What works for therapists conducting family meetings : Treatment integrity in family-focused grief therapy during palliative care and bereavement
- Authors: Chan, Eunice , O'Neill, Imogen , McKenzie, Maria , Love, Anthony , Kissane, David
- Date: 2004
- Type: Text , Journal article
- Relation: Journal of Pain and Symptom Management Vol. 27, no. 6 (2004), p. 502-512
- Full Text: false
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- Description: The purpose of this study was to evaluate the treatment integrity of Family-focused Grief Therapy (FFGT), a preventive intervention designed for families at high risk of poor functioning during palliative care and bereavement. From the 81 families participating in a randomized controlled trial (53 assigned to therapy), 28 were randomly selected for this study of treatment fidelity using the ITGT integrity measure. A total of 109 family sessions were appraised. This represented a review of 62 % of treated families, 38 % of total therapy sessions, and 87% of the 15 participating therapists. Weighted mean percentage occurences therapist behaviors permitted trends in therapy application to be observed. Inter-rater reliability using the FFGT integrity measure was satisfactory, with 88 % overall agreement. Eighty-six percent of therapists adhered faithfully to core elements of the model. Therapist competence was evidenced by a strong therapeutic alliance (94 %), affirmation of family strengths in over 90%, and focus on agreed themes in 76 % of sessions. Therapists averaged 10 grief-related questions per session, 7 on communication-related issues during assessment, 7 on conflict late in therapy, and 4 on cohesiveness across the course of therapy. Consistent application of FFGT, with attention to its low-key themes of family communication, cohesiveness, conflict resolution, and shared grief has been demonstrated. The model is generalizable when applied by family therapists. (C) 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
The role of psychopathic traits and substance abuse in predicting violent victimization in patients with schizophrenia spectrum disorders
- Authors: Dolan, Mairead , O'Malley, Kate , McGregor, Kate
- Date: 2013
- Type: Text , Journal article
- Relation: Personality and Mental Health Vol. 7, no. 1 (2013), p. 28-38
- Full Text: false
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- Description: We examined the relationship between psychopathic traits and substance abuse and violent victimization in 94 community patients meeting DSM-IV criteria for schizophrenia spectrum disorders in contact with public mental health services in Victoria, Australia. Data on violence and victimization were collated from multiple sources and combined to categorize patients into victims of serious violence (VV; n=74) and those who were not victims of serious violence (NVV; n=20) groups. The VV group had higher rates of unemployment and previous violence but did not differ from the NVV on current symptom ratings. The VV group has significantly higher substance abuse and psychopathy scores, but only psychopathy score significantly contributed to the prediction of victimization. All psychopathy facets were reasonably good predictors of victimization status, but the antisocial facet contributed most to the prediction of victimization. A better understanding of the role and contribution of antisocial (particularly psychopathic) traits in violent victimization in mentally ill populations is needed to better inform community management plans. © 2012 John Wiley & Sons, Ltd.
The Importance of Foot Care in Older People With Diabetes
- Authors: Fortington, Lauren , Geertzen, Jeertzen , Van Netten, Jaap , Van Baal, Jeff , Bus, Sicco , Schaper, Nicolaas
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 14, no. 2 (February 2013 2013), p. 136
- Full Text: false
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- Description: C1
Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors
- Authors: Sawyer, Neroli
- Date: 2010
- Type: Text , Journal article
- Relation: Human Reproduction Vol. 25, no. 5 (2010), p. 1089-1096
- Full Text: false
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- Description: The majority of countries that support the use of donor insemination (DI) in artificial reproductive technology (ART) limit the number of children born from one donor. The setting of these donor limits, though intended to control for the risk of inadvertent half-sibling unions between the offspring of anonymous donors, actually have no evidence base. Controlling for the risk of inadvertent half-sibling unions may soon become unnecessary due to the increasing world-wide use of open-identity sperm donors and the revocation of donor anonymity in many countries. With the shift from anonymous to open-identity donation, the central issue is not the risk of genetic abnormality from inadvertent half-sibling consanguinity; it is the psycho-social impact of the multiple use of open-identity sperm donors. Despite this, the jurisdictions that allow or mandate the use of open-identity donors continue to observe existing limits that do not consider nor specifically control for the psycho-! social impact of the multiple use of open-identity sperm donors. It is proposed that: (i) conservative interim donor limits be placed on the multiple use of open-identity donors, while research into the psycho-social impact of disclosure is undertaken to inform the establishment of evidence-based limits; and (ii) the existing limits in jurisdictions where anonymity is still commonly practiced or protected could be raised, if an updated mathematical model was used for calculating evidence-based anonymous donor limits.
Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia
- Authors: Finch, Caroline , Clapperton, Angela , McCrory, Paul
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 198, no. 8 (2013), p. 427-430
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective: To describe trends in hospitalisation for sport-related concussion. Design, setting and patients: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002-03 to 2010-11 financial years for patients aged ≥15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. Main outcome measures: Number and cost of hospitalisations; rate of hospitalisation per 100000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100000 participants over 9 years. Results: There were 4745 hospitalisations of people aged ≥15 years for sport-related concussion, with a total hospital treatment cost of $17944799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%-77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100000 participants also increased significantly, by 38.9% (95% CI, 17.5%-61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling. Conclusions: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 years. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.
- Description: 2003011025
Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury : Population-based study
- Authors: Finch, Caroline , Shee, Anna Wong , Clapperton, Angela
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 7. e005043
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
The emotion self-confidence model of suicidal ideation
- Authors: Deeley, Stephanie , Love, Anthony
- Date: 2012
- Type: Text , Journal article
- Relation: Advances in Mental Health Vol. 10, no. 3 (2012), p. 246-257
- Full Text: false
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- Description: Developing and testing theoretical models of suicidal processes is an important step towards designing appropriately targeted interventions. Though numerous correlates of suicidal ideation have been identifi ed, little theory articulates exactly how suicidal ideation arises in such contexts. Drawing on empirical and theoretical literature, we present the rationale for a stress-coping model to explain the development of suicidal ideation within an individual (the emotion self-confi dence model of suicidal ideation). Negative emotionality is viewed as an internal contextual stressor, potentially leading to the coping response of suicidal ideation, depending on how well an individual believes he/she can cope with or change the negative emotionality (emotion self-confi dence). In particular, high levels of negative emotionality coupled with low emotion self-confi dence would be expected to predispose towards thoughts of suicide. We discuss the relationship between emotion self-confi dence and processes associated with suicidal ideation, such as depression and hopelessness, as well as how emotion self-confi dence relates to broader cognitive behavioral constructs involving coping expectations. Accordingly, we outline the benefi ts of conceptualizing the model within Lazarus and Folkman's (1984; Lazarus, 1999) stress-coping framework. © eContent Management Pty Ltd.
Implementing person-environment approaches to prevent falls: A qualitative inquiry in applying the Westmead approach to occupational therapy home visits
- Authors: Clemson, Lindy , Donaldson, Alex , Hill, Keith , Day, Lesley
- Date: 2014
- Type: Text , Journal article
- Relation: Australian Occupational Therapy Journal Vol. 61, no. 5 (2014), p. 325-334
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- Description: Background/aims: Despite evidence of the effectiveness of home safety interventions for preventing falls, there is limited uptake of such interventions within community services. Therefore, as part of a broader translational project, we explored issues underlying the implementation of an evidence-based home safety fall prevention intervention. Method: We conducted in-depth interviews with eight occupational therapists and two programme coordinators engaged to deliver a home safety fall prevention intervention. Six community health centres within two metropolitan regions of Melbourne, Australia participated. The RE-AIM framework and Diffusion of Innovations theory underpinned the interviews which examine the enablers and barriers to implementing a home safety fall prevention intervention and integrating it into routine community preventive practice. Analysis involved thematic and content analysis. Results: Investment in the home safety for fall prevention intervention was supported and valued by coordinators and therapists alike, and a number of themes emerged which influenced implementation of this intervention. These included issues of: compatibility with organisational processes, individual practitioner practices and skills, a prevention approach, and client expectations; relative advantage in terms of flexibility of the process, client engagement and regional capacity building; complexity of implementing the intervention; and observability related to the invisible nature of fall prevention outcomes. Conclusion: Implementation of this home safety fall prevention intervention was influenced by a range of interrelated organisational, practitioner and client related factors. The findings from this project provide insights into, and opportunities to increase the sustainable implementation of the home safety fall prevention intervention into practice.
Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: new developments and revised recommendations
- Authors: Johnson, David , Jones, Graham , Mathew, Timothy , Ludlow, Marie , Doogue, Matthew , Jose, Matthew , Langham, Robyn , Lawton, Paul , McTaggart, Steven , Peake, Michael , Polkinghorne, Kevan , Usherwood, Timothy
- Date: 2012
- Type: Text , Journal article
- Relation: Medical Journal Of Australia Vol. 197, no. 4 (2012), p. 222-223
- Full Text: false
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- Description: The publication of the Australasian Creatinine Consensus Working Group’s position statements in 2005 and 2007 resulted in automatic reporting of estimated glomerular filtration rate (eGFR) with requests for serum creatinine concentration in adults, facilitated the unification of units of measurement for creatinine and eGFR, and promoted the standardisation of assays. New advancements and continuing debate led the Australasian Creatinine Consensus Working Group to reconvene in 2010.
A population-based survey of knowledge of first aid for burns in New South Wales
- Authors: Harvey, Lara , Barr, Margo , Poulos, Roslyn , Finch, Caroline , Sherker, Shauna , Harvey, Jack
- Date: 2011
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 195, no. 8 (2011), p. 465-468
- Full Text: false
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- Description: Objective: To determine the current level of knowledge of first aid for a burn injury and sources of this knowledge among the general population of New South Wales. Design, setting and participants: People aged 16 years or older were interviewed as part of the 2007 NSW Population Health Survey, a continuous telephone survey of NSW residents. Main outcome measure: Weighted proportion of the population with optimal first aid knowledge for burns. Results: In total, 7320 respondents were asked questions related to burn injuries and first aid. Of the surveyed population, 82% reported that they would cool a burn with water, and 9% reported that they would cool the burn for the recommended 20 minutes. Few respondents reported that they would remove the patient’s clothing and keep the injured person warm. The most common sources of first aid information were a first aid book (42%) and the internet (33%). Speaking a language other than English at home, and being over 65 years of age were associated with a lack of first aid knowledge. Conclusions: A minority of people living in NSW know the optimal time for cooling a burn injury and other appropriate first aid steps for burns. This study demonstrates a gap in the public’s knowledge, especially among non-English speaking people and older people, and highlights the need for a clear, consistent first aid message.
Mobility in Elderly People With a Lower Limb Amputation: A Systematic Review
- Authors: Fortington, Lauren , Rommers, Gerardus , Geertzen, Jan , Postema, Klaas , Dijkstra, Pieter
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 13, no. 4 (May 2012 2012), p. 319-325
- Full Text: false
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- Description: Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring extensive rehabilitation and long term care. Mobility is key to regaining independence; however, the impact of multiple comorbidities in this patient group can make regaining mobility a particularly challenging task. An evidence-based prognosis for mobility is needed for rehabilitation and long term care planning. This systematic review summarizes the prosthetic and nonprosthetic mobility outcomes achieved by elderly people with a lower limb amputation, to determine whether an accurate prognosis for mobility can be made. MEDLINE, EMBASE, and CINAHL were searched for studies published before May 2010 in English, German, Dutch, or French, using keywords and synonyms for elderly, mobility, rehabilitation, and amputation. Mobility focused on actual movement (moving from one place to another) and was limited to long-term measurements, 6 months after amputation or 3 months after discharge from rehabilitation. The 15 included studies featured a diversity of objective outcome measures and mobility grades that proved difficult to compare meaningfully. In general, studies that included selected populations of prosthetic walkers showed that advanced prosthetic mobility skills can be achieved by the elderly person with a lower limb amputation, including outdoor/community walking. Studies that included all subjects undergoing a lower limb amputation reported that less than half of the elderly population achieved a household level of prosthetic mobility. The predominant findings from the included studies were incomplete reporting of study populations and poor reporting of the reliability of the mobility measures used. The strength of conclusions from this review was therefore limited and the prognosis for mobility in elderly people after lower limb amputation remains unclear. Further research into mobility outcomes of this population is needed to provide evidence that enables more informed choices in rehabilitation and long term care.
- Description: C1
Mixed methods research: a design for emergency care research?
- Authors: Cooper, Simon J. , Porter, Joanne , Endacott, Ruth
- Date: 2010
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 28, no. (2010), p. 682-685
- Full Text: false
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- Description: This paper follows previous publications on generic qualitative approaches, qualitative designs and action research in emergency care by this group of authors. Contemporary views on mixed methods approaches are considered, with a particular focus on the design choice and the amalgamation of qualitative and quantitative data emphasising the timing of data collection for each approach, their relative ‘weight’ and how they will be mixed. Mixed methods studies in emergency care are reviewed before the variety of methodological approaches and best practice considerations are presented. The use of mixed methods in clinical studies is increasing, aiming to answer questions such as ‘how many’ and ‘why’ in the same study, and as such are an important and useful approach to many key questions in emergency care.
