ORCID Profile
0000-0002-2165-5917
Current Organisations
University of Cambridge
,
Tropical Australian Academic Health Centre
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Publisher: BMJ
Date: 04-2014
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-037327
Abstract: Clinical practice guidelines (CPGs) are intended to optimise patient care by recommending care pathways based on the best available research evidence and practice experience. Patient and public involvement (PPI) in healthcare is recommended based on the expectation that it will improve the quality and relevance of outcomes. There is no consensus on what constitutes meaningful and effective PPI in CPG. We will conduct a scoping review to identify and synthesise knowledge in four key areas: who have been the patients and public previously involved in CPG development, how were they recruited, at what stage in the CPG process were they involved and how were they involved. This knowledge will inform a general model of PPI in CPG to inform CPGs development. We will conduct a scoping review using the Methodology for Scoping Reviews refined by the Joanna Briggs Institute. Searches will be conducted in electronic databases (PubMed, Embase, CINAHL and PsycINFO). National standards for developing CPGs from Australia, UK, Canada and the USA will also be identified. A forward and backward citation search will be conducted on the included studies and national standards. Abstracts and full-text studies will be independently screened by two researchers. Extracted data will include study details, type of clinical guideline and the four key areas, which patients and public were involved, how were they recruited, at what stage were they included and how they were involved. Data will be narratively synthesised. As a scoping review, this study does not require ethics approval. We intend to disseminate the results through publication in a peer-reviewed journal and conference presentations. Furthermore, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.
Publisher: JMIR Publications Inc.
Date: 02-08-2020
Abstract: imely and effective contact tracing is an essential public health measure for curbing the transmission of COVID-19. App-based contact tracing has the potential to optimize the resources of overstretched public health departments. However, its efficiency is dependent on widespread adoption. his study aimed to investigate the uptake of the Australian Government’s COVIDSafe app among Australians and examine the reasons why some Australians have not downloaded the app. n online national survey, with representative quotas for age and gender, was conducted between May 8 and May 11, 2020. Participants were excluded if they were a health care professional or had been tested for COVID-19. f the 1802 potential participants contacted, 289 (16.0%) were excluded prior to completing the survey, 13 (0.7%) declined, and 1500 (83.2%) participated in the survey. Of the 1500 survey participants, 37.3% (n=560) had downloaded the COVIDSafe app, 18.7% (n=280) intended to do so, 27.7% (n=416) refused to do so, and 16.3% (n=244) were undecided. Equally proportioned reasons for not downloading the app included privacy (165/660, 25.0%) and technical concerns (159/660, 24.1%). Other reasons included the belief that social distancing was sufficient and the app was unnecessary (111/660, 16.8%), distrust in the government (73/660, 11.1%), and other miscellaneous responses (eg, apathy and following the decisions of others) (73/660, 11.1%). In addition, knowledge about COVIDSafe varied among participants, as some were confused about its purpose and capabilities. or the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.
Publisher: Cold Spring Harbor Laboratory
Date: 29-07-2020
DOI: 10.1101/2020.07.27.20163204
Abstract: Public cooperation to practice preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies. An online cross-sectional survey conducted May 8 to May 11 2020. A national s le of 1500 Australian adults with representative quotas for age and gender provided by online panel provider. Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Most participants correctly identified “washing your hands regularly with soap and water” (92%) and “staying at least 1.5m away from others” (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them contracting COVID-19. Views about face masks were ided. Only 66% of participants correctly identified that “regular use of antibiotics” would not prevent COVID-19. Most participants (90%) identified “fever, fatigue and cough” as indicators of COVID-19. However, 42% of participants thought that being unable to “hold your breath for 10 seconds without coughing” was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%), and the Australian Government COVID-19 information app (31%). Public messaging about hand hygiene and physical distancing to prevent transmission appear to have been effective. However, there are clear, identified barriers for many in iduals that have the potential to impede uptake or maintenance of these behaviours in the long-term. Currently these non-drug interventions are our only effective strategy to combat this pandemic. Ensuring ongoing adherence to is critical. The current strategies to prevent the transmission of COVID-19 are behavioural (hand hygiene, physical distancing, quarantining and testing if symptomatic) and rely on the public knowledge and subsequent practice of these strategies. Previous research has demonstrated a good level of public knowledge of COVID-19 symptoms and preventive behaviours but a wide variation in practicing the recommended behaviours. Although knowledge can facilitate behaviour change, knowledge alone is insufficient to reliably change behaviour to the widespread extent require to combat health crises. Participants reveal confusion about whether wearing masks will reduce transmission, apprehension about attending health services, and perceptions that antibiotics and alternative remedies (such as essential oils) prevent transmission. Analysis of why participants hold these beliefs revealed two dominant themes: an incomplete or inaccurate understanding of how COVID-19 is transmitted, and the belief that the behaviours were unnecessary. This study underlines the necessity to not only target public messaging at effective preventative behaviours, but enhance behaviour change by clearly explaining why each behaviour is important.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.BRAT.2021.104016
Abstract: This paper examines the efficacy of a universally-offered parenting program, Tuning in to Toddlers (TOTS), that aims to improve parent emotion socialization, reduce parent and toddler stress and improve social, emotional, and behavioral functioning in toddlers. Three hundred parents of an 18-36 month old toddler were cluster randomized into intervention or control. Parents in the intervention participated in 6 × 2 h group sessions of TOTS. Baseline and 12-months post-intervention measures were collected using parent-report questionnaires and hair s les from parents and toddlers of systemic cortisol stress. Compared to controls, intervention parents reported significantly greater reductions in difficulties in emotion regulation (difficulty remaining goal directed: 95% CI.10, 1.71, p = .028 lack of access to strategies: 95% CI 0.62, 2.42, p = .001), emotion dismissing (beliefs: 95% CI 2.33,4.82, p < .001 behaviors: 95% CI 0.32, 0.65, p = <.001), greater increase in empathy (95% CI -2.83, -1.50, p < .001), emotion coaching (beliefs: 95% CI -2.56, -0.27, p = .016 behaviors: 95% CI -0.58, -0.24, p = <.001), children's behavior (95% CI 0.19, 2.43, p = .022) and competence (95% CI -1.46, -0.22, p = .008). Significant greater reductions in systemic cortisol were found for intervention but not control children (95% CI 0.01, 0.35, p = .041). Findings provide preliminary support for the use of TOTS as a universal prevention program to improve parent emotion socialization and children's functioning. Trial Registration: Australian and New Zealand Clinical Trials Registry: ACTRN12615000962538.
