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Grant JB, Mackinnon AJ, Christensen H, Walker J. Participants' perceptions of motivation, randomisation and withdrawal in a randomised controlled trial of interventions for prevention of depression. JOURNAL OF MEDICAL ETHICS 2009; 35:768-773. [PMID: 19948934 DOI: 10.1136/jme.2008.028035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS AND BACKGROUND Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants' motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial (RCT) for prevention of depression. METHODS Participants were older adults reporting elevated depression symptoms (N = 900) living in urban and regional locations in Australia who had consented to participate in an RCT of interventions to prevent depression. Participants rated their agreement with various statements describing motivations for enrolment in the trial and opinions regarding randomisation and withdrawal. RESULTS The majority of participants expressed a triad of altruistic motivation for participation, relative lack of concern about randomisation and commitment to the trial. Certain subgroups of participants, such as women and those with higher depression scores, reported higher levels of concern about specific issues. CONCLUSIONS The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes (eg, high commitment, low expectation of personal gain) towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials.
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Batterham PJ, Christensen H, Mackinnon AJ. Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach. BMC Psychiatry 2009; 9:75. [PMID: 19930610 PMCID: PMC2784764 DOI: 10.1186/1471-244x-9-75] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 11/22/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. METHODS The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. RESULTS The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. CONCLUSION The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.
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Cherbuin N, Reglade-Meslin C, Kumar R, Jacomb P, Easteal S, Christensen H, Sachdev P, Anstey KJ. Risk factors of transition from normal cognition to mild cognitive disorder: the PATH through Life Study. Dement Geriatr Cogn Disord 2009; 28:47-55. [PMID: 19628940 DOI: 10.1159/000229025] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2009] [Indexed: 11/19/2022] Open
Abstract
AIMS The aim of this study was to identify physical and mental health and lifestyle predictors of transition from normal cognition to mild cognitive disorder (MCD). METHODS A total of 2,082 individuals, aged 60-64 years, were assessed at 2 time-points 4 years apart for mild cognitive impairment (MCI) and other MCDs. RESULTS The main predictors of conversion to MCI and to other mild cognitive disorders were past alcohol intake, current anxiety and depression medication, increased systolic blood pressure, and past smoking. CONCLUSION Participants with a history of smoking or harmful alcohol consumption, hypertension, or who took medication for anxiety or depression were at increased risk of transitioning to MCI or any MCD. Strategies targeted at managing the above risk factors may have benefits in preventing mild cognitive decline in relatively healthy middle-aged individuals living in the community.
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Batterham PJ, Christensen H, Mackinnon AJ. Fluid intelligence is independently associated with all-cause mortality over 17 years in an elderly community sample: An investigation of potential mechanisms. INTELLIGENCE 2009. [DOI: 10.1016/j.intell.2008.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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380
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Anstey KJ, Low LF, Christensen H, Sachdev P. Level of cognitive performance as a correlate and predictor of health behaviors that protect against cognitive decline in late life: The path through life study. INTELLIGENCE 2009. [DOI: 10.1016/j.intell.2008.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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381
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Costin DL, Mackinnon AJ, Griffiths KM, Batterham PJ, Bennett AJ, Bennett K, Christensen H. Health e-cards as a means of encouraging help seeking for depression among young adults: randomized controlled trial. J Med Internet Res 2009; 11:e42. [PMID: 19850549 PMCID: PMC2802564 DOI: 10.2196/jmir.1294] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 08/15/2009] [Accepted: 08/27/2009] [Indexed: 12/22/2022] Open
Abstract
Background There is a need to identify interventions that increase help seeking for depression among young adults. Objective The aim was to evaluate a brief depression information intervention employing health e-cards (personalized emails containing links to health information presented on a Web page). Methods A randomized controlled trial was carried out with 348 19- to 24-year-olds drawn from the community. Participants were randomized to receive one of three conditions, all of which delivered a short series of health e-cards. Two active conditions involved the delivery of depression information designed to increase help-seeking behavior and intentions and to improve beliefs and knowledge associated with help seeking. A control arm delivered information about general health issues unrelated to depression. The primary outcome was help-seeking behavior. Secondary outcomes were help-seeking intentions; beliefs about the efficacy of depression treatments and help sources; ability to recognize depression; knowledge of the help-seeking process; and depressive symptoms. The study’s primary focus was outcomes relating to formal help seeking (consultation with a general practitioner or mental health professional) but also targeted behaviors, intentions, and beliefs relating to informal help seeking. Results Relative to the control condition, depression health e-cards were not associated with an increase in formal help-seeking behavior, nor were they associated with improved beliefs about depression treatments; ability to recognize depression; knowledge of the help-seeking process; or depressive symptoms. Depression e-cards were associated with improved beliefs about the overall efficacy of formal help sources (z = 2.4, P = .02). At post-intervention, participants in all conditions, relative to pre-intervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t641 = 5.8, P < .001) and were more likely to rate interpersonal psychotherapy as being helpful (z = 2.0, P = .047). Depression e-cards were not associated with any significant changes in informal help-seeking behavior, intentions, or beliefs. Conclusions The study found no evidence that providing depression information in the form of brief e-cards encourages help seeking for depression among young adults. Involvement in the study may have been associated with increased help-seeking intentions among participants in all conditions, suggesting that mechanisms other than depression information may increase help seeking. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN98406912; http://www.controlled-trials.com/ISRCTN98406912/ISRCTN98406912 (Archived by WebCite at http://www.webcitation.org/5k221KiMi)
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Gregersen RH, Neubauer C, Christensen H, Bojesen AM, Hess M, Bisgaard M. Comparative studies on [Pasteurella] testudinis and [P.] testudinis-like bacteria and proposal of Chelonobacter oris gen. nov., sp. nov. as a new member of the family Pasteurellaceae. Int J Syst Evol Microbiol 2009. [DOI: 10.1099/ijs.0.66817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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383
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Christensen H, Bisgaard M. Phylogenetic relationships of Riemerella anatipestifer serovars and related taxa and an evaluation of specific PCR tests reported for R. anatipestifer. J Appl Microbiol 2009; 108:1612-9. [PMID: 19840176 DOI: 10.1111/j.1365-2672.2009.04558.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS The aims of the present investigation were to characterize and identify serovars of Riemerella anatipestifer and Riemerella-like isolates genetically and to test the specificity of PCR tests reported for the identification of R. anatipestifer. METHODS AND RESULTS A total of 50 isolates from poultry tentatively classified with Riemerella anatipestifer were characterized genetically by partial sequencing of rpoB and by nearly full sequencing of the 16S rRNA gene for selected isolates. The results obtained were compared with the data from 13 reference strains by phylogenetic analysis. A total of 41 isolates were identified as R. anatipestifer, three as Wautersiella falsenii like, a single isolate as Pelistega europaea, while five isolates were classified as new, unnamed taxa. None of the reported PCR tests for identification of R. anatipestifer were found specific. CONCLUSIONS Characterization of R. anatipestifer and related bacteria by traditional methods is often inconclusive because of inconsistent reactions and phenotypic diversity. For the same reason, gene sequencing and phylogenetic analysis are essential to allow proper classification and identification as demonstrated in the present study. SIGNIFICANCE AND IMPACT OF THE STUDY The present investigations demonstrated that isolates of R. anatipestifer are often misidentified, and that new serovars should not be accepted unless they have been properly characterized by relevant genetic methods such as gene sequencing. In addition, we showed that the published PCR tests are not specific for this species. Finally, two new taxa were outlined, the final taxonomic positions of which remain to be identified.
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384
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Calear AL, Christensen H. Systematic review of school-based prevention and early intervention programs for depression. J Adolesc 2009; 33:429-38. [PMID: 19647310 DOI: 10.1016/j.adolescence.2009.07.004] [Citation(s) in RCA: 238] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 04/24/2009] [Accepted: 07/08/2009] [Indexed: 11/18/2022]
Abstract
A systematic review was conducted to identify and describe school-based prevention and early intervention programs for depression and to evaluate their effectiveness in reducing depressive symptoms. Forty-two randomised controlled trials, relating to 28 individual school-based programs, were identified through the Cochrane Library, PsycInfo and PubMed databases. A large proportion of the programs identified were based on cognitive behavioural therapy (CBT), and delivered by a mental health professional or graduate student over 8-12 sessions. Indicated programs, which targeted students exhibiting elevated levels of depression, were found to be the most effective, with effect sizes for all programs ranging from 0.21 to 1.40. Teacher program leaders and the employment of attention control conditions were associated with fewer significant effects. Further school-based research is required that involves the use of attention controls, long-term follow-ups and which focuses on the training and evaluation of sustainable program leaders, such as teachers.
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385
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Low LF, Anstey KJ, Jorm AF, Rodgers B, Christensen H. Reproductive period and cognitive function in a representative sample of naturally postmenopausal women aged 60–64 years. Climacteric 2009; 8:380-9. [PMID: 16390773 DOI: 10.1080/13697130500345240] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Greater lifetime estrogen exposure has been postulated to result in better cognition in later life, particularly in the area of verbal memory. In women, the highest levels of endogenous estrogen occur during their reproductive period, between menarche and menopause. OBJECTIVE To investigate the association between reproductive period and cognition. METHODS The sample consisted of 760 naturally postmenopausal women aged 60-64 years (mean age 62.5 +/- 1.5 years) participating in the PATH Through Life Study who were randomly drawn from the population of Canberra, Australia. Participants were administered a verbal learning test (immediate recall and 1-minute delay), the Mini-Mental State Examination (MMSE), digit span backwards, the Symbol-Digit Modalities Test and simple and choice reaction time tests. RESULTS There were no significant associations detected between reproductive period and performance on any of the cognitive tests, either before or after controlling for potential confounding variables. CONCLUSIONS Reproductive period, a surrogate measure of endogenous estrogen exposure, had no detectable effect on cognitive performance in this sample.
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386
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Skovgaard Larsen L, Rosenkilde M, Christensen H, Bang N, Bolvig L, Christiansen, Laurberg S. Can contrast-enhanced ultrasonography replace multidetector-computed tomography in the detection of liver metastases from colorectal cancer? Clin Imaging 2009. [DOI: 10.1016/j.clinimag.2009.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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387
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de Vries LE, Christensen H, Skov RL, Aarestrup FM, Agerso Y. Diversity of the tetracycline resistance gene tet(M) and identification of Tn916- and Tn5801-like (Tn6014) transposons in Staphylococcus aureus from humans and animals. J Antimicrob Chemother 2009; 64:490-500. [DOI: 10.1093/jac/dkp214] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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388
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Gregersen RH, Neubauer C, Christensen H, Bojesen AM, Hess M, Bisgaard M. Comparative studies on [Pasteurella] testudinis and [P.] testudinis-like bacteria and proposal of Chelonobacter oris gen. nov., sp. nov. as a new member of the family Pasteurellaceae. Int J Syst Evol Microbiol 2009. [DOI: 10.1099/ijs.0.007203-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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389
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Skottheim IB, Stormark K, Christensen H, Jakobsen GS, Hjelmesaeth J, Jenssen T, Reubsaet JLE, Sandbu R, Asberg A. Significantly altered systemic exposure to atorvastatin acid following gastric bypass surgery in morbidly obese patients. Clin Pharmacol Ther 2009; 86:311-8. [PMID: 19494810 DOI: 10.1038/clpt.2009.82] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The impact of gastric bypass on atorvastatin pharmacokinetics was investigated in 12 morbidly obese patients being treated with 20-80 mg atorvastatin each morning. Eight-hour pharmacokinetic investigations were performed the day before the surgery and at a median of 5 weeks (range 3-6 weeks) after the surgery. Gastric bypass surgery produced a variable effect on individual systemic exposure to atorvastatin acid (area under the plasma concentration vs. time curve from 0 to 8 h postdose (AUC(0-8))), ranging from a threefold decrease to a twofold increase (median ratio = 1.1, P = 0.99). Patients with the highest systemic exposure to atorvastatin before surgery showed reduced exposure after surgery (n = 3, median ratio = 0.4, range = 0.3-0.5, P < 0.01), whereas those with lower systemic exposure before surgery showed a median 1.2-fold increase in atorvastatin AUC(0-8) (n = 9, range = 0.8-2.3, P = 0.03) after surgery. This study indicates that the presurgical first-pass metabolic capacity influences the effect of gastric bypass on atorvastatin bioavailability. Because individual first-pass metabolic capacity is not readily assessable clinically, retitration up to the lowest effective dose should be performed after the surgery.
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390
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Hedegaard L, Christensen H, Chadfield MS, Christensen JP, Bisgaard M. Association of Streptococcus pluranimalium with valvular endocarditis and septicaemia in adult broiler parents. Avian Pathol 2009; 38:155-60. [PMID: 19322715 DOI: 10.1080/03079450902737763] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The genus Streptococcus consists of more than 60 species, but only Streptococcus equi subspecies zooepidemicus, Streptococcus gallolyticus ssp. gallolyticus, Streptococcus gallinaceus, Streptococcus dysgalactiae, Streptococcus mutans and Streptococcus suis have been isolated from poultry. During investigations of the aetiology of increased mortality in broiler parent stock at the end of production, pure cultures of streptococcal-like organisms that could not be classified among these six species were obtained from 24 cases of septicaemia or valvular endocarditis and septicaemia. Phenotypic characterization using the API20 STREP kit identified the isolates as Aerococcus viridans (10), Aerococcus urinae (2), Leuconostoc species (4), Streptococcus salivarius (2), Streptococcus bovis II 3 (1), Enterococcus avium (3), Enterococcus faecium (1) or Gemella morbillorum (1). However, this identification was misleading as subsequent genetic investigations using pulse field gel electrophoresis and sequencing of 16S rRNA genes showed that 19 isolates were classified as Streptococcus pluranimalium, while the remaining isolates were E. avium (3), E. faecium (1) or Lactobacillus species (1). Misidentification by API20 STREP was related to the database provided by the manufacturer, as the phenotypic characteristics could identify these organisms as S. pluranimalium. The isolates of S. pluranimalium belonged to at least three different clones as determined by pulsed field gel electrophoresis of SmaI-digested genomic DNA. The capacity that these isolates had to colonize the valvular endothelium was suggested by the occurrence of valvular endocarditis in 12 of 19 cases. Demonstration of the same clone in all four houses on a farm suggested the pathogenic potential of this organism.
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391
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O'Kearney R, Kang K, Christensen H, Griffiths K. A controlled trial of a school-based Internet program for reducing depressive symptoms in adolescent girls. Depress Anxiety 2009; 26:65-72. [PMID: 18828141 DOI: 10.1002/da.20507] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study evaluates the benefits of a self-directed Internet intervention for depression (MoodGYM) delivered as a part of the high school curriculum. METHOD One hundred and fifty-seven girls, aged 15 and 16 years, were allocated to undertake either MoodGYM or their usual curriculum. MoodGYM's impact on depressive symptoms, risk of depression, attributional style, depression literacy and attitudes toward depression was examined using random effect regression. RESULTS MoodGYM produced a significantly faster rate of decline in depressive symptoms over the trial period than the control condition. The effect size for MoodGYM was not significant immediately after the intervention (Cohen's d=.19, 95% CI -.18-.56) but was moderate and significant 20 weeks after the intervention (d=.46, 95% CI .10-.82). Girls with high depression scores before intervention showed the strongest benefits on self-reported depression at follow-up (d=.92, 95% CI .10-1.38). There were no significant intervention effects on depression status, attributional style, depression literacy, and attitudes. Approximately 70% of girls in the MoodGYM group completed less than three of its modules and completion of fewer modules was related to high depression score before intervention. CONCLUSIONS The findings suggest that there are benefits from MoodGYM on self-reported depressive symptoms but has low rates of completion highlight problems in ensuring adherence to Internet programs for depression.
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Christensen H, Griffiths KM, Farrer L. Adherence in internet interventions for anxiety and depression. J Med Internet Res 2009; 11:e13. [PMID: 19403466 PMCID: PMC2762797 DOI: 10.2196/jmir.1194] [Citation(s) in RCA: 735] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 03/11/2009] [Accepted: 03/17/2009] [Indexed: 11/13/2022] Open
Abstract
Background Open access websites which deliver cognitive and behavioral interventions for anxiety and depression are characterised by poor adherence. We need to understand more about adherence in order to maximize the impact of Internet-based interventions on the disease burden associated with common mental disorders. Objective The aims of this paper are to review briefly the adherence literature with respect to Internet interventions and to investigate the rates of dropout and compliance in randomized controlled trials of anxiety and depression Web studies. Methods A systematic review of randomized controlled trials using Internet interventions for anxiety and depression was conducted, and data was collected on dropout and adherence, predictors of adherence, and reasons for dropout. Results Relative to reported rates of dropout from open access sites, the present study found that the rates of attrition in randomized controlled trials were lower, ranging from approximately 1 - 50%. Predictors of adherence included disease severity, treatment length, and chronicity. Very few studies formally examined reasons for dropout, and most studies failed to use appropriate statistical techniques to analyze missing data. Conclusions Dropout rates from randomized controlled trials of Web interventions are low relative to dropout from open access websites. The development of theoretical models of adherence is as important in the area of Internet intervention research as it is in the behavioral health literature. Disease-based factors in anxiety and depression need further investigation.
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Bisgaard M, Korczak BM, Busse HJ, Kuhnert P, Bojesen AM, Christensen H. Classification of the taxon 2 and taxon 3 complex of Bisgaard within Gallibacterium and description of Gallibacterium melopsittaci sp. nov., Gallibacterium trehalosifermentans sp. nov. and Gallibacterium salpingitidis sp. nov. Int J Syst Evol Microbiol 2009; 59:735-44. [DOI: 10.1099/ijs.0.005694-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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394
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Griffiths KM, Christensen H, Jorm AF. Mental health literacy as a function of remoteness of residence: an Australian national study. BMC Public Health 2009; 9:92. [PMID: 19327161 PMCID: PMC2670295 DOI: 10.1186/1471-2458-9-92] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 03/27/2009] [Indexed: 11/13/2022] Open
Abstract
Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australian national survey of the mental health literacy of 3998 adults. Measures included the perceived helpfulness of a range of professionals, non-professionals and interventions, and the causes, prognosis, and outcomes after treatment for four case vignettes describing depression, depression with suicidal ideation, early schizophrenia and chronic schizophrenia. Participant awareness of Australia's national depression initiative and depression in the media, their symptoms of depression and exposure to the conditions depicted in the vignettes were also compared. Results Mental health literacy was similar across remoteness categories. However, inner regional residents showed superior identification of the disorders depicted in the suicidal ideation and chronic schizophrenia vignettes. They were also more likely to report having heard of Australia's national depression health promotion campaign. Conversely, they were less likely than major city residents to rate the evidence-based treatment of psychotherapy helpful for depression. Both inner regional and outer-remote residents were less likely to rate psychologists as helpful for depression alone. The rural groups were more likely to rate the non-evidence based interventions of drinking and painkillers as helpful for a depression vignette. In addition, outer-remote residents were more likely to identify the evidence based treatment of antipsychotics as harmful for early schizophrenia and less likely to endorse psychiatrists, psychologists, social workers and general practitioners as helpful for the condition. Conclusion Mental health awareness campaigns in rural and remote regions may be most appropriately focused on communicating which interventions are effective for depression and schizophrenia and which mental health and other professionals are trained in the best-practice delivery and management of these. There is also a need to communicate to rural residents that alcohol and pain relievers are not an effective solution for depression.
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Neil AL, Batterham P, Christensen H, Bennett K, Griffiths KM. Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings. J Med Internet Res 2009; 11:e6. [PMID: 19275982 PMCID: PMC2762770 DOI: 10.2196/jmir.1050] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Revised: 11/04/2008] [Accepted: 11/21/2008] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There have been no previous studies of the variables that predict adherence to online depression and anxiety intervention programs among adolescents. However, research of traditionally delivered intervention programs for a variety of health conditions in adolescence suggests that health knowledge, type and level of symptomatology, race, socioeconomic status, treatment setting, and support may predict adherence. OBJECTIVE The aim was to compare adherence rates and identify the predictors of adherence to a cognitive behavior therapy website in two adolescent samples that were offered the program in different settings and under different conditions of support. METHODS The first adolescent sample consisted of 1000 school students who completed the MoodGYM program in a classroom setting over five weeks as part of a randomized controlled trial. The second sample consisted of 7207 adolescents who accessed the MoodGYM program spontaneously and directly through the open access URL. All users completed a brief survey before the start of the program that measured background characteristics, depression history, symptoms of depression and anxiety, and dysfunctional thinking. RESULTS Adolescents in the school-based sample completed significantly more online exercises (mean = 9.38, SD = 6.84) than adolescents in the open access community sample (mean = 3.10, SD = 3.85; t(1088.62) = -28.39, P < .001). A multiple linear regression revealed that school-based setting (P < .001) and female gender (P < .001) were predictive of greater adherence, as were living in a rural area (P < .001) and lower pre-test anxiety (P = .04) scores for the school-based sample and higher pre-test depression scores (P = .01) for the community sample. A history of depression (P = .33) and pre-test warpy thoughts scores (P = .35) were not predictive of adherence in the school-based or community sample. CONCLUSION Adherence is greater in monitored settings, and the predictors of adherence differ between settings. Understanding these differences may improve program effectiveness and efficiency.
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396
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Barney LJ, Griffiths KM, Christensen H, Jorm AF. Exploring the nature of stigmatising beliefs about depression and help-seeking: implications for reducing stigma. BMC Public Health 2009; 9:61. [PMID: 19228435 PMCID: PMC2654888 DOI: 10.1186/1471-2458-9-61] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2008] [Accepted: 02/20/2009] [Indexed: 11/30/2022] Open
Abstract
Background In-depth and structured evaluation of the stigma associated with depression has been lacking. This study aimed to inform the design of interventions to reduce stigma by systematically investigating community perceptions of beliefs about depression according to theorised dimensional components of stigma. Methods Focus group discussions were held with a total of 23 adults with personal experience of depression. The discussions were taped, transcribed and thematically analysed. Results Participants typically reported experiencing considerable stigma, particularly that others believe depressed people are responsible for their own condition, are undesirable to be around, and may be a threat. Participants expressed particular concerns about help-seeking in the workplace and from mental health professionals. Conclusion Findings indicate that interventions to reduce the stigma of depression should target attributions of blame; reduce avoidance of depressed people; label depression as a 'health condition' rather than 'mental illness'; and improve responses of help-sources (i.e. via informing professionals of client fears).
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397
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Neil AL, Christensen H. Efficacy and effectiveness of school-based prevention and early intervention programs for anxiety. Clin Psychol Rev 2009; 29:208-15. [PMID: 19232805 DOI: 10.1016/j.cpr.2009.01.002] [Citation(s) in RCA: 227] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 01/11/2009] [Accepted: 01/20/2009] [Indexed: 10/21/2022]
Abstract
A systematic review was conducted of school-based prevention and early intervention programs for anxiety. The aim of the review was to identify and describe the programs available, and to evaluate their effectiveness in reducing symptoms of anxiety. Twenty-seven outcome trials, describing 20 individual programs, were identified through the Cochrane Library, PsycInfo and PubMed databases. Results of the review indicated that most universal, selective and indicated prevention programs are effective in reducing symptoms of anxiety in children and adolescents, with effect sizes ranging from 0.11 to 1.37. Most programs targeted adolescents (59%), were aimed at reducing the symptoms of nonspecific anxiety (67%), and delivered cognitive behavioural therapy (CBT; 78%). Further quality school-based research is required that involves longer-term follow-up, the use of attention control conditions and evaluates teacher delivery.
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Kuhnert P, Christensen H. International Committee on Systematics of Prokaryotes; Subcommittee on the taxonomy of Pasteurellaceae: Minutes of the meetings, 6 August 2008, Istanbul, Turkey. Int J Syst Evol Microbiol 2009. [DOI: 10.1099/ijs.0.009746-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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399
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Leach LS, Christensen H, Mackinnon AJ, Windsor TD, Butterworth P. Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc Psychiatry Psychiatr Epidemiol 2008; 43:983-98. [PMID: 18575787 DOI: 10.1007/s00127-008-0388-z] [Citation(s) in RCA: 230] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 05/22/2008] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is robust epidemiological and clinical evidence that a greater number of women than men experience depression and anxiety. This study investigated a number of socio-demographic, health and lifestyle, psychological and social factors as possible mediators for the gender difference in depression and anxiety in three cohorts (20-24, 40-44, 60-64). METHODS Responses were from a representative, community based survey (n = 7,485) conducted in Canberra and Queanbeyan (NSW), in Australia. Depression and anxiety were measured using the self-report Goldberg Anxiety and Depression Scales. The analyses initially identified gender differences in the potential mediators, followed by univariate and multivariate mediation models. RESULTS The results indicated several shared mediators for depression and anxiety across the three age groups including: childhood adversity, mastery, behavioural inhibition, ruminative style, neuroticism, physical health, physical activity, and perceived interpersonal and employment problems. There was a decrease in the number of social mediators as age increased. The multivariate models accounted for gender differences in both conditions for all age groups, except for anxiety in the 20-24 years old. This suggests further important unmeasured mediators for this age group. CONCLUSIONS These findings add to the literature surrounding gender differences in depression and anxiety, and provide a basis for future research exploring variation in these gender disparities over the adult lifespan.
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400
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Lund H, Juul-Kristensen B, Hansen K, Christensen R, Christensen H, Danneskiold-Samsoe B, Bliddal H. Movement detection impaired in patients with knee osteoarthritis compared to healthy controls: a cross-sectional case-control study. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2008; 8:391-400. [PMID: 19147977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this study was to clarify whether osteoarthritis (OA) patients have a localized or a generalized reduction in proprioception. Twenty one women with knee OA (mean age [SD]: 57.1 [12.0] years) and 29 healthy women (mean age [SD]: 55.3 [10.1] years) had their joint position sense (JPS) and threshold to detection of a passive movement (TDPM) measured in both knees and elbows. JPS was measured as the participant's ability to actively reproduce the position of the elbow and knee joints. TDPM was measured as the participant's ability to recognize a passive motion of the elbow and knee joints. The absolute error (AE) for JPS (i.e., absolute difference in degrees between target and estimated position) and for TDPM (i.e., the difference in degrees at movement start and response when recognizing the movement) was calculated. For TDPM a higher AE (mean [SE]) was found in the involved knees in patients than in the matched knees of healthy participants (AE: 2.41 degrees [0.20 degrees] versus 1.47 degrees [0.14], p=0.001). The same held true for the non-involved knees between OA and healthy subjects (AE: 2.20 degrees [0.20 degrees] versus 1.57 degrees [0.14 degrees], p=0.016). Furthermore TDPM was higher in OA patients' right elbows compared to healthy participants' right elbows (AE: 2.15 degrees [0.20 degrees] versus 1.45 degrees [0.15 degrees], p=0.011). No significant difference between healthy women and OA patients regarding the left elbow for TDPM, or JPS was observed. The present age-controlled, cross-sectional study suggests that there is an increase in threshold to detection of a passive motion in knees and elbows for patients with knee OA. This indicates that OA may be associated with a generalized defect in proprioception with possible implications for the pathogenesis of the joint degeneration.
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