ORCID Profile
0000-0002-0365-7775
Current Organisation
University of Nottingham
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Publisher: Swansea University
Date: 07-06-2023
Abstract: The use of administrative health data for research, monitoring, and quality improvement has proliferated in recent decades, leading to improvements in health across many disease areas and across the life course. However, not all populations are equally visible in administrative health data, and those that are less visible may be excluded from the benefits of associated research. Socially excluded populations -- including the homeless, people with substance dependence, people involved in sex work, migrants or asylum seekers, and people with a history of incarceration -- are typically characterised by health inequity. Yet people who experience social exclusion are often invisible within routinely collected administrative health data because information on their markers of social exclusion are not routinely recorded by healthcare providers. These circumstances make it difficult to understand the often complex health needs of socially excluded populations, evaluate and improve the quality of health services that they interact with, provide more accessible and appropriate health services, and develop effective and integrated responses to reduce health inequity. In this commentary we discuss how linking data from multiple sectors with administrative health data, often called cross-sectoral data linkage, is a key method for systematically identifying socially excluded populations in administrative health data and addressing other issues related to data quality and representativeness. We discuss how cross-sectoral data linkage can improve the representation of socially excluded populations in research, monitoring, and quality improvement initiatives, which can in turn inform coordinated responses across multiple sectors of service delivery. Finally, we articulate key challenges and potential solutions for advancing the use of cross-sectoral data linkage to improve the health of socially excluded populations, using international ex les.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Hindawi Limited
Date: 04-09-2019
DOI: 10.1111/HSC.12851
Abstract: Trafficked people require timely and ongoing access to healthcare services. Yet, many encounter difficulties accessing and utilising healthcare services, both while in situations of exploitation and after their escape. This research investigated barriers that hinder healthcare providers from identifying, providing care and making necessary referrals for trafficked people in the United Kingdom (UK). Semi-structured, face-to-face interviews were conducted with healthcare (n = 23) and non-health (n = 27) professionals with relevant policy or practical experience related to human trafficking in the UK. Topic guides covered identifying, referring and providing care to trafficked people. Transcripts were analysed using thematic analysis. Four interconnected themes emerged: trafficked persons' entitlements to healthcare, availability of healthcare resources, providers' knowledge about trafficking, and the particular needs of trafficked in iduals. Providers explained that policies limiting entitlements to healthcare created significant obstacles to care, as did the inadequate resourcing of interpreter services, trafficking support services, and specialist mental health services. Few healthcare professionals reported having received training on responses to trafficked people and most were unaware of support options and referral routes. Healthcare professionals will be better equipped to serve trafficked in iduals if they are provided training to identify and respond to human trafficking, guidance on referral and support options and entitlements to care. Simultaneously, improving trafficked people's healthcare access and use will also require government interventions to ensure they are not unjustifiably denied healthcare.
Publisher: BMJ
Date: 06-02-2019
DOI: 10.1136/BMJ.L94
Abstract: To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Systematic analysis. Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). The total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%). Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
Publisher: SAGE Publications
Date: 29-09-2017
Abstract: Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison. Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations. During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In all, 83 (6.4%) participants presented due to self-harm, accounting for 165 (4.4%) presentations. The crude incidence rates of self-harm for males and females were 49.2 (95% confidence interval: [41.2, 58.7]) and 60.5 (95% confidence interval: [44.9, 81.6]) per 1000 person-years, respectively. Presenting due to self-harm was associated with being Indigenous (incidence rate ratio: 2.01 95% confidence interval: [1.11, 3.62]), having a lifetime history of a mental disorder (incidence rate ratio: 2.13 95% confidence interval: [1.19, 3.82]), having previously been hospitalised for psychiatric treatment (incidence rate ratio: 2.68 95% confidence interval: [1.40, 5.14]) and having previously presented due to self-harm (incidence rate ratio: 3.91 95% confidence interval: [1.85, 8.30]). Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release. Demographic and mental health variables help to identify at-risk groups, and such presentations could provide opportunities for suicide prevention in this population. Transition from prison to the community is challenging, particularly for those with a history of mental disorder mental health support during and after release may reduce the risk of adverse outcomes, including self-harm.
Publisher: American Psychiatric Association Publishing
Date: 02-2017
DOI: 10.1176/APPI.PS.201500509
Abstract: This study estimated the prevalence and correlates of self-harm among adult victims of human trafficking who accessed secondary mental health services, and it estimated the responses of mental health services to these in iduals. A clinical records database was searched for self-harm, sociodemographic, clinical, and service use characteristics among trafficked adults who accessed secondary mental health services in South London (2006-2012). Logistic regression models compared trafficked patients (N=84) and a matched cohort of nontrafficked patients (N=287). Among trafficked patients, 33% had engaged in self-harm prior to care and 25% in self-harm during care. After engaging in self-harm, trafficked patients were more likely than nontrafficked patients to be admitted as a psychiatric inpatient (adjusted odds ratio [AOR]=2.81) but less likely to visit an emergency department (AOR=.47). Self-harm is prevalent among trafficked adults accessing secondary mental health services, and mental health professionals have a crucial role to play in supporting survivors.
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.DRUGALCDEP.2015.08.034
Abstract: The relative contributions of cannabis and alcohol use to educational outcomes are unclear. We examined the extent to which adolescent cannabis or alcohol use predicts educational attainment in emerging adulthood. Participant-level data were integrated from three longitudinal studies from Australia and New Zealand (Australian Temperament Project, Christchurch Health and Development Study, and Victorian Adolescent Health Cohort Study). The number of participants varied by analysis (N=2179-3678) and were assessed on multiple occasions between ages 13 and 25. We described the association between frequency of cannabis or alcohol use prior to age 17 and high school non-completion, university non-enrolment, and degree non-attainment by age 25. Two other measures of alcohol use in adolescence were also examined. After covariate adjustment using a propensity score approach, adolescent cannabis use (weekly+) was associated with 1½ to two-fold increases in the odds of high school non-completion (OR=1.60, 95% CI=1.09-2.35), university non-enrolment (OR=1.51, 95% CI=1.06-2.13), and degree non-attainment (OR=1.96, 95% CI=1.36-2.81). In contrast, adjusted associations for all measures of adolescent alcohol use were inconsistent and weaker. Attributable risk estimates indicated adolescent cannabis use accounted for a greater proportion of the overall rate of non-progression with formal education than adolescent alcohol use. Findings are important to the debate about the relative harms of cannabis and alcohol use. Adolescent cannabis use is a better marker of lower educational attainment than adolescent alcohol use and identifies an important target population for preventive intervention.
Publisher: Wiley
Date: 13-04-2015
DOI: 10.1111/DAR.12259
Abstract: To assess the prevalence of use and subjective effect profile of methoxetamine among a group of polydrug users. Cross-sectional, anonymous, online survey of UK-based polydrug users was conducted. Prevalence of lifetime, last year and last month use, sourcing of the drugs, motivations for use, and subjective effect and risk profile compared with that of ketamine were measured. There were 7700 UK-based polydrug users, of whom 326 reported recent use of methoxetamine. Of the whole s le, 4.2% reported last 12 month use of methoxetamine compared with 24.5% for ketamine. The most common route of use was intranasal and the predominate effect described as psychedelic. Of the 15.5% of last year users of ketamine reporting last year use of methoxetamine, only 18.7% reported that they thought methoxetamine was less damaging to their kidneys or bladder than ketamine. Its broad effect profile, based on participants' first experience of use, was very similar to that of ketamine. Almost one-third of users reported that they did not intend to try the drug again. Methoxetamine appears to have a broadly similar effect profile to that of ketamine. Only a minority of participants were motivated to use it because they believed it was less damaging to their kidneys or bladder than ketamine. The impact of the recent temporary banning order on availability and use of both methoxetamine and ketamine should be monitored carefully.
