ORCID Profile
0000-0001-6619-8484
Current Organisation
Deakin University
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Publisher: American Public Health Association
Date: 08-2008
Abstract: Objectives. We sought to assess the impact of several tobacco control policies and televised antismoking advertising on adult smoking prevalence. Methods. We used a population survey in which smoking prevalence was measured each month from 1995 through 2006. Time-series analysis assessed the effect on smoking prevalence of televised antismoking advertising (with gross audience rating points [GRPs] per month), cigarette costliness, monthly sales of nicotine replacement therapy (NRT) and bupropion, and smoke-free restaurant laws. Results. Increases in cigarette costliness and exposure to tobacco control media c aigns significantly reduced smoking prevalence. We found a 0.3-percentage-point reduction in smoking prevalence by either exposing the population to televised antismoking ads an average of almost 4 times per month (390 GRPs) or by increasing the costliness of a pack of cigarettes by 0.03% of gross average weekly earnings. Monthly sales of NRT and bupropion, exposure to NRT advertising, and smoke-free restaurant laws had no detectable impact on smoking prevalence. Conclusions. Increases in the real price of cigarettes and tobacco control mass media c aigns broadcast at sufficient exposure levels and at regular intervals are critical for reducing population smoking prevalence.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-04-2013
Abstract: Summary evidence on the effectiveness of quality improvement interventions (QIIs) directed at cancer specialists is needed for two reasons. First, there are some innovations over which only cancer specialists have control (eg, surgical technique or chemotherapy regimen). Second, implementation of QIIs has opportunity costs the time and money spent on an ineffective QII might be better spent on direct patient care. Medical Subject Headings and text words for “quality improvement” were combined with those for “neoplasm” to search MEDLINE, PsycINFO, CINAHL, and EMBASE from January 1990 to August 2012 for studies of QIIs directed at cancer specialists (eg, medical/radiation oncologist, surgeon). All study designs were included. Five thousand seven hundred eighty-one articles were screened, but only 12 met the inclusion criteria, including three cluster randomized controlled trials (cRCTs), seven uncontrolled before-and-after comparisons, and two cross-sectional studies. All 12 studies were conducted in response to concerns about quality of care. No cRCT showed a benefit of the QIIs tested. Some uncontrolled before-and-after and cross-sectional studies reported a benefit from the QII, but these studies are difficult to interpret because of concerns about uncontrolled confounding. Interventions in all studies were multifaceted, but descriptions of different components were limited, and only one study examined their separate impact. The published evidence about how to facilitate timely and consistent adoption of new clinical knowledge by cancer specialists into everyday clinical practice is thin. More investment is needed in research about the solution (QIIs) to match the investment in research about the problem (inconsistent/slow adoption of innovative cancer treatments).
Publisher: SAGE Publications
Date: 10-2003
Abstract: For many women, the only alternative to breast reconstruction following a mastectomy is to use external prostheses, which need replacing regularly at a cost of up to $395 per prosthesis. Commonwealth and state governments across Australia have responded to this need by providing subsidies to assist in the purchase of breast prostheses. However, current arrangements have been highly variable and sometimes difficult to access. As part of a larger review of breast pros-thesis services in Victoria, Australia, the aim of this research was to evaluate client satisfaction among Victorian women who accessed funds through the State Government's Aids and Equipment Program, compare the responses of the program service providers with the experiences of clients accessing funding, and identify opportunities to improve service provision.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1111/J.1753-6405.2009.00362.X
Abstract: To compare trends in smoking prevalence between 1996 and 2005 among Indigenous and non-Indigenous secondary students across Australia. Representative random s les of secondary students aged 12-17 years completed self-report anonymous surveys. Questionnaires assessed any cigarette smoking in lifetime, and smoking in past month, week and on at least three of the previous seven days. Intention to smoke in the next 12 months was assessed on a 7-point scale. Students self-identified as being of Aboriginal or Torres Strait Islander descent. Three to four per cent of students identified as being Indigenous at each survey. Smoking was more common among Indigenous than non-Indigenous students. Between 1996 and 2005, the proportion of smoking declined among both Indigenous and non-Indigenous students. However, among 12-15 year olds, the rate of decline was different for the two groups. Among non-Indigenous students in this age group, prevalence decreased steadily between 1996 and 2005. Among Indigenous students, the decrease mainly occurred between 1999 and 2002. Smoking intention was higher for Indigenous than non-Indigenous students. The mean intention decreased between 1996 and 2005 among both student groups. Smoking prevalence decreased among both Indigenous and non-Indigenous students between 1996 and 2005. Reductions in Indigenous students' tobacco use and intentions coincided with a period of increased tobacco control activity, suggesting that these activities may positively influence smoking behaviours.
Publisher: Wiley
Date: 31-08-2022
DOI: 10.1111/CEO.14146
Abstract: Age‐related macular degeneration, a prevalent degenerative retinal disease, is associated with non‐visual and psychosocial impairments that may affect sleep. In this systematic review, we evaluated associations between age‐related macular degeneration (AMD) and sleep, highlighted knowledge gaps and provided evidence‐based recommendations to clinicians to enable holistic management of AMD patients. We searched PubMed, Embase and the Cochrane Central registries for papers published before May 2022. Non‐English, qualitative studies and grey literature were excluded. Studies evaluating the association between AMD and sleep (including sleep disorders like insomnia and sleep apnea), and vice versa, were included. The quality of shortlisted studies was evaluated using the Newcastle Ottawa Scale. Six (two case–control studies, three longitudinal cohort studies and one cross‐sectional study) of 551 studies were included in this review. Four studies found that AMD was associated with increased rates of sleep apnea and poorer reported sleep quality, while five studies showed that patients with sleep apnea or insomnia were at higher risk of developing AMD. Associations between self‐reported sleep quantity and AMD were conflicting. No study evaluated the relationship between AMD and sleep using objective sleep assessment tools. Only a limited number of studies investigated associations between AMD and sleep. These studies suggest a bidirectional relationship between AMD and sleep dysfunction yet disagree on the relationship between sleep quantity and the likelihood of AMD. Additional studies, using objective characterisation of sleep in patients with AMD are required to confirm these findings.
Publisher: Wiley
Date: 12-02-1995
DOI: 10.1111/J.1753-6405.1995.TB00408.X
Abstract: The prevalence of cigarette smoking in Australian secondary school students in 1993 was estimated from a survey of 22 696 12- to 17-year-old students from 332 secondary schools (and feeder schools) in all states and the Northern Territory. Self-administered questionnaires were answered anonymously by groups of up to 20 students selected randomly from school rolls, a method that replicated previous surveys in 1984, 1987 and 1990. Current smoking (smoking at least one cigarette in the week preceding the survey) at 12 years of age was 8 per cent in boys and 7 per cent in girls, but in those 17 years of age the prevalence was much higher (28 per cent of boys, 31 per cent of girls). Age was also associated with the mean number of cigarettes smoked per week by current smokers (8.6 in boys and 7.0 in girls at age 12 and 43.8 in boys and 32.0 in girls at age 17). After controlling for sex, age, school type and state of residence, the percentage of 12- to 15-year-olds who were current smokers rose from 15.7 per cent to 17.5 per cent between 1990 and 1993, an effect that was more pronounced in boys. On the other hand, the mean number of cigarettes smoked by 12- to 15-year-old current smokers dropped from 23 per week to 19.5, and the reduced consumption was greatest in boys. Furthermore, there was no increase in the proportion of students who smoked on three or more days per week, which suggests the increase was limited to occasional, casual or social smoking.
Publisher: Wiley
Date: 06-07-2017
DOI: 10.1111/ADD.13873
Abstract: To determine (i) whether Australian adolescents' exposure to television alcohol advertisements changed between 1999 and 2011 and (ii) examine the association between television alcohol advertising and adolescent drinking behaviours. Cross-sectional surveys conducted every 3 years between 1999 and 2011. Analyses examined associations between advertising exposures and reported drinking. Five Australian major cities. Students aged 12-17 years participating in a triennial nationally representative school-based survey residing in the television advertising markets associated with the major cities (s le size range per survey: 12 644-16 004). Outcome measures were: drinking in the past month, past week and past-week risky drinking (5+ drinks on a day). The key predictor variable was past-month adolescent-directed alcohol advertising Targeted Rating Points (TRPs, a measure of television advertising exposure). Control measures included student-level characteristics, government alcohol-control advertising TRPs, road safety (drink-driving) TRPs and time of survey. Average monthly adolescent alcohol TRPs increased between 1999 (mean = 2371) to 2005 (mean = 2679) (P < 0.01) then decreased between 2005 and 2011: (mean = 880) (P < 0.01). Multi-level logistic regression analyses that adjusted for survey timing, student level factors and alcohol-control advertising variables showed a significant association between past-month alcohol TRPs and past-month drinking [odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.07-1.15), past-week drinking (OR = 1.10, 95% CI = 1.06-1.14) and past-week risky drinking (OR = 1.15, 95% CI = 1.09-1.22). Past-week risky drinking was associated inversely with road safety TRPs (OR = 0.69, 95% CI = 0.49-0.98). While Australian adolescents' exposure to alcohol advertising on television reduced between 1999 and 2011, higher levels of past-month television alcohol advertising were associated with an increased likelihood of adolescents' drinking. The reduction in television alcohol advertising in Australia in the late 2000s may have played a part in reducing adolescents' drinking prevalence.
Publisher: Oxford University Press (OUP)
Date: 08-2005
DOI: 10.1080/14622200500184333
Abstract: When faced with high cigarette prices, smokers can potentially control cigarette expenditures by limiting consumption or seeking cheaper cigarettes. The present study examined both these options and whether the use of price-minimizing strategies (the second option) could counteract a further price increase without smokers having to reduce consumption. Data for 5,109 smokers who purchased manufactured cigarettes were from the 2002 cross-sectional, population-based, random-digit-dialed California Tobacco Survey. We used logistic regression to examine which smokers used consumption-limiting or price-minimizing strategies, and multiple linear regression to determine how much price-minimizing strategies reduced the average price paid per pack. Overall, 32.3% of California smokers said they limited consumption and 74.1% used at least one of the five price-minimizing strategies identified: choosing cheaper retail outlets (61.1%), using promotional offers (35.2%), choosing cheaper brands (28.7%), purchasing by the carton (27.7%), and using low-tax or nontaxed sources (6.3%). Different groups of smokers used different strategies. Except for the use of promotional offers, all price-minimizing strategies significantly reduced the price paid per pack. Carton purchasers saved 1.01 US dollars ack, and those buying from low-tax or nontaxed sources saved 1.23 US dollars ack. However, pack buyers were reluctant to purchase cartons, mostly because they thought they might smoke too much, or because they considered the upfront cost unaffordable. The average California smoker could potentially save 0.33-0.66 US dollars ack or 6.00-12.00 US dollars/month by using other price-minimizing strategies. Reducing consumption by 3 cigarettes/day could save a smoker 18.00 US dollars/month. Whereas price-minimizing strategies appeared to save money, cutting consumption could save even more. Thus further substantial tax increases would likely have the desired effect.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2003
DOI: 10.1097/00002820-200306000-00002
Abstract: After mastectomy, the provision of an appropriate breast prosthesis can help to improve body image and quality of life and reduce associated emotional distress. Although up to 90% of women use an external breast prosthesis after mastectomy, little is known about their experiences and satisfaction with breast prosthesis use. Focus groups were conducted with women who had been fitted with an external breast prosthesis, breast care nurses, and prosthesis fitters to explore women's experiences of prosthesis use. Qualitative thematic content analysis of focus group transcripts indicated that whereas women's initial reaction to the prosthesis generally was negative, this improved over time. Provision of adequate information and support, characteristics of the fitter and the fitting experience, and relationships with breast care nurses and prosthesis fitters were important to women's acceptance and satisfaction with their prosthesis. The study results highlighted the key role that breast care nurses play and the underestimation of the prosthesis fitter's role. Common themes concerning the impact of prosthesis use included body image, appearance, and feminine identity. These findings have important implications for professionals involved in the delivery of breast prostheses services.
Publisher: Springer Science and Business Media LLC
Date: 19-01-2019
DOI: 10.1007/S00520-018-4625-Z
Abstract: This study examined the mediating effects of cancer type, treatment, and distress on health-related quality of life (HRQoL) for early diagnosis cancer patients. Results were interpreted with respect to established thresholds for clinical meaningfulness. A cross-sectional design was used. Patients completed surveys collecting demographics, cancer type, treatment, comorbid conditions, distress (HADS), and HRQoL (FACT-G). Hierarchical multivariate regressions examined associations between cancer type, treatment, and distress on HRQoL. Established minimum differences were used to identify clinically meaningful changes in HRQoL. Of the 1183 patients surveyed, 21% were classified as having elevated anxiety and 13% had elevated depression. Our s le reported significantly lower physical and emotional well-being compared to population norms. Patients with prostate, melanoma, gynaecological, and urological cancers had higher HRQoL scores than those with colorectal cancer. However, when effects for treatment type and distress were considered, differences between cancer types became non-significant. Anxiety and depression were associated with lower HRQoL scores as was chemotherapy. Only depression, anxiety, and chemotherapy were associated with clinically meaningful decreases in HRQoL scores. While statistically significant differences in HRQoL were found between different cancer types, only chemotherapy, anxiety, and depression produced clinically meaningful poorer HRQoL scores. In practice, clinically meaningful differences could promote a shift in resources toward interventions where a positive effect on patient well-being is appreciated by both the patient and health professional.
Publisher: Wiley
Date: 29-09-2011
DOI: 10.1111/J.1465-3362.2010.00246.X
Abstract: Over recent years, numerous school-based preventive strategies have been explored as possible options to address illicit drug use by young people. However, there is scope to extend current knowledge of which school students are most at risk of illicit drug-related harm. To investigate potential differential risk, the prevalence and patterns of illicit drug use of Australian secondary school students were examined according to demographic, school, economic and licit drug use factors. Analyses were conducted on the 2005 Australian Secondary Students' Alcohol and Drug survey. A total of 21 805 secondary school students aged 12-17 years from 376 schools completed the pencil and paper classroom questionnaire. The greatest risk factors for students using illicit drugs were tobacco and alcohol use. Students with self-rated below average academic achievement, with more than $20 a week of disposable income, and who were Indigenous were more likely to report illicit drug use. While causal pathways could not be examined in the current data, and these relationships are likely to be complex and multi-directional, the findings indicate potentially at-risk populations who warrant extra support to address illicit drug-related harm.
