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1.
Hum Vaccin Immunother ; 20(1): 2359623, 2024 Dec 31.
Article in English | MEDLINE | ID: mdl-38845399

ABSTRACT

Data on routine childhood vaccination coverage can only tell us who is under-vaccinated; it cannot explain why vaccine coverage is low. Collecting data on the reasons behind under-vaccination is necessary to implement cost-effective strategies that address key barriers and target interventions appropriately. However, no instruments that measure both vaccine acceptance and access factors among parents of children <5 y have been validated in high-income countries. This study aims to develop and validate the Vaccine Barriers Assessment Tool (VBAT) for Australia. We applied three phases of mixed methods data collection and analysis. In Phase 1, we developed a comprehensive list of 80 items reflecting all potential parental barriers to childhood vaccination, derived from published literature and behavioral theory. Through cognitive interviews (n = 28), we refined this list to 45 items. In Phase 2, we conducted a two-wave online survey to test the reliability and validity of these items in an Australian sample of parents (n = 532) with structural equation modeling, further refining the list to 35 items. In Phase 3, we conducted a final parent survey (n = 156), administering these items along with the Parent Attitudes toward Childhood Vaccination (PACV) scale for comparison. We reviewed participants' immunization register data to assess the predictive validity of the proposed models. The final 6-item short form and 15-item long form Vaccine Barriers Assessment Tool assess access, communal benefit, personal risk, equity, commitment, social norms, and trust in health-care workers. It is being applied for national surveillance in Australia and will be adapted for additional populations and vaccines.


Subject(s)
Parents , Vaccination , Humans , Australia , Parents/psychology , Female , Infant , Child, Preschool , Male , Vaccination/psychology , Vaccination/statistics & numerical data , Surveys and Questionnaires , Adult , Vaccination Coverage/statistics & numerical data , Reproducibility of Results , Vaccination Hesitancy/statistics & numerical data , Vaccination Hesitancy/psychology , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/psychology , Vaccines/administration & dosage
2.
Front Public Health ; 12: 1342562, 2024.
Article in English | MEDLINE | ID: mdl-38846622

ABSTRACT

Background: There is wide acknowledgement in the literature that social connection is protective against loneliness and depression. More robust research, however, is needed to evaluate interventions that promote social connection. This protocol paper outlines the evaluation of a community-wide social connection program, Connect Local, in metropolitan Melbourne, Australia to support people 65 years and older to increase access to local community services/activities; and to ascertain impact on social connection, loneliness, depressive symptoms, physical and mental wellbeing, and use of health services. Methods: A Type 1 Hybrid design, including program effectiveness, cost-effectiveness, and implementation evaluation of the Connect Local program, will be undertaken. Eighty-eight participants aged ≥65 years with one or more chronic health condition, who are also either experiencing or at risk of loneliness, social isolation and depressive symptoms will be invited to participate in the evaluation. Outcomes, measured at baseline, 3, 6 and 12 months, include loneliness, social isolation, depressive symptoms, social anxiety, goal attainment, wellbeing, quality of life and health care utilisation. A gender and age matched comparator group of 88 individuals will be recruited from outside the intervention local government area. Impact of the intervention on community service providers in the target region will be evaluated using mixed methods, where triangulation will be used to combine the qualitative and quantitative data using a deductive-simultaneous design. Changes in wellbeing and quality of life of community volunteers will also be measured. All groups will be interviewed to ascertain their experience and perceptions of the program. The economic evaluation will use a Social Return on Investment (SROI) approach, to include outcomes at the individual, community, and system levels. Implementation outcomes will consider Reach, Adoption, Feasibility, Acceptability, Appropriateness, Fidelity, and Sustainability of the intervention. Discussion: This study will provide a better understanding of the impacts of a community-wide social connection approach in older adults, the community and broader system. Clinical trial registration: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385192; Identifier ACTRN12623000968673.