Publisher: BMJ
Date: 06-09-2012
Publisher: BMJ
Date: 10-2023
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.DRUGALCDEP.2019.107742
Abstract: Self-reported non-fatal overdose (NFOD) is a predictor of future overdose and is often used to target overdose prevention for people released from prison. However, the level of agreement between self-reported and medically-verified NFOD history remains unknown. This study aimed to determine the agreement between, and predictive value of, self-reported and medically-verified history of NFOD in people recently released from prison. Pre-release baseline survey data from 1307 adults in prison surveyed from 2008 to 2010 in Queensland, Australia were linked to ambulance, emergency department, and hospital records. We compared the agreement of self-reported NFOD history in the baseline survey and medically-verified NFOD ascertained through linked medical data. Unadjusted and adjusted regression models were used to determine the association between self-reported and medically verified NFOD history and medically-verified NFOD after release from prison. 224 (19 %) participants self-reported NFOD history only, 75 (5 %) had medically-verified NFOD history only, and 56 (4 %) both self-reported and had medically-verified NFOD history. Compared to those with no NFOD history, those who self-reported and had a medical history of NFOD (adjusted hazard ratio (AHR) 6.1, 95 %CI 3.1-11.9), those with a medical history only (AHR 3.4, 95 %CI 1.7-7.0), and those who self-reported only (AHR 1.8, 95 %CI 1.0-3.5) were at increased risk of medically-verified NFOD after release from prison. Relying on self-report of NFOD is likely to miss people at increased risk of future NFOD, many of whom could be identified through medical records. Wherever possible, data related to NFOD should be triangulated from multiple sources.
Publisher: Hindawi Limited
Date: 15-04-2014
DOI: 10.1111/IJCP.12429
Abstract: Prescription drug misuse has become a public health problem in several developed countries. In the UK, there has been no increase in people seeking treatment for prescription drug dependence, but there has been a progressive rise in fatal overdoses involving tramadol. To explore the source, motivations for use and patterns of use of tramadol in the UK. We conducted anonymous online survey of drug use and related behaviours as part of an ongoing drug trend monitoring initiative. We included questions assessing the patterns of use, source and function of tramadol. UK Survey respondents (n = 7360) were predominantly young (mean age 29), and 90% reported being employed or studying. Less than 1% reported past-year use of heroin or methadone, but about 1/3 reported past-year use of cocaine. 326 (5% of respondents) reported having used tramadol in the preceding year, usually obtained by prescription but in 1/3 of cases from a friend rarely from a dealer or from the internet. Most used the drug for pain relief, but 163 respondents (44%) reported using tramadol for reasons other than pain relief - particularly, using it to relax, to sleep, to get high or to relieve boredom. Nineteen per cent took doses higher than prescribed, and 10% reported difficulty discontinuing. Twenty-eight per cent combined tramadol with alcohol or other drugs to enhance its effect. Misuse and sharing of tramadol, supplied by prescription, was common.
Publisher: BMJ
Date: 30-03-2020
DOI: 10.1136/INJURYPREV-2018-043092
Abstract: In population studies, the risk of injury declines after early adulthood. It is unclear if a similar age difference in the risk of injury exists among people released from prison. Prerelease survey data collected between 1 August 2008 and 31 July 2010, from a representative cohort of sentenced adults (≥18 years) in Queensland, Australia, were linked prospectively and retrospectively to person-level emergency department, inpatient hospital and correctional records. To ascertain predictors of injury-related hospital contact, we fit a multivariate Andersen-Gill model and tested the interactions between age group ( years, ≥25 years) and each variable. In 1307 adults released from prison, there were 3804 person-years of follow-up. The crude injury rate was 385 (95% CI 364 to 407) per 1000 person-years and did not differ according to age group. Factors associated with increased injury-related hospital contact included a history of mental illness, preincarceration injury, a history of incarceration, release from a short prison sentence ( days), being reincarcerated during follow-up and identifying as Indigenous. The effect of mental illness, risky alcohol use, prior incarceration and intellectual disability differed across age group and predicted increased risk of injury among people aged ≥25 years compared with their counterparts without these characteristics. Unlike in the general population where the risk of injury declines with age, older adults released from prison are at similar risk compared with their younger peers. Adults released from prison with mental illness, a history of injury-related hospital contact and who identify as Indigenous are particularly indicated groups for injury prevention.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2018
Publisher: SAGE Publications
Date: 2010
Abstract: This study aimed to retrospectively examine demographic and referral data for all detainees under Section 136 of the Mental Health Act (1983) at a ‘place of safety’ in one London Mental Health Trust over a three-year period. Data were collected for 887 consecutive detentions and indicated a clear over-representation of black detainees compared with their representation in the local population. A high proportion of detentions (41.2%) did not result in hospital admission. Implications for practice and service user experience should be considered as long as Section 136 remains an entry point to mental health services for many black people. There are implications for interprofessional practice where Mental Health Trust resources are expended supporting Section 136 detentions in which no hospital treatment follows.
Publisher: Elsevier BV
Date: 02-2020
Publisher: SAGE Publications
Date: 2010
Abstract: Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove in iduals who appear to be suffering from a mental illness from any public place to a designated ‘place of safety’ for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. A review of the literature revealed a high prevalence of schizophrenia, personality disorders and mania in in iduals detained under Section 136 and an over-representation of black detainees. Several studies also reported poor communication between different agencies and poor levels of knowledge regarding the implementation of the section. There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed.
Publisher: Springer Science and Business Media LLC
Date: 23-02-2010
Publisher: Elsevier BV
Date: 2020
Publisher: Informa UK Limited
Date: 07-10-2014
Publisher: Wiley
Date: 22-11-2013
DOI: 10.1111/J.1365-2850.2012.01964.X
Abstract: This paper describes key components of a mental health practice development training programme, which aimed to translate into practice a deeper, more evidence-based understanding of the lived experience of service users detained under the Mental Health Act (1983/2007), using action research as the underpinning paradigm. The programme explored the myriad applications of the six categories of intervention initially proposed by Heron and the widespread applicability of solution-focused brief therapy. The programme evaluation used open-ended questionnaires in order to obtain participants' views on facilitation and workshop content, in addition to two focus groups. The aim of the evaluation was to provide insight into participants' experience of the programme. Feedback from participants reflected a high degree of skill acquisition and enhancement and a noticeable change in ward culture after completing the programme. Service user researchers were intimately involved during all stages of the design, implementation and analysis including service user interviews for Phase 1 and the education intervention element of the practice development programme. Implications for evidence-based mental health nursing practice, service user involvement in research and directions for future research are discussed.