Publisher: BMJ
Date: 25-02-2015
Publisher: BMJ
Date: 25-02-2015
Publisher: Springer Science and Business Media LLC
Date: 08-05-2023
DOI: 10.1007/S13187-023-02305-9
Abstract: Communication skills training can enhance health professionals’ knowledge and repertoire of effective communication practices. This paper describes the conceptual model underlying a 3-day retreat communication skills training program, methods used for training, and participant perception of outcomes from the training using qualitative interviews. Repeated qualitative telephone interviews (approximately 6 months apart) with participants of a 3-day Clinical Consultation Skills Retreat. Fourteen participants (70% response, 57% doctors) took part at Time 1, with 12 participating at Time 2. Semi-structured interviews were recorded and transcribed, and directional content analysis was conducted to assess themes in areas of key learnings, implementation of skills, and barriers. The training was received very positively with participants valuing the small group learning, role play, and facilitator skills. Key learnings were grouped into two themes: (i) tips and strategies to use in clinical practice and (ii) communication frameworks/methods, with the second theme reflecting an awareness of different communication styles. Most participants had tried to implement their new skills, with implementation reported as a more deliberate activity at T1 than at T2. Those implementing the new skills noted more open conversations with patients. Practical barriers of lack of time and expectations of others were mentioned more often at T2. A 3-day retreat-based communication training program was positively received and had a positive impact on the use of new communication skills. While further work is needed to determine whether effects of training are evidenced in objective clinical behaviors, the positive longer-term benefits found suggest this work would be worthwhile.
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.EJSO.2010.07.008
Abstract: Clinical practice guidelines/recommendations have been promoted as a mechanism for ensuring evidence-based medicine. We examine the impact of the publication of Australian treatment recommendations (ATR) for ductal carcinoma in situ (DCIS) on clinical practice and surgeons' attitudes to the ATR. All new cases of DCIS diagnosed in the 12-months immediately before the ATR release (pre-ATR: September 2002 to August 2003) and three years later (post-ATR: September 2006 to August 2007) were identified from the state of Victoria's population cancer registry. Treatment information, extracted for each case by treating surgeon or study manager, was available for 342 of 353 (97%) tumours pre-ATR and 371 of 378 (98%) tumours post-ATR. Sixty-three surgeons (58% response) completed a survey on awareness and attitudes to the ATR. The proportion of cases undergoing image-guided biopsy, or breast conservation surgery (BCS) did not change between surveys nor did extent of surgical margins. Compared to the pre-ATR period, more BCS cases were referred to a radiation oncologist (67% versus 58%) and more received radiotherapy (53% versus 44%) post-ATR. Tumours greater than 20 mm, of intermediate grade and moderate necrosis were more likely to receive radiotherapy post-ATR. While surgeons agreed with most recommendations, items reflecting radiotherapy recommendations generated most disagreement. With the possible exception of adjuvant radiotherapy, most DCIS cases were treated according to treatment recommendations before the ATR's release. The lack of change in radiotherapy for low grade, smaller tumours may reflect surgeon's uncertainty regarding this therapy for all BCS treated cases.
Publisher: Hindawi Limited
Date: 05-2005
DOI: 10.1111/J.1365-2354.2005.00505.X
Abstract: The broad aims of the present evaluation were, firstly, to describe the information and support needs of callers to a Cancer Helpline and, secondly, to describe the response of the service to these needs. A further aim was to use these results to develop strategies to improve the service. Anonymous caller information collected over a 6-year period was analysed. The setting of the study was the Cancer Helpline service operated by the Cancer Council Victoria within the state of Victoria, Australia. The caller profile was similar to that described in the literature, with the majority of callers being women, younger than the general cancer population and enquiring most commonly about breast cancer. Patients and their relatives called to obtain information about cancer diagnosis, treatment and management and to obtain psychological and emotional support. Callers received emotional support, were supplied with verbal and written information and were referred to a variety of support services. Some population groups are underrepresented in the data. Changes to the Helpline and other services over the 6-year period are described. The pattern of callers to the Cancer Helpline appears similar to that described in the USA and Europe. Many issues and challenges are common. The paper discusses additional strategies for meeting the information and support needs of those affected by cancer and describes current and suggested research areas.
Publisher: Wiley
Date: 21-06-2011
DOI: 10.1111/J.1360-0443.2011.03429.X
Abstract: To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. Australia, 1990-2005. A nationally representative s le of secondary students (aged 12-17 years) participating in a triennial survey (s le size per survey range: 20 560 to 27 480). Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking.
Publisher: Wiley
Date: 21-02-2018
DOI: 10.1111/ADD.14164
Abstract: To determine (i) whether the strength of Australian alcohol control policy in three domains (youth access, trading hours and drink driving) changed during the 2000s and (ii) estimate associations between these policies and adolescent drinking after adjusting for television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence. Repeated cross-sectional surveys conducted triennially from 2002 to 2011. Multi-level modelling examined the association between alcohol control policies and drinking prevalence after adjusting for covariates. Four Australian capital cities between 2002 and 2011. Students aged 12-17 years participating in a triennial national representative school-based survey (s le size range/survey: 9805-13 119). Outcome measures were: past month drinking and risky drinking (5+ drinks on a day) in the past 7 days. Policy strength in each of three domains (youth access, trading hours, drink-driving) were the key predictor variables. Covariates included: past 3-month television alcohol and alcohol-control advertising, alcohol outlet density, alcohol price change, negatively framed newspaper alcohol articles, adult drinking prevalence and student demographic characteristics. During the study period, the strength of youth access policies increased by 10%, trading hours policies by 14% and drink-driving policies by 58%. Past-month and risky drinking prevalence decreased (e.g. past-month: 2002: 47.4% to 2011: 26.3%). Multivariable analyses that included all policy variables and adjusted for year, student and other covariates showed past-month drinking to be associated inversely with stronger trading hours policies [odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.69, 0.94], but not youth access (OR = 0.92 95% CI = 0.81, 1.04) or drink-driving (OR = 1.00, 95% CI = 0.93, 1.09). Risky drinking was associated inversely with stronger youth access policies (OR = 0.82, 95% CI = 0.69, 0.98), but not trading hours (OR = 0.85, 95% CI = 0.66, 1.09) or drink-driving (OR = 1.02, 95% CI = 0.90, 1.14) policies. Population-directed policies designed to reduce alcohol availability and promotion may reduce adolescents' alcohol use.
Publisher: Informa UK Limited
Date: 05-2019
DOI: 10.2147/CLEP.S197968
Publisher: Wiley
Date: 07-08-2008
DOI: 10.1111/J.1360-0443.2008.02294.X
Abstract: To assess the impact of the introduction of graphic health warning labels on cigarette packets on adolescents at different smoking uptake stages. School-based surveys conducted in the year prior to (2005) and approximately 6 months after (2006) the introduction of the graphic health warnings. The 2006 survey was conducted after a TV advertising c aign promoting two new health warnings. Secondary schools in greater metropolitan Melbourne, Australia. Students in year levels 8-12: 2432 students in 2005, and 2050 in 2006, participated. Smoking uptake stage, intention to smoke, reported exposure to cigarette packs, knowledge of health effects of smoking, cognitive processing of warning labels and perceptions of cigarette pack image. At baseline, 72% of students had seen cigarette packs in the previous 6 months, while at follow-up 77% had seen packs and 88% of these had seen the new warning labels. Cognitive processing of warning labels increased, with students more frequently reading, attending to, thinking and talking about warning labels at follow-up. Experimental and established smokers thought about quitting and forgoing cigarettes more at follow-up. At follow-up intention to smoke was lower among those students who had talked about the warning labels and had forgone cigarettes. Graphic warning labels on cigarette packs are noticed by the majority of adolescents, increase adolescents' cognitive processing of these messages and have the potential to lower smoking intentions. Our findings suggest that the introduction of graphic warning labels may help to reduce smoking among adolescents.
Publisher: Wiley
Date: 12-2007
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2007
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-12-2014
Abstract: To assess the effectiveness of a telephone-based peer-delivered intervention in reducing distress among women with a BRCA1 or BRCA2 gene mutation. The intervention involved trained peer volunteers contacting women multiple times over a 4-month period to provide informational, emotional, and practical support. Three hundred thirty-seven participants completed the baseline questionnaire, and those reporting interest in talking to other mutation carriers were randomly assigned to either the usual care group (UCG n = 102) or the intervention group (IG n = 105). Participants and researchers were not blinded to group allocation. Two follow-up questionnaires were completed, one at the end of the intervention (4 months after random assignment, time 2) and one 2 months later (time 3). Outcomes included breast cancer distress (primary outcome), unmet information needs, cognitive appraisals about mutation testing, and feelings of isolation. There was a greater decrease in breast cancer distress scores in the IG than UCG at time 2 (mean difference, −5.96 95% CI, −9.80 to −2.12 P = .002) and time 3 (mean difference, −3.94 95% CI, −7.70 to −0.17 P = .04). There was a greater reduction in unmet information needs in the IG than UCG (P .01), with unmet needs being lower in the IG than UCG at time 2. There was a greater reduction in Cognitive Appraisals About Genetic Testing stress subscale scores in the IG than UCG (P = .02), with significantly lower scores among the IG than UCG at time 2 (P .01). The intervention is effective in reducing distress and unmet information needs for this group of women. Identifying strategies for prolonging intervention effects is warranted.
Publisher: Cambridge University Press (CUP)
Date: 28-09-2010
DOI: 10.1017/S1478951510000313
Abstract: Discussing the transition from active anti-cancer treatment to palliative care can be difficult for cancer patients and oncology health professionals (OHP). We developed a brief communication skills workshop to assist OHP with these conversations, and examined satisfaction with the workshop and perceived confidence regarding these discussions. Interactive workshops were conducted by trained facilitators and included cognitive, behavioral, and experiential components. The major component of the workshop involved role-plays with trained actors (simulated patients). Participants completed an evaluation questionnaire. Sixty-two OHP participated in workshops. Overall, participants were highly satisfied with the workshop content and format. All participants felt the workshop provided relevant practical information, and % thought that participation benefited their work. Over 98% said that the workshop had increased confidence in their communication skills. Participants were very satisfied with the workshop, and thought that participation increased confidence in communicating about the transition to palliative care. Dissemination of this model of communication skills training seems warranted.
Publisher: SAGE Publications
Date: 06-2004
Abstract: This study examines the impact of passive and active parental consent procedures on the type of adolescents participating in a school-based survey examining substance use. Schools recruited from a random s le of metropolitan schools were assigned to passive or active parental consent condition. Results showed that participationrates in active consent schools were lower than in passive consent schools for junior students (60% vs. 80%) but not senior students. Although consent condition had limited impact on prevalence estimates among older students, among younger students estimates of cannabis use and ecstasy use were higher in the passive consent condition than the active consent condition. Active consent procedures introduce some degree of selection bias into studies of adolescents’ substance use and may compromise the external validity of prevalence estimates produced, especially among younger students.
Publisher: JMIR Publications Inc.
Date: 12-01-2022
DOI: 10.2196/30026
Abstract: Web-based mindfulness programs may be beneficial in improving the well-being outcomes of those living with chronic illnesses. Adherence to programs is a key indicator in improving outcomes however, with the digitization of programs, it is necessary to enhance engagement and encourage people to return to digital health platforms. More information is needed on how engagement strategies have been used in web-based mindfulness programs to encourage adherence. The aim of this study is to develop a list of engagement strategies for web-based mindfulness programs and evaluate the impact of engagement strategies on adherence. A narrative systematic review was conducted across the MEDLINE Complete, CINAHL Complete, APA PsycINFO, and Embase databases and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Articles were screened using the population, intervention, comparator, and outcome framework. Adults aged years with chronic health conditions were included in the study. Mindfulness interventions, including those in combination with mindfulness-based cognitive therapy, delivered on the web through the internet or smartphone technology were included. Interventions lasted at least 2 weeks. Studies with a randomized controlled trial design or a pilot randomized controlled trial design were included. Engagement strategies, including web-based program features and facilitator-led strategies, adherence, and retention, were included. A total of 1265 articles were screened, of which 19 were relevant and were included in the review. On average, 70.98% (2258/3181) of the study participants were women with a mean age of 46 (SD 13) years. Most commonly, mindfulness programs were delivered to people living with mental health conditions (8/19, 42%). Of the 19 studies, 8 (42%) used only program features to encourage adherence, 5 (26%) used facilitator-led strategies, and 6 (32%) used a combination of the two. Encouraging program adherence was the most common engagement strategy used, which was used in 77% (10/13) of the facilitator-led studies and 57% (8/14) of the program feature studies. Nearly two-thirds (63%) of the studies provided a definition of adherence, which varied between 50% and 100% completion across studies. The overall mean participant compliance to the mindfulness programs was 56% (SD 15%). Most studies (10/19, 53%) had a long-term follow-up, with the most common follow-up period being 12 weeks after intervention (3/10, 30%). After the intervention, the mean retention was 78% (SD 15%). Engagement strategies in web-based mindfulness programs comprise reminders to use the program. Other features may be suitable for encouraging adherence to interventions, and a facilitator-led component may result in higher retention. There is variance in the way adherence is measured, and intervention lengths and follow-up periods are inconsistent. More thorough reporting and a standardized framework for measuring adherence are needed to more accurately assess adherence and engagement strategies.
Publisher: Springer Science and Business Media LLC
Date: 04-03-2008
Publisher: Wiley
Date: 09-10-2017
DOI: 10.1111/EJH.12941
Abstract: To examine the influence of anxiety, depression and unmet supportive care needs on future quality of life (QoL) in multiple myeloma (MM) and diffuse large B-cell lymphoma (DLBCL) patients. Multiple myeloma and DLBCL patients recruited through the population-based Victorian Cancer Registry. Data were collected through two telephone interviews: (T1) on average 7 months postdiagnosis, (T2) average 8 months later. QoL was examined at T2 using the Functional Assessment of Cancer Therapy (FACT-G) scale. The Hospital Anxiety and Depression Scale measured anxiety and depression, and the Supportive Care Needs Survey measured unmet needs at T1. Multivariate linear regression examined associations between QoL subscales (physical, emotional, social and functional well-being and overall QoL) and T1 anxiety, depression and unmet needs. Except physical well-being, all other QoL subscales and overall QoL were significantly associated with T1 anxiety. All QoL subscales and overall QoL were significantly associated with T1 depression. Only patient care needs were associated with physical and social well-being and overall QoL. Anxiety, depression and patient care unmet needs during treatment are associated with diminished physical and emotional well-being in the following months. Psychological distress and unmet supportive care needs experienced during treatment should be addressed to maximise future QoL.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.HEALTHPLACE.2013.12.007
Abstract: A trial installing shade sails at secondary schools found increased students' use of newly shaded areas, but relatively low use overall. We examined site features and weather related to use of these shaded areas. Tables with seats and temperatures ≥27°C increased student use of shaded areas, presence of grass decreased use. Focus groups at eight schools suggest students were unaware of changes to their habitual use of favoured locations. Results infer careful selection of locations for built-shade and provision of tables with seats will assist in maximising student use and investments in shade sails.
