ORCID Profile
0000-0001-9823-7425
Current Organisations
Flinders University
,
Monash University
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Sociological Methodology and Research Methods | Care for Disabled | Aged Health Care | Public Health and Health Services
Social Structure and Health | Disability and Functional Capacity | Health Related to Ageing |
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-060524
Abstract: Practice-based research networks (PBRNs) are sustained collaborations between healthcare professionals, researchers and members of the community that develop, conduct and report on research relevant to local needs. While PBRNs have traditionally been focused towards primary care practices and their patients, there has been increasing interest in how they may help facilitate healthcare integration. Yet, little is known on the ways in which PBRNs can best integrate with the broader healthcare system, in particular Advanced Health Research and Translation Centres. The overall project aim is to build a sustainable collaboration between a PBRN and an Advanced Health Research and Translation Centre to generate a research platform suitable for planning, undertaking and translating research to improve care across the healthcare continuum. We will use a developmental evaluation design. Our iterative approach will be informed by a programme logic model and consists of: preparation work (pre-implementation assessment, literature review, community and stakeholder engagement), adaptation and building for a sustainable collaboration (strategy for recruitment and sustainment of members) and planning for network action (designing and implementing priority initiatives, monitoring and follow-up). This project was approved by the Monash Health ethics committee (ERM Reference Number: 76281 Monash Health Ref: RES-21-0000-392L) and the Monash University Human Research ethics committee (Reference Number: 29786). Dissemination will take place via various channels, including relevant national and international committees and conferences, peer-reviewed journals and social media. Continuous dissemination to and communication with all participants in this project as well as other relevant stakeholders will help strengthen and sustain the network.
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.JAD.2010.05.002
Abstract: Associations between 24-hour urinary 6-sulphatoxy melatonin excretion and symptoms of posttraumatic stress disorder were assessed 2 days, 1 month and 6 months after traumatic injury requiring hospitalisation. Forty-eight participants were recruited following an admission to hospital for an acute traumatic injury. They completed assessments 48h after the accident, 1 month and 6 months later. A 24-hour urine collection was initiated the morning before questionnaires were administered. PTSD symptoms and caseness was determined using the Impact of Event Scale (IES-R) and the Clinician Administered PTSD Scale respectively. Urinary 6-sulphatoxy melatonin was assayed by radioimmunoassay. Mean age of participants was 34 years (SD=12.72) and 75% were males. Ten (27%) participants met the criteria for PTSD 1 month post trauma and 6 (21%) met the criteria for PTSD at 6 months. Four of the six (67%) participants with PTSD at 6 months were also positive for major depression. Significant negative correlations were found between 6-sulphatoxy melatonin excretion at day 2 and all subscales and total score of the IES-R at the six month assessment. Controlling for depression, every one unit decrease in 6-sulphatoxy melatonin excretion was associated with a 13% increase in PTSD risk at six months (OR=1.13, 95% CI 1.00-1.27). However, this association was lost when self-reported pain, gender and employment was added to the model (OR=1.11, 0.93-1.32). This study provides preliminary data suggesting disrupted melatonin levels in the first 48h following trauma may place in iduals at increased risk of PTSD.
Publisher: Wiley
Date: 29-09-2021
DOI: 10.1111/RESP.14147
Abstract: Oral corticosteroids (OCS) are frequently used for asthma treatment. This medication is highly effective for both acute and chronic diseases, but evidence indicates that indiscriminate OCS use is common, posing a risk of serious side effects and irreversible harm. There is now an urgent need to introduce OCS stewardship approaches, akin to successful initiatives that optimized appropriate antibiotic usage. The aim of this TSANZ (Thoracic Society of Australia and New Zealand) position paper is to review current knowledge pertaining to OCS use in asthma and then delineate principles of OCS stewardship. Recent evidence indicates overuse and over‐reliance on OCS for asthma and that doses mg prednisolone‐equivalent cumulatively are likely to have serious side effects and adverse outcomes. Patient perspectives emphasize the detrimental impacts of OCS‐related side effects such as weight gain, insomnia, mood disturbances and skin changes. Improvements in asthma control and prevention of exacerbations can be achieved by improved inhaler technique, adherence to therapy, asthma education, smoking cessation, multidisciplinary review, optimized medications and other strategies. Recently, add‐on therapies including novel biological agents and macrolide antibiotics have demonstrated reductions in OCS requirements. Harm reduction may also be achieved through identification and mitigation of predictable adverse effects. OCS stewardship should entail greater awareness of appropriate indications for OCS prescription, risk–benefits of OCS medications, side effects, effective add‐on therapies and multidisciplinary review. If implemented, OCS stewardship can ensure that clinicians and patients with asthma are aware that OCS should not be used lightly, while providing reassurance that asthma can be controlled in most people without frequent use of OCS.
Publisher: Oxford University Press (OUP)
Date: 20-04-2016
DOI: 10.1093/IJE/DYW011
Publisher: Elsevier BV
Date: 07-2003
DOI: 10.1016/S0954-6111(03)00029-5
Abstract: Adherence to asthma medication regimens by asthma patients is often poor and contributes to the continued and substantial burden of asthma in the community. There is evidence of increased rates of behavioural problems, anxiety and depression in people with moderate-to-severe asthma and these factors may interfere with adherence and contribute to poor asthma control. An alternative explanation is that the relationship between feelings of anxiety and depression, and adherence to the treatment regimen may be more accurately predicted from the coping styles used, rather than the experience of asthma itself. The objective of this paper was to review evidence for associations between coping strategies used by asthma patients, asthma management and health outcomes. The Medline and PsychInfo databases were searched for articles containing the terms "asthma" and "coping". Patients with asthma tended to use different strategies for coping with stress and illness compared to healthy participants and in iduals with other chronic illnesses. Emotion-focussed coping strategies such as denial were commonly used by patients with poor medication adherence, those who attended emergency departments for asthma, were admitted to hospital for asthma, or suffered near-fatal asthma attacks. Interventions to improve coping strategies have been effective in reducing symptoms and psychological distress. The availability of coping resources to patients and/or their caregivers and the coping strategies that are used are likely to mediate the influence of psychosocial factors on the management of asthma. Further studies exploring the ways in which in iduals cope with asthma will improve our understanding of the mechanisms linking psychological and social status to asthma morbidity and mortality.
Publisher: Informa UK Limited
Date: 05-08-2020
Publisher: Mary Ann Liebert Inc
Date: 04-2023
Publisher: Royal College of General Practitioners
Date: 28-04-2021
Abstract: Alcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person’s alcohol use with advice to reduce health risks. Despite their effectiveness, ABIs are not routinely performed by clinicians. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices. To explore the facilitators and barriers to increasing the uptake of ABIs in primary care, including acceptability, reach, adoption, fidelity, and sustainability. A mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). The implementation strategies and resources will be trialled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention. The study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1176/APPI.PSY.49.5.369
Abstract: The classification and etiology of medically unexplained symptoms remain a clinical challenge. Recent proposals to improve systems of classification include ending the tradition of separating symptoms into medical or psychiatric groups. Several research questions are proposed to resolve some of the ergent opinions about the nature of these difficulties. Unitary models of somatic symptom causation should not be presumed. Examination of the causes and nature of somatic distress in those with and without psychiatric disorders requires separate investigation for each, and these should not be presumed to be similar. Psychophysiological models of somatic symptoms are required that can be studied in research protocols.
Publisher: Oxford University Press (OUP)
Date: 28-01-2021
Abstract: Approximately half of the opioids prescribed by Australian GP and GP registrars are for chronic non-cancer pain—despite limited therapeutic benefit, and serious risks of harm. Understanding the factors driving non-evidence-based opioid prescribing may improve GP training and education. To explore attitudes, beliefs, knowledge and self-reported factors influencing the opioid-prescribing decisions of Australian GP registrars. Telephone interviews were undertaken with 20 GP registrars in 2018–19. Interviews were 30–60 minutes in duration, audio-recorded and de-identified. Braun and Clarke’s 6-phase framework was adopted for reflexive thematic analysis of data and managed using QSR NVivo software. Twenty registrars were recruited 8 men and 12 women. Three themes were identified. Difficult chronic pain consultations negatively affected the registrar well-being. Registrars role modelled their supervisors’ opioid-prescribing practices, even if they perceived it to be unsafe. Registrars lacked confidence in initiating, prescribing and weaning opioids, recognizing drug-seeking behaviours and declining to prescribe—but felt confident in their knowledge of opioid pharmacology. Registrars were aware of evidence-based prescribing recommendations and risk reduction strategies but struggled to translate this into practice. Non-evidence-based opioid prescribing by Australian GP registrars is multifactorial. Emotionally difficult pain consultations, poor supervision and low prescriber confidence may contribute to unsafe prescribing. Improving registrar prescribing may require interventions to improve risk reduction, training in communication and role modelling by supervisors.
Publisher: SAGE Publications
Date: 15-05-2022
DOI: 10.1177/17423953221101337
Abstract: To compare self-reported levels of ‘anticipated’ stigma and experience of care in general practice between current and ex-smokers living with COPD, other chronic illnesses, or those with no chronic conditions. Participants completed an online survey, advertised through social media, about their experience of care from general practitioners (GPs) in the past 12 months. Respondents self-reported doctor-diagnosed chronic illnesses. Experience of care and anticipated stigma was assessed using validated questions. Multi-nominal regressions were used to determine independent effect of smoking status on anticipated stigma and other indicators of patient experience in primary care. Patients with COPD (n = 161) reported significantly higher anticipated stigma scores compared to those with other chronic conditions (n = 225) and this was strongly related to delayed or avoidance in seeking help from a GP when needed. This relationship remained irrespective of current smoking status. There was no difference between groups for relational components of experience of care. Primary care patients living with COPD reported worse experience of care across several domains and were more likely to anticipate experiencing stigma in the GP setting irrespective of their current smoking status compared to those with other chronic illnesses or no chronic illnesses.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1111/J.1753-6405.2008.00304.X
Abstract: The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an in idual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross-sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.
Publisher: Wiley
Date: 13-11-2018
DOI: 10.1111/CEA.13290
Abstract: Markers of microbial exposure are thought to be associated with risk of allergic sensitization however, the associations are inconsistent and may be related to gene-environment interactions. To examine the relationship between polymorphisms in the CD14 gene and allergic sensitization and whether sibling exposure, as a marker of microbial exposure, modified this relationship. We used data from the Tasmanian Longitudinal Health Study and the Melbourne Atopy Cohort Study. Two CD14 polymorphisms were genotyped. Allergic sensitization was defined by a positive response to a skin prick test. Sibling exposure was measured as cumulative exposure to siblings before age 6 months, 2 and 4 years. Logistic regression and multi-level mixed-effects logistic regression were used to examine the associations. Effect estimates across the cohorts were pooled using random-effects meta-analysis. CD14 SNPs were not in idually associated with allergic sensitization in either cohort. In TAHS, cumulative sibling exposure before age 6 months, 2 and 4 years was each associated with a reduced risk of allergic sensitization at age 45 years. A similar effect was observed in MACS. Meta-analysis across the two cohorts showed consistent evidence of an interaction between cumulative sibling exposure before 6 months and the rs5744455-SNP (P = 0.001) but not with the rs2569190-SNP (P = 0.60). The pooled meta-analysis showed that the odds of sensitization with increasing cumulative exposure to sibling before 6 months of age was 20.9% smaller in those with the rs5744455-C-allele than the T-allele (OR = 0.83 vs 1.05, respectively). Cumulative sibling exposure reduced the risk of sensitization from childhood to middle age in genetically susceptible in iduals.
Publisher: Springer Science and Business Media LLC
Date: 17-05-2022
DOI: 10.1186/S12877-022-03105-4
Abstract: The transition of an older family member into a residential aged care facility (RACF) is often challenging for both the person being admitted and their family carer. This review aimed to identify the protective and contributing factors to adverse mental health outcomes among family carers following the decision to move a family member to a RACF. A search of CINAHL, PubMed and PsycINFO was conducted for empirical papers published in English between 2004 and 2019, exploring the mental health or quality of life (QoL) of family carers of those recently admitted, or considering admission, to a RACF. Articles were reviewed by two authors for inclusion. Twenty-three studies met the inclusion criteria. Pre-existing depressive symptoms and poor subjective health were related to adverse mental health outcomes following admission. Information from the facility, support to change roles, and factors related to carer’s health and demographics, were associated with changes in the mental health outcomes of carers during the transition of their relative to a RACF. Key protective factors of carer’s mental health outcomes following the transition of their relative to a RACF are flow and transparency of information between carer and the facility staff, and staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. There is evidence to suggest factors such lack of flow and transparency of information between carer and the facility staff may predispose carers to poor mental health and QoL following the transition of a relative to a RACF. Key protective factors of carer’s mental health following admission are staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. This review also indicates that the combination of factors that puts family carers more at risk of poor mental health and lower quality of life throughout the transition period. Policy and practice should follow recommendations that consider a combination of the above factors when addressing the needs of family carers before and after admission of an older person to RACF.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2011
Publisher: Informa UK Limited
Date: 03-2011
Publisher: Queensland University of Technology
Date: 24-07-2016
DOI: 10.5204/SSJ.V7I2.341
Abstract: This paper reports on a program-level teaching support initiative that was implemented in a Health Sciences undergraduate degree with a large and highly casualised teaching team. It has been argued that to improve student retention and success, universities need to consider implementing comprehensive teaching support models that address institutional, program, and in idual level needs. We report on the implementation of our project and reflect on participant feedback, which demonstrated the value of the program for improving staff wellbeing. We argue that introducing support strategies for staff at a local level is essential not only for delivery of high quality learning experiences, but also for staff wellbeing which, in turn, has important implications for student success and retention.
Publisher: Oxford University Press (OUP)
Date: 12-2008
Publisher: MDPI AG
Date: 12-12-2019
DOI: 10.3390/ANTIBIOTICS8040263
Abstract: The scope of antimicrobial stewardship (AMS) surveys on community pharmacists (CPs) is uncertain. This study examines the breadth and quality of AMS survey tools measuring the stewardship knowledge, perceptions and practices (KPP) of CPs and analyse survey outcomes. Following PRISMA-ScR checklist and Arksey and O’Malley’s methodological framework seven medical databases were searched. Two reviewers independently screened the literatures, assessed quality of surveys and KPP outcomes were analysed and described. Ten surveys were identified that assessed CPs’ AMS perceptions (n = 7) and practices (n = 8) but none that assessed AMS knowledge. Three survey tools had been formally validated. Most CPs perceived that AMS improved patient care (median 86.0%, IQR, 83.3–93.5%, n = 6), and reduced inappropriate antibiotic use (84.0%, IQR, 83–85%, n = 2). CPs collaborated with prescribers for infection control (54.7%, IQR 34.8–63.2%, n = 4) and for uncertain antibiotic treatment (77.0%, IQR 55.2–77.8%, n = 5). CPs educated patients (53.0%, IQR, 43.2–67.4%, n = 5) and screened guideline-compliance of antimicrobial prescriptions (47.5%, IQR, 25.2–58.3%, n = 3). Guidelines, training, interactions with prescribers, and reimbursement models were major barriers to CP-led AMS implementation. A limited number of validated survey tools are available to assess AMS perceptions and practices of CPs. AMS survey tools require further development to assess stewardship knowledge, stewardship targets, and implementation by CPs.
Publisher: BMJ
Date: 03-2023
DOI: 10.1136/BMJRESP-2022-001514
Abstract: People living with chronic obstructive pulmonary disease (COPD) are a group who may be particularly vulnerable to COVID-19. This vulnerability has been associated with increased anxiety or fear about exposure to the virus, which may also impact upon experience in healthcare settings. The aim of this narrative mixed-methods review was to systematically scope, identify and synthesise findings from peer-reviewed qualitative, quantitative and mixed-methods studies published in academic journals describing the healthcare experiences of adults living with COPD independently in the community, following the emergence of COVID-19 in December 2019–June 2022. Databases including Ovid MEDLINE, PsychINFO, Ovid Emcare and CINAHL Plus were searched. Studies were uploaded to Covidence to support selection and appraisal of studies. Studies were appraised for quality using the Mixed Methods Appraisal Tool. A narrative synthesis of these themes was provided, and qualitative and quantitative findings are interpreted together in the discussion. The quality and experience of care for patients with COPD was impacted through the COVID-19 pandemic. Innovations and adoption of technologies such as telehealth and telerehabilitation were well received and mitigated the potential implications of severe disruption to care access to some extent. Patients feared feeling forgotten and experienced isolation and anxiety however, telerehabilitation and exercise through modalities such as Zoom classes help support social connection and physical activity. These innovations are likely to be useful to be offered to patients on an ongoing basis, and education and standardised protocols around their use will benefit healthcare providers and patients alike. CRD42022341168.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2007
Abstract: The aim of this study was to assess the impact that Academic Detailing (AD) had on General Practitioners' use of diagnostic imaging for shoulder complaints in general practice and their knowledge and confidence to manage shoulder pain. One-to-one Academic Detailing (AD) for management of shoulder pain was delivered to 87 General Practitioners (GPs) in metropolitan Adelaide, South Australia, together with locally developed clinical guidelines and a video/DVD on how to examine the shoulder. Three months after the initial AD a further small group or an in idual follow up session was offered. A 10-item questionnaire to assess knowledge about the shoulders was administered before, immediately after, and 3 months after AD, together with questions to assess confidence to manage shoulder complaints. The number of requests for plain film (X-ray) and ultrasound (US) imaging of the shoulder was obtained for the intervention group as well as a random comparison group of 90 GP's from the same two Divisions. The change in the rate of requests was assessed using a log Poisson GEE with adjustment for clustering at the practice level. A linear mixed effects model was used to analyse changes in knowledge. In an average week 54% of GPs reported seeing fewer than 6 patients with shoulder problems. Mean (SD) GP knowledge score before, immediately after and 3-months after AD, was 6.2/10 (1.5) 8.6/10 (0.96) and 7.2/10 (1.5) respectively (p 0.0001). Three months after AD, GPs reported feeling able to take a more meaningful history, more confident managing shoulder pain, and felt their management of shoulder pain had improved. Requests for ultrasound imaging were approximately 43.8% higher in the period 2 years before detailing compared to six months after detailing (p 0.0001), but an upward trend toward baseline was observed in the period 6 months to 1 year after AD. There was no statistically significant change in the rate of requests from before to after AD for plain-radiographs (p = 0.11). No significant changes in the rate of requests over time were observed in the control groups. These results provide evidence that AD together with education materials and guidelines can improve GPs' knowledge and confidence to manage shoulder problems and reduce the use of imaging, at least in the short term.
Publisher: Informa UK Limited
Date: 2005
Abstract: Adjustment for psychosocial and family problems is common in epidemiological research. Recursive partitioning algorithms, such as CHi Square Automatic Interaction Detection (CHAID), can be used to explore complex interactions between these factors and predictor and outcome variables. We investigated the nature of interactions between asthma management variables and psychosocial problems and how these interactions changed the risk of asthma mortality 50 cases of asthma death and 201 emergency department controls were recruited. A validated questionnaire was used to collect data. An extended version of CHAID was used to identify statistically significant (p 31 years (OR = 6.5 95% CI 2.6-16.1) but not for younger patients. Males were at increased risk overall, but females with family problems (OR = 4.3 95% CI 1.7-10.7) were at greater risk then males (OR = 3.1 95% CI 1.2-7.9) with family problems. Alcohol use increased risk of mortality for in iduals with verbal instructions (OR = 5.4 95% CI 1.5-19.5) or without a written action plan (OR = 4.4 95% CI 1.0-19.4). In iduals with severe asthma and who reported having lung function tests were at increased risk for mortality if family (OR = 8.2 95% CI 1.6-41.6) or financial problems (OR = 11.5 95% CI 2.0-65.9) were present. This analysis highlights some important interactions and the magnitude of additional risk for mortality associated with psychosocial or family problems. Psychosocial problems need to be identified and addressed as part of asthma management, because even with best practice, these problems place patients at an increased risk of dying.
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.PSYNEUEN.2010.10.007
Abstract: This study sought to characterize the variability of the acute cortisol response following trauma and its relationship to posttraumatic stress disorder (PTSD). Forty eight participants were recruited within 24h of a traumatic accident requiring hospital admission. A saliva s le was collected at 08.00 h and 16.00 h 2 days, 1 month and 6 months after hospital admission, together with 24-h urine collection. Participants completed a dexamethasone suppression test (0.5mg DEX at 21.00 h) at each follow up, together with self-report questionnaires. The Clinician Administered PTSD Scale (CAPS) was administered at 1 and 6 months to identify PTSD. Prevalence of PTSD was 27% at 1 month and 21% at 6 months. PTSD symptoms at 6 months were negatively correlated with salivary cortisol at 08.00 h on day 2 (r=-0.36, p=0.04), but positively correlated with 16.00 h cortisols (r=0.41, p=0.03). A lower rise in cortisol at 08.00 h on day 2 was associated with an increase in risk of PTSD at both 1 month (OR=1.411 (1.017, 1.957)) and 6 months (OR=1.411 (1.066, 1.866)). At 1 month, 70% of participants with PTSD suppressed cortisol to more than 90% of pre-dex levels compared with 25% without PTSD (χ(2)=6.77, p=0.034). Urinary cortisol excretion was not different between groups at any time point. The findings support a hypothesis that sensitization of the HPA axis and enhanced suppression of cortisol following the dexamethasone suppression test are established early in the disease process.
Publisher: Springer Science and Business Media LLC
Date: 06-2005
Publisher: OMICS Publishing Group
Date: 30-06-2009
DOI: 10.4066/AMJ.2009.57
Publisher: Springer Science and Business Media LLC
Date: 27-11-2019
DOI: 10.1186/S12889-019-7939-Y
Abstract: Smoking prevalence remains inequitably high for lower SES (socioeconomic status) populations. The psychosocial interactive model of resilience theorises that resilience might be ‘switched on’ in order to support and/or maintain smoking cessation for these populations. This study aimed to develop a Resilience Intervention for Smoking Cessation (RISC) through reviewing the extant literature around efficacious interventions for smoking cessation. Deliberative democracy principles were then used to understand lay perspectives regarding this potential smoking cessation program. Public health databases were searched to find efficacious psycho-social resilience interventions in the peer-reviewed literature for smoking cessation amongst lower SES populations. Potential components for RISC were selected based on evidence within the literature for their effectiveness. We then employed the Nominal Group Technique (NGT) to create discussion and consensus on the most socially appropriate and feasible components from the perspective of smokers from low SES areas. The NGT included 16 people from a lower SES population in southern metropolitan Adelaide who indicated they were seriously contemplating quitting smoking or had recently quit. Data were collected from multiple Likert ratings and rankings of the interventions during the NGT workshop and analysed descriptively. The Wilcoxon signed-ranked test was used where appropriate. Qualitative data were collected from participant reflections and group discussion, and analysed thematically. Six smoking cessation interventions, likely to enhance resilience, were selected as potential constituents for RISC: mindfulness training setting realistic goals support groups smoke free environments mobile phone apps and motivational interviewing. Consensus indicated that mindfulness training and setting realistic goals were the most acceptable resilience enhancing interventions, based on perceived usefulness and feasibility. This research applied principles from deliberative democracy in order to illuminate lay knowledge regarding an appropriate and acceptable smoking cessation resilience program for a lower SES population. This process of collaborative and complex knowledge-generation is critically important to confront inequities as an ongoing challenge in public health, such as smoking cessation for disadvantaged groups. Further research should involve development and trial of this resilience program.
Publisher: BMJ
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 20-04-2008
Abstract: A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. Twenty-nine practices were randomly allocated to one of three study arms. Australian asthma management guidelines were adapted to accommodate characteristics of the local area. GPs in the intervention arm (Group 1, n = 18 GPs) participated in a small group based education program and were provided with the adapted guidelines. One control arm (Group 2, n = 18 GPs) received only the adapted guidelines, while the other control arm (Group 3, n = 15 GPs) received an unrelated education intervention. GPs' knowledge, attitudes and management of paediatric asthma was assessed. Post intervention, intervention arm GPs were no more likely to provide a written asthma action plan, but were better able to assess the severity of asthma attack (Group 1vs Group 2 p = 0.05 and Group 1 vs Group 3 p = 0.01), better able to identify patients at high risk of severe attack (Group 1vs Group 3 p = 0.06), and tended to score higher on the asthma knowledge questionnaire (Group 1 vs Group 2 p = 0.06 and Group 1 vs Group 3 p = 0.2). Most intervention arm GPs felt more confident than control GPs to manage acute asthma attack and ongoing management of infrequent episodic asthma. Using interactive small group workshops to disseminate locally adapted guidelines was associated with improvement in GP's knowledge and confidence to manage asthma, but did not change GP's self-reported provision of written action plans.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Publisher: SAGE Publications
Date: 12-2005
DOI: 10.1177/17423953050010041201
Abstract: Objective: To describe the experiences of Australian parents caring for children with asthma. Methods: A combination of random s ling, purposeful s ling and quota s ling was used to select care-givers from general practices in Melbourne's north and north-western suburbs. Data collection involved a single semi-structured in-depth interview with 21 parents caring for a child with asthma. Thematic analysis was aided by QSR NVivo. Results: Children experienced predominantly mild-to-moderate, episodic asthma. Six themes emerged from the interviews: emotions and behaviours, coping strategies, disruption to activities, health and treatment beliefs, problems with asthma management, and relationships with doctors. Parents' experiences and health beliefs impacted on their management of asthma. These may act as barriers to optimal asthma care in some families. The overriding theme to emerge was `it gets easier'. It got easier with time because the children could communicate more effectively, and were better able to take care of themselves, and their asthma became less severe or less of a problem. Discussion: This research has highlighted the need for health professionals to emphasize the chronic nature of asthma, but negotiate strategies with care-givers to optimize the use of asthma medications, with consideration being given to care-givers' fears, frustrations and health beliefs.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2019
DOI: 10.1038/S41533-019-0143-9
Abstract: Our study measures effects of the Spirometry Learning Module (SLM) on health-care professionals’ knowledge of spirometry test quality and perceived confidence, experience, and understanding of spirometry measurements and interpretation. Professionals from both primary and hospital-based settings enrolled in the SLM, a training model focusing on spirometry test performance and interpretation, including an online interactive learning component and a face-to-face workshop. Participants were asked to submit patient spirometry assessment worksheets for feedback on quality and interpretation. Data were collected at baseline, SLM completion (20 weeks), and 12 months after SLM completion. Knowledge of spirometry test quality was evaluated with questions relating to five case-based assessments of common spirometric patterns. Perceived confidence, experience, and knowledge in test performance were measured using a 7-point Likert scale. The Friedman test combined with post hoc analyses were used to analyse differences between baseline, 20-week, and 12-month post completion. Qualitative interviews were performed to assess reasons for non-completion. Of the 90 participants enrolled in the SLM and consented to research, 48 completed the 20-week measurement and 11 completed the 12-month measurement. Statistically significant improvements were detected in all outcomes in participants who completed the SLM to 20-week and 12-month follow-up assessments (all p values 0.01). Barriers to completion were limited access to patients requiring spirometry, high clinic workload, and having a different spirometer at the workplace compared to the one used during SLM demonstrations. Our data suggest that participants’ confidence, experience, and knowledge regarding spirometry may improve through SLM completion.
Publisher: JMIR Publications Inc.
Date: 06-08-2020
Abstract: ames, when used as interventional tools, can influence behavior change by incentivizing, reinforcing, educating, providing feedback loops, prompting, persuading, or providing meaning, fun, and community. However, not all game elements will appeal to all consumers equally, and different elements might work for different people and in different contexts. he aim of this study was to conduct a realist review of tabletop games targeting behavior change and to propose a framework for designing effective behavior change games. realist review was conducted to inform program theory in the development of tabletop games for health behavior change. The context, mechanisms used to change behavior, and outcomes of included studies were reviewed through a realist lens. hirty-one papers met the eligibility criteria and were included in the review. Several design methods were identified that enhanced the efficacy of the games to change behavior. These included design by local teams, pilot testing, clearly defined targets of behavior change, conscious attention to all aspects of game design, including game mechanics, dynamics, aesthetics, and the elicitation of emotions. Delivery with other mediums, leveraging behavioral insights, prior training for delivery, and repeated play were also important. Some design elements that were found to reduce efficacy included limited replayability or lack of fun for immersive engagement. ame designers need to consider all aspects of the context and the mechanisms to achieve the desired behavior change outcomes. Careful design thinking should include consideration of the game mechanics, dynamics, aesthetics, emotions, and contexts of the game and the players. People who know the players and the contexts well should design the games or have significant input. Testing in real-world settings is likely to lead to better outcomes. Careful selection and purposeful design of the behavior change mechanisms at play is essential. Fun and enjoyment of the player should be considered, as without engagement, there will be no desired intervention effect.
Publisher: Wiley
Date: 07-03-2012
DOI: 10.1111/J.1365-2702.2011.03990.X
Abstract: Aim and objective. This study aimed to understand older people’s perceptions of their and other older peoples’ falls risk, to increase understanding of why older people might not believe falls are relevant to themselves. Background. One‐third of the people aged ≥65 years (older people) fall yearly. Many older people do not participate in falls prevention programmes because they purport they are not personally vulnerable. Design. A qualitative study was conducted, guided by the tenets of grounded theory. Method. Semi‐structured interviews were conducted with nine community‐dwelling older people living in metropolitan Adelaide, South Australia. The interview explored participant’s direct and indirect experience of falling, their perceived chance of falling in the next 12 months and that of others of the same age and sex to themselves and their reasons for this. Results. Participants carefully presented themselves as being ‘not the type who fall’, who they view negatively. They believed their or their friends past or future falls were (or could be) because of factors outside of their personal control or because they were not paying attention at that moment of falling, as opposed to being the type of person who falls. They used these explanations as strategies to maintain or protect their identity as being physically competent. Conclusions. Older people know that falling can be viewed negatively. Falling is a threat to their identity as the type of person who does not fall. This explanation is consistent with self‐presentation theory, where people use accounting strategies in social interaction to create a desired impression. Relevance to clinical practice. Falls prevention messages are likely to be rejected if the target group associate the message with a negative identity. These findings can assist nurses to understand older people’s reluctance to engage in falls prevention and can stimulate thinking regarding alternative engagement strategies.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY14129
Abstract: This study was undertaken to provide a snapshot of the academic primary health-care workforce in Australia and to provide some insight into research capacity in academic primary health care following changes to funding for this sector. A convenience s le of in iduals self-identifying as working within academic primary health care (n = 405) completed an anonymous online survey. Respondents were identified from several academic primary health-care mailing lists. The survey explored workforce demographics, clarity of career pathways, career trajectories and enablers/barriers to ‘getting in’ and ‘getting on’. A mix of early career (41%), mid-career (25%) and senior academics (35%) responded. Early career academics tended to be female and younger than mid-career and senior academics, who tended to be male and working in ‘balanced’ (teaching and research) roles and listing medicine as their disciplinary background. Almost three-quarters (74%) indicated career pathways were either ‘completely’ or ‘somewhat unclear’, irrespective of gender and disciplinary backgrounds. Just over half (51%) had a permanent position. Males were more likely to have permanent positions, as were those with a medical background. Less than half (43%) reported having a mentor, and of the 57% without a mentor, more than two-thirds (69%) would like one. These results suggest a lack of clarity in career paths, uncertainty in employment and a large number of temporary (contract) or casual positions represent barriers to sustainable careers in academic primary health care, especially for women who are from non-medicine backgrounds. Professional development or a mentoring program for primary health-care academics was desired and may address some of the issues identified by survey respondents.
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/16094069221145282
Abstract: Translation in qualitative research is an essential process to accurately convey participants’ meanings between languages, thus ensuring the trustworthiness of qualitative research. However, detailed reporting of this crucial process is not included in current reporting guidelines. We will illustrate the complexity of the translation process based on our experiences across research contexts in three countries. We also provide recommendations to preserve participants’ meanings and research trustworthiness. These experiences highlight the importance of accurately reporting the translation process in cross-language qualitative health research and emphasise the need for a clear and comprehensive reporting guideline.
Publisher: European Respiratory Society
Date: 03-2013
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 10-2019
Publisher: Association for Computing Machinery (ACM)
Date: 22-09-2022
DOI: 10.1145/3526087
Abstract: The prediction of express delivery sequence, i.e., modeling and estimating the volumes of daily incoming and outgoing parcels for delivery, is critical for online business, logistics, and positive customer experience, and specifically for resource allocation optimization and promotional activity arrangement. A precise estimate of consumer delivery requests has to involve sequential factors such as shopping behaviors, weather conditions, events, business c aigns, and their couplings. Despite that various methods have integrated external features to enhance the effects, extant works fail to address complex feature-sequence couplings in the following aspects: weaken the inter-dependencies when processing heterogeneous data and ignore the cumulative and evolving situation of coupling relationships. To address these issues, we propose DeepExpress—a deep-learning-based express delivery sequence prediction model, which extends the classic seq2seq framework to learn feature-sequence couplings. DeepExpress leverages an express delivery seq2seq learning, a carefully designed heterogeneous feature representation, and a novel joint training attention mechanism to adaptively handle heterogeneity issues and capture feature-sequence couplings for accurate prediction. Experimental results on real-world data demonstrate that the proposed method outperforms both shallow and deep baseline models.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 08-2019
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.SEIZURE.2017.06.005
Abstract: Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions bronchitis/asthma and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000 lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC 17% -CSCC) compared with asthma (11% +CSCC 14% -CSCC) or diabetes (14% +CSCC 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable, minimise costs to the health budget, and maximise health care quality.
Publisher: Springer Science and Business Media LLC
Date: 27-09-2023
Publisher: Springer Science and Business Media LLC
Date: 23-12-2022
DOI: 10.1186/S12889-022-14696-3
Abstract: General practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of electronic cigarettes (e-cigarettes) as a smoking cessation aid, there is growing interest in the role e-cigarettes might play as an alternative to smoking tobacco. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the knowledge, attitudes, beliefs and social norms of GPs with respect to the use of e-cigarettes as smoking cessation aids. This study adhered to the PRISMA guidelines. Studies from MEDLINE, CINAHL, SCOPUS, PsycINFO, EMBASE and grey literature were searched. Two independent reviewers screened abstracts and full-text articles to identify studies that met the inclusion criteria. A data extraction form was used to extract relevant data from included papers and were quality appraised using the MMAT checklist. A PRISMA flow diagram was used to record the flow of papers and reasons for exclusion. Studies were included if they collected quantitative, qualitative or mixed methods data to determine knowledge, attitudes, beliefs and social norms of GPs for use of e-cigarettes as smoking cessation aids. A total of 4056 abstracts were screened and 25 articles were included. Our findings showed that GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were optimistic and had recommended e-cigarettes to their patients. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as smoking cessation alternatives. This systematic review shows there are mixed views on e-cigarettes as smoking cessation aids. Clear guidance on the role of e-cigarettes is needed to inform and upskill GPs about e-cigarettes for smoking cessation. CRD42021227612.
Publisher: Oxford University Press (OUP)
Date: 26-11-2019
Abstract: Over the last three decades, Australian opioid-prescribing rates and related morbidity and mortality have dramatically increased. Opioids are frequently prescribed by general practitioners (GPs) to manage chronic non-cancer pain, despite evidence-based recommendations from the Centre for Disease Control, National Institute for Health and Care Excellence and World Health Organization widely cautioning their use. Little is known about the factors influencing the opioid prescribing decisions of Australian GPs, especially when not evidence based. To explore the opioid prescribing knowledge, attitudes and practices of Australian GPs. Semi-structured interviews with 20 GPs recruited from the Monash University practice-based research network in metropolitan, southeastern Melbourne. Thematic analysis was used to identify emergent themes. Data were managed using QSR NVivo. Ethics approval was granted by Monash University. Three key themes emerged. GP attitudes towards opioid use for chronic pain varied by age of patient and goals for therapy. Use of opioids for elderly patients was positively perceived. GPs were reluctant to use opioids in younger patients due to fears of addiction and difficulty weaning. GPs felt obliged to prescribe opioids recommended by specialists, even if they believed the opioids were unsafe. This study identified and described the patient-centred nature of GP opioid prescribing decisions. Patient age and perceived age-related opioid harm were important factors influencing prescribing decisions. Future work should inform interventions that value GP autonomy while still encouraging a collaborative inter-speciality approach to managing chronic pain patients with opioids.
Publisher: Royal College of General Practitioners
Date: 13-12-2022
Abstract: Exacerbations are the strongest risk factor for future exacerbations for patients living with chronic obstructive pulmonary disease (COPD). The period immediately following exacerbation is a high-risk period for recurrence and hospital admission, and is a critical time to intervene. GPs are ideally positioned to deliver this care. To explore perceptions of GPs regarding the care of patients following exacerbations of COPD and to identify factors affecting the provision of evidence-based care. A descriptive qualitative study was undertaken involving semi-structured, in-depth interviews with Australian GPs who volunteered to participate following a national survey of general practice care for COPD patients following exacerbations. Interviews were conducted via the Zoom video conference platform, which were audio-recorded and transcribed verbatim. QSR NVivo was used to support data management, coding, and inductive thematic analysis. Eighteen GPs completed interviews. Six key themes were identified: 1) GPs’ perceptions and knowledge in the management of COPD patients following exacerbation and admission to hospital 2) pharmacological management 3) consultation time 4) communication between healthcare professionals 5) access to other health services and 6) patient compliance. Delivery of post-exacerbation care to COPD patients is affected by GPs, patients, and health service-related factors. The care of COPD patients may be further improved by supporting GPs to overcome identified barriers.
Publisher: JMIR Publications Inc.
Date: 31-03-2021
DOI: 10.2196/23302
Abstract: Games, when used as interventional tools, can influence behavior change by incentivizing, reinforcing, educating, providing feedback loops, prompting, persuading, or providing meaning, fun, and community. However, not all game elements will appeal to all consumers equally, and different elements might work for different people and in different contexts. The aim of this study was to conduct a realist review of tabletop games targeting behavior change and to propose a framework for designing effective behavior change games. A realist review was conducted to inform program theory in the development of tabletop games for health behavior change. The context, mechanisms used to change behavior, and outcomes of included studies were reviewed through a realist lens. Thirty-one papers met the eligibility criteria and were included in the review. Several design methods were identified that enhanced the efficacy of the games to change behavior. These included design by local teams, pilot testing, clearly defined targets of behavior change, conscious attention to all aspects of game design, including game mechanics, dynamics, aesthetics, and the elicitation of emotions. Delivery with other mediums, leveraging behavioral insights, prior training for delivery, and repeated play were also important. Some design elements that were found to reduce efficacy included limited replayability or lack of fun for immersive engagement. Game designers need to consider all aspects of the context and the mechanisms to achieve the desired behavior change outcomes. Careful design thinking should include consideration of the game mechanics, dynamics, aesthetics, emotions, and contexts of the game and the players. People who know the players and the contexts well should design the games or have significant input. Testing in real-world settings is likely to lead to better outcomes. Careful selection and purposeful design of the behavior change mechanisms at play is essential. Fun and enjoyment of the player should be considered, as without engagement, there will be no desired intervention effect.
Publisher: Wiley
Date: 07-12-2011
Publisher: Elsevier BV
Date: 06-2018
Publisher: Wiley
Date: 29-05-2022
DOI: 10.1111/COB.12538
Abstract: Understanding the experience of people living with obesity is crucial for delivering holistic care relevant to the socio‐cultural context. Although half of the Malaysian adults have excessive weight, the lived experience of people with obesity in the Malaysian context is not well studied. Using the principles of hermeneutic phenomenology, this study explores the lived experience of adults with obesity in Malaysia and their perspective on the environmental influences on obesity. Participants were adults from Peninsular Malaysia living with obesity recruited from social media, clinics and snowball s ling. Twenty‐five teleconference interviews in Malay were audio‐recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach, and quotes were translated into English. We identified five themes: (1) Malaysian life is centred around food (2) social norms shape people living with obesity's perceptions of themselves and obesity (3) people living with obesity are physically restricted by their body (4) people living with obesity have repeated thoughts about efforts to lose weight and (5) stigmatization of people living with obesity leads to negative emotions. Socio‐cultural influences were highly impactful on participants' lifeworld, and these influences need to be considered in clinical practice and policy for obesity management in Malaysia. Clinical management should focus on assisting patients in navigating the unsupportive food and social environment instead of overfocusing on the in idual's responsibility for weight reduction.
Publisher: Oxford University Press (OUP)
Date: 02-09-2021
Abstract: Brief interventions (BIs) delivered in primary care can reduce harmful alcohol consumption. Yet, clinicians do not routinely offer BIs to reduce harmful alcohol use. We explored the perspectives of clinicians and patients about the use of alcohol BIs during consultations in Australian primary care. Semi-structured interviews and focus groups (face-to-face and virtual) were undertaken with 34 general practitioners, eight practice nurses and 17 patients. Field notes were made from audio-recordings and themes were identified using a descriptive qualitative approach with the field notes as the point of data analysis. Participants identified barriers within the consultation, practice setting and wider healthcare system plus across the community which reduce the delivery of BIs in primary care including: Australian drinking norms inconsistent public health messaging around alcohol harm primary care not recognized as a place to go for help community stigma towards alcohol use practice team culture towards preventive health, including systems for recording alcohol histories limitations of clinical software and current patient resources. Multiple layers of the healthcare system influence the use of BIs in primary care. Identified facilitators for embedding BIs in primary care included: (i) raising community and clinician awareness of the health harms of alcohol, (ii) reinforcing a primary care culture that promotes prevention and, (iii) supportive resources to facilitate discussion about alcohol use and strategies to reduce intake. Alcohol BIs in primary care could be further supported by community public health messages about alcohol use.
Publisher: Informa UK Limited
Date: 25-03-2020
Publisher: Informa UK Limited
Date: 13-01-2019
DOI: 10.1080/10826084.2018.1501066
Abstract: There is a growing evidence that resilience to stress can promote nonsmoking. However, few studies have undertaken quantitative research to investigate whether resilience, generated by internal and external factors, moderates the impact of stress on the likelihood of smoking. This study aims to help fill this knowledge gap in relation to smokers and ex-smokers, and those people who have never smoked. A large online cross-sectional survey was administered in Australia (2015-2016) to collect data on demographic variables, levels of internal and external resilience, and stress from current and past smokers (n = 400) and those who have never-smoked (n = 921). Logistic regressions were employed to test our hypotheses. Most participants were female (82%) and ranged between 18 and 77 years. Higher levels of reported perceived stress and stress-related variables did significantly predict smoking. The combined impact of internal and external resilience factors predicted never-smoking and lessened the relationship between perceived stress and stress-related variables, and the likelihood of smoking. These results are important because they suggest that the social environment should be developed to augment social support and internal properties such as developing "a strong sense of purpose in life" to encourage people not to commence smoking, rather than focus on smoking cessation.
Publisher: Elsevier BV
Date: 11-2020
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/20552076211047390
Abstract: Machine learning involves the use of algorithms without explicit instructions. Of late, machine learning models have been widely applied for the prediction of type 2 diabetes. However, no evidence synthesis of the performance of these prediction models of type 2 diabetes is available. We aim to identify machine learning prediction models for type 2 diabetes in clinical and community care settings and determine their predictive performance. The systematic review of English language machine learning predictive modeling studies in 12 databases will be conducted. Studies predicting type 2 diabetes in predefined clinical or community settings are eligible. Standard CHARMS and TRIPOD guidelines will guide data extraction. Methodological quality will be assessed using a predefined risk of bias assessment tool. The extent of validation will be categorized by Reilly–Evans levels. Primary outcomes include model performance metrics of discrimination ability, calibration, and classification accuracy. Secondary outcomes include candidate predictors, algorithms used, level of validation, and intended use of models. The random-effects meta-analysis of c-indices will be performed to evaluate discrimination abilities. The c-indices will be pooled per prediction model, per model type, and per algorithm. Publication bias will be assessed through funnel plots and regression tests. Sensitivity analysis will be conducted to estimate the effects of study quality and missing data on primary outcome. The sources of heterogeneity will be assessed through meta-regression. Subgroup analyses will be performed for primary outcomes. No ethics approval is required, as no primary or personal data are collected. Findings will be disseminated through scientific sessions and peer-reviewed journals. CRD42019130886
Publisher: Springer Science and Business Media LLC
Date: 03-05-2021
DOI: 10.1186/S13063-021-05288-4
Abstract: Undertaking recruitment for research in schools is an effective way to recruit young people for research participation but it is not without its challenges. Gaining access and coordinating many levels of different organisations and stakeholders whose cooperation and approval are crucial all add time and sometimes logistical challenges for the research team. In addition, recruiting around sensitive research topics can elicit additional barriers to successful research. The research team aimed to conduct a pragmatic cluster randomised controlled trial involving schools in a local government region in Victoria, Australia, to assess the effect of a vaccination-based educational card game called “Vaxcards” on vaccine consent returns. Schools were contacted via phone and email to determine which staff member would best be a contact point for a face-to-face meeting to discuss the methods and purpose of the study. Email follow-ups were scheduled to follow up non-responsive schools and consent forms. The minimum required s le size was 13. Of 31 eligible schools, 13 were recruited. The research team encountered several unanticipated challenges before achieving the recruitment target. The most common reasons for non-participation were being too busy with other commitments, concerns regarding the topic of vaccination being too sensitive, and concerns that key stakeholders in the school would not approve of the research topic of vaccination. One school required a review by a private research ethics board that rejected the study. Significant hesitancy and misinformation about vaccine science was observed that affected engagement with a small number of schools. This paper highlights the challenges of recruiting schools in the context of public anxieties about vaccines and has several important learning lessons for successful recruitment about sensitive topics. This includes navigating approval processes for research in schools, the importance of local ch ions, dealing with misinformation and the importance of strong relationships and organisational trust. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618001753246 . Prospectively registered on 25 October 2018 8:24:21 AM
Publisher: Springer Science and Business Media LLC
Date: 12-2004
Publisher: Public Library of Science (PLoS)
Date: 25-04-2023
DOI: 10.1371/JOURNAL.PONE.0284731
Abstract: Acute exacerbations of COPD (AECOPDs) are one of the leading causes of preventable hospital admissions in Australia. Exacerbations are the strongest predictor for future exacerbations. The period immediately following an exacerbation is a high-risk period for recurrence and critical time to intervene. The aim of this study was to identify current general practice care for patients following an AECOPD in Australia and gain insights into knowledge of evidence-based care. A cross-sectional survey was created and disseminated electronically to Australian general practitioners (GPs). Data were analysed descriptively. Comparisons between groups were made using Chi squared tests. From 64 responses, 47% were familiar with the COPD-X Plan. Only 50% described reviewing patients within seven days of discharge mostly related to a lack of awareness of the hospital admission. 50% of surveyed GPs reported hospital discharge summaries did not provide the information they required. Smoking, immunisation and medications were regularly assessed by % respondents at follow-up visits, while referrals to pulmonary rehabilitation, and evaluation of spirometry and oxygen therapy were not prioritised. GPs appear to require support to increase their familiarity with COPD guidelines and inform evidence-based clinical practice. The handover/communication process from hospital to primary care appears an important area for future improvement.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Informa UK Limited
Date: 2002
Abstract: In this analysis, we sought to determine factors that predicted the level of asthma knowledge in a s le of adolescents with asthma and their parents. Eighty-five young people aged 10-24 years attending tertiary care asthma clinics and 46 of their parents answered validated respiratory and asthma knowledge questionnaires. Older adolescents were more knowledgeable about asthma than were younger adolescents (r=0.36, p=0.001). Young people with severe asthma (p=0.015) scored higher on the asthma knowledge questionnaire than those with mild/moderate asthma. Asthma knowledge among young people was related to that of their mothers (r=0.47, p=0.014), however, only age and the asthma knowledge of fathers significantly predicted adolescent asthma knowledge. Adolescents develop increasing autonomy for asthma self-management as they mature, but parents remain an important source of information about asthma for young people.
Publisher: Informa UK Limited
Date: 14-08-2023
Publisher: Oxford University Press (OUP)
Date: 23-03-2010
Abstract: To improve health outcomes of children and adolescents with asthma using a multifaceted intervention for GPs. The design of the study was a cluster randomized controlled trial. GPs were randomized at a practice level in general practice clinics in Melbourne, Australia. Participants were children/adolescents aged 2-14 years with asthma and their caregivers identified from the medical records of participating clinics. Questionnaires were completed by 411 at baseline and 341 at follow-up. The intervention arm (n = 18 GPs) participated in a small group asthma education programme and was provided with locally adapted paediatric asthma guidelines. One control arm (n = 18 GPs) received only the adapted paediatric asthma guidelines, while the other control arm (n = 15 GPs) received an unrelated educational intervention. The outcome measures of the study were children/adolescents and caregivers completed questionnaires about asthma management and control, asthma knowledge and quality of life at recruitment and 6 months later. Ownership of a written asthma action plan (WAAP) was the primary outcome. There was no evidence for changes in ownership of WAAPs between the three study arms. Adolescents in the intervention group reported an improvement in quality of life subscale score 'positive effects' (mean difference = 2.64, P = 0.01), but there was no evidence for an effect of the intervention on other study outcomes among the three study arms. The intervention was associated with some improvement in quality of life for adolescents. However, overall, the intervention did not translate into increased ownership of WAAPs, control of asthma or improved quality of life.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2019
Publisher: Wiley
Date: 27-02-2020
DOI: 10.1111/JOCN.15206
Publisher: CSIRO Publishing
Date: 30-11-2021
DOI: 10.1071/PY20307
Abstract: As the population ages, so does the prevalence of dementia, a condition in which timely advance care planning (ACP) is recommended. This study explored the barriers and enablers of ACP for Australian GPs caring for people with dementia. Semi-structured qualitative telephone interviews informed by the theoretical domains framework (TDF) were conducted with 16 GPs from the south-east region of metropolitan Melbourne. The most prevalent domains of the TDF were: (1) environmental context and resources (2) beliefs about consequences and (3) social rofessional role and identity. Further thematic analysis found that: (1) ACP was felt to be within the scope of general practice, but more so before the onset of dementia because lack of confidence in capacity assessment acted as a barrier once a diagnosis was made (2) beliefs about the perceived benefits of ACP motivated GPs to engage patients in ACP and (3) doctors felt that patients were often reluctant to discuss ACP, especially in the time-pressured context of the standard consultation. This study’s use of the TDF provides direction for potential interventions to alleviate challenges faced by Australian GPs with ACP in dementia. Improving ACP in general practice may require a focus on public health c aigns to educate patients about the benefits of ACP before the onset of dementia. GPs’ difficulty assessing a patient’s decisional capacity may be addressed through skills development workshops.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2014
Publisher: European Respiratory Society (ERS)
Date: 08-01-2016
DOI: 10.1183/23120541.00581-2022
Abstract: Studies investigating lived experiences of patients with COPD raise important concerns about interactions with healthcare professionals. Patients often describe feelings of guilt and shame associated with their COPD and may experience stigma and poor patient experience of care. The aims and objectives of the present study were to systematically scope and synthesise findings from peer-reviewed qualitative studies describing healthcare experiences of patients living with COPD across community care settings. A meta-ethnography was undertaken. Database searches were performed in Ovid MEDLINE, PsychINFO, Ovid Emcare, CINAHL Plus and Sociological Abstracts. Eligible qualitative studies were included. Study screening and data extraction was performed by two independent reviewers. A “line-of-argument” synthesis and deductive and inductive analysis was used to identify key themes, where the deductive element aligned to Wong and Haggerty's six key dimensions of patient experiences. Data from 23 studies were included. Experiences and their meaning to patients were explored within the context of six domains of patient experience including access, interpersonal communication, continuity and coordination, comprehensiveness and trust. Inductive coding revealed emotion, stigma, identity and vulnerability shaped healthcare experiences of adults with COPD. Experiences often fell short of what was expected and needed in community settings. Adopting strategies to improve experiences of care in the community can be expected to improve self-management and contribute to improved health outcomes and quality of life. These strategies should take account of vulnerability, stigma and emotions such as guilt and blame that are potent affective drivers of the experience of care for patients with COPD.
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/02770900802468525
Abstract: Alexithymia is a personality trait associated with difficulty identifying and verbalizing feelings. It has been associated with poorly controlled asthma and near-fatal asthma. The primary objectives were to (1) determine the prevalence of alexithymia in a group of moderate to severe asthmatics who attended an Outpatient Clinic and (2) investigate the relationship between alexithymia and asthma control, management, and communication. Twenty-five moderate to severe asthma patients were recruited from the Royal Adelaide Hospital Outpatient Respiratory Clinic. Participants were either mailed the questionnaire pack or completed it after a clinic appointment. Existing validated questionnaires were used to collect data. The primary outcome measures were alexithymia, asthma control, adherence to medication patient satisfaction with communication with health care providers and health-related quality of life. Data were analyzed using Pearson correlations, linear regression and analysis of variance (ANOVA) in SPSS. A p value <or= 0.05 was required for statistical significance. A total of 11 male (44%) and 14 female (56%) patients with moderate to severe persistent asthma (mean age 44 years +/- 11) participated. Alexithymia scores ranged between 23.0-76.0 (x = 48.3, SD = 13.2) 12% of participants reported high alexithymia scores, 32% reported borderline alexithymia scores, and 56% reported low alexithymia scores. Alexithymia mean scores were not statistically different across sociodemographic variables. A higher alexithymia score was associated with worse asthma control score (r = 0.57, p < 0.01) (where higher asthma control scores indicate worse asthma control) poor adherence (p = 0.03), and worse quality of life (r = - 0.65, p < 0.01). Alexithymia score was not correlated with satisfaction with communication (r = - 0.27, p = 0.2).), or the number of hospitalizations for asthma (p = 0.25). This is the first study to investigate relationships between alexithymia, asthma control, asthma management and communication with health care professionals. The study reaffirms associations between alexithymia and asthma control, but a larger s le size is needed to determine the impact of alexithymia on self-management and provision of clinical care for asthma.
Publisher: Royal College of General Practitioners
Date: 06-06-2023
Abstract: Background: Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol-related Harm (REACH) Project aimed to increase the delivery of BIs in primary care. Aim: The aim of this paper is to assess the effectiveness of the REACH program in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians. Design and Setting: This paper reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia. Method: We conducted time-series analyses using routinely-collected patient records and semi-structured interviews, guided by the Consolidated Framework for Implementation Research. Results: The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%). Conclusion: REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.
Publisher: Wiley
Date: 12-04-2020
DOI: 10.1111/JOCN.15243
Publisher: Informa UK Limited
Date: 10-2011
DOI: 10.1080/07481187.2011.553315
Abstract: A grounded theory study was undertaken to understand how general practitioners (GPs) experience the death of their patients. Eleven GPs participated in semistructured interviews. The participants explained their experience of a patient's death using the "death journey" metaphor. This journey, the Journey with the Dying, could be described from 5 different moments in the participants' encounters with people who are dying: private acknowledgement, communication of prognosis, continuity of care, the moment of death, and looking after the family. Emotional responses for each of the stages, and coping strategies in general, were outlined. GPs' narratives about professional identity, learning about dying and death, and death beliefs were also important in the Journey with the Dying. The experience of death described by the GPs in this study was different from that reported by medical doctors in other care settings. The 5 phases of the Journey with the Dying identified here show the different adjustments and appraisals that GPs undertake to comprehend and to be able to work in the presence of death.
Publisher: SAGE Publications
Date: 02-2017
Abstract: We evaluated whether a chronic obstructive pulmonary disease (COPD) assessment test (CAT) with adjusted weights for the CAT items could better predict future respiratory-related hospitalizations than the original CAT. Two focus groups (respiratory nurses and physicians) generated two adjusted CAT algorithms. Two multivariate logistic regression models for infrequent (≤1/year) versus frequent ( /year) future respiratory-related hospitalizations were defined: one with the adjusted CAT score that correlated best with future hospitalizations and one with the original CAT score. Patient characteristics related to future hospitalizations ( p ≤ 0.2) were also entered. Eighty-two COPD patients were included. The CAT algorithm derived from the nurse focus group was a borderline significant predictor of hospitalization risk (odds ratio (OR): 1.07 95% confidence interval (CI): 1.00–1.14 p = 0.050) in a model that also included hospitalization frequency in the previous year (OR: 3.98 95% CI: 1.30–12.16 p = 0.016) and anticholinergic risk score (OR: 3.08 95% CI: 0.87–10.89 p = 0.081). Presence of ischemic heart disease and/or heart failure appeared ‘protective’ (OR: 0.17 95% CI: 0.05–0.62 p = 0.007). The original CAT score was not significantly associated with hospitalization risk. In conclusion, as a predictor of respiratory-related hospitalizations, an adjusted CAT score was marginally significant (although the original CAT score was not). ‘Previous respiratory-related hospitalizations’ was the strongest factor in this equation.
Publisher: CSIRO Publishing
Date: 22-03-2021
DOI: 10.1071/PY20074
Abstract: We explored patients’ and GPs’ perceptions of an alternative payment system, a Patient-Chosen Gap Payment, where a gap fee is determined by the patient based on their perceived value of the service, including the choice to pay nothing. Semi-structured, in-depth interviews held with GPs (n = 10) and patients (n = 10) were audio-recorded, transcribed and analysed for emerging themes. We found three emergent themes: (1) the cost of quality: health care was difficult to value for both GPs and patients there was belief in universal coverage and the importance of quality, but trade-offs in quality of care were a common perception (2) the doctor–patient relationship: patient-centred care was a common goal and perceived as a good measure of quality care and a way for patients to place a value on the service/care and (3) the business of general practice: participants wanted to see sustainable business models for primary care that incentivised quality of care. A Patient-Chosen Gap Payment (PCGP) funding model could incentivise doctors to provide better care without limiting access to health care. Further research is needed to model real-world application.
Publisher: Wiley
Date: 18-05-2013
DOI: 10.1111/J.1741-6612.2012.00597.X
Abstract: To determine whether older community-dwelling people underestimate their own perceived chance of falling compared with that of other older people (comparative optimism), and whether a history of falls is associated with comparative optimism. A s le of community-dwelling South Australians aged ≥65 years (n= 389) completed a computer-assisted telephone interview about their 12-month fall history, their perceived chance of falling and their rating of other older people's chance of falling. Respondents were comparatively optimistic about their chance of falling (Z =-8.1, P < 0.001). Those who had fallen in the last 12 months had a lower comparative optimism score (Z =-3.0, P < 0.003). As older people were comparatively optimistic about their likelihood of falling, they might not find fall prevention messages relevant. When older people present with a fall, clinicians could provide fall prevention information consistent with how older people present themselves.
Publisher: Springer Science and Business Media LLC
Date: 02-10-2009
Publisher: MDPI AG
Date: 03-02-2018
Publisher: The Royal Australian College of General Practitioners
Date: 05-2021
Publisher: Springer Science and Business Media LLC
Date: 12-2003
DOI: 10.1038/PCRJ.2003.65
Publisher: Springer Science and Business Media LLC
Date: 04-2002
DOI: 10.1007/BF03344008
Publisher: Informa UK Limited
Date: 27-07-2012
DOI: 10.1080/13607863.2012.702730
Abstract: Primary care providers often struggle to identify depression, with patients with multiple chronic conditions presenting additional unique challenges. Whilst the diagnosis and treatment of depression has been explored in a range of contexts in the literature, there is a paucity of information on the impact of multimorbidity on general practitioners (GPs) attempting to diagnose and manage depression in primary care. Eight GPs with multiple referrals to a multidisciplinary clinic engaged in a semi-structured interview to discuss the impact of multimorbidity on the diagnosis and detection of depression. Interviews were transcribed and thematic analysis was used to identify key themes. Grounded theory was generated from data relating to the role of multimorbidity. Participants described multimorbidity as obscuring symptom causation, but also creating time to investigate causation and negotiate the depression diagnosis with the patient, and generating relationship through frequent presentations. Knowledge of the patient impacted on intervention recommendations, and trust facilitated patient receptivity. Treatment was affected by a range of variables, and included medical and social interventions. GP process for multimorbid patients is similar to that of patients with chronic illness. Further research is needed to know whether different processes or diagnostic categories are warranted where multiple chronic illnesses are present. Also, GPs recommend social interventions where medical interventions are perceived as inappropriate. Research into the efficacy of social interventions in multimorbid patients is needed.
Publisher: Wiley
Date: 18-05-2021
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.EXPLORE.2010.03.008
Abstract: This article reports on the processes of staff members in referring patients to a study that explored the experience of palliative patients, family members, and health professionals with the implementation of a family meeting model as an instrument of spiritual care. The reported qualitative study was undertaken in two large metropolitan Australian hospitals. Criteria other than those set by the study protocol were employed by staff members referring patients. These included subjective opinions of who was suitable to refer and perceptions of patients' attitudes to religion or spirituality. Such practices raise ethical issues and may compromise studies that have received ethics approval.
Publisher: Wiley
Date: 19-07-2023
DOI: 10.1002/HPJA.783
Abstract: This cross‐sectional analysis of the Australian 3D study aimed to determine the prevalence of psychological distress and describe its associated characteristics in adults recently diagnosed with type 2 diabetes. Adults (aged 18 years and over) who were recently diagnosed with type 2 diabetes ( months prior) were recruited through the Australian National Diabetes Services Scheme in 2018–2019. Demographic and health data were collected via interview‐administered telephone surveys. Hierarchical regression was used to analyse whether demographic, self‐care and clinical characteristics were associated with psychological distress, as measured by the K10 questionnaire. Of the participants ( n = 223), 26.3% presented with psychological distress, with 8.4% reporting mild, 8.4% reporting moderate and 9.5% reporting severe psychological distress. Neither age, sex, body mass index or taking anti‐depressant medications were associated with the presence of psychological distress ( p .05). Being a smoker, living situation, less physical activity and poorer healthy eating beliefs and intentions were significantly associated with psychological distress in those not taking anti‐depressant medications ( p .05). Being female was significantly associated with psychological distress in those taking anti‐depressant medications ( p .05). The study found that psychological distress is highly prevalent in adults recently diagnosed with type 2 diabetes. Behavioural factors such as smoking and low physical activity, as well as psycho‐social factors such as living situation, poor healthy eating beliefs and intentions were significantly associated with psychological distress. This has implications for the management of people with newly diagnosed type 2 diabetes. Psychological distress is highly prevalent in Australian adults newly diagnosed with type 2 diabetes, emphasising the urgent need for enhanced psychological care to support this group.
Publisher: Oxford University Press (OUP)
Date: 25-10-2021
Publisher: Royal College of General Practitioners
Date: 2021
Abstract: Electronic cigarettes (e-cigarettes) are being marketed to people who smoke (PWS) as a smoking cessation aid. GPs have an important role in providing patients with support to encourage them to quit smoking. The emergence and marketing of e-cigarettes as a smoking cessation alternative poses challenges to GPs in advising and supporting PWS to quit. This systematic review aims to synthesise available evidence on the knowledge, attitudes, and perceptions of GPs about e-cigarettes as a smoking cessation aid. Mixed-methods study review including quantitative, qualitative, and mixed-methods studies of GPs in primary care settings. MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus, PsycINFO, and Embase databases will be searched to identify articles published between 1 January 2003 and 30 June 2021. A Google search will be conducted to identify grey literature. Two independent reviewers will screen abstracts for relevance and full-text studies. Articles will be appraised for quality using the Mixed Methods Appraisal Tool (MMAT) and a Preferred Reporting Items for Systematic Reviews, and Meta-Analysis (PRISMA) diagram will illustrate the flow of articles and reasons for exclusion. An evidence synthesis method will be employed and guided by the Theory of Planned Behaviour (TPB). A descriptive qualitative synthesis of the findings will be reported. Findings will provide a synthesis of current evidence regarding the knowledge, attitudes, and perceptions among GPs of e-cigarettes as a smoking cessation aid. This information will be useful to guide future research on the needs of GPs in advising and supporting patients to quit smoking. It will also assist in the development of health policy and guidelines on the role and place of e-cigarettes as a smoking cessation aid.
Publisher: BMJ
Date: 10-2019
DOI: 10.1136/BMJOPEN-2019-030581
Abstract: Chronic conditions are associated with over one-third of potentially avoidable hospitalisations. Integrated care programmes aim to help people with chronic conditions to self-manage their health, thus avoiding hospital admissions. While founded on principles of person-centred care, the experiences of people with multiple chronic conditions in integrated care programmes are not widely known. Our study will explore how person-centred care is incorporated into an integrated care programme for people with multiple chronic conditions. This is a qualitative phenomenological study being conducted from March 2018 to June 2019, in a large metropolitan health service in Melbourne, Australia. Participants will be programme clients (and/or their carers) and staff working in the programme. We will interview staff about their experiences of the programme. Recruited staff will assist with recruitment of clients who recently completed an episode of care, to participate in a semistructured interview in their home. We will also analyse the medical records of interviewed clients, and observe outpatient clinics connected to the programme, based on the findings of the interviews. We will analyse all data using thematic analysis, with overarching themes representing staff and client perspectives of person-centred care. Ethical approval was granted by Monash Health (HREC/18/MonH/33) and Monash University (12260) Human Research Ethics Committees. Our study will provide a comprehensive exploration of person-centred care in an integrated care programme. It will add information to person-centred care literature on participants’ perceptions of what works and why, including barriers and enablers to person-centred care in a complex environment. Findings of this study will be disseminated via publications, conferences and presentations to the health service participants.
Publisher: Scientific Research Publishing, Inc.
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 29-08-2019
Publisher: Ubiquity Press, Ltd.
Date: 29-11-2007
DOI: 10.5334/IJIC.216
Publisher: Springer Science and Business Media LLC
Date: 09-2009
DOI: 10.1057/JPHP.2009.21
Abstract: We use the literature reporting prevalence and aetiology of post-traumatic stress disorder (PTSD) in first responders as a catalyst to discuss for organisations the policy implications for prevention and intervention of psychiatric morbidity. We searched PubMed and Google to identify studies and reports of mental health and behavioural problems in occupations including police, fire, and emergency service workers. The prevalence of PTSD ranged from 6 per cent to 32 per cent. Biological markers of PTSD, such as neuroendocrine activity, appear less useful than psychological markers, such as levels of hostility and self-efficacy, to predict PTSD. Prevalence of PTSD was generally less than that found among victims themselves, but higher than general community prevalence. Theoretically, if prevention and intervention strategies were working effectively, there should be a minimal rate of psychiatric morbidity attributable to these in iduals' workplaces. Against this background, there is a case for routine screening on an annual basis for those at risk.
Publisher: The Royal Australian College of General Practitioners
Date: 04-2023
Publisher: Springer Science and Business Media LLC
Date: 03-06-2009
Publisher: AMPCo
Date: 11-2005
DOI: 10.5694/J.1326-5377.2005.TB07181.X
Abstract: The Care and Prevention Programme (CPP) began in 1998. It is based on the philosophy of primary health care, and has improved health among homosexually active men, including about a third of HIV-positive South Australians. The CPP was assessed using financial analysis and qualitative methods. Participants wanted to access care where they could feel comfortable and safe to talk about issues of sexuality and lifestyle. The CPP model is "economically" sustainable, but not "financially" sustainable within the Medicare Benefits Schedule. It is vulnerable to changes in political environment. The financing model for the CPP has been adapted by including state funding. General practitioners have adapted by lowering their personal incomes (but not quality of care). These adaptations have achieved fragile financial viability. Facilitators of sustainability for the CPP included: It is part of the community that it serves The creation of deeply integrated networks of ersity-competent service providers and "Virtuous non-adaptability" of service providers in refusing to compromise care standards despite financial pressure to do so. Threats to sustainability included: Difficulty maintaining a ersity-competent workforce skilled in HIV medicine Marginal financial viability and Political vulnerability.
Publisher: Oxford University Press (OUP)
Date: 04-2010
DOI: 10.7205/MILMED-D-09-00287
Abstract: The objectives of this study were to determine the prevalence of smoking, identify the effects of deployment on smoking behavior and risk factors for smoking, and determine the short-term health outcomes associated with smoking in Australian Defence Force (ADF) personnel. Participants were randomly s led from ADF members who deployed to the Solomon Islands between 2003 and 2005 and from a nondeployed comparison group. In total, 435 of 995 (44%) eligible in iduals completed the study questionnaires. The prevalence of current smoking was highest in those who had completed less formal education and those who served in the Navy. Nearly two-thirds (63%) of current or former smokers smoked more while on overseas deployment. Current smokers were more likely to report current wheeze, shortness of breath, and persistent cough compared with nonsmokers. The ADF should continue to address cigarette smoking through its health promotion and health review programs and implement activities to reduce cigarette smoking on deployment.
Publisher: FapUNIFESP (SciELO)
Date: 1
Publisher: InTech
Date: 27-04-2012
DOI: 10.5772/38470
Start Date: 12-2020
End Date: 06-2024
Amount: $508,220.00
Funder: Australian Research Council
View Funded Activity