Publisher: Cambridge University Press (CUP)
Date: 04-2012
DOI: 10.1016/J.EURPSY.2011.04.005
Abstract: To identify from the literature, and to critically evaluate, all validated instruments currently available to measure self-harming behaviour in adults. Medline, Embase, PsycInfo, Health and Psychosocial Instruments and Google scholar were searched, grey literature was sought and the reference lists of relevant articles were checked to identify instruments. A total of seven validated instruments which met our inclusion criteria were identified and data were extracted regarding each instrument's format, administration method, psychometric properties and number of items and domains included. Considerable variation was observed in the overall quality of these instruments. Fourteen other instruments were identified which did not describe their psychometric properties or had not been published and were subsequently excluded from our review. Although many instruments were identified in our search, only a small number had been validated with published psychometric properties. Of the identified instruments, the Suicide Attempt Self-Injury Interview (SASII) appears to be the most robust and comprehensive instrument currently available. Despite the absence of psychometric data, numerous other instruments have been used in published studies, including clinical trials. Our results highlight the pressing need for a standardized, empirically validated and versatile measure of intentional self-harming behaviour for use in both clinical and research settings. The optimum characteristics of such an instrument are discussed.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Informa UK Limited
Date: 08-2014
Publisher: Elsevier BV
Date: 02-2019
Publisher: JMIR Publications Inc.
Date: 27-06-2022
Abstract: here is no consensus on how the disruption or maintenance of heritage culture and language affect mental health outcomes in adolescents with a migrant (also known as “immigrant” or “international migrant”) background. Even though previous literature reviews have investigated the association between acculturation and mental health in migrants, none have explicitly focused on adolescents. he aim of the scoping review described in this protocol is to understand (1) the focus, scope, and nature of quantitative empirical research investigating heritage cultural maintenance, including linguistic maintenance, and mental health outcomes in adolescents with a migrant background worldwide and (2) the potential effects of cultural and linguistic maintenance or disruption on migrant adolescent mental health outcomes. total of 11 key electronic health, medical, social science, and language databases (APA PsycArticles Full Text Embase Classic+Embase Ovid MEDLINE All and Epub Ahead of Print, In-Process, In-Data-Review and Other Non-Indexed Citations and Daily Ovid MEDLINE All APA PsycInfo University of Melbourne full-text journals Science Citation Index Expanded Social Sciences Citation Index Arts & Humanities Citation Index Scopus Linguistics and Language Behavior Abstracts) were searched. Databases were searched without time restrictions from the beginning of their coverage. Publication date, location, and quantitative study design (except for literature reviews) were not restricted however, the search was only conducted in English. Data from included studies will be extracted using a template with predefined data items, and results will be summarized in a structured, narrative summary. search was conducted on April 20, 2021, returning 2569 results. We are currently at the final stages of screening titles and abstracts of our search results, which will be followed by a full-text review and the data extraction of included studies. We expect to submit the full review for publication by the end of 2023. he scoping review aims to provide a better understanding of existing research on the association between cultural (including linguistic) maintenance and mental health in migrant adolescents. It will help identify gaps in the existing literature and develop hypotheses that could inform future research, eventually facilitating the development of targeted prevention initiatives and improving migrant adolescents’ well-being. ERR1-10.2196/40143
Publisher: Elsevier BV
Date: 08-2017
Publisher: Elsevier BV
Date: 12-2023
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JAD.2017.12.064
Abstract: Women in the perinatal period are at increased risk of experiencing self-harm ideation. The current study longitudinally examines the prevalence, trajectories, and correlates of self-harm ideation in a population-based s le of Australian women from pregnancy through to the early years of parenting. Drawing on data from 1507 women participating in a prospective pregnancy cohort study, data were collected during pregnancy, at 3-, 6-, 12-, and 18-months postpartum, and 4-years postpartum. Longitudinal Latent Class Analysis was conducted to identify groups of women based on their responses to thoughts of self-harm at each time-point. Logistic regression analysis was used to identify factors associated with group membership. Approximately 4-5% of women reported experiencing self-harm ideation at each time-point from pregnancy to 4-years postpartum. Cross-sectional analyses revealed that self-harm ideation was most frequently endorsed in the first 12-months postpartum (4.6%), and approximately 15% of women reported self-harm ideation at least once during the study period. Longitudinally, approximately 7% of women had an enduring pattern of self-harm ideation from pregnancy to 4-years postpartum. Women who had experienced a range of preconception and current social health issues and disadvantage were at increased risk of self-harm ideation over time. Limitations included use of brief measures, along with an underrepresentation of participants with particular socio-demographic characteristics. A proportion of women are at increased risk of experiencing self-harm ideation during the perinatal period and in the early years of parenting, underscoring the need for early identification during pregnancy and early postpartum to facilitate timely early intervention.
Publisher: American Medical Association (AMA)
Date: 28-08-2018
Publisher: Royal College of Psychiatrists
Date: 07-2022
DOI: 10.1192/BJO.2022.553
Abstract: Little is known about the degree to which social factors interact with COVID-19-related adversity to increase the risk of self-harm thoughts and behaviours. Using data derived from a UK cohort study, Paul & Fancourt found that loneliness was associated with an increase in the odds of self-harm thoughts and behaviours, whereas high-quality social support protected against self-harm thoughts and behaviours. The authors concluded that it is the quality of social support and interactions, rather than the act of engaging in social interaction per se, that protects against self-harm in the context of adversity. The COVID-19 pandemic may exert longer-lasting effects on population mental health, and continued surveillance of mental health, including self-harm status, will be essential. If accompanied by appropriate measures of the availability and quality of social support, such monitoring could also inform the development of more effective adaptive interventions for those at risk of engaging in self-harm.
Publisher: Elsevier BV
Date: 02-2020
Publisher: Wiley
Date: 21-09-2022
DOI: 10.1111/ADD.15679
Publisher: Springer Science and Business Media LLC
Date: 11-02-2020
Publisher: Springer Science and Business Media LLC
Date: 14-08-2018
Publisher: Springer Science and Business Media LLC
Date: 27-06-2014
Publisher: Elsevier BV
Date: 02-2018
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.DRUGALCDEP.2019.02.004
Abstract: To determine the extent to which the transition to parenthood protects against heavy and problematic alcohol consumption in young men and women. Integrated participant-level data analysis from three population-based prospective Australasian cohort studies. General community participants from the Australian Temperament Study, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. Recent binge drinking, alcohol abuse/dependence and number of standard drinks consumed per occasion. 4015 participants (2151 females 54%) were assessed on four occasions between ages 21 and 35. Compared to women with children aged <12 months, women who had not transitioned to parenthood were more likely to meet the criteria for alcohol abuse/dependence (fully adjusted risk ratio [RR] 3.5 95% CI 1.5-7.9) and to report recent binge drinking (RR 3.0 95% CI 2.1-4.3). The proportion of women meeting the criteria for alcohol abuse/dependence and/or binge drinking increased with the age of participants' youngest child, as did the mean number of standard drinks consumed on each occasion (1.8 if the youngest child was <1 year of age vs. 3.6 for 5+ years of age). Associations between parenthood and male drinking behaviour were considerably weaker. For most women in their twenties and thirties, parenting a child <1 year of age was associated with reduced alcohol consumption. However, this protective effect diminished after 12 months with drinking levels close to pre-parenthood levels after five years. There was little change in male drinking with the transition to parenthood.
Publisher: Wiley
Date: 26-05-2010
Publisher: Informa UK Limited
Date: 03-2013
Publisher: Elsevier BV
Date: 2012
Publisher: SAGE Publications
Date: 06-2015
Abstract: Synthetic cannabinoids (SCs) have become increasingly popular in recent years. Diverse in chemical structure, many have been subjected to legislative regulation, but their availability and use persists. Often marketed to reflect their similar effects to cannabis, their use has been associated with a range of negative health effects. We sought to determine the relative risk of seeking emergency medical treatment (EMT) following use of SCs and natural cannabis. We utilized an anonymous online survey of drug use, obtaining data from 22,289 respondents. We calculated the relative risk of seeking EMT between the two substances using an estimate for days used in the past year. Thirty-seven cannabis users (0.2%) and 21 SC users (1.0%) had sought EMT during the past year following use. The relative risk associated with the use of SCs was 30 (95% CI 17.5–51.2) times higher than that associated with cannabis. Significantly more symptoms ( p=0.03) were reported by respondents seeking treatment for SCs than for cannabis. Whilst these findings must be treated with caution, SCs potentially pose a greater risk to users’ health than natural forms of cannabis. Regulation is unlikely to remove SCs from the market, so well-informed user-focused health promotion messages need to be crafted to discourage their use.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2017
Publisher: Elsevier BV
Date: 05-2018
Publisher: Informa UK Limited
Date: 03-2013
Publisher: Future Medicine Ltd
Date: 07-2018
Abstract: Renal cell carcinoma (RCC) has typically been considered an immunogenic malignancy with responses seen to IL-2 and IFN-α. Response rates, however, were low and at the cost of considerable toxicity and as such, agents targeting angiogenesis have become the mainstay of treatment. Nivolumab is an immune checkpoint inhibitor targeting PD-1 thereby upregulating the host immune response against tumor cells. Nivolumab has emerged as a promising new therapy in advanced malignancies, and the first agent to show survival advantage in patients failing prior VEGFR-targeted therapy in metastatic RCC. This review summarizes the present evidence, toxicity profile, potential predictive biomarkers and promising future strategies with nivolumab in metastatic RCC.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.CANEP.2009.09.003
Abstract: Australia has the highest incidence of skin cancer of any country in the world, even though the risk of contracting the disease can be lowered considerably by engaging in appropriate sun-protective behaviours. We aimed to construct and validate a questionnaire to assess the readiness of a group of mostly young people to change their levels of sun-protective behaviour by assigning them to a stage of change based on the transtheoretical model of behaviour change. A s le of 122 undergraduate students in Queensland, Australia completed the readiness to alter sun-protective behaviour questionnaire (the RASP-B, a 12-item questionnaire about their attitudes toward sun-protection), in addition to a short questionnaire about their current sun-protective behaviours. A principal component analysis revealed a clear three-factor structure corresponding to the precontemplation, contemplation, and action stages of the transtheoretical model. Participants in the action stage reported engaging in significantly higher levels of sun-protective behaviour than participants in the earlier precontemplation and contemplation stages. These behaviours included avoiding exposure to direct sunlight by wearing long-sleeved clothing and remaining in the shade or indoors. Participants in the different stages reported no significant differences in the reported frequency of sunscreen use, although respondents across all three stages reported using sunscreen infrequently. The RASP-B requires approximately 5 min to complete, can be self-administered and has satisfactory psychometric properties, and thus has utility in primary health care settings where time and client-practitioner contact are often limited.
Publisher: Public Library of Science (PLoS)
Date: 15-02-2018
Publisher: Informa UK Limited
Date: 05-2012
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.DRUGALCDEP.2019.107707
Abstract: Adults released from prison are at increased risk of poor health outcomes and preventable mortality, including from overdose. Non-fatal overdose (NFOD) is a strong predictor of future overdose and associated with considerable morbidity. This study aims to the determine the incidence, predictors and clinical characteristics of NFOD following release from prison. We used pre-release interview data collected for a randomised controlled trial in 2008-2010, and linked person-level, state-wide ambulance, emergency department, and hospital records, from a representative s le of 1307 adults incarcerated in Queensland, Australia. The incidence of NFOD following release from prison was calculated. A multivariate Andersen-Gill model was used to identify demographic, health, social, and criminal justice predictors of NFOD. The crude incidence rate (IR) of NFOD was 47.6 (95%CI 41.1-55.0) per 1000 person-years and was highest in the first 14 days after release from prison (IR = 296 per 1000 person-years, 95%CI 206-426). In multivariate analyses, NFOD after release from prison was positively associated with a recent history of substance use disorder (SUD), dual diagnosis of mental illness and SUD, lifetime history of injecting drug use, lifetime history of NFOD, being dispensed benzodiazepines after release, a shorter index incarceration, and low perceived social support. The risk of NFOD was lower for people with high-risk alcohol use and while incarcerated. Adults released from prison are at high risk of non-fatal overdose, particularly in the first 14 days after release. Providing coordinated transitional care between prison and the community is likely critical to reduce the risk of overdose.
Publisher: Wiley
Date: 2020
DOI: 10.1111/PPE.12602
Abstract: There is increasing evidence that parental determinants of offspring early life development begin well before pregnancy. We established the Victorian Intergenerational Health Cohort Study (VIHCS) to examine the contributions of parental mental health, substance use, and socio-economic characteristics before pregnancy to child emotional, physical, social, and cognitive development. Men and women were recruited from the Victorian Adolescent Health Cohort (VAHCS), an existing cohort study beginning in 1992 that assessed a representative s le of 1943 secondary school students in Victoria, Australia, repeatedly from adolescence (wave 1, mean age 14 years) to adulthood (wave 10, mean age 35 years). Victorian Adolescent Health Cohort participants with children born between 2006 and 2013 were recruited to VIHCS and invited to participate during trimester three, at 2 months postpartum, and 1 year postpartum. Parental mental health, substance use and socio-economic characteristics were assessed repeatedly throughout infant characteristics were assessed postnatally and in infancy. Data will be supplemented by linkage to routine datasets. A further follow-up is underway as children reach 8 years of age. Of the 1307 infants born to VAHCS participants between 2006 and 2013, 1030 were recruited to VIHCS. At VIHCS study entry, 18% of recruited parents had preconception common mental disorder in adolescence and young adulthood, 18% smoked daily in adolescence and young adulthood, and 6% had not completed high school. Half of VIHCS infants were female (48%), 4% were from multiple births, and 7% were preterm (<37 weeks' gestation). Victorian Intergenerational Health Cohort Study is a prospective cohort of 1030 children with up to nine waves of preconception parental data and three waves of perinatal parental and infant data. These will allow examination of continuities of parental health and health risks from the decades before pregnancy to offspring childhood, and the contributions of exposures before pregnancy to offspring outcomes in childhood.
Publisher: Wiley
Date: 12-09-2022
DOI: 10.1111/DAR.13380
Abstract: People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence‐related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status. Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state‐wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen‐Gill model. Differences according to sex and Indigenous status were investigated using effect modification. A total of 225 (18.2%) people experienced 410 violence‐related events that were recorded in health records. The incidence was 12.8 per 100 person‐years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence‐related morbidity included diagnosed mental illness [hazard ratio (HR) = 2.0, 95% CI 1.1, 3.8], substance use disorder (HR = 1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR = 3.2, 95% CI 2.2, 4.8) high‐risk alcohol use (HR = 2.1, 95% CI 1.5, 2.8) being Indigenous (HR = 1.7, 95% CI 1.2, 2.5) and two or more prison releases (HR = 1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence‐related morbidity, with Indigenous men having twice the risk of non‐Indigenous men (HR = 1.9, 95% CI 1.3, 2.8). Approximately one in five people released from prisons in Queensland experienced violence‐related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence‐related morbidity in this population.
Publisher: Elsevier BV
Date: 09-2016
Publisher: John Wiley & Sons, Ltd
Date: 16-07-2013
Publisher: Wiley
Date: 26-09-2016
Publisher: Springer Science and Business Media LLC
Date: 19-05-2011
Publisher: Elsevier BV
Date: 02-2018
Publisher: BMJ
Date: 18-09-2013
DOI: 10.1136/BMJ.F5599
Publisher: Informa UK Limited
Date: 12-2012
Publisher: Elsevier BV
Date: 02-2022
Publisher: Elsevier BV
Date: 05-2019
Publisher: Informa UK Limited
Date: 16-03-2020
Publisher: Public Library of Science (PLoS)
Date: 06-08-2020
Publisher: Springer Science and Business Media LLC
Date: 03-08-2018
Publisher: BMJ
Date: 08-01-2020
DOI: 10.1136/INJURYPREV-2019-043296
Abstract: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm—the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.
Publisher: Wiley
Date: 18-06-2015
DOI: 10.1111/DAR.12280
Abstract: Substance use and psychotic symptoms/disorders are associated. There has been little examination of this issue in young offenders, despite elevated substance use in this group. Semistructured interviews were conducted by trained researchers with 514 young offenders. Psychotic symptoms were assessed using a previously validated screening measure, with scores ≥3 indicative of possible psychotic disorder. Associations between this indicator and patterns of offending, common symptoms of mental disorders and health risk behaviours, including substance use were examined. The extent to which substance use and psychotic symptoms remained associated after adjustment for possible confounding was evaluated. Thirteen percent screened positive for psychosis. Participants who screened positive for psychosis were more likely than those who did not to have: unstable housing been expelled from school a family history of substance use/mental health problems, and depressive symptoms. Amphetamine, sedative and cannabis dependence were all strongly associated with screening positive for psychosis. Screening positive remained significantly associated with hetamine and sedative dependence, and daily cannabis and sedative use, in multivariable regressions. One in eight young offenders reported symptoms consistent with psychosis. Symptomatology was strongly associated with heavy use of a range of illicit drugs. Given the frequency of these symptoms and the potential for them to be related to or exacerbated by drug use, this study highlights the importance of co-ordinated alcohol and other drugs and mental health treatment for young offenders, both due to co-occurrence and given the possibility that treating SUDs may impact on mental health symptoms.
Publisher: Elsevier BV
Date: 2018
Publisher: FapUNIFESP (SciELO)
Date: 2020
DOI: 10.1590/0102-311X00104619
Abstract: Abstract: Suicide among adolescents has become a major public health problem worldwide. Our study sought to describe the most commonly used methods of suicide among adolescents aged 10 to 19 years in Brazil between 2006 and 2015. Complete data were obtained from the Brazilian Health Informatics Department (DATASUS) and coded into seven categories of suicide methods. The following statistical analyzes were performed: chi-square (χ2) tests to examine the association between the frequency of each suicide method and the year odds ratios (OR) and 95% confidence intervals (95%CI) compared the relative chances of each suicide method occurring between boys and girls. In total, 8,026 suicides among Brazilian adolescents were registered over the analyzed period. The most commonly used method of suicide by both sexes was hanging (2015 = 70.3%), and the most significant increase was observed in girls (2015 = 65.82%). The proportional use of arms (2006 = 14.2% 2015 = 9.1%) and poisoning (2006 = 13.3% 2015 = 9.2%) decreased over the period. The increase in hanging is worrisome, mostly due to difficulties to impose access barriers and to its high lethality. In such context, a comprehensive understanding of suicide behaviors among adolescents in Brazil should be drawn to inform general prevention measures and, more specifically, the reasons for the increase in hanging need to be further investigated.
Publisher: Springer Science and Business Media LLC
Date: 14-07-2015
DOI: 10.1007/S00127-015-1084-4
Abstract: Military populations may experience more severe forms of domestic violence than the general population. Although mental disorders are associated with domestic violence perpetration among the general population, it is not clear whether this is the case for military populations. This review aimed to establish the prevalence and odds of domestic violence perpetration among male and female military personnel with mental disorders. Systematic review: searches of eleven electronic databases were supplemented by hand searches, reference screening, citation tracking and expert recommendations. Ten studies were included nine reporting on partner violence and one on violence against an adult family member. Median prevalence estimates were calculated for partner violence perpetration among male military personnel with post-traumatic stress disorder (PTSD) estimates on other disorders were not possible due to lack of data. 27.5 % of men with PTSD reported past year physical violence perpetration against a partner and 91.0 % reported past year psychological violence perpetration against a partner. Due to limited data, no median estimates could be calculated for female military personnel. Data from in idual papers indicate increased odds of past year partner violence perpetration among male and female military personnel with depression inconsistent findings were reported for risk of partner violence perpetration among male and female military personnel with PTSD. There is some evidence that mental disorders among military personnel are associated with past year domestic violence perpetration, though current data cannot confirm direction of causality. Research is needed to inform the development of interventions targeted to reduce domestic violence perpetration among military personnel.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2018
Publisher: Royal College of Psychiatrists
Date: 05-2013
DOI: 10.1192/BJP.BP.112.117762
Abstract: People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published. To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan. An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness. In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU n =46) or TAU alone ( n =42). This represented approximately 75% of our target s le size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) =1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR)=0.74, 95% CI 0.34-1.63, P =0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs. It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.
Publisher: BMJ
Date: 06-2023
DOI: 10.1136/BMJOPEN-2022-069237
Abstract: Asylum seekers and refugees are at an elevated risk of self-harm, with younger age and traumatic experiences found to further increase such risk. Despite this, evidence regarding self-harm among unaccompanied asylum seekers and refugee minors has not been synthesised. As self-harm among minors is a risk factor for a range of adverse clinical and social outcomes, including suicide, such information may help to inform evidence-based prevention strategies among these vulnerable populations. This systematic review will synthesise findings from the literature regarding the prevalence, methods and characteristics of self-harm, including risk and protective factors, among unaccompanied asylum seekers and refugee minors internationally. We searched key electronic databases (PsycINFO, Scopus, PubMed and Ovid MEDLINE) and grey literature for relevant studies published in English from database inception to 10 February 2023. Our primary outcome is self-harm among unaccompanied asylum seekers and/or refugee minors. With the exception of single-case studies, clinical trials and case-control studies, we will include all types of study design that examine the prevalence of self-harm in unaccompanied asylum seekers and/or refugee minors. We will exclude dissertations, conference abstracts, letters, book chapters, editorials, study registrations, registered protocols and qualitative studies. Only studies reporting on participants aged years will be eligible for inclusion. The Methodological Standard for Epidemiological Research Scale will be used to assess the quality of included studies. If there are sufficient studies and homogeneity between them, we will conduct meta-analyses to calculate pooled estimates of self-harm rates, as well as comparisons between subgroups of relevance. If the studies do not report sufficient data, or there is substantial heterogeneity, we will provide a narrative synthesis of the findings. This review is exempt from ethics approval. Our findings will be disseminated through peer-reviewed publications and conference presentations. CRD42021292709.
Publisher: JMIR Publications Inc.
Date: 20-06-2023
DOI: 10.2196/40143
Abstract: There is no consensus on how the disruption or maintenance of heritage culture and language affect mental health outcomes in adolescents with a migrant (also known as “immigrant” or “international migrant”) background. Even though previous literature reviews have investigated the association between acculturation and mental health in migrants, none have explicitly focused on adolescents. The aim of the scoping review described in this protocol is to understand (1) the focus, scope, and nature of quantitative empirical research investigating heritage cultural maintenance, including linguistic maintenance, and mental health outcomes in adolescents with a migrant background worldwide and (2) the potential effects of cultural and linguistic maintenance or disruption on migrant adolescent mental health outcomes. A total of 11 key electronic health, medical, social science, and language databases (APA PsycArticles Full Text Embase Classic+Embase Ovid MEDLINE All and Epub Ahead of Print, In-Process, In-Data-Review and Other Non-Indexed Citations and Daily Ovid MEDLINE All APA PsycInfo University of Melbourne full-text journals Science Citation Index Expanded Social Sciences Citation Index Arts & Humanities Citation Index Scopus Linguistics and Language Behavior Abstracts) were searched. Databases were searched without time restrictions from the beginning of their coverage. Publication date, location, and quantitative study design (except for literature reviews) were not restricted however, the search was only conducted in English. Data from included studies will be extracted using a template with predefined data items, and results will be summarized in a structured, narrative summary. A search was conducted on April 20, 2021, returning 2569 results. We are currently at the final stages of screening titles and abstracts of our search results, which will be followed by a full-text review and the data extraction of included studies. We expect to submit the full review for publication by the end of 2023. The scoping review aims to provide a better understanding of existing research on the association between cultural (including linguistic) maintenance and mental health in migrant adolescents. It will help identify gaps in the existing literature and develop hypotheses that could inform future research, eventually facilitating the development of targeted prevention initiatives and improving migrant adolescents’ well-being. DERR1-10.2196/40143
Publisher: EDITORA SCIENTIFIC
Date: 10-2019
Publisher: Elsevier BV
Date: 08-2017
Publisher: Springer Science and Business Media LLC
Date: 07-04-2017
DOI: 10.1007/S00127-017-1383-Z
Abstract: Incarcerated adults are at high risk of self-harm and suicide and remain so after release into the community. The aims of this study were to estimate the number of ambulance attendances due to self-harm in adults following release from prison, and to identify factors predictive of such attendances. Baseline surveys with 1309 adults within 6 weeks of expected release from prison between 2008 and 2010 were linked prospectively with state-wide correctional, ambulance, emergency department, hospital and death records in Queensland, Australia. Associations between baseline demographic, criminal justice and mental health-related factors, and subsequent ambulance attendances resulting from self-harm, were investigated using negative binomial regression. During 4691 person-years of follow-up (median 3.86 years per participant), there were 2892 ambulance attendances in the community, of which 120 (3.9%) were due to self-harm. In multivariable analyses, being Indigenous [incidence rate ratio (IRR): 2.10 (95% CI 1.14-3.86)], having previously been hospitalised for psychiatric treatment [IRR: 2.65 (95% CI 1.44-4.87)], being identified by prison staff as being at risk of self-harm whilst incarcerated [IRR: 2.12 (95% CI 1.11-4.06)] and having a prior ambulance attendance due to self-harm [IRR: 3.16 (95% CI 1.31-7.61)] were associated with self-harm attendances. Ambulance attendances resulting from self-harm following release from prison are common and represent an opportunity for tertiary intervention for self-harm. The high prevalence of such attendances, in conjunction with the strong association with prior psychiatric problems, reinforces the importance of providing appropriate ambulance staff training in the assessment and management of self-harm, and mental health problems more broadly, in this vulnerable population.
Publisher: MDPI AG
Date: 12-05-2021
DOI: 10.3390/ADOLESCENTS1020014
Abstract: Background: The transition from prison to the community can be a difficult process and may present different challenges for adolescents (aged 25 years) compared with their older peers. Methods: Using data from a prospective cohort study in Australia, we compared the health and welfare outcomes of adolescents (aged 25 years) and adults (aged ≥ 25 years) at 1, 3, and 6 months after release from prison. Results: After one month, adolescents were less likely to be unemployed (adjusted odds ratio (aOR) 0.31 95% CI 0.15–0.63), report low levels of social support (aOR 0.41 95% CI 0.21–0.80), or report high psychological distress (aOR 0.50 95% CI 0.25–0.99). After three months, adults were more likely to have visited a general practitioner (aOR 2.05 95% CI 1.04–4.07) and adolescents remained less likely to be unemployed (aOR 0.37 95% CI 0.19–0.74). After six months, adolescents were three times more likely to have used hetamine-type stimulants (aOR 3.42 95% CI 1.29–9.09). Conclusions: Adolescents experience different challenges than their older peers when transitioning from prison to the community. Age-specific, integrated support is needed for adolescents during this critical period, including strategies to promote early primary care contact, capitalise on social support networks, and discourage risky substance use.
Publisher: Wiley
Date: 18-03-2019
DOI: 10.1002/AB.21828
Abstract: While the association between heavy alcohol consumption and aggression has been well documented, the causal direction of this association, particularly at a population level, is disputed. A number of causal sequences have been proposed. First, that aggression leads to heavy alcohol use. Second, that heavy alcohol use leads to aggression. Third, that the association between alcohol use and aggression is due to confounding by (a) sociodemographic variables or (b) delinquency. We report here data from four Australasian prospective longitudinal studies of adolescents, to assess the temporal sequence of heavy drinking and aggression over the period from adolescence to young adulthood. The four cohort studies provide a total s le of 6,706 persons (Australian Temperament Project, n = 1701 Christchurch Health and Development Study, n = 931 Mater-University of Queensland Study of Pregnancy, n = 2437 Victorian Adolescent Health Cohort Study, n = 1637). We use multinomial logistic regression to determine whether early adolescent aggression predicts subsequent age of onset of heavy episodic drinking (HED), after adjustment for concurrent sociodemographic factors and delinquency. We then consider whether HED predicts subsequent aggression, after adjusting for past aggression, concurrent delinquency, and a range of confounders. There are broadly consistent findings across the four cohort studies. Early aggression strongly predicts subsequent HED. HED predicts later aggression after adjustment for prior aggression and other confounders. Policies that alter population levels of alcohol consumption are likely to impact on levels of aggression in societies where HED linked to aggression is more common.
Publisher: Wiley
Date: 22-08-2017
DOI: 10.1111/JCPP.12791
Abstract: While the prevalence of language and communication difficulties among young people in custody is well established, holistic understanding of the complexity and co-occurrence of additional vulnerabilities among this population are rare. Ninety-three young people in a young offenders institution in England were assessed using the Comprehensive Health Assessment Tool, the Test of Word Knowledge, and a range of additional assessments of communication, cognition, and neurodevelopmental difficulties. Forty-seven percent of the young people demonstrated an aspect of language skills significantly below the population average, with more than one in four identified as having impairment. Only one in four of those with an impairment had previously accessed speech and language services. Language needs were associated with difficulties with social communication and nonverbal cognition, as well as higher risk of self-harm and substance misuse. Earlier identification of language difficulties requires routine assessment of young people at risk of engagement in offending behavior. Where language difficulties are identified, holistic assessments of needs should be undertaken. There is a need for speech and language therapy provision within youth justice services, as well as in other services accessed by young people at risk of engagement in offending.
Publisher: Springer Science and Business Media LLC
Date: 09-04-2018
DOI: 10.1007/S10549-018-4777-Z
Abstract: The functions of many proteins are tightly regulated with a complex array of cellular functions including ubiquitination. In cancer cells, aberrant ubiquitination may promote the activity of oncogenic pathways with subsequent tumour progression. Kelch-like family member 7 (KLHL7) is involved in the regulation of ubiquitination and may play a role in breast cancer (BC). Present study aims to evaluate the biological and clinical usefulness of KLHL7 in BC utilising large well-characterised cohorts with long-term follow-up. The relationships between KLHL7 gene copy number alteration (CNA) and mRNA expression and clinicopathological variables and clinical outcomes were evaluated in 1980 patients from the METABRIC BC cohort. Prognostic significance of KLHL7 mRNA was validated using the Breast Cancer Gene-Expression Miner v4.0 datasets (n = 5206). KLHL7 protein expression was assessed using immunohistochemistry in a large annotated series of early-stage BC (n = 917) with long-term follow-up. KLHL7 CNA was significantly correlated with its mRNA expression. KLHL7 mRNA expression was higher in luminal B and basal-like molecular subtypes and in higher grade tumours. Increased KLHL7 protein expression was significantly correlated with features of aggressive phenotype including lymphovascular invasion, high histological grade, hormonal receptor negativity, high PIK3CA and p53 expression. Outcome analysis showed that high KLHL7 expression is an independent predictor of shorter survival (p = 0.0011). KLHL7 appears to play an important role in BC progression. High KLHL7 protein expression identified a subgroup of BC with aggressive behaviour and provided independent prognostic information.
Publisher: MDPI AG
Date: 26-01-2018
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.JAD.2016.11.022
Abstract: Prior anxiety and depression have been identified as risk factors for maternal perinatal mental health problems, but other preconception mental disorders have not been prospectively examined. This study investigated prospectively whether women with preconception personality disorder have increased rates of antenatal anxiety and/or depressive symptoms. 244 women in a population cohort were assessed for personality disorder at age 24 using the Standardised Assessment of Personality. Five to twelve years later, women were screened with the Clinical Interview Schedule, Revised Anxiety Subscale and the Edinburgh Postnatal Depression Scale during the third trimester of 328 pregnancies. Preconception personality disorder was associated with a three-fold increase in the odds of antenatal anxiety symptoms, which remained with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 2.84, 95% CI 1.31-6.15). Preconception personality disorder was associated with doubled odds of antenatal depressive symptoms, however this was attenuated with adjustment for preconception background factors and preconception common mental disorder (adjusted OR 1.98, 95% CI 0.81-4.81). Our findings are restricted to pregnant women aged 29-35 years. Anxiety and depression may have been under-identified because they were assessed at a single antenatal time point. Residual confounding of the associations by preconception common mental disorder at other time points may have occurred. Women with personality disorder are at heightened risk of anxiety symptoms in pregnancy, over and above risks associated with prior common mental disorder. This raises a possibility that pregnancy brings particular emotional challenges for women with personality disorders.
Publisher: Elsevier BV
Date: 07-2019
Publisher: Cambridge University Press (CUP)
Date: 25-09-2017
DOI: 10.1017/S2045796017000506
Abstract: People released from prison are at higher risk of mortality from potentially preventable causes than their peers in the general population. Because most studies of this phenomenon are reliant on registry data, there is little health and behavioural information available on those at risk, h ering the development of targeted, evidence-based preventive responses. Our aim was to identify modifiable risk and protective factors for external cause and cause-specific mortality after release from prison. We undertook a nested case–control study using data from a larger retrospective cohort study of mortality after release from prison in Queensland, Australia between 1994 and 2007. Cases were 286 in iduals who had died from external causes (drug overdose, suicide, transport accidents, or violence) matched with 286 controls on sex, Indigenous status, and release date. We extracted data from detention, case-management, and prison medical records. Factors associated with increased risk of external cause mortality included use of heroin and other opioids in the community [odds ratio (OR) = 2.20, 95% CI 1.41–3.43, p 0.001], a prescription for antidepressants during the current prison sentence (OR = 1.94, 95% CI 1.02–3.67, p = 0.042), a history of problematic alcohol use in the community (OR = 1.54, 95% CI 1.05–2.26, p = 0.028), and having ever served two or more custodial sentences (OR = 1.51, 95% CI 1.01–2.25, p = 0.045). Being married (OR = 0.45, 95% CI 0.29–0.70, p 0.001) was protective. Fewer predictors were associated with cause-specific mortality. We identified several behavioural, psychosocial, and clinical markers associated with mortality from preventable causes in people released from prison. Emerging evidence points to interventions that could be targeted at those at increased risk of external cause mortality. These include treatment and harm reduction programmes (for substance use), improving transitional support programmes and continuity of care (for mental health), ersion and drug reform (for repeat incarceration) and nurturing stable relationships during incarceration. The period of imprisonment and shortly after release provides a unique opportunity to improve the long-term health of ex-prisoners and overcome the disadvantage associated with imprisonment.
Publisher: Informa UK Limited
Date: 04-05-2023
Publisher: Public Library of Science (PLoS)
Date: 17-01-2017
Publisher: Wiley
Date: 23-06-2014
DOI: 10.1111/ACPS.12306
Publisher: Elsevier BV
Date: 08-2019
Publisher: Wiley
Date: 25-09-2015
DOI: 10.1002/WPS.20256
Publisher: Elsevier BV
Date: 11-2021
Publisher: Wiley
Date: 29-04-2014
DOI: 10.1111/SLTB.12096
Abstract: The prevalence and correlates of self-harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community-based orders (CBOs n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self-harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4% OR 3.10, 95% CI: 1.74-5.55). Multiple incidents were more common in females and 24% (95% CI: 19-39) of participants who had self-harmed reported having done so with suicidal intent. Self-harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk-taking behavior in the preceding year. The epidemiological profile of self-harm in this population appears to be distinct from that seen in the general population. Young offenders who self-harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within-and during the transition from-the youth justice system.
Publisher: SAGE Publications
Date: 29-04-2011
Publisher: Wiley
Date: 13-04-2015
DOI: 10.1111/DAR.12263
Abstract: Polysubstance use is associated with adverse health and social outcomes, but few studies have investigated whether these associations differ between in iduals engaged in different patterns of illicit drug and non-prescription medication use. Latent class analysis (LCA) was used to identify patterns of drug use in the Global Drug Survey, a purposive s le collected in late 2012 and surveyed using an online questionnaire including past-year drug use, sociodemographics, mental illness, involvement in violence and sexual behaviour. The s le analysed (n = 14, 869 median age 27 years 68.5% male) included those residing in the UK (n = 5869), Australia (n = 6313) and the USA (n = 2687). LCA of cannabis, ecstasy, cocaine, stimulants, nitrous, ketamine, benzodiazepines and opioid painkiller use identified six classes: no polysubstance use (Class 1, 49.1%) cannabis and ecstasy (Class 2, 23.6%) all illicit drugs (Class 3, 9.4%) ecstasy and cocaine (Class 4, 8.3%) cannabis and medication (Class 5, 5.9%) and all drugs (Class 6, 3.8%). Participants diagnosed with anxiety were most likely to belong to Class 5 [odds ratio (OR) 2.66, 95% confidence interval (CI) 2.10-3.38]. Violent behaviour was most strongly associated with Class 6 membership (OR 1.9, 95% CI 1.36-2.64). Sexual risk-taking also predicted membership of this class (OR 5.79, 95% CI 4.66-7.18) and Class 4 (OR 4.41, 95% CI 3.57-5.43). Five heterogeneous groups of polysubstance users were identified in this international s le covering the UK, Australia and USA. Anxiety disorders were associated with medication and cannabis use, while high-risk behaviours predicted use of cocaine and ecstasy, or wide-ranging polysubstance use including ketamine and medications.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2017
Publisher: Wiley
Date: 19-06-2018
DOI: 10.1111/ADD.14263
Abstract: Studies have linked adolescent alcohol use with adverse consequences in adulthood, yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer-term psychosocial harms taking into account in idual, family and peer factors. Participant-level data were integrated from four long-running longitudinal studies: Australian Temperament Project, Christchurch Health and Development Study, Mater Hospital and University of Queensland Study of Pregnancy and Victorian Adolescent Health Cohort Study. Australia and New Zealand. Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991 to 2012). Number of participants varied (up to n = 9453) by analysis. Three patterns of alcohol use (frequent, heavy episodic and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behaviour, sexual risk-taking, accidents, socio-economic functioning, mental health and partner relationships. After covariate adjustment, weekly drinking prior to age 17 was associated with a two- to threefold increase in the odds of binge drinking [odds ratio (OR) = 2.14 95% confidence interval (CI) = 1.57-2.90], drink driving (OR = 2.78 95% CI = 1.84-4.19), alcohol-related problems (OR = 3.04 95% CI = 1.90-4.84) and alcohol dependence (OR = 3.30 95% CI = 1.69-6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic and problem drinking in adolescence and most non-alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of in idual, family and peer predictors of those outcomes.
Publisher: Public Library of Science (PLoS)
Date: 30-11-2020
DOI: 10.1371/JOURNAL.PONE.0242802
Abstract: No prospective studies have examined the prevalence, antecedents or concurrent characteristics associated with self-harm in non-treatment-seeking primary school-aged children. In this cohort study from Melbourne, Australia we assessed 1239 children annually from age 8–9 years (wave 1) to 11–12 years (wave 4) on a range of health, social, educational and family measures. Past-year self-harm was assessed at wave 4. We estimated the prevalence of self-harm and used multivariable logistic regression to examine associations with concurrent and antecedent factors. 28 participants (3% of the 1059 with self-harm data 18 girls [3%], 10 boys [2%]) reported self-harm at age 11–12 years. Antecedent (waves 1–3) predictors of self-harm were: persistent symptoms of depression (sex-age-socioeconomic status adjusted odds ratio [aOR]: 7.8 95% confidence intervals [CI] 2.6 to 24) or anxiety (aOR: 5.1 95%CI 2.1 to 12), frequent bullying victimisation (aOR: 24.6 95%CI 3.8 to 158), and recent alcohol consumption (aOR: 2.9 95%CI 1.2 to 7.1). Concurrent (wave 4) associations with self-harm were: having few friends (aOR: 8.7 95%CI 3.2 to 24), poor emotional control (aOR: 4.2 95%CI 1.9 to 9.6), antisocial behaviour (theft—aOR: 3.1 95%CI 1.2 to 7.9 carrying a weapon—aOR: 6.9 95%CI 3.1 to 15), and being in mid-puberty (aOR: 6.5 95%CI 1.5 to 28) or late ost-puberty (aOR: 14.4 95%CI 2.9 to 70). The focus of intervention efforts aimed at preventing and reducing adolescent self-harm should extend to primary school-aged children, with a focus on mental health and peer relationships during the pubertal transition.
Publisher: Royal College of Psychiatrists
Date: 06-2015
DOI: 10.1192/BJP.BP.114.152835
Abstract: This editorial explores the implications of social media practices whereby people with mental health problems share their experiences in online public spaces and challenge mental health stigma. Social media enable in iduals to bring personal experience into the public domain with the potential to affect public attitudes and mainstream media. We draw tentative conclusions regarding the use of social media by c aigning organisations.
Publisher: SAGE Publications
Date: 27-11-2013
Abstract: This paper presents original research on prevalence, user characteristics and effect profile of N,N-dimethyltryptamine (DMT), a potent hallucinogenic which acts primarily through the serotonergic system. Data were obtained from the Global Drug Survey (an anonymous online survey of people, many of whom have used drugs) conducted between November and December 2012 with 22,289 responses. Lifetime prevalence of DMT use was 8.9% ( n=1980) and past year prevalence use was 5.0% ( n=1123). We explored the effect profile of DMT in 472 participants who identified DMT as the last new drug they had tried for the first time and compared it with ratings provided by other respondents on psilocybin (magic mushrooms), LSD and ketamine. DMT was most often smoked and offered a strong, intense, short-lived psychedelic high with relatively few negative effects or “come down”. It had a larger proportion of new users compared with the other substances (24%), suggesting its popularity may increase. Overall, DMT seems to have a very desirable effect profile indicating a high abuse liability that maybe offset by a low urge to use more.
Publisher: Public Library of Science (PLoS)
Date: 14-04-2017
Publisher: Wiley
Date: 20-05-2018
DOI: 10.1111/JPC.13938
Abstract: Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide.
Publisher: Royal College of Psychiatrists
Date: 03-2018
DOI: 10.1192/BJO.2017.10
Abstract: We examined prospective associations between men's common mental disorders in the decades prior to offspring conception and subsequent paternal antenatal mental health problems. Data came from a prospective intergenerational cohort study which assessed common mental disorder nine times from age 14 to 29 years, and in the third trimester of subsequent pregnancies to age 35 years ( N = 295 pregnancies to 214 men). Men with histories of adolescent and young adult common mental disorders were over four times more likely to experience antenatal mental health problems. Future research identifying modifiable perinatal factors that counteract preconception risk would provide further targets for intervention. None.
Publisher: Wiley
Date: 15-11-2018
DOI: 10.1111/ACPS.12833
Publisher: American Psychiatric Association Publishing
Date: 06-2014
DOI: 10.1176/APPI.PS.201300303
Abstract: Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a s le of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing in idually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.
Publisher: Elsevier BV
Date: 07-2016
Publisher: Elsevier BV
Date: 11-2017
Publisher: Cambridge University Press (CUP)
Date: 18-12-2019
DOI: 10.1017/S0033291718003689
Abstract: Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems. The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum. Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39 mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome. Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United States of America
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rohan Borschmann.