Publisher: Wiley
Date: 30-11-2009
Publisher: BMJ
Date: 09-2023
Publisher: Springer Science and Business Media LLC
Date: 11-1994
DOI: 10.1007/BF01071561
Abstract: To use OCTA to collect normative data describing the vascular perfusion of the macula and optic disc in adolescents. This cross-sectional, school-based study was conducted from Oct 15, 2019, to Nov 30, 2019, in Tuyou County, Baotou, China. All eligible participants underwent a comprehensive questionnaire and ocular examination. The vascular perfusion of the macula and optic disc was determined using a spectral-domain OCTA device. A total of 570 anatomically normal eyes without a history of pathologic disease from 570 adolescents (mean ± SD age, 15.1 ± 1.9 years 298 girls [52.3%]) were enrolled. In the macula, the mean ± SD perifoveal perfusion density (PD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was 44.2% ± 4.37% and 50.74% ± 3.98%, respectively. The mean ± SD foveal avascular zone (FAZ) was 0.32 mm Quantitative studies of the perifoveal vasculature in adolescents should consider the patient's sex and AL. Our findings may provide useful information for the understanding and the management of retinal perfusion in Chinese adolescents.
Publisher: Wiley
Date: 16-06-2021
DOI: 10.1002/PON.5744
Abstract: Previous research has described the low uptake of psychosocial support services in people living with cancer. While characteristics of in iduals using services have been examined, mechanisms applied to link in iduals to support services are less frequently considered. This review aims to identify the mechanisms used to link people with cancer to support services and assess their impact. Systematic searches of Pubmed, CINAHL, EMBASE and PsycINFO were conducted up to May 2020. Studies reporting service use associated with mechanisms to link adults with cancer to support services targeting emotional, informational, practical or social support needs were eligible. Eligible study designs included controlled trials, pre‐post designs and observational studies. Study quality was assessed and a narrative synthesis of findings undertaken. A total of 10 papers (from 8,037 unique titles) were eligible. Testing the feasibility of the linkage mechanism was the primary aim in five (50%) studies. Three linkage mechanisms were identified: (a) outreach from the support service (b) clinician recommendation/referral (c) mailed invitation. Outreach was the most successful in connecting people with cancer to services (52%–90% use) clinician recommendation/referral was least successful (3%–28%). The impact of different linkage mechanisms for different demographic groups was not assessed. Outreach from services shows the most potential for increasing access to support services. However, the limited number of studies and limitations in the types of support services people with cancer were linked to, demonstrated the need for further work in this area. Identifying mechanisms that are effective for underserved, high‐needs patient groups is also needed.
Publisher: Oxford University Press (OUP)
Date: 04-09-2014
Abstract: The portrayal of alcohol in the news media, including newspapers, plays an important role in influencing societal norms and setting public agendas. We present the first large-scale examination of news coverage of alcohol-related issues in Australian newspapers. Content analysis was performed on a s le of alcohol-related newspaper articles (n = 4217) published across Australia from 2000 to 2011. Articles were coded for type, theme, prominence, topic slant, opinion slant and sources/spokesperson. Across the period, the most common themes were promotion (21%), drink-driving (16%) and restrictions olicy (16%). Themes of restrictions olicy and responsible beverage services became more common over time. Promotion and business-related articles significantly declined over time. Overall, the topic slant of the majority of news related articles disapproved of alcohol use. Disapproval increased over time while approval of alcohol use decreased. While the slant of opinion pieces was predominantly approving of alcohol, this decreased over time. Presence of an alcohol industry representative in articles declined over time. The presentation of alcohol use in Australian newspapers became more disapproving over time, which may suggest that harmful alcohol use has become less acceptable among the broader Australian community.
Publisher: Mary Ann Liebert Inc
Date: 03-2017
Abstract: To assess what is currently known about unmet needs and care experiences of adolescents and young adults (AYAs) with cancer, identify gaps in the research literature, and highlight potential areas for improvement in future research. Medline, PsycINFO, CINAHL, and EMBASE databases were searched to identify relevant studies from 1990 to July 2015. Eligible articles included self-reported care experiences or unmet needs of cancer patients aged between 15 and 30 years in the period between symptom onset and 2 years post-treatment. Qualitative and quantitative designs were included. Forty-five articles from 39 studies (23 qualitative, 12 quantitative, and 4 mixed methods) were rated as "adequate" or "good" quality and reviewed. The majority included any cancer diagnoses and none was longitudinal. There was considerable variation in age ranges and time since diagnosis between studies. Only two studies used standardized survey tools, with both tools validated on adult populations. The most common areas assessed for care experiences and needs were information/communication and fertility. In addition, care experience studies commonly examined clinical expertise and age-appropriate settings, while unmet needs studies reported on emotional support and peer interaction. Findings highlight the need for age-appropriate information and treatment facilities, access to emotional support services, and contact with peers. Fertility information and services are a priority issue for this group. Future research would benefit from a consistent definition of the AYA age range, increased used of standardized scales validated with this population, and longitudinal designs to assess changes over time.
Publisher: Informa UK Limited
Date: 21-06-2017
Publisher: Wiley
Date: 23-06-2023
DOI: 10.1111/JOCN.16806
Abstract: Unmet supportive care needs (SCN) refer to perceived gaps in the support parents want to manage caregiving activities for children with chronic health conditions (CHC) and the support received. This review aims to systematically identify the unmet SCN of families with children living with five common paediatric CHC and characterise the assessment tools used to measure SCN. Systematic review methodology with narrative synthesis of data. Reporting followed the PRISMA statement guidelines. Literature searches were conducted in electronic databases Medline complete, PsycINFO, CINHAL and EMBASE to retrieve relevant articles published between 1990 and July 2022. Eligible studies involved (i) children aged 0–18 years diagnosed with either of cancer, congenital heart disease (CHD), diabetes, asthma, renal disease and (ii) assessment of unmet SCN. Studies involving children with genetic or developmental conditions were excluded. The methodological quality of studies was assessed using JBI assessment tool. Of 6223 articles screened, 34 papers were included (25 quantitative, 5 qualitative and 4 mixed design). Most papers explored unmet needs of families with cancer ( n = 26). The remaining articles concerned CHD ( n = 5), asthma ( n = 2) and mixed CHC ( n = 1, renal failure, and diabetes). Information (e.g. treatment, lifestyle, etc.) and health care (e.g. emotional support, practical services, etc.) were the most common unmet need domains across health conditions. A variety of methods and need assessments h ered comparisons between studies both across and within CHC. Irrespective of illness, addressing unmet informational or health care needs may help to optimise outcomes and care for children and families living with common CHC. There was considerable variation in reporting styles, study design and need assessments both within and across conditions. Health care professionals must routinely evaluate the type, quality and quantity of psychoeducation and support that families of children with CHC want and receive. Providing nurses with more effective strategies to assess child and family needs across a broad range of domains may help to increase understanding of where further support for families is required. There was no patient or public contribution to this study as it involved a systematic review of existing literature.
Publisher: BMJ
Date: 07-2016
Publisher: Springer Science and Business Media LLC
Date: 29-03-2015
DOI: 10.1007/S10689-015-9797-9
Abstract: Women with a BRCA1/2 gene mutation face complex risk management decisions and communication issues that can lead to increased levels of distress and unmet needs. We describe the implementation of a peer-support program that aims to reduce distress among women with a BRCA1/2 mutation, including peer and support recipient satisfaction with the program, challenges and lessons learnt. Participants with a BRCA1/2 mutation were matched with a trained peer volunteer (also a mutation carrier) to have regular one-on-one phone calls, over 4 months. Details of the calls, including topics discussed, time spent and number, were collected. Peers and recipients completed surveys assessing how they felt the contact went, satisfaction with the program, and preferences for matching. Satisfaction with the program was high for both peers and recipients. 80% of pairs ended contact through mutual agreement. Peers and recipients differed in the importance placed on age and surgery experience to determine matches. The most challenging aspect of the program for peers was difficulty in contacting recipients. Peer support for women with a BRCA1/2 mutation is feasible. However, to encourage continued involvement by peers and recipients greater flexibility in the method and delivery of contact is needed. We advocate the use of text-messaging and/or email as mechanisms for pairs to arrange and maintain contact. These strategies should be in addition to, rather than replacing, calls. A mixed medium intervention, where recipients can tailor the method of communication to suit their needs, may be preferable and effective, though this would need to be tested.
Publisher: Elsevier BV
Date: 10-2007
DOI: 10.1016/J.SOCSCIMED.2007.05.011
Abstract: Television (TV) food advertising has attracted criticism for its potential role in promoting unhealthy dietary practices among children. Content analyses indicate junk food advertising is prevalent on Australian children's TV healthy eating is rarely promoted. This paper presents (a) a cross-sectional survey examining associations between children's regular TV viewing habits and their food-related attitudes and behaviour and (b) an experiment assessing the impact of varying combinations of TV advertisements (ads) for unhealthy and healthy foods on children's dietary knowledge, attitudes and intentions. The experimental conditions simulated possible models for regulating food ads on children's TV. Participants were 919 grade five and six students from schools in Melbourne, Australia. The survey showed that heavier TV use and more frequent commercial TV viewing were independently associated with more positive attitudes toward junk food heavier TV use was also independently associated with higher reported junk food consumption. The experiment found that ads for nutritious foods promote selected positive attitudes and beliefs concerning these foods. Findings are discussed in light of methodological issues in media effects research and their implications for policy and practice. It is concluded that changing the food advertising environment on children's TV to one where nutritious foods are promoted and junk foods are relatively unrepresented would help to normalize and reinforce healthy eating.
Publisher: Japan Epidemiological Association
Date: 2010
Publisher: Wiley
Date: 10-2002
DOI: 10.1046/J.1445-2197.2002.02532.X
Abstract: In the present paper we describe the presentation and management of ductal carcinoma in situ (DCIS) of the breast in women in Australia in 1995. This representative, national data set provides a historical comparator for studies examining DCIS management that follow. Surgeons identified by population-based cancer registries as having treated a new diagnosis of DCIS between 1 April and 30 September 1995 completed a questionnaire on the presentation and management of each case. Two hundred and five surgeons supplied treatment details on 418 DCIS tumours in 415 women. Half of all tumours were detected at Breast Screen clinics and a further 25% were detected at other mammography centres. Twenty-six percent of tumours were palpable at presentation, 33% were multifocal and 55% were high grade (including comedocarcinoma). Breast conserving therapy (BCT) rather than mastectomy was utilized in 260 (62%)of cases. Tumours that were of low grade, small in size and not multifocal were more likely to be treated by BCT. Surgeons seeing six or moreDCIS cases in the 6-month period were more likely to utilize BCT. Of the conservatively treated cases, 22% were referred for a radiation oncology consultation. The most common reasons for treating DCIS with mastectomy were that the tumour was too extensive or multifocal (63%), it extended to margins of the specimen (42%), or patient concerns about recurrence (34%). In 1995 the majority of DCIS was treated with breast conserving surgery alone. Surgeons treating more DCIS cases were more likely to perform conservative surgery than surgeons treating only one DCIS case in the study period.
Publisher: Wiley
Date: 25-03-2004
Publisher: BMJ
Date: 08-2019
DOI: 10.1136/TOBACCOCONTROL-2019-054988
Abstract: To assess the long-term impact of plain packaging (PP) of cigarettes with larger graphic health warnings (HW) introduced in December 2012 on adolescents’ relevant tobacco-related perceptions. Cross-sectional school-based surveys of 12 to 17 year olds in 2011 (n=4413), 2013 (n=4423), 2014 (n=4576) and 2017 (n=4266). Students rated the character of four popular cigarette brands, indicated their agreement regarding brand differences in smoking ease, quitting, addictiveness, harmfulness and pack attractiveness and positive/negative perceptions of pack image. The frequency of students reading, attending to, thinking and talking about HW was assessed. Responses of students seeing cigarette packs in the previous 6 months (2011: 63% 2013: 67%, 2014: 56%, 2017: 56%) were examined. Smoking prevalence declined from 2011 to 2017. Among students who had recently seen packs, cigarette packs were rated less positively and more negatively in 2017 than in 2011 (p .001) with ratings similar between 2013 and 2017. Positive character ratings for each brand reduced between 2011 and 2013 (ps .05) with further reductions between 2013 and 2017 (ps .05). Fewer students agreed, and more were uncertain, that brands differed in their smoking ease, addictiveness, harmfulness and pack attractiveness in 2017 than 2011. The frequency of students reading, attending, talking or thinking about HW did not change between 2011 and 2017. PP’s initial impact in reducing adolescent’s positive perceptions of cigarette packs and brand differences continued in the following years with tobacco packaging less appealing to young people in 2017 than 2011 and students more uncertain about brand differences.
Publisher: Wiley
Date: 2006
DOI: 10.1111/J.1445-2197.2006.03640.X
Abstract: Background: This study examines changes in the management of ductal carcinoma in situ between 1995 and 1999 in the Australian State of Victoria. This period was before the release of Australian treatment recommendations. Methods: All new cases of ductal carcinoma in situ diagnosed between 1 April and 30 September in 1995 and 1999 were identified from the population cancer registry. Treating surgeons completed a questionnaire on the presentation and management of each case. In 1995, 64 out of 70 surgeons returned questionnaires for 137 cases (case response, 94%). In 1999, 68 surgeons treated 159 registered cases and 141 completed surveys were returned (case response, 89%). Results: More cases underwent an image‐guided biopsy in 1999 (54%) than in 1995 (34%). Breast‐conserving surgery (BCS) was used to treat 69% of cases in 1999 and 63% in 1995. The use of axillary procedures (clearance or s ling) for women treated by mastectomy decreased from 61% in 1995 to 30% in 1999. More patients treated with BCS had margins simply described as ‘clear’ in 1995 (49%) than in 1999 (21%). In 1995, only 7% of cases treated with BCS had radiotherapy, and this was 25% in 1999. Conclusion: In both 1999 and 1995, the majority of patients were treated by BCS, but only a minority received radiotherapy.
Publisher: Oxford University Press (OUP)
Date: 13-03-2012
DOI: 10.1093/NTR/NTS073
Publisher: Springer Science and Business Media LLC
Date: 03-05-2022
DOI: 10.1007/S00520-022-07021-6
Abstract: In response to the onset of the COVID-19 pandemic, telehealth was rapidly rolled out in health services across Australia including those delivering cancer care. This study aimed to understand people with cancer and carers’ experiences with telehealth for cancer care during the COVID-19 pandemic and associated restrictions. Semi-structured interviews conducted with people with cancer and carers via telephone or online video link between December 2020 and May 2021. Participants were recruited through cancer networks and social media. Interviews were transcribed and thematic analysis undertaken. Twenty-three patients and 5 carers were interviewed. Telephone-based appointments were most common. Responses to telehealth were influenced by existing relationships with doctors, treatment/cancer stage and type of appointment. Four themes were derived: (i) benefits, (ii) quality of care concerns, (iii) involving carers, and (iv) optimising use of telehealth. Benefits included efficiency and reduced travel. Quality of care concerns identified subthemes: transactional feel to appointments difficulties for rapport suitability for appointment type and adequacy for monitoring. Both patients and carers noted a lack of opportunity for carers to participate in telephone-based appointments. Aligning appointment mode (i.e. telehealth or in person) with appointment purpose and ensuring telehealth was the patient’s choice were seen as essential for its ongoing use. While telehealth has benefits, its potential to reduce the quality of interactions with clinicians made it less attractive for cancer patients. Patient-centred guidelines that ensure patient choice, quality communication, and alignment with appointment purpose may help to increase telehealth’s utility for people affected by cancer.
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2022-064202
Abstract: To explore how cigarette packet branding and colours influence young male smokers’ perceptions of tobacco brands in Cambodia. Mixed-methods study. Worksites, living accommodations, a university and public locations in Phnom Penh, Cambodia. 147 male Cambodian smokers (18–24 years). Participants were shown mock-up pictures of different cigarette packet branding and colour variations and asked to respond to close-ended and short-response questions. Brand recognition, appeal and harm perceptions of cigarette packet branding and colours. When shown three packets with brand names removed, 98.6% of participants recognised packet one as Mevius brand, 21.1% recognised packet two as Marlboro and 38.8% recognised packet three as 555. For the three fully-branded and three matching plain packets, most participants selected a fully-branded packet as the most appealing taste (83.0%) and most appealing to youth (81.7%). Participants described their chosen brand as appealing due to beliefs about its superior taste/quality, reduced harm and symbolic attitudes surrounding tobacco brands and smokers of different brands in a social status hierarchy. When shown six different colours of unbranded packets, participants selected the blue packet (51.0%) as the most appealing for taste, the white packet as the least harmful (25.2%), and the red (15.0%) and black (12.9%) packets as the most harmful to health. They described their associations of packet colours with abstract imagery concerning smoking-related harms and their future well-being. Findings suggest that packet branding and colours influence young male smokers’ recognition, appeal and harm perceptions of tobacco brands in Cambodia and remain an influential marketing tool for tobacco companies where advertising is banned. Consequently, Cambodia and other low and middle-income countries in Southeast Asia should implement plain packaging.
Publisher: Springer Science and Business Media LLC
Date: 09-02-2008
DOI: 10.1007/S10552-008-9127-8
Abstract: To examine whether socio-economic status (SES) was associated with changes in smoking prevalence among Australian adolescents during three phases of tobacco-control activity between 1987 and 2005. Triennial cross-sectional national studies of representative random s les of secondary students aged 12-17 years have been conducted since 1987. Numbers range from 19,203 in 1987 to 29,853 in 1996. Self-report anonymous surveys assessed cigarette use in the past month, week (current), and on at least three of the previous seven days (committed). Students' residential postcode was collected and the Index of Relative Socio-Economic Disadvantage (IRSD) associated with each postcode determined SES quartiles. Between 1987 and 2005, smoking prevalence decreased in all SES groups. Tobacco-control activity level was associated with changes in smoking prevalence and whether changes were consistent across SES groups. In a period of low tobacco-control funding (1992-1996) and activity, smoking prevalence increased among 12- to 15-year-olds, the increase being greatest among low SES students. In a period of high tobacco-control activity (1997-2005) smoking decreased and reductions were generally consistent across SES groups. Well-funded, population-based tobacco-control programs can be effective in reducing smoking among students from all SES groups.
Publisher: Cambridge University Press (CUP)
Date: 17-07-2022
DOI: 10.1017/S0033291720002251
Abstract: Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition. We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses. In total 70 eligible studies across 17 health conditions [most commonly: cancer ( k = 20), chronic pain ( k = 9), arthritis ( k = 6) and multiple sclerosis ( k = 5), diabetes ( k = 4), fibromyalgia ( k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22–0.39), anxiety g = 0.19 (95% CI 0.12–0.27), and distress g = 0.36 (95% CI 0.23–0.49). Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.
Publisher: Elsevier BV
Date: 10-2023
Publisher: American Association for Cancer Research (AACR)
Date: 09-2018
DOI: 10.1158/1055-9965.EPI-18-0210
Abstract: Background: Longer cancer pathways may contribute to rural–urban survival disparities, but research in this area is lacking. We investigated time to diagnosis and treatment for rural and urban patients with colorectal or breast cancer in Victoria, Australia. Methods: Population-based surveys (2013–2014) of patients (aged ≥40, approached within 6 months of diagnosis), primary care physicians (PCPs), and specialists were collected as part of the International Cancer Benchmarking Partnership, Module 4. Six intervals were examined: patient (symptom to presentation), primary care (presentation to referral), diagnostic (presentation/screening to diagnosis), treatment (diagnosis to treatment), health system (presentation to treatment), and total interval (symptom/screening to treatment). Rural and urban intervals were compared using quantile regression including age, sex, insurance, and socioeconomic status. Results: 433 colorectal (48% rural) and 489 breast (42% rural) patients, 621 PCPs, and 370 specialists participated. Compared with urban patients, patients with symptomatic colorectal cancer from rural areas had significantly longer total intervals at the 50th [18 days longer, 95% confidence interval (CI): 9–27], 75th (53, 95% CI: 47–59), and 90th percentiles (44, 95% CI: 40–48). These patients also had longer diagnostic and health system intervals (6–85 days longer). Breast cancer intervals were similar by area of residence, except the patient interval, which was shorter for rural patients with either cancer in the higher percentiles. Conclusions: Rural residence was associated with longer total intervals for colorectal but not breast cancer with most disparities postpresentation. Impact: Interventions targeting time from presentation to diagnosis may help reduce colorectal cancer rural–urban disparities. Cancer Epidemiol Biomarkers Prev 27(9) 1036–46. ©2018 AACR.
Publisher: BMJ
Date: 29-08-2013
DOI: 10.1136/TOBACCOCONTROL-2012-050945
Abstract: To examine how the intensity and duration of tobacco control advertising relate to adolescent smoking prevalence. Australian students (aged 12-17 years) participating in a national survey conducted triennially between 1993 and 2008 (s le size range 12 314-16 611). The outcome measure was students' smoking in the previous 4 weeks collected through anonymous, self-completed surveys. For each student, monthly targeted rating points (TRPs, a measure of television advertising exposure) for tobacco control advertising was calculated for the 3 and 12 months prior to surveying. For each time period, cumulative TRPs exposure and exposure to three intensity levels (≥100 TRPs/month ≥400 TRPs/month ≥800 TRPs/month) over increasing durations (eg, 1 month, 2 months, etc) were calculated. Logistic regression examined associations between TRPs and adolescent smoking after controlling for demographic and policy variables. Past 3-month cumulative TRPs were found to have an inverse relationship with smoking prevalence. Low TRPs exposure in the past 12 months was positively associated with adolescent smoking prevalence. However, smoking prevalence reduced with cumulative exposure levels above 5800 cumulative TRPs. Additionally, exposure to ≥400 TRPs/month and ≥800 TRPs/month were associated with reduced likelihood of smoking, although the duration needed for this effect differed for the two intensity levels. When intensity was ≥400 TRPs/month, the odds of smoking only reduced with continuous exposure. When intensity was ≥800 TRPs/month, exposure at levels less than monthly was associated with reductions in smoking prevalence. Both antismoking advertising intensity and duration are important for ensuring reductions in adolescent smoking prevalence.
Publisher: BMJ
Date: 17-02-2009
DOI: 10.1136/BMJ.B95
Publisher: Wiley
Date: 03-1994
Publisher: Springer Science and Business Media LLC
Date: 23-12-2013
DOI: 10.1007/S10689-012-9596-5
Abstract: Distress levels among female BRCA1/2 mutation carriers can be similar to levels found among breast cancer patients. While psychological distress has been associated with unmet needs among cancer patients no study has examined this among BRCA1/2 mutation carriers. The objectives of this study were to: (1) describe the unmet support needs of women with a known BRCA1/2 mutation, (2) determine how unmet needs are related to psychological distress, and (3) identify variables that predict level of unmet need and distress. Female BRCA1/2 mutation carriers were identified through Familial Cancer Centers in 3 Australian states. Two-hundred and seventy-nine participants completed surveys assessing need for help on 16 information and support items. The Impact of Events Scale assessed genetic test related distress. Participants reported an average of 5.4 (SD = 4.9) moderate to very high unmet needs. Twenty-one percent had scores indicating moderate distress, and 13 % indicating severe distress. Younger age (t = -3.34 p < 0.01), not having someone to confide in about the gene mutation (t = 2.57 p = 0.01) and shorter time since notification of mutation status (t = -2.49 p = 0.01) were associated with higher unmet need scores in linear regression analyses. Greater number of unmet needs was associated with a greater likelihood of moderate to severe levels of distress (OR = 1.19 p < 0.01) in logistic regression analyses. Identifying appropriate interventions that target unmet needs among younger women and those with no confidante may help to reduce distress. Interventions that provide an opportunity for women to confide in someone, such as Peer support programs, may be one way of meeting the emotional needs of this population.
Publisher: Hindawi Limited
Date: 23-08-2018
DOI: 10.1111/ECC.12897
Publisher: Hindawi Limited
Date: 19-07-2011
DOI: 10.1111/J.1365-2354.2011.01265.X
Abstract: Following the release of the national clinical treatment recommendations for ductal carcinoma in situ (DCIS), consumers' and surgeons' characterisation of this disease was assessed. Telephone interviews were conducted with 231 women diagnosed with DCIS, in Victoria, Australia in 2006/2007 and 63 treating surgeons completed a mailed survey. The main outcome measures were: women's diagnostic experience, women's and surgeons' description of DCIS, women's understanding of DCIS, confusion and worry about the disease and risk perceptions. While the majority of women had not heard of DCIS prior to diagnosis, most reported a positive diagnostic experience. Surgeons' and women's description of DCIS were consistent. Women understood that DCIS is a contained disease (86%), can progress (88%) and treatment aims to prevent invasive cancer (97%). However, only 13% understood that DCIS alone cannot spread to other parts of the body. A quarter of the women were confused about the risk of DCIS spreading. Younger women had more concerns about developing breast cancer (P= 0.008) and the disease spreading (P= 0.002) and rated their risk of invasive disease higher (P= 0.007). Most women diagnosed with DCIS in 2006/2007 understand the 'early, contained nature' of the disease, but understanding of the 'non-invasive' nature of DCIS could be improved.
Publisher: Wiley
Date: 11-08-2010
DOI: 10.1002/PON.1609
Abstract: To examine the psychological impact of a referral and telephone intervention, involving information and support, among men with colorectal cancer (CRC) and prostate cancer. 571 newly diagnosed male CRC (N=182) and prostate (N=389) cancer patients were block-randomised into three arms. In the two intervention arms, the specialist actively referred men to a Cancer Helpline. In Active Referral--4 outcalls, men received calls from the Helpline within 1 week of diagnosis, and at 6 weeks, 3 months and 6 months post-diagnosis. In Active Referral--1 outcall, men received one call within 1 week of diagnosis. In the control arm, Passive Referral, patients were referred to the Helpline, with contact at their initiative. Participants completed scales measuring cancer-specific distress, anxiety and depression at study entry, then 4, 7 and 12 months post-diagnosis. Random effects regression models compared rates of change in these outcomes between study arms. At the first outcall, over 85% of participants in both intervention arms discussed treatment management and psychological/emotional issues. Among the Active Referral--4 outcalls arm, over 80% of participants discussed psychological/emotional issues at each call. Mean changes over time in cancer-specific distress, anxiety and depression were similar between study arms. Although men were willing to discuss psychosocial issues via the telephone, we found no psychological impact. Further research is required to determine whether the intervention is more effective for patients who do not have psychosocial support or have unmet information needs.
Publisher: Springer Science and Business Media LLC
Date: 09-2006
DOI: 10.1007/S00520-006-0128-4
Abstract: Many cancer patients experience unmet needs and elevated levels of anxiety and depression. This paper describes a volunteer-delivered intervention to reduce the psychosocial needs of cancer patients and presents findings from a feasibility study of this intervention. The telephone-based intervention, called the Pathfinder Program, involves the assignment of volunteers to patients to assist them in addressing their needs as identified in questionnaires. Fifty-two patients with colorectal cancer were involved in the feasibility study, with 18 in the intervention. Sixty-two percent of the s le was male and the mean age was 64 years. Patients' needs were assessed using The Supportive Care Needs Survey, a colorectal cancer symptom checklist, and the Hospital Anxiety and Depression Scale. All patients completed baseline questionnaires (Time 1) and 47 completed Time 2 questionnaires 3 months later. The most common needs were fear of the cancer spreading and returning, concerns about the worries of others, gas or wind, changes in weight, and bowel problems such as diarrhea, constipation, and pain. A statistically significant Time 1 to Time 2 decrease in supportive care needs and depression was found for the intervention group. The Pathfinder Program has been found to be feasible, acceptable for patients, and has the potential to reduce needs and depression. A larger, randomized controlled trial is needed to determine the impact of this program on colorectal symptoms and anxiety.
Publisher: Wiley
Date: 12-02-1991
DOI: 10.1111/J.1753-6405.1991.TB00005.X
Abstract: A s le of 3527 adults aged 16 years and over was interviewed in their homes to obtain Australian data on selected behavioural risk factors for cancer. Four fifths of those interviewed nominated at least one step that in iduals may take to reduce their risk of cancer, while 14 per cent believed there were no preventive measures available. Most salient among the preventive steps mentioned were 'not smoking' (58 per cent), dietary measures (30 per cent) and protection of the skin against the sun (13 per cent). Various psychological factors were mentioned by 7 per cent. Beliefs about dietary factors associated with cancer and the direction of the relationship tended to be accurate but there appeared to be some confusion with heart disease dietary risk factors. One third of respondents had at some time noticed a skin sign they thought might be cancer, and this was related (as expected) to latitude of residence. Nearly half had at some time systematically checked their skin for lesions, and 13 per cent said they had done this at least six times in the preceding year. Overall, 78 per cent of women respondents said they had been screened for cervical cancer, and 51 per cent said this had taken place in the past two years. Twelve per cent reported having had a mammogram, 7 per cent that were apparently diagnostic and 5 per cent that were reported to be routine screening mammograms. Overall, 78 per cent said they had done systematic breast self-examination at least once, including 41 per cent who said they had done breast self-examination in the past month and 23 per cent who reported having done it monthly over the previous year.
Publisher: Elsevier BV
Date: 2009
Publisher: E.U. European Publishing
Date: 06-12-2022
DOI: 10.18332/TID/155391
Publisher: Wiley
Date: 18-07-2011
DOI: 10.1002/PON.2019
Abstract: The objective was to assess the effectiveness of a volunteer-delivered tailored telephone-based intervention in reducing prevalence of unmet supportive care needs, elevated levels of anxiety and depression among people with colorectal cancer over a 9-month period. There were 653 participants who completed the baseline questionnaire and were randomised to usual care (n = 341) or intervention (n = 306). Three follow-up questionnaires were completed at 3-monthly intervals (response rates: 93%, 87%, 82%, respectively). All four questionnaires contained the Supportive Care Needs Survey (SCNS), Hospital Anxiety and Depression Scale (HADS) and checklists for colorectal cancer symptoms and use of support services. The intervention consisted of trained volunteers providing emotional support, service referral and information and was delivered after completion of each of the first three questionnaires. Primary outcomes were prevalence of moderate to high SCNS needs and elevated levels (scores of 8+) of HADS anxiety and depression. Over the study period, SCNS needs decreased similarly for both groups, and prevalence of elevated depression did not change for either group. There was a greater reduction in the prevalence of elevated anxiety in the intervention than usual care group (p < 0.01), with the intervention group decrease mainly occurring between baseline and the first follow-up survey (p < 0.01). However, the prevalence of elevated anxiety was similar between the two groups at each follow-up point. The intervention had no effect on supportive care needs or depression, although it may be associated with a greater reduction in anxiety. Future research should test the intervention with patients closer to diagnosis.
Publisher: Wiley
Date: 19-06-2015
DOI: 10.1111/DAR.12286
Abstract: The aim of this study was to determine changes in advertising expenditures across eight media channels for the four main alcohol beverage types and alcohol retailers in Australia. Yearly advertising expenditures between January 1997 and December 2011 obtained from a leading media-monitoring company. Media channels assessed were: free-to-air television, newspapers, magazines, radio, outdoors (billboards), cinema, direct mail (from 2005) and online (from 2008). Data were categorised into alcohol retailers (e.g. supermarkets, off-licences) or four alcoholic beverage types (beer, wine, spirits, premixed spirits/cider). Regression analyses examined associations between year and expenditure. Total alcohol advertising expenditure peaked in 2007, then declined to 2011 (P = 0.02). Television advertising expenditure declined between 2000 and 2011 (P < 0.001), while outdoor advertising expenditure increased between 1997 and 2007. Alcohol retailers' advertising expenditure increased over time (P < 0.001), and from the mid-2000s exceeded expenditure for any single beverage category. For both beer and spirits, television advertising expenditure declined over time (beer: P < 0.001 spirits: P < 0.001) while outdoor advertising expenditure increased (beer: P < 0.001 spirits: P = 0.02). However, the number of advertised beer (P < 0.001), spirits (P < 0.001) and wine (P = 0.01) products increased over time. Retailers are playing an increasing role in advertising alcohol. As our study excluded non-traditional advertising media (e.g. sponsorships, in-store) we cannot determine whether declines in television advertising have been offset by increases in advertising in newer media channels. However, our findings that media channels used for alcohol advertising have changed over time highlights the need for adequate controls on alcohol advertising in all media channels. [White V, Faulkner A, Coomber K, Azar D, Room R, Livingston M, Chikritzhs T, Wakefield M. How has alcohol advertising in traditional and online media in Australia changed? Trends in advertising expenditure 1997-2011. Drug Alcohol Rev 2015]2015 :521-530.
Publisher: Wiley
Date: 11-08-2021
DOI: 10.1111/DAR.13130
Publisher: Wiley
Date: 10-07-2023
DOI: 10.1002/PON.6177
Abstract: Caregivers play an important role supporting people diagnosed with cancer, yet report significant unmet information and support needs that impact on their psychological wellbeing. Health literacy and social connectedness are key factors that influence wellbeing, yet few studies have examined their relative role in psychological wellbeing of carers. This study investigated relationships between caregiver and care recipient health literacy, social support, and social connectedness on psychological morbidity in a cancer setting. This cross‐sectional study included 125 caregiver‐cancer care recipient dyads. Participants completed the Health Literacy Survey‐EU‐Q16, Social Connectedness Scale‐Revised, the Medical Outcomes Study–Social Support Survey, and the Depression, Anxiety and Stress Scale‐21 (DASS21). Relationships between factors were examined using hierarchical multiple regression with care recipient factors entered at Step 1 and caregiver factors at Step 2. Most caregivers provided care for their spouse (69.6%) caregivers mean total DASS21 score was 24.38 (SD = 22.48). Mean DASS21 subscale scores for depression, anxiety, stress in caregivers were 4.02 (SD = 4.07), 2.7 (SD = 3.64), and 5.48 (SD = 4.24) respectively, suggesting normal range of depression and stress, and mild anxiety. Care recipients had a diagnosis of breast (46.4%), gastrointestinal (32.8%), lung (13.6%), or genitourinary (7.2%) cancer, and a mean DASS21 score of 31.95 (SD = 20.99). Mean DASS21 subscale scores for depression, anxiety, stress in care recipients were 5.10 (SD = 4.18), 4.26 (SD = 3.65), and 6.62 (SD = 3.99) respectively, suggesting mild depression and anxiety, and normal stress scores. Regression analyses showed that only caregiver factors (age, illness/disability, health literacy and social connectedness) were independent predictors of caregiver psychological morbidity ( F [10,114] = 18.07, p 0.001). Only caregiver, and not care recipient, factors were found to influence caregiver psychological morbidity. While both health literacy and social connectedness influenced caregiver psychological morbidity, perceived social connectedness had the strongest influence. Interventions that ensure caregivers have adequate health literacy skills, as well as understand the value of social connection when providing care, and are supported to develop skills to seek support, have the potential to promote optimal psychological wellbeing in cancer caregivers.
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.PEC.2007.11.016
Abstract: To identify models of peer support for cancer patients and systematically review evidence of their effectiveness in improving psychosocial adjustment. CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and PsychINFO databases were used to identify relevant literature published from 1980 to April 2007. Data on characteristics of the peer-support program, s le size, design, measures, and findings were extracted and papers were also rated with respect to research quality (categories 'poor', 'fair' or 'good'). Forty-three research papers that included data from at least 1 group were reviewed in detail, including 26 descriptive papers, 8 non-randomized comparative papers, and 10 papers reporting eight randomized controlled trials (RCTs). Five models of peer support were identified: one-on-one face-to-face, one-on-one telephone, group face-to-face, group telephone, and group Internet. Papers indicated a high level of satisfaction with peer-support programs however, evidence for psychosocial benefit was mixed. One-on-one face-to-face and group Internet peer-support programs should be given priority when considering ways to offer peer support. Nevertheless, the other models discussed in this review should not be dismissed until further research is conducted with a wide range of cancer populations.
Publisher: Oxford University Press (OUP)
Date: 11-05-2007
Abstract: The aim of this study was to provide a current assessment of Australian secondary students' self-reported dietary, physical activity and sedentary behaviour. This study also examined the relationship between television viewing and students' dietary behaviour. Data are from a cross-sectional survey of 18 486 secondary students in 2005 from all Australian states except Western Australia. Participants reported their usual daily consumption (number of serves) of vegetables and fruit their weekly consumption of unhealthy/non-core foods including fast food meals, snack foods and high-energy drinks their engagement in moderate-vigorous physical activity over the previous week and hours spent using electronic media for entertainment and doing homework on school days. The study found that 20% of students were meeting the daily requirement of four serves of vegetables, whereas 39% were eating the recommended three daily serves of fruit. Consumption of unhealthy/non-core foods was high, with 46% of students having fast food meals at least twice a week, 51% eating snack foods four or more times per week and 44% having high-energy drinks four or more times per week. Fourteen per cent of students engaged in recommended levels of physical activity and 29% engaged in recommended levels of sedentary behaviour. Age and gender differences occurred for most measures, and there were some socio-economic status differences. Heavier television use was associated with lower consumption of fruit and higher consumption of unhealthy/non-core foods. On the basis of the results of this study, it appears that a significant proportion of Australian secondary students fall short of current, national dietary and physical activity recommendations for teenagers. Continual monitoring of these behaviours is essential to help inform research and policy and identify where future efforts should be directed.
Publisher: JMIR Publications Inc.
Date: 29-04-2021
Abstract: eb-based mindfulness programs may be beneficial in improving the well-being outcomes of those living with chronic illnesses. Adherence to programs is a key indicator in improving outcomes however, with the digitization of programs, it is necessary to enhance engagement and encourage people to return to digital health platforms. More information is needed on how engagement strategies have been used in web-based mindfulness programs to encourage adherence. he aim of this study is to develop a list of engagement strategies for web-based mindfulness programs and evaluate the impact of engagement strategies on adherence. narrative systematic review was conducted across the MEDLINE Complete, CINAHL Complete, APA PsycINFO, and Embase databases and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Articles were screened using the population, intervention, comparator, and outcome framework. Adults aged & years with chronic health conditions were included in the study. Mindfulness interventions, including those in combination with mindfulness-based cognitive therapy, delivered on the web through the internet or smartphone technology were included. Interventions lasted at least 2 weeks. Studies with a randomized controlled trial design or a pilot randomized controlled trial design were included. Engagement strategies, including web-based program features and facilitator-led strategies, adherence, and retention, were included. total of 1265 articles were screened, of which 19 were relevant and were included in the review. On average, 70.98% (2258/3181) of the study participants were women with a mean age of 46 (SD 13) years. Most commonly, mindfulness programs were delivered to people living with mental health conditions (8/19, 42%). Of the 19 studies, 8 (42%) used only program features to encourage adherence, 5 (26%) used facilitator-led strategies, and 6 (32%) used a combination of the two. Encouraging program adherence was the most common engagement strategy used, which was used in 77% (10/13) of the facilitator-led studies and 57% (8/14) of the program feature studies. Nearly two-thirds (63%) of the studies provided a definition of adherence, which varied between 50% and 100% completion across studies. The overall mean participant compliance to the mindfulness programs was 56% (SD 15%). Most studies (10/19, 53%) had a long-term follow-up, with the most common follow-up period being 12 weeks after intervention (3/10, 30%). After the intervention, the mean retention was 78% (SD 15%). ngagement strategies in web-based mindfulness programs comprise reminders to use the program. Other features may be suitable for encouraging adherence to interventions, and a facilitator-led component may result in higher retention. There is variance in the way adherence is measured, and intervention lengths and follow-up periods are inconsistent. More thorough reporting and a standardized framework for measuring adherence are needed to more accurately assess adherence and engagement strategies.
Publisher: Wiley
Date: 08-2003
DOI: 10.1046/J.1360-0443.2003.00427.X
Abstract: To incorporate a psychosocial model of tobacco smoking into a behaviour genetic design to examine genetic and environmental influences on variation in smoking involvement. Longitudinal twin study. Twins initially aged between 13 and 18 years and registered with the Australian Twin Registry were surveyed three times between 1988 and 1996. A total of 414 pairs of identical and same-sex fraternal twin pairs participated in all three surveys, aged between 20 and 25 at wave 3. Biometric modelling estimated the influence of genetic and environmental factors in determining variation in smoking at each wave, both before and after adjusting for perceived smoking behaviours of peers and parents. Twins answered a questionnaire on their own smoking status and reported on the use of tobacco by parents and friends as they perceived it, at each survey wave. At all three surveys, current smokers were more likely to have parents who smoked and to have smokers among their peers. Genes and environmental factors, both common and unique, contributed to variation in smoking behaviours. However, after controlling for the smoking behaviours of peers and parents, the role of genes in determining variation in smoking involvement was reduced by 100% at wave 1 and by 30% at wave 2. Friends' smoking reduced the magnitude of the common environment variance by 11%, 30% and 40% at waves 1, 2 and 3, respectively. Parents' smoking behaviours explained part of the common environment. Biometric modelling of the covariation between smoking involvement and peer smoking suggested that genes might influence smoking involvement at wave 1 by influencing choice of peers. Environmental factors play the greatest role in determining variation in tobacco smoking among adolescents and young adults. Among adolescents, genes may influence variation in smoking behaviours indirectly by influencing choice of peers. However, genes seem to have a direct influence on variations in the smoking behaviours of young adults.
Publisher: Springer Science and Business Media LLC
Date: 29-05-2023
DOI: 10.1007/S12519-023-00730-W
Abstract: The aim of this study was to identify similarities and differences in the unmet supportive care needs (USCN) of families of children with major chronic health conditions (CHCs) using a universal need assessment tool. A cross-sectional online survey involving parents of children with congenital heart disease (CHD), type 1 diabetes mellitus (T1D), cancer, and asthma diagnosed within the last 5 years recruited via social media and support organizations. Thirty-four items assessing the USCN across six domains (care needs, physical and social needs, informational needs, support needs, financial needs, child-related emotional needs) were responded to on a 4-point Likert scale [no need (1) to high need (4)]. Descriptive statistics identified the level of need, and linear regressions identified factors associated with higher need domain scores. Due to small numbers, the asthma group was excluded from comparisons across CHCs. One hundred and ninety-four parents completed the survey (CHD: n = 97, T1D: n = 50, cancer: n = 39, and asthma: n = 8). Parents of children with cancer were most likely to report at least one USCN (92%), followed by parents of children with T1D (62%). The five most commonly reported USCN across CHCs were drawn from four domains: child-related emotional, support, care, and financial. Three need items were included in the top five needs for all conditions. A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support. Using a universal need assessment tool, this is one of the first studies to characterize USCN in families of children diagnosed with common CHCs. While proportions endorsing different needs varied across conditions, the most endorsed needs were similar across the illness groups. This suggests that support programs or services could be shared across different CHCs.
Publisher: Springer Science and Business Media LLC
Date: 04-2008
DOI: 10.1080/08858190802039177
Abstract: In this article, we report on the effects of patient education for people with cancer in comparison to family and friends. Data are from 666 participants with cancer and 324 family and friends who completed preprogram and postprogram questionnaires. Results show high levels of participant satisfaction and positive changes in measures such as illness perceptions and emotional functioning. In many cases, the pattern of change was different for people with cancer compared to family and friends. This education program may be useful for helping people with cancer cope with the disease, with some distinct benefits for family and friends.
Publisher: Wiley
Date: 17-01-2022
DOI: 10.1002/HPJA.570
Abstract: Introduced relatively recently in the Australian market, flavour capsule cigarettes pose a risk to adolescents by providing a palatable pathway to smoking initiation. The present study aimed to establish the prevalence of the use of flavour capsule cigarettes in Australian adolescents and to examine the association between frequency of use and smoking behaviour and intentions and perceptions of cigarette brand differences. Data were from a 2017 cross‐sectional school‐based survey of secondary students aged 12‐17 years (N = 4266) in Victoria who self‐reported their smoking behaviours, smoking intentions and cigarette brand perceptions. Regression analyses were conducted controlling for sex, age group, education sector and other covariates. Overall, 5% (n = 195) of all students reported ever using flavour capsule cigarettes. Of the 675 students who had ever smoked, 29% (n = 194) had tried a flavour capsule cigarette. The likelihood of past‐month and past‐week smoking was significantly higher, and future smoking intentions were significantly stronger, for ever‐smokers who had used flavour capsule cigarettes multiple times compared to those who had never used this type of cigarette. Ever‐smokers were more likely to agree that ‘some brands of cigarettes are easier to smoke than others’ if they had tried a flavour capsule cigarette. There are high levels of use of flavour capsule cigarettes among Australian adolescent smokers, with more frequent use associated with greater involvement in smoking. These findings add to those of other studies suggesting that flavour capsule cigarettes may have negative impacts on youth smoking, strengthening the case for their prohibition in Australia.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.PEC.2016.12.009
Abstract: People with cancer can experience psychological distress but do not always desire, or engage with, professional support to assist with managing distress. Interventions that are self-directed or guided by patients may hold promise as they allow patients to engage with interventions as they need. The objective of this review is to describe and appraise the evidence for effectiveness of self-guided interventions that aim to manage psychological distress in people with cancer. A systematic search of Medline, PsychInfo and CINAHL identified 15 relevant papers, reporting on 14 studies. Of the interventions, three studies comprised hard-copy workbooks, six studies used resource packs, four were online resources and one was a brief multimedia resource. One study was adequately powered and demonstrated a positive effect. Almost all interventions required some level of facilitation. Distressed participants may benefit more from interventions. Self-guided interventions represent a potentially efficient way of delivering support for people affected by cancer, however evidence supporting them is lacking. There is a need to generate evidence to understand the impact of self-guided interventions for: i) the ideal delivery point in the disease trajectory, ii) patient groups, iii) intervention content and iv) type and mode of delivery.
Publisher: American Association for Cancer Research (AACR)
Date: 16-07-2021
DOI: 10.1158/1055-9965.EPI-21-0222
Abstract: Socio-economic inequalities in colon cancer survival exist in high-income countries, but the reasons are unclear. We assessed the mediating effects of stage at diagnosis, comorbidities, and treatment (surgery and intravenous chemotherapy) on survival from colon cancer. We identified 2,203 people aged 15 to 79 years with first primary colon cancer diagnosed in Victoria, Australia, between 2008 and 2011. Colon cancer cases were identified through the Victorian Cancer Registry (VCR), and clinical information was obtained from hospital records. Deaths till December 31, 2016 (n = 807), were identified from Victorian and national death registries. Socio-economic disadvantage was based on residential address at diagnosis. For stage III disease, we decomposed its total effect into direct and indirect effects using interventional mediation analysis. Socio-economic inequalities in colon cancer survival were not explained by stage and were greater for men than women. For men with stage III disease, there were 161 [95% confidence interval (CI), 67–256] additional deaths per 1,000 cases in the 5 years following diagnosis for the most disadvantaged compared with the least disadvantaged. The indirect effects through comorbidities and intravenous chemotherapy explained 6 (95% CI, −10–21) and 15 (95% CI, −14–44) per 1,000 of these additional deaths, respectively. Surgery did not explain the observed gap in survival. Disadvantaged men have lower survival from stage III colon cancer that is only modestly explained by having comorbidities or not receiving chemotherapy after surgery. Future studies should investigate the potential mediating role of factors occurring beyond the first year following diagnosis, such as compliance with surveillance for recurrence and supportive care services.
Publisher: Wiley
Date: 09-10-2016
DOI: 10.1111/ADD.13143
Abstract: While recent evidence suggests that higher alcohol outlet density is associated with greater alcohol use among adolescents, influence of the four main outlet types on youth drinking within urban and regional communities is unknown. This study provides the first investigation of this relationship. Repeated cross-sectional surveys with random s les of secondary students clustered by school. Mixed-effects logistic regression analyses examined the association between each outlet type and the drinking outcomes, with interaction terms used to test urban/regional differences. Australia, 2002-11. Respondents participating in a triennial survey (aged 12-17 years) 44 897 from urban settings, 23 311 from regional settings. The key outcome measures were past month alcohol use, risky drinking among all students and risky drinking among past week drinkers. For each survey year, students were assigned a postcode-level outlet density (number of licences per 1000 population) for each outlet type (general, on-premise, off-premise, clubs). Interaction terms revealed a significant association between off-premises outlet density and risky drinking among all adolescents in urban (odds ratio = 1.36, 95% confidence interval CI = 1.05-1.75, P < 0.05) but not regional areas. Similarly, club density was associated with the drinking outcomes in urban communities only. General and on-premises density was associated with alcohol use and risky drinking among all adolescents. Higher densities of general, on- and off-premises outlets in an adolescent's immediate neighbourhood are related to increased likelihood of alcohol consumption among all adolescents. The density of licensed clubs is associated more strongly with drinking for urban than for regional adolescents.
Publisher: Wiley
Date: 24-07-2018
DOI: 10.1002/PBC.27349
Abstract: While several studies have examined the treatment of adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL), studies of acute myeloid leukemia (AML) are rare. Using national data for Australia, we describe (i) the number and type of treatment centers caring for AYAs, (ii) induction/first-line treatments, and (iii) survival outcomes. National population-based study assessing treatment of 15- to 24-year-olds diagnosed with ALL or AML between 2007 and 2012. Treatment details were abstracted from hospital medical records. Treatment centers were classified as pediatric or adult (adult AYA-focused or other adult and by AYA volume [high/low]). Cox proportional hazard regression analyses examined associations between treatment and overall, event-free, and relapse-free survival outcomes. Forty-seven hospitals delivered induction therapy to 351 patients (181 ALL and 170 AML), with 74 (21%) treated at pediatric centers 70% of hospitals treated less than two AYA leukemia patients per year. Regardless of treatment center, 82% of ALL patients were on pediatric protocols. For AML, pediatric protocols were not used in adult centers, with adult centers using a non-COG 7+3-type induction protocol (51%, where COG is Cooperative Oncology Group) or an ICE-type protocol (39%, where ICE is idarubicin, cytarabine, etoposide). Exploratory analyses suggested that for both ALL and AML, AYAs selected for adult protocols have worse overall, event-free, and relapse-free survival outcomes. Pediatric protocols were commonly used for ALL patients regardless of where they are treated, indicating rapid assimilation of recent evidence by Australian hematologists. For AML, pediatric protocols were only used at pediatric centers. Further investigation is warranted to determine the optimal treatment approach for AYA AML patients.
Publisher: Elsevier BV
Date: 2008
DOI: 10.1016/J.PEC.2007.08.005
Abstract: To conduct a systematic review of literature reporting on the use of volunteers in support programs for people with cancer. PsycINFO, Medline and CINAHL were used to identify papers published up to April 2007 reporting one-to-one support programs using volunteers. Program data were extracted from the papers, which were rated on research quality and descriptions of the program, volunteers and support recipients. Twenty-eight papers were reviewed. Nineteen (69%) reported peer-support programs, with four (14%) pertaining to the Reach to Recovery program for women with breast cancer, and eight (28%) describing other peer-support programs for women with breast cancer. Few papers described the programs sufficiently to enable a good understanding of support recipients, volunteers, and what transpired between volunteers and support recipients. Twenty papers (71%) were research studies: 10 (36%) with one group descriptive data, 6 (21%) were non-randomized comparative studies and 4 (14%) were randomized controlled trials. While most papers reported that programs were beneficial, few presented data from studies using rigorous research methodologies to support these claims. Using volunteers in cancer care may have merits however, papers need to provide more information regarding these programs and further evidence is required to determine their effectiveness.
Publisher: Mary Ann Liebert Inc
Date: 03-2017
Publisher: Informa UK Limited
Date: 27-05-2008
Publisher: BMJ
Date: 17-02-2022
DOI: 10.1136/TOBACCOCONTROL-2021-057063
Abstract: Tobacco companies have used below-the-line marketing in novel ways to promote their brands to youth in low/middle-income countries in Southeast Asia. This study explores how young male smokers in Cambodia experience below-the-line marketing strategies. Convenience s ling was used to recruit 147 young male smokers (18–24 years) in Cambodia in early 2020. Local research assistants conducted mixed-methods interviews with participants in Khmer or English. Participants recalled exposure to below-the-line marketing strategies and provided in-depth descriptions about their experiences with in idual sales promotions. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using thematic analysis. 54% of participants recalled exposure to at least one below-the-line marketing strategy, including point-of-sale promotions (32.7%), in idual sales promotions (27.9%) and online advertising (14.3%). Participants described in idual sales promotions in public settings, and recalled that promoters were mostly female, attractive and targeted young males. Tactics used to encourage young people to accept promotional offers included free cigarettes and s le packets, swapping current cigarettes for new brands and collecting consumer details after interviewing. The brands and product features of cigarettes being promoted were readily described by participants. This study provides evidence that illegal below-the-line marketing is still occurring in Cambodia, and increased monitoring and enforcement of advertising restrictions is needed.
Publisher: Hindawi Limited
Date: 15-05-2019
DOI: 10.1111/ECC.13096
Abstract: Wellness centres offer people affected by cancer to access to information and services in a supportive environment. This study aimed to understand stakeholder opinions and perspectives about the potential of wellness centres to contribute to cancer care. This study adopted a qualitative approach with health professionals, leaders of key cancer organisations and cancer policy stakeholders interviewed. Results were analysed with thematic analysis. Twenty-three stakeholders representing 13 organisations participated. The following three key themes were identified: (a) The promise and ambition of wellness centres (b) The hesitations and questions and (c) Optimising wellness. While many recognised the ambition of wellness centres to offer non-clinical spaces and support for patients and family, there were several concerns raised about the drivers, evidence, throughput, access and equity of services, in the context of other cancer care priorities. Participants made recommendations that focused on use of data models of community or clinical integration accessibility and scope approaches to engaging minority or disadvantaged groups and contribution to cancer care and psycho-oncology. Professional stakeholders hold varied views about the potential of wellness centres in contributing to cancer care. Research opportunities include understanding models of community clinical engagement and how to engage minority or disadvantaged populations to ensure equity of access.
Publisher: Elsevier BV
Date: 06-2007
DOI: 10.1016/J.YPMED.2007.02.015
Abstract: To examine the influence of tan preference and skin type on sun protection behaviors of Australian adolescents. The Australian Secondary School Alcohol and Drug Questionnaires were conducted in 1993, 1996, 1999 and 2002 among randomly selected students aged 12--17. Schools were randomly selected from each education sector in each state. The self-administered questionnaire contained questions about tan preferences, skin type and usual SunSmart behavior (use of sunscreen, hats and covering clothing). The routine use of SunSmart behavior was low in all survey years. There was a significant decrease over time in the proportion of students who practiced SunSmart behavior, with prevalence rates lower in 2002 than in any other survey year (males: p<0.01 and females: p<0.01). As desire for a tan increased, routine practice of SunSmart behaviors decreased. Across the four survey periods, male (p<0.01) and female (p<0.01) students who preferred no tan were significantly more likely to practice SunSmart behavior than students who preferred any sort of tan. Across the four survey years, male (p<0.01) and female (p<0.01) students with skin that 'just burns' were most likely to routinely practice SunSmart behavior. Sun protection practices among adolescents have continued to decline significantly over time. Future educational programs require an innovative approach to modify adolescent behaviors in relation to sun exposure and sun protection.
Publisher: BMJ
Date: 02-2006
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.NEDT.2022.105500
Abstract: To assess the impact of cultural competence training for health professionals on patient outcomes. A systematic review of cultural competence training interventions for healthcare workers including papers published January 2010 to January 2021, identified through MEDLINE, CINAHL, ERIC and APA PsychINFO. Health conditions were not specified, however, only studies reporting patient outcomes were included. Training frameworks and delivery, measures of health professional cultural competence, and patient outcomes were reviewed. Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre ost study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. Cultural competence training is promoted to improve outcomes of patients from culturally erse backgrounds however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre ost study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study. Cultural competence training is promoted to improve outcomes of patients from culturally erse backgrounds however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes. To ascertain the benefits of health professional cultural competence training on patient outcomes, research needs to address the issues of definition, theoretical frameworks and implementation approaches to training.
Publisher: Hindawi Limited
Date: 12-2006
DOI: 10.1111/J.1365-2354.2006.00688.X
Abstract: The objective of this study was to determine the feasibility and acceptability of a referral and outcall programme from a telephone-based information and support service, for men newly diagnosed with colorectal or prostate cancer. A block randomized controlled trial was performed involving 100 newly diagnosed colorectal and prostate cancer patients. Patients were referred to the Cancer Information Support Service (CISS) through clinicians at diagnosis. Clinicians were randomized into one of three conditions. Active referral 1: specialist referral with four CISS outcalls: (1)<or=1 week of diagnosis (2) at 6 weeks (3) 3 months and (4) 6 months post diagnosis. Active referral 2: specialist referral with one CISS outcall<or=1 week of diagnosis. Passive referral: specialist recommended patient contacts CISS, but contact at the patient's initiative. Patients completed research questionnaires at study entry (before CISS contact), then 4 and 7 months post diagnosis. Overall, 96% of participants reported a positive experience with the referral process 87% reported they were not concerned about receiving the calls and 84% indicated the timing of the calls was helpful. In conclusion, the referral and outcall programme was achievable and acceptable for men newly diagnosed with colorectal or prostate cancer.
Publisher: Hindawi Limited
Date: 26-08-2011
DOI: 10.1111/J.1365-2354.2010.01218.X
Abstract: While colorectal cancer is the most common cancer affecting both men and women in Australia, disease-specific peer support services are lacking. This study examined the acceptability and preferred models of peer support among people with colorectal cancer. First, a mixed-method study examined enablers and barriers to peer support participation and model preferences. Participants were recruited from metropolitan and regional areas of Victoria. Fifty-three participants completed a questionnaire and four focus groups and 10 telephone interviews were conducted (n = 34). Participants demonstrated enthusiasm for peer support. Feeling unwell and worry about accessing toilet facilities were main barriers, while accessing information about treatment side effects and making treatment decisions were main positive features. Second, a pilot study determined the response to a face-to-face group and one-on-one telephone programme, the preferred models from study 1. In total, 34 support recipients recruited through clinicians, participated. Half elected to participate in the telephone programme and half in the group programme. Support recipients completed surveys before and after the programmes. Both models were acceptable to participants with high satisfaction rates reported (94-100%) and findings suggested that the two models catered to different peer support needs. Timing of referral and clinician promotion contributed to participation.
