ORCID Profile
0000-0003-0133-2763
Current Organisation
University of Alberta
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
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.
Primary Health Care | Mental Health | Aboriginal and Torres Strait Islander Health | Public Health and Health Services
Aboriginal and Torres Strait Islander Health - Determinants of Health | Aboriginal and Torres Strait Islander Health - Health Status and Outcomes | Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) |
Publisher: Elsevier BV
Date: 12-2016
Publisher: Cambridge University Press (CUP)
Date: 25-03-2021
DOI: 10.1017/JIE.2019.3
Abstract: Abstract More than 4000 Indigenous Australian students enrol and take up a placement at boarding school each year. While reasons for attending boarding school vary, the impetus for many remote and very remote-dwelling students is restricted secondary educational opportunities in their home communities. A large multi-site study is being undertaken across Queensland to understand the conditions required for these students to be resilient while studying away from home. This paper reports on levels of student satisfaction with Queensland Department of Education's Transition Support Service (TSS) that provide assistance to remote-dwelling Indigenous students in the transition to boarding schools. A survey instrument administered to students included 22 close-ended questions to elicit levels of student satisfaction with TSS. Data were collected electronically using SurveyMonkey™ and analysed in SPSS v24. Descriptive statistics were calculated for variables assessing service support, student perceptions and experiences. A total of 294 primary, secondary and re-engaging students across 21 sites responded. Nearly all primary students (97%) anticipated that TSS would assist their move to boarding school. All secondary students identified that TSS had assisted their transition to boarding school. All re-engaging students agreed that TSS support had increased their capacity to cope when things go wrong. Lower scores related to students’ ability to access TSS when needed. Very high levels of satisfaction with TSS were countered by constraints of distance between TSS and students, and resources available to support the work of TSS. Findings point to the need for equitable provision of transition services in Queensland that emphasise the importance of relationship between service provider and student, and can inform the design of similar transition services across Australia.
Publisher: Frontiers Media SA
Date: 07-07-2017
Publisher: Springer Science and Business Media LLC
Date: 21-03-2017
Publisher: MDPI AG
Date: 26-02-2018
Publisher: Wiley
Date: 31-05-2022
DOI: 10.1111/ACPS.13457
Abstract: Little is known about the economic value of clinical interventions for delirium. This review aims to synthesise and appraise available economic evidence, including resource use, costs, and cost‐effectiveness of interventions for reducing, preventing, and treating delirium. Systematic review of published and grey literature on full and partial economic evaluations. Study quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Fourteen economic evaluations (43% full, 57% partial) across nine multicomponent and nonpharmacological intervention types met inclusion criteria. The intervention costs ranged between US$386 and $553 per person in inpatient settings. Multicomponent delirium prevention intervention and the Hospital Elder Life Program (HELP) reported statistically significant cost savings or cost offsets somewhere else in the health system. Cost savings related to inpatient, outpatient, and out‐of‐pocket costs ranged between $194 and $6022 per person. The average CHEERS score was 74% (±SD 10%). Evidence on a joint distribution of costs and outcomes of delirium interventions was limited, varied and of generally low quality. Directed expansion of health economics towards the evaluation of delirium care is necessary to ensure effective implementation that meets patients' needs and is cost‐effective in achieving similar or better outcomes for the same or lower cost.
Publisher: Informa UK Limited
Date: 15-03-2019
DOI: 10.1080/13696998.2019.1588126
Abstract: Residential step-up/step-down services provide transitional care and reintegration into the community for in iduals experiencing episodes of subacute mental illness. This study aims to examine psychiatric inpatient admissions, length of stay, and per capita cost of care following the establishment of a step-up/step-down Prevention And Recovery Care (PARC) facility in regional Australia. This was a pragmatic before and after study set within a participatory action research methodology. The target s le comprised patients at a PARC facility over 15 months. Six-month in idual level data prior to study entry, during, and over 6-months from study exit were examined using patient activity records. Costs were expressed in 2015-2016AU$. An audit included 192 people experiencing 243 episodes of care represented by males (58%), mean age = 39.3 years (SD = 12.7), primarily diagnosed with schizophrenia (48%) or mood disorders (30%). The cost of 1 day in a psychiatric inpatient unit was found to be comparable to an average of 5 treatment days in PARC the mean cost difference per-bed day (AU$1,167) was associated with fewer and shorter inpatient stays. Reduced use of inpatient facility translated into an opportunity cost of improved patient flow equivalent to AU$12,555 per resident (bootstrapped 95% CI = $5,680-$19,280). More noticeable outcomes were observed among those who stayed in PARC for longer during index admission (r Efforts should be directed toward the adoption of cost-effective alternatives to psychiatric inpatient facilities that provide comparable or improved patient outcomes.