Subject(s)
Depression , Loneliness , Quality of Life , Social Isolation , Humans , Aged , Loneliness/psychology , Female , Male , Australia , Social Isolation/psychology , Program Evaluation , Social Support , Cost-Benefit Analysis , Aged, 80 and over , Health Promotion/methods
3.
PLoS One ; 19(6): e0305085, 2024.
Article in English | MEDLINE | ID: mdl-38857242

ABSTRACT

INTRODUCTION: The prevention of unintended pregnancy is a public health issue affecting women worldwide. In Australia, women are required to get a prescription to obtain the oral contraceptive pill (OCP), which may limit access and be a barrier to its initiation and continuing use. Changing the availability of the OCP from prescription-only to over-the-counter (OTC) is one solution, however, to ensure success policymakers need to understand women's preferences. Telehealth services also might serve as an alternative to obtain prescriptions and increase accessibility to OCPs. This study aims to explore the preferences for OTC OCPs among Australian women, and whether the expansion of telehealth impacted women's preferences. METHODS: A mixed methods approach was used to explore women's preferences regarding access to the OCP. Focus group discussions (FGDs) were conducted to organically identify the preferences followed by an empirical ranking exercise. Three FGDs in two phases were conducted, pre and post-expansion of telehealth in Australia due to the COVID-19 pandemic. Convenience sampling was employed. The technique of constant comparison was used for thematic analysis where transcripts were analysed iteratively, and codes were allowed to emerge during the process to give the best chance for the attributes to develop from the data. RESULTS: Thematic analysis revealed that women perceived OTC availability of OCPs as a mechanism to increase the accessibility of contraception by reducing cost, travel time, waiting time, and increasing opening hours. They also believed that it would increase adherence to OCPs. However, some potential safety concerns and logistical issues were raised, including pharmacist training, access to patient's medical history, the ability to discuss other health issues or undertake opportunistic health screening, adherence to checklists, and privacy in the pharmacy environment. Following the expansion of telehealth, accessibility issues such as opening hours, travel time, and location of the facility were considered less important. CONCLUSIONS: The participants expressed their support for reclassifying OCPs to OTC, particularly for repeat prescriptions, as it would save valuable resources and time. However, some safety and logistical issues were raised. Women indicated they would balance these concerns with the benefits when deciding to use OTC OCPs. This could be explored using a discrete choice experiment. The expansion of telehealth was perceived to reduce barriers to accessing OCPs. The findings are likely to be informative for policymakers deciding whether to reclassify OCPs to OTC, and the concerns of women that need addressing to ensure the success of any policy change.


Subject(s)
Contraceptives, Oral , Nonprescription Drugs , Humans , Female , Australia , Nonprescription Drugs/supply & distribution , Contraceptives, Oral/supply & distribution , Adult , Telemedicine , COVID-19/epidemiology , COVID-19/prevention & control , Young Adult , Health Services Accessibility , Focus Groups , SARS-CoV-2 , Patient Preference/statistics & numerical data , Pregnancy , Middle Aged , Adolescent
4.
PeerJ ; 12: e17406, 2024.
Article in English | MEDLINE | ID: mdl-38860213

ABSTRACT

Amphibians are experiencing declines globally, with emerging infectious diseases as one of the main causes. Haematological parameters present a useful method for determining the health status of animals and the effects of particular diseases, but the interpretation of differential cell counts relies on knowing the normal ranges for the species and factors that can affect these counts. However, there is very little data on either normal haematological parameters or guides for blood cell types for free-ranging frog species across the world. This study aims to 1) create a visual guide for three different Australian frog species: Litoria paraewingi, Limnodynastes dumerilii, and Crinia signifera, 2) determine the proportions of erythrocytes to leukocytes and 3) differential leukocytes within blood smears from these three species and 4) assess the association between parasites and differential counts. We collected blood samples from free-ranging frogs and analysed blood smears. We also looked for ectoparasites and tested for the fungal disease chytridiomycosis. Overall, we found that the differentials of erythrocytes to leukocytes were not affected by species, but the proportions of different leukocytes did vary across species. For example, while lymphocytes were the most common type of leukocyte across the three species, eosinophils were relatively common in Limnodynastes dumerilii but rarely present in the other two species. We noted chytridiomycosis infection as well as ectoparasites present in some individuals but found no effect of parasites on blood parameters. Our results add baseline haematological parameters for three Australian frog species and provide an example of how different frog species can vary in their differential blood cell counts. More information is needed on frog haematological data before these parameters can be used to determine the health status of wild or captive frogs.


Subject(s)
Anura , Animals , Anura/blood , Anura/parasitology , Anura/microbiology , Australia , Reference Values , Erythrocytes/parasitology , Blood Cell Count/veterinary , Hematologic Tests/veterinary , Species Specificity , Leukocyte Count , Male
5.
Glob Chang Biol ; 30(6): e17313, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38837834

ABSTRACT

Anthropogenic debris is a global threat that impacts threatened species through various lethal and sub-lethal consequences, as well as overall ecosystem health. This study used a database of over 24,000 beach surveys of marine debris collated by the Australian Marine Debris Initiative from 2012 to 2021, with two key objectives: (1) identify variables that most influence the occurrence of debris hotspots on a continental scale and (2) use these findings to identify likely hotspots of interaction between threatened species and marine debris. The number of particles found in each beach survey was modelled alongside fifteen biological, social, and physical spatial variables including land use, physical oceanography, population, rainfall, distance to waste facilities, ports, and mangroves to identify the significant drivers of debris deposition. The model of best fit for predicting debris particle abundance was calculated using a generalized additive model. Overall, debris was more abundant at sites near catchments with high annual rainfall (mm), intensive land use (km2), and that were nearer to ports (km) and mangroves (km). These results support previous studies which state that mangroves are a significant sink for marine debris, and that large ports and urbanized catchments are significant sources for marine debris. We illustrate the applicability of these models by quantifying significant overlap between debris hotspots and the distributions for four internationally listed threatened species that exhibit debris interactions; green turtle (26,868 km2), dugong (16,164 km2), Australian sea lion (2903 km2) and Flesh-footed Shearwater (2413 km2). This equates to less than 1% (Flesh-footed Shearwater, Australian sea lion), over 2% (green sea turtle) and over 5% (dugong) of their habitat being identified as areas of high risk for marine debris interactions. The results of this study hold practical value, informing decision-making processes, managing debris pollution at continental scales, as well as identifying gaps in species monitoring.


Subject(s)
Endangered Species , Australia , Animals , Models, Theoretical , Waste Products/analysis , Waste Products/statistics & numerical data , Environmental Monitoring/methods
6.
J Safety Res ; 89: 83-90, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38858065

ABSTRACT

INTRODUCTION: Workers operating on high-speed roads (i.e., incident responders and emergency service workers) are at significant risk of being fatally injured while working. An identified gap in current prevention strategies is training focused on developing the skills of workers to effectively communicate and coordinate safety responses when operating on roads. METHODS: This study discusses the development of a program designed to optimize communication and coordination of safety practices at the scene of an incident on a high-speed road. The program is referred to as 'Safety in the Grey Zone.' The goal of the study is to present the results from an evaluation on its implementation across 23 sessions involving 158 participants from 7 incident response agencies in 1 state in Australia. RESULTS: The results of this study provide support for effectiveness in implementing the program as planned. The results also provide preliminary support for effectiveness of the program in achieving its learning outcomes as demonstrated by feedback received from participants following completion of the program. CONCLUSIONS: The findings of this study provide recommendations to consider in the program's future roll-out, as well as suggestions for future evaluations to assess the program's effectiveness in improving the safety of incident responders operating on high-speed roads.


Subject(s)
Accidents, Traffic , Emergency Responders , Humans , Emergency Responders/education , Accidents, Traffic/prevention & control , Program Evaluation , Australia , Inservice Training , Safety Management/methods , Occupational Health , Communication
8.
Front Public Health ; 12: 1403866, 2024.
Article in English | MEDLINE | ID: mdl-38841685

ABSTRACT

Children with disability face many barriers to participating in community sports. Little Athletics Australia aims to increase fair and meaningful inclusion via a new structure which will enable all children to take part in the same contest by competing for their 'personal best' score. Named the True Inclusion Method (TIM), this new structure will be piloted in 13 sites across six states. Formative evaluation of this pilot will critique TIM and its implementation using observations of events, and interviews and surveys with child athletes with and without disability, their parents/carers and Little Athletics volunteers. Implementation outcomes are acceptability, appropriateness, adoption, feasibility and fidelity. Qualitative data will be analysed thematically. TIM is designed to encourage inclusive participation by children with disability in sporting events, and to improve the competitive experience for all children by celebrating personal achievement and fostering fun.


Subject(s)
Disabled Children , Sports , Humans , Child , Disabled Children/rehabilitation , Australia , Male , Female , Pilot Projects , Adolescent , Program Evaluation
9.
J Wound Care ; 33(Sup6): S13-S18, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38843048

ABSTRACT

OBJECTIVE: A feasibility study to test the proposed methodology for a larger randomised control trial was conducted, investigating the comparative effectiveness of the two types of pressure management support surfaces with regards to healing pressure injuries (PI). A secondary objective was to provide insights into the user acceptability of the two types of pressure management support surfaces. METHOD: A randomised control feasibility study was conducted in a community health setting in Canberra, Australia. Patients aged ≥65 years with an existing Stage 2 PI who slept in a bed were eligible. Participants were randomised to either the active mattress group or the reactive mattress group for use on their bed. All participants received standard wound care by community nursing staff and were provided an air-flotation cushion for use when not in bed. Photographs were taken and used for blind assessment of wound healing. Secondary information was gathered through a survey regarding user acceptability of the support surfaces and changes in habits regarding PI prevention strategies. RESULTS: In total, five patients were recruited, with one passing away prior to mattress allocation. Results were inconclusive with regards to comparative effectiveness and user acceptability due to the small sample size; however, secondary data indicated an increasing implementation of PI prevention strategies. CONCLUSION: This study confirmed the need for further high quality research comparing reactive and active pressure mattresses. Trends indicate the importance of including education on PI prevention strategies to promote changes in behaviour. Changes to the proposed methodology will be made to increase recruitment in the primary study.


Subject(s)
Beds , Pressure Ulcer , Wound Healing , Humans , Pressure Ulcer/prevention & control , Pilot Projects , Aged , Male , Female , Aged, 80 and over , Feasibility Studies , Australia
12.
J Robot Surg ; 18(1): 246, 2024 Jun 08.
Article in English | MEDLINE | ID: mdl-38850319

ABSTRACT

Australia has seen a significant rise in the use of Robotic-Assisted Surgery (RAS), with general surgery being the fastest-growing field in this technology. The proportion of general surgical RAS has grown from 1% to 17% of all RAS between 2008 and 2023 in Australasia. As of May 2023, there were 162 robotic platforms in Australasia, with 26 of them in the public sector. As the cost of establishing RAS decreases over time, public hospital robotics systems are expected to become more accessible. Despite the increasing demand, many specialties, including general surgery, do not have an agreed RAS curriculum for trainees. It is imperative for Australia to develop its own curriculum akin to our overseas colleagues to match this growth.


Subject(s)
Curriculum , Robotic Surgical Procedures , Robotic Surgical Procedures/education , Robotic Surgical Procedures/methods , Australia , Humans , General Surgery/education
13.
JAMA Netw Open ; 7(6): e2415983, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38848061

ABSTRACT

Importance: Sport-related concussion (SRC), a form of mild traumatic brain injury, is a prevalent occurrence in collision sports. There are no well-established approaches for tracking neurobiologic recovery after SRC. Objective: To examine the levels of serum glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) in Australian football athletes who experience SRC. Design, Setting, and Participants: A cohort study recruiting from April 10, 2021, to September 17, 2022, was conducted through the Victorian Amateur Football Association, Melbourne, Australia. Participants included adult Australian football players with or without SRC. Data analysis was performed from May 26, 2023, to March 27, 2024. Exposure: Sport-related concussion, defined as at least 1 observable sign and/or 2 or more symptoms. Main Outcomes and Measures: Primary outcomes were serum GFAP and NfL levels at 24 hours, and 1, 2, 4, 6, 8, 12, and 26 weeks. Secondary outcomes were symptoms, cognitive performance, and return to training times. Results: Eighty-one individuals with SRC (median age, 22.8 [IQR, 21.3-26.0] years; 89% male) and 56 control individuals (median age, 24.6 [IQR, 22.4-27.3] years; 96% male) completed a total of 945 of 1057 eligible testing sessions. Compared with control participants, those with SRC exhibited higher GFAP levels at 24 hours (mean difference [MD] in natural log, pg/mL, 0.66 [95% CI, 0.50-0.82]) and 4 weeks (MD, 0.17 [95% CI, 0.02-0.32]), and NfL from 1 to 12 weeks (1-week MD, 0.31 [95% CI, 0.12-0.51]; 2-week MD, 0.38 [95% CI, 0.19-0.58]; 4-week MD, 0.31 [95% CI, 0.12-0.51]; 6-week MD, 0.27 [95% CI, 0.07-0.47]; 8-week MD, 0.36 [95% CI, 0.15-0.56]; and 12-week MD, 0.25 [95% CI, 0.04-0.46]). Growth mixture modeling identified 2 GFAP subgroups: extreme prolonged (16%) and moderate transient (84%). For NfL, 3 subgroups were identified: extreme prolonged (7%), moderate prolonged (15%), and minimal or no change (78%). Individuals with SRC who reported loss of consciousness (LOC) (33% of SRC cases) had higher GFAP at 24 hours (MD, 1.01 [95% CI, 0.77-1.24]), 1 week (MD, 0.27 [95% CI, 0.06-0.49]), 2 weeks (MD, 0.21 [95% CI, 0.004-0.42]) and 4 weeks (MD, 0.34 [95% CI, 0.13-0.55]), and higher NfL from 1 week to 12 weeks (1-week MD, 0.73 [95% CI, 0.42-1.03]; 2-week MD, 0.91 [95% CI, 0.61-1.21]; 4-week MD, 0.90 [95% CI, 0.59-1.20]; 6-week MD, 0.81 [95% CI, 0.50-1.13]; 8-week MD, 0.73 [95% CI, 0.42-1.04]; and 12-week MD, 0.54 [95% CI, 0.22-0.85]) compared with SRC participants without LOC. Return to training times were longer in the GFAP extreme compared with moderate subgroup (incident rate ratio [IRR], 1.99 [95% CI, 1.69-2.34]; NfL extreme (IRR, 3.24 [95% CI, 2.63-3.97]) and moderate (IRR, 1.43 [95% CI, 1.18-1.72]) subgroups compared with the minimal subgroup, and for individuals with LOC compared with those without LOC (IRR, 1.65 [95% CI, 1.41-1.93]). Conclusions and Relevance: In this cohort study, a subset of SRC cases, particularly those with LOC, showed heightened and prolonged increases in GFAP and NfL levels, that persisted for at least 4 weeks. These findings suggest that serial biomarker measurement could identify such cases, guiding return to play decisions based on neurobiologic recovery. While further investigation is warranted, the association between prolonged biomarker elevations and LOC may support the use of more conservative return to play timelines for athletes with this clinical feature.


Subject(s)
Athletic Injuries , Biomarkers , Brain Concussion , Glial Fibrillary Acidic Protein , Humans , Brain Concussion/blood , Brain Concussion/physiopathology , Brain Concussion/complications , Male , Female , Biomarkers/blood , Adult , Glial Fibrillary Acidic Protein/blood , Athletic Injuries/blood , Athletic Injuries/complications , Athletic Injuries/physiopathology , Young Adult , Football/injuries , Australia , Neurofilament Proteins/blood , Cohort Studies , Recovery of Function/physiology , Athletes/statistics & numerical data
14.
PLoS One ; 19(6): e0305106, 2024.
Article in English | MEDLINE | ID: mdl-38848391

ABSTRACT

Extreme weather events across coastal environments are expected to increase in frequency under predicted climate change scenarios. These events can impact coastal recreational fisheries and their supporting ecosystems by influencing the productivity of fish stocks or altering behaviours and decision-making among fishers. Using off-site telephone/diary survey data on estuarine and oceanic recreational fishing activity in eastern Australia, we analyse interannual and geographic variability in bream (Acanthopagrus spp) and snapper (Chrysophrys auratus) catch, total effort and total catch per unit effort (CPUE) through a period (2013/2014, 2017/2018 and 2019/2020) that encompassed severe drought, bushfires and flooding. Interacting spatial and temporal differences were detected for bream and may reflect spatial variation in the intensity and extent of some of the extreme weather events. The catch of snapper did not change temporally, providing little evidence that this species' catch may be influenced by the extreme weather events. Independent bioregional and temporal effects on effort were detected, while CPUE only showed significant bioregional differences. Although adverse conditions created by the extreme weather events may have dissuaded fisher participation and impacted effort, we propose that the observed temporal patterns in effort reflect the early influence of socio-economic changes brought on by the COVID-19 pandemic on coastal recreational fishing, over and above the impacts of extreme weather events. This study demonstrates how interrelated ecological, social and economic factors can shape coastal recreational fisheries and facilitates development of management strategies to address future threats to the sector.


Subject(s)
COVID-19 , Extreme Weather , Fisheries , Animals , COVID-19/epidemiology , Australia , Recreation , Ecosystem , Spatio-Temporal Analysis , Climate Change , Fishes/physiology , Humans , SARS-CoV-2/isolation & purification
15.
BMC Neurol ; 24(1): 185, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38824519

ABSTRACT

BACKGROUND: Rates of dementia for Aboriginal and Torres Strait Islander peoples are three to five times greater compared to non-Indigenous Australians, with earlier age of onset. However, the risk and protective factors that drive these higher rates vary across existing cohort studies, with minimal findings on the role of vascular risk factors beyond stroke. Harmonisation of data across studies may offer greater insights through enhanced diversity and strengthened statistical capabilities. This study aims to combine three landmark cohort studies of Aboriginal and Torres Strait Islander participants to better understand the determinants of cognitive health and dementia. METHODS/DESIGN: Three cohort studies - the Kimberley Healthy Adults Project (KHAP, N = 363), Koori Growing Old Well Study (KGOWS, N = 336) and Torres Strait Dementia Prevalence Study (TSDPS, N = 274) - share a similar research methodology with demographic, medical history, psychosocial factors, cognitive tests and consensus clinical diagnoses of cognitive impairment and dementia. Associations between risk and protective factors of interest and the presence of dementia and/or cognitive impairment diagnoses will be evaluated by univariable and multivariable logistic regression in a harmonised cross-sectional cohort of 898 participants. Factors associated with incident dementia and/or cognitive impairment will be assessed in a subset of KHAP (n = 189) and KGOWS participants (n = 165) who were available in longitudinal follow-up, after exclusion of those with baseline dementia or cognitive impairment. Analyses in relation to outcome measure of death or dementia will be conducted to account for the competing risk of death. Logistic regression will be used to evaluate the association between the individual components of the 16-component Kimberley Indigenous Cognitive Assessment (KICA) tool and the presence of dementia and cognitive impairment determined by independent consensus diagnoses. Multivariable binary logistic regression will be used to adjust for the effect of confounding variables. Results will be reported as odds ratios (OR) with 95% confidence intervals (95% CI). DISCUSSION: Greater understanding of risk and protective factors of dementia and cognitive impairment relevant to Aboriginal and Torres Strait Islander peoples may improve approaches across the life course to delay cognitive decline and reduce dementia risk.


Subject(s)
Australian Aboriginal and Torres Strait Islander Peoples , Cognitive Dysfunction , Dementia , Adult , Aged , Female , Humans , Male , Middle Aged , Australia/epidemiology , Australia/ethnology , Cognitive Dysfunction/ethnology , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/diagnosis , Cohort Studies , Cross-Sectional Studies , Dementia/epidemiology , Dementia/ethnology , Dementia/diagnosis , Protective Factors , Risk Factors
16.
Support Care Cancer ; 32(7): 435, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38878200

ABSTRACT

PURPOSE: A new Parent Support Worker (PSW) service was piloted in three Australian hospitals. This study assesses the feasibility and acceptability (including preliminary effectiveness) of the service in supporting cancer patients with children. METHODS: A multi-site, mixed-methods study collected quantitative and qualitative data on the effectiveness of the service (pre post-test, n = 36), qualitative and quantitative data on acceptability of the service (survey, n = 43), and qualitative data on acceptability (semi-structured interviews, n = 13). Feasibility was assessed through rates of service uptake amongst referred parents. RESULTS: Of 1133 parents referred, 810 (71%) accepted to receive the service, suggesting high interest in PSW support. Interviewees likewise reported that the service was accessible and facilitated further referrals, indicating good feasibility. Surveys completed three months after accessing PSW support showed high acceptability and satisfaction. Additionally, there was preliminary evidence of service impacts: parents' distress, parenting concerns, parenting efficacy, and stress about situations of concern improved significantly from pre- to post-service (all p < 0.005). Interviewees further described how their emotional coping and confidence to support and communicate with their children had improved through contact with the service. CONCLUSION: The PSW service, integrated into a novel cross-sector model of care, showed to be feasible and acceptable to parent patients and their partners and improved psychological and parenting outcomes. The study suggests refinements to the service and the need for future larger studies to explore the effectiveness of the service in improving parents' outcomes. This study complements previous evidence on the implementation of the PSW service in hospitals.


Subject(s)
Feasibility Studies , Neoplasms , Parents , Humans , Neoplasms/therapy , Neoplasms/psychology , Parents/psychology , Male , Female , Australia , Adult , Child , Pilot Projects , Adaptation, Psychological , Social Support , Middle Aged , Adolescent , Surveys and Questionnaires , Child, Preschool
17.
Front Public Health ; 12: 1383270, 2024.
Article in English | MEDLINE | ID: mdl-38883200

ABSTRACT

Background: Recent research proposes that as much as 40% of dementia risk is amendable. Promoting healthy lifestyle behaviors in early life through educational methods can cultivate habits that may decrease dementia risk in later life. This study explores parental acceptance of brain health programs tailored for preschool children, aiming to identify barriers and facilitators affecting parental and child engagement. Methods: Mixed-methods cross-sectional study. Urban and suburban parents (N = 187, M age = 37.3 SD = 5.53, range = 29) of children aged three to five years across Australia. Parents participated in an online survey containing both open and closed questions exploring their personal views and opinions on brain health programs for their preschool children. Descriptive statistics, multiple linear regression analyses, and thematic analysis were used to explore sociodemographic factors associated with parental program acceptance. Results: Most participants accepted a brain health program with over 98% agreeing a program would be useful for their child(ren). Participants with younger aged children were more likely to exhibit acceptance of a program (ß = -0.209, p = 0.007). Three main categories emerged: dual home and preschool environments, the need for engaging brain health programs that were hands-on and screen-free, and addressing key barriers such as time and financial constraints to support implementation. Conclusion: Participants valued educating their children for a healthy life and viewed brain health programs favorably. This study contributes to early childhood education discussions, offering guidance for future generations' brain health and wellbeing.


Subject(s)
Parents , Humans , Child, Preschool , Male , Cross-Sectional Studies , Female , Parents/psychology , Parents/education , Adult , Australia , Surveys and Questionnaires , Health Promotion/methods
18.
Sci Rep ; 14(1): 11789, 2024 06 12.
Article in English | MEDLINE | ID: mdl-38866826

ABSTRACT

Pterosaur remains have been reported from every continent; however, pterosaur skeletons remain rare. A new pterosaur is presented here, Haliskia peterseni gen. et sp. nov., constituting the most complete specimen from Australia from the upper Albian Toolebuc Formation of the Eromanga Basin (Queensland, Australia). A combination of features, including the presence of a premaxillary crest and curved teeth, and the morphology of the scapulocoracoid, support its referral to Anhangueria. Haliskia can be distinguished from all other anhanguerian pterosaurs based on two dental characters: the 4th and 5th tooth pairs are smaller than the 3rd and 6th, and the 2nd and 5th alveoli are smaller than 3-4 and 6-8. Moreover, the hyoid is 70% the total length of the mandible. The phylogenetic analyses presented here place Haliskia within Anhangueria. In one analysis, Haliskia and Ferrodraco are resolved as sister taxa, with Tropeognathus mesembrinus sister to that clade. The other resolves Haliskia, Mythunga and Ferrodraco in a polytomy within Tropeognathinae. The new Australian pterosaur attests to the success of Anhangueria during the latest Early Cretaceous and suggests that the Australian forms were more taxonomically diverse and palaeobiogeographically complex than previously recognized.


Subject(s)
Dinosaurs , Fossils , Phylogeny , Animals , Fossils/anatomy & histology , Dinosaurs/anatomy & histology , Dinosaurs/classification , Australia , Tooth/anatomy & histology
19.
BMC Health Serv Res ; 24(1): 724, 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38867177

ABSTRACT

BACKGROUND: The growth in online qualitative research and data collection provides several advantages for health service researchers and participants, including convenience and extended geographic reach. However, these online processes can also present unexpected challenges, including instances of participant fraud or scam behaviour. This study describes an incident of participant fraud identified during online focus group discussions and interviews for a PhD health services research project on paediatric neurodevelopmental care. METHODS: We aimed to recruit carers of Australian children with neurodevelopmental disorders. Potential participants were recruited via a publicly available social media advert on Facebook offering $50 AUD compensation. Those who expressed interest via email (n = 254) were sent a pre-interview Qualtrics survey to complete. We identified imposters at an early stage via inconsistencies in their self-reported geographical location and that captured by the survey as well as recognition of suspicious actions before, during and after focus group discussions and interviews. RESULTS: Interest in participation was unexpectedly high. We determined that all potential participants were likely imposters, posing as multiple individuals and using different IP addresses across Nigeria, Australia, and the United States. In doing so, we were able to characterise several "red flags" for identifying imposter participants, particularly those posing as multiple individuals. These comprise a combination of factors including large volumes and strange timings of email responses, unlikely demographic characteristics, short or vague interviews, a preference for nonvisual participation, fixation on monetary compensation, and inconsistencies in reported geographical location. Additionally, we propose several strategies to combat this issue such as providing proof of location or eligibility during recruitment and data collection, examining email and consent form patterns, and comparing demographic data with regional statistics. CONCLUSIONS: The emergent risk of imposter participants is an important consideration for those seeking to conduct health services research using qualitative approaches in online environments. Methodological design choices intended to improve equity and access for the target population may have an unintended consequence of improving access for fraudulent actors unless appropriate risk mitigation strategies are also employed. Lessons learned from this experience are likely to be valuable for novice health service researchers involved in online focus group discussions and interviews.


Subject(s)
Focus Groups , Qualitative Research , Humans , Male , Female , Australia , Health Services Research , Adult , Child , Interviews as Topic , Internet
20.
PLoS One ; 19(6): e0300624, 2024.
Article in English | MEDLINE | ID: mdl-38870244

ABSTRACT

This observational study evaluated the impact of a sponsor company-provided Patient Support Program (PSP) on discontinuation of adalimumab in adult Australian patients eligible for Pharmaceutical Benefit Scheme (PBS)-reimbursed adalimumab for Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), Psoriatic Arthritis (PsA), Crohn's Disease (CD), Ulcerative Colitis (UC), or Hidradenitis Suppurativa (HS). Patients initiating adalimumab between May 2018 and September 2019 were enrolled into two prospective cohorts based on their decision to opt for or decline the PSP (PSP or non-PSP cohorts). In addition, a historical, retrospective Non-PSP cohort was established from the Services Australia 10% PBS dataset by extracting data of patients initiating adalimumab prior to the introduction of adalimumab PSPs and based on adalimumab PBS listing dates (AS: April 2007 to March 2009; PsA/RA: January 2007 to December 2008; CD: January 2009 to December 2010; HS and UC indications not included). Follow-up for all cohorts was 12 months. The primary endpoint was the time to discontinuation, compared between the prospective PSP cohort and the prospective or retrospective Non-PSP cohort. Inverse probability of treatment weighting was used to balance the cohorts. A Cox proportional hazards model indicated no difference in time to discontinuation between the prospective PSP (n = 162) and non-PSP (n = 65) cohorts (HR [95% CI] = 1.256 [0.616-2.563], p = 0.5304). The 12-month adalimumab persistence rates (95% CI) were 78% (69%, 84%) and 82% (67%, 90%), respectively. In contrast, discontinuation was less likely in the prospective PSP (n = 151) compared with the retrospective non-PSP (n = 297) cohort (HR [95% CI] = 0.44 [0.28-0.68], p<0.001). The 12-month persistence rates (95% CI) were 81% (76%, 90%) and 61% (56%, 67%), respectively. Overall, this study suggests that optimal adalimumab persistence can be achieved with either a structured PSP or healthcare support from other sources, but this was not the case more than a decade ago.


Subject(s)
Adalimumab , Humans , Adalimumab/therapeutic use , Adalimumab/administration & dosage , Female , Male , Adult , Middle Aged , Australia , Retrospective Studies , Prospective Studies , Antirheumatic Agents/therapeutic use , Antirheumatic Agents/administration & dosage , Spondylitis, Ankylosing/drug therapy , Aged , Withholding Treatment
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