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1.
Rural Remote Health ; 22(1): 6930, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35130708

RESUMEN

INTRODUCTION: Access to healthcare services should be equitable no matter where you live. However, the podiatry needs of rural populations are poorly addressed, partly because of workforce maldistribution. Encouraging emerging podiatrists to work in rural areas is a key solution. The aims were to explore (1) recently graduated podiatrists' perceptions regarding working rurally and (2) broader industry views of the factors likely to be successful for rural recruitment and retention. METHODS: Recruitment for interviews pertaining to podiatrist recruitment and retention was conducted during 2017. Recruitment was through social media, podiatry professional association newsletters, public health podiatry emails. Graduate perceptions were explored via two focus groups of Australian podiatrists enrolled in the Podiatrists in Australia: Investigating Graduate Employment longitudinal survey. Industry views were explored through semistructured interviews with podiatry profession stakeholders. Inductive thematic analysis was used to analyse data about the perceptions of recently graduated podiatrists and stakeholders and the themes were triangulated between the two groups. RESULTS: Overall, 11 recent graduate podiatrists and 15 stakeholders participated. The overarching themes among the two groups were the importance of 'growing me' and 'growing the profession'. Three superordinate themes were generated through analysis of both datasets, including (i) building a career, (ii) why I stay, and (iii) it cannot be done alone. CONCLUSION: This study identified that recently graduated podiatrists are likely to be attracted to rural work and retained in rural areas if they foresee opportunities for career progression in stable jobs, have a background of training and living in rural areas, like the lifestyle, and are able to access appropriate professional and personal supports. Building employment that spans public and private sector opportunities might be attractive to new graduate podiatrists seeking a breadth of career options. It is also important to recognise rural generalist podiatrists for any extended scope of services they provide along with raising public awareness of the role of rural podiatrist as a core part of multidisciplinary rural healthcare teams. Future training and workforce planning in podiatry must promote podiatrists taking up rural training and work so that maldistribution is reduced.


Asunto(s)
Podiatría , Servicios de Salud Rural , Técnicos Medios en Salud , Australia , Humanos , Investigación Cualitativa , Población Rural
2.
BMC Public Health ; 22(1): 911, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35525945

RESUMEN

BACKGROUND: Refugee women are potentially at increased risk for chronic pain due to circumstances both in the pre-migration and post-settlement setting. However, this relationship between refugee-related challenges introduced along their migration trajectories and chronic pain remains unclear. This study will therefore examine the association between pre- and post-migration factors and chronic pain in refugee women five years into resettlement in Australia. METHODS: The first five waves of data from the 'Building a New Life in Australia' longitudinal study of humanitarian refugees living in Australia was analysed using logistic regression models to investigate the association between predictor variables and chronic pain. The study outcome was chronic pain and predictors were migration process and resettlement factors in both the pre-and post-settlement setting. RESULTS: Chronic pain was reported in 45% (n = 139) of women, and among these a further 66% (n = 120) also reported having a long-term disability or health condition that had lasted 12 months. Pre- migration factors such as increasing age (OR 1.08; 95% CI 1.05, 1.11) and women who migrated under the Women at Risk Visa category (OR 2.40; 95% CI 1.26, 4.56) had greater odds of experiencing chronic pain. Interestingly, post migration factors such as women with better general health (OR 0.04; 95% CI 0.01, 0.11) or those who settled within metropolitan cities (OR 0.29; 95% CI 0.13, 0.68) had lower odds of experiencing chronic pain, and those who experience discrimination (OR 11.23; 95% CI 1.76, 71.51) had greater odds of experiencing chronic pain. CONCLUSION: Our results show that there is a high prevalence of chronic pain in refugee women across the initial years of resettlement in Australia. This may be in part due to pre-migration factors such as age and migration pathway, but more significantly the post migration context that these women settle into such as rurality of settlement, poorer general health and perceived discriminatory experiences. These findings suggest that there may be many unmet health needs which are compounded by the challenges of resettlement in a new society, highlighting the need for increased clinical awareness to help inform refugee health care and settlement service providers managing chronic pain.


Asunto(s)
Dolor Crónico , Refugiados , Australia/epidemiología , Dolor Crónico/epidemiología , Femenino , Humanos , Estudios Longitudinales , Población Rural
3.
Reprod Health ; 19(1): 111, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35525995

RESUMEN

BACKGROUND: Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don't use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time. METHODS: Using data from 15,244 young women from the Australian Longitudinal Study on Women's Health (born 1989-1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. RESULTS: Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using 'other' contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using 'other' contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease. CONCLUSION: The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women's contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.


Chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor outcomes for both the mother and baby. To optimise outcomes, it is important for these women to plan pregnancies and use effective contraception until such time. However, there is a lack of understanding of how these women use or don't use contraception, particularly with respect to highly effective contraception. This study examined patterns of contraceptive use among an Australian cohort of young women (born 1989­1995) and investigated the influence of chronic disease on contraceptive use over time. We found differences in contraceptive use over time for women with cardiac disease and those with autoinflammatory diseases. Importantly, compared to women without chronic disease using the pill alone, women with cardiac disease had double the odds of using low efficacy contraception. While women with autoinflammatory disease were 69% more likely to use long-acting methods combined with condoms, these women were also 70% more likely to use low efficacy contraception, compared to women without chronic disease who used the pill only. Contraceptive patterns did not differ for women with asthma or diabetes from women without chronic disease. The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women's contraceptive knowledge and contraceptive decision-making, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.


Asunto(s)
Anticoncepción , Anticonceptivos Orales Combinados , Australia/epidemiología , Enfermedad Crónica , Conducta Anticonceptiva , Femenino , Humanos , Estudios Longitudinales , Masculino , Embarazo , Estudios Prospectivos
4.
BMC Psychol ; 10(1): 119, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35526020

RESUMEN

BACKGROUND: Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country's population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia's population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners' attitudes toward this diversity and their level of cultural competence. AIM: Given the relationship between practitioner cultural competence and the mental health outcomes of non-White clients, this study aimed to identify factors that influence non-White and White practitioners' cultural competence. METHODS: An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Balanced Inventory of Desirable Responding (BIDR); the Multicultural Counselling Inventory (MCI); and the Color-blind Racial Attitudes Scale (CoBRAS). Descriptive statistics were used to summarise participants' demographic characteristics. One-way ANOVA and Kruskal-Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence and racial and ethnic blindness. Correlation analyses were conducted to determine the association between participants' gender or age and cultural competence. Hierarchical multiple regression analysis was conducted to predict cultural competence. RESULTS: The study demonstrates that non-White mental health practitioners are more culturally aware and have better multicultural counselling relationships with non-White people than their White counterparts. Higher MCI total scores (measuring cultural competence) were associated with older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to think more highly of themselves (e.g., have higher self-deceptive positive enhancement scores on the BIDR) than those with lower MCI total scores. CONCLUSION: The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners' age, racial/ethnic background and practitioner engagement with prior cultural competence training.


Asunto(s)
Competencia Cultural , Salud Mental , Actitud , Australia , Competencia Cultural/educación , Competencia Cultural/psicología , Diversidad Cultural , Humanos
5.
J Fam Pract ; 71(2): 85-87, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35507811

RESUMEN

A recent Australian study demonstrated a significant reduction in A-fib recurrence and burden among regular drinkers who abstained from alcohol.


Asunto(s)
Abstinencia de Alcohol , Consumo de Bebidas Alcohólicas , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/prevención & control , Australia/epidemiología , Humanos
6.
Health Informatics J ; 28(2): 14604582221100678, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35531625

RESUMEN

Drug-drug interaction (DDI) alerts are frequently included in electronic medical record (eMR) systems to provide users with relevant information and guidance at the point of care. In this study, we aimed to examine views of DDI alerts among prescribers, including junior doctors, registrars and senior doctors, across Australia. A validated survey for assessing prescribers' reported acceptance and use of DDI alerts was distributed among researcher networks and in newsletters. Fifty useable responses were received, more than half (n = 28) from senior doctors. Prescribers at all levels expected DDI alerts to improve performance but junior doctors reported that this was at a high cost, with respect to time and effort. Senior doctors and registrars reported rarely reading alerts and rarely changing prescribing decisions based on alerts. Respondents identified a number of problems with current alerts including limited relevance, repetition, and poor design, highlighting some clear areas for alert improvement.


Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas , Sistemas de Entrada de Órdenes Médicas , Médicos , Australia , Interacciones Farmacológicas , Humanos , Encuestas y Cuestionarios
8.
Funct Plant Biol ; 49(6): i-iii, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35533097

RESUMEN

sion="1.0" encoding="utf-8"?> FP Functional Plant Biology Funct. Plant Biol. 1445-4408 1445-4416 CSIRO Publishing 36 Gardiner Road Clayton VIC 3168 Australia FP22050 10.1071/FP22050 Foreword Advanced technologies in studying plant photosynthesis: principles and applications A. Zavafer et al . https://orcid.org/0000-0002-8905-1618 Zavafer Alonso A Fan Dayong B * https://orcid.org/0000-0001-8150-9535 Murakami Keach C Handling Editor Shabala Sergey Plant Science Division, Research School of Biology, The Australian National University, Canberra, ACT 2001, Australia. Hokkaido Agricultural Research Center (HARC), National Agriculture and Food Research Organization (NARO), 1 Hitsujigaoka, Toyohira, Sapporo 062-8555, Japan. College of Forestry, Beijing Forestry, University, Beijing 100083, China. * Correspondence to: Dayong Fan Hokkaido Agricultural Research Center (HARC), National Agriculture and Food Research Organization (NARO), 1 Hitsujigaoka, Toyohira, Sapporo 062-8555, Japan Email: dayong73fan@163.com 9 May 2022 49 6 Special Issue i iii 9 May 2022 Published: 9 May 2022 © 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing 2022 The Authors The foreword to this special issue on the advanced technologies in studying photosynthesis focuses on the main contributions of Fred Chow, one of the key Australian scientists studying light reactions in plants.


Asunto(s)
Agricultura Forestal , Fotosíntesis , Agricultura , Australia , Humanos , Investigación
9.
Circulation ; 145(19): 1443-1455, 2022 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-35533220

RESUMEN

BACKGROUND: TEXTMEDS (Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome) examined the effects of text message-delivered cardiac education and support on medication adherence after an acute coronary syndrome. METHODS: TEXTMEDS was a single-blind, multicenter, randomized controlled trial of patients after acute coronary syndrome. The control group received usual care (secondary prevention as determined by the treating clinician); the intervention group also received multiple motivational and supportive weekly text messages on medications and healthy lifestyle with the opportunity for 2-way communication (text or telephone). The primary end point of self-reported medication adherence was the percentage of patients who were adherent, defined as >80% adherence to each of up to 5 indicated cardioprotective medications, at both 6 and 12 months. RESULTS: A total of 1424 patients (mean age, 58 years [SD, 11]; 79% male) were randomized from 18 Australian public teaching hospitals. There was no significant difference in the primary end point of self-reported medication adherence between the intervention and control groups (relative risk, 0.93 [95% CI, 0.84-1.03]; P=0.15). There was no difference between intervention and control groups at 12 months in adherence to individual medications (aspirin, 96% vs 96%; ß-blocker, 84% vs 84%; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, 77% vs 80%; statin, 95% vs 95%; second antiplatelet, 84% vs 84% [all P>0.05]), systolic blood pressure (130 vs 129 mm Hg; P=0.26), low-density lipoprotein cholesterol (2.0 vs 1.9 mmol/L; P=0.34), smoking (P=0.59), or exercising regularly (71% vs 68%; P=0.52). There were small differences in lifestyle risk factors in favor of intervention on body mass index <25 kg/m2 (21% vs 18%; P=0.01), eating ≥5 servings per day of vegetables (9% vs 5%; P=0.03), and eating ≥2 servings per day of fruit (44% vs 39%; P=0.01). CONCLUSIONS: A text message-based program had no effect on medical adherence but small effects on lifestyle risk factors. REGISTRATION: URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364448; Unique identifier: ANZCTR ACTRN12613000793718.


Asunto(s)
Síndrome Coronario Agudo , Envío de Mensajes de Texto , Síndrome Coronario Agudo/tratamiento farmacológico , Síndrome Coronario Agudo/prevención & control , Australia , Femenino , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Prevención Secundaria , Método Simple Ciego
10.
BMJ Open Respir Res ; 9(1)2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35534039

RESUMEN

INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare, progressive, inherited ciliopathic disorder, which is incurable and frequently complicated by the development of bronchiectasis. There are few randomised controlled trials (RCTs) involving children and adults with PCD and thus evidence of efficacy for interventions are usually extrapolated from people with cystic fibrosis. Our planned RCT seeks to address some of these unmet needs by employing a currently prescribed (but unapproved for long-term use in PCD) macrolide antibiotic (azithromycin) and a novel mucolytic agent (erdosteine). The primary aim of our RCT is to determine whether regular oral azithromycin and erdosteine over a 12-month period reduces acute respiratory exacerbations among children and adults with PCD. Our primary hypothesis is that: people with PCD who regularly use oral azithromycin and/or erdosteine will have fewer exacerbations than those receiving the corresponding placebo medications. Our secondary aims are to determine the effect of the trial medications on PCD-specific quality-of-life (QoL) and other clinical outcomes (lung function, time-to-next exacerbation, hospitalisations) and nasopharyngeal bacterial carriage and antimicrobial resistance. METHODS AND ANALYSIS: We are currently undertaking a multicentre, double-blind, double-dummy RCT to evaluate whether 12 months of azithromycin and/or erdosteine is beneficial for children and adults with PCD. We plan to recruit 104 children and adults with PCD to a parallel, 2×2 partial factorial superiority RCT at five sites across Australia. Our primary endpoint is the rate of exacerbations over 12 months. Our main secondary outcomes are QoL, lung function and nasopharyngeal carriage by respiratory bacterial pathogens and their associated azithromycin resistance. ETHICS AND DISSEMINATION: Our RCT is conducted in accordance with Good Clinical Practice and the Australian legislation and National Health and Medical Research Council guidelines for ethical conduct of Research, including that for First Nations Australians. TRIAL REGISTRATION NUMBER: ACTRN12619000564156.


Asunto(s)
Azitromicina , Trastornos de la Motilidad Ciliar , Adulto , Australia , Azitromicina/uso terapéutico , Niño , Trastornos de la Motilidad Ciliar/tratamiento farmacológico , Humanos , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Tioglicolatos , Tiofenos
11.
BMJ Open ; 12(5): e051887, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534066

RESUMEN

PURPOSE: The Women Aware with Their Children study was created because prospective data are required to accurately guide prevention programmes for intimate partner violence (IPV) and to improve the mental health and resettlement trajectories of women from refugee backgrounds in Australia. PARTICIPANTS: 1335 women (685 consecutively enrolled from refugee backgrounds and 650 randomly selected Australian-born) recruited during pregnancy from three public antenatal clinics in Sydney and Melbourne, Australia. The mean age was 29.7 years among women from refugee backgrounds and 29.0 years among women born in the host nation. Main measures include IPV, mood, panic, post-traumatic stress disorder, disability and living difficulties. FINDINGS TO DATE: Prevalence of IPV at all three time points is significantly higher for refugee-background women. The trend data showed that reported IPV rates among Australian-born women increased from 25.8% at time 1 to 30.1% at time 3, while for refugee-background women this rate declined from 44.4% at time 1 to 42.6% at time 3. Prevalence of major depressive disorder (MDD) at all three time points is higher for refugee-background women. MDD among Australian-born women significantly declined from 14.5% at time 1 to 9.9% at time 3, while for refugee-background women it fluctuated from 25.1% at time 1 to 17.3% at time 2 and to 19.1% at time 3. FUTURE PLANS: We are currently examining trajectories of IPV and mental disorder across four time points. Time 4 occurred during the COVID-19 pandemic, enabling a unique opportunity to examine the impacts of the pandemic over time. Time 5 started in August 2021 and time 6 will begin approximately 12 months later. The children at time 5 are in the early school years, providing the capacity to examine behaviour, development and well-being of the index child.


Asunto(s)
COVID-19 , Trastorno Depresivo Mayor , Violencia de Pareja , Refugiados , Adulto , Australia/epidemiología , Niño , Estudios de Cohortes , Trastorno Depresivo Mayor/epidemiología , Femenino , Humanos , Violencia de Pareja/psicología , Masculino , Salud Mental , Pandemias , Embarazo , Estudios Prospectivos , Refugiados/psicología
12.
Open Heart ; 9(1)2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35534092

RESUMEN

BACKGROUND: Despite rapid technological advances and growth, quality in imaging has not received the focus seen elsewhere in cardiovascular medicine, resulting in significant gaps between guidelines and practice. Contemporary echocardiography practice requires comprehensive real-time data collection to allow dynamic auditing and benchmarking of key performance indices. The American College of Cardiology (ACC) proposed additional data standardisation, structured reporting identifying key data elements and imaging registries. In the absence of an Australian echocardiography registry, we developed a national clinical quality registry (GenesisCare Cardiovascular Outcomes Echo Registry). We hypothesised that measurement and local reporting of data would improve compliance of echo studies with quality guidelines and hence their clinical value. METHODS AND RESULTS: We prospectively collected data on 4 099 281 echocardiographic studies entered directly into a central electronic database from 63 laboratories across four Australian states between 2010 and 2021. Real-time auditing of key data elements and introduction of quality improvement pathways were performed to maximise completeness and uniformity of data acquisition and reporting. We compared completeness of key data element acquisition (AV peak velocity, left ventricular ejection fraction, E/e', LA area, rhythm, RVSP) by time and state using de-identified data. Key performance outcomes benchmarked against the aggregated study cohort and international standards were reported to individual sites to drive quality improvement. Between 2010 and 2014 there were significant improvements in data completeness (72.0%+/-26.8% vs 86.8%+/-13.5%, p=0.02), which were maintained to 2020. In addition, interstate variability fell for both EF and E/e' (p<0.002). CONCLUSIONS: This large-scale collaboration provides a platform for the development of major quality improvement initiatives in echocardiography. Introduction of local quality assurance programmes via a unified national data set significantly improved the completeness of reporting of key echo quality measures. This in turn significantly improved the quality of, and reduced the interstate variability of, echo data. Developing a centralised database allowed rapid adoption nationally of local quality improvements.


Asunto(s)
Ecocardiografía , Función Ventricular Izquierda , Australia , Humanos , Sistema de Registros , Volumen Sistólico , Estados Unidos
13.
J Nutr Educ Behav ; 54(5): 397-405, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35534098

RESUMEN

OBJECTIVE: To investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults. DESIGN: Cross-sectional analysis. PARTICIPANTS: Young adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study. MAIN OUTCOME MEASURES: Four eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods. ANALYSIS: Multivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders. RESULTS: Greater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P < 0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P < 0.001). CONCLUSIONS AND IMPLICATIONS: Perceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.


Asunto(s)
Dieta , Conducta Alimentaria , Adulto , Australia , Estudios Transversales , Ingestión de Alimentos , Conducta Alimentaria/fisiología , Femenino , Alimentos , Humanos , Masculino , Adulto Joven
14.
BMC Health Serv Res ; 22(1): 617, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534853

RESUMEN

BACKGROUND: The first aim of this study was to investigate the impact of providing an additional four hours of Saturday occupational therapy to patients receiving Saturday physiotherapy in an inpatient setting on length of stay, functional independence, gait and balance. The second aim was to conduct an economic evaluation to determine if the introduction of a Saturday occupational therapy service in addition to physiotherapy resulted in a net cost savings for the rehabilitation facility. METHODS: A prospective cohort study with a historical control was conducted in an Australian private mixed rehabilitation unit from 2015-2017. Clinical outcomes included the Functional Independence Measure (Motor, Cognitive, Total), gait speed (10 Meter Walk test) and five balance measures (Timed Up and Go test, Step test, Functional Reach, Feet Together Eyes Closed and the Balance Outcome Measure of Elder Rehabilitation). Economic outcomes were rehabilitation unit length of stay and additional treatment costs. RESULTS: A total of 366 patients were admitted to the rehabilitation unit over two 20-week periods. The prospective cohort (receiving Saturday occupational therapy and physiotherapy) had 192 participants and the historical control group (receiving Saturday physiotherapy only) had 174 participants. On admission, intervention group participants had higher cognitive (p < 0.01) and total (p < 0.01) Functional Independence Measure scores. Participation in weekend therapy by the intervention group was 11% higher, attending more sessions (p < 0.01) for a greater length of time (p < 0.01) compared to the historical control group. After controlling for differences in admission Functional Independence Measure scores, rehabilitation length of stay was estimated to be reduced by 1.39 (p = 0.08) days. The economic evaluation identified potential cost savings of AUD1,536 per patient. The largest potential savings were attributed to neurological patients AUD4,854. Traumatic and elective orthopaedic patients realised potential patient related cost savings per admission of AUD2,668 and AUD2,180, respectively. CONCLUSIONS: Implementation of four hours of Saturday occupational therapy in addition to physiotherapy results in a more efficient service, enabling a greater amount of therapy to be provided on a Saturday over a shorter length of stay. Provision of multidisciplinary Saturday rehabilitation is potentially cost reducing for the treating hospital.


Asunto(s)
Terapia Ocupacional , Adulto , Anciano , Australia , Estudios de Cohortes , Humanos , Pacientes Internos , Tiempo de Internación , Modalidades de Fisioterapia , Equilibrio Postural , Estudios Prospectivos , Estudios de Tiempo y Movimiento
15.
Cell Rep Med ; 3(4): 100611, 2022 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-35522100

RESUMEN

In this Q&A we speak with David Lynn, an EMBL Australia Group Leader at the South Australian Health and Medical Research Institute and a professor at Flinders University, about his research applying systems immunology approaches to better understand how pathogen and commensal microbes regulate our immune system in different contexts.


Asunto(s)
Investigación Biomédica , Australia , Humanos , Australia del Sur , Simbiosis , Universidades
16.
J Med Internet Res ; 24(5): e34769, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35522458

RESUMEN

BACKGROUND: Self-guided web-based programs are effective; however, inadequate implementation of these programs limits their potential to provide effective and low-cost treatment for common mental health problems at scale. There is a lack of research examining optimal methods for the dissemination of web-based programs in the community. OBJECTIVE: This study aimed to compare the uptake, reach, relative costs, and adherence associated with 3 community-based pathways for delivering a low-intensity web-based transdiagnostic mental health program. The 3 dissemination pathways were social media advertising, advertising in general practice, and advertising in pharmacies. METHODS: Participants were recruited on the web, from general practices, or from community pharmacies; completed a screener for psychological distress; and were offered the 4-week FitMindKit program-a 12-module psychotherapeutic intervention. Uptake was defined as the number of participants who enrolled in the web-based program; reach was defined as the rate of uptake per exposure; and costs were calculated based on staff time, equipment, and advertising. Adherence was assessed as the number of modules of FitMindKit completed by the participants. RESULTS: Uptake comprised 1014 participants who were recruited through the 3 dissemination pathways: on the web (991/1014, 97.73%), in general practice (16/1014, 1.58%), and in pharmacy (7/1014, 0.69%). Reach was highest for social media: 1 in every 50 people exposed to web-based advertising took up the intervention compared with 1 in every 441 in general practitioner clinics and 1 in every 1708 in pharmacies. The dissemination cost was US $4.87 per user on social media, US $557 per user for general practitioner clinics, and US $1272 per user for pharmacy dissemination. No significant differences in adherence were observed between the conditions, whereas all pathways showed an underrepresentation of men and linguistic diversity. CONCLUSIONS: The web-based dissemination pathway was the most efficient and cost-effective for delivering a self-guided internet-based mental health program to people in the community. More research is needed to identify how best to engage men and those with culturally diverse backgrounds in web-based interventions. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618001688279; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376113.


Asunto(s)
Intervención basada en la Internet , Ideación Suicida , Ansiedad/terapia , Australia , Depresión/terapia , Humanos , Internet , Masculino
17.
BMJ Open ; 12(5): e056212, 2022 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-35523493

RESUMEN

OBJECTIVES: Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-individual associations between changes in work and commute hours with changes in food practices. DESIGN: Longitudinal study SETTING: Australia PARTICIPANTS: Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The sample for this analysis included individuals who were in paid employment in at least one of the four waves. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption. RESULTS: Results indicated the longer individuals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: ß=-0.002 (95% CI -0.003 to -0.001), vegetables: ß=-0.002 (95% CI -0.003 to -0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-individual changes (IRR=1.006 (95% CI 1.005 to 1.007)). CONCLUSIONS: Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.


Asunto(s)
Frutas , Verduras , Australia , Dieta , Empleo , Conducta Alimentaria , Humanos , Encuestas y Cuestionarios , Transportes
18.
PLoS One ; 17(5): e0266571, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35511808

RESUMEN

Adolescents can easily access esports betting sites and place bets using cash or skins. This descriptive cross-sectional study examined the characteristics of adolescent esports bettors and relationships between their esports betting, video gaming activities, monetary gambling participation, and at-risk/problem gambling. Two survey samples of Australians aged 12-17 years were recruited through advertisements (n = 841) and online panel providers (n = 826). In both samples, gender and parents' living situation did not differ by past-month esports cash and skin betting, but recent esports betting was associated with engaging in esports gaming activities such as playing and watching esports, and in monetary gambling activities. Past-month esports betting using cash and skins was significantly associated with at-risk/problem gambling. After controlling for recent monetary gambling, recent esports skin bettors were over 3 times more likely to meet criteria for at-risk/problem gambling. Esports betting using skins appears to pose risks for young people and is easily accessible through unlicensed operators.


Asunto(s)
Conducta Adictiva , Juego de Azar , Deportes , Juegos de Video , Adolescente , Australia , Conducta Adictiva/epidemiología , Estudios Transversales , Humanos
19.
PLoS One ; 17(5): e0267877, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35511876

RESUMEN

The aim of this study was to investigate differences in psychological characteristics between people with knee osteoarthritis (OA) from Japan and Australia. Sixty-two adults from Japan and 168 adults from Australia aged over 50 years with knee pain were included. Japanese data were collected from patients with knee OA diagnosed by medical doctors. Australian data were baseline data from a randomized controlled trial. Participants were not exercising regularly or receiving physiotherapy at the time. Psychological characteristics evaluated were depressive symptoms, fear of movement, and pain catastrophizing. These psychological characteristics were compared between the Japanese and Australian cohorts by calculating 95% confidence intervals (CIs) for difference of the mean. To test for equivalence, an equivalence margin was set at 0.5 standard deviations (SD) of the mean, where these SDs were based on the Australian data. When the 95%CI for the difference of the mean value lay entirely within the range of equivalence margin (i.e. between -0.5 and 0.5 times the Australian SD), the outcome was considered equivalent. There were no differences between the groups from Japan and Australia for depressive symptoms and the two groups were considered equivalent. There was no difference between groups for fear of movement, however the criteria for equivalence was not met. People from Japan with knee OA had higher scores for pain catastrophizing than people from Australia. The findings should be confirmed in other samples of people with knee OA from Japan and Australia due to the limitations of the participant recruitment strategy in this study. However, our findings suggest there may be a greater need to consider pain catastrophizing and build pain self-efficacy when managing Japanese people with knee OA. Implementation of international clinical practice guidelines for OA management may require different strategies in different countries due to different psychological profiles.


Asunto(s)
Osteoartritis de la Rodilla , Adulto , Anciano , Australia , Estudios Transversales , Humanos , Japón , Osteoartritis de la Rodilla/diagnóstico , Dolor/psicología
20.
Methods Mol Biol ; 2489: 395-420, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35524061

RESUMEN

Metabolic engineering of heterologous hosts requires coexpression of multiple genes, often more than ten for a single pathway. Traditional approaches to create genetic constructs for this purpose are highly inflexible and suffer from very low throughput. In this book chapter, we describe a powerful method to overcome this bottleneck, namely, combinatorial co-expression in the Australian tobacco plant Nicotiana benthamiana. This system is based on Agrobacterium tumefaciens-mediated transient gene expression, often called agroinfiltration. Herein, instead of creating complex multigenic constructs, coexpression is achieved by simply mixing different plasmid-bearing Agrobacterium strains without the need for different selection markers. We present a practical guide for coexpressing multiple biosynthetic genes followed by GC-MS analysis, using production of the plant triterpene ß-amyrin as an example. Our chapter provides a guideline to harness the potential of this versatile expression system in the natural product community for studying and engineering metabolic pathways.


Asunto(s)
Agrobacterium tumefaciens , Tabaco , Agrobacterium tumefaciens/genética , Agrobacterium tumefaciens/metabolismo , Australia , Ingeniería Metabólica/métodos , Hojas de la Planta/metabolismo , Plantas Modificadas Genéticamente/genética , Tabaco/metabolismo
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