ORCID Profile
0000-0001-6361-7356
Current Organisations
University of Tasmania
,
Makerere University
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Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Wiley
Date: 08-10-2022
DOI: 10.1111/INM.12939
Abstract: Advance statements, advance directives, or psychiatric wills are a key component of a shift to mental healthcare that promotes autonomy and choice and aims to reduce restrictive and coercive care practices in mental health treatment settings. The use of advance statements has gained momentum to provide a means for in iduals to detail clear preferences for mental health treatment. This paper uses a qualitative descriptive design to explore the experiences of clinicians (n = 15) implementing advance statements in the state of Victoria, Australia, a region that introduced advance statements as part of an overhaul of mental health legislation in 2014. The study, reported using the COREQ framework, found two key themes after analysis: experiences of advance statement training, with the availability and quality of training and training as a driver of change emerging as sub-themes, and experiences of advance statements in practice, with participants providing narratives of the barriers and facilitators to successful advance statement implementation. We recommend that clinician and service user experiences of advance statement implementation are further explored to identify existing and emerging barriers to implementation of these tools, which are crucial to achieve autonomy and choice for in iduals receiving mental healthcare.
Publisher: Wiley
Date: 20-05-2022
DOI: 10.1111/INM.13022
Abstract: Embedded into Victoria's mental health legislation as part of the 2014 Mental Health Act suite of reforms, advance statements are designed to convey an in iduals' preferences for treatment during times when the ability to communicate or make decisions may be impaired. This study investigated Victorian mental health clinicians' knowledge and attitudes of advance statements as well as their experience with training and implementation. We used an online Qualtrics survey of Victorian mental health clinicians ( n = 190) to achieve this aim. Instrument validity was determined using the Content Validity Index (CVI) with field experts rating each item for relevance. A value of 80% or higher was sought and computed for each in idual item on the scale, as well as for the overall scale. The Cronbach's Alpha coefficient was conducted to determine internal consistency reliability with a value of α = 0.721 for the survey, suggesting that the scale had acceptable internal consistency and reliability. Despite widespread support and positive attitudes towards advance statements existing among mental health clinician participants, the level of knowledge and perception of barriers continues to significantly affect the wide‐spread uptake of advance statements. The quality and extent of training in legal and clinical aspects of advance statement varied widely among the study participants, with the quality and benefits of the training affecting participant reported confidence level as well as their practical experience with advance statements. Three recommendations can be made: that advance statements are embed into routine mental health practice to identify in iduals who have existing advance statements and support those who do not to prepare one that regular co‐produced and facilitated training be provided to increase understanding, promotion, and overall use and uptake of advance statements and finally, for local mental health service to develop a culture for positive engagement and promotion of autonomy through inclusive practices around decision‐making.
Publisher: Springer Science and Business Media LLC
Date: 30-12-2012
DOI: 10.1007/S11250-012-0346-3
Abstract: This study was conducted to determine the prevalence and characteristics of Johne's disease (JD) lesions in Ugandan cattle slaughtered at two of the main abattoirs in K ala. Ileocaecal junction and the associated lymph nodes of 1,022 cattle were examined for gross and microscopic lesions, followed by Ziehl Neelsen staining of the tissues bearing lesions. Confirmation of Mycobacterium avium subsp. paratuberculosis infection was done in some of the tissues using culture and IS900 PCR. The lesions were then described, characterised and tabulated. Characteristic Johne's disease granulomas were found in 4.7% of the s les examined, derived from Zebu, Ankole longhorn, Friesian breeds of cattle and their crosses. Lesions were found both in the lymph nodes and ileocaecal junction mucosa. The lesions tended to be more severe in the lymph node than in the mucosa. There were also some unique and atypical lesions found in association with Johne's disease granulomas. The diagnostic values of various gross lesions and criteria of lesion classifications and diagnosis are revisited and discussed based on the findings of this study. The prevalence of Johne's disease lesions among slaughtered cattle in K ala's two abattoirs indicates that the disease is well established in the cattle population in the country. The erse manifestations in lesions of JD need to be considered when making histological diagnosis in tissues where the disease is suspected.
Publisher: Wiley
Date: 25-03-2022
DOI: 10.1111/INM.12998
Abstract: The recently released Victorian Mental Health Royal Commission report has recommended a shift to integrated treatment, defined as treatment for alcohol and substance use disorders and mental ill health occurring in parallel, rather than distinct systems catering to each need. However, little work has sought to determine the perceptions of nurses working in alcohol and other drug (AOD) treatment towards integrating with mental health services. In this study, we explore the perspectives of specialist AOD nurses towards the integration of mental health and AOD treatment services. Secondary analysis of semi-structured interviews with Australian specialist AOD nurses (n = 46) conducted as part of a wider workforce study in 2019. Data were analysed using thematic analysis and reported using the COREQ guidelines. Of the interviews analysed, six were AOD nurses working in an Australian state that had recently undergone service integration however, many participants expressed perceptions of service integration. Two key themes are reported in this paper: (i) perceptions of service integration, where AOD nurses participating in our study were concerned that integration would result in the model of care they worked under being replaced by a mental health-based model that was felt to be highly risk averse, and (ii) experiences of service integration. Concerns about the focus of care as well as the complexity of care differing between the two services demonstrated a contrast in both philosophical approaches to work with consumers and legislative difference in voluntary versus compulsory care provision.
Publisher: American Association of Zoo Veterinarians
Date: 12-2014
DOI: 10.1638/2014-0080.1
Abstract: Respiratory neoplasia is rarely reported in avian species. A 17-yr-old Quaker parrot (Myiopsitta monachus) was admitted with a 2-wk history of anorexia, depression, and respiratory distress. Clinical examination revealed a large, firm mass in the left pectoral muscle. Radiology showed a mass silhouetting the heart and the liver. Supportive treatment was provided, but the bird died during the seventh weekly visit to drain thoracic cavity fluid. Necropsy showed a white, 3 x 3 x 2-cm, hard, gritty sternal mass. Histology showed a nonencapsulated, moderately differentiated air sac carcinoma of the sternum. Immunohistochemically the neoplasm was cytokeratin positive and vimentin and calretinin negative. This is the first report of an air sac neoplasia in a Quaker parrot and one of few respiratory tumors in psittacines.
Publisher: Informa UK Limited
Date: 12-11-2019
DOI: 10.1080/01612840.2019.1652871
Abstract: This article provides context to the establishment of advance statements within the Australian mental health setting, in the state of Victoria. A movement to legislate for a more humane and liberal approach to mental health consumer care resulted in changes to the Victorian Mental Health Act (2014a). This Act mirrored legislative changes across the western world and resulted in a socially progressive movement embracing recovery focussed care and consumer clinician partnerships. Thus, we purport that an identified need for a more liberal way to work with in iduals who have a diagnosis of mental ill health was a major aim of this law reform. The advance statement model is seen as a tool in addressing a growing recognition of how mental health providers engage consumers of mental health services, and value their preferences to care received. This article arises from a larger study which has aimed to explore the role and scope of advance statements. This research has sought to demonstrate how advanced statements can be used within mental health services by providing recommendations for the mental health nursing workforce in relation to the implementation and deliverables for training.
No related grants have been discovered for Julius Okuni.