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Co-design of an Australian health service framework and implementation plan for involving consumers in research
Get PDFObjectives: The value of engaging health service users and their families (consumers) in research is increasingly being recognised in planning and evaluating health services to meet diverse needs. This project aimed to co-design a strategic consumer involvement framework and implementation plan for a public Australian hospital and health service. Methods:A co-design approach was used to adopt a framework and develop an implementation plan across five stages: (1) an initial consultation with key stakeholders, (2) a survey of health service staff about involving consumers in research at the health service, (3) three group sessions using Nominal Group Technique with health service consumers and staff that explored barriers and solutions to involving consumers, (4) data synthesis, and (5) a workshop of key stakeholders to develop and refine the implemen- tation plan. Three consumer partners contributed to protocol development, research design, data analysis, and manuscript writing. Results:Survey and group session data highlighted a need for governance, infrastructure, capacity building, and leadership and culture within the organisa- tion to support the involvement of consumers in research at the health service. These aligned with the South Australian Health and Medical Research Institute (SAHMRI) Framework domains. Implementation strategies were adjusted on the basis of insights from the local context to facilitate adoption within the health service. Conclusions:By better supporting consumers and researchers to work together in health service research, organisations can enhance the relevance, quality, and impact of their research efforts. This project provides a valuable blueprint for developing a local, contextualised approach to promoting effective consumer–researcher rela- tionships in Australian public health services
Moderate- to Long-Term Effect of Dietary Interventions for Depression and Anxiety: A Systematic Review and Meta-analysis
No full textBackground: Dietary interventions are a potential alternative treatment of depression and anxiety.Purpose: To evaluate the effects of dietary interventions on depression and anxiety. Data Sources: PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and PsycINFO searched from inception until 12 December 2024. Trial registries and forward and backward citation analysis done on 3 January 2025. Study Selection: Randomized controlled trials (RCTs) evaluated the effect of dietary advice with or without food provision compared with no specific dietary advice or active interventions for 3 months or longer on depression and/or anxiety. Data Extraction: Two authors independently screened articles, extracted data, and assessed risk of bias. Primary outcomes included depression and anxiety symptoms at 3 months or longer. Random-effects meta-analyses were done, and the certainty of evidence was assessed. Data Synthesis: Twenty-five RCTs were included. Compared with no specific dietary advice, depressive symptoms might be improved in adults with elevated cardiometabolic risk by dietary advice on calorie restriction (standardized mean difference [SMD], -0.23 [95% CI, -0.38 to -0.09]; low certainty). Low-fat diets may also have very small effects on depressive symptoms in adults with elevated cardiometabolic risk (SMD, -0.03 [CI, -0.04 to -0.01]; low certainty). Evidence on other diets, comparing diets with active comparisons, and on anxiety was limited by study limitations and clinical or methodological heterogeneity. Limitation: Limited studies did not allow for adequate exploration of heterogeneity. Conclusion: Calorie restrictions and low-fat diets might reduce depressive symptoms among adults with elevated cardiometabolic risk, but the differences were small and confidence in the findings was low. Evidence on other diets, comparisons to active interventions, and other outcomes is limited
Agency: Intention and the eco-systemic dimension. Letter of response to Konopasky et al.'s 2025 conceptualisations of agency (AMEE guide No.177)
No full textWe commend Konopasky et al. for their 2025 paper concerning agency [Citation1]. Here we offer additional considerations that we hope will be received in the spirit of collegial engagement and shared inquiry. We deeply appreciate their recognition of privilege, oppression, and systemic violence as central to the formation of agency and selfhood, and we find their emphasis on relationality—where the self is co-constructed through interaction—both timely and insightful. Their articulation of positionality within cultural worlds adds important nuance to how we understand the diversity of agency across contexts. Traditional and contemporary perspectives often emphasize the agent’s capacity to choose among possibilities and act with purpose—elements we believe are vital to distinguishing agency from general causality [Citation2]. We feel Konopasky et al.’s definition currently refers to any causal process and misses the distinct importance of decision-making and motivation. While acknowledging some sympathy for a functional characterization of agency, we stress the need to distinguish it from causality. We also see value in more explicitly addressing selfhood alongside agency, as the two are deeply intertwined
The association between dietary exposures and anxiety symptoms: A prospective analysis of the Australian longitudinal study on women’s health cohort
Get PDFBackground:Nutrition is a potentially modifiable risk factor for mental disorders. Since anxiety is the most common mental disorder globally and most commonly impacts women, understanding its relationship with dietary exposures may elucidate important prevention and treatment approaches. We aimed to explore the association between dietary exposures and incident anxiety in women.Methods:We used prospective longitudinal dietary data from 20,307 women enrolled in the Australian Longitudinal Study on Women's Health from 1973 to 1978 (young cohort between waves 3–5) and 1946–1951 (mid cohort between waves 3–7). Dietary exposures were defined according to the Global Burden of Disease framework (from wave 3). The primary outcome, anxiety and secondary outcome, depression were measured using subscales of the Goldberg Anxiety and Depression Scale (from wave 4). Generalized estimating equation Poisson regression models estimated risk ratios with 95 % confidence intervals, adjusting for age, socioeconomic status, and energy intake.Results:Higher intakes of vegetables (adjusted risk ratio [aRR]: 0.94, 95%CI: 0.93–0.96 per serve increase), fruits (aRR: 0.93, 95%CI: 0.92–0.94), nuts and seeds (aRR: 0.93, 95%CI: 0.89–0.98 per serve), milk (aRR: 0.98, 95%CI: 0.96 to 0.99 per serve), fiber (aRR: 0.76, 95%CI: 0.72 to 0.81 per 30-g) and calcium (aRR: 0.88, 95%CI: 0.84 to 0.91 per gram) were associated with lower risk of incident anxiety. Conversely, higher intake of processed meat (aRR: 1.02, 95%CI: 1.00–1.05 per serve) and sodium (aRR: 1.15, 95 % CI: 1.09–1.22 per 2-g) was associated with higher anxiety risk.Conclusions:Higher intake of plant-based foods and lower intake of processed foods may help reduce the risk of anxiety. Further prospective and intervention studies should confirm these associations and underlying biological mechanisms
Enhancing climate change resilience: Does development aid and governance mitigate climate change vulnerability in the Asia-Pacific?
No full textThe Asia-Pacific developing countries continue to bear the brunt of climate change. Adapting and building resilience against climate risks demand significant financial resources and an efficient governance system. However, financial and institutional constraints limit the ability of the Asia-Pacific developing countries to adapt and build resilience against climate change risk. Currently, there are insufficient studies on the impact of governance as an adaptive capacity and development aid (foreign aid) on climate change vulnerability, focusing on the Asia-Pacific developing countries. This study, therefore, assesses the role of governance and foreign aid on climate change vulnerability, relying on panel data from 37 Asia-Pacific developing countries from 1995 to 2022. Our empirical analysis, based on the panel-corrected standard error model, shows that foreign aid is significantly associated with climate change vulnerability reduction. Also, governance variables such as the control corruption index, political stability index and voice and accountability index significantly worsen climate change vulnerability, while the government effectiveness index and regulatory quality index are significantly associated with climate change vulnerability reduction. The analysis showed that the impact of foreign aid on climate change vulnerability depends on governance in the Asia-Pacific developing countries, and in most cases, governance weakens the influence of foreign aid on lowering climate change vulnerability. These findings remain robust when endogeneity and distributional heterogeneity are addressed with alternative estimation techniques. These findings highlight that reducing climate change risk requires significant support from development aid donors as well as policies to strengthen governance in the region
Public–Private Partnerships for Universal Health Coverage in Sub-Saharan Africa: A Scoping Review Protocol
No full textBackground and Aims: Globally in the health sector, governments use public–private partnerships (PPPs) to make significant contributions to the development and implementation of national health policies and strategies to improve health systems and health outcomes. Following the World Health Organization's resolution on universal health coverage (UHC), healthcare PPPs have emerged as an innovative policy option, especially, for countries in sub-Saharan Africa (SSA) to progress towards achieving UHC. Although many studies have reported the use of healthcare PPPs, it appears no review has been conducted to synthesize evidence on how it facilitates or hinders progress toward attaining UHC in the SSA context. This review seeks to fill this research gap by systematically synthesizing the literature on healthcare PPPs used in SSA and examining how various forms of healthcare PPPs affect progress towards attaining UHC in SSA. Methods: Arksey and O'Malley's guidelines for conducting scoping reviews will guide the review process. PubMed, Medline (Ovid), Global Health (Ovid), Web of Science, Scopus, and EconLit will be searched for studies published from January 2013 to December 2023. Thematic analysis of data will be employed for this review. Discussion: Since the WHO endorsed the use of PPPs as a means of achieving UHC, PPPs in the health sector have increasingly become popular for many healthcare projects and services especially in SSA. Yet, limited evidence around how PPP models have taken shape and their impact on achieving UHC creates a significant gap in understanding how PPPs affect progress toward UHC. Conclusion: To the best of our knowledge, this scoping review is the first to identify and examine healthcare PPPs in SSA for UHC. The approaches outlined in this protocol make several important advances in methods for examining PPPs, particularly for UHC in SSA, and can be applied elsewhere. Protocol Registration: This protocol has been registered on Open Science Framework and can be accessed at https://doi.org/10.17605/OSF.IO/V9874. © 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC
A global profile of occupational therapy and primary care: results from the World Federation of Occupational Therapists survey
Get PDFBackground:Despite the clearly identified roles and need for occupational therapy in primary care, guidance on a consistent global response is lacking.Purpose:This study aimed to gain insight into the global state of occupational therapy primary care services.Method:Data from an online survey of the 100 WFOT member organisations was grouped by country income levels; weighted global means and ANOVA were calculated.Results:Fifty-nine member organisations from five world regions responded, 33 (55.9%) representing high-income countries. Activities of daily living was the most addressed area; other health facilities (e.g., mental health services, rehabilitation services) were reported as a common setting. People with developmental disabilities, those with chronic illness/needs, and older adults were most likely to receive occupational therapy primary care services, with a higher likelihood of being financed by government (public) in one-on-one settings. Workforce supply, funding and training were consistently reported as key limiting factors for the profession in primary care.Implications:While recognizing regional histories and needs, it behooves the profession to work collectively to advance its capacity to provide primary care services. Key enablers to advance this area include workforce initiatives and funding access in line with a global workforce strategy for occupational therapy
Future directions
No full textThis Handbook is testimony to the complex, evolving and challenging landscape in modern sport as at 2024. Several contributors identify potential areas for future consideration or make valuable suggestions for reform and improvement. Interestingly, many of these suggestions involve regulatory reconfiguration to existing regimes by challenging sports autonomy or justifying the preservation of the sports status quo with new or modified regulations. The following paragraphs examine the areas for future research across the four themes
Machine-learning based performance assessment of TMD-equipped buildings subjected to near-field pulse-like ground motions
No full textTuned mass dampers (TMDs) are widely recognized for improving structural responses under dynamic loads. This study investigates the impact of near-field pulse-like ground motions on the optimal design parameters and performance of TMDs. Utilizing 5, 10, 15, and 20-story building structures subjected to 150 near-field earthquakes, Particle Swarm Optimization (PSO) is employed to minimize the maximum top-story displacement. A Random Forest (RF) model is trained with the optimization results and earthquake features to predict structural responses. To enhance the accuracy of the RF model, Bayesian optimization is utilized to refine input selection and tune its hyperparameters. A parametric analysis is then performed to assess the influence of inputs on the objective function. The findings demonstrate the effectiveness of TMD in mitigating displacement, the robustness of PSO in optimization, and the role of earthquake characteristics in shaping TMD performance. The feature importance assessment highlights the dominant influence of the TMD frequency ratio on displacement reduction with over 40 % contribution. The TMD showed more efficiency in high-frequency structures and during earthquakes with low impulsiveness, high energy levels, and high velocity. Additionally, RF proved capable of simulating the behavior of controlled structures under seismic loads, providing a computationally efficient tool for analyzing the TMD performance.</p
Gap analysis of cyberlaws in Pacific Small Island Developing States
No full textThis Gap Analysis of Cyberlaws in the Pacific Small Island Developing State providesa timely analysis of the legislative developments in Pacific SIDS. It highlights significantgaps in cyberlaws across the region and reveals that no country has yet fully establishedcomprehensive legal frameworks to support a thriving digital economy. Although someprogress has been made, the absence of robust legislation continues to expose businessesand consumers to risks such as fraud, inadequate consumer protection and cybersecuritythreats. These gaps not only hinder the growth of the digital economy but undermine theregion’s ability to fully engage in global online trade. However, the study shows that manycountries are increasingly recognizing the weaknesses in their legal frameworks and areprioritizing reforms. Several countries are actively working toward adopting internationaland regional legal instruments, signalling a commitment to building stronger, more resilientdigital economies