Acupuncture for comorbid depression and insomnia in perimenopause : a feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial
- Zhao, Fei, Zheng, Zhen, Fu, Qiang-Qiang, Conduit, Russell, Xu, Hong, Wang, Hui-ru, Huang, Yu-Ling, Jiang, Ting, Zhang, Wen-Jing, Kennedy, Gerard
- Authors: Zhao, Fei , Zheng, Zhen , Fu, Qiang-Qiang , Conduit, Russell , Xu, Hong , Wang, Hui-ru , Huang, Yu-Ling , Jiang, Ting , Zhang, Wen-Jing , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background and objective: Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods: Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results: Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion: Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture. Copyright © 2023 Zhao, Zheng, Fu, Conduit, Xu, Wang, Huang, Jiang, Zhang and Kennedy.
- Authors: Zhao, Fei , Zheng, Zhen , Fu, Qiang-Qiang , Conduit, Russell , Xu, Hong , Wang, Hui-ru , Huang, Yu-Ling , Jiang, Ting , Zhang, Wen-Jing , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background and objective: Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods: Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results: Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion: Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture. Copyright © 2023 Zhao, Zheng, Fu, Conduit, Xu, Wang, Huang, Jiang, Zhang and Kennedy.
Agile ageing : implementation considerations for a walking basketball program
- Talpey, Scott, Pascoe, Deborah, Wallen, Mathew
- Authors: Talpey, Scott , Pascoe, Deborah , Wallen, Mathew
- Date: 2023
- Type: Text , Journal article
- Relation: Activities, Adaptation and Aging Vol. 47, no. 3 (2023), p. 301-314
- Full Text:
- Reviewed:
- Description: Physical activity generally declines with increasing age and lack of enjoyment is a noted barrier to older adults participating in traditional exercise programs. Walking basketball is a modified version of basketball designed to align with the physical capabilities of older adults, where participants are required to walk rather than run and body contact is not allowed. A walking basketball program provides participants with an opportunity to obtain the physical, mental and social health benefits of exercise in a competitive and social context. Due to the dynamic environment of a walking basketball program, participants are exposed to a unique stimulus combining both physical and cognitive demands, that is unmatched by traditional exercise programs. However, an increased risk of injury coincides with the unique demands of the activity. Therefore, the purpose of this manuscript is to provide practical applications for sporting organization that wish to implement a walking basketball program. © 2022 Taylor & Francis Group, LLC.
- Authors: Talpey, Scott , Pascoe, Deborah , Wallen, Mathew
- Date: 2023
- Type: Text , Journal article
- Relation: Activities, Adaptation and Aging Vol. 47, no. 3 (2023), p. 301-314
- Full Text:
- Reviewed:
- Description: Physical activity generally declines with increasing age and lack of enjoyment is a noted barrier to older adults participating in traditional exercise programs. Walking basketball is a modified version of basketball designed to align with the physical capabilities of older adults, where participants are required to walk rather than run and body contact is not allowed. A walking basketball program provides participants with an opportunity to obtain the physical, mental and social health benefits of exercise in a competitive and social context. Due to the dynamic environment of a walking basketball program, participants are exposed to a unique stimulus combining both physical and cognitive demands, that is unmatched by traditional exercise programs. However, an increased risk of injury coincides with the unique demands of the activity. Therefore, the purpose of this manuscript is to provide practical applications for sporting organization that wish to implement a walking basketball program. © 2022 Taylor & Francis Group, LLC.
Associations between smartphone keystroke metadata and mental health symptoms in adolescents: findings from the future proofing study
- Braund, Taylor, O'Dea, Bridianne, Bal, Debopriyo, Maston, Kate, Larsen, Mark, Werner-Seidler, Aliza, Tillman, Gabriel, Christensen, Helen
- Authors: Braund, Taylor , O'Dea, Bridianne , Bal, Debopriyo , Maston, Kate , Larsen, Mark , Werner-Seidler, Aliza , Tillman, Gabriel , Christensen, Helen
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 10, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Mental disorders are prevalent during adolescence. Among the digital phenotypes currently being developed to monitor mental health symptoms, typing behavior is one promising candidate. However, few studies have directly assessed associations between typing behavior and mental health symptom severity, and whether these relationships differs between genders. Objective: In a cross-sectional analysis of a large cohort, we tested whether various features of typing behavior derived from keystroke metadata were associated with mental health symptoms and whether these relationships differed between genders. Methods: A total of 934 adolescents from the Future Proofing study undertook 2 typing tasks on their smartphones through the Future Proofing app. Common keystroke timing and frequency features were extracted across tasks. Mental health symptoms were assessed using the Patient Health Questionnaire-Adolescent version, the Children's Anxiety Scale-Short Form, the Distress Questionnaire 5, and the Insomnia Severity Index. Bivariate correlations were used to test whether keystroke features were associated with mental health symptoms. The false discovery rates of P values were adjusted to q values. Machine learning models were trained and tested using independent samples (ie, 80% train 20% test) to identify whether keystroke features could be combined to predict mental health symptoms. Results: Keystroke timing features showed a weak negative association with mental health symptoms across participants. When split by gender, females showed weak negative relationships between keystroke timing features and mental health symptoms, and weak positive relationships between keystroke frequency features and mental health symptoms. The opposite relationships were found for males (except for dwell). Machine learning models using keystroke features alone did not predict mental health symptoms. Conclusions: Increased mental health symptoms are weakly associated with faster typing, with important gender differences. Keystroke metadata should be collected longitudinally and combined with other digital phenotypes to enhance their clinical relevance. ©Taylor A Braund, Bridianne O'Dea, Debopriyo Bal, Kate Maston, Mark Larsen, Aliza Werner-Seidler, Gabriel Tillman, Helen Christensen.
- Authors: Braund, Taylor , O'Dea, Bridianne , Bal, Debopriyo , Maston, Kate , Larsen, Mark , Werner-Seidler, Aliza , Tillman, Gabriel , Christensen, Helen
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Mental Health Vol. 10, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Mental disorders are prevalent during adolescence. Among the digital phenotypes currently being developed to monitor mental health symptoms, typing behavior is one promising candidate. However, few studies have directly assessed associations between typing behavior and mental health symptom severity, and whether these relationships differs between genders. Objective: In a cross-sectional analysis of a large cohort, we tested whether various features of typing behavior derived from keystroke metadata were associated with mental health symptoms and whether these relationships differed between genders. Methods: A total of 934 adolescents from the Future Proofing study undertook 2 typing tasks on their smartphones through the Future Proofing app. Common keystroke timing and frequency features were extracted across tasks. Mental health symptoms were assessed using the Patient Health Questionnaire-Adolescent version, the Children's Anxiety Scale-Short Form, the Distress Questionnaire 5, and the Insomnia Severity Index. Bivariate correlations were used to test whether keystroke features were associated with mental health symptoms. The false discovery rates of P values were adjusted to q values. Machine learning models were trained and tested using independent samples (ie, 80% train 20% test) to identify whether keystroke features could be combined to predict mental health symptoms. Results: Keystroke timing features showed a weak negative association with mental health symptoms across participants. When split by gender, females showed weak negative relationships between keystroke timing features and mental health symptoms, and weak positive relationships between keystroke frequency features and mental health symptoms. The opposite relationships were found for males (except for dwell). Machine learning models using keystroke features alone did not predict mental health symptoms. Conclusions: Increased mental health symptoms are weakly associated with faster typing, with important gender differences. Keystroke metadata should be collected longitudinally and combined with other digital phenotypes to enhance their clinical relevance. ©Taylor A Braund, Bridianne O'Dea, Debopriyo Bal, Kate Maston, Mark Larsen, Aliza Werner-Seidler, Gabriel Tillman, Helen Christensen.
Australian men’s sheds and their role in the health and wellbeing of men : a systematic review
- Barbagallo, Michael, Brito, Sara, Porter, Joanne
- Authors: Barbagallo, Michael , Brito, Sara , Porter, Joanne
- Date: 2023
- Type: Text , Journal article
- Relation: Health & Social care in the Community Vol. 2023, no. (2023), p. 1-9
- Full Text:
- Reviewed:
- Description: Men’s sheds are a community-based organisation that allows a space for a community of men to interact and engage with one another with hands-on activities. As such, men’s sheds form an appropriate setting to deliver health and wellbeing initiatives. This review aims to understand the role of Australian men’s sheds with respect to the health and wellbeing of their male participants. This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) following a three-step process of planning, conducting, and reporting the review. All three authors reviewed all the eligible articles. There was significant methodological heterogeneity between the sources identified (n = 11). A narrative synthesis identified three key themes: health promotion, wellbeing, and socialisation intergenerational mentoring and Aboriginal and Torres Strait Islander men’s health. Men’s sheds serve as ideal locations for the delivery of initiatives that can positively impact on the health and wellbeing of their male participants. Furthermore, research is needed to explore the implementation and evaluation of these health and wellbeing initiatives for men in their respective communities.
- Authors: Barbagallo, Michael , Brito, Sara , Porter, Joanne
- Date: 2023
- Type: Text , Journal article
- Relation: Health & Social care in the Community Vol. 2023, no. (2023), p. 1-9
- Full Text:
- Reviewed:
- Description: Men’s sheds are a community-based organisation that allows a space for a community of men to interact and engage with one another with hands-on activities. As such, men’s sheds form an appropriate setting to deliver health and wellbeing initiatives. This review aims to understand the role of Australian men’s sheds with respect to the health and wellbeing of their male participants. This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) following a three-step process of planning, conducting, and reporting the review. All three authors reviewed all the eligible articles. There was significant methodological heterogeneity between the sources identified (n = 11). A narrative synthesis identified three key themes: health promotion, wellbeing, and socialisation intergenerational mentoring and Aboriginal and Torres Strait Islander men’s health. Men’s sheds serve as ideal locations for the delivery of initiatives that can positively impact on the health and wellbeing of their male participants. Furthermore, research is needed to explore the implementation and evaluation of these health and wellbeing initiatives for men in their respective communities.
Cross-sectional study of soil-transmitted helminthiases in black belt region of Alabama, USA
- Poole, Claudette, Barker, Troy, Bradbury, Richard, Capone, Drew, Chatham, Amy, Handali, Sukwan, Rodriguez, Eduardo, Qvarnstrom, Yvonne, Brown, Joe
- Authors: Poole, Claudette , Barker, Troy , Bradbury, Richard , Capone, Drew , Chatham, Amy , Handali, Sukwan , Rodriguez, Eduardo , Qvarnstrom, Yvonne , Brown, Joe
- Date: 2023
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 29, no. 12 (2023), p. 2461-2470
- Full Text:
- Reviewed:
- Description: We conducted a cross-sectional study to determine the prevalence of soil-transmitted helminthiases (STH) in areas of rural Alabama, USA, that have sanitation deficits. We enrolled 777 children; 704 submitted stool specimens and 227 a dried blood spot sample. We microscopically examined stool specimens from all 704 children by using Mini-FLOTAC for helminth eggs. We tested a subset by using molecular techniques: real-time PCR analysis for 5 STH species, TaqMan Array Cards for enteric helminths, and digital PCR for Necator americanus hookworm. We analyzed dried blood spots for Strongyloides stercoralis and Toxocara spp. roundworms by using serologic testing. Despite 12% of our cohort reporting living in homes that directly discharge untreated domestic wastewater, stool testing for STH was negative; however, 5% of dried blood spots were positive for Toxocara spp. roundworms. Survey data suggests substantial numbers of children in this region may be exposed to raw sewage, which is itself a major public health concern. © 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.
- Authors: Poole, Claudette , Barker, Troy , Bradbury, Richard , Capone, Drew , Chatham, Amy , Handali, Sukwan , Rodriguez, Eduardo , Qvarnstrom, Yvonne , Brown, Joe
- Date: 2023
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 29, no. 12 (2023), p. 2461-2470
- Full Text:
- Reviewed:
- Description: We conducted a cross-sectional study to determine the prevalence of soil-transmitted helminthiases (STH) in areas of rural Alabama, USA, that have sanitation deficits. We enrolled 777 children; 704 submitted stool specimens and 227 a dried blood spot sample. We microscopically examined stool specimens from all 704 children by using Mini-FLOTAC for helminth eggs. We tested a subset by using molecular techniques: real-time PCR analysis for 5 STH species, TaqMan Array Cards for enteric helminths, and digital PCR for Necator americanus hookworm. We analyzed dried blood spots for Strongyloides stercoralis and Toxocara spp. roundworms by using serologic testing. Despite 12% of our cohort reporting living in homes that directly discharge untreated domestic wastewater, stool testing for STH was negative; however, 5% of dried blood spots were positive for Toxocara spp. roundworms. Survey data suggests substantial numbers of children in this region may be exposed to raw sewage, which is itself a major public health concern. © 2023 Centers for Disease Control and Prevention (CDC). All rights reserved.
Efficacy of a digital mental health biopsychosocial transdiagnostic intervention with or without therapist assistance for adults with anxiety and depression : adaptive randomized controlled trial
- Andrews, Brooke, Klein, Britt, Nguyen, Huy, Corboy, Denise, McLaren, Suzanne, Watson, Shaun
- Authors: Andrews, Brooke , Klein, Britt , Nguyen, Huy , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. ©Brooke Andrews, Britt Klein, Huy Van Nguyen, Denise Corboy, Suzanne McLaren, Shaun Watson.
- Authors: Andrews, Brooke , Klein, Britt , Nguyen, Huy , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. ©Brooke Andrews, Britt Klein, Huy Van Nguyen, Denise Corboy, Suzanne McLaren, Shaun Watson.
Evaluation of various support intensities of digital mental health treatment for reducing anxiety and depression in adults : protocol for a mixed methods, adaptive, randomized clinical trial
- Andrews, Brooke, Klein, Britt, McLaren, Suzanne, Watson, Shaun, Corboy, Denise
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
Exploring adaptations to the clinical reasoning cycle for forensic mental health nursing : a qualitative enquiry
- Maguire, Tessa, Garvey, Loretta, Ryan, Jo, Levett-Jones, Tracy, Olasoji, Michael, Willetts, Georgina
- Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Willetts, Georgina
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 2 (2023), p. 544-555
- Full Text:
- Reviewed:
- Description: Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to ‘own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team. © 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
- Authors: Maguire, Tessa , Garvey, Loretta , Ryan, Jo , Levett-Jones, Tracy , Olasoji, Michael , Willetts, Georgina
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 2 (2023), p. 544-555
- Full Text:
- Reviewed:
- Description: Forensic mental health nurses (FMHN) provide care to address the needs of people who have mental illnesses across a range of diverse settings. The Clinical Reasoning Cycle (CRC) has been identified as a potential framework to assist FMHNs; however, adaptations were required to reflect the unique nature of the clinical setting. This study aimed to explore adaptations made to determine suitability prior to implementation in practice. Nominal Group Technique was used to explore suggested adaptations determined from a previous study and reach a consensus on the changes. Fourteen senior nurses from a state-wide Forensic mental Health (FMH) service participated. A consensus was reached for two proposed changes. Data were analysed using thematic analysis. Three main themes were interpreted from the data; FMH adaptations are warranted, the focus of the CRC, and who owns the cycle? Nurses in this study considered the need to include offence and risk issues due to the impact these factors have on the therapeutic relationship and cognitive bias; however, they also identified the need to focus on recovery-oriented care while engaging in clinical reasoning. Nurses in this study also expressed some reluctance for nursing to ‘own' the model, due to concern that ownership may cause division among the team or result in inconsistency in care. However, some participant's suggested the CRC with adaptations assisted FMH nurses to articulate their specialist skills and knowledge to others and highlight the nursing contribution to care. Further work is needed to finalize adaptations with a focus on engaging the consumer carer workforce and interdisciplinary team. © 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
Exploring the role of the nurse unit manager in forensic mental health inpatient units : a qualitative study
- Maguire, Tessa, Mawren, Daveena, Ryan, Jo, Ennis, Gary, Olasoji, Michael
- Authors: Maguire, Tessa , Mawren, Daveena , Ryan, Jo , Ennis, Gary , Olasoji, Michael
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 6 (2023), p. 1756-1765
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- Description: Forensic mental health (FMH) inpatient settings are complex working environments at times due to a number of factors including the presence of challenging behaviours that may include violence and aggression, restrictions related to legislation, extended length of stay and the impact of trauma. Nurse unit managers (NUMs) play an important role in managing the unit environment and clinical standards of care to achieve better outcomes for consumers and staff. However, the role of NUMs in an FMH setting is poorly understood. The overall aim of this study was to explore the role of NUMs working within an FMH setting in Victoria, Australia. To our knowledge, this is the first study that has examined the subject. Data were collected via focus groups from n = 32 participants which included NUMs, their managers, staff who work alongside the NUMs and the staff the NUMs manage. Data were analysed using thematic analysis and four themes were interpreted from the data, (i) lack of role clarity, (ii) the importance of clinical Leadership and forensic mental health knowledge, (iii) step up in responsibility and step down in pay and (iv) seeing the difference you make. The role of the NUM within a forensic mental health setting comes with a number of challenges, but also opportunities to enact change. An ongoing effort to better support those employed within the NUM role and make the role desirable for aspiring staff is critical to the sustainability of a skilled clinical workforce and quality of care in this complex setting. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
- Authors: Maguire, Tessa , Mawren, Daveena , Ryan, Jo , Ennis, Gary , Olasoji, Michael
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 6 (2023), p. 1756-1765
- Full Text:
- Reviewed:
- Description: Forensic mental health (FMH) inpatient settings are complex working environments at times due to a number of factors including the presence of challenging behaviours that may include violence and aggression, restrictions related to legislation, extended length of stay and the impact of trauma. Nurse unit managers (NUMs) play an important role in managing the unit environment and clinical standards of care to achieve better outcomes for consumers and staff. However, the role of NUMs in an FMH setting is poorly understood. The overall aim of this study was to explore the role of NUMs working within an FMH setting in Victoria, Australia. To our knowledge, this is the first study that has examined the subject. Data were collected via focus groups from n = 32 participants which included NUMs, their managers, staff who work alongside the NUMs and the staff the NUMs manage. Data were analysed using thematic analysis and four themes were interpreted from the data, (i) lack of role clarity, (ii) the importance of clinical Leadership and forensic mental health knowledge, (iii) step up in responsibility and step down in pay and (iv) seeing the difference you make. The role of the NUM within a forensic mental health setting comes with a number of challenges, but also opportunities to enact change. An ongoing effort to better support those employed within the NUM role and make the role desirable for aspiring staff is critical to the sustainability of a skilled clinical workforce and quality of care in this complex setting. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
Factors influencing the timeliness of care for patients with lung cancer in Bangladesh
- Ansar, Adnan, Lewis, Virginia, McDonald, Christine, Liu, Chaojie, Rahman, Muhammad Aziz
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 23, no. 1 (2023), p.
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- Description: Background: This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. Methods: A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. Results: A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. Conclusion: The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals. © 2023, The Author(s).
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Background: This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. Methods: A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. Results: A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. Conclusion: The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals. © 2023, The Author(s).
Gambling-related suicide in Victoria, Australia : a population-based cross-sectional study
- Rintoul, Angela, Dwyer, Jeremy, Millar, Ciara, Bugeja, Lyndal, Nguyen, Huy
- Authors: Rintoul, Angela , Dwyer, Jeremy , Millar, Ciara , Bugeja, Lyndal , Nguyen, Huy
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Regional Health - Western Pacific Vol. 41, no. (2023), p.
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- Description: Background: Gambling is associated with serious harms to health, including suicide. Yet public health systems for recording the role of gambling in suicide deaths are relatively underdeveloped. This study contributes to the understanding of this relationship. Methods: A population-based cross-sectional study of suicides reported to the Coroners Court of Victoria between 2009 and 2016 was performed to identify the incidence and characteristics of gambling-related suicides (GRS). Findings: From 2009 to 2016 there were 4788 suicide deaths in Victoria. Of these, 184 were identified as direct GRS and a further 17 were GRS by ‘affected others’. Together, these GRS comprise 4.2% of all suicides in Victoria over this eight-year period. Direct GRS account for an annual average rate of 5.13 GRS per million Victorian adults. GRS were significantly more likely to be male (n = 153, 83%), than the Victorian population of total suicide deaths and significantly more likely to occur among those most disadvantaged. Family members and friends were more likely than clinicians to know about the deceased gambling. Interpretation: Given that gambling is not routinely investigated by coroners and may be hidden from family, friends, and health professionals, this is an underestimate of the true scale of the GRS in Victoria. A range of measures should be introduced to prevent, screen, support, and treat gambling harm. Family members and friends should also be provided with help services. Preventing gambling-related harm through public health measures could significantly reduce suicidality and suicide, both in Australia and globally. Funding: Federation University Australia, Coroners Court of Victoria, Suicide Prevention Australia. © 2023 The Authors
- Authors: Rintoul, Angela , Dwyer, Jeremy , Millar, Ciara , Bugeja, Lyndal , Nguyen, Huy
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Regional Health - Western Pacific Vol. 41, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Gambling is associated with serious harms to health, including suicide. Yet public health systems for recording the role of gambling in suicide deaths are relatively underdeveloped. This study contributes to the understanding of this relationship. Methods: A population-based cross-sectional study of suicides reported to the Coroners Court of Victoria between 2009 and 2016 was performed to identify the incidence and characteristics of gambling-related suicides (GRS). Findings: From 2009 to 2016 there were 4788 suicide deaths in Victoria. Of these, 184 were identified as direct GRS and a further 17 were GRS by ‘affected others’. Together, these GRS comprise 4.2% of all suicides in Victoria over this eight-year period. Direct GRS account for an annual average rate of 5.13 GRS per million Victorian adults. GRS were significantly more likely to be male (n = 153, 83%), than the Victorian population of total suicide deaths and significantly more likely to occur among those most disadvantaged. Family members and friends were more likely than clinicians to know about the deceased gambling. Interpretation: Given that gambling is not routinely investigated by coroners and may be hidden from family, friends, and health professionals, this is an underestimate of the true scale of the GRS in Victoria. A range of measures should be introduced to prevent, screen, support, and treat gambling harm. Family members and friends should also be provided with help services. Preventing gambling-related harm through public health measures could significantly reduce suicidality and suicide, both in Australia and globally. Funding: Federation University Australia, Coroners Court of Victoria, Suicide Prevention Australia. © 2023 The Authors
Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
- Momtazmanesh, Sara, Moghaddam, Sahar, Ghamari, Seyyed-Hadi, Rad, Elaheh, Rezaei, Negar, Shobeiri, Parnian, Aali, Amirali, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abdelmasseh, Michael, Abdoun, Meriem, Abdulah, Deldar, Md Abdullah, Abu, Abedi, Aidin, Abolhassani, Hassan, Abrehdari-Tafreshi, Zahra, Achappa, Basavaprabhu, Adane, Denberu, Adane, Tigist, Addo, Isaac, Adnan, Mohammad, Adnani, Qorinah, Ahmad, Sajjad, Ahmadi, Ali, Ahmadi, Keivan, Ahmed, Ali, Ahmed, Ayman, Rashid, Tarik, Al Hamad, Hanadi, Alahdab, Fares, Ur Rahman, Mohammad Hifz, oh, oi, oj, ok;, Rahman, Mosiur, Rahman, Muhammad Aziz
- Authors: Momtazmanesh, Sara , Moghaddam, Sahar , Ghamari, Seyyed-Hadi , Rad, Elaheh , Rezaei, Negar , Shobeiri, Parnian , Aali, Amirali , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abdelmasseh, Michael , Abdoun, Meriem , Abdulah, Deldar , Md Abdullah, Abu , Abedi, Aidin , Abolhassani, Hassan , Abrehdari-Tafreshi, Zahra , Achappa, Basavaprabhu , Adane, Denberu , Adane, Tigist , Addo, Isaac , Adnan, Mohammad , Adnani, Qorinah , Ahmad, Sajjad , Ahmadi, Ali , Ahmadi, Keivan , Ahmed, Ali , Ahmed, Ayman , Rashid, Tarik , Al Hamad, Hanadi , Alahdab, Fares , Ur Rahman, Mohammad Hifz , oh, oi, oj, ok; , Rahman, Mosiur , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 59, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
- Authors: Momtazmanesh, Sara , Moghaddam, Sahar , Ghamari, Seyyed-Hadi , Rad, Elaheh , Rezaei, Negar , Shobeiri, Parnian , Aali, Amirali , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abdelmasseh, Michael , Abdoun, Meriem , Abdulah, Deldar , Md Abdullah, Abu , Abedi, Aidin , Abolhassani, Hassan , Abrehdari-Tafreshi, Zahra , Achappa, Basavaprabhu , Adane, Denberu , Adane, Tigist , Addo, Isaac , Adnan, Mohammad , Adnani, Qorinah , Ahmad, Sajjad , Ahmadi, Ali , Ahmadi, Keivan , Ahmed, Ali , Ahmed, Ayman , Rashid, Tarik , Al Hamad, Hanadi , Alahdab, Fares , Ur Rahman, Mohammad Hifz , oh, oi, oj, ok; , Rahman, Mosiur , Rahman, Muhammad Aziz
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 59, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation. © 2023 The Authors
Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019
- Wu, Dongze, Jin, Yingzhao, Xing, Yuhan, Abate, Melsew, Abbasian, Mohammadreza, Abbasi-Kangevari, Mohsen, Abbasi-Kangevari, Zeinab, Abd-Allah, Foad, Abdelmasseh, Michael, Abdollahifar, Mohammad-Amin, Abdulah, Deldar, Abedi, Aidin, Abedi, Vida, Abidi, Hassan, Aboagye, Richard, Abolhassani, Hassan, Abuabara, Katrina, Abyadeh, Morteza, Addo, Isaac, Adeniji, Kayode, Adepoju, Abiola, Adesina, Miracle, Adnani, Qorinah, Afarideh, Mohsen, Aghamiri, Shahin, Agodi, Antonella, Agrawal, Anurag, Arriagada, Constanza, Ahmad, Antonella, Rahman, Muhammad Aziz, Alif, Sheikh
- Authors: Wu, Dongze , Jin, Yingzhao , Xing, Yuhan , Abate, Melsew , Abbasian, Mohammadreza , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abd-Allah, Foad , Abdelmasseh, Michael , Abdollahifar, Mohammad-Amin , Abdulah, Deldar , Abedi, Aidin , Abedi, Vida , Abidi, Hassan , Aboagye, Richard , Abolhassani, Hassan , Abuabara, Katrina , Abyadeh, Morteza , Addo, Isaac , Adeniji, Kayode , Adepoju, Abiola , Adesina, Miracle , Adnani, Qorinah , Afarideh, Mohsen , Aghamiri, Shahin , Agodi, Antonella , Agrawal, Anurag , Arriagada, Constanza , Ahmad, Antonella , Rahman, Muhammad Aziz , Alif, Sheikh
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 64, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of
- Authors: Wu, Dongze , Jin, Yingzhao , Xing, Yuhan , Abate, Melsew , Abbasian, Mohammadreza , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abd-Allah, Foad , Abdelmasseh, Michael , Abdollahifar, Mohammad-Amin , Abdulah, Deldar , Abedi, Aidin , Abedi, Vida , Abidi, Hassan , Aboagye, Richard , Abolhassani, Hassan , Abuabara, Katrina , Abyadeh, Morteza , Addo, Isaac , Adeniji, Kayode , Adepoju, Abiola , Adesina, Miracle , Adnani, Qorinah , Afarideh, Mohsen , Aghamiri, Shahin , Agodi, Antonella , Agrawal, Anurag , Arriagada, Constanza , Ahmad, Antonella , Rahman, Muhammad Aziz , Alif, Sheikh
- Date: 2023
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 64, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of
Hybridizing five neural-metaheuristic paradigms to predict the pillar stress in bord and pillar method
- Zhou, Jian, Chen, Yuxin, Chen, Hui, Khandelwal, Manoj, Monjezi, Masoud, Peng, Kang
- Authors: Zhou, Jian , Chen, Yuxin , Chen, Hui , Khandelwal, Manoj , Monjezi, Masoud , Peng, Kang
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Pillar stability is an important condition for safe work in room-and-pillar mines. The instability of pillars will lead to large-scale collapse hazards, and the accurate estimation of induced stresses at different positions in the pillar is helpful for pillar design and guaranteeing pillar stability. There are many modeling methods to design pillars and evaluate their stability, including empirical and numerical method. However, empirical methods are difficult to be applied to places other than the original environmental characteristics, and numerical methods often simplify the boundary conditions and material properties, which cannot guarantee the stability of the design. Currently, machine learning (ML) algorithms have been successfully applied to pillar stability assessment with higher accuracy. Thus, the study adopted a back-propagation neural network (BPNN) and five elements including the sparrow search algorithm (SSA), gray wolf optimizer (GWO), butterfly optimization algorithm (BOA), tunicate swarm algorithm (TSA), and multi-verse optimizer (MVO). Combining metaheuristic algorithms, five hybrid models were developed to predict the induced stress within the pillar. The weight and threshold of the BPNN model are optimized by metaheuristic algorithms, in which the mean absolute error (MAE) is utilized as the fitness function. A database containing 149 data samples was established, where the input variables were the angle of goafline (A), depth of the working coal seam (H), specific gravity (G), distance of the point from the center of the pillar (C), and distance of the point from goafline (D), and the output variable was the induced stress. Furthermore, the predictive performance of the proposed model is evaluated by five metrics, namely coefficient of determination (R2), root mean squared error (RMSE), variance accounted for (VAF), mean absolute error (MAE), and mean absolute percentage error (MAPE). The results showed that the five hybrid models developed have good prediction performance, especially the GWO-BPNN model performed the best (Training set: R2 = 0.9991, RMSE = 0.1535, VAF = 99.91, MAE = 0.0884, MAPE = 0.6107; Test set: R2 = 0.9983, RMSE = 0.1783, VAF = 99.83, MAE = 0.1230, MAPE = 0.9253). Copyright © 2023 Zhou, Chen, Chen, Khandelwal, Monjezi and Peng.
- Authors: Zhou, Jian , Chen, Yuxin , Chen, Hui , Khandelwal, Manoj , Monjezi, Masoud , Peng, Kang
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Pillar stability is an important condition for safe work in room-and-pillar mines. The instability of pillars will lead to large-scale collapse hazards, and the accurate estimation of induced stresses at different positions in the pillar is helpful for pillar design and guaranteeing pillar stability. There are many modeling methods to design pillars and evaluate their stability, including empirical and numerical method. However, empirical methods are difficult to be applied to places other than the original environmental characteristics, and numerical methods often simplify the boundary conditions and material properties, which cannot guarantee the stability of the design. Currently, machine learning (ML) algorithms have been successfully applied to pillar stability assessment with higher accuracy. Thus, the study adopted a back-propagation neural network (BPNN) and five elements including the sparrow search algorithm (SSA), gray wolf optimizer (GWO), butterfly optimization algorithm (BOA), tunicate swarm algorithm (TSA), and multi-verse optimizer (MVO). Combining metaheuristic algorithms, five hybrid models were developed to predict the induced stress within the pillar. The weight and threshold of the BPNN model are optimized by metaheuristic algorithms, in which the mean absolute error (MAE) is utilized as the fitness function. A database containing 149 data samples was established, where the input variables were the angle of goafline (A), depth of the working coal seam (H), specific gravity (G), distance of the point from the center of the pillar (C), and distance of the point from goafline (D), and the output variable was the induced stress. Furthermore, the predictive performance of the proposed model is evaluated by five metrics, namely coefficient of determination (R2), root mean squared error (RMSE), variance accounted for (VAF), mean absolute error (MAE), and mean absolute percentage error (MAPE). The results showed that the five hybrid models developed have good prediction performance, especially the GWO-BPNN model performed the best (Training set: R2 = 0.9991, RMSE = 0.1535, VAF = 99.91, MAE = 0.0884, MAPE = 0.6107; Test set: R2 = 0.9983, RMSE = 0.1783, VAF = 99.83, MAE = 0.1230, MAPE = 0.9253). Copyright © 2023 Zhou, Chen, Chen, Khandelwal, Monjezi and Peng.
Identifying complementary and alternative medicine recommendations for insomnia treatment and care : a systematic review and critical assessment of comprehensive clinical practice guidelines
- Zhao, Fei-Yi. Y., Xu, Peijie, Kennedy, Gerard, Conduit, Russell, Zhang, Wen-Jing, Wang, Yan-Mei, Fu, Qiang-Qiang, Zheng, Zhen
- Authors: Zhao, Fei-Yi. Y. , Xu, Peijie , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Wang, Yan-Mei , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
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- Description: Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155. Copyright © 2023 Zhao, Xu, Kennedy, Conduit, Zhang, Wang, Fu and Zheng.
- Authors: Zhao, Fei-Yi. Y. , Xu, Peijie , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Wang, Yan-Mei , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155. Copyright © 2023 Zhao, Xu, Kennedy, Conduit, Zhang, Wang, Fu and Zheng.
Incontinence during and following hospitalisation : a prospective study of prevalence, incidence and association with clinical outcomes
- Campbell, Jill, Hubbard, Ruth, Ostaszkiewicz, Joan, Green, Theresa, Coyer, Fiona, Mudge, Alison
- Authors: Campbell, Jill , Hubbard, Ruth , Ostaszkiewicz, Joan , Green, Theresa , Coyer, Fiona , Mudge, Alison
- Date: 2023
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 52, no. 9 (2023), p.
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- Description: Background: Incontinence is common in hospitalised older adults but few studies report new incidence during or following hospitalisation. Objective: To describe prevalence and incidence of incontinence in older inpatients and associations with clinical outcomes. Design: Secondary analysis of prospectively collected data from consecutive consenting inpatients age 65 years and older on medical and surgical wards in four Australian public hospitals. Methods: Participants self-reported urinary and faecal incontinence 2 weeks prior to admission, at hospital discharge and 30 days after discharge as part of comprehensive assessment by a trained research assistant. Outcomes were length of stay, facility discharge, 30-day readmission and 6-month mortality. Results: Analysis included 970 participants (mean age 76.7 years, 48.9% female). Urinary and/or faecal incontinence was self-reported in 310/970 (32.0%, [95% confidence interval (CI) 29.0-35.0]) participants 2 weeks before admission, 201/834 (24.1% [95% CI 21.2-27.2]) at discharge and 193/776 (24.9% [95% CI 21.9-28.1]) 30 days after discharge. Continence patterns were dynamic within the peri-hospital period. Of participants without pre-hospital incontinence, 74/567 (13.1% [95% CI 10.4-16.1) reported incontinence at discharge and 85/537 (15.8% [95% CI 12.8-19.2]) reported incontinence at 30 days follow-up. Median hospital stay was longer in participants with pre-hospital incontinence (7 vs. 6 days, P = 0.02) even in adjusted analyses and pre-hospital incontinence was significantly associated with mortality in unadjusted but not adjusted analyses. Conclusion: Pre-hospital, hospital-acquired and new post-hospital incontinence are common in older inpatients. Better understanding of incontinence patterns may help target interventions to reduce this complication. © 2023 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
- Authors: Campbell, Jill , Hubbard, Ruth , Ostaszkiewicz, Joan , Green, Theresa , Coyer, Fiona , Mudge, Alison
- Date: 2023
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 52, no. 9 (2023), p.
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- Description: Background: Incontinence is common in hospitalised older adults but few studies report new incidence during or following hospitalisation. Objective: To describe prevalence and incidence of incontinence in older inpatients and associations with clinical outcomes. Design: Secondary analysis of prospectively collected data from consecutive consenting inpatients age 65 years and older on medical and surgical wards in four Australian public hospitals. Methods: Participants self-reported urinary and faecal incontinence 2 weeks prior to admission, at hospital discharge and 30 days after discharge as part of comprehensive assessment by a trained research assistant. Outcomes were length of stay, facility discharge, 30-day readmission and 6-month mortality. Results: Analysis included 970 participants (mean age 76.7 years, 48.9% female). Urinary and/or faecal incontinence was self-reported in 310/970 (32.0%, [95% confidence interval (CI) 29.0-35.0]) participants 2 weeks before admission, 201/834 (24.1% [95% CI 21.2-27.2]) at discharge and 193/776 (24.9% [95% CI 21.9-28.1]) 30 days after discharge. Continence patterns were dynamic within the peri-hospital period. Of participants without pre-hospital incontinence, 74/567 (13.1% [95% CI 10.4-16.1) reported incontinence at discharge and 85/537 (15.8% [95% CI 12.8-19.2]) reported incontinence at 30 days follow-up. Median hospital stay was longer in participants with pre-hospital incontinence (7 vs. 6 days, P = 0.02) even in adjusted analyses and pre-hospital incontinence was significantly associated with mortality in unadjusted but not adjusted analyses. Conclusion: Pre-hospital, hospital-acquired and new post-hospital incontinence are common in older inpatients. Better understanding of incontinence patterns may help target interventions to reduce this complication. © 2023 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
Key issues of health and safety for workers in residential aged care : an expert study
- Seaward, Liz, Morgan, Damian, Thomson, Alana
- Authors: Seaward, Liz , Morgan, Damian , Thomson, Alana
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 10, no. (2023), p.
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- Description: Introduction: Residential aged care (RAC) represents a fast-growing sector within Australia's health care system and is characterized by high levels of workplace injury. To better understand this injury problem, this study investigated key informant perspectives concerning sector occupational health and safety (OHS) focused on key issues associated with the risk of worker injury. Method: Semi-structured interviews were undertaken with nine key informants representing (OHS) specialists, healthcare employers, regulators, worker association representatives, and academic researchers in OHS or healthcare. Interviews were transcribed verbatim and analyzed using thematic analysis. Results: This study identified six themes on OHS within RAC including (i) the physical and emotional nature of the work, (ii) casualization of employment, (iii) prioritization, (iv) workforce profile, (v) OHS role construction, and (vi) clinical standards. The study highlighted differences in OHS roles between RAC and other safety-critical sectors regarding governance and management of OHS. The key informants identified a propensity within RAC to downplay or disregard worker OHS issues justified through prioritizing resident safety. Further, neither OHS professional nor institutional logics are prominent in RAC leadership and decision-making where the emphasis is placed on mandatory standards to maintain funding purposes. Several recommendations are made to address identified issues. Copyright © 2023 Seaward, Morgan and Thomson.
- Authors: Seaward, Liz , Morgan, Damian , Thomson, Alana
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 10, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: Residential aged care (RAC) represents a fast-growing sector within Australia's health care system and is characterized by high levels of workplace injury. To better understand this injury problem, this study investigated key informant perspectives concerning sector occupational health and safety (OHS) focused on key issues associated with the risk of worker injury. Method: Semi-structured interviews were undertaken with nine key informants representing (OHS) specialists, healthcare employers, regulators, worker association representatives, and academic researchers in OHS or healthcare. Interviews were transcribed verbatim and analyzed using thematic analysis. Results: This study identified six themes on OHS within RAC including (i) the physical and emotional nature of the work, (ii) casualization of employment, (iii) prioritization, (iv) workforce profile, (v) OHS role construction, and (vi) clinical standards. The study highlighted differences in OHS roles between RAC and other safety-critical sectors regarding governance and management of OHS. The key informants identified a propensity within RAC to downplay or disregard worker OHS issues justified through prioritizing resident safety. Further, neither OHS professional nor institutional logics are prominent in RAC leadership and decision-making where the emphasis is placed on mandatory standards to maintain funding purposes. Several recommendations are made to address identified issues. Copyright © 2023 Seaward, Morgan and Thomson.
Mental health nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient psychiatric units : a non-participant observation study
- Sreeram, Anju, Cross, Wendy, Townsin, Louise
- Authors: Sreeram, Anju , Cross, Wendy , Townsin, Louise
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 4 (2023), p. 1112-1128
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- Description: National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery-oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery-oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice specifically. Therefore, this non-participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale-v4 and The Recovery Attitudes Questionnaire inspired the development of a non-participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery-oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
- Authors: Sreeram, Anju , Cross, Wendy , Townsin, Louise
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 32, no. 4 (2023), p. 1112-1128
- Full Text:
- Reviewed:
- Description: National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery-oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery-oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice specifically. Therefore, this non-participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery-oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale-v4 and The Recovery Attitudes Questionnaire inspired the development of a non-participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery-oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses. © 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.
Occupational characteristics and disability-free survival after retirement age : an exploratory analysis from the ASPREE study
- Alif, Sheikh, Benke, Geza, Ronaldson, Kathlyn, Walker-Bone, Karen, Woods, Robyn, Tran, Cammie, Beilin, Lawrence, Tonkin, Andrew, Owen, Alice, McNeil, John
- Authors: Alif, Sheikh , Benke, Geza , Ronaldson, Kathlyn , Walker-Bone, Karen , Woods, Robyn , Tran, Cammie , Beilin, Lawrence , Tonkin, Andrew , Owen, Alice , McNeil, John
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
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- Description: Background: Certain occupational characteristics have been linked with poor health and reduced longevity. However, the association between occupational characteristics and survival free of disability in a post-retirement age group has not been investigated. Methods: We investigated outcomes in 12,215 healthy older Australian adults in the Aspirin in Reducing Events in the Elderly (ASPREE) and ASPREE Longitudinal Study of Older Persons (ALSOP) sub-study. The ISCO-88 major occupational groups, settings, and activity levels were assigned based on free-text job descriptions. The Finnish Job Exposure Matrix was used to assign occupational characteristics to the three longest-held jobs. The primary endpoint, disability-free survival, was defined as a composite measure of death, dementia, or persistent physical disability. The endpoint of all-cause mortality was analyzed separately. Because of multiple exploratory analyses, only those associations with a two-sided value of p less than 0.005 were considered statistically significant. Cox proportional hazard models were used to calculate adjusted hazard ratios. Results: Having worked in an ‘elementary’ occupation was associated with a reduction in disability-free survival. A specific impact on disability-free survival was observed among those whose work had involved high accident risk and adverse social climate. No significant relationship was identified with those previously exposed to sedentary work, vigorous physical activity, work primarily outdoors, or a range of other occupational characteristics. All-cause mortality was not increased among any of the occupational groups. Conclusion: This exploratory study found a reduction in disability-free survival among people who worked in ‘elementary’ occupations, with specific risks associated with occupations involving high accident risks and adverse social climate. Copyright © 2023 Alif, Benke, Ronaldson, Walker-Bone, Woods, Tran, Beilin, Tonkin, Owen and McNeil.
- Authors: Alif, Sheikh , Benke, Geza , Ronaldson, Kathlyn , Walker-Bone, Karen , Woods, Robyn , Tran, Cammie , Beilin, Lawrence , Tonkin, Andrew , Owen, Alice , McNeil, John
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Certain occupational characteristics have been linked with poor health and reduced longevity. However, the association between occupational characteristics and survival free of disability in a post-retirement age group has not been investigated. Methods: We investigated outcomes in 12,215 healthy older Australian adults in the Aspirin in Reducing Events in the Elderly (ASPREE) and ASPREE Longitudinal Study of Older Persons (ALSOP) sub-study. The ISCO-88 major occupational groups, settings, and activity levels were assigned based on free-text job descriptions. The Finnish Job Exposure Matrix was used to assign occupational characteristics to the three longest-held jobs. The primary endpoint, disability-free survival, was defined as a composite measure of death, dementia, or persistent physical disability. The endpoint of all-cause mortality was analyzed separately. Because of multiple exploratory analyses, only those associations with a two-sided value of p less than 0.005 were considered statistically significant. Cox proportional hazard models were used to calculate adjusted hazard ratios. Results: Having worked in an ‘elementary’ occupation was associated with a reduction in disability-free survival. A specific impact on disability-free survival was observed among those whose work had involved high accident risk and adverse social climate. No significant relationship was identified with those previously exposed to sedentary work, vigorous physical activity, work primarily outdoors, or a range of other occupational characteristics. All-cause mortality was not increased among any of the occupational groups. Conclusion: This exploratory study found a reduction in disability-free survival among people who worked in ‘elementary’ occupations, with specific risks associated with occupations involving high accident risks and adverse social climate. Copyright © 2023 Alif, Benke, Ronaldson, Walker-Bone, Woods, Tran, Beilin, Tonkin, Owen and McNeil.
Older adults' preferences for Internet-based services : type and content
- Klein, Britt, Shandley, Kerrie, McLaren, Suzanne, Clinnick, Lisa
- Authors: Klein, Britt , Shandley, Kerrie , McLaren, Suzanne , Clinnick, Lisa
- Date: 2023
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 42, no. 4 (2023), p. 780-785
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- Description: Objective(s): The aim of this paper was to report on qualitative survey responses provided by older Australian adults regarding their preferences for Internet-based services and content. Methods: Two qualitative questions (‘What type of Internet-based mental health and well-being (1) services, and (2) content would be of most interest to you?’) from a broader survey investigating the mental and physical health of older Australians were thematically analysed for commonly occurring themes. Eighty-nine participants aged 65 years or older (mean age = 71 years, SD = 5.30) responded to at least one qualitative question. Participants were primarily female (60%, n = 53), born in Australia (65%, n = 58), in a relationship (58%, n = 52), living in the community (79%, n = 70) and relatively well educated, with the majority having completed a university degree (38%, n = 34). Results: Themes indicated that participants were most interested in Facebook-style services (n = 17), chat groups (n = 16) and email-based services (n = 4) designed specifically for older adults (n = 14). However, some concerns were raised regarding the trustworthiness of Internet-based services, with the largest proportion of participants (n = 22) noting that they were unlikely to use Internet- or social media-based services. The primary content-related themes were mental fitness (n = 34), grief and loss (n = 20), health information (n = 13), socialisation (n = 11) and physical fitness (n = 10). Conclusions: Participants indicated interest in tailor-made Facebook-style services for older adults that allow them to communicate with their peers and create new social networks and incorporate content relating to strategies for working on mental and physical fitness, information on coping with grief and loss, as well as health information. These findings can be used by organisations to develop Internet-based services and content for older Australian adults. © 2023 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.
- Authors: Klein, Britt , Shandley, Kerrie , McLaren, Suzanne , Clinnick, Lisa
- Date: 2023
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 42, no. 4 (2023), p. 780-785
- Full Text:
- Reviewed:
- Description: Objective(s): The aim of this paper was to report on qualitative survey responses provided by older Australian adults regarding their preferences for Internet-based services and content. Methods: Two qualitative questions (‘What type of Internet-based mental health and well-being (1) services, and (2) content would be of most interest to you?’) from a broader survey investigating the mental and physical health of older Australians were thematically analysed for commonly occurring themes. Eighty-nine participants aged 65 years or older (mean age = 71 years, SD = 5.30) responded to at least one qualitative question. Participants were primarily female (60%, n = 53), born in Australia (65%, n = 58), in a relationship (58%, n = 52), living in the community (79%, n = 70) and relatively well educated, with the majority having completed a university degree (38%, n = 34). Results: Themes indicated that participants were most interested in Facebook-style services (n = 17), chat groups (n = 16) and email-based services (n = 4) designed specifically for older adults (n = 14). However, some concerns were raised regarding the trustworthiness of Internet-based services, with the largest proportion of participants (n = 22) noting that they were unlikely to use Internet- or social media-based services. The primary content-related themes were mental fitness (n = 34), grief and loss (n = 20), health information (n = 13), socialisation (n = 11) and physical fitness (n = 10). Conclusions: Participants indicated interest in tailor-made Facebook-style services for older adults that allow them to communicate with their peers and create new social networks and incorporate content relating to strategies for working on mental and physical fitness, information on coping with grief and loss, as well as health information. These findings can be used by organisations to develop Internet-based services and content for older Australian adults. © 2023 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.