregivers, as well as challenge unrealistic standards for motherhood. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
- Authors: Williamson, Tricia , Wagstaff, Danielle , Goodwin, Jane , Smith, Naomi
- Date: 2023
- Type: Text , Journal article
- Relation: Sex Roles Vol. 88, no. 1-2 (2023), p. 101-117
- Full Text:
- Reviewed:
- Description: Good mother ideology refers to beliefs that women are only ‘good’ mothers if they adhere to the tenets of dominant parenting discourse, such as intensive mothering ideology, which prioritizes children’s needs and child-raising above all else. Undergirded by this ideology, mothers’ attempts to navigate the transition to motherhood are fraught with pressures, and the transition is associated with negative health outcomes for mothers and children; yet existing research gives little attention to the quality or dynamics of the partner relationship as part of this transition. The current study examined motherhood pressure and the impact on partner relationships through individual, semi-structured interviews with 19 mothers living in Australia who were 18 years or older in a heterosexual relationship with at least one child under the age of five. Thematic analysis revealed four key themes: discourses on motherhood: criticisms of mothers and internalised guilt; transformation of identity; entrenchment of gender roles through childrearing; and positive relationship dynamics: supportive fathers and challenging gender roles. This study contributes to the larger body of literature highlighting the complexity of dominant mothering ideology and its entanglement with and impact on partner relationships. Further, this study includes mothers’ perceptions of how they navigate these pressures within the relationship with their partner and the family unit. These findings have implications for programs to support mothers and other caregivers, as well as challenge unrealistic standards for motherhood. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Deficiency of MicroRNA-181a results in transcriptome-wide cell-specific changes in the kidney and increases blood pressure
- Paterson, Madeleine, Jackson, Kristy, Dona, Malathi, Farrugia, Gabriella, Visniauskas, Bruna, Watson, Anna, Johnson, Chad, Prieto, Minolfa, Evans, Roger, Charchar, Fadi, Pinto, Alexander, Marques, Francine, Head, Geoffrey
- Authors: Paterson, Madeleine , Jackson, Kristy , Dona, Malathi , Farrugia, Gabriella , Visniauskas, Bruna , Watson, Anna , Johnson, Chad , Prieto, Minolfa , Evans, Roger , Charchar, Fadi , Pinto, Alexander , Marques, Francine , Head, Geoffrey
- Date: 2021
- Type: Text , Journal article
- Relation: Hypertension Vol. 78, no. 5 (Nov 2021), p. 1322-1334
- Full Text:
- Reviewed:
- Description: MicroRNA miR-181a is downregulated in the kidneys of hypertensive patients and hypertensive mice. In vitro, miR-181a is a posttranslational inhibitor of renin expression, but pleiotropic mechanisms by which miR-181a may influence blood pressure (BP) are unknown. Here, we determined whether deletion of miR-181a/b-1 in vivo changes BP and the molecular mechanisms involved at the single-cell level. We developed a KO (knockout) mouse model lacking miR-181a/b-1 genes using CRISPR/Cas9 technology. Radiotelemetry probes were implanted in 12-week-old C57BL/6J WT (wild type) and miR-181a/b-1 KO mice. Systolic and diastolic BP were 4- to 5-mm Hg higher in KO compared with WT mice over 24 hours (P<0.01). Compared with WT mice, renal renin was higher in the juxtaglomerular cells of KO mice. BP was similar in WT mice on a high- (3.1%) versus low- (0.3%) sodium diet (+0.4 +/- 0.8 mm Hg), but KO mice showed salt sensitivity (+3.3 +/- 0.8 mm Hg; P<0.001). Since microRNAs can target several mRNAs simultaneously, we performed single-nuclei RNA sequencing in 6699 renal cells. We identified 12 distinct types of renal cells, all of which had genes that were dysregulated. This included genes involved in renal fibrosis and inflammation such as Stat4, Col4a1, Cd81, Flt3l, Cxcl16, and Smad4. We observed upregulation of pathways related to the immune system, inflammatory response, reactive oxygen species, and nerve development, consistent with higher tyrosine hydroxylase in the kidney. In conclusion, downregulation of the miR-181a gene led to increased BP and salt sensitivity in mice. This is likely due to an increase in renin expression in juxtaglomerular cells, as well as microRNA-driven pleiotropic effects impacting renal pathways associated with hypertension.