Publisher: Wiley
Date: 20-03-2017
DOI: 10.1111/DME.13340
Abstract: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with in idual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA Group-based education interventions are more effective than usual care, waiting list control and in idual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2021
DOI: 10.1161/CIRCOUTCOMES.120.007160
Abstract: Recent US guidelines lowered the threshold for diagnosing hypertension while other international guidelines use alternative/no labels for the same group (blood pressure [BP], /90 mm Hg). We investigated potential benefits and harms of hypertension and high-normal BP labels, compared with control, among people at lower risk of cardiovascular disease. We conducted a randomized experiment using a national s le of Australians (n=1318) 40 to 50 years of age recruited from an online panel. Participants were randomized to 1 of 3 hypothetical scenarios where a general practitioner told them they had a BP reading of 135/85 mm Hg, using either hypertension/high-normal BP/control (general BP description) labels. Participants were then randomized to receive an additional absolute risk description or nothing. Primary outcomes were willingness to change diet and worry. Secondary outcomes included exercise/medication intentions, risk perceptions, and other psychosocial outcomes. There was no difference in willingness to change diet across label groups ( P =0.22). The hypertension label (mean difference [MD], 0.74 [95% CI, 0.41–1.06] P .001) and high-normal BP label (MD, 0.45 [95% CI, 0.12–0.78] P =0.008) had increased worry about cardiovascular disease risk compared with control. There was no evidence that either label increased willingness to exercise ( P =0.80). However, the hypertension (MD, 0.20 [95% CI, 0.04–0.36] P =0.014), but not high-normal label (MD, 0.06 [95% CI, −0.10 to 0.21] P =0.49), increased willingness to accept BP-lowering medication compared with control. Psychosocial differences including lower control, higher risk perceptions, and more negative affect were found for the hypertension and high-normal labels compared with control. Providing absolute risk information decreased willingness to change diet (MD, 0.25 [95% CI, 0.10–0.41] P =0.001) and increase exercise (MD, 0.28 [95% CI, 0.11–0.45] P =0.001) in the hypertension group. Neither hypertension nor high-normal labels motivated participants to change their diet or exercise more than control, but both labels had adverse psychosocial outcomes. Labeling people with systolic BP of 130 to 140 mm Hg, who are otherwise at low risk of cardiovascular disease, may cause harms that outweigh benefit. URL: www.anzctr.org.au/ Unique identifier: ACTRN12618001700224.
Publisher: Wiley
Date: 21-06-2021
DOI: 10.1111/HEX.13286
Abstract: Current guidelines recommend that patients attending general practice should be screened for excess weight, and provided with weight management advice. This study sought to elicit the views of people with overweight and obesity about the role of GPs in initiating conversations about weight management. Participants with a body mass index ≥25 were recruited from a region in Australia to take part in a Community Jury. Over 2 days, participants (n = 11) deliberated on two interconnected questions: ‘Should GPs initiate discussions about weight management?’ And ‘if so, when: (a) opportunistically, (b) in the context of disease prevention, (c) in the context of disease management or (d) other?’ The jury deliberations were analysed qualitatively to elicit their views and recommendations. The jury concluded GPs should be discussing weight management, but within the broader context of general health. The jury were ided about the utility of screening. Jurors felt GPs should initiate the conversation if directly relevant for disease prevention or management, otherwise GPs should provide opportunities for patients to consent to the issue being raised. The jury's verdict suggests informed people affected by overweight and obesity believe GPs should discuss weight management with their patients. GPs should feel reassured that discussions are likely to be welcomed by patients, particularly if embedded within a more holistic focus on person‐centred care. Members of the public took part in the conduct of this study as jurors, but were not involved in the design, analysis or write‐up.
Publisher: Wiley
Date: 29-07-2020
DOI: 10.1111/CODI.15235
Abstract: We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay 14 days (LOS), major complication rates at 30 days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS 14 days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods.
Publisher: Wiley
Date: 03-02-2019
DOI: 10.1111/HEX.12871
Publisher: Elsevier BV
Date: 09-2021
Publisher: Wiley
Date: 2011
DOI: 10.1111/J.1467-8624.2010.01548.X
Abstract: In a randomized controlled trial, the effectiveness of Parent-Child Interaction Therapy (PCIT) and correlates of maltreatment outcomes were examined. Mothers (N = 150) had a history or were at high risk of maltreating their children. After 12 weeks and compared to waitlist, PCIT mothers were observed to have improved parent-child interactions and reported better child behavior and decreased stress. At PCIT completion, improvements continued and mothers reported less child abuse potential and had improved maternal sensitivity. Also, PCIT completers were less likely to be notified to child welfare than noncompleters. Finally, those families not notified post-PCIT showed greater reductions in child abuse potential and improvements in observed sensitivity during treatment. Implications for theory and practice are discussed.
Publisher: Informa UK Limited
Date: 06-07-2018
DOI: 10.1080/15374416.2018.1479966
Abstract: Children with co-occurring conduct problems and callous-unemotional (CU) traits show a distinct pattern of early starting, chronic, and aggressive antisocial behaviors that are resistant to traditional parent-training interventions. The aim of this study was to examine in an open trial the acceptability and initial outcomes of a novel adaptation of Parent-Child Interaction Therapy, called PCIT-CU, designed to target 3 distinct deficits of children with CU traits. Twenty-three Australian families with a 3- to 6-year-old (M age = 4.5 years, SD = .92) child with clinically significant conduct problems and CU traits participated in the 21-week intervention and 5 assessments measuring child conduct problems, CU traits, and empathy at a university-based research clinic. Treatment retention was high (74%), and parents reported a high level of satisfaction with the program. Results of linear mixed models indicated that the intervention produced decreases in child conduct problems and CU traits, and increases in empathy, with "medium" to "huge" effect sizes (ds = 0.7-2.0) that maintained at a 3-month follow-up. By 3 months posttreatment, 75% of treatment completers no longer showed clinically significant conduct problems relative to 25% of dropouts. Findings provide preliminary support for using the targeted PCIT-CU adaptation to treat young children with conduct problems and co-occurring CU traits.
Publisher: IOP Publishing
Date: 16-08-2022
Abstract: Cone-beam computed tomography (CBCT) imaging is becoming increasingly important for a wide range of applications such as image-guided surgery, image-guided radiation therapy as well as diagnostic imaging such as breast and orthopaedic imaging. The potential benefits of non-circular source-detector trajectories was recognized in early work to improve the completeness of CBCT s ling and extend the field of view (FOV). Another important feature of interventional imaging is that prior knowledge of patient anatomy such as a preoperative CBCT or prior CT is commonly available. This provides the opportunity to integrate such prior information into the image acquisition process by customized CBCT source-detector trajectories. Such customized trajectories can be designed in order to optimize task-specific imaging performance, providing intervention or patient-specific imaging settings. The recently developed robotic CBCT C-arms as well as novel multi-source CBCT imaging systems with additional degrees of freedom provide the possibility to largely expand the scanning geometries beyond the conventional circular source-detector trajectory. This recent development has inspired the research community to innovate enhanced image quality by modifying image geometry, as opposed to hardware or algorithms. The recently proposed techniques in this field facilitate image quality improvement, FOV extension, radiation dose reduction, metal artifact reduction as well as 3D imaging under kinematic constraints. Because of the great practical value and the increasing importance of CBCT imaging in image-guided therapy for clinical and preclinical applications as well as in industry, this paper focuses on the review and discussion of the available literature in the CBCT trajectory optimization field. To the best of our knowledge, this paper is the first study that provides an exhaustive literature review regarding customized CBCT algorithms and tries to update the community with the clarification of in-depth information on the current progress and future trends.
Publisher: Springer Science and Business Media LLC
Date: 02-2014
DOI: 10.1007/S10488-013-0471-Y
Abstract: The extent evidence-based treatments (EBTs) are used in clinical practice within the Australian therapeutic child welfare sector is unknown. In this study, we investigated practitioners' knowledge, attitudes, and use of EBT when providing interventions to children and families and how the intended outcomes of interventions are evaluated. Practitioners (N = 112) from 41 non-government organizations were surveyed and reported few barriers to implementing EBTs and positive attitudes. While just over half the practitioners surveyed provided an accurate definition of EBT, 72 % of practitioners reported using EBTs in their clinical practice. Of those, 88 % reported modifying the EBT, however interventions were rarely evaluated systematically. Implications for the use of EBTs, how they are modified, and the role of systematic evaluation are discussed.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2007
DOI: 10.1007/S10802-007-9104-9
Abstract: We conducted a review and meta-analyses of 24 studies to evaluate and compare the outcomes of two widely disseminated parenting interventions-Parent-Child Interaction Therapy and Triple P-Positive Parenting Program. Participants in all studies were caregivers and 3- to 12-year-old children. In general, our analyses revealed positive effects of both interventions, but effects varied depending on intervention length, components, and source of outcome data. Both interventions reduced parent-reported child behavior and parenting problems. The effect sizes for PCIT were large when outcomes of child and parent behaviors were assessed with parent-report, with the exclusion of Abbreviated PCIT, which had moderate effect sizes. All forms of Triple P had moderate to large effects when outcomes were parent-reported child behaviors and parenting, with the exception of Media Triple P, which had small effects. PCIT and an enhanced version of Triple P were associated with improvements in observed child behaviors. These findings provide information about the relative efficacy of two programs that have received substantial funding in the USA and Australia, and findings should assist in making decisions about allocations of funding and dissemination of these parenting interventions in the future.
Publisher: Springer Science and Business Media LLC
Date: 07-02-2020
DOI: 10.1186/S12884-020-2745-1
Abstract: Gestational diabetes mellitus (GDM) - a transitory form of diabetes induced by pregnancy - has potentially important short and long-term health consequences for both the mother and her baby. There is no globally agreed definition of GDM, but definition changes have increased the incidence in some countries in recent years, with some research suggesting minimal clinical improvement in outcomes. The aim of this qualitative systematic review was to identify the psychosocial experiences a diagnosis of GDM has on women during pregnancy and the postpartum period. We searched CINAHL, EMBASE, MEDLINE and PsycINFO databases for studies that provided qualitative data on the psychosocial experiences of a diagnosis of GDM on women across any stage of pregnancy and/or the postpartum period. We appraised the methodological quality of the included studies using the Critical Appraisal Skills Programme Checklist for Qualitative Studies and used thematic analysis to synthesis the data. Of 840 studies identified, 41 studies of erse populations met the selection criteria. The synthesis revealed eight key themes: initial psychological impact communicating the diagnosis knowledge of GDM risk perception management of GDM burden of GDM social support and gaining control. The identified benefits of a GDM diagnosis were largely behavioural and included an opportunity to make healthy eating changes. The identified harms were emotional, financial and cultural. Women commented about the added responsibility (eating regimens, appointments), financial constraints (expensive food, medical bills) and conflicts with their cultural practices (alternative eating, lack of information about traditional food). Some women reported living in fear of risking the health of their baby and conducted extreme behaviours such as purging and starving themselves. A diagnosis of GDM has wide reaching consequences that are common to a erse group of women. Threshold cut-offs for blood glucose levels have been determined using the risk of physiological harms to mother and baby. It may also be advantageous to consider the harms and benefits from a psychosocial and a physiological perspective. This may avoid unnecessary burden to an already vulnerable population.
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2020-037283
Abstract: Examining patient and public understanding of overtesting and overdiagnosis (OverTD) is vital for reducing the burden of OverTD. Studies from disparate contexts, disciplines and focusing on disparate healthcare issues have examined patient and public understanding of OverTD. A synthesis is needed to bring this literature together, examine common themes, strengthen conclusions and identify gaps. This will help steer further research, policy and practice to improve patient and public understanding of OverTD. The objective of this study is to synthesise qualitative research data about patient and public understanding of OverTD. A thematic meta-synthesis will be used to synthesise primary qualitative research and qualitative components of primary mixed-methods research about patient and public understanding of OverTD. Studies published in English will be included. These will be identified using systematic searches from inception to March 2020 in the Scopus, CINAHL, PsycINFO and MEDLINE databases. Studies that satisfy eligibility criteria will be assessed for methodological quality using the Critical Appraisal Skills Programme (CASP) checklist. Thematic meta-synthesis will comprise three stages: (1) line-by-line coding (2) generation of descriptive themes and (3) generation of analytic themes. Confidence in the synthesis findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence (GRADE CERQual) approach. A summary of GRADE CERQual results will be presented alongside the key themes. Study eligibility screening, data extraction, analysis and the CASP and GRADE CERQual assessments will be undertaken independently by two review authors. Ethics approval is not required for this secondary analysis of published data. The results will be disseminated in peer-reviewed journals and may be presented in conference papers and elsewhere. CRD42020156838
Publisher: Queensland University of Technology
Date: 13-07-2023
DOI: 10.5204/SSJ.2874
Abstract: Aboriginal and Torres Strait Islander students continue to experience racism in Australian university classrooms. The Reconciliation Australia Barometer report (2022, p. 5) recently noted that experiences of racial prejudice have increased for Indigenous people with 60% of Indigenous people who responded to the survey experiencing at least one form of racial prejudice in the past six months. Many universities are attempting to implement action against racism and there have been concerted efforts to Indigenise curriculum across numerous universities. But there are many challenges and complexities to this process and more work is needed to increase cultural competency of university staff and students. This article explores findings from a National Centre for Student Equity in Higher Education (NCSEHE) funded project that focused on “what works” to support Indigenous students to complete their degrees. This article draws on data from interviews with graduates that highlight the perceived experiences of racism in the classroom from peers and staff and the need for further Indigenisation of the curriculum to improve Indigenous student completion rates. The article concludes by discussing recommendations for universities to create a safer environment for Indigenous students. These recommendations echo previous ones (e.g., Behrendt et al., 2012) yet they have not yet been adequately addressed by universities.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2019
Publisher: AMPCo
Date: 04-2015
DOI: 10.5694/MJA14.01606
Publisher: SAGE Publications
Date: 08-2012
Abstract: It is common practice to augment efficacious treatment protocols for special populations (Durlak & DuPre, 2008), but this is often done before establishing that standard services are not appropriate. In this randomized controlled trial with families at risk or with a history of maltreatment ( N = 151), we investigated the effectiveness of standard 12-session Parent–Child Interaction Therapy (PCIT). This is in contrast to other PCIT studies with similar parents, which have allowed for longer and sometimes variable treatment length and with modifications to PCIT protocol. After treatment and compared to Waitlist, mothers reported fewer child externalizing and internalizing behaviors, decreased stress, and were observed to have more positive verbalizations and maternal sensitivity. These outcomes were equivalent or better than outcomes of our previous PCIT trial with high-risk families (Thomas & Zimmer-Gembeck, 2011) when treatment length was variable and often longer. These findings support standard protocol PCIT as an efficacious intervention for families in the child welfare system.
Publisher: Cold Spring Harbor Laboratory
Date: 09-06-2020
DOI: 10.1101/2020.06.09.20126110
Abstract: Timely and effective contact tracing is an essential public health role to curb the transmission of COVID-19. App-based contact tracing has the potential to optimise the resources of overstretched public health departments. However, it’s efficiency is dependent on wide-spread adoption. We aimed to identify the proportion of people who had downloaded the Australian Government COVIDSafe app and examine the reasons why some did not. An online national survey with representative quotas for age and gender was conducted between May 8 and May 11 2020. Participants were excluded if they were a healthcare professional or had been tested for COVID-19. Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Of survey participants, 37% had downloaded the COVIDSafe app, 19% intended to, 28% refused, and 16% were undecided. Equally proportioned reasons for not downloading the app included privacy (25%) and technical concerns (24%). Other reasons included a belief that social distancing was sufficient and the app is unnecessary (16%), distrust in the Government (11%), and apathy (11%). In addition, COVIDSafe knowledge varied with confusion about its purpose and capabilities. For the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of its citizens, specifically in regards to privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives such as download and correct use.
Publisher: SAGE Publications
Date: 18-11-2013
Abstract: The same stressor can evoke different emotions across in iduals, and emotions can prompt certain coping responses. Responding to four videotaped interpersonal stressors, adolescents ( N = 230, [Formula: see text] = 10 years) reported their sadness, fear and anger, and 12 coping strategies. After identifying emotion patterns using cluster analysis, associations with coping were examined. Intensity of emotion, and emotion and stressor type were associated with coping. Adolescents with intense emotions (i.e., highly sad, afraid, and angry) anticipated using more of most coping responses, whereas diffuse but moderate intensity emotion was associated with more active coping relative to other strategies. Anger was associated with less passive and more opposition coping. However, the expected coping clusters and patterns for fear and sadness were not found no cluster of adolescents was intensely fearful or sad only. Support seeking and opposition were more common for peer-related stress, and active withdrawal was more common for parent-related stress.
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.INFBEH.2010.07.004
Abstract: Because infants and toddlers are particularly susceptible to parents' socialization efforts, the purpose of this 2-year longitudinal study (N=4271 infants) was to forecast toddlers' competence and problems (adaptational outcomes, age M=30 months) from parenting experiences when they were infants (age M=9 months). Using structural equation modeling and data from a nationally representative s le, parenting during infancy was important to toddlers' adaptational outcomes, with parenting warmth most strongly connected to toddler competence and parenting hostility most strongly connected to toddler problems. Additionally, toddlers' outcomes were associated with their parents' mental health symptoms, life difficulty, coping and self-efficacy when measured 2 years earlier (parent context), and parenting warmth and hostility mediated some of these associations. These pathways indicated that the infant parenting context had some spill over effect on toddlers via parental warmth and hostility. However, mediational paths were not as common as expected, suggesting that the parent context had more direct than indirect effects on toddlers. Conclusions were similar even after accounting for infant temperament, family demographic characteristics and infant birthweight, with substantial reductions in effects only found for associations of parenting self-efficacy with toddlers' outcomes.
Publisher: JMIR Publications Inc.
Date: 04-11-2020
DOI: 10.2196/23081
Abstract: Timely and effective contact tracing is an essential public health measure for curbing the transmission of COVID-19. App-based contact tracing has the potential to optimize the resources of overstretched public health departments. However, its efficiency is dependent on widespread adoption. This study aimed to investigate the uptake of the Australian Government’s COVIDSafe app among Australians and examine the reasons why some Australians have not downloaded the app. An online national survey, with representative quotas for age and gender, was conducted between May 8 and May 11, 2020. Participants were excluded if they were a health care professional or had been tested for COVID-19. Of the 1802 potential participants contacted, 289 (16.0%) were excluded prior to completing the survey, 13 (0.7%) declined, and 1500 (83.2%) participated in the survey. Of the 1500 survey participants, 37.3% (n=560) had downloaded the COVIDSafe app, 18.7% (n=280) intended to do so, 27.7% (n=416) refused to do so, and 16.3% (n=244) were undecided. Equally proportioned reasons for not downloading the app included privacy (165/660, 25.0%) and technical concerns (159/660, 24.1%). Other reasons included the belief that social distancing was sufficient and the app was unnecessary (111/660, 16.8%), distrust in the government (73/660, 11.1%), and other miscellaneous responses (eg, apathy and following the decisions of others) (73/660, 11.1%). In addition, knowledge about COVIDSafe varied among participants, as some were confused about its purpose and capabilities. For the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2021-055428
Abstract: Organisations that develop clinical practice guidelines (CPGs) encourage involvement of patients and the publics in their development, however, there are no standard methodologies for doing so. To examine how CPGs report patient and public involvement (PPI), we conducted a scoping review of the evidence addressing the following four questions: (1) who are the patients and publics involved in developing the CPG? (2) from where and how are the patients and publics recruited? (3) at what stage in the CPG development process are the patients and publics involved? and (4) how do the patients and publics contribute their views? We also extracted data on the use of PPI reporting checklists by the included studies. We used the methodology developed by Arksey and O’Malley and refined by the Joanna Briggs Institute. We searched PubMed, Embase, CINAHL and PsycINFO, websites of national guideline bodies from the UK, Canada, Australia and the USA, and conducted a forward citation search. No language, date or participant demographics restrictions were applied. Data were synthesised narratively. We included 47 studies addressing 1 or more of the 4 questions. All included studies reported who the patient and publics involved (PPI members) were, and several studies reported PPI members from different groups. Patients were reported in 43/47 studies, advocates were reported in 22/47 studies, patients and advocates reported in 17/47 studies, and general public reported in 2/47 studies. Thirty-four studies reported from where the patients and publics were recruited, with patient groups being the most common (20/34). Stage of involvement was reported by 42/47 studies, most commonly at question identification (26/42) and draft review (18/42) stages. Forty-two studies reported how the patients contributed, most commonly via group meetings (18/42) or in idual interviews. Ten studies cited or used a reporting checklist to report findings. Our scoping review has revealed knowledge gaps to inform future research in several ways: replication, terminology and inclusion. First, no standard approach to PPI in CPG development could be inferred from the research. Second, inconsistent terminology to describe patients and publics reduces clarity around which patients and publics have been involved in developing CPGs. Finally, the under-representation of research describing PPI in the development of screening, as opposed to treatment, CPGs warrants further attention.
Publisher: Center for Open Science
Date: 23-01-2023
Abstract: The primary objective of this trial is to estimate the effectiveness of audit and feedback for reducing requests for 10 commonly overused combinations of pathology tests by high-requesting Australian general practitioners (GPs) compared with no intervention control. This includes requests for any combination of 2 or 3 pathology tests for Iron Studies, Thyroid Stimulating Hormone, Thyroid Function Tests, Vitamin D and Vitamin B12. A secondary objective is to evaluate which forms of audit and feedback are most effective in reducing overuse of the pathology test combinations.This 2x2x2 factorial cluster randomised controlled trial allocated clusters of general practices based on geographical location with at least one GP who was in the top 10% of requesters for 10 targeted combinations of pathology tests and for at least 2 of the in idual pathology test combinations between 1 July 2019 to 30 June 2021. Only high-requesting GPs within participating practices were included. The trial will be conducted between 12 May 2022 and 11 May 2023, with final follow-up on 11 August 2023.Eligible clusters were simultaneously randomised on 12 May 2022 to 1 of 8 different in idualised written audit and feedback interventions that varied factorially by (1) invitation to participate in CPD-accredited education (yes vs no), (2) provision of cost information on pathology test combinations (yes vs no), and (3) format of feedback (p hlet vs letter) or to a no intervention control. Participants were not blinded to allocation. The primary outcome is the overall rate of requesting of any of the displayed combinations of pathology tests by each GP per 1,000 category 1 consultations over 6 months using routinely collected Medicare Benefits Schedule data. Primary analyses will include all randomised GPs who have at least one category 1 consultation during the 12-month study period and will be conducted by statisticians blinded to group allocation.
Publisher: BMJ
Date: 05-2018
Publisher: Wiley
Date: 23-02-2020
DOI: 10.1111/HEX.13036
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1016/J.CHIABU.2013.02.003
Abstract: Children who have experienced maltreatment can often display behavioral difficulties their parents may lack disciplinary knowledge, be less sensitive to their children, and engage in coercive parenting practices. Parent-child interaction therapy (PCIT) is a well-known, evidence-based treatment (EBT) for child behavior problems and within the last decade has garnered significant evidence to suggest its utility for parents engaged in child maltreatment. This article uses a case ex le to describe PCIT treatment phases and PCIT research within the child maltreatment sector is synthesized with particular focus on treatment modifications. Successful augmentations and modifications include a motivation component, keeping therapeutic time shorter rather than longer, and whether to incorporate in idual counseling and in-home PCIT are also considered. Practical strategies from both a therapeutic and research experience are discussed.
Publisher: Public Library of Science (PLoS)
Date: 26-10-2020
Publisher: Frontiers Media SA
Date: 16-05-2019
Publisher: Wiley
Date: 12-03-2019
DOI: 10.1111/HEX.12880
Publisher: Informa UK Limited
Date: 28-09-2023
Publisher: AMPCo
Date: 10-2015
DOI: 10.5694/MJA15.00164
Abstract: To elicit the views of well informed community members on the ethical obligations of general practitioners regarding prostate-specific antigen (PSA) testing, and what should be required before a man undergoes a PSA test. Three community juries held at the University of Sydney over 6 months in 2014. Forty participants from New South Wales, of erse social and cultural backgrounds and with no experience of prostate cancer, recruited through public advertising: two juries of mixed gender and ages one all-male jury of PSA screening age. In contrast to Royal Australian College of General Practitioners guidelines, the three juries concluded that GPs should initiate discussions about PSA testing with asymptomatic men over 50 years of age. The mixed juries voted for GPs offering detailed information about all potential consequent benefits and harms before PSA testing, and favoured a cooling-off period before undertaking the test. The all-male jury recommended a staggered approach to providing information. They recommended that written information be available to those who wanted it, but eight of the 12 jurors thought that doctors should discuss the benefits and harms of biopsy and treatment only after a man had received an elevated PSA test result. Informed jury participants preferred that GPs actively supported in idual men in making decisions about PSA testing, and that they allowed a cooling-off period before testing. However, men of screening age argued that uncertain and detailed information should be communicated only after receiving an elevated PSA test result.
Publisher: Wiley
Date: 08-05-2022
DOI: 10.1111/HEX.13522
Abstract: Using risk stratification to determine eligibility for cancer screening is likely to improve the efficiency of screening programmes by targeting resources towards those most likely to benefit. We aimed to explore the implications of this approach from a societal perspective by understanding public views on the most acceptable stratification strategies. We conducted three online community juries with 9 or 10 participants in each. Participants were purposefully s led by age (40–79 years), sex, ethnicity, social grade and English region. On the first day, participants were informed of the potential benefits and harms of cancer screening and the implications of different ways of introducing stratification using scenarios based on phenotypic and genetic risk scores. On the second day, participants deliberated to reach a verdict on the research question, ‘Which approach(es) to inviting people to screening are acceptable, and under what circumstances?’ Deliberations and feedback were recorded and analysed using thematic analysis. Across the juries, the principle of risk stratification was generally considered to be an acceptable approach for determining eligibility for screening. Disregarding increasing capacity, the participants considered it to enable efficient resource allocation to high‐risk in iduals and could see how it might help to save lives. However, there were concerns regarding fair implementation, particularly how the risk assessment would be performed at scale and how people at low risk would be managed. Some favoured using the most accurate risk prediction model whereas others thought that certain risk factors should be prioritized (particularly factors considered as non‐modifiable and relatively stable, such as genetics and family history). Transparently justifying the programme and public education about cancer risk emerged as important contributors to acceptability. Using risk stratification to determine eligibility for cancer screening was acceptable to informed members of the public, particularly if it included risk factors they considered fair and when communicated transparently. Two patient and public involvement representatives were involved throughout this study. They were not involved in synthesizing the results but contributed to producing study materials, co‐facilitated the community juries and commented on the interpretation of the findings and final report.
Publisher: BMJ
Date: 30-01-2019
DOI: 10.1136/BMJ.L351
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJOPEN-2020-043421
Abstract: Public cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies. An online cross-sectional survey. A national s le of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider. Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Of the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were ided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19. Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%). Public messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many in iduals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.
Publisher: BMJ
Date: 05-2023
DOI: 10.1136/BMJOPEN-2023-072248
Abstract: Consistent evidence shows pathology services are overused worldwide and that about one-third of testing is unnecessary. Audit and feedback (AF) is effective for improving care but few trials evaluating AF to reduce pathology test requesting in primary care have been conducted. The aim of this trial is to estimate the effectiveness of AF for reducing requests for commonly overused pathology test combinations by high-requesting Australian general practitioners (GPs) compared with no intervention control. A secondary aim is to evaluate which forms of AF are most effective. This is a factorial cluster randomised trial conducted in Australian general practice. It uses routinely collected Medicare Benefits Schedule data to identify the study population, apply eligibility criteria, generate the interventions and analyse outcomes. On 12 May 2022, all eligible GPs were simultaneously randomised to either no intervention control or to one of eight intervention groups. GPs allocated to an intervention group received in idualised AF on their rate of requesting of pathology test combinations compared with their GP peers. Three separate elements of the AF intervention will be evaluated when outcome data become available on 11 August 2023: (1) invitation to participate in continuing professional development-accredited education on appropriate pathology requesting, (2) provision of cost information on pathology test combinations and (3) format of feedback. The primary outcome is the overall rate of requesting of any of the displayed combinations of pathology tests of GPs over 6 months following intervention delivery. With 3371 clusters, assuming no interaction and similar effects for each intervention, we anticipate over 95% power to detect a difference of 4.4 requests in the mean rate of pathology test combination requests between the control and intervention groups. Ethics approval was received from the Bond University Human Research Ethics Committee (#JH03507 approved 30 November 2021). The results of this study will be published in a peer-reviewed journal and presented at conferences. Reporting will adhere to Consolidated Standards of Reporting Trials. ACTRN12622000566730.
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2019-032327
Abstract: Worldwide, attention deficit hyperactivity disorder (ADHD) diagnosis rates in children and adolescents have been increasing consistently over the past decades, fuelling a debate about the underlying reasons for this trend. While many hypothesise that a substantial number of these additional cases are overdiagnosed, to date there has been no comprehensive evaluation of evidence for or against this hypothesis. Thus, with this scoping review we aim to synthesise published evidence on the topic in order to investigate whether existing literature is consistent with the occurrence of overdiagnosis and/or overtreatment of ADHD in children and adolescents. The proposed scoping review will be conducted in the context of a framework of five questions, developed specifically to identify areas in medicine with the potential for overdiagnosis and overtreatment. The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. We will search Medline, Embase, PsycINFO and the Cochrane Library electronic databases for primary studies published in English from 1979 onwards. We will also conduct forward and backward citation searches of included articles. Data from studies that meet our predefined exclusion and inclusion criteria will be charted into a standardised extraction template with results mapped to our predetermined five-question framework in the form of a table and summarised in narrative form. The proposed study is a scoping review of the existing literature and as such does not require ethics approval. We intend to disseminate the results from the scoping review through publication in a peer-reviewed journal and through conference presentations. Further, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-064447
Abstract: The treatment workload associated with end-stage kidney disease (ESKD) is high. The treatment burdens experienced by patients with ESKD are not well understood. In this study, we aimed to elucidate the most important areas of treatment burden for discussion in a clinical encounter from the perspectives of patients with ESKD and nephrologists. We sought to explore possible solutions to these high priority treatment burden challenges. Nominal group technique (NGT) sessions. Three in-person NGT sessions were conducted with 19 patients with dialysis-dependent ESKD from one tertiary treatment centre (mean age 64 years range 47–82). All patients were either retired or on a disability pension 74% perceived moderate or severe treatment burden and 90% spent more than 11 hours on treatment-related activities per week (range 11–30). One online NGT session was conducted with six nephrologists from two Australian states. The primary outcome was a ranked list of treatment burden priorities. The secondary outcome was potential solutions to these treatment burden challenges. Every patient group ranked health system issues as the most important treatment burden priority. This encompassed lack of continuity and coordination of care, dissatisfaction with frequent healthcare encounters and challenges around healthcare access. Psychosocial burdens on patients and families were perceived to be the most important area of treatment burden by physicians, and were ranked the second highest priority by patients. Discussing treatment burden in a clinical encounter may lead to a better understanding of patients’ capacity to cope with their treatment workload. This could facilitate tailored care, improve health outcomes, treatment sustainability and patients’ overall quality of life.
Publisher: Wiley
Date: 21-06-2022
DOI: 10.1002/EJP.1981
Abstract: Diagnostic labels may influence treatment intentions. We examined the effect of labelling low back pain (LBP) on beliefs about imaging, surgery, second opinion, seriousness, recovery, work, and physical activities. Six-arm online randomized experiment with blinded participants with and without LBP. Participants received one of six labels: 'disc bulge', 'degeneration', 'arthritis', 'lumbar sprain', 'non-specific LBP', 'episode of back pain'. The primary outcome was the belief about the need for imaging. A total of 1375 participants (mean [SD] age, 41.7 years [18.4 years] 748 women [54.4%]) were included. The need for imaging was rated lower with the labels 'episode of back pain' (4.2 [2.9]), 'lumbar sprain' (4.2 [2.9]) and 'non-specific LBP' (4.4 [3.0]) compared to the labels 'arthritis' (6.0 [2.9]), 'degeneration' (5.7 [3.2]) and 'disc bulge' (5.7 [3.1]). The same labels led to higher recovery expectations and lower ratings of need for a second opinion, surgery and perceived seriousness compared to 'disc bulge', 'degeneration' and 'arthritis'. Differences were larger amongst participants with current LBP who had a history of seeking care. No differences were found in beliefs about physical activity and work between the six labels. 'Episode of back pain', 'lumbar sprain' and 'non-specific LBP' reduced need for imaging, surgery and second opinion compared to 'arthritis', 'degeneration' and 'disc bulge' amongst public and patients with LBP as well as reducing the perceived seriousness of LBP and enhancing recovery expectations. The impact of labels appears most relevant amongst those at risk of poor outcomes (participants with current LBP who had a history of seeking care).
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-037392
Abstract: When health conditions are labelled it is often to classify and communicate a set of symptoms. While diagnostic labelling can provide explanation for an in idual’s symptoms, it can also impact how in iduals and others view those symptoms. Despite existing research regarding the effects of labelling health conditions, a synthesis of these effects has not occurred. We will conduct a systematic scoping review to synthesise the reported consequences and impact of being given a label for a health condition from an in idual, societal and health practitioner perspective and explore in what context labelling of health conditions is considered important. The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. Searches will be conducted in five electronic databases (PubMed, Embase, PsycINFO, Cochrane, CINAHL). Reference lists of included studies will be screened and forward and backward citation searching of included articles will be conducted. We will include reviews and original studies which describe the consequences for in iduals labelled with a non-cancer health condition. We will exclude hypothetical research designs and studies focused on the consequences of labelling cancer conditions, intellectual disabilities and/or social attributes. We will conduct thematic analyses for qualitative data and descriptive or meta-analyses for quantitative data where appropriate. Ethical approval is not required for a scoping review. Results will be disseminated via publication in a peer-reviewed journal, conference presentations and lay-person summaries on various online platforms. Findings from this systematic scoping review will identify gaps in current understanding of how, when, why and for whom a diagnostic label is important and inform future research.
Publisher: AMPCo
Date: 10-2014
DOI: 10.5694/MJA14.00637
Abstract: To determine how many children had health problems identified by the Healthy Kids Check (HKC) and whether this resulted in changes to clinical management. A medical records audit from two Queensland general practices, identifying 557 files of children who undertook an HKC between January 2010 and May 2013. Child health problems identified in the medical records before, during and after the HKC. Most children in our s le had no problems detected in their medical record (56%), 21% had problems detected during the HKC assessment, 19% had problems detected before, and 4% after. Most frequent health concerns detected during the HKC were speech and language (20%), toileting, hearing and vision (15% each), and behavioural problems (9%). Of the 116 children with problems detected during the HKC, 19 (3% of the total s le) had these confirmed, which resulted in a change of management. No further action was recorded for 9% of children. Missing data from reviews or referral outcomes for 8% precluded analyses of these outcomes. We estimated that the change in clinical management to children with health concerns directly relating to the HKC ranged between 3% and 11%. Overall, data suggest that general practitioners are diligent in detecting and managing child health problems. Some of these problems were detected only during the HKC appointment, resulting in change of management for some children. Further studies are required to estimate the full benefits and harms, and particularly the false negatives and true positives, of the HKC.
Publisher: BMJ
Date: 05-11-2013
DOI: 10.1136/BMJ.F6172
Publisher: Imprensa da Universidade de Coimbra
Date: 2022
DOI: 10.14195/978-989-26-2298-9_118
Abstract: In the current work, a numerical study is performed to investigate the effect on the downslope field by a wind driven surface fire in the presence of an idealised building structure. Fires burning with an intensity of 15 MW/m on inclined terrain with various downslope angles of 0, -10, -20, and -30°, and under a constant wind speed of 12 m/s are simulated using a large eddy simulation (LES) solver, implemented in open-source platform FireFOAM. The results are validated with experimental measurements of a full-scale cubic building model. The presented outcomes highlight the physical effect of sloped terrain on a building in the vicinity of a line-fire. The results show that at a constant fire intensity and wind speed, an increase in downslope angle leads to an increase in the surface temperature of the structure downstream of the fire source. In addition, it is shown that increasing the downslope angle from 0˚ to -30°, results in a reduction of the average air density around the structure downstream of the fire. Furthermore, by increasing the downslope inclination of the terrain from 0˚ to -30° increases the average temperature of the building surface by 30%, and increases the temperature of zone downstream of the fire by 9%.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rae Thomas.