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Opio J, Wynne K, Attia J, Oldmeadow C, Hancock S, Kelly B, Inder K, McEvoy M. Metabolic Health, Overweight or Obesity, and Depressive Symptoms among Older Australian Adults. Nutrients 2024; 16:928. [PMID: 38612960 PMCID: PMC11013641 DOI: 10.3390/nu16070928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The relationship between overweight or obesity and depressive symptoms in individuals with or without cardio-metabolic abnormalities is unclear. In a cross-sectional study we examined the odds of experiencing depressive symptoms in overweight or obese older adults with or without metabolic abnormalities. METHODS The participants included 3318 older adults from the Hunter Community Study Cohort with a Body Mass Index (BMI) ≥ 18.5 kgm2, stratified by BMI and metabolic health risk. Obesity was defined as BMI ≥ 30 kgm2 and metabolically healthy as the absence of metabolic risk factors, according to International Diabetic Federation criteria for metabolic syndromes. Moderate to severe depressive symptoms were defined as a Centre for Epidemiological Studies Depression Scale (CES-D) score ≥ 16. RESULTS Compared to the metabolically healthy normal weight (MHNW) group, the odds of experiencing moderate/severe depressive symptoms were higher in those classified as a metabolically unhealthy normal weight (MUNW) (odds ratio (OR) = 1.25, 95% Confidence Interval (CI): 0.76-2.06) or metabolically unhealthy obesity (MUO) (OR = 1.48, 95% CI: 1.00-2.19), but not in those classified as metabolically unhealthy overweight (MUOW) (OR = 0.96, 95% CI: 0.63-1.45), metabolically healthy overweight (MHOW) (OR = 0.80, 95% CI: 0.51-1.26), and metabolically healthy obesity (MHO) (OR = 1.03, 95% CI: 0.65-1.64). Compared with MHNW males, the odds of moderate/severe depressive symptoms were increased in all other BMI category-metabolic health groups for males and females. LIMITATIONS Our relatively small sample size and cross-sectional design did not allow us to robustly establish causality. CONCLUSION The odds of experiencing moderate/severe depressive symptoms were increased in metabolically unhealthy older adults regardless of normal weight or obesity, with the odds of having moderate/severe depressive symptoms being higher in females than in males.
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Affiliation(s)
- Jacob Opio
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
| | - Katie Wynne
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
- Diabetes and Endocrinology, John Hunter Hospital, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
| | - Stephen Hancock
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
| | - Kerry Inder
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.O.); (K.W.); (J.A.); (C.O.); (B.K.)
- Hunter Medical Research Institute, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.H.); (K.I.)
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Edwards Road, Flora Hill, VIC 3552, Australia
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Chu G, Pitt V, Cant R, Johnson A, Inder K. Students' evaluation of professional experience placement quality in a pre-registration nursing programme: A cross-sectional survey. Nurse Educ Pract 2024; 75:103877. [PMID: 38232675 DOI: 10.1016/j.nepr.2024.103877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
AIM To evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University. BACKGROUND Professional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student's perspective. DESIGN Cross-sectional survey. METHODS A descriptive cross-sectional survey was administered online to 800 second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students' learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student's overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (β) and confidence interval (CI). Free-text comments were thematically analysed. RESULTS A total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1-19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (β: 2.61, 95% CI: 0.75, 4.47 and β: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (β: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment. CONCLUSIONS Most students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student's placement experience.
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Affiliation(s)
- Ginger Chu
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia.
| | - Victoria Pitt
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Robyn Cant
- Health Innovation and Transformation Centre, Federation University Australia, Berwick, VIC, Australia
| | - Amanda Johnson
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia
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Cheng C, Yang CY, Zhou M, Bai J, Inder K, Chan SWC. Validity and reliability of an Emotional Thermometer tool: an exploratory cross-sectional study. Contemp Nurse 2023:1-11. [PMID: 37218582 DOI: 10.1080/10376178.2023.2217952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
INTRODUCTION There are a few screening tools to detect psychological symptoms among people with multiple chronic conditions (MCCs) in China. AIM The aim of this study was to examine the validity and reliability of a translated version of the Emotional Thermometer (ET) tool. MATERIALS AND METHODS This cross-sectional study consisted of two phases: (1) translation and content validity testing; and (2) assessment of psychometric properties, including internal consistency, test-retest reliability, and construct validity. For the first phase, the authors used a forward-backward translation approach for the Chinese version of the instrument and tested its content validity with a panel of six experts. For the second phase, the data, including the ET tool and demographic characteristics were collected in a convenience sample of 197 Chinese people with MCCs recruited from a university hospital. The first 50 participants participated in the two-week retest. RESULTS The Chinese version of the ET tool had satisfactory psychometric properties; content validity index (0.83), internal consistency (0.92), and ICC (0.93 to 0.98 [p < 0.01]). Principal component analysis showed that there was only one component with an eigenvalue greater than 1 (value=3.80), with 76.67% of the variance responding. All items loaded significantly onto this factor and demonstrated strong loadings of > 0.70. CONCLUSION The Chinese-version of the ET tool is psychometrically sound. It has the potential to be used as a screening tool for psychological symptoms in Chinese people with MCCs. IMPACT STATEMENT Findings from testing the Chinese translation of the Emotional Thermometer indicate this could be a convenient and useful screening tool to detect psychological symptoms in patients with multiple chronic conditions.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Fudan University, Shanghai, China PR
- School of Nursing and Midwifery, the University of Newcastle, Callaghan, Australia
| | - Cong-Yan Yang
- Department of Nursing, the First Affiliated Hospital of Bengbu Medical College, Bengbu, China PR
| | - Meng Zhou
- School of Medicine and Public Health, the University of Newcastle, Callaghan, Australia
| | - Jie Bai
- Department of Nursing, Bengbu Medical College, Bengbu, China PR
| | - Kerry Inder
- School of Nursing and Midwifery, the University of Newcastle, Callaghan, Australia
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Kocanda L, Schumacher TL, Plotnikoff RC, Whatnall MC, Fenwick M, Brown LJ, Rollo ME, Jansson A, Burrows TL, Duncan MJ, Britton B, May J, Kerr J, Rutherford J, Boyle A, Inder K, Collins CE. Effectiveness and reporting of nutrition interventions in cardiac rehabilitation programmes: a systematic review. Eur J Cardiovasc Nurs 2023; 22:1-12. [PMID: 35672581 DOI: 10.1093/eurjcn/zvac033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 01/14/2023]
Abstract
AIMS Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review's objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. METHODS AND RESULTS Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO; CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. CONCLUSION There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality; 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. REGISTRATION PROSPERO; CRD42020188723.
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Affiliation(s)
- Lucy Kocanda
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia.,School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tracy L Schumacher
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Megan C Whatnall
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Matthew Fenwick
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Leanne J Brown
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Megan E Rollo
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Anna Jansson
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tracy L Burrows
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Mitch J Duncan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Ben Britton
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jennifer May
- Department of Rural Health, University of Newcastle, Tamworth, NSW 2340, Australia
| | - Jane Kerr
- Hunter New England Local Health District, Tamworth, NSW 2340, Australia
| | - Julie Rutherford
- Hunter New England Local Health District, Maitland, NSW 2320, Australia
| | - Andrew Boyle
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kerry Inder
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
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Snape AJ, Duff J, Gumuskaya O, Inder K, Hutton A. Strategies to prevent inadvertent retained surgical items: An integrative review. Journal of Perioperative Nursing 2022. [DOI: 10.26550/2209-1092.1196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hansen A, Hazelton M, Rosina R, Inder K. What do we know about the experience of seclusion in a forensic setting? An integrative literature review. Int J Ment Health Nurs 2022; 31:1109-1124. [PMID: 35384224 PMCID: PMC9543699 DOI: 10.1111/inm.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma-related harm and re-traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer-reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex-specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.
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Affiliation(s)
- Alison Hansen
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael Hazelton
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Robyn Rosina
- Independent Researcher, Sydney, New South Wales, Australia
| | - Kerry Inder
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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Hansen A, Hazelton M, Rosina R, Inder K. What do we know about the experience of seclusion in a forensic setting? An integrative literature review. Int J Ment Health Nurs 2022; 31:1109-1124. [PMID: 35592928 PMCID: PMC9546340 DOI: 10.1111/inm.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
Seclusion is used in forensic and general mental health settings to protect a person or others from harm. However, seclusion can result in trauma-related harm and re-traumatization with little known about the experience of seclusion for consumers in forensic mental health settings from their perspectives. This article explores consumer experiences of seclusion in forensic mental health settings and explores the differences between female and male experiences of seclusion. Five electronic databases were systematically searched using keywords and variations of experience, attitude, seclusion, coercion, forensic mental health, and forensic psychiatry. Inclusion criteria were original peer-reviewed studies conducted in adult forensic mental health settings reporting data on the experiences of or attitudes towards seclusion. Seven studies met the criteria for inclusion and a quality assessment was undertaken. Results found consumers in forensic mental health settings perceive seclusion to be harmful, a punishment for their behaviour, and largely a negative experience that impacts their emotional health. Some consumers report positive experiences of seclusion. Differences in the experience of seclusion for females and males are unclear. Further research is required to understand the experience of seclusion for women in forensic mental health settings. Identification and consideration of differences in the experience of seclusion for males and females may assist in identifying sex-specific interventions and may inform policy and practices to eliminate or reduce the trauma associated with seclusion use.
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Affiliation(s)
- Alison Hansen
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,School of Nursing & Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michael Hazelton
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Robyn Rosina
- Independent Researcher, Sydney, New South Wales, Australia
| | - Kerry Inder
- School of Nursing & Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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Summons P, Harmon J, Park M, Colloc J, Yeom S, Pitt V, Inder K. Development of a Framework for Problem Domain Transference in Health-Related Problem Based Learning and Assessment. J Probl Based Learn 2021. [DOI: 10.24313/jpbl.2021.00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
ObjectiveInvestigate the capability of a knowledge-based framework and architecture, used in a specific health domain problem that can utilise transfer learning, to speed virtual patient development for problem-based training and assessment in other health domains.MethodsAnalysis of a case study, based on a virtual patient used in the training of pharmacy students, to discover the viability of using generic, ontological knowledge capable of transfer to virtual patients in other health domains.ResultsAreas of the virtual pharmacy patient knowledge-base were identified, along with corresponding expected student questions, that are generic to other health domains. Using the framework from the case study to develop a new virtual patient for problem-based learning and assessment in a new health domain, these generic target questions could be utilised to speed up the development of other learning stimuli in future projects involving different health domains, such as nurse training in pain management.ConclusionsWith some modification, the framework of the case-study virtual patient was found to be capable of supporting generic expected student questions capable of re-use in virtual patients with new clinical conditions.
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Cheng C, Yang CY, Inder K, Chan SWC. Psychometric properties of Brief Coping Orientation to Problems Experienced in patients with multiple chronic conditions: A preliminary study. Int J Nurs Pract 2021; 28:e12955. [PMID: 34062623 DOI: 10.1111/ijn.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping-oriented interventions. PURPOSE The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE-CN) inventory in patients with MCCs. METHOD This study adopted a cross-sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE-CN, sociodemographic characteristics and clinical data were collected using a self-reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. RESULTS The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE-CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from .65 to .85 for the five subscales. CONCLUSIONS The psychometric properties of the Brief COPE-CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health-care professionals understand patients' coping and develop coping-based interventions to promote coping in this population.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
| | - Cong-Yan Yang
- Department of Nursing, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Kerry Inder
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally Wai-Chi Chan
- UON Singapore Department, The University of Newcastle Singapore, Singapore
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10
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Cheng C, Inder K, Chan SWC. The relationship between coping strategies and psychological distress in Chinese older adults with multiple chronic conditions. Australas J Ageing 2021; 40:397-405. [PMID: 33755297 DOI: 10.1111/ajag.12946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 02/05/2021] [Accepted: 02/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the relationship between socio-demographic and clinical variables, physical function, coping strategies and symptoms of anxiety and depression in Chinese older adults with multiple chronic conditions (MCCs). METHODS A secondary analysis of data from a prior cross-sectional survey investigated coping and mental health among adults with multiple chronic conditions living in China. A convenience sample of 185 adults with MCCs was recruited from a university-affiliated hospital between November 2017 and May 2018 in Northern Anhui, China. RESULTS Of the 185 participants, 63% of participants had scores indicating symptoms of anxiety and 54% had scores indicating depression. Stepwise regression models explained 47% of the total variance for the levels of anxiety and 34% for the levels of depression. In the anxiety model, gender, body pain, physical functioning, positive adaptation, denial and disengagement coping, and spiritual coping showed significant associations. In the depression model, gender, physical functioning, positive adaptation and spiritual coping showed significant associations. CONCLUSIONS This study demonstrates the need to screen for anxiety and depression among older adults with MCCs. Individualised interventions that address coping strategies should be encouraged to maintain psychological well-being in this population.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kerry Inder
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, Australia
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Cheng C, Yang CY, Inder K, Wai-Chi Chan S. Urban-rural differences in mental health among Chinese patients with multiple chronic conditions. Int J Ment Health Nurs 2020; 29:224-234. [PMID: 31609539 DOI: 10.1111/inm.12666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 09/04/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022]
Abstract
Mental health is impacted by social, economic, and environmental influences related to where people live. Mental health problems commonly co-occur with long-term physical conditions and impact individuals' health synergistically. Multiple chronic conditions (MCCs) including mental health problems are becoming a public health challenge globally. However, there is limited information about urban-rural differences in mental health among patients with MCCs in China. The present study aimed to identify differences in mental health between urban and rural patients with MCCs. Using a cross-sectional design, 347 patients with MCCs were recruited from a tertiary hospital in North Anhui, China. A self-reported questionnaire, including socio-demographic and clinical variables, the 12-item Short-Form survey version 2 on quality of life, and the Hospital Anxiety and Depression Scale, was administered to outpatients. Findings showed that rural participants reported more symptoms of anxiety and depression and had worse mental health compared to urban participants. Unemployment status, lower educational level, more long-term health conditions, and a higher degree of anxiety were associated with worse mental health. This study highlights disparities in mental health among patients with MCCs living in urban and rural areas of China. Appropriate mental health support programmes should be developed for patients with MCCs, especially for those living in rural areas.
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Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia.,Department of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Cong-Yan Yang
- Department of Nursing, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Glaw X, Hazelton M, Kable A, Inder K. Exploring academics beliefs about the meaning of life to inform mental health clinical practice. Arch Psychiatr Nurs 2020; 34:36-42. [PMID: 32248932 DOI: 10.1016/j.apnu.2020.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 02/08/2020] [Indexed: 11/27/2022]
Abstract
The aim of this research was to understand academic's beliefs about the meaning of life to gain knowledge to inform mental health clinical practice and research. Qualitative research was conducted using descriptive text and interviews from a sample of Australian midlife academic staff from one university who described their beliefs about the meaning of life. Their beliefs included that: life is a journey of self-development, is about religious or non-religious beliefs, is about living well, is about family, love and relationships, and is about making a difference. These findings may be used by mental health clinicians to help clients explore their beliefs about the meaning of life. Consumers with depression may suffer from meaninglessness, existential crises, severe depression and risk suicide. Working on understanding their beliefs about the meaning of life may result in better mental health outcomes for these people.
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Affiliation(s)
- Xanthe Glaw
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; School of Nursing, Midwifery and Paramedicine, Faculty of Health, Australian Catholic University, 33 Berry St, North Sydney, NSW 2059, Australia.
| | - Michael Hazelton
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Ashley Kable
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Kerry Inder
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia.
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13
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Cheng C, Inder K, Chan SW. Coping with multiple chronic conditions: An integrative review. Nurs Health Sci 2020; 22:486-497. [DOI: 10.1111/nhs.12695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery The University of Newcastle Callaghan New South Wales Australia
- Department of Nursing Bengbu Medical College Bengbu China
| | - Kerry Inder
- School of Nursing and Midwifery The University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
| | - Sally Wai‐Chi Chan
- Hunter Medical Research Institute New Lambton Heights New South Wales Australia
- The University of Newcastle Singapore Singapore Singapore
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14
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Williams T, Condon J, Davies A, Brown J, Matheson L, Warner T, Savage L, Boyle A, Collins N, Inder K. Nursing-led ultrasound to aid in trans-radial access in cardiac catheterisation: a feasibility study. J Res Nurs 2020; 25:159-172. [PMID: 34394621 DOI: 10.1177/1744987119900374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Trans-radial access is increasingly common for cardiac catheterisation. Benefits include reduced bleeding complications, length of hospital stay and costs. Aims To determine the feasibility of implementing a nurse-led ultrasound programme to measure radial artery diameter before and after cardiac catheterisation; to determine radial artery occlusion (RAO) rates, risk factors for RAO and predictors of radial artery (RA) diameter. Method A prospective observational cohort study design for 100 consecutive patients undergoing cardiac catheterisation, using RA access. Pre- and post-procedural RA diameter were measured using ultrasound, by specialist nurses trained to do so. Logistic regression analyses were performed to determine risk factors for RAO and predictors of RA diameter with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results There were no adverse events, supporting the feasibility of nurse led ultrasound programmes. A 4% (n = 4) rate of occlusion was observed. Haemostasis device application time of greater than 190 min was a predictor of RAO (OR 3.12, 95% CI 0.31-31). Male gender and height were predictors for a RA diameter of >2.2 mm. Conclusions Nurses can lead the assessment of RA occlusion using ultrasound to enhance planning and care, including monitoring compression times to reduce RAO.
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Affiliation(s)
- Trent Williams
- Clinical Nurse Consultant, Department of Cardiology, John Hunter Hospital, Australia
| | - Jeremy Condon
- Registered Nurse, Department of Cardiology, John Hunter Hospital, Australia
| | - Allan Davies
- Interventional Fellow, Cardiology, John Hunter Hospital, Australia
| | - Jennifer Brown
- Registered Nurse, Cardiology, John Hunter Hospital, Australia
| | | | | | - Lindsay Savage
- Clinical Nurse Consultant, Cardiology, John Hunter Hospital, Australia
| | - Andrew Boyle
- Professor of Cardiovascular Medicine, Director of Priority Clinical Centre for Cardiovascular health, Department of Cardiology, John Hunter Hospital, Australia
| | - Nicholas Collins
- Associate Professor, Director, Cardiac Catheterisation Lab, John Hunter Hospital, Australia
| | - Kerry Inder
- Associate Professor of Nursing: Deputy Head of School-Research, School of Nursing and Midwifery, University of Newcastle, Australia
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Cheng C, Yang C, Inder K, Chan SWC. Illness Perceptions, Coping Strategies, and Quality of Life in People With Multiple Chronic Conditions. J Nurs Scholarsh 2020; 52:145-154. [DOI: 10.1111/jnu.12540] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Cheng Cheng
- PhD candidate, School of Nursing and Midwifery, the University of Newcastle, Callaghan, Australia; Lecturer, Department of Nursing Bengbu Medical College Bengbu China
| | - Cong‐Yan Yang
- Head nurse, Department of Nursing the First Affiliated Hospital of Bengbu Medical College Bengbu China
| | - Kerry Inder
- Associate Professor, School of Nursing and Midwifery the University of Newcastle Callaghan Australia
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Cheng C, Bai J, Yang C, Li M, Inder K, Chan SW. Patients' experiences of coping with multiple chronic conditions: A qualitative descriptive study. J Clin Nurs 2019; 28:4400-4411. [DOI: 10.1111/jocn.15022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/04/2019] [Accepted: 08/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery University of Newcastle Callaghan NSW Australia
- Department of Nursing Bengbu Medical College Bengbu Anhui China
| | - Jie Bai
- Department of Nursing Bengbu Medical College Bengbu Anhui China
| | - Cong‐Yan Yang
- Department of Nursing The First Affiliated Hospital of Bengbu Medical College Bengbu Anhui China
| | - Ming Li
- Department of Neurology The First Affiliated Hospital of Bengbu Medical College Bengbu Anhui China
| | - Kerry Inder
- School of Nursing and Midwifery University of Newcastle Callaghan NSW Australia
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Whitehead N, Williams T, Brienesse S, Ferreira D, Murray N, Inder K, Beautement S, Spratt N, Boyle AJ, Collins N. Contemporary trends in stroke complicating cardiac catheterisation. Intern Med J 2019; 50:859-865. [PMID: 31211489 DOI: 10.1111/imj.14405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 06/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stroke remains an important complication of diagnostic cardiac catheterisation and percutaneous coronary intervention and is associated with high rates of in-hospital mortality. AIMS To evaluate the incidence of stroke over a 10-year period and assess the long-term influence of stroke following cardiac catheterisation and PCI on functional outcomes, based on modified Rankin score and mortality. METHODS The study was performed using a case-control design in a single tertiary referral centre. Patients were identified by correlating those patients undergoing cardiac catheterisation between October 2006 and December 2016 with patients who underwent neuroimaging within 7 days to identify possible cases of suspected stroke or transient ischaemic attack. RESULTS A total of 21 510 patients underwent cardiac catheterisation during the study period. Sixty (0.28%) patients experienced stroke or transient ischaemic attack. Compared to control patients, those who did experience cerebral ischaemic events were older (70.5 vs 64 years; P < 0.001), with higher rates of atrial fibrillation, hypertension and diabetes mellitus. Stroke complicating cardiac catheterisation was associated with an increased risk of readmission, with a significantly higher hazard of readmission for stroke noted. Despite minimal functional impairment based on modified Rankin score, stroke was associated with a significant risk of early and cumulative mortality. Stroke incidence remained stable over the study period despite changes in procedural practice. CONCLUSIONS The incidence and functional severity of stroke remains low despite evolving procedural practice with a stable incidence over time despite changes in procedural practice; however, post-procedural stroke confirms an increased mortality hazard.
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Affiliation(s)
- Nicholas Whitehead
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Trent Williams
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,School of Health and Biomedical Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Stephen Brienesse
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - David Ferreira
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Natalia Murray
- School of Health and Biomedical Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kerry Inder
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Neurology Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Stephen Beautement
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Neil Spratt
- School of Health and Biomedical Sciences, University of Newcastle, Newcastle, New South Wales, Australia.,Neurology Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Andrew J Boyle
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Neurology Department, John Hunter Hospital, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Nicholas Collins
- Cardiovascular Department, John Hunter Hospital, Newcastle, New South Wales, Australia
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Abstract
Background: Despite extensive knowledge and research in cardiac health there is limited understanding in how a cardiac arrest influences the life of long-term survivors. Objective: The aim of this study was to explore how long-term survivors of a cardiac arrest adjusted to their new reality, expressed in their re-storied narratives. Methods: Seven individuals surviving a cardiac arrest 5–26 years ago were interviewed through in-depth conversations over a six-month period. These interviews were analysed using Clandinin and Connelly’s framework of narrative inquiry. Results: Seven threads were found: Disbelief, Surveillance of their body, Loss of control and desire for normality, Keeping fit and informing others, Gratefulness, Spirituality – luck and fate, and Fragility of life and dying. Conclusions: All seven long-term survivors of cardiac arrest expressed a positive attitude. Despite the nature of the cardiac arrest and the hurdles that followed, they have a heightened appreciation for life. This indicates that after the adaptation to their new reality of being a cardiac arrest survivor life returns to a new normality.
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Affiliation(s)
| | | | - Kerry Inder
- University of Newcastle, Port Macquarie, Australia
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Cheng C, Inder K, Chan SWC. Patients' experiences of coping with multiple chronic conditions: A meta-ethnography of qualitative work. Int J Ment Health Nurs 2019; 28:54-70. [PMID: 30232822 DOI: 10.1111/inm.12544] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2018] [Indexed: 12/21/2022]
Abstract
Multiple chronic conditions (MCCs) pose a major and growing burden on the individuals' health. The ways in which people cope with their stresses related to their chronic conditions are significant to their health outcomes. This review sought to understand lived experiences of coping with MCCs by a meta-ethnography of qualitative studies. Twenty-six studies were identified in four electronic databases including PubMed, PsycINFO, EMBASE, and CINAHL that were searched from 1966 to 2017. A seven-step analytic method was used after a quality evaluation based on Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings illustrated that experiences of coping with MCCs were interacted with (i) appraisals of MCCs, (ii) strategies to maintain a normal life, (iii) strategies to keep the spirits up, and (iv) coping in the social context. To sum up, this review provided a collection of narratives on coping with MCCs. The findings would help to recognize the high complexity experienced by these patients, also potentially offered a foundation for the design of a feasible intervention to more optimally highlight the demands of managing MCCs.
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Affiliation(s)
- Cheng Cheng
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing, Bengbu Medical College, Bengbu, Anhui, China
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
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20
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Whitehead N, Williams T, Brienesse S, Ferriera D, Murray N, Inder K, Beautement S, Spratt N, Boyle A, Collins N. Contemporary Trends in Stroke Complicating Cardiac Catheterisation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rich J, Handley T, Inder K, Perkins D. An experiment in using open-text comments from the Australian Rural Mental Health Study on health service priorities. Rural Remote Health 2018; 18:4208. [PMID: 29397045 DOI: 10.22605/rrh4208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Conducting research in rural and remote areas is compounded by challenges associated with accessing relatively small populations spread over large geographical areas. Open-ended questions provided in a postal survey format are an advantageous way of including rural and remote residents in research studies. This method means that it is possible to ask for in-depth perspectives, from a large sample, in a relatively resource-efficient way. Such questions are frequently included in population-based surveys; however, they are rarely analysed. The aim of this article is to explore word cloud analysis, to evaluate the utility of automated programs to supplement the analysis of open-ended survey responses. METHODS Participants from the Australian Rural Mental Health Study completed the open-ended question 'What health services would you like to see the local health district providing that are currently not available in your area?' A word cloud analysis was then undertaken using the program Wordle; the size of the word in the cloud illustrates how many times, in proportion to other words, a word has appeared in responses, and provides an easily interpretable visual illustration of research results. RESULTS In total, 388 participants provided a response to the free-text question. Using the word cloud as a visual guide, key words were identified and used to locate relevant quotes from the full open-text responses. \'Mental health\' was the most frequent request, cited by 81 people (20.8%). Following mental health, requests for more \'specialists\' (n=59) and \'services\' (n=53) were the second and third most frequent responses respectively. Visiting specialists were requested by multiple respondents (n=14). Less frequent requests illustrated in the word cloud are important when considering representatives from smaller population groups such as those with specific health needs or conditions including \'maternity\' services (n=13), \'cancer\' (n=10), \'drug and alcohol\' services (n=8), and \'aged care\' (n=7) services are all core services even though they were being called for by fewer people. This lesser frequency may suggest that these services are already considered as available in some rural and remote communities. CONCLUSIONS This research aimed to determine whether meaningful and informative data could be obtained from short responses from open-ended survey questions using an automated data analysis technique to supplement a more in-depth analysis. The findings showed that, while not as detailed as interview responses, the open-ended survey questions provided sufficient information to develop a broad overview of the health service priorities identified by this large rural sample. Such automated data analysis techniques are rarely employed; however, the current research provides valuable support for their utility in rural and remote health research. This research has implications for researchers interested in engaging rural and remote residents, demonstrating that meaningful information can be extracted from short survey response data, contributing a resource-efficient supplement to a more detailed analysis. Open-ended questions are often asked in population-based studies yet they are rarely analysed, posing both an opportunity and a challenge for researchers using such participant-driven responses. The lessons learned from the methodology applied can be transferred to other population-based survey studies more widely.
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Affiliation(s)
- Jane Rich
- University of Newcastle, Callaghan, NSW, Australia
| | | | - Kerry Inder
- University of Newcastle, Callaghan, NSW, Australia
| | - David Perkins
- University of Newcastle, c/o Bloomfield Hospital, Orange, NSW, Australia
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Williams T, Collins N, Inder K, Boyle A. A Decade Review of Major Complications After Cardiac Catheterisation and Percutaneous Coronary Intervention: A Nursing-Led Review. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Williams T, Condon J, Davies A, Brown J, Matheson L, Warner T, Savage L, Collins N, Boyle A, Inder K. A Nursing-Led Examination of Radial Artery Diameters, Occlusion Rates and Vascular Complications Utilising Ultrasound Measurements. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Macklin R, Wang H, Loo D, Martin S, Cumming A, Cai N, Lane R, Ponce NS, Topkas E, Inder K, Saunders NA, Endo-Munoz L. Extracellular vesicles secreted by highly metastatic clonal variants of osteosarcoma preferentially localize to the lungs and induce metastatic behaviour in poorly metastatic clones. Oncotarget 2017; 7:43570-43587. [PMID: 27259278 PMCID: PMC5190045 DOI: 10.18632/oncotarget.9781] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/25/2016] [Indexed: 12/18/2022] Open
Abstract
Osteosarcoma (OS) is the most common pediatric bone tumor and is associated with the emergence of pulmonary metastasis. Unfortunately, the mechanistic basis for metastasis remains unclear. Tumor-derived extracellular vesicles (EVs) have been shown to play critical roles in cell-to-cell communication and metastatic progression in other cancers, but their role in OS has not been explored. We show that EVs secreted by cells derived from a highly metastatic clonal variant of the KHOS cell line can be internalized by a poorly metastatic clonal variant of the same cell line and induce a migratory and invasive phenotype. This horizontal phenotypic transfer is unidirectional and provides evidence that metastatic potential may arise via interclonal co-operation. Proteomic analysis of the EVs secreted by highly metastatic OS clonal variants results in the identification of a number of proteins and G-protein coupled receptor signaling events as potential drivers of OS metastasis and novel therapeutic targets. Finally, multiphoton microscopy with fluorescence lifetime imaging in vivo, demonstrated a preferential seeding of lung tissue by EVs derived from highly metastatic OS clonal variants. Thus, we show that EVs derived from highly metastatic clonal variants of OS may drive metastatic behaviour via interclonal co-operation and preferential colonization of the lungs.
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Affiliation(s)
- Rebecca Macklin
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Haolu Wang
- Therapeutics Research Centre, School of Medicine, University of Queensland, Brisbane, Australia
| | - Dorothy Loo
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Sally Martin
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia.,Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Australia
| | - Andrew Cumming
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Na Cai
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Rebecca Lane
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia.,Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Australia
| | - Natalia Saenz Ponce
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Eleni Topkas
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Kerry Inder
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Nicholas A Saunders
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Liliana Endo-Munoz
- The University of Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, Australia
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Haydon G, van der Riet P, Inder K. A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest. Eur J Cardiovasc Nurs 2017; 16:475-483. [PMID: 28436244 DOI: 10.1177/1474515117705486] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Survival following cardiac arrest and subsequent cardiopulmonary resuscitation (CPR) is increasing worldwide, mainly due to greater awareness of the symptoms of cardiac events and an increased attention to CPR training. Although patient outcomes remain unpredictable and quantitative studies suggest that the overall quality of life (QOL) is acceptable, it is valuable to synthesise qualitative studies exploring these phenomena in depth, providing a deeper knowledge of survivors' experiences and QOL. AIMS To critically appraise and synthesise the qualitative literature on survivors' experiences of a cardiac arrest and CPR with the aim of identifying common themes that can inform clinical pathways and thereby improve survivor outcomes and QOL. METHODS A systematic review and meta-synthesis of the qualitative literature, using Thomas and Harden's framework, and confined to peer-reviewed papers published from 2000 to 2015, which were identified through database searches of EBSCO, OVID and ProQuest. RESULTS The search produced 204 papers, and of these, seven relevant papers were identified for review. Data extraction included setting, participants, research design, data collection, analysis and themes. Five qualitative themes were identified and were the subject of this meta-synthesis: multitude of contrasting feelings; disruption in the continuum of time; new reality and psychological challenges; changed body with new limitations; and confrontation with death. CONCLUSION This review provides insights into the experiences of survivors' QOL after CPR. Increased knowledge can improve person-centred care in the immediate and forthcoming care after the event, both in terms of planning for discharge and in the future care of people who survive a cardiac arrest.
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Abstract
The aim of this integrative literature review was to identify high quality empirical research and theoretical literature on the sources of meaning in life and people's beliefs regarding the meaning of life. This will inform current mental health clinical practice and research by providing a synthesis of empirical and theoretical literature. Failure to address meaninglessness or the existential crisis can lead to psychopathologies such as depression, anxiety, addiction, aggression, hopelessness, apathy, lower levels of well-being, physical illness, and suicide. Integrative literature reviews incorporate empirical research and theoretical literature. The inclusion criteria were primary research and theoretical papers and books by prominent theorists. Thirty-nine items underwent the critical appraisal process. Thirty-two papers or books were included. Overwhelmingly the results revealed that relationships, particularly relationships with family, are cited as the most important source of meaning in people's lives in all cultures and age groups. There was no consensus identified to answer the meaning of life question. These results and future research will allow mental health clinicians to help patients deepen their understanding of themselves, identify where they find meaning and understand their beliefs about meaning of life, contributing to a reduction in symptomatology and meaninglessness, and an increase in happiness, life satisfaction, positive affect, better coping, psychosocial health and well-being, and more meaningfulness in life.
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Affiliation(s)
- Xanthe Glaw
- a The University of Newcastle, School of Nursing and Midwifery, Faculty of Health and Medicine , Callaghan , New South Wales , Australia
| | - Ashley Kable
- a The University of Newcastle, School of Nursing and Midwifery, Faculty of Health and Medicine , Callaghan , New South Wales , Australia
| | - Michael Hazelton
- a The University of Newcastle, School of Nursing and Midwifery, Faculty of Health and Medicine , Callaghan , New South Wales , Australia
| | - Kerry Inder
- a The University of Newcastle, School of Nursing and Midwifery, Faculty of Health and Medicine , Callaghan , New South Wales , Australia
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Considine R, Tynan R, James C, Wiggers J, Lewin T, Inder K, Perkins D, Handley T, Kelly B. The Contribution of Individual, Social and Work Characteristics to Employee Mental Health in a Coal Mining Industry Population. PLoS One 2017; 12:e0168445. [PMID: 28045935 PMCID: PMC5207427 DOI: 10.1371/journal.pone.0168445] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 12/01/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence regarding the extent of mental health problems and the associated characteristics within an employee population is necessary to inform appropriate and tailored workplace mental health programs. Mental health within male dominated industries (such as mining) has received recent public attention, chiefly through observations regarding suicide in such populations in Australia and internationally. Currently there is limited empirical evidence regarding the mental health needs in the mining industry as an exemplar of a male dominated workforce, and the relative contribution to such problems of individual, socio-economic and workplace factors. This study aimed to investigate the mental health and associated characteristics among employees in the Australian coal mining industry with a specific focus on identifying modifiable work characteristics. METHODS A cross-sectional study was conducted among employees (n = 1457) across eight coal mines stratified by key mine characteristics (state, mine type and employee commute arrangements). Participants completed measures of psychological distress (K10+) and key variables across four categories (socio-demographic characteristics, health history, current health behaviours, work attitudes and characteristics). RESULTS Psychological distress levels within this sample were significantly higher in comparison with a community sample of employed Australians. The following factors contributed significantly to levels of psychological distress using hierarchical linear regression analysis: lower social networks; a past history of depression, anxiety or drug/alcohol problems; high recent alcohol use; work role (managers) and a set of work characteristics (level of satisfaction with work, financial factors and job insecurity; perception of lower workplace support for people with mental health problems. CONCLUSION This is the first study to examine the characteristics associated with mental health problems in the Australian coal mining industry. The findings indicate the salience of mental health needs in this population, and the associated interplay of personal, social and work characteristics. The work characteristics associated with psychological distress are modifiable and can guide an industry response, as well as help inform the understanding of the role of workplace factors in mental health problems in a male dominated workforce more generally.
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Affiliation(s)
- Robyn Considine
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ross Tynan
- Hunter Institute of Mental Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Resources Health and Safety, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Carole James
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Centre for Resources Health and Safety, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Terry Lewin
- Priority Research Centre in Brain and Mental Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
| | - David Perkins
- Priority Research Centre in Brain and Mental Health, University of Newcastle, Callaghan, New South Wales, Australia
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, New South Wales, Australia
| | - Tonelle Handley
- Priority Research Centre in Brain and Mental Health, University of Newcastle, Callaghan, New South Wales, Australia
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, New South Wales, Australia
| | - Brian Kelly
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Centre for Resources Health and Safety, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre in Brain and Mental Health, University of Newcastle, Callaghan, New South Wales, Australia
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Tynan RJ, Considine R, Wiggers J, Lewin TJ, James C, Inder K, Kay-Lambkin F, Baker AL, Skehan J, Perkins D, Kelly BJ. Alcohol consumption in the Australian coal mining industry. Occup Environ Med 2016; 74:259-267. [DOI: 10.1136/oemed-2016-103602] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 09/07/2016] [Accepted: 10/03/2016] [Indexed: 11/03/2022]
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Tynan RJ, Considine R, Rich JL, Skehan J, Wiggers J, Lewin TJ, James C, Inder K, Baker AL, Kay-Lambkin F, Perkins D, Kelly BJ. Help-seeking for mental health problems by employees in the Australian Mining Industry. BMC Health Serv Res 2016; 16:498. [PMID: 27654943 PMCID: PMC5031264 DOI: 10.1186/s12913-016-1755-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/14/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The current study examined help-seeking behavior for mental health problems of employees in the mining industry. METHODS The research involved a paper-based survey completed by a cross-section of employees from eight coalmine sites. The research aimed to investigate the frequency of contact with professional and non-professional sources of support, and to determine the socio-demographic and workplace factors associated. RESULTS A total of 1,457 employees participated, of which, 46.6 % of participants reported contact with support to discuss their own mental health within the preceding 12 months. Hierarchical logistic regression revealed a significant contribution of workplace variables, with job security and satisfaction with work significantly associated with help-seeking behavior. CONCLUSIONS The results provide an insight into the help-seeking behaviour of mining employees, providing useful information to guide mental health workplace program development for the mining industry, and male-dominated industry more broadly.
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Affiliation(s)
- Ross J Tynan
- Hunter Institute of Mental Health, Newcastle, Australia. .,NHMRC Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Old Waratah Post Office, 22 Turton Road, Waratah, NSW, Australia. .,School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia.
| | - Robyn Considine
- Centre for Resources Health and Safety, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
| | - Jane L Rich
- Centre for Resources Health and Safety, University of Newcastle, PO Box 833, Newcastle, 2300, Australia.,Centre for Rural and Remote Mental Health, University of Newcastle, HMRI Building, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Jaelea Skehan
- Hunter Institute of Mental Health, Newcastle, Australia
| | - John Wiggers
- Population Health, NSW Government Hunter New England Area Health Service, Booth Building, Longworth Avenue, Wallsend, NSW, 2287, Australia
| | - Terry J Lewin
- School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
| | - Carole James
- Centre for Rural and Remote Mental Health, University of Newcastle, HMRI Building, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter Building, University Drive, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Kerry Inder
- School of Nursing and Midwifery, University of Newcastle, Newcastle, 2300, Australia.,Richardson Wing, School of Nursing and Midwifery, University Drive, University of Newcastle, Callaghan, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
| | - Frances Kay-Lambkin
- NHMRC Centre for Research Excellence in Mental Health and Substance Use, University of New South Wales, Old Waratah Post Office, 22 Turton Road, Waratah, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
| | - David Perkins
- Centre for Rural and Remote Mental Health, University of Newcastle, HMRI Building, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
| | - Brian J Kelly
- Centre for Resources Health and Safety, University of Newcastle, PO Box 833, Newcastle, 2300, Australia.,School of Medicine and Public Health, University of Newcastle, PO Box 833, Newcastle, 2300, Australia
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Brew B, Inder K, Allen J, Thomas M, Kelly B. The health and wellbeing of Australian farmers: a longitudinal cohort study. BMC Public Health 2016; 16:988. [PMID: 27634298 PMCID: PMC5025556 DOI: 10.1186/s12889-016-3664-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/12/2016] [Indexed: 11/13/2022] Open
Abstract
Background Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. Methods The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. Results Farmers who lived remotely reported worse mental health (β −0.33, 95 % CI −0.53, −0.13) and wellbeing (β −0.21(95 % CI −0.35, −0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. Conclusions Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3664-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bronwyn Brew
- Bathurst Rural Clinical School, Western Sydney University, Bathurst Base Hospital, Howick St, Bathurst, NSW, Australia. .,Centre for Rural and Remote Mental Health, University of Newcastle, Forest Road, Orange, NSW, Australia. .,Medical Epidemiology and Biostatistics Department, Karolinska Institute, Stockholm, SE-171 77, Sweden.
| | - Kerry Inder
- Centre for Rural and Remote Mental Health, University of Newcastle, Forest Road, Orange, NSW, Australia.,School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Joanne Allen
- Massey University, Private Bag 11222, Palmerston North, New Zealand.,Centre for Brain and Mental Health Research, and School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Matthew Thomas
- School of Psychology, Charles Sturt University, Panorama Drive, Bathurst, NSW, Australia
| | - Brian Kelly
- Centre for Brain and Mental Health Research, and School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
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Williams T, Inder K, Savage L, Collins N. Risk Factor Profile of Patients Sustaining Femoral Vascular Complications in a Tertiary Referral Cardiac Catheterisation Laboratory. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carey M, Boyes A, Noble N, Waller A, Inder K. Validation of the PHQ-2 against the PHQ-9 for detecting depression in a large sample of Australian general practice patients. Aust J Prim Health 2016; 22:262-266. [DOI: 10.1071/py14149] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/21/2015] [Indexed: 11/23/2022]
Abstract
There is increasing interest in the use of brief screening tools to improve detection of depression in the primary care setting. The aim of the present study was to compare the accuracy of the two-item Patient Health Questionnaire (PHQ-2) against the nine-item Patient Health Questionnaire (PHQ-9) for detecting depression among general practice patients. A cross-sectional sample of 3626 adults attending 12 Australian general practices was recruited. Participants completed the PHQ-2 and PHQ-9 via a touchscreen computer. Depression was defined as a PHQ-9 score ≥10. The area under the curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value were calculated. The PHQ-2 had good overall accuracy relative to the PHQ-9 for discriminating between cases and non-cases of depression, with an AUC of 0.92 (95% confidence interval 0.90–0.93). The PHQ-2 threshold of ≥3 was the best balance between sensitivity (91%) and specificity (78%) for detecting possible cases of depression. For clinical use, the optimal threshold was ≥2, with only 2% of possible cases missed.
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Moon H, Sharpe L, Choi E, Bielefeldt-Ohmann H, Nassar Z, Parat MO, Francois M, Lee CS, Brown A, Russell P, Inder K, Hill M. Abstract 4950: Hypercholesterolemia promotes prostate cancer PC-3 metastases in orthotopic xenograft mice. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-4950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Hypercholesterolemia has been proposed as a potential risk factor for advanced prostate cancer, and use of cholesterol-lowering drugs, statins, inversely correlates with advanced prostate cancer risk. Hypercholesterolemia increases growth of androgen-sensitive LNCaP xenograft in vivo, potentially via androgen signaling. The aim of this study was to determine if hypercholesterolemia affects castration-resistant prostate tumor progression using an androgen receptor-negative prostate cancer cell line PC-3. Compared to control media, cholesterol-deficient media reduced PC-3 proliferation, migration and anchorage-independent growth in vitro. While adding cholesterol did not significantly increase proliferation or anchorage-independent growth, cholesterol replacement in cholesterol-deficient media significantly increased PC-3 transmigration. In order to determine the in vivo effect, mice were randomly assigned to normal or hypercholesterolemic, isocaloric diet groups (N=14 and 15, respectively). After two weeks, hypercholesterolemic diet significantly increased circulating cholesterol but did not increase body weight. PC-3 cells stably expressing luciferase were orthotopically injected into the dorsolateral prostate. Tumor progression and metastases were monitored by in vivo and ex vivo optical bioluminescence imaging for 6 weeks. Strikingly, the results show that diet-induced hypercholesterolemia accelerated tumor metastases to lymph nodes, lung, proximal and distant bones without significantly affecting primary tumor growth. The metastases were confirmed histopathologcally. Hypercholesterolemia was not associated with elevated weight or circulating testosterone. This is the first study to directly demonstrate a causal relationship between hypercholesterolemia and prostate tumor metastases mediated through androgen-independent mechanisms, highlighting the potential clinical benefit of cholesterol lowering therapy such as statins in advanced, castration-resistant, prostate cancer patients.
Citation Format: Hyeongsun Moon, Laura Sharpe, Eunju Choi, Helle Bielefeldt-Ohmann, Zeyad Nassar, Marie-Odile Parat, Mathias Francois, C Soon Lee, Andrew Brown, Pamela Russell, Kerry Inder, Michelle Hill. Hypercholesterolemia promotes prostate cancer PC-3 metastases in orthotopic xenograft mice. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4950. doi:10.1158/1538-7445.AM2014-4950
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Affiliation(s)
- Hyeongsun Moon
- 1The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Laura Sharpe
- 2School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - Eunju Choi
- 1The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | | | - Zeyad Nassar
- 4School of Pharmacy, The University of Queensland, Brisbane, Australia
| | - Marie-Odile Parat
- 4School of Pharmacy, The University of Queensland, Brisbane, Australia
| | - Mathias Francois
- 5Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - C Soon Lee
- 6Disipline of Pathology, School of Medicine and Molecular Medicine Research Group, University of Western Sydney, Sydney, Australia
| | - Andrew Brown
- 2School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - Pamela Russell
- 7Australian Prostate Cancer Research Centre–Queensland and Institute for Biomedical Health & Innovation, Queensland University of Technology, Translational Research Institute, Brisbane, Australia
| | - Kerry Inder
- 1The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Michelle Hill
- 1The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
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Abstract
OBJECTIVE Primary care is an important setting for the treatment of depression. The aim of the study was to describe the accuracy of unassisted general practitioner judgements of patients' depression compared to a standardised depression-screening tool delivered via touch-screen computer. METHOD English-speaking patients, aged 18 or older, completed the Patient Health Questionnaire-9 (PHQ-9) when presenting for care to one of 51 general practitioners in Australia. General practitioners were asked whether they thought the patients were clinically depressed. General practitioner judgements of depression status were compared to PHQ-9 results. RESULTS A total of 1558 patients participated. Twenty per cent of patients were identified by the PHQ-9 as being depressed. General practitioners estimated a similar prevalence; however, when compared to the PHQ-9, GP judgement had a sensitivity of 51% (95% CI [32%, 66%]) and a specificity of 87% (95% CI [78%, 93%]). CONCLUSIONS General practitioner unassisted judgements of depression in their patients lacked sensitivity when compared to a standardised psychiatric measure used in general practice.
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Affiliation(s)
- Mariko Carey
- Priority Research Centre for Health Behaviour, Faculty of Health, University of Newcastle, Callaghan, Australia,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Kim Jones
- Priority Research Centre for Health Behaviour, Faculty of Health, University of Newcastle, Callaghan, Australia,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Graham Meadows
- Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry, Monash University, Clayton, Australia
| | - Rob Sanson-Fisher
- Priority Research Centre for Health Behaviour, Faculty of Health, University of Newcastle, Callaghan, Australia,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Catherine D’Este
- Hunter Medical Research Institute, New Lambton Heights, Australia,Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, Australia
| | - Kerry Inder
- Hunter Medical Research Institute, New Lambton Heights, Australia,Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- Priority Research Centre for Health Behaviour, Faculty of Health, University of Newcastle, Callaghan, Australia,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Grant Russell
- Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Australia
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Ariotti N, Fernandez-Rojo M, Zhou Y, Hill M, Rodkey T, Inder K, Tanner L, Wenk M, Hancock J, Parton R. Caveolae regulate the nanoscale organization of the plasma membrane to remotely control Ras signaling. J Gen Physiol 2014. [DOI: 10.1085/jgp.1434oia10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gunathilake R, Oldmeadow C, McEvoy M, Kelly B, Inder K, Schofield P, Attia J. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc 2013; 61:1838-9. [PMID: 24117308 DOI: 10.1111/jgs.12468] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roshan Gunathilake
- Department of General Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
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Moon H, Lee CS, Sharma S, Inder K, Black D, Lê Cao KA, Winterford C, Ling P, Craik D, Parton R, Russell P, Hill M. Abstract 3040: Cavin-1 alters oncogenic effects of caveolin-1 microdomains in prostate cancer. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Caveolin-1 is associated with prostate cancer progression and has been suggested to be a biomarker and therapeutic target. Mature caveolin-1 resides in lipid raft domains at the plasma membrane, where it forms caveolae upon co-expression of cavin-1 (also known as PTRF; polymerase I and transcript release factor). In the absence of cavin-1, caveolin-1 does not form caveolae but are found on flat membrane. To determine if oncogenic caveolin-1 in prostate cancer is present in caveolae, we examined the relative expression of caveolin-1 and cavin-1 in normal, non-malignant and malignant prostate tissues. We found that caveolin-1 is induced in prostate cancer without cavin-1, an expression pattern mirror in the PC3 cell line. Previously we showed that expression of cavin-1 in PC3 cells recruits flat membrane caveolin-1 to caveolae and reduced transmigration. Here we report that cavin-1 expression reduces tumour size and metastasis of PC3 cells in vivo, using an orthotopic prostate cancer xenograft mouse model. To determine if cavin-1 acts by neutralizing oncogenic caveolin-1, we expressed cavin-1 in caveolin-1 negative LNCaP and 22Rv1 cells. While caveolin-1 over-expression increased anchorage-independent growth of LNCaP and 22Rv1 cells, cavin-1 over-expression had no effect. Furthermore, co-expression of cavin-1 in LNCaP+caveolin-1 cells reversed caveolin-1 effect. Taken together, these results suggest that caveolin-1 in prostate cancer is present outside of caveolae, and caveola formation by cavin-1 co-expression alters the oncogenic effect of non-caveolar caveolin-1 microdomains.
Citation Format: Hyeongsun Moon, C Soon Lee, Sowmya Sharma, Kerry Inder, Debra Black, Kim-Anh Lê Cao, Clay Winterford, Patrick Ling, the Australian Prostate Cancer BioResource, David Craik, Robert Parton, Pamela Russell, Michelle Hill. Cavin-1 alters oncogenic effects of caveolin-1 microdomains in prostate cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3040. doi:10.1158/1538-7445.AM2013-3040
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Affiliation(s)
- Hyeongsun Moon
- 1The University of Queensland Diamantina Institute, Brisbane, Australia
| | - C Soon Lee
- 2School of Medicine and Molecular Medicine Research Group, University of Western Sydney, Sydney, Australia
| | - Sowmya Sharma
- 2School of Medicine and Molecular Medicine Research Group, University of Western Sydney, Sydney, Australia
| | - Kerry Inder
- 1The University of Queensland Diamantina Institute, Brisbane, Australia
| | - Debra Black
- 1The University of Queensland Diamantina Institute, Brisbane, Australia
| | - Kim-Anh Lê Cao
- 3Queensland Facility for Advanced Bioinformatics, The University of Queensland, Brisbane, Australia
| | - Clay Winterford
- 4School of Medicine, The University of Queensland, Brisbane, Australia
| | - Patrick Ling
- 5Australian Prostate Cancer Research Centre–Queensland and Institute for Biomedical Health & Innovation, Queensland University of Technology, Brisbane, Australia
| | - David Craik
- 7Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Robert Parton
- 7Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Pamela Russell
- 5Australian Prostate Cancer Research Centre–Queensland and Institute for Biomedical Health & Innovation, Queensland University of Technology, Brisbane, Australia
| | - Michelle Hill
- 1The University of Queensland Diamantina Institute, Brisbane, Australia
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Abstract
Signaling via the Raf/MEK/ERK (MAPK) module controls multiple cell functions including proliferation, differentiation and survival. How this single pathway can regulate such diverse cell fates is unknown. Recently, we examined system outputs of the MAPK pathway from different cellular compartments. We observed robust activation of the MAPK cascade from both the plasma membrane and the Golgi. When the MAPK module is localized to plasma membrane nanoclusters corresponding to those occupied by activated H-, N- and K-ras, ERKpp output is digital, with both low and high Raf kinase inputs processed to generate a maximal ERKpp output. In contrast, when the MAPK module is localized to the Golgi, ERKpp output is graded such that Raf kinase input corresponds to ERKpp output. These results clearly demonstrate that different cellular environments available to the MAPK module can fundamentally rewire system output, which in turn may allow this single cascade to direct different cell fate decisions.
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Affiliation(s)
- Kerry Inder
- Institute for Molecular Bioscience; University of Queensland; Brisbane Australia
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Halland M, Young M, Fitzgerald MN, Inder K, Duggan JM, Duggan A. Bleeding peptic ulcer: characteristics and outcomes in Newcastle, NSW. Intern Med J 2012; 41:605-9. [PMID: 21040320 DOI: 10.1111/j.1445-5994.2010.02357.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Peptic ulcer disease risk factors have changed, as has the impact of treatment on morbidity and mortality. Recent data on clinical presentation and outcome are sparse in Australia. AIM To determine the characteristics and outcome of patients presenting with a bleeding peptic ulcer to a tertiary referral centre. METHODS We evaluated patients diagnosed with peptic ulcer bleeding between 2004 and 2008 at a tertiary referral hospital. Variables assessed included demographic data, comorbidities, medication use and Rockall score. Outcomes of interest were the time to endoscopy, peptic ulcer treatment, transfusion requirements, urgent surgery and survival. RESULTS Peptic ulcers were confirmed in 265 patients (55% male), of which 145 were gastric and 119 duodenal. The mean age was 71 years. On admission 38% of patients had haemodynamic instability and 92% had one or more comorbidity. Consumption of ulcerogenic medications at the time of admission was frequent (non-steroidal anti-inflammatory drugs (NSAIDs) 22%, aspirin 41%, clopidogrel or warfarin 10%) and proton pump inhibitors infrequent (15%). A gastroenterologist managed all patients according to their usual practice. Only a minority of patients received over three units of packed red cells. Few patients were referred for surgery (3%) or died (3%), but both events were significantly higher for the duodenal ulcer group. CONCLUSION The characteristics and outcomes in patients with peptic ulcer bleeding have changed. Peptic ulcer disease remains a public health problem with modifiable risk factors, such as Helicobacter pylori infection and NSAIDs, which should be targeted to reduce the burden of illness.
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Affiliation(s)
- M Halland
- Department of Gastroenterology, John Hunter Hospital, Newcastle, Australia.
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Allen J, Inder K, Kelly B, Attia J, Lewin T. P2-496 An interaction of social support and remoteness in the prediction of psychological distress. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976m.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Halland M, Young M, Fitzgerald MN, Inder K, Duggan JM, Duggan A. Characteristics and outcomes of upper gastrointestinal hemorrhage in a tertiary referral hospital. Dig Dis Sci 2010; 55:3430-5. [PMID: 20407826 DOI: 10.1007/s10620-010-1223-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Accepted: 03/23/2010] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS Upper gastrointestinal hemorrhage remains a problem in spite of improved diagnosis and management. There is sparse knowledge of recent epidemiology and outcomes. We wanted to evaluate the characteristics and outcomes of patients with upper gastrointestinal hemorrhage over a 4-year period in a tertiary referral hospital. METHODS We prospectively collected data on patients admitted with upper gastrointestinal hemorrhage to John Hunter Hospital between August 2004 and December 2008. Variables of interest included age, gender, co-morbidities, and time to endoscopy. Main outcomes included etiology, treatment, and survival. Variceal and non-variceal bleeds were analyzed separately. RESULTS There were 792 admissions from 734 unique patients (61% male) with a mean age of 66 years. The most frequent causes of non-variceal bleeds (88%) included ulcers 265 (33%); Mallory Weiss tear 91 (11%); esophagitis 60 (8%), and malignancy 29 (4%). Most patients had one or more co-morbidity (74%). Transfusion was not employed in 41%. Overall mortality was 4.0% (5.4% in the variceal and 3.9% in the non-variceal group). Only 1.9% of patients had surgery. CONCLUSIONS Patients presenting with upper gastrointestinal hemorrhage are overall elderly with significant co-morbidities. Our overall mortality and surgery rates are lower than in previously published international data.
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Affiliation(s)
- Magnus Halland
- Department of Gastroenterology, John Hunter Hospital, Locked Bag 1, New Lambton, Newcastle, NSW 2305, Australia.
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Chuang S, Inder K. An effectiveness analysis of healthcare systems using a systems theoretic approach. BMC Health Serv Res 2009; 9:195. [PMID: 19852837 PMCID: PMC2773779 DOI: 10.1186/1472-6963-9-195] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 10/24/2009] [Indexed: 11/24/2022] Open
Abstract
Background The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning. Methods/design To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research. Results Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation surveyors is developed that provides a systematic search for improving the impact of accreditation on quality of care and hence on the accreditation/performance correlation. Conclusion There is clear value in developing a theoretical systems approach to achieving quality in health care. The introduction of the systematic surveyor-based search for improvements creates an adaptive-control system to optimize health care quality. It is hoped that these outcomes will stimulate further research in the development of strategic planning using systems theoretic approach for the improvement of quality in health care.
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Affiliation(s)
- Sheuwen Chuang
- Health Services Research Group, University of Newcastle, 3rd floor, David Maddison Building, Cnr King and Watt St, Newcastle, NSW, 2300, Australia.
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Inder K, Harding A, Plowman SJ, Philips MR, Parton RG, Hancock JF. Activation of the MAPK module from different spatial locations generates distinct system outputs. Mol Biol Cell 2008; 19:4776-84. [PMID: 18784252 DOI: 10.1091/mbc.e08-04-0407] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The Ras/Raf/MEK/ERK (MAPK) pathway directs multiple cell fate decisions within a single cell. How different system outputs are generated is unknown. Here we explore whether activating the MAPK module from different membrane environments can rewire system output. We identify two classes of nanoscale environment within the plasma membrane. The first, which corresponds to nanoclusters occupied by GTP-loaded H-, N- or K-Ras, supports Raf activation and amplifies low Raf kinase input to generate a digital ERKpp output. The second class, which corresponds to nanoclusters occupied by GDP-loaded Ras, cannot activate Raf and therefore does not activate the MAPK module, illustrating how lateral segregation on plasma membrane influences signal output. The MAPK module is activated at the Golgi, but in striking contrast to the plasma membrane, ERKpp output is analog. Different modes of Raf activation precisely correlate with these different ERKpp system outputs. Intriguingly, the Golgi contains two distinct membrane environments that generate ERKpp, but only one is competent to drive PC12 cell differentiation. The MAPK module is not activated from the ER. Taken together these data clearly demonstrate that the different nanoscale environments available to Ras generate distinct circuit configurations for the MAPK module, bestowing cells with a simple mechanism to generate multiple system outputs from a single cascade.
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Affiliation(s)
- Kerry Inder
- Institute for Molecular Bioscience, University of Queensland, Brisbane 4072, Australia
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Tian T, Harding A, Inder K, Plowman S, Parton RG, Hancock JF. Plasma membrane nanoswitches generate high-fidelity Ras signal transduction. Nat Cell Biol 2007; 9:905-14. [PMID: 17618274 DOI: 10.1038/ncb1615] [Citation(s) in RCA: 303] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Accepted: 05/22/2007] [Indexed: 11/09/2022]
Abstract
Ras proteins occupy dynamic plasma membrane nanodomains called nanoclusters. The significance of this spatial organization is unknown. Here we show, using in silico and in vivo analyses of mitogen-activated protein (MAP) kinase signalling, that Ras nanoclusters operate as sensitive switches, converting graded ligand inputs into fixed outputs of activated extracellular signal-regulated kinase (ERK). By generating Ras nanoclusters in direct proportion to ligand input, cells build an analogue-digital-analogue circuit relay that transmits a signal across the plasma membrane with high fidelity. Signal transmission is completely dependent on Ras spatial organization and fails if nanoclustering is abrogated. A requirement for high-fidelity signalling may explain the non-random distribution of other plasma membrane signalling complexes.
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Affiliation(s)
- Tianhai Tian
- Institute for Molecular Bioscience, University of Queensland, Brisbane 4072, Australia
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Abstract
BACKGROUND Although practice guidelines and policy statements for cardiac rehabilitation recommend that it be offered to all patients with cardiovascular disease, the participation rates in most Western countries are low. PURPOSE This study aimed to determine the factors associated with referral to outpatient cardiac rehabilitation in the Hunter region of New South Wales, Australia. METHODS The study sample comprised 1933 patients discharged from public hospitals in the Hunter region between March 1, 1998 and February 28, 1999 who were eligible for cardiac rehabilitation, and for inclusion on the Hunter Area Heart and Stroke Register (the Register). Data were obtained from the Register database (gender, age, clinical information) and via a self-completed questionnaire eliciting referral, sociodemographic, and cardiovascular disease risk factor information. Multiple logistic regression analysis was conducted to determine the factors independently associated with referral. RESULTS : Of the respondents (1202/1933), 41% (493/1202; 95% confidence interval, 38-44%) reported that they had been referred to outpatient cardiac rehabilitation. The factors independently associated with referral were age younger than 65 years, previous participation in an outpatient cardiac rehabilitation program, admission to a hospital that provides outpatient cardiac rehabilitation, a discharge diagnosis of acute myocardial infarction, and coronary artery bypass surgery. CONCLUSIONS Younger age, previous participation in outpatient cardiac rehabilitation, admission to a hospital that provides outpatient cardiac rehabilitation, a discharge diagnosis of acute myocardial infarction, and coronary artery bypass surgery were associated with referral to cardiac rehabilitation. Research testing strategies designed to increase cardiac rehabilitation referral rates are needed and could include testing the potential role of modern quality management methods.
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Affiliation(s)
- Natalie Johnson
- Centre for Clinical Epidemiology and Biostatistics, School of Medical Practice and Population Health, The University of Newcastle, NSW, Australia.
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Nicholls S, Inder K, Lowe J, Bastian B, Candlish P, Holliday J, O'Connell D. Outcome in patients participating in a pilot heart failure clinic. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.07881.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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O'Connell D, Lowe J, Candlish P, Wilkinson A, Silberberg J, Inder K. Exercise rehabilitation in patients with congestive heart failure—A systematic review of the literature. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.09053.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nicholls S, Bastian B, Lowe J, Inder K, Candlish P, Holliday J, O'Connell D. Outcome in patients with cardiac failure and normal left ventricular systolic contraction. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.0787x.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nagle A, Wiggers J, Fisher J, Johnson N, Inder K. Prevalence and predictors of being invited, attending and completing phase II outpatient cardiac rehabilitation. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.09090.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Leitch JW, Newling RP, Basta M, Inder K, Dear K, Fletcher PJ. Randomized trial of a hospital-based exercise training program after acute myocardial infarction: cardiac autonomic effects. J Am Coll Cardiol 1997; 29:1263-8. [PMID: 9137222 DOI: 10.1016/s0735-1097(97)00050-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study sought to determine whether a moderate intensity supervised exercise training program, performed immediately after an uncomplicated acute myocardial infarction, improves recovery in cardiac autonomic function compared with standard advice about activity at home. BACKGROUND Exercise training has beneficial effects on cardiac autonomic function and may improve prognosis after acute myocardial infarction. METHODS Thirty-nine male and 10 female patients, mean (+/-SE) age 57 +/- 1 years, with an uncomplicated acute myocardial infarction were randomized to either a 6-week moderate intensity supervised hospital-based exercise training program (exercise group) or to an unsupervised low intensity home walking program (control group). Outcome measures included changes in baroreflex sensitivity (phenylephrine bolus method) and heart rate variability (24-h Holter monitoring) and the endurance time at 85% of peak oxygen consumption. RESULTS At baseline, there were no significant differences in left ventricular ejection fraction (57 +/- 2% vs. 53 +/- 2%), frequency of anterior infarction (27% vs. 18%) and peak creatine kinase (1,256 +/- 170 vs. 2,599 +/- 295 IU) between the exercise and control groups. Baroreflex sensitivity (10.5 +/- 1.0 vs. 8.4 +/- 1.2 ms/mm Hg) and time domain measures of heart rate variability were also similar. After completion of the program, the exercise group exercised for a median of 15 min (interquartile range 12 to 25) at a workload of 104 +/- 7 W compared with 7 min (interquartile range 3.5 to 12) at a workload of 89 +/- 8 W in the control group (p < 0.01). There were significant (p < 0.001) improvements in baroreflex sensitivity and heart rate variability for the 49 patients combined but no differences between the exercise and control groups. Baroreflex sensitivity improved by 3.4 +/- 1.0 and 1.7 +/- 1.0 ms/mm Hg and the standard deviation of 24-h RR intervals by 36 +/- 6 and 40 +/- 10 ms, respectively (p > 0.1). CONCLUSIONS A hospital-based exercise training program increased endurance capacity but did not improve recovery of cardiovascular antonomic function after uncomplicated acute myocardial infarction.
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Affiliation(s)
- J W Leitch
- Department of Medicine, John Hunter Hospital, University of Newcastle, Australia.
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