- Authors: Paterson, Madeleine , Jackson, Kristy , Dona, Malathi , Farrugia, Gabriella , Visniauskas, Bruna , Watson, Anna , Johnson, Chad , Prieto, Minolfa , Evans, Roger , Charchar, Fadi , Pinto, Alexander , Marques, Francine , Head, Geoffrey
- Date: 2021
- Type: Text , Journal article
- Relation: Hypertension Vol. 78, no. 5 (Nov 2021), p. 1322-1334
- Full Text:
- Reviewed:
- Description: MicroRNA miR-181a is downregulated in the kidneys of hypertensive patients and hypertensive mice. In vitro, miR-181a is a posttranslational inhibitor of renin expression, but pleiotropic mechanisms by which miR-181a may influence blood pressure (BP) are unknown. Here, we determined whether deletion of miR-181a/b-1 in vivo changes BP and the molecular mechanisms involved at the single-cell level. We developed a KO (knockout) mouse model lacking miR-181a/b-1 genes using CRISPR/Cas9 technology. Radiotelemetry probes were implanted in 12-week-old C57BL/6J WT (wild type) and miR-181a/b-1 KO mice. Systolic and diastolic BP were 4- to 5-mm Hg higher in KO compared with WT mice over 24 hours (P<0.01). Compared with WT mice, renal renin was higher in the juxtaglomerular cells of KO mice. BP was similar in WT mice on a high- (3.1%) versus low- (0.3%) sodium diet (+0.4 +/- 0.8 mm Hg), but KO mice showed salt sensitivity (+3.3 +/- 0.8 mm Hg; P<0.001). Since microRNAs can target several mRNAs simultaneously, we performed single-nuclei RNA sequencing in 6699 renal cells. We identified 12 distinct types of renal cells, all of which had genes that were dysregulated. This included genes involved in renal fibrosis and inflammation such as Stat4, Col4a1, Cd81, Flt3l, Cxcl16, and Smad4. We observed upregulation of pathways related to the immune system, inflammatory response, reactive oxygen species, and nerve development, consistent with higher tyrosine hydroxylase in the kidney. In conclusion, downregulation of the miR-181a gene led to increased BP and salt sensitivity in mice. This is likely due to an increase in renin expression in juxtaglomerular cells, as well as microRNA-driven pleiotropic effects impacting renal pathways associated with hypertension.
Applying Turner's three-process theory of power to the study of power relations in a troubled information systems implementation
- Ye, Michelle, de Salas, Kristy, Ollington, Nadia, McKay, Judy
- Authors: Ye, Michelle , de Salas, Kristy , Ollington, Nadia , McKay, Judy
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Journal of Information Systems Vol. 21, no. (2017), p. 1-25
- Full Text:
- Reviewed:
- Description: This paper explores the nature and exercise of power in an interpretive case study of a troubled information systems (IS) implementation in a university in the Asia Pacific region using Turner's Three-Process Theory of Power based on Social Identity Theory and Self-Categorisation Theory. The findings demonstrate the value of Turner's theoretical lens as well as its insufficiency for explaining all power related activities. This research has led to the development of an extended Three-Process Theory of Power by adding the alternative components that emerged from the data in the case study in relation to the nature and exercises of power. Based on the findings, we further recommend specific guidelines for IS theoreticians and practitioners including advice to project managers on a range of key issues. Thus, this paper contributes theorising the sources of power and tactical applications of power in given situations, particularly in IS implementation projects. © 2017 Ye, de Salas, Ollington & McKay.
- Authors: Ye, Michelle , de Salas, Kristy , Ollington, Nadia , McKay, Judy
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Journal of Information Systems Vol. 21, no. (2017), p. 1-25
- Full Text:
- Reviewed:
- Description: This paper explores the nature and exercise of power in an interpretive case study of a troubled information systems (IS) implementation in a university in the Asia Pacific region using Turner's Three-Process Theory of Power based on Social Identity Theory and Self-Categorisation Theory. The findings demonstrate the value of Turner's theoretical lens as well as its insufficiency for explaining all power related activities. This research has led to the development of an extended Three-Process Theory of Power by adding the alternative components that emerged from the data in the case study in relation to the nature and exercises of power. Based on the findings, we further recommend specific guidelines for IS theoreticians and practitioners including advice to project managers on a range of key issues. Thus, this paper contributes theorising the sources of power and tactical applications of power in given situations, particularly in IS implementation projects. © 2017 Ye, de Salas, Ollington & McKay.
Evaluating SafeClub : Can risk management training improve the safety activities of community soccer clubs?
- Abbott, Kristy, Klarenaar, Paul, Donaldson, Alex, Sherker, Shauna
- Authors: Abbott, Kristy , Klarenaar, Paul , Donaldson, Alex , Sherker, Shauna
- Date: 2008
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 42, no. 6 (Jun 2008), p. 460-465
- Full Text:
- Reviewed:
- Description: Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
- Description: C1
- Description: 2003005630
- Authors: Abbott, Kristy , Klarenaar, Paul , Donaldson, Alex , Sherker, Shauna
- Date: 2008
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 42, no. 6 (Jun 2008), p. 460-465
- Full Text:
- Reviewed:
- Description: Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
- Description: C1
- Description: 2003005630
Transnational suburbia : suburban settings in Australian video games
- Authors: Speed, Lesley
- Date: 2023
- Type: Text , Journal article
- Relation: Continuum Vol. 37, no. 2 (2023), p. 169-181
- Full Text:
- Reviewed:
- Description: Video games with suburban settings offer distinctive experiences of quotidian environments. This article examines how Australian games set in homes or verdant residential neighbourhoods contribute to a global circulation of ideas about suburban life. It contributes to understanding the relationship between Australian games and Australian society by showing how gameworlds that represent everyday spatial environments exist at intersections of the global and the local. By using suburbia as a focal point for demonstrating how Australian games can be read on both international and local levels, the article explores an alternative to a cultural nationalist approach. The Australian games examined are Rumu (Robot House, 2017), Roombo: First Blood (Samurai Punk, 2019), Mars Underground (Moloch Media, 2019), Moving Out (SMG Studio and DevM Games, 2020), Untitled Goose Game (House House, 2020) and Unpacking (Witch Beam, 2021). This article argues that by positioning suburbia as both familiar and foreign, games offer experiences of virtual travel and exploration that contribute to re-imagining everyday environments. While addressing universal themes such as moving house and domestic labour, these games can also be understood in relation to Australian cultural traditions and contexts. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Speed, Lesley
- Date: 2023
- Type: Text , Journal article
- Relation: Continuum Vol. 37, no. 2 (2023), p. 169-181
- Full Text:
- Reviewed:
- Description: Video games with suburban settings offer distinctive experiences of quotidian environments. This article examines how Australian games set in homes or verdant residential neighbourhoods contribute to a global circulation of ideas about suburban life. It contributes to understanding the relationship between Australian games and Australian society by showing how gameworlds that represent everyday spatial environments exist at intersections of the global and the local. By using suburbia as a focal point for demonstrating how Australian games can be read on both international and local levels, the article explores an alternative to a cultural nationalist approach. The Australian games examined are Rumu (Robot House, 2017), Roombo: First Blood (Samurai Punk, 2019), Mars Underground (Moloch Media, 2019), Moving Out (SMG Studio and DevM Games, 2020), Untitled Goose Game (House House, 2020) and Unpacking (Witch Beam, 2021). This article argues that by positioning suburbia as both familiar and foreign, games offer experiences of virtual travel and exploration that contribute to re-imagining everyday environments. While addressing universal themes such as moving house and domestic labour, these games can also be understood in relation to Australian cultural traditions and contexts. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Renal nerves contribute to hypertension in Schlager BPH/2J mice
- Gueguen, Cindy, Jackson, Kristy, Marques, Francine, Eikelis, Nina, Phillips, Sarah, Stevenson, Emily, Charchar, Fadi, Lambert, Gavin, Davern, Pamela, Head, Geoffrey
- Authors: Gueguen, Cindy , Jackson, Kristy , Marques, Francine , Eikelis, Nina , Phillips, Sarah , Stevenson, Emily , Charchar, Fadi , Lambert, Gavin , Davern, Pamela , Head, Geoffrey
- Date: 2019
- Type: Text , Journal article
- Relation: Hypertension Research Vol. 42, no. 3 (2019), p. 306-318
- Full Text:
- Reviewed:
- Description: Schlager mice (BPH/2J) are hypertensive due to a greater contribution of the sympathetic nervous system (SNS) and renin-angiotensin system (RAS). The kidneys of BPH/2J are hyper-innervated suggesting renal nerves may contribute to the hypertension. We therefore determined the effect of bilateral renal denervation (RD) on hypertension in BPH/2J. Mean arterial pressure (MAP) was measured by radiotelemetry before and for 3 weeks after RD in BPH/2J and BPN/3J. The effects of pentolinium and enalaprilat were examined to determine the contribution of the SNS and RAS, respectively. After 3 weeks, MAP was −10.9 ± 2.1 mmHg lower in RD BPH/2J compared to baseline and −2.1 ± 2.2 mmHg in sham BPH/2J (P < 0.001, n = 8–10). RD had no effect in BPN/3J (P > 0.1). The depressor response to pentolinium was greater in BPH/2J than BPN/3J, but in both cases the response in RD mice was similar to sham. Enalaprilat decreased MAP more in RD BPH/2J compared to sham (−12 vs −3 mmHg, P < 0.001) but had no effect in BPN/3J. RD reduced renal noradrenaline in both strains but more so in BPH/2J. RD reduced renin mRNA and protein, but not plasma renin in BPH/2J to levels comparable with BPN/3J mice. We conclude that renal nerves contribute to hypertension in BPH mice as RD induced a sustained fall in MAP, which was associated with a reduction of intrarenal renin expression. The lack of inhibition of the depressor effects of pentolinium and enalaprilat by RD suggests that vasoconstrictor effects of the SNS or RAS are not involved.
- Authors: Gueguen, Cindy , Jackson, Kristy , Marques, Francine , Eikelis, Nina , Phillips, Sarah , Stevenson, Emily , Charchar, Fadi , Lambert, Gavin , Davern, Pamela , Head, Geoffrey
- Date: 2019
- Type: Text , Journal article
- Relation: Hypertension Research Vol. 42, no. 3 (2019), p. 306-318
- Full Text:
- Reviewed:
- Description: Schlager mice (BPH/2J) are hypertensive due to a greater contribution of the sympathetic nervous system (SNS) and renin-angiotensin system (RAS). The kidneys of BPH/2J are hyper-innervated suggesting renal nerves may contribute to the hypertension. We therefore determined the effect of bilateral renal denervation (RD) on hypertension in BPH/2J. Mean arterial pressure (MAP) was measured by radiotelemetry before and for 3 weeks after RD in BPH/2J and BPN/3J. The effects of pentolinium and enalaprilat were examined to determine the contribution of the SNS and RAS, respectively. After 3 weeks, MAP was −10.9 ± 2.1 mmHg lower in RD BPH/2J compared to baseline and −2.1 ± 2.2 mmHg in sham BPH/2J (P < 0.001, n = 8–10). RD had no effect in BPN/3J (P > 0.1). The depressor response to pentolinium was greater in BPH/2J than BPN/3J, but in both cases the response in RD mice was similar to sham. Enalaprilat decreased MAP more in RD BPH/2J compared to sham (−12 vs −3 mmHg, P < 0.001) but had no effect in BPN/3J. RD reduced renal noradrenaline in both strains but more so in BPH/2J. RD reduced renin mRNA and protein, but not plasma renin in BPH/2J to levels comparable with BPN/3J mice. We conclude that renal nerves contribute to hypertension in BPH mice as RD induced a sustained fall in MAP, which was associated with a reduction of intrarenal renin expression. The lack of inhibition of the depressor effects of pentolinium and enalaprilat by RD suggests that vasoconstrictor effects of the SNS or RAS are not involved.
Malay muslim religious ideology : representations of gendered beauty ideals in women’s magazines
- French, Juliana, Lee, Christina, Brace-Govan, Jan
- Authors: French, Juliana , Lee, Christina , Brace-Govan, Jan
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Macromarketing Vol. 40, no. 4 (2020), p. 459-474
- Full Text:
- Reviewed:
- Description: Responding to Drenten and McManus (2016) call on the lack of scholarship on the intersections of macromarketing and religion, this article uses magazines to demonstrate how beauty discourses reinforce or contest religious ideology in Malaysia. We draw from institutional logics to show how magazine discourses present macrolevel belief systems that can both shape and constrain the micro level behaviour of women. We identify three dialectical tensions of gendered beauty ideals as firstly both something that is embraced and something that is imposed; secondly it is collectively and individually displayed in fashion and thirdly offers contradictory discourses over blending-in versus standing-out in physical appearance. This study supplements the very limited literature on how the media as an institutional and social structure injects religious ideology to gendered representations of beauty ideals. © The Author(s) 2020.
- Authors: French, Juliana , Lee, Christina , Brace-Govan, Jan
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Macromarketing Vol. 40, no. 4 (2020), p. 459-474
- Full Text:
- Reviewed:
- Description: Responding to Drenten and McManus (2016) call on the lack of scholarship on the intersections of macromarketing and religion, this article uses magazines to demonstrate how beauty discourses reinforce or contest religious ideology in Malaysia. We draw from institutional logics to show how magazine discourses present macrolevel belief systems that can both shape and constrain the micro level behaviour of women. We identify three dialectical tensions of gendered beauty ideals as firstly both something that is embraced and something that is imposed; secondly it is collectively and individually displayed in fashion and thirdly offers contradictory discourses over blending-in versus standing-out in physical appearance. This study supplements the very limited literature on how the media as an institutional and social structure injects religious ideology to gendered representations of beauty ideals. © The Author(s) 2020.
Australian rural adolescents’ experiences of accessing psychological help for a mental health problem
- Boyd, Candice, Francis, Kristy, Aisbett, Damon, Newnham, Krystal, Sewell, Jessica, Dawes, Graham, Nurse, Sarah
- Authors: Boyd, Candice , Francis, Kristy , Aisbett, Damon , Newnham, Krystal , Sewell, Jessica , Dawes, Graham , Nurse, Sarah
- Date: 2007
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 15, no. (2007), p. 196-200
- Full Text:
- Reviewed:
- Description: Objective: This study aims to explore Australian rural adolescents’ experiences of accessing help for a mental health problem in the context of their rural communities. Design and setting: A qualitative research design was used whereby university students who had sought help for a mental health problem during their adolescence were interviewed about their experiences. Interviews were conducted face-to-face at the university. Main outcome measures: A semi-structured interview schedule was designed around the study’s main research questions. Audio-taped interviews were transcribed and thematically coded using a constant comparative method. Participants: Participants were first-year undergraduate psychology students between the ages of 17 and 21 years who sought help for a mental health issue during their adolescence and who at that time resided in a rural area. Results: Participants highlighted various barriers to seeking help for mental health problems in the context of a rural community, including: social visibility, lack of anonymity, a culture of self-reliance, and social stigma of mental illness. Participants’ access to help was primarily school-based, and participants expressed a preference for supportive counselling over structured interventions. Characteristics of school-based helpers that made them approachable included: ‘caring’, ‘nonjudgemental’, ‘genuine’, ‘young’, and able to maintain confidentiality. Conclusions: The findings support previous research that reveals barriers to help seeking for mental health problems that are unique to the culture of rural communities. The study raises questions about the merit of delivery of primary mental health care to young people via GPs alone and suggests that school-based counsellors be considered as the first step in a young person’s access to mental health care.
- Description: C1
- Description: 2003005807
- Authors: Boyd, Candice , Francis, Kristy , Aisbett, Damon , Newnham, Krystal , Sewell, Jessica , Dawes, Graham , Nurse, Sarah
- Date: 2007
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 15, no. (2007), p. 196-200
- Full Text:
- Reviewed:
- Description: Objective: This study aims to explore Australian rural adolescents’ experiences of accessing help for a mental health problem in the context of their rural communities. Design and setting: A qualitative research design was used whereby university students who had sought help for a mental health problem during their adolescence were interviewed about their experiences. Interviews were conducted face-to-face at the university. Main outcome measures: A semi-structured interview schedule was designed around the study’s main research questions. Audio-taped interviews were transcribed and thematically coded using a constant comparative method. Participants: Participants were first-year undergraduate psychology students between the ages of 17 and 21 years who sought help for a mental health issue during their adolescence and who at that time resided in a rural area. Results: Participants highlighted various barriers to seeking help for mental health problems in the context of a rural community, including: social visibility, lack of anonymity, a culture of self-reliance, and social stigma of mental illness. Participants’ access to help was primarily school-based, and participants expressed a preference for supportive counselling over structured interventions. Characteristics of school-based helpers that made them approachable included: ‘caring’, ‘nonjudgemental’, ‘genuine’, ‘young’, and able to maintain confidentiality. Conclusions: The findings support previous research that reveals barriers to help seeking for mental health problems that are unique to the culture of rural communities. The study raises questions about the merit of delivery of primary mental health care to young people via GPs alone and suggests that school-based counsellors be considered as the first step in a young person’s access to mental health care.
- Description: C1
- Description: 2003005807
Access and engagement of First Nations women in maternal and child health services
- Authors: Austin, Catherine
- Date: 2023
- Type: Text , Thesis , PhD
- Full Text:
- Description: This thesis explores and describes the engagement of First Nations women, with children from birth to five years of age, with Maternal and Child Health (MCH) services in Victoria, Australia. Identification of the factors that facilitate, support or hinder these women’s engagement with MCH services could strengthen the model of care to effectively engage First Nations women with these services. Access in the early years of a child’s life to integrated, effective, community-based services is a well-established predictor of a child’s successful transition to school and their lifelong education and employment outcomes. Such access is crucial in a child’s first 2,000 days (the period from conception to the child’s fifth year), which forms the foundation for a child’s lifetime development and health. Prior evaluative studies have shown that participation in MCH services in Victoria improves the health outcomes for children and families, particularly First Nations families. However, First Nations women and their children in Victoria show poorer health outcomes and lower participation in MCH services compared to non-Indigenous persons; this suggests a need to improve the current Victorian MCH service model. This thesis contributes recommendations for such improvements. The literature review (Chapter 2) identified the absence of a synthesis of qualitative studies of models of care to help guide MCH practice and innovation for all families, especially those at risk of child abuse and neglect. To address this gap, a three-phase qualitative study was conducted in the Glenelg Shire, Victoria, Australia, using narrative inquiry integrated with the Indigenous philosophy ‘Dadirri’. ‘Dadirri’, which emphasises deep and respectful listening, guided the development of the research design; this methodology assisted in understanding Indigenous culture and its sensitivities, building trust with the First Nations peoples involved in the studies, developing open-ended and conversational dialogue, and building respectful relationships. This method enabled First Nations women’s voices to be heard and the collection of rich data based on participants’ perspectives of and experiences with MCH services in Victoria. Study One (Chapter 4) recruited First Nations women residing in the Glenelg Shire, with at least one child aged birth to five years, to explore their perceptions and experiences of MCH services and barriers to accessing and engaging with MCH services. Study Two (Chapter 5) compared Study One data with accounts from MCH nurses working in Glenelg Shire. Study Three (Chapter 6) reviewed a piloting of the Early Assessment Referral Links (EARL) concept (developed by the researcher) that aims to improve First Nations women and their children’s access to and engagement with MCH services. EARL involved the core principles of narrative inquiry integrated with ‘Dadirri’. Study One and Two found that enabling factors for access and engagement include interventions that are culturally sensitive and effective; recognise the social determinates of health (SDOH) and social and emotional wellbeing; are timely, appropriate, culturally strong, flexible, holistic and community-based; support continuity of care and communication; and encourage early identification of risk, particularly of family violence (FV), and further assessment, intervention, referral and support in the child’s first 2,000 days. Barriers to access and engagement include an ineffective service model built on mistrust, poor communication due to cultural differences between client and provider (particularly around identification and disclosure of woman’s risk of FV), lack of continuity of care between services, limited flexibility of service delivery to suit individual needs, and a service model that does not recognise the importance of the SDOH and social and emotional wellbeing. Study Three results showed that participation of First Nations families in MCH services was consistently above the state average during the pilot period, and several First Nations families were referred to EARL stakeholders and other health professionals during the pilot. Further, there were increases in First Nations children being breastfed, fully immunised and attending Early Start Kindergarten, and identification of First Nations children at risk of abuse or neglect improved (with a significant increase in referrals for FV and child protection and significant decrease in episodes of out-of-home care). This thesis’s findings can support policy development. This research shows that timely, effective, holistic engagement with First Nations women in their child’s first 2,000 days, that respects their culture and facilitates genuine partnerships built on co-design and shared decision-making with the Indigenous community, needs to be an essential part of the MCH service model. Additionally, this thesis recommends adopting a strengths-based approach that respects First Nations peoples’ child-rearing practices and culture, and providing necessary training to MCH nurses who work with First Nations families. Keywords: child family health, continuity of care, First Nations women
- Description: Doctor of Philosophy
- Authors: Austin, Catherine
- Date: 2023
- Type: Text , Thesis , PhD
- Full Text:
- Description: This thesis explores and describes the engagement of First Nations women, with children from birth to five years of age, with Maternal and Child Health (MCH) services in Victoria, Australia. Identification of the factors that facilitate, support or hinder these women’s engagement with MCH services could strengthen the model of care to effectively engage First Nations women with these services. Access in the early years of a child’s life to integrated, effective, community-based services is a well-established predictor of a child’s successful transition to school and their lifelong education and employment outcomes. Such access is crucial in a child’s first 2,000 days (the period from conception to the child’s fifth year), which forms the foundation for a child’s lifetime development and health. Prior evaluative studies have shown that participation in MCH services in Victoria improves the health outcomes for children and families, particularly First Nations families. However, First Nations women and their children in Victoria show poorer health outcomes and lower participation in MCH services compared to non-Indigenous persons; this suggests a need to improve the current Victorian MCH service model. This thesis contributes recommendations for such improvements. The literature review (Chapter 2) identified the absence of a synthesis of qualitative studies of models of care to help guide MCH practice and innovation for all families, especially those at risk of child abuse and neglect. To address this gap, a three-phase qualitative study was conducted in the Glenelg Shire, Victoria, Australia, using narrative inquiry integrated with the Indigenous philosophy ‘Dadirri’. ‘Dadirri’, which emphasises deep and respectful listening, guided the development of the research design; this methodology assisted in understanding Indigenous culture and its sensitivities, building trust with the First Nations peoples involved in the studies, developing open-ended and conversational dialogue, and building respectful relationships. This method enabled First Nations women’s voices to be heard and the collection of rich data based on participants’ perspectives of and experiences with MCH services in Victoria. Study One (Chapter 4) recruited First Nations women residing in the Glenelg Shire, with at least one child aged birth to five years, to explore their perceptions and experiences of MCH services and barriers to accessing and engaging with MCH services. Study Two (Chapter 5) compared Study One data with accounts from MCH nurses working in Glenelg Shire. Study Three (Chapter 6) reviewed a piloting of the Early Assessment Referral Links (EARL) concept (developed by the researcher) that aims to improve First Nations women and their children’s access to and engagement with MCH services. EARL involved the core principles of narrative inquiry integrated with ‘Dadirri’. Study One and Two found that enabling factors for access and engagement include interventions that are culturally sensitive and effective; recognise the social determinates of health (SDOH) and social and emotional wellbeing; are timely, appropriate, culturally strong, flexible, holistic and community-based; support continuity of care and communication; and encourage early identification of risk, particularly of family violence (FV), and further assessment, intervention, referral and support in the child’s first 2,000 days. Barriers to access and engagement include an ineffective service model built on mistrust, poor communication due to cultural differences between client and provider (particularly around identification and disclosure of woman’s risk of FV), lack of continuity of care between services, limited flexibility of service delivery to suit individual needs, and a service model that does not recognise the importance of the SDOH and social and emotional wellbeing. Study Three results showed that participation of First Nations families in MCH services was consistently above the state average during the pilot period, and several First Nations families were referred to EARL stakeholders and other health professionals during the pilot. Further, there were increases in First Nations children being breastfed, fully immunised and attending Early Start Kindergarten, and identification of First Nations children at risk of abuse or neglect improved (with a significant increase in referrals for FV and child protection and significant decrease in episodes of out-of-home care). This thesis’s findings can support policy development. This research shows that timely, effective, holistic engagement with First Nations women in their child’s first 2,000 days, that respects their culture and facilitates genuine partnerships built on co-design and shared decision-making with the Indigenous community, needs to be an essential part of the MCH service model. Additionally, this thesis recommends adopting a strengths-based approach that respects First Nations peoples’ child-rearing practices and culture, and providing necessary training to MCH nurses who work with First Nations families. Keywords: child family health, continuity of care, First Nations women
- Description: Doctor of Philosophy
A fuzzy logic approach to experience based
- Authors: Sun, Zhaohao , Finnie, Gavin
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Intelligent Systems Vol. 22, no. 8 (2007), p. 867-889
- Full Text: false
- Reviewed:
- Description: International Journal of Intelligent Systems archive Volume 22 Issue 8, August 2007 John Wiley & Sons, Inc. New York, NY, USA table of contents doi>10.1002/int.v22:8
Introduction: the promise of ageing labour forces
- Authors: Taylor, Philip
- Date: 2008
- Type: Text , Book chapter
- Relation: Ageing labour forces: Promises and prospects p. 1-22
- Full Text: false
- Reviewed: