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Laslett AM, Anderson-Luxford D, Willoughby B, Room R, Doran C, Egerton-Warburton D, Jenkinson R, Smit K, Jiang H. Harm from the drinking of people you know: A range of effects from different relationships. Addiction 2024. [PMID: 38698662 DOI: 10.1111/add.16509] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/25/2024] [Indexed: 05/05/2024]
Abstract
AIMS To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co-workers. DESIGN, SETTING AND PARTICIPANTS Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey. MEASUREMENTS Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio-economic status. FINDINGS Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%-62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%-23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13-1.95), younger people, rural, Australian-born (vs. respondents born overseas in non-English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model. CONCLUSIONS Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives.
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Affiliation(s)
- Anne-Marie Laslett
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Care Economy Research Institute, La Trobe University, Melbourne, Australia
| | | | - Bree Willoughby
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Social Research Centre on Alcohol and Drugs (SORAD), Stockholm University, Stockholm, Sweden
| | - Chris Doran
- Central Queensland University, Brisbane, Australia
| | - Diana Egerton-Warburton
- Australasian College of Emergency Medicine, Melbourne, Australia
- Monash Health, Melbourne, Australia
| | - Rebecca Jenkinson
- Australian Human Rights Commission, Melbourne, Australia
- Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Koen Smit
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Heng Jiang
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Edge L, Cunningham C, Murphy N, Dillon A, Flynn S, O'Shaughnessy Í, Davis A, O'Rourke B, Brossier L, Doran C, Hennessy A, Kennedy U, McMahon G, McNamara R, Shields D, Staunton P, Horgan F. 142 FRAILTY IDENTIFICATION AND INTERDISCIPLINARY ASSESSMENT OF OLDER PEOPLE IN THE EMERGENCY DEPARTMENT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.142] [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: 02/25/2023] Open
Abstract
Abstract
Background
Older People are attending Emergency Departments (EDs) in increasing numbers but the optimal assessment measures to use have yet to be established. This study examined the clinical utility of different assessments of strength, functional mobility, sarcopenia, cognition and frailty used by the physiotherapist in an interdisciplinary team (IDT) in the ED and determined any associations with clinical outcomes.
Methods
This observational cross-sectional study recruited adults ≥70 years who were assessed by an IDT on weekdays during working hours. Demographic variables such as age, gender, social situation, baseline mobility, falls and clinical measures such as Clinical Frailty Scale (CFS), 4AT, hand-held dynamometry, calf circumference and functional mobility in ED were recorded. Clinical outcomes were admission to hospital, discharge from ED with onward referral (ambulatory care or community) and discharge from ED with no referral. Ethical approval was obtained and SPSS was used for statistical analysis.
Results
Two hundred and fifty four participants were recruited, 58.3% female, mean age 80.23 (SD 6.56). Median CFS was 4 (IRQ 2.0), range 1–7 with 32.7% (n = 83) considered frail. Sarcopenia prevalence was 89.3% using grip strength and 7.1% using calf circumference. Grip strength predicted frailty even after adjusting for age (p < 0.0001), gender (p < 0.0001) and falls (p = 0.043). Admission to hospital was predicted by major diagnostic category (p = 0.016) and inability to sit to stand independently in ED (p < 0.0001). Seventy percent (n = 179) of participants were discharged from ED, with 27.6% referred to ambulatory care or community services. Onward referral was predicted by frailty (p = 0.016) and falls in the last six months (p = 0.028).
Conclusion
Grip strength in addition to a validated tool such as CFS may assist an experienced IDT in identifying frailty, which can in turn inform decision-making regarding ED disposition and pathways of care for older people. Functional assessment in the ED is also important to determine the need for hospital admission.
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Affiliation(s)
- L Edge
- St James's Hospital , Dublin, Ireland
| | | | - N Murphy
- St James's Hospital , Dublin, Ireland
| | - A Dillon
- St James's Hospital , Dublin, Ireland
| | - S Flynn
- St James's Hospital , Dublin, Ireland
| | | | - A Davis
- St James's Hospital , Dublin, Ireland
| | - B O'Rourke
- Royal College of Surgeons in Ireland , Dublin, Ireland
| | - L Brossier
- Royal College of Surgeons in Ireland , Dublin, Ireland
| | - C Doran
- Royal College of Surgeons in Ireland , Dublin, Ireland
| | | | - U Kennedy
- St James's Hospital , Dublin, Ireland
| | - G McMahon
- St James's Hospital , Dublin, Ireland
| | | | - D Shields
- St James's Hospital , Dublin, Ireland
| | | | - F Horgan
- Royal College of Surgeons in Ireland , Dublin, Ireland
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Krzak AM, Millar Z, Doran C, Ferreira Bruco ME, Purohit K, Nagrodzki J, van Loggerenberg A, Khanduja V. 1564 Not all roads lead to Rome! – A Retrospective Insight into a Young Adult Hip Pain Referral Pathway. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.781] [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: 11/13/2022]
Abstract
Abstract
Introduction
Young adult hip pain is increasingly recognized as an early warning sign for development of debilitating arthritis later in life. Two common causes for young adult hip pain are femoroacetabular impingement (FAI) and dysplasia. Yet, no universal referral pathway exists in the UK for young patients experiencing hip pain. Our aim was to investigate the timeline and journey of patients seen in a specialist young adult hip clinic at a tertiary orthopaedic centre.
Method
We conducted a case series using a two-part open question questionnaire given to 40 patients at a young adult hip clinic at a tertiary orthopaedic centre between March and November 2019.
Results
Average time from onset of symptoms to appointment in specialist clinic was 2.9 (± 3.9) years, with range between 1 month and 23 years. Average time between first GP appointment and appointment at a tertiary centre was 2.1 (±2.4) years. A total of 33 (83%) patients were seen in secondary care prior to referral to a specialist clinic at a tertiary centre. Imaging modalities prior to attendance were as follows: 23 (58%) patients had a hip X-ray, 15 (38%) a CT scan, 30 (75%) an MRI scan and 6 (15%) an ultrasound scan of their hip. A total of 23 (58%) patients had corticosteroid injections prior to referral to a specialist clinic.
Conclusions
Large variation seen in our results highlights an opportunity for service improvement and development of a universal referral pathway to improve patient care and reduce burden on other services.
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Affiliation(s)
- A M Krzak
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - Z Millar
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - C Doran
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - M E Ferreira Bruco
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - K Purohit
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - J Nagrodzki
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - A van Loggerenberg
- Cambridge University School of Clinical Medicine, Cambridge, United Kingdom
| | - V Khanduja
- Cambridge University Hospitals, Cambridge, United Kingdom
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Dworkin M, Akintayo T, Calem D, Doran C, Guth A, Kamami EM, Kar J, LaRosa J, Liu JC, Pérez Jiménez IN, Frasso R. Life during the pandemic: an international photo-elicitation study with medical students. BMC Med Educ 2021; 21:244. [PMID: 33906671 PMCID: PMC8078097 DOI: 10.1186/s12909-021-02684-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/16/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND The SARS-CoV-2 (COVID-19) pandemic is a global event with unprecedented impact on individuals and communities around the world. The purpose of this study is to use a modified photo-elicitation methodology to examine the impact of the COVID-19 pandemic on the lives of medical students and their communities around the world. METHODS Participating medical students were asked to take photographs for 14 days. In lieu of an interview, which is customary for photo-elicitation projects, participants were asked to share a reflection (a paragraph or two) for each photograph they contributed to the study. RESULTS Between April 27th, 2020 and May 11th, 2020 26 students from 19 medical schools across 13 countries shared photographs and reflections. Qualitative analysis of written reflections revealed that medical students felt the impact of the pandemic on several levels 1) individual, 2) interpersonal, 3) educational, and 4) societal. CONCLUSIONS The COVID-19 pandemic has impacted the lives of medical students on multiple levels. As individuals, students felt emotional distress but found resilience through physical activity and the establishment of new routines. Many students felt isolated as their interpersonal relationships were confined due to social distancing measures. These feelings could be combated with new educational initiatives focused on group collaboration. Lastly, students reflecting on the larger societal implications were concerned with the economic ramifications of the virus and its impact on their future. This study brought together students from several different countries to engage in an applied learning program as a model for equitable global health research.
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Affiliation(s)
- M Dworkin
- Warren Alpert Medical School, Brown University, Providence, RI, USA
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - T Akintayo
- Obafemi Awolowo University, Ife, Nigeria
| | - D Calem
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - C Doran
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - A Guth
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - E M Kamami
- Drexel University, Philadelphia, PA, USA
| | - J Kar
- New Vision University School of Medicine, Tbilisi, Georgia
| | - J LaRosa
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - J C Liu
- Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain
| | - I N Pérez Jiménez
- Universidad Nacional Autónoma de México, Facultad de Medicina, Mexico City, Mexico
| | - R Frasso
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
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McCalman J, Bainbridge R, James YC, Bailie R, Tsey K, Matthews V, Ungar M, Askew D, Fagan R, Visser H, Spurling G, Percival N, Blignault I, Doran C. Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach. BMC Public Health 2020; 20:1810. [PMID: 33246445 PMCID: PMC7694265 DOI: 10.1186/s12889-020-09885-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children works towards developing a spectrum of effective, community-based services and supports. These services and supports are organised into a coordinated network, build meaningful partnerships with families and address their cultural and linguistic needs, to help children to function better at home, in school, in the community, and throughout life. This study is conducted in partnership with primary healthcare (PHC) and other services in three diverse Indigenous Australian communities. It entails conceptualising, co-designing, implementing, and evaluating the effectiveness of systems integration to promote the mental health and wellbeing of Indigenous school-aged children (4-17 years). This paper outlines a protocol for implementing such complex community-driven research. METHODS/DESIGN Using continuous quality improvement processes, community co-designed strategies for improved systems integration will be informed by narratives from yarning circles with Indigenous children and service providers, and quantitative data from surveys of service providers and audits of PHC client records and intersectoral systems. Agreed strategies to improve the integration of community-based services and supports will be modelled using microsimulation software, with a preferred model implemented in each community. The evaluation will investigate changes in the: 1) availability of services that are community-driven, youth-informed and culturally competent; 2) extent of collaborative service networks; 3) identification by PHC services of children's social and emotional wellbeing concerns; and 4) ratio of children receiving services to identified need. Costs and benefits of improvements to systems integration will also be calculated. DISCUSSION The study will provide evidence-informed, community-driven, and tested models that can be used for implementing systems integration to promote the mental health and wellbeing of Indigenous children. It will identify the situational enablers and barriers that impact systems integration and determine the extent to which systems integration improves service availability, systems and child outcomes. Evidence for the cost effectiveness of systems-level integration will contribute to national mental health policy reform.
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Affiliation(s)
- Janya McCalman
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
| | - Roxanne Bainbridge
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
| | - Yvonne Cadet James
- Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD, 4870, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, McGregor Rd, Cairns, QLD, 4878, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, 6420 Coburg Rd, Halifax, NS, B3H 4R2, Canada
| | - Deborah Askew
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Ruth Fagan
- Gurriny Yealamucka Health Service, Bukki Rd, Yarrabah, QLD, 4871, Australia
| | - Hannah Visser
- Bulgarr Ngaru Medical Aboriginal Corporation, 153 Canterbury St, Casino, NSW, 2470, Australia
| | - Geoffrey Spurling
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Nikki Percival
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW, 2007, Australia
| | - Ilse Blignault
- Translational Health Research Institute, University of Western Sydney, School of Medicine, Campbelltown Campus, NSW, 2560, Australia
| | - Chris Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
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Allan J, Nott S, Chambers B, Hawthorn G, Munro A, Doran C, Oldmeadow C, Coleman C, Saksena T. A stepped wedge trial of efficacy and scalability of a virtual clinical pharmacy service (VCPS) in rural and remote NSW health facilities. BMC Health Serv Res 2020; 20:373. [PMID: 32366308 PMCID: PMC7197111 DOI: 10.1186/s12913-020-05229-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Medication errors are a leading cause of mortality and morbidity. Clinical pharmacy services provided in hospital can reduce medication errors and medication related harm. However, few rural or remote hospitals in Australia have a clinical pharmacy service. This study will evaluate a virtual clinical pharmacy service (VCPS) provided via telehealth to eight rural and remote hospitals in NSW, Australia. Methods A stepped wedge cluster randomised trial design will use routinely collected data from patients’ electronic medical records (n = 2080) to evaluate the VCPS at eight facilities. The sequence of steps is randomised, allowing for control of potential confounding temporal trends. Primary outcomes are number of medication reconciliations completed on admission and discharge. Secondary outcomes are length of stay, falls and 28 day readmissions. A cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) will be conducted. The CEA will answer the question of whether the VCPS is more cost-effective compared to treatment as usual; the CBA will consider the rate of return on investing in the VCPS. A patient experience measure (n = 500) and medication adherence questionnaire (n = 100 pre and post) will also be used to identify patient responses to the virtual service. Focus groups will investigate implementation from hospital staff perspectives at each site. Analyses of routine data will comprise generalised linear mixed models. Descriptive statistical analysis will summarise patient experience responses. Differences in medication adherence will be compared using linear regression models. Thematic analysis of focus groups will identify barriers and facilitators to VCPS implementation. Discussion We aim to demonstrate the effectiveness of virtual pharmacy interventions for rural populations, and inform best practice for using virtual healthcare to improve access to pharmacy services. It is widely recognised that clinical pharmacists are best placed to reduce medication errors. However, pharmacy services are limited in rural and remote hospitals. This project will provide evidence about ways in which the benefits of hospital pharmacists can be maximised utilising telehealth technology. If successful, this project can provide a model for pharmacy delivery in rural and remote locations. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) -ACTRN12619001757101 Prospectively registered on 11 December 2019. Record available from: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378878&isReview=true
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Affiliation(s)
- Julaine Allan
- School of Health and Society, University of Wollongong, Wollongong, Australia.
| | - Shannon Nott
- Western NSW Local Health District, Dubbo, Australia
| | | | - Ged Hawthorn
- Western NSW Local Health District, Dubbo, Australia
| | - Alice Munro
- Western NSW Local Health District, Dubbo, Australia
| | - Chris Doran
- Central Queensland University, Brisbane, Australia
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7
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Wolfenden L, Bolsewicz K, Grady A, McCrabb S, Kingsland M, Wiggers J, Bauman A, Wyse R, Nathan N, Sutherland R, Hodder RK, Fernandez M, Lewis C, Taylor N, McKay H, Grimshaw J, Hall A, Moullin J, Albers B, Batchelor S, Attia J, Milat A, Bailey A, Rissel C, Reeves P, Sims-Gould J, Mildon R, Doran C, Yoong SL. Optimisation: defining and exploring a concept to enhance the impact of public health initiatives. Health Res Policy Syst 2019; 17:108. [PMID: 31888666 PMCID: PMC6937822 DOI: 10.1186/s12961-019-0502-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/31/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Repeated, data-driven optimisation processes have been applied in many fields to rapidly transform the performance of products, processes and interventions. While such processes may similarly be employed to enhance the impact of public health initiatives, optimisation has not been defined in the context of public health and there has been little exploration of its key concepts. METHODS We used a modified, three-round Delphi study with an international group of researchers, public health policy-makers and practitioners to (1) generate a consensus-based definition of optimisation in the context of public health and (2i) describe key considerations for optimisation in that context. A pre-workshop literature review and elicitation of participant views regarding optimisation in public health (round 1) were followed by a daylong workshop and facilitated face-to-face group discussions to refine the definition and generate key considerations (round 2); finally, post-workshop discussions were undertaken to refine and finalise the findings (round 3). A thematic analysis was performed at each round. Study findings reflect an iterative consultation process with study participants. RESULTS Thirty of 33 invited individuals (91%) participated in the study. Participants reached consensus on the following definition of optimisation in public health: "A deliberate, iterative and data-driven process to improve a health intervention and/or its implementation to meet stakeholder-defined public health impacts within resource constraints". A range of optimisation considerations were explored. Optimisation was considered most suitable when existing public health initiatives are not sufficiently effective, meaningful improvements from an optimisation process are anticipated, quality data to assess impacts are routinely available, and there are stable and ongoing resources to support it. Participants believed optimisation could be applied to improve the impacts of an intervention, an implementation strategy or both, on outcomes valued by stakeholders or end users. While optimisation processes were thought to be facilitated by an understanding of the mechanisms of an intervention or implementation strategy, no agreement was reached regarding the best approach to inform decisions about modifications to improve impact. CONCLUSIONS The study findings provide a strong basis for future research to explore the potential impact of optimisation in the field of public health.
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Affiliation(s)
- Luke Wolfenden
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | | | - Alice Grady
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Sam McCrabb
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
| | - Melanie Kingsland
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - John Wiggers
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
| | - Adrian Bauman
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
| | - Rebecca Wyse
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Nicole Nathan
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Rachel Sutherland
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Rebecca Kate Hodder
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Maria Fernandez
- Centre for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Centre, Houston, TX United States of America
| | - Cara Lewis
- Kaiser Permanent Washington Health Research Institute, Seattle, WA United States of America
| | - Natalie Taylor
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
- Cancer Council NSW, Woollomooloo, NSW Australia
| | - Heather McKay
- Centre for Hip Health and Mobility, Robert H N Ho Research Centre, University of British Columbia, Vancouver, BC Canada
| | | | - Alix Hall
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Joanna Moullin
- Faculty of Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA Australia
| | - Bianca Albers
- European Implementation Collaborative, Sydney, Australia
| | | | - John Attia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Andrew Milat
- NSW Ministry of Health, North Sydney, NSW Australia
| | - Andrew Bailey
- Mid North Coast Local Health District, Port Macquarie, NSW Australia
| | - Chris Rissel
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
- NSW Office of Preventive Health, Liverpool, NSW Australia
| | - Penny Reeves
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Joanie Sims-Gould
- Centre for Hip Health and Mobility, Robert H N Ho Research Centre, University of British Columbia, Vancouver, BC Canada
| | - Robyn Mildon
- Centre for Evidence and Implementation, Carlton, VIC Australia
| | - Chris Doran
- Central Queensland University, North Rockhampton, QLD Australia
| | - Sze Lin Yoong
- Hunter New England Local Health District, Wallsend, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, NSW Australia
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8
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Clinton-McHarg T, Gonzalez S, Milner S, Sherker S, Kingsland M, Lecathelinais C, Hall A, Doran C, Wiggers J, Wolfenden L. Implementing health policies in Australian junior sports clubs: an RCT. BMC Public Health 2019; 19:556. [PMID: 31088417 PMCID: PMC6515613 DOI: 10.1186/s12889-019-6873-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/11/2018] [Accepted: 04/18/2019] [Indexed: 12/03/2022] Open
Abstract
Background This pilot study aimed to test the potential effectiveness and acceptability of an intervention to support the implementation of 16 recommended policies and practices to improve the health promotion environment of junior sporting clubs. Reported child exposure to health promoting practices at clubs was also assessed. Methods A cluster randomised trial was conducted with eight football leagues. Fourty-one junior football clubs belonging to four leagues in the intervention group received support (e.g. physical resources, recognition and rewards, systems and prompts) to implement 16 policies and practices that targeted child exposure to alcohol, tobacco, healthy food and beverages, and participation in physical activity. Thirty-eight clubs belonging to the four control group leagues did not receive the implementation intervention. Study outcomes were assessed via telephone interviews with nominated club representatives and parents of junior players. Between group differences in the mean number of policies and practices implemented at the club level at follow-up were examined using a multiple linear regression model. Results While the intervention was found to be acceptable, there was no significant difference between the mean number of practices and policies reported to be implemented by intervention and control clubs at post-intervention (Estimate − 0.05; 95% CI -0.91, 0.80; p = 0.90). There was also no significant difference in the proportion of children reported to be exposed to: alcohol (OR 1.16; 95% CI 0.41, 3.28; p = 0.78); tobacco (OR 0.97; CI 0.45, 2.10; p = 0.94); healthy food purchases (OR 0.49; CI 0.11, 2.27; p = 0.35); healthy drink purchases (OR 1.48; CI 0.72, 3.05; p = 0.27); or participation in physical activity (OR 0.76; CI 0.14, 4.08; p = 0.74). Conclusions Support strategies that better address barriers to the implementation of health promotion interventions in junior sports clubs are required. Trial registration Retrospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617001044314). Electronic supplementary material The online version of this article (10.1186/s12889-019-6873-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Sharleen Gonzalez
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Sharin Milner
- Alcohol and Drug Foundation, Melbourne, VIC, 3051, Australia
| | - Shauna Sherker
- Alcohol and Drug Foundation, Melbourne, VIC, 3051, Australia
| | - Melanie Kingsland
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | | | - Alix Hall
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Chris Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, Brisbane, QLD, 4000, Australia
| | - John Wiggers
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Luke Wolfenden
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia. .,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
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9
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Miller P, Droste N, Egerton‐Warburton D, Caldicott D, Fulde G, Ezard N, Preisz P, Walby A, Lloyd‐Jones M, Stella J, Sheridan M, Baker T, Hall M, Shakeshaft A, Havard A, Bowe S, Staiger PK, D'Este C, Doran C, Coomber K, Hyder S, Barker D, Shepherd J. Driving change: A partnership study protocol using shared emergency department data to reduce alcohol‐related harm. Emerg Med Australas 2019; 31:942-947. [DOI: 10.1111/1742-6723.13266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Miller
- School of PsychologyDeakin University Geelong Victoria Australia
| | - Nicolas Droste
- School of PsychologyDeakin University Geelong Victoria Australia
| | | | - David Caldicott
- Calvary Health Care Canberra Australian Capital Territory Australia
| | - Gordian Fulde
- St Vincent's Hospital Sydney Sydney New South Wales Australia
| | - Nadine Ezard
- St Vincent's Hospital Sydney Sydney New South Wales Australia
| | - Paul Preisz
- St Vincent's Hospital Sydney Sydney New South Wales Australia
| | - Andrew Walby
- St Vincent's Hospital Melbourne Melbourne Victoria Australia
| | | | | | | | - Tim Baker
- Southwest Health Care Warrnambool Victoria Australia
| | - Michael Hall
- The Canberra Hospital and Health Service Canberra Australian Capital Territory Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, The University of New South Wales Sydney New South Wales Australia
| | - Alys Havard
- Centre for Big Data Research in HealthThe University of New South Wales Sydney New South Wales Australia
| | - Steve Bowe
- School of PsychologyDeakin University Geelong Victoria Australia
| | - Petra K Staiger
- School of PsychologyDeakin University Geelong Victoria Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population HealthThe Australian National University Canberra Australian Capital Territory Australia
- The University of Newcastle Newcastle New South Wales Australia
| | - Chris Doran
- Central Queensland University Rockhampton Queensland Australia
| | - Kerri Coomber
- School of PsychologyDeakin University Geelong Victoria Australia
| | - Shannon Hyder
- School of PsychologyDeakin University Geelong Victoria Australia
| | - Daniel Barker
- Central Queensland University Rockhampton Queensland Australia
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10
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Litton E, Bass F, Delaney A, Hillis G, Marasco S, McGuinness S, Myles PS, Reid CM, Smith JA, Bagshaw SM, Keri-Anne Cowdrey HB, Frengley R, Ferrier J, Gilder E, Henderson S, Larobina M, Merthens J, Morgan M, Navarra L, Rudas M, Turner L, Reid K, Wise M, Young N, Young P, McGiffin D, Duncan J, Kaczmarek M, Seevanayagam S, Shaw M, Shardey G, Skillington P, Chorley T, Baker L, Zhang B, Bright C, Baker R, Canning N, Gilfillan, Kruger R, Fayers T, Kyte M, Doran C, Smith J, Baxter H, Seah P, Scaybrook S, James A, Goodwin K, Dignan R, Hewitt N, Gerrard K, Curtis L, Smith J, Baxter H, Tiruvoipati R, Broukal N, Wolfenden H, Muir, Worthington M, Wong C, Tatoulis J, Wynne R, Marshman D, Sze D, Wilson M, Turner L, Passage J, Kolybaba M, Fermanis G, Newbon P, Passage J, Kolybaba M, Newcomb A, Mack J, Duve K, Jansz P, Hunter T, Bissaker P, Dennis N, Burke N, Yadav S, Cooper K, Chard R, Halaka M, Tran L, Huq M, Billah B, Reid CM. Six-Month Outcomes After High-Risk Coronary Artery Bypass Graft Surgery and Preoperative Intra-aortic Balloon Counterpulsation Use: An Inception Cohort Study. J Cardiothorac Vasc Anesth 2018; 32:2067-2073. [DOI: 10.1053/j.jvca.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Indexed: 11/11/2022]
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11
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Doran C, Platt SR, Garosi LS. Long-term imaging follow-up of a conservatively managed presumptive osseous cervical stenotic myelopathy in a puppy. J Small Anim Pract 2018; 60:198. [PMID: 30239997 DOI: 10.1111/jsap.12923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/16/2018] [Accepted: 06/27/2018] [Indexed: 11/26/2022]
Affiliation(s)
- C Doran
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
| | - S R Platt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA
| | - L S Garosi
- Davies Veterinary Specialists, Hitchin, SG5 3HR, UK
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12
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Edmunds K, Ling R, Shakeshaft A, Doran C, Searles A. Systematic review of economic evaluations of interventions for high risk young people. BMC Health Serv Res 2018; 18:660. [PMID: 30139384 PMCID: PMC6108123 DOI: 10.1186/s12913-018-3450-x] [Citation(s) in RCA: 14] [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: 12/05/2017] [Accepted: 08/07/2018] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this systematic literature review is to identify and critique full economic evaluations of interventions for high risk young people with the purpose of informing the design of future rigorous economic evaluations of such intervention programs. Methods A PRISMA compliant search of the literature between 2000 and April 2018 was conducted to identify full economic evaluations of youth focussed interventions for at risk young people. Duplicates were removed and two researchers independently screened the article titles and abstracts according to PICOS criteria for exclusion and inclusion. The remaining full text articles were assessed for eligibility and a quality assessment of the included articles was conducted using the Drummond checklist. Results The database, grey literature and hand searches located 488 studies of interventions for at risk young people. After preliminary screening of titles and abstracts, 104 studies remained for full text examination and 29 empirical studies containing 32 separate economic evaluations were judged eligible for inclusion in the review. These comprised 13 cost-benefit analyses (41%), 17 cost-effectiveness analyses (53%), one cost-utility analysis (3%) and a social return on investment (3%). Three main methodological challenges were identified: 1. attribution of effects; 2. measuring and valuing outcomes; and 3. identifying relevant costs and consequences. Conclusions A cost-benefit analysis would best capture the dynamic nature of a multi-component intervention for high risk young people, incorporating broader intersectoral outcomes and enabling measurement of more domains of risk. Prospective long-term data collection and a strong study design that incorporates a control group contribute to the quality of economic evaluation. Extrapolation of impact into the future is important for this population, in order to account for the time lag in effect of many impacts and benefits arising from youth interventions. Electronic supplementary material The online version of this article (10.1186/s12913-018-3450-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kim Edmunds
- Hunter Medical Research Institute, University of Newcastle, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - Rod Ling
- Hunter Medical Research Institute, University of Newcastle, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick Campus, 22-32 King Street, Randwick, NSW, 2031, Australia
| | - Chris Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, 160 Ann Street, Brisbane, QLD, 4000, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, University of Newcastle, Lot 1, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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13
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Parkinson L, Banbury A, Livingstone A, Gordon S, Ray B, Byrne L, Nancarrow S, Doran C, McAllister M, Petersen C, Pedell S, Wood D. Caring for Carers of People with Dementia: A Protocol for Harnessing Innovation Through Deploying Leading Edge Technologies to Enable Virtual Support Groups and Services. Stud Health Technol Inform 2018; 246:29-41. [PMID: 29507258] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In rural Australia, knowledge and utilisation of support by informal carers is lacking. During the caregiving period, socioemotional support from family and friends plays an important role in sustaining caregiving activities. Post-care, these social networks facilitate adjustment to role change and dealing with grief. Developing and improving access to peer support to enable carers to effectively cope with the challenges of caring may positively influence their caring experience. The primary objective of this project is to examine the response of isolated rural carers for older people with dementia to a videoconference (VC) based peer support and information program. Will participation in the program improve self-efficacy, quality of life, and mental health? Secondary objectives are to develop a VC based peer support program for isolated rural carers for older people with dementia, using a co-design approach; and to assess the feasibility of VC technology for enhancing social support to family caregivers in their homes. This project will collaboratively co-design and evaluate a facilitated VC peer support and information program to carers of people with dementia within rural areas. Carers will be recruited through community health and care providers. Program development will use an information sharing approach to facilitate social interaction. A focus of the project is to use off-the-shelf technology which will be more accessible than specialised bespoke solutions that are currently popular in this area of research. A mixed methods repeated measures randomized wait list design will be used to evaluate the project. The primary outcomes are self-efficacy, quality of life, and mental health. Secondary outcomes are perceived social support and user satisfaction with the technology, and intention to continue VC interaction.
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Affiliation(s)
| | - Annie Banbury
- Prevention First, Kingscliff, New South Wales, Australia
| | | | - Steven Gordon
- Central Queensland University, Rockhampton, Queensland, Australia
| | - Biplob Ray
- Central Queensland University, Rockhampton, Queensland, Australia
| | | | | | - Chris Doran
- Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Carrie Petersen
- World Health Organisation, Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Pedell
- Swinburne University, Melbourne, Victoria, Australia
| | - Denise Wood
- Central Queensland University, Rockhampton, Queensland, Australia
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14
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Rees P, Waller B, Buckley AM, Doran C, Bland S, Scott T, Matthews J. REBOA at Role 2 Afloat: resuscitative endovascular balloon occlusion of the aorta as a bridge to damage control surgery in the military maritime setting. J ROY ARMY MED CORPS 2017; 164:72-76. [PMID: 29269480 DOI: 10.1136/jramc-2017-000874] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 11/04/2022]
Abstract
Role 2 Afloat provides a damage control resuscitation and surgery facility in support of maritime, littoral and aviation operations. Resuscitative endovascular balloon occlusion of the aorta (REBOA) offers a rapid, effective solution to exsanguinating haemorrhage from pelvic and non-compressible torso haemorrhage. It should be considered when the patient presents in a peri-arrest state, if surgery is likely to be delayed, or where the single operating table is occupied by another case. This paper will outline the data in support of endovascular haemorrhage control, describe the technique and explore how REBOA could be delivered using equipment currently available in the Royal Navy Role 2 Afloat equipment module. Also discussed are potential future directions in endovascular resuscitation.
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Affiliation(s)
- Paul Rees
- Academic Department of Military Medicine, London, UK.,University of St Andrews School of Medicine, St Andrews, UK
| | - B Waller
- Shackleton Department of Anaesthetics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A M Buckley
- Academic Department of Military Medicine, London, UK
| | - C Doran
- Department of Surgery, Royal Centre for Defence Medicine, Birmingham, UK
| | - S Bland
- Department of Emergency Medicine, Queen Alexandra Hospital, Portsmouth, UK
| | - T Scott
- Department of Anaesthesia and Critical Care, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - J Matthews
- Department of Orthopaedics and Trauma Surgery, Royal Cornwall Hospitals NHS Trust, Truro, UK.,Clinical Director Role 2 Afloat, National Command Headquarters, Portsmouth, UK
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15
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Searles A, Doran C, Attia J, Knight D, Wiggers J, Deeming S, Mattes J, Webb B, Hannan S, Ling R, Edmunds K, Reeves P, Nilsson M. An approach to measuring and encouraging research translation and research impact. Health Res Policy Syst 2016; 14:60. [PMID: 27507300 PMCID: PMC4979128 DOI: 10.1186/s12961-016-0131-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 07/07/2016] [Indexed: 11/18/2022] Open
Abstract
Background Research translation, particularly in the biomedical area, is often discussed but there are few methods that are routinely used to measure it or its impact. Of the impact measurement methods that are used, most aim to provide accountability – to measure and explain what was generated as a consequence of funding research. This case study reports on the development of a novel, conceptual framework that goes beyond measurement. The Framework To Assess the Impact from Translational health research, or FAIT, is a platform designed to prospectively measure and encourage research translation and research impact. A key assumption underpinning FAIT is that research translation is a prerequisite for research impact. Methods The research impact literature was mined to understand the range of existing frameworks and techniques employed to measure and encourage research translation and research impact. This review provided insights for the development of a FAIT prototype. A Steering Committee oversaw the project and provided the feedback that was used to refine FAIT. Results The outcome of the case study was the conceptual framework, FAIT, which is based on a modified program logic model and a hybrid of three proven methodologies for measuring research impact, namely a modified Payback method, social return on investment, and case studies or narratives of the process by which research translates and generates impact. Conclusion As funders increasingly seek to understand the return on their research investments, the routine measurement of research translation and research impact is likely to become mandatory rather than optional. Measurement of research impact on its own is insufficient. There should also be a mechanism attached to measurement that encourages research translation and impact – FAIT was designed for this task.
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Affiliation(s)
- Andrew Searles
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia. .,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Chris Doran
- Central Queensland University, Brisbane, 4000, Australia
| | - John Attia
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Department of Medicine, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, 2305, Australia
| | - Darryl Knight
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Biomedical Science and Pharmacy, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Department of Medicine, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, 2305, Australia
| | - Simon Deeming
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Joerg Mattes
- Experimental & Translational Respiratory Medicine, Priority Research Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute & University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Children's Hospital, Newcastle, NSW, Australia
| | - Brad Webb
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia
| | - Steve Hannan
- The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Rod Ling
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Kim Edmunds
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Penny Reeves
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Michael Nilsson
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW, 2305, Australia.,School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Department of Medicine, John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, 2305, Australia
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16
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Pande R, Saratzis A, Winter Beatty J, Doran C, Kirby R, Harmston C. Contemporary characteristics of blunt abdominal trauma in a regional series from the UK. Ann R Coll Surg Engl 2016; 99:82-87. [PMID: 27490986 DOI: 10.1308/rcsann.2016.0223] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 11/22/2022] Open
Abstract
INTRODUCTION Blunt abdominal trauma (BAT) is a common injury in recent trauma series. The characteristics of patients with BAT have changed following the reconfiguration of UK trauma services. The aim of this study was to build a new profile for BAT patients undergoing immediate or delayed laparotomy. METHODS All 5,401 consecutive adults presenting with major trauma between April 2012 and April 2014 in the 3 major trauma centres in the West Midlands were analysed to identify all patients with BAT. A total of 2,793 patients with a mechanism of injury or symptomatology consistent with BAT were identified (52%). Outcomes were analysed using local electronic clinical results systems and notes. RESULTS Of the 2,793 patients, 179 (6.4%) had a mesenteric or hollow viscus injury, 168 (6.0%) had a hepatobiliary injury, 149 (5.4%) had a splenic injury and 46 (1.6%) had a vascular injury. Overall, 103 patients (3.7%) underwent an early (<12 hours) laparotomy while 30 (1.1%) underwent a delayed (>12 hours) laparotomy. Twenty (66.7%) of those undergoing a delayed laparotomy had a hollow viscus injury. In total, 170 deaths occurred among the BAT patients (6.1%). In the early laparotomy group, 53 patients died (51.5%) whereas in the delayed laparotomy group, 6 patients died (20.0%). CONCLUSIONS This series has attempted to provide the characteristics of patients with BAT in a large contemporary UK cohort. BAT was found to be a common type of injury. Early and delayed laparotomy occurred in 3.7% and 1.1% of these patients respectively, mostly because of hollow viscus injury in both cases. Outcomes were comparable with those in the international literature from regions with mature trauma services.
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Affiliation(s)
- R Pande
- University Hospitals Coventry and Warwickshire NHS Trust , UK.,Contributed equally
| | - A Saratzis
- University of Leicester , UK.,Contributed equally
| | - J Winter Beatty
- University Hospitals Coventry and Warwickshire NHS Trust , UK
| | - C Doran
- University Hospitals Birmingham NHS Foundation Trust , UK
| | - R Kirby
- University Hospitals of North Midlands NHS Trust , UK
| | - C Harmston
- University Hospitals Coventry and Warwickshire NHS Trust , UK
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17
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Abstract
In this Perspective, Wayne Hall and Chris Doran discuss Lightwood and Glantz's findings and the implications for tobacco control programs in the US, which are currently poorly funded.
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Affiliation(s)
- Wayne Hall
- University of Queensland Centre for Youth Substance Abuse Research, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
- National Addiction Centre, King’s College London, London, United Kingdom
- * E-mail:
| | - Chris Doran
- School of Human Health and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
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18
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McCalman J, Bainbridge R, Russo S, Rutherford K, Tsey K, Wenitong M, Shakeshaft A, Doran C, Jacups S. Psycho-social resilience, vulnerability and suicide prevention: impact evaluation of a mentoring approach to modify suicide risk for remote Indigenous Australian students at boarding school. BMC Public Health 2016; 16:98. [PMID: 26833339 PMCID: PMC4736696 DOI: 10.1186/s12889-016-2762-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 12/21/2015] [Accepted: 01/20/2016] [Indexed: 11/29/2022] Open
Abstract
Background The proposed study was developed in response to increased suicide risk identified in Aboriginal and Torres Strait Islander students who are compelled to attend boarding schools across Queensland when there is no secondary schooling provision in their remote home communities. It will investigate the impact of a multicomponent mentoring intervention to increase levels of psychosocial resilience. We aim to test the null hypothesis that students’ resilience is not positively influenced by the intervention. The 5-year project was funded by the Australian National Health and Medical Research Council from December 2014. Methods/Design An integrated mixed methods approach will be adopted; each component iteratively informing the other. Using an interrupted time series design, the primary research methods are quantitative: 1) assessment of change in students’ resilience, educational outcomes and suicide risk; and 2) calculation of costs of the intervention. Secondary methods are qualitative: 3) a grounded theoretical model of the process of enhancing students’ psychosocial resilience to protect against suicide. Additionally, there is a tertiary focus on capacity development: more experienced researchers in the team will provide research mentorship to less experienced researchers through regular meetings; while Indigenous team members provide cultural mentorship in research practices to non-Indigenous members. Discussion Australia’s suicide prevention policy is progressive but a strong service delivery model is lacking, particularly for Indigenous peoples. The proposed research will potentially improve students’ levels of resilience to mitigate against suicide risk. Additionally, it could reduce the economic and social costs of Indigenous youth suicide by obtaining agreement on what is good suicide prevention practice for remote Indigenous students who transition to boarding schools for education, and identifying the benefits-costs of an evidence-based multi-component mentoring intervention to improve resilience.
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Affiliation(s)
- Janya McCalman
- The Cairns Institute, James Cook University, PO Box 6811, Cairns, QLD, 4870, Australia. .,School of Human Health and Social Sciences, CQUniversity Australia, Cairns Square, Level 3, Corner Abbott and Shields Streets, Cairns, QLD, 4870, Australia.
| | - Roxanne Bainbridge
- The Cairns Institute, James Cook University, PO Box 6811, Cairns, QLD, 4870, Australia. .,School of Human Health and Social Sciences, CQUniversity Australia, Cairns Square, Level 3, Corner Abbott and Shields Streets, Cairns, QLD, 4870, Australia.
| | - Sandra Russo
- Transition Support Service, Queensland Department of Education, Training and Employment, P O Box 2268, Cairns, QLD, 4870, Australia.
| | - Katrina Rutherford
- Transition Support Service, Queensland Department of Education, Training and Employment, P O Box 2268, Cairns, QLD, 4870, Australia.
| | - Komla Tsey
- The Cairns Institute, James Cook University, PO Box 6811, Cairns, QLD, 4870, Australia.
| | - Mark Wenitong
- Apunipima Cape York Health Council, PO box 12045, Westcourt, QLD, 4870, Australia.
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of NSW, 22-32 King St, Randwick, NSW, 2031, Australia.
| | - Chris Doran
- CQUniversity, 160 Ann Street, Brisbane, QLD, 4000, Australia.
| | - Susan Jacups
- The Cairns Institute, James Cook University, PO Box 6811, Cairns, QLD, 4870, Australia.
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Spreadborough P, Doran C. The current thinking on colorectal cancer. J R Nav Med Serv 2015; 101:47-54. [PMID: 26292393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is the fourth most common cancer in the UK and the incidence has increased over recent decades. Although only 1.5% of cases are diagnosed in those aged under 40 years, it remains an important condition to be aware of in the military population. Patients who are genetically predisposed can have a lifetime risk of 80-100% of developing CRC and are likely to develop symptoms during their service. 20% of patients will present with metastatic disease. While surgical and oncological treatments have improved outcomes, early diagnosis of CRC is essential to reducing mortality. This paper provides an overview of the aetiology, investigations and treatment options for CRC. Explanation of primary surgical options and the principles of adjuvant therapies are included to aid informed discussions with patients.
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Woolley T, Midwinter M, Spencer P, Watts S, Doran C, Kirkman E. Utility of interim ROTEM(®) values of clot strength, A5 and A10, in predicting final assessment of coagulation status in severely injured battle patients. Injury 2013; 44:593-9. [PMID: 22487164 DOI: 10.1016/j.injury.2012.03.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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: 11/15/2011] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Proactive management of trauma-related coagulopathy requires early identification and rapid assessment in order to allow targeted resuscitation. This study determined whether early (interim) ROTEM(®) (TEM International GmbH, Munich, Germany) values could predict hypocoagulopathy in seriously injured military patients. METHODS Normal ranges for ROTEM(®) values were obtained from 50 volunteers. 108 samples were collected during the early phase of clinical management from 48 severe trauma patients. The blood was subject to EXTEM analysis and compared to the 95% tolerance limits from the volunteers. Coagulopathy (was deemed to be present if EXTEM MCF was below 40 mm, which is in the range indicating clinical concern defined by the ROTEM(®) Expert Working Group. RESULTS The normal range data was broadly similar to ROTEM(®) published data. Admission samples were available from 31 battlefield casualties, and 39% of these were coagulopathic 51% of the samples from all 48 patients were coagulopathic (EXTEM MCF<40 mm) and interim EXTEM values of these at 5 and 10 min (A5 and A10) predicted coagulopathy with sensitivities/specificities of 0.96/0.58 (A5) and 1.00/0.70 (A10). In addition, statistical comparison of clotting domains between normal volunteers and trauma patients suggests a difference in clot strengths due to a difference in platelet function rather than platelet number (mean 142 × 10(9)l(-1)). CONCLUSIONS The A10 value of ROTEM(®) provides an early sensitive and specific assessment of coagulopathy after military trauma and may be of utility in guiding bespoke resuscitation. We found some speculative evidence that in major trauma platelet function is particularly affected.
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Affiliation(s)
- T Woolley
- Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, ICT Building, Birmingham, Research Park, Vincent Drive, Birmingham B15 2SQ, United Kingdom.
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Gong W, Ritter A, Bright D, Doran C. How profitable is methamphetamine dealing in Australia? Drug Alcohol Depend 2012; 122:208-12. [PMID: 22036302 DOI: 10.1016/j.drugalcdep.2011.09.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 01/11/2011] [Revised: 09/28/2011] [Accepted: 09/30/2011] [Indexed: 10/15/2022]
Abstract
INTRODUCTION The illicit drug trade is the largest in value among global illicit commodities, at some $320 billion US dollars, according to the UN World Drug Report. Endeavours to control such a large illicit market would be enhanced by improved understanding of the economics of the trade. However, due to its illicit nature many aspects of the illicit drug market are largely unknown. This study explored one economic aspect of illicit drug dealing, profitability, with the aim of developing a better picture of the financial gains from illicit drug dealing. METHODS Data were obtained from judges sentencing remarks, key informants from law enforcement, and other published reports which detail the prices paid for methamphetamine in Australia. The financial margins attained from non-crystal methamphetamine dealing in Australia were calculated by examining the best fit for the relationship between prices and quantities: in this case a power law. RESULTS If it is assumed that a single deal is divided ("cut") between 4 times and 20 times before selling to the next customer, the mark-ups can range from 24% to 59%. The mark-ups appear low compared with those found in US research, but similar to those found in UK research. CONCLUSIONS To our knowledge, this is the first attempt to analyse profitability of methamphetamine dealing in Australia. The findings of this study will help in understanding the motivations and decisions of drug dealers, and potentially assist drug law enforcement agencies to design better strategies to dismantle supply chain linkages which generate excessive profits.
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Affiliation(s)
- Wendy Gong
- University of New South Wales, Sydney, Australia
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22
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Maddox P, Doran C, Williams ID, Kus M. The role of intergenerational influence in waste education programmes: the THAW project. Waste Manag 2011; 31:2590-2600. [PMID: 21868211 DOI: 10.1016/j.wasman.2011.07.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 07/12/2011] [Accepted: 07/19/2011] [Indexed: 05/31/2023]
Abstract
Whilst the education of young people is often seen as a part of the solution to current environmental problems seeking urgent attention, it is often forgotten that their parents and other household members can also be educated/influenced via home-based educational activities. This paper explores the theory of intergenerational influence in relation to school based waste education. Waste Watch, a UK-based environmental charity (www.wastewatch.org.uk), has pioneered a model that uses practical activities and whole school involvement to promote school based action on waste. This methodology has been adopted nationally. This paper outlines and evaluates how effective school based waste education is in promoting action at a household level. The paper outlines Waste Watch's 'Taking Home Action on Waste (THAW)' project carried out for two and half years in Rotherham, a town in South Yorkshire, England. The project worked with 6705 primary age children in 39 schools (44% of primary schools in the project area) to enable them to take the "reduce, reuse and recycle message" home to their families and to engage these (i.e. families) in sustainable waste management practices. As well as substantial increases in students' knowledge and understanding of waste reduction, measurement of the impact of the project in areas around 12 carefully chosen sample schools showed evidence of increased participation in recycling and recycling tonnages as well as declining levels of residual waste. Following delivery of the project in these areas, an average increase of 8.6% was recorded in recycling set out rates which led to a 4.3% increase in paper recycling tonnages and an 8.7% increase in tonnages of cans, glass and textiles collected for recycling. Correspondingly, there was a 4.5% fall in tonnages of residual waste. Waste Watch's THAW project was the first serious attempt to measure the intergenerational influence of an education programme on behaviour at home (i.e. other than schools' own waste). It clearly shows that household recycling behaviour can be positively impacted by intergenerational influence via a practical school-based waste education model. However, although the model could potentially have a big impact if rolled out nationally, it will require seed funding and the long-term durability of the model has not yet been fully quantified.
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Affiliation(s)
- P Maddox
- Waste Watch, 56-64 Leonard Street, London EC2A 4LT, United Kingdom
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Haswell MR, Kavanagh D, Tsey K, Reilly L, Cadet-James Y, Laliberte A, Wilson A, Doran C. Psychometric validation of the Growth and Empowerment Measure (GEM) applied with Indigenous Australians. Aust N Z J Psychiatry 2010; 44:791-9. [PMID: 20815665 DOI: 10.3109/00048674.2010.482919] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Empowerment is a complex process of psychological, social, organizational and structural change. It allows individuals and groups to achieve positive growth and effectively address the social and psychological impacts of historical oppression, marginalization and disadvantage. The Growth and Empowerment Measure (GEM) was developed to measure change in dimensions of empowerment as defined and described by Aboriginal Australians who participated in the Family Well Being programme. METHOD The GEM has two components: a 14-item Emotional Empowerment Scale (EES14) and 12 Scenarios (12S). It is accompanied by the Kessler 6 Psychological Distress Scale (K6), supplemented by two questions assessing frequency of happy and angry feelings. For validation, the measure was applied with 184 Indigenous Australian participants involved in personal and/or organizational social health activities. RESULTS Psychometric analyses of the new instruments support their validity and reliability and indicate two-component structures for both the EES (Self-capacity; Inner peace) and the 12S (Healing and enabling growth, Connection and purpose). Strong correlations were observed across the scales and subscales. Participants who scored higher on the newly developed scales showed lower distress on the K6, particularly when the two additional questions were included. However, exploratory factor analyses demonstrated that GEM subscales are separable from the Kessler distress measure. CONCLUSION The GEM shows promise in enabling measurement and enhancing understanding of both process and outcome of psychological and social empowerment within an Australian Indigenous context.
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Affiliation(s)
- Melissa R Haswell
- Muru Marri Indigenous Health Unit, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
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Ghaffari S, Doran C, Wilson A, Aisbett C. Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.5.460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ghaffari S, Doran C, Wilson A, Aisbett C. Trialling diagnosis-related groups classification in the Iranian health system: a case study examining the feasibility of introducing casemix. East Mediterr Health J 2010; 16:460-466. [PMID: 20799543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This paper examines the quality of routinely collected information in an Iranian hospital in a trial of casemix classification. Australian Refined Diagnosis Related Groups (AR-DRG) were used to classify patient episodes. There were 327 DRGs identified, of which 20% had only 1 case. The grouper program identified invalid records for 4% of total separations. Approximately 4.5% of cases were classified into error DRGs and 3.4% were ungroupable. No complication and comorbidity effects were identified with 93% of total cases. R2 (variance in length of stay explained) was 44% for untrimmed cases, increasing to 63%, 57% and 58% after trimming by L3H3, IQR and 10th-95th percentile methods respectively.
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Affiliation(s)
- S Ghaffari
- School of Population Health, University of Queensland, Brisbane, Australia.
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Henley N, Tovey S, Doran C, McMillan D. The Role of the Systemic Inflammatory Response in Long Term Outcome from Operable Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4050] [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
Aims: It is recognised that the presence of a systemic inflammatory response has independent prognostic value in a number of advanced and operable tumours. There is also evidence in advanced breast cancer (Al Murri et al., 2006). However, results in operable breast cancer have been conflicting. Therefore, we prospectively examined the relationship between the systemic inflammatory response and long term survival in primary operable breast cancer.Methods: Patients with invasive primary operable breast cancer (n=154) treated at Royal and Western Infirmaries, Glasgow between October 2000- January 2002 were studied. The systemic inflammatory response, as evidenced by elevated CRP and Il-6, was measured pre-operatively and approximately 12 months later. An elevated CRP was defined as >10mg/l, and IL-6 as >5ng/l. Demographic and clinical data including age, tumour size, histological grade, lymph node status oestrogen receptor (ER) status and HER2 status were recorded. The Nottingham prognostic index (NPI) was calculated and subdivided into good (0-3.4), intermediate (3.41-5.4) and poor (>5.41) prognosis. Patients were followed-up until 1st March 2009.Results: Mean age was 59 (range 34-87). HER-2 was positive in 18 patients (12%), ER status was positive in 121 patients (79%). NPI was good/ intermediate/poor in 55 (36%)/ 73 (47%)/ 26 (17%). Circulating concentrations of interleukin-6 were significantly correlated with those of C-reactive protein (rs=0.449, p<0.001). Median follow-up was 8 years (range 7 – 8.5 years). During this period, there were 20 breast cancer deaths and 16 of other causes. On univariate analysis, NPI (p<0.001), pre-operative CRP (p=0.03), pre-operative IL-6 (p=0.05) and post-operative CRP (p=0.05) predicted breast cancer specific survival. In contrast, post-operative IL-6, ER and HER2 status did not. On multivariate analysis, NPI (HR 7.78 95% CI: 3.44-17.61 p<0.001) and pre-operative CRP (HR 6.36 95% CI: 2.11-19.18, p=0.001) predicted breast cancer specific survival.Conclusions: The results of the present study suggest that the presence of a systemic inflammatory response prior to surgery, in particular CRP, predicts breast cancer specific survival independent of tumour based factors. Therefore measurement of the systemic inflammatory response may be useful in the pre-operative assessment of patients with primary operable breast cancer.We acknowledge the advice and support of Timothy G Cooke who died 20th July 2008.ReferenceAl Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC. Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer. 2006;94:227-30.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4050.
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Affiliation(s)
- N. Henley
- 1Glasgow Royal Infirmary, United Kingdom
| | - S. Tovey
- 1Glasgow Royal Infirmary, United Kingdom
| | - C. Doran
- 1Glasgow Royal Infirmary, United Kingdom
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Digiusto E, Mattick RP, Kimber J, O'Brien S, Doran C, Henderson N, Breen C. National evaluation of pharmacotherapies for opioid dependence-why have we done it? Drug Alcohol Rev 2009. [DOI: 10.1080/09595230123583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Chisholm D, Doran C, Shibuya K, Rehm J. Comparative cost-effectiveness of policy instruments for reducing the global burden of alcohol, tobacco and illicit drug use. Drug Alcohol Rev 2009; 25:553-65. [PMID: 17132573 DOI: 10.1080/09595230600944487] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Alcohol, tobacco and illicit drug use together pose a formidable challenge to international public health. Building on earlier estimates of the demonstrated burden of alcohol, tobacco and illicit drug use at the global level, this review aims to consider the comparative cost-effectiveness of evidence-based interventions for reducing the global burden of disease from these three risk factors. Although the number of published cost-effectiveness studies in the addictions field is now extensive (reviewed briefly here) there are a series of practical problems in using them for sector-wide decision making, including methodological heterogeneity, differences in analytical reference point and the specificity of findings to a particular context. In response to these limitations, a more generalised form of cost-effectiveness analysis (CEA) is proposed, which enables like-with-like comparisons of the relative efficiency of preventive or individual-based strategies to be made, not only within but also across diseases or their risk factors. The application of generalised CEA to a range of personal and non-personal interventions for reducing the burden of addictive substances is described. While such a development avoids many of the obstacles that have plagued earlier attempts and in so doing opens up new opportunities to address important policy questions, there remain a number of caveats to population-level analysis of this kind, particularly when conducted at the global level. These issues are the subject of the final section of this review.
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Affiliation(s)
- Dan Chisholm
- Evidence and Information for Policy, World Health Organisation, Geneva, Switzerland.
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Petrie D, Doran C, Shakeshaft A, Sanson-Fisher R. The relationship between alcohol consumption and self-reported health status using the EQ5D: Evidence from rural Australia. Soc Sci Med 2008; 67:1717-26. [DOI: 10.1016/j.socscimed.2008.09.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Indexed: 11/24/2022]
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Forbes D, Creamer M, Phelps A, Bryant R, McFarlane A, Devilly GJ, Matthews L, Raphael B, Doran C, Merlin T, Newton S. Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Aust N Z J Psychiatry 2007; 41:637-48. [PMID: 17620160 DOI: 10.1080/00048670701449161] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [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: 10/23/2022]
Abstract
Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis.
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Affiliation(s)
- David Forbes
- Australian Centre for Posttraumatic Mental Health, West Heidelberg, Vic, Australia
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Lasenby A, Doran C, Pritchard J, Caceres A, Dolan S. Bound states and decay times of fermions in a Schwarzschild black hole background. Int J Clin Exp Med 2005. [DOI: 10.1103/physrevd.72.105014] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bonevski B, Doran C, Bailey C, Lowe J. Description of an early discharge post-acute care program: length of hospital stay, patient and carer needs and cost. AUST HEALTH REV 2002; 25:78-86. [PMID: 12046158 DOI: 10.1071/ah020078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of the project was to evaluate a pilot Post Acute Community Care (PACC) program for orthopaedic patients. A series of cross-sectional surveys elicited responses of patient and home carer needs and GP and hospital staff acceptability while a cost-minimisation analysis compared the average cost of the PACC program with general orthopaedic hospital care. Patients were classified according to Australian National Diagnosis Related Groups (DRGs). Average length of hospital stay in 1998/99 for PACC patients was 7.7 days compared to 12.3 for general orthopaedic patients. Only 3% of patients had an unplanned readmission to hospital. Patients and carers expressed a number of unmet needs. This study confirms the popularity of early discharge schemes with patients, and provides little evidence of adverse health outcomes or that the burden of care is shifted to carers in a way that is unacceptable for this older population.
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Digiusto E, Mattick RP, Kimber J, O'Brien S, Doran C, Henderson N, Breen C. National evaluation of pharmacotherapies for opioid dependence - why have we done it? Drug Alcohol Rev 2001. [DOI: 10.1080/09595230120058524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Doran C. Managing epilepsy. Nurs Times 2000; 96:37-8. [PMID: 11962281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Chapman S, Scollo M, Doran C, Sanson-Fisher R. Tobacco taxes are no insurance against litigation. Aust N Z J Public Health 2000; 24:103-4. [PMID: 10777992 DOI: 10.1111/j.1467-842x.2000.tb00736.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Doran C, Kenny S, Leonard PJ. Changes in acid base components of blood on storage at room temperature. Ir J Med Sci 1970; 3:409-14. [PMID: 5517048 DOI: 10.1007/bf02962162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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