Publisher: Springer Science and Business Media LLC
Date: 18-03-2022
DOI: 10.1186/S12890-022-01861-Y
Abstract: Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age. This cross-sectional study conducted face-to-face interviews with a random s le of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65 years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity. Of people interviewed, 6,608 were working-aged (49.9% male 67.5% had post-secondary qualifications 70.9% were in paid full- or part-time work and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6% mMRC 1, 51.7% mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full-time and AU$1.6b for part-time work range AU$5.9b, AU$49.7b). Worsening persisting breathlessness is associated with lower workforce participation with direct financial consequences, greatest for older males.
Publisher: MDPI AG
Date: 29-12-2020
Abstract: This mixed-methods study reports on the key stakeholders’ perspectives on the ear, nose, and throat (ENT) service redesign in remote Australia, using a participatory action research (PAR) approach. A primary health care (PHC) clinician survey was conducted to assess local needs and possible educational gaps in clinical knowledge. This was followed by an internal stakeholder forum and a follow-up survey with Torres and Cape Hospital and Health Service staff to gain their perspectives on current service delivery and table ideas for a new ENT health service model. Qualitative data were analyzed inductively and grouped in emerging themes. Quantitative data were imported into tables and analyzed descriptively. PAR allowed for input from 19 PHC clinicians, 10 face-to-face stakeholders perspectives, and 18 stakeholder follow-up survey respondents. Four themes emerged: 1. Training for health workers in ENT management 2. Improved local service access 3. New referral pathways to improve continuity of care and 4. Introduction of telehealth. PAR engaged key stakeholders, identifying gaps in ENT service delivery, and guided the development of the new service model. The inclusion of stakeholders throughout the service redesign process is likely to create a more sustainable model of care which already has local “buy-in”.
Publisher: Wiley
Date: 15-06-2022
DOI: 10.1002/CEY2.231
Abstract: Direct recycling has been regarded as one of the most promising approaches to dealing with the increasing amount of spent lithium‐ion batteries (LIBs). However, the current direct recycling method remains insufficient to regenerate outdated cathodes to meet current industry needs as it only aims at recovering the structure and composition of degraded cathodes. Herein, a nickel (Ni) and manganese (Mn) co‐doping strategy has been adopted to enhance LiCoO 2 (LCO) cathode for next‐generation high‐performance LIBs through a conventional hydrothermal treatment combined with short annealing approach. Unlike direct recycling methods that make no changes to the chemical composition of cathodes, the unique upcycling process fabricates a series of cathodes doped with different contents of Ni and Mn. The regenerated LCO cathode with 5% doping delivers excellent electrochemical performance with a discharge capacity of 160.23 mAh g −1 at 1.0 C and capacity retention of 91.2% after 100 cycles, considerably surpassing those of the pristine one (124.05 mAh g −1 and 89.05%). All results indicate the feasibility of such Ni–Mn co‐doping‐enabled upcycling on regenerating LCO cathodes.
Publisher: Frontiers Media SA
Date: 02-05-2018
Publisher: Springer Science and Business Media LLC
Date: 14-08-2019
DOI: 10.1007/S40258-019-00505-3
Abstract: Universal suicide education and awareness training in schools are promising suicide prevention initiatives. This study aims to evaluate a suicide awareness training (safeTALK) and to model potential return on investment (ROI) on a population basis. SafeTALK, comprises a 3-h education session, and has been delivered to secondary school students (aged 15-16 years) in Mackay, located in the Australian state of Queensland. Evaluation consisted of two phases, ex-post and ex-ante. Phase I was a pre-post, follow-up analysis using a mixed-method questionnaire administered immediately prior (Time 1), immediately after (Time 2), and 4 weeks after training (Time 3). Phase II involved decision analytic modelling comparing safeTALK to the status quo. ROI was modelled using Markov chains for a hypothetical population of students aged 15-19 years in Mackay (n = 2561 suicide rate 78.1 per 100,000), Queensland (n = 296,287 10.2) and Australia (n = 1,421,595 8.3). Model parameters, including rates of hospitalised self-harm and suicide, cost implications and effectiveness of safeTALK were drawn from published literature. The baseline model adapted a health and justice system's perspective, with an alternative model incorporating a societal perspective. All costs were adjusted to reflect AU$2017-2018. Students reported seeking help mostly from friends (79%) or parents (68%) in the last 6 months 61% considered another student's behaviour as suicidal, but only 21% reported asking about this. The main barriers to help-seeking were (i) being too embarrassed, (ii) shy or (iii) being judged. Students who attended safeTALK gained suicide-related knowledge (p < 0.001), confidence (p < 0.001), willingness (p = 0.006), and likelihood of seeking help (p = 0.044) and retained these up until follow-up assessment 4 weeks later with the exception of seeking help. From a health and justice system's perspective, the model estimated a cumulative return of AU$1.45 per AU$1 invested in safeTALK in Mackay AU$0.19 in Queensland AU$0.15 across Australia. From a societal perspective, ROI increased to AU$31.21, AU$4.05 and AU$3.28, respectively. Results strengthen the premise that safeTALK is feasible to implement within a school setting. The economic case for implementation of safeTALK is promising on a population basis, especially in high-risk communities, but further research is required to confirm the study results.
Publisher: OMICS Publishing Group
Date: 2016
Publisher: Springer Science and Business Media LLC
Date: 23-07-2015
Publisher: Springer Science and Business Media LLC
Date: 15-11-2020
DOI: 10.1007/S00127-019-01807-6
Abstract: To report the comparative rates, average length of stay and cost per episode of hospital management for self-harm in three age cohorts: 15-19 years, 20-24 years and 25-29 years by sex and indigeneity. A secondary data analysis of the Australian Institute of Health and Welfare (AIHW) dataset between 1st January 2014 and 31st December 2014 inclusive. Cost per episode of hospitalised self-harm and rates by age group, sex and Indigenous status. The rate of hospitalised self-harm among Australian youth was 254.0 per 100,000 population. This rate resulted in an annual cost to the healthcare system of AU$55 million or an average cost per episode of $4649 (95% CI $4488:$4810). Hospitalised self-harm was 21 times higher than the rate of suicide (11,820 episodes of hospitalised self-harm/564 suicides). Indigenous youth had on average a 1.4 times higher rate of hospitalised self-harm and 2.2 times higher rate of suicide than non-Indigenous counterparts. When controlling for age and sex, the average cost per episode was significantly lower for Indigenous youth compared to non-Indigenous youth, estimated marginal means $4538 and $4954, respectively (p < 0.001). Hospitalised self-harm among Australian youth resulted in a substantial cost to the healthcare system. This cost is only part of the overall burden associated with self-harm. The rate of hospitalised self-harm was significantly higher in Indigenous youth, but the associated cost per episode was significantly lower.
Publisher: Wiley
Date: 06-06-2022
DOI: 10.1002/GPS.5764
Abstract: The burden on care partners, particularly once dementia emerges, is among the greatest of all caregiving groups. This meta‐review aimed to (1) synthesis evidence on the self‐reported needs of care partners supporting people living with neurodegenerative disorders (2) compare the needs according to care partner and care recipient characteristics and (3) determine the face validity of existing care partner needs assessment tools. We conducted a systematic review of reviews involving a thematic synthesis of care partner needs and differences in needs according to demographic and other characteristics. We then conducted a gap analysis by identifying the themes of needs from existing needs assessment tools specific to dementia and cross‐matching them with the needs derived from the thematic synthesis. Drawing on 17 published reviews, the identified range of needs fell into four key themes: (1) knowledge and information, (2) physical, social and emotional support, (3) care partner self‐care, and (4) care recipient needs. Needs may differ according to disease trajectory, relationship to the care recipient, and the demographic characteristics of the care partner and recipient. The ‘captured needs’ range between 8% and 66% across all the included needs assessment tools. Current tools do not fully or adequately capture the self‐identified needs of care partners of people living with neurodegenerative disorders. Given the high burden on care partners, which has been further exacerbated by the COVID‐19 (SARS CoV‐2) pandemic, the needs assessment tools should align with the self‐reported needs of care partners throughout the caregiving trajectory to better understand unmet needs and target supportive interventions.