Managing patient deterioration: assessing teamwork and individual performance
- Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Missen, Karen , Sparkes, Louise , McConnell-Henry, Tracy , Endacott, Ruth
- Date: 2013
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 30, no. 5 (2013), p.
- Full Text: false
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- Description: Objective To assess the ability of rural Australian nurse teams to manage deteriorating patients. Methods This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Results Knowledge in relation to patient deterioration management varied (mean 63%, range 27–100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17–83%, SD 14.03) with significantly higher levels in younger participants (r=−0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Conclusion Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
Threshold and subthreshold generalized anxiety disorder in later life
- Authors: Miloyan, Beyon , Byrne, Gerard , Pachana, Nancy
- Date: 2015
- Type: Text , Journal article
- Relation: American Journal of Geriatric Psychiatry Vol. 23, no. 6 (2015), p. 633-641
- Full Text: false
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- Description: Objective Symptoms and disorders of anxiety are highly prevalent among older adults; however, late-life anxiety disorders remain underdiagnosed. The objective of this study was to (1) estimate the prevalence of late-life threshold and subthreshold generalized anxiety disorder (GAD), (2) examine sociodemographic and health correlates associated with membership in these groups, (3) assess 3-year conversion rates of these groups, and (4) explore characteristics associated with 3-year conversion to GAD. Methods Using Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions, 13,420 participants aged 55-98 years were included in this study. Results Subthreshold GAD was more highly prevalent than threshold GAD and was interposed between asymptomatic and GAD groups in terms of severity of health characteristics. Although most participants with subthreshold and threshold GAD were asymptomatic by Wave 2, differences in disability persisted. Subthreshold GAD at baseline was not a predictor of threshold GAD at follow-up. Conclusion These findings suggest that late-life GAD should be conceptualized as a dimensional rather than categorical construct. The temporal stability of anxiety-associated disability further suggests that subthreshold GAD bears clinical significance. However, the suitability and efficacy of interventions for minimizing negative sequelae in this group remain to be determined.
Cardiac response to exercise in normal ageing : What can we learn from masters athletes?
- Authors: Beaumont, Alexander , Campbell, Amy , Grace, Fergal , Sculthorpe, Nicholas
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Current Cardiology Reviews Vol. 14, no. 4 (2018), p. 245-253
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- Description: Background: Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. Conclusion: This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy. © 2018 Bentham Science Publishers.
Quality of life among individuals with rugby-related spinal cord injuries in South Africa : A descriptive cross-sectional study
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
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- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
Clonal origins of Vibrio cholerae O1 El Tor strains, Papua New Guinea, 2009-2011
- Authors: Horwood, Paul , Collins, Deirdre , Jonduo, Marinjho , Rosewell, Alexander , Dutta, Samir , Dagina, Rosheila , Ropa, Berry , Siba, Peter , Greenhill, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 17, no. 11 (2011), p. 2063-2065
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- Description: We used multilocus sequence typing and variable number tandem repeat analysis to determine the clonal origins of Vibrio cholerae O1 El Tor strains from an outbreak of cholera that began in 2009 in Papua New Guinea. The epidemic is ongoing, and transmission risk is elevated within the Pacific region.
An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds : A protocol paper for Teeth Tales
- Authors: Gibbs, Lisa , Waters, Elizabeth , De Silva, Andrea , Riggs, Elisha , Moore, Laurence , Armit, Christine , Johnson, Britt , Morris, Michal , Calache, Hanny , Gussy, Mark , Young, Dana , Tadic, Maryanne , Christian, Bradley , Gondal, Iqbal , Watt, Richard , Pradel, Veronika , Truong, Mandy , Gold, Lisa
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 3 (2014), p. 1-14
- Full Text:
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- Description: Introduction: Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006-2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia. Methods and analysis: This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1-4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe). Ethics and dissemination: Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
Managing panic disorder in general practice
- Authors: Austin, David , Blashki, Grant , Barton, David , Klein, Britt
- Date: 2005
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 34, no. 7 (2005), p. 563-571
- Full Text: false
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- Description: BACKGROUND: Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns. OBJECTIVE: This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies. DISCUSSION Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.
Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India : A qualitative inquiry
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 3 (2018), p. 1-11
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- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.