Publisher: Wiley
Date: 12-02-1995
DOI: 10.1111/J.1753-6405.1995.TB00449.X
Abstract: To estimate the prevalence of smoking among Australian adults in 1992, 6046 adults aged 16 years and over (3063 men and 2983 women) were interviewed. A large market-research firm interviewed the s le, face-to-face in their homes during weekends. Overall, 28.2 per cent of men and 23.8 per cent of women were current smokers 32.3 per cent of men and 21.9 per cent of women were past smokers. On average, male smokers consumed 22.1 factor-made cigarettes a day and female smokers consumed 19.1 cigarettes a day. The daily tar intake was 179 mg for male smokers and 131 mg for women. The most popular packet size was 25 (40 per cent of smokers) followed by the packet of 50 (17 per cent). Occupational and education status were inversely related to smoking prevalence. Men and women with less education and men in low-status occupations were more likely to use cigarettes from the large packet sizes. Comparison with earlier data suggests that smoking prevalence is still declining, with a significant recent drop in female but not male smoking prevalence. While in 1992, the prevalence of smoking among women was less than that for men, projected estimates suggest that by the year 2001 more women than men will smoke.
Publisher: Springer Science and Business Media LLC
Date: 08-06-2020
Publisher: Oxford University Press (OUP)
Date: 19-09-2015
DOI: 10.1093/NTR/NTU184
Abstract: To examine the long-term impact of graphic health-warning labels (GHWL) on adolescents' cognitive processing of warning labels and cigarette pack perceptions. Cross-sectional school-based surveys of students aged 13-17 years residing in urban centers, conducted prior to GHWL introduction (2005) and 6 months (2006), 2 years (2008), and 5 years (2011) post-GHWL introduction. Students who had seen a cigarette pack in the previous 6 months or in 2006, who had seen GHWL were included in analyses (2005 n = 2,560 2006 n = 1,306 2008 n = 2,303 2011 n = 2,716). Smoking stage, reported exposure to cigarette packs, cognitive processing of GHWL, and positive and negative perceptions of pack image were assessed. While cognitive processing of GHWL in 2006 and 2008 was greater than 2005 (p < .01), by 2011 scores had returned to 2005 levels. This pattern of change was consistent across smoking status groups. Pack image perceptions became more negative over time among all students, irrespective of smoking experience. While positive pack image ratings were lower in all subsequent years than 2005, the 2008 rating was higher than 2006 (p < .01). A significant interaction between survey time and smoking status (p < .01) showed that significant increases in positive pack ratings after 2006 only occurred among current and experimental smokers. When novel, GHWL on cigarette packs increase cognitive processing among adolescents. However, this effect diminishes after 5 years, suggesting more regular message refreshment is needed. Australia's adoption of plain packaging is intended to undermine positive pack appeal and increase warning salience.
Publisher: Elsevier BV
Date: 09-1992
DOI: 10.1016/0091-7435(92)90072-P
Abstract: To determine the independent contribution of behavioral factors to the occurrence of sunburn, sun protection behavior was assessed over 13 successive summer weekends in a total of 1,655 adults in Melbourne, Australia. Telephone survey respondents provided detailed accounts of activities engaged in, time spent outside, and hat, clothing, and sunscreen coverage in the 4 hr around the solar midday on both weekend days, as well as skin type, sociodemographic descriptors, and degree of sunburn experienced. Independent measures of atmospheric temperature and ambient ultraviolet radiation (UVR) were added to in idual records. The (mostly recreational) weekend sunburn in this urban s le was strongly associated with UVR, as expected. Temperature at 3 PM, sensitive skin type, youthfulness, and being male were also independently associated with sunburn. After all other predictors were controlled for, the body exposure index (which took into account time outside and hat, clothing, and sunscreen coverage) made a strong independent contribution to the explanation of sunburn (P < 0.001). It was concluded that behavior change strategies to prevent malignant melanoma of the skin are warranted.
Publisher: Wiley
Date: 09-2016
DOI: 10.1111/IMJ.13191
Abstract: The aim of this study was to describe the time and documentation needed to gain ethics and governance approvals in Australian states with and without a centralised ethical review system. This is a prospective descriptive study undertaken between February 2012 and March 2015. Paediatric and adult hospitals (n = 67) in Australian states were approached to allow the review of their medical records. Participants included 15- to 24-year-olds diagnosed with cancer between 2008 and 2012. The main outcomes measures were time (weeks) to approval for ethics and governance and the number and type of documents submitted. Centralised ethics approval processes were used in five states, with approval taking between 2 and 18 weeks. One state did not use a centralised process, with ethics approval taking a median of 4.5 weeks (range: 0-15) per site. In four states using a centralised ethics process, 33 governance applications were submitted, with 20 requiring a site clinician listed as an investigator. Governance applications required the submission of 11 documents on average, including a Site-Specific Assessment form. Thirty-two governance applications required original signatures from a median of 3.5 (range: 1-10) non-research persons, which took a median of 5 weeks (range: 0-15) to obtain. Governance approval took a median of 6 weeks (range: 1-45). Twelve research study agreements were needed, each taking a median of 7.5 weeks (range: 1-20) to finalise. The benefits of centralised ethics review systems have not been realised due to duplicative, inflexible governance processes. A system that allowed the recognition of prior ethical approval and low-risk applications was more efficient than a central ethics and site-specific governance process.
Publisher: Elsevier BV
Date: 12-2013
Abstract: To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Cross-sectional survey data of 2,044 secondary school students aged 12-17 years was combined with tobacco outlet audit data. Associations between students' self-reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio-demographic and school-related variables included as covariates. Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13 95% CI 1.02-1.26), but not the odds of smoking in the past month in the larger s le (OR=1.06 95% CI 0.90-1.24), after controlling for local mean price of cigarettes and socio-demographic and school-related variables. This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.JSAMS.2010.05.004
Abstract: There is evidence to suggest that the prevalence of anabolic-androgenic steroids (AAS) is higher among young people than the general population. The purpose of the current study was to examine the proportion of students who reported lifetime and past-year AAS use, explore other drug use among those who reported AAS use, and investigate demographic correlates of AAS use. Data was taken from a cross-sectional survey of a representative s le of Australian secondary students. A stratified two-stage probability s ling methodology was employed and schools were randomly s led from each Australian State and Territory. A total of 376 schools participated in the survey. Lifetime AAS use was reported by 2.4% of 12-17-year-old students use was more common among 12-15-year olds then 16-17-year olds. Regardless of age, being male, speaking a language other than English at home, not be at school on the previous school day, and rating own scholastic ability as below average were all associated with a greater likelihood of using AAS in their lifetime and in the past year. Those who reported AAS use also reported the use of a range of other substances, suggesting that AAS use may be part of a broader experimentation with substances. Interventions towards these groups regarding AAS may best be placed within a larger substance use intervention rather than being AAS-specific. In light of the low levels of AAS use among this group, more detailed research into AAS use among adolescent sporting groups may be warranted.
Publisher: Hindawi Limited
Date: 20-12-2011
DOI: 10.1111/J.1365-2354.2009.01151.X
Abstract: This study explored the perceived needs of health professional and peer facilitators of cancer support groups. Participants were facilitators of support groups affiliated with The Cancer Council Victoria (Australia). Facilitators completed questionnaires assessing their experience of support group facilitation, including training and support needs. Data from health professional and peer facilitators (n= 74) were analysed in this paper. The majority of facilitators (88%) were female 57% had run their group for more than 3 years, and 47% reported between 11 and 20 people attended each group. Although results showed the characteristics of support groups are broadly similar for peers and professionals, there were some distinct differences in perceived needs. Health professional facilitators were more likely than peers to regard training as valuable and beneficial to their role. In addition, health professionals more frequently reported needing debriefing as well as more difficulty accessing debriefing than cancer peers. This study builds on the small body of literature exploring the experiences of cancer support group facilitators. Given the experiences and needs of health professional and peer facilitators may differ, it may be relevant to tailor training and support so that it meets the needs of both health professionals and cancer peers.
Publisher: Oxford University Press (OUP)
Date: 10-2005
DOI: 10.1080/14622200500259796
Abstract: Recent evidence indicates that higher smoking rates among young adults in the United States may be related in part to increased initiation during young adulthood. The tobacco industry, restricted from overtly targeting adolescents, appears to be focusing on young adults. Thus it is important to estimate the percentage and identify the characteristics of the young adult population (aged 18-29 years) at risk for future smoking. This group would include all current established smokers (smoked at least 100 cigarettes in their lifetime), current experimenters, former established smokers, and former experimenters at risk for smoking again, as well as never-smokers who do not rule out future smoking. Using data from the population-based 2002 California Tobacco Survey (N = 9,364 young adults aged 18-29 years), we designated groups of young adults at risk and identified factors associated with risk. Altogether, 86.7+/-1.5% of current and former established smokers were at risk for future smoking, and 59.6+/-4.3% of former established smokers were at risk. Over half (52.2+/-2.0%) of all experimenters but only 9.0+/-1.2% of never-smokers were at risk. Overall, 43.0+/-1.2% of the young adult population was at risk. Although different demographic and other factors were associated with risk among former established smokers, experimenters, and never-smokers, three factors were consistently associated in each group: Younger age, not having a smoke-free home, and going to bars and clubs. We conclude that the group of young adults at risk for future smoking is sizable and presents a fertile target for tobacco industry efforts to promote smoking. Counter-efforts might include promotion of smoke-free environments.
Publisher: Springer Science and Business Media LLC
Date: 17-03-2022
DOI: 10.1186/S12885-022-09389-4
Abstract: Prostate cancer is the most common internal malignancy in Australian men, and although most patients have good survival outcomes, treatment toxicities can impair function, leading to diminished quality of life for prostate cancer survivors. Socioeconomic disadvantage and geographical remoteness have been shown to be related to worse oncologic outcomes, and it is expected that they would similarly influence functional outcomes in prostate cancer. Using data from the Victorian Prostate Cancer Outcomes Registry ( n = 10,924), we investigated functional outcomes as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC-26) following prostate cancer treatment, focusing on associations with socioeconomic status and geographical remoteness and controlling for clinicopathologic characteristics. A single composite score was developed from the five separate EPIC-26 domains for use in geo-mapping. A total of 7690 patients had complete EPIC-26 data, allowing mapping hotspots of poor function using our composite score. These hotspots were observed to relate to areas of socioeconomic disadvantage. Significant heterogeneity in outcomes was seen in urban areas, with hotspots of good and poor function. Both socioeconomic disadvantage and geographical remoteness were found to predict for worse functional outcomes, although only the former is significant on multivariate analysis. Geo-mapping of functional outcomes in prostate cancer has the potential to guide health care service provision and planning. A nuanced policy approach is required so as not to miss disadvantaged patients who live in urban areas. We have demonstrated the potential of geo-mapping to visualise population-level outcomes, potentially allowing targeted interventions to address inequities in quality of care.
Publisher: Wiley
Date: 09-06-2017
DOI: 10.1111/BJU.13889
Abstract: To determine whether the use of nephron-sparing surgery (NSS) for treatment of stage 1 renal cell carcinoma (RCC) changed between 2009 and the end of 2013 in Australia. All adult cases of RCC diagnosed in 2009, 2012 and 2013 were identified through the population-based Victorian Cancer Registry. For each identified patient, trained data-abstractors attended treating hospitals or clinician rooms to extract tumour and treatment data through medical record review. Multivariable logistic regression analyses were carried out to examine the significance of change in use of NSS over time, after adjusting for potential confounders. A total of 1 836 patients with RCC were identified. Of these, the proportion of cases with stage 1 tumours was 64% in 2009, 66% in 2012 and 69% in 2013. For T1a tumours, the proportion of patients residing in metropolitan areas receiving NSS increased from 43% in 2009 to 58% in 2012 (P < 0.05), and 69% in 2013 (P < 0.05). For patients residing in non-metropolitan areas, the proportion receiving NSS increased from 27% in 2009 to 49% in 2012, and 61% in 2013 (P < 0.01). Univariable logistic regression showed patients with moderate (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.94) or severe comorbidities (OR 0.58, 95% CI 0.33-0.99), residing in non-metropolitan areas (OR 0.65, 95% CI 0.47-0.90), were less likely to be treated by NSS, while those attending high-volume hospitals (≥30 cases/year: OR 1.79, 95% CI 1.21-2.65) and those with higher socio-economic status (OR 1.45, 95% CI 1.02-2.07) were more likely to be treated by NSS. In multivariable analyses, patients with T1a tumours in 2012 (OR 2.00, 95% CI 1.34-2.97) and 2013 (OR 3.15, 95% CI 2.13-4.68) were more likely to be treated by NSS than those in 2009. For T1b tumours, use of NSS increased from 8% in 2009 to 20% in 2013 (P < 0.05). This population-based study of the management of T1 renal tumours in Australia found that the use of NSS increased over the period 2009 to 2013. Between 2009 and 2013 clinical practice for the treatment of small renal tumours in Australia has increasingly conformed to international guidelines.
Publisher: Wiley
Date: 06-2003
Publisher: Wiley
Date: 21-01-2013
DOI: 10.1002/PON.3242
Abstract: Palliative care is expected to incorporate comprehensive support for family caregivers given that many caregivers suffer psychological morbidity. However, systematically implemented evidence-based psychological support initiatives are lacking. The objective of this study was to prepare caregivers for the role of supporting a patient with advanced cancer receiving home-based palliative care by offering a one-to-one psycho-educational intervention. We hypothesised that primary family caregivers who participated in the intervention would report decreased psychological distress (primary outcome), fewer unmet needs and increased levels of perceived preparedness, competence and positive emotions. A three-arm randomised controlled trial was conducted comparing two versions of the intervention (one face-to-face visit versus two visits) plus standard care to a control group (standard care) across four sites in Australia. A total of 298 participants were recruited 148 were in the Control condition, 57 in Intervention 1 (one visit) and 93 in Intervention 2 (two visits). Relative to participants in the control group the psychological well-being of participants in the intervention condition was improved by a small amount but non-significantly. No significant reduction in unmet needs or improvements in positive aspects of caregiving amongst the intervention group were identified. However, the intervention demonstrated significant improvements in participants' levels of preparedness and competence for Intervention 2. This research adds to accumulating body of evidence demonstrating that relatively short psycho-educational interventions can enable family caregivers to feel more prepared and competent in the role of supporting a dying relative. Further investigation is required to determine the longer term outcomes of such interventions.
Publisher: BMJ
Date: 06-2005
Publisher: Wiley
Date: 11-2018
DOI: 10.1111/BJU.14585
Abstract: To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states. All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages of patients treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined factors associated with PN. Clinicians treating RCC were sent surveys to assess attitudes towards PN. Data were collected on 956 patients (Victoria: n = 548 Queensland: n = 404) with stage T1a RCC. Of those undergoing surgery (n = 865), PN was more common for those aged <65 years (61%) than for those aged ≥65 years (44%), with this difference significant after adjusting for patient, tumour (odds ratio 0.50, 95% confidence interval 0.36-0.70). There were significant interactions between age and treatment centre volume (P < 0.05) and residential state (P < 0.05). PN was less likely for younger patients treated at lower-volume hospitals (<24 patients a year) but hospital volume was not associated with PN for older patients. PN was less likely for older patients in Queensland than Victoria. In multivariable analyses, age was not related to laparoscopic surgery. Queensland clinicians were less likely than those from Victoria to agree that PN was the treatment of choice for most T1aN0M0 tumours (P 65 years with small renal cancers were less likely to be treated by PN than younger patients. The variation in the surgical procedure used to treat older T1a RCC patients by state and hospital volume indicates that better evidence is needed to direct practice in this area.
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.ADDBEH.2006.02.025
Abstract: Research suggests that the presence of a total ban on smoking in the home is associated with a reduced likelihood of tobacco experimentation among adolescents. While the influence of parental smoking on this association is examined in this work, no study has examined the influence of friends' smoking behavior. In this study, we use data from a statewide survey of students (n=4125) from the Australian State of Victoria to examine the association between home smoking bans and stage of smoking uptake after controlling for parental smoking and smoking among friends. Logistic regression revealed that students residing in homes with a total ban on smoking were least likely to be susceptible to smoking or to have experimented with smoking. While there was an interaction between parental smoking status and home bans on smoking uptake stage, indicating that the effect of home bans was strongest when neither parent smoked, there was no interaction between home bans and friends' smoking. The results suggest that home smoking bans reduce the likelihood of an adolescent trying tobacco regardless of their friends' smoking behavior. By adopting strong home smoking bans, parents can reduce some of the influence friends' smoking can have on the smoking behavior of their adolescent.
Publisher: Wiley
Date: 19-07-2004
DOI: 10.1002/CNCR.20401
Abstract: Clinical practice guidelines for the management of breast carcinoma were introduced in Australia in October, 1995. This article describes the management of early-stage breast carcinoma both before and after the introduction of these guidelines. All cases of early breast carcinoma that were diagnosed over the same 6-month period in 1995 and 1999 and registered with a state-based cancer registry were identified. Treating surgeons completed a survey assessing tumor characteristics and primary treatment. In 1995, 95% of 188 surgeons who were approached participated and 96% of the surveys were returned. In 1999, 92% of 159 surgeons who were approached participated and 91% of the surveys were returned. Analyses are based on 1066 cases from 1995 and 1001 cases from 1999. The pathologic disease stage of the patients was similar in both study years. The proportion of patients who underwent breast-conserving therapy (BCT) increased from 54% in 1995 to 69% in 1999. This increase was noted across most levels of disease characteristics but was not evident among those patients treated by the least active surgeons. The proportion of patients treated with BCT who received radiotherapy increased from 59% in 1995 to 80% in 1999. This trend was observed across most levels of tumor characteristics and surgeon caseload. The proportion of women with receptor-positive tumors who were treated with endocrine therapy increased, whereas the proportion of patients with receptor-negative tumors who received this therapy decreased from 39% in 1995 to 17% in 1999. The management of early breast carcinoma in the state of Victoria appeared to change between 1995 and 1999 in the direction expected if the national guidelines had been incorporated into the practice patterns of surgeons treating breast carcinoma patients.
Publisher: Oxford University Press (OUP)
Date: 1991
DOI: 10.1093/HER/6.3.297
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.AMEPRE.2005.11.001
Abstract: Promotional offers on cigarettes (e.g., dollar-off, multipack discounts) composed the largest share of tobacco industry marketing expenditures, totaling $8.9 billion, or 72% of the total budget in 2002. Internal industry documents indicate that young adults, potential quitters, and other price-sensitive groups are the targets of these marketing tactics. How effective they are in actually reaching these groups in the general population of smokers has not yet been investigated. Data were from 4618 current smokers responding to the large, random-digit-dialed population-based 2002 California Tobacco Survey. The characteristics were identified of smokers who reported that they used these offers "every time I see one." Thirty-five percent of smokers used promotional offers every time they saw one. Multivariate analyses identified young adults, women, African Americans, those with higher daily cigarette consumption, and those worried about cigarette costs as more likely to use promotional offers at every opportunity. Smokers most committed to quitting were no more likely to use promotional offers than those with no intention to quit. Cigarette brand was highly correlated with age and race/ethnicity, and therefore was not included in the multivariate analysis. Those who smoked menthol cigarettes and Camels, more often young adults and African Americans, were much more likely than those of other brands to use promotional offers. With the exception of smokers intending to quit, cigarette promotional offers are effectively reaching most industry-targeted groups. Importantly, young adults, who have the greatest long-term customer potential, are responding.
Publisher: BMJ
Date: 16-02-2012
DOI: 10.1136/TOBACCOCONTROL-2011-050359
Abstract: Smoking initiation is a key behaviour that determines the future health consequences of smoking in a society. There is a marked difference in smoking patterns around the world, driven by initiation rates. While a number of high-income countries have seen smoking prevalence decline markedly from peak, many low-income and middle-income countries appear to still be on an upward trend. Unlike cessation where changes are limited by nicotine dependence, rates of smoking initiation can change rapidly over a short time span. Interventions that can be effective in achieving this include increases in the price of tobacco products, mass media anti-smoking advertising, smoke-free policies, smoking curricula in schools, restrictions on marketing opportunities for the tobacco industry as well as social norms that lead to restrictions on adolescents' ability to purchase cigarettes. Comprehensive tobacco control programmes that aim to denormalise smoking behaviour in the community contain all of these interventions. Rapid reductions in smoking initiation in adolescents have been documented in two case studies of comprehensive tobacco control programmes in California and Australia. Consistent and inescapable messages from multiple sources appear to be key to success. However, the California experience indicates that the rapid decline in adolescent smoking will not continue if tobacco control expenditures and the relative price of cigarettes are reduced. These case studies provide strong additional evidence of the importance of countries implementing the provisions of the Framework Treaty on Tobacco Control.
Publisher: Oxford University Press (OUP)
Date: 2021
Abstract: Shared breast cancer follow-up care involving a breast cancer specialist and a general practitioner (GP) has been demonstrated to be effective, yet barriers to participation in this model by women remain. This study explores the responses of women who recently finished active treatment for early breast cancer (EBC) to a proposed model of shared follow-up care to understand the type of information needed to support participation. Qualitative study based on focus groups with women with EBC in the early stage of follow-up care from across metropolitan, regional and rural settings in Australia. Discussions were transcribed and thematic analysis is undertaken. Four focus groups were conducted, involving 31 women aged between 32 and 78 years. The discussion focused on two topics. In the first topic 'Current experiences of follow-up care', two themes emerged: (i) follow-up as a continuation of active treatment (ii) GPs involvement in care during active treatment influence attitudes to shared follow-up care. In the second topic area 'Perceptions of shared follow-up care' four themes emerged: (i) a need for evidence regarding model effectiveness (ii) choice (iii) concerns regarding capacity and capability of GPs to deliver care and (iv) the need for clear communication between GPs, specialists and women. Women need information regarding the evidence for the effectiveness of shared follow-up care to assure them it does not pose a risk to their health outcomes. Clear descriptions of GP and specialist roles and the opportunity to jointly decide participation is essential for the model to be adopted.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.CLML.2013.09.011
Abstract: Guidelines for the management of symptomatic multiple myeloma (MM) recommend upfront autologous stem cell transplantation (ASCT) for transplant-eligible patients. Using population-based data, we examined the characteristics of transplant-eligible patients who do not undergo upfront ASCT. Altogether, 686 newly diagnosed MM cases were identified through the population-based central cancer registry in Victoria, Australia from 2008 to 2009. We performed a detailed review of clinical notes and follow-up for at least 12 months after diagnosis for a subset of 225 patients who were aged < 70 years at diagnosis and had symptomatic MM. Of these 225 patients, 123 (55%) proceeded to receive upfront ASCT. Patient and disease factors associated with not receiving upfront ASCT were the presence of severe medical comorbidities, MM-associated renal impairment, and initial referral to a medical oncologist rather than a hematologist. Place of residence (rural vs. metropolitan) was not significant. Of 121 patients aged < 65 years at diagnosis who had minor or no comorbidities, only 75 (62%) proceeded to upfront ASCT. A substantial percentage of apparently transplant-eligible patients with newly diagnosed MM do not proceed to upfront ASCT. Community practice appears to erge from clinical guidelines. The reasons for this ergence require further study but reasons may include perceptions of toxicity vs. benefits of upfront ASCT.
Publisher: Wiley
Date: 03-04-2023
DOI: 10.1002/CNCR.34767
Abstract: Engaging with online social media consumer groups for rare cancers may help to develop collaborations between consumers and researchers. This study, a collaboration with the Granulosa Cell Tumor‐Survivor Sisters (GCT‐SS) Facebook group, explores the results of their survey of member's treatment and follow‐up experiences. Members of the closed multinational GCT‐SS Facebook group completed a 43‐item survey covering symptoms, diagnosis, treatment, recurrence, follow‐up, and possible risk factors for GCT. Group members could have adult ( a GCT) or juvenile ( j GCT) disease. Data was collected via an online survey between 2014 and 2019. A total of 743 members (average 4.4 years [SD = 5.9] post‐diagnosis) participated including 52 with j GCT. A total of 67% had stage I disease and 8% had stage III–IV at diagnosis, although 30% of a GCT and 25% of j GCT reported recurrent disease at survey completion. A total of 48% of a GCT had laparoscopic surgery, tumor encapsulation was reported by 49%, and tumor bagging reported by 29% overall (37% laparoscopic 8% open). Recurrence rates were higher when the tumor was cut or ruptured (ruptured: p .001 cut: p = .01). A total of 19% of a GCT had chemotherapy with this most common for stage II‐III disease. Bleomycin, etoposide, and cisplatin protocols became less common over time (diagnosed before 2015: 47% vs. diagnosed post‐2015: 21%). This is one of the largest surveys of GCT treatment. Members of the GCT‐SS group report treatment patterns generally in line with those found from clinical audits. Using naturally forming consumer groups may assist with developing the evidence base for care and supporting those living with GCT ovarian cancer. This study is a collaboration between members of Granulosa Cell Tumor‐Survivor Sisters (GCT‐SS) Facebook group and researchers to assess members' experiences of treatment and follow‐up. A total of 743 members (52 with juvenile GCT) completed an online survey. A total of 67% had stage I disease at diagnosis. Treatment patterns were generally in line with those found from clinical audits: 95% had surgery and 19% of those with adult GCT had chemotherapy. A total of 30% reported recurrent disease, with recurrence occurring within 5 years of diagnosis for 33%. Using naturally forming consumer groups may assist with developing the evidence base for care and supporting those living with GCT ovarian cancer.
Publisher: Elsevier BV
Date: 12-2003
DOI: 10.1016/J.YPMED.2003.09.004
Abstract: This study compared the sun exposure and sun protection behaviours of adolescent students between 1993 and 1999. Schools from all Australian states and the two territories participated in each of the 1993, 1996, and 1999 surveys and a s le of students from years 7 to 12 were surveyed. In each of the states and territories a random s le of schools was selected within each education sector (government, Catholic, independent). The questionnaire was a self-completed booklet with questions about sunburn history during the previous summer, tan preferences, skin-type, and usual reported behaviour. Data from a total of 78,032 students were available for analysis. From 1993 to 1999 there was a significant increase in the number of students reporting sunburn during the previous summer (chi(2) = 225.77, df = 2, P < 0.01). However, the percentage of students who preferred no tan at all increased over the same period (chi(2) = 184.47, df = 2, P < 0.01). The percentage of students who usually or always wore clothing that covered most of their body decreased between 1993 and 1999 (chi(2) = 20.46, df = 2, P < 0.01) the percentage of students usually or always wearing maximum protection sunscreen decreased over time (chi(2) = 27.71, df = 2, P < 0.01). Staying in the shade increased from 1993 (26%) to 1996 (32%) but decreased slightly in 1999 (30%). Across all survey years, only 11% of students routinely followed all three protective behaviours of wearing a hat, sunscreen, and clothes that cover the body. Sun protection practices among adolescents are still below optimal levels. Future educational programs require innovative approaches that aims to change attitudes toward tanning as being healthy and attractive and modify adolescent behaviours in relation to sun exposure.
Publisher: Wiley
Date: 15-10-2013
DOI: 10.1111/BJU.12204
Abstract: To describe the contemporary patterns of care for renal cell carcinoma (RCC) using a whole of population series from Victoria. Retrospective review of medical records of all patients diagnosed and treated for RCC in Victoria in 2009. Patients were identified via the State-wide Victorian Cancer Registry. Patient demographic characteristics, symptoms, stage, and first-line treatment were assessed. Associations between case residential location (metropolitan or rural) and treatment were examined using multivariate logistic regression after adjusting for age, sex, socioeconomic status, treatment in private or public hospital and comorbidity. Data were obtained for 499 of 577 eligible patients. In all, 413 patients (83%) underwent surgery. Laparoscopic radical nephrectomy (RN) was the most common procedure for Stage I pT1a T1b tumours (51.2%) partial nephrectomy (PN) was performed for 27% of Stage I RCC In multivariate analysis, regional patients were less likely to receive PN (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.18-0.85) for Stage I RCC, and less likely to receive systemic therapy for Stage IV RCC (OR 0.06, 95% CI 0.01-0.41). Multidisciplinary team meetings were recorded for only 25% of patients and 3% were enrolled in a clinical trial. Most contemporary patients diagnosed with RCC are still treated with RN, including those with smaller tumours amenable to PN. This may impact future outcomes, including increased risk of chronic kidney disease and its potential financial healthcare burden. Patterns of treatment also appear to differ between metropolitan and regional populations.
Publisher: SAGE Publications
Date: 02-2005
Abstract: The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38womenwho received their hospital’s usual fundingwere recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was “very good” or “excellent.” Satisfaction was significantly associatedwith how well the prosthesis fit (1 week,p =.001 3 months,p =.01), level of comfort (3 months,p =.005), and appearance of the prosthesis when worn (6 months,p = .001). Quality was significantly associated with how well it fit (1 week,p = .001 3months,p = .001), how natural it felt (1 week,p = .001 6months,p =.01), the weight of the prosthesis (3 months,p =.003), and appearance when worn (6 months,p = .03). The results will be used to improve women’s access to a quality prosthesis.
No related grants have been discovered for Victoria White.