Publisher: Springer Science and Business Media LLC
Date: 28-11-2200
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.CHIABU.2019.104228
Abstract: Child abuse and Youth Sexual Violence and Abuse (YSVA) are persistent social issues across the globe. The development and implementation of effective prevention strategies are a common focus for those working at the coalface. The Cairns Child Protection Investigation Unit of the Queensland Police Service (QPS) developed and implemented the "Speak Up. Be Strong. Be Heard." (SUBSBH) initiative. This police-led multi-component child abuse prevention initiative has been implemented in 26 Aboriginal and Torres Strait Islander communities across the Far North Queensland Police District since June 2016. The aim of this research was to evaluate the success of the SUBSBH initiative. Existing data held by QPS were examined. These data include statistics on reporting of YSVA offences, internal program documents and reports, and evaluation feedback forms completed prior to this evaluation study. Information collected via these sources pertained to 26 Indigenous communities within the Far North Queensland Police District. The above-mentioned feedback forms were completed by 307 participants, of whom approximately 90% are Indigenous. This study adopted desktop analysis and triangulation through a range of qualitative and quantitative data to ensure robust and rigorous evaluation of the SUBSBH initiative. The study found that the initiative was successful in meeting basic accepted practice for child abuse and YSVA prevention programs, receiving positive participant feedback on the educational program, achieving the initiative's objective to increase reporting of YSVA, and achieving cost-efficiency in meeting outcomes. Importantly, the increase in reporting of YSVA was statistically significant. This study contributes to current understanding regarding the implementation of multi-component child abuse prevention initiatives and provides an ex le of a cost-efficient police-led community response to child abuse and YSVA in Indigenous communities. The findings may guide responses in other communities which grapple with this critical social issue.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JPAINSYMMAN.2019.09.021
Abstract: Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population. This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota s ling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors. About 2977 respondents had all relevant scores (female 51.2% median age 45.0 [range 18-92]). Prevalence of breathlessness (mMRC ≥2) was 2.4%, anxiety 6.0%, depression 2.7%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8). Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
Publisher: American Chemical Society (ACS)
Date: 20-01-2022
DOI: 10.1021/ACS.NANOLETT.1C04709
Abstract: Zinc metal anodes show great promise for cheap and safe energy storage devices. However, it remains challenging to regulate highly efficient Zn plating/stripping under a high depth of discharge (DOD). Guided by density functional theory calculation, we here synthesized an oxygen- and nitrogen-codoped carbon superstructure as an efficient host for high-DOD Zn metal anodes through rational monomer selection, polymer self-assembly, and structure-preserved carbonization. With microscale 3D hierarchical structures, microcrystalline graphitic layers, and zincophilic heteroatom dopants, a flower-shaped carbon (C
Publisher: Portico
Date: 11-2022
Publisher: Cambridge University Press (CUP)
Date: 2023
DOI: 10.1017/S0266462323000235
Abstract: Healthcare innovations often represent important improvements in population welfare, but at what cost, and to whom? Health technology assessment (HTA) is a multidisciplinary process to inform resource allocation. HTA is conventionally anchored on health maximization as the only relevant output of health services. If we accept the proposition that health technologies can generate value outside the healthcare system, resource allocation decisions could be suboptimal from a societal perspective. Incorporating “broader value” in HTA as derived from social values and patient experience could provide a richer evaluative space for informing resource allocation decisions. This article considers how HTA is practiced and what its current context implies for adopting “broader value” to evaluating health technologies. Methodological challenges are highlighted, as is a future research agenda. Ireland serves as an ex le of a healthcare system that both has an explicit role for HTA and is evolving under a current program of reform to offer universal, single-tier access to public services. There are various ways in which HTA processes could move beyond health, including considering the processes of care delivery and/or expanding the evaluative space to some broader concept of well-being. Methods to facilitate the latter exist, but their adaptation to HTA is still emerging. We recommend a multi-stakeholder working group to develop and advance an international agenda for HTA that captures welfare/benefit beyond health.
Publisher: Wiley
Date: 21-01-2021
DOI: 10.1002/ALZ.12262
Abstract: This review aims to systematically identify and appraise the methodological quality of claims on the cost of delirium and discuss challenges and opportunities for improvements in the precision of the estimates. Searches of scientific papers and gray literature were performed up until June 2020. The Larg and Moss checklist was used to assess the methodological quality of the included studies. After deduplication, the search identified 317 potentially relevant articles, of which 17 articles were eligible for inclusion. After adjusting for inflation and common currency, the cost of delirium ranged between $806 and $24,509 (in 2019 US$). This review found significant variation among the cost estimates and methodological quality. There has been limited focus on dementia as a sequela of delirium in terms of economic implications, but recent evidence suggests cost implications of delirium may be 52% higher when dementia is considered.
Publisher: Springer Science and Business Media LLC
Date: 12-2018
Publisher: Informa UK Limited
Date: 15-03-2018
Publisher: Wiley
Date: 12-10-2018
DOI: 10.1111/JEP.13044
Abstract: This costing evaluation compares three service delivery models for ear, nose, and throat (ENT) surgery for remote living Indigenous children to improve their hearing outcomes, with the aim to identify the least costly model. The main outcome measure presented was the incremental cost difference between the base case (Model 1) and two alternative models (Model 2, 3). The costs in 2017 Australian dollars are assessed from two viewpoints: (1) health system perspective, and (2) patients and their families including travel out-of-pocket expenses, presented separately according to the funding source. Findings indicate that the least costly model offered low-risk ENT surgery from a state funded hospital in a remote setting, with high use of videoconference technology: TeleHealth (Model 3) could save $3626 to $5067 per patient, compared with patients travelling to a regional centre public hospital (Model 1). A federally funded scheme which allowed groups of patients to access a direct flight charter transfer to the private hospital in regional centre (Model 2) reduced the cost by $2178 to $2711 per patient when compared with standard care (Model 1). From a societal perspective, Model 1 required out-of-pocket patient expenses, with greater time away from home, and hence appears the least preferred option. The sensitivity analyses also demonstrate that Model 3 would be the more economical model for providing ENT surgery for remote living children. By proving an accurate assessment of the true costs of delivering these important ear and hearing health services, strategic health service planners may be better informed and sufficient budgets can be allocated to provide improved service delivery. The benefits of Model 3, over Models 1 or 2, would also incorporate improvements to patient safety as a result of reducing patient travel, which should in-turn, reduce failure-to-attend rates.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.EVALPROGPLAN.2019.01.004
Abstract: Researchers worldwide are increasingly reporting the societal impact of their research as part of national research productivity assessments. However, the challenges they encounter in developing their impact case studies against specified government assessment criteria and how pitfalls can be mitigated are not reported. This paper examines the key steps taken to develop an Aboriginal Family Wellbeing (FWB) empowerment research impact case study in the context of an Australian Research Council (ARC) pilot research impact assessment exercise and the challenges involved in applying the ARC criteria. The requirement that researchers demonstrate how their institutions support them to conduct impactful research has the potential to create supportive environments for researchers to be more responsive to the needs of users outside academia. However, the 15-year reference period for the associated research underpinning the reported impact and the focus on researcher's current institutional affiliation constitute potential constraints to demonstrating the true impact of research. For researchers working with Indigenous people, relationships that build over long periods of time, irrespective of university affiliation, are critical to conducting impactful research. A more open-ended time-frame, with no institutional restrictions for the 'associated research' provides the best opportunity to demonstrate the true benefits of research not only for Indigenous people but for Australian society more broadly.
Location: United States of America
Start Date: 07-2020
End Date: 11-2022
Amount: $699,000.00
Funder: Australian Research Council
View Funded Activity