30913 research outputs found
Sort by
Combined Audience and Video Feedback With Cognitive Review Improves State Anxiety and Self-Perceptions During Speech Tasks in Socially Anxious Individuals
Get PDF© 2017 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 24 month embargo from date of publication (December 2017) in accordance with the publisher’s archiving policyThis study investigated the effects of combined audience feedback with video feedback plus cognitive preparation, and cognitive review (enabling deeper processing of feedback) on state anxiety and self-perceptions including perception of performance and perceived probability of negative evaluation in socially anxious individuals during a speech performance. One hundred and forty socially anxious students were randomly assigned to four conditions: Cognitive Preparation + Video Feedback + Audience Feedback + Cognitive Review (CP + VF + AF + CR), Cognitive Preparation + Video Feedback + Cognitive Review (CP + VF + CR), Cognitive Preparation + Video Feedback only (CP + VF), and Control. They were asked to deliver two impromptu speeches that were evaluated by confederates. Participants’ levels of anxiety and self-perceptions pertaining to the speech task were assessed before and after feedback, and after the second speech. Compared to participants in the other conditions, participants in the CP + VF + AF + CR condition reported a significant decrease in their state anxiety and perceived probability of negative evaluation scores, and a significant increase in their positive perception of speech performance from before to after the feedback. These effects generalized to the second speech. Our results suggest that adding audience feedback to video feedback plus cognitive preparation and cognitive review may improve the effects of existing video feedback procedures in reducing anxiety symptoms and distorted self-representations in socially anxious individuals
Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia
Get PDFCopyright © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background
The importance of evaluating policy processes to achieve health equity is well recognised but such evaluation encounters methodological, theoretical and political challenges. This paper describes how a program theorybased evaluation framework can be developed and tested, using the example of an evaluation of the South Australian Health in All Policies (HiAP) initiative.
Methods
A framework of the theorised components and relationships of the HiAP initiative was produced to guide evaluation. The framework was the product of a collaborative, iterative process underpinned by a policy-research partnership and drew on social and political science theory and relevant policy literature.
Results
The process engaged key stakeholders to capture both HiAP specific and broader bureaucratic knowledge and was informed by a number of social and political science theories. The framework provides a basis for exploring the interactions between framework components and how they shape policy-making and public policy. It also enables an assessment of HiAP’s success in integrating health and equity considerations in policies, thereby laying a foundation for predicting the impacts of resulting policies.
Conclusion
The use of a program theory-based evaluation framework developed through a consultative process and informed by social and political science theory has accommodated the complexity of public policy-making. The framework allows for examination of HiAP processes and impacts, and for the tracking of contribution towards distal outcomes through the explicit articulation of the underpinning program theory
The role of negative affect in the assessment of quality of life among women with type 1 diabetes mellitus
Get PDFThis is an Open Access article distributed under the terms of the Creative Commons
Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/)
which permits unrestricted non-commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.Background
The purpose of this study is to determine the impact of negative affect (defined in terms of lack of optimism, depressogenic attributional style, and hopelessness depression) on the quality of life of women with type 1 diabetes mellitus.
Methods
Participants (n=177) completed either an online or paper questionnaire made available to members of Australian diabetes support groups. Measures of optimism, attributional style, hopelessness depression, disease-specific data, and diabetes-related quality of life were sought. Bivariate correlations informed the construction of a structural equation model.
Results
Participants were 36.3±11.3 years old, with a disease duration of 18.4±11.2 years. Age and recent glycosylated hemoglobin readings were significant contextual variables in the model. All bivariate associations involving the components of negative affect were as hypothesized. That is, poorer quality of life was associated with a greater depressogenic attributional style, higher hopelessness depression, and lower optimism. The structural equation model demonstrated significant direct effects of depressogenic attributional style and hopelessness depression on quality of life, while (lack of) optimism contributed to quality of life indirectly by way of these variables.
Conclusion
The recognition of negative affect presentations among patients, and an understanding of its relevance to diabetes-related quality of life, is a valuable tool for the practitioner
HAP1 Is required for endocytosis and signalling of BDNF and Its receptors in neurons
Get PDF"This is a post-peer-review, pre-copyedit version of an article published in Molecular Neurobiology. The final authenticated version is available online at: https://doi.org/10.1007/s12035-016-0379-0”.When BDNF binds to its receptors, TrkB and p75NTR, the BDNF-receptor complex is endocytosed and trafficked to the cell body for downstream signal transduction, which plays a critical role in neuronal functions. Huntingtin-associated protein 1 (HAP1) is involved in trafficking of vesicles intracellularly and also interacts with several membrane proteins including TrkB. Although it has been known that HAP1 has functions in vesicular trafficking and receptor stabilisation, it is not yet established whether HAP1 has a role in BDNF and its receptor endocytosis. In the present study, we found that HAP1 is in an interacting complex with p75NTR, TrkB and BDNF, especially newly endocytosed BDNF. BDNF and TrkB internalisation is abolished in HAP1 knock-out (KO) cortical neurons. TrkB downstream signalling pathways such as ERK, Akt and PLCγ-1 are also impaired in HAP1 KO cortical neurons upon BDNF stimulation. Proliferation of cerebellar granule cells is also impaired in cell culture and cerebellum of HAP1 KO mice. Our findings suggest that HAP1 may play a key role in BDNF and its receptor endocytosis and may promote neuronal survival and proliferation.This project was supported by an NHMRC grant to XFZ&XJL (480423). Yoon Lim was supported by an NHMRC Postgraduate Scholarship (GNT1017711), and LLW was supported by an IPRS Scholarship from Flinders University
Direct health and residential care costs of people living with dementia in Australian residential aged care
Get PDFThis is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any
medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.Objectives: This analysis estimates the whole‐of‐system direct costs for people living with
dementia in residential care by using a broad health and social care provision perspective and
compares it to people without dementia living in residential care.
Methods: Data were collected from 541 individuals living permanently in 17 care facilities
across Australia. The annual cost of health and residential care was determined by using individual
resource use data and reported by the dementia status of the individuals.
Results: The average annual whole‐of‐system cost for people living with dementia in
residential care was approximately AU 67 100) per person in 2016. The cost of
residential care constituted 93% of the total costs. The direct health care costs were comprised
mainly of hospital admissions (48%), pharmaceuticals (31%) and out‐of‐hospital attendances
(15%). While total costs were not significantly different between those with and without dementia,
the cost of residential care was significantly higher and the cost of health care was significantly
lower for people living with dementia.
Conclusion: This study provides the first estimate of the whole‐of‐system costs of providing
health and residential care for people living with dementia in residential aged care in Australia
using individual level health and social care data. This predominantly bottom‐up cost estimate
indicates the high cost associated with caring for people with dementia living permanently in
residential care, which is underestimated when limited cost perspectives or top‐down, population
costing approaches are taken.National Health and Medical Research Council
(NHMRC) Partnership Centre on Dealing with
Cognitive and Related Functional Decline in
Older People (CDPC), Grant/Award Number:
GNT910000
Intersectoral action on SDH and equity in Australian health policy
No full text© The Author 2016. Published by Oxford University Press. All rights reserved.Intersectoral action between public agencies across policy sectors, and between levels of government, is seen as essential for effective action by governments to address social determinants of health (SDH) and to reduce health inequities. The health sector has been identified as having a crucial stewardship role, to engage other policy sectors in action to address the impacts of their policies on health. This article reports on research to investigate intersectoral action on SDH and health inequities in Australian health policy. We gathered and individually analysed 266 policy documents, being all of the published, strategic health policies of the national Australian government and eight State/Territory governments, current at the time of sampling in late 2012—early 2013. Our analysis showed that strategies for intersectoral action were common in Australian health policy, but predominantly concerned with extending access to individualized medical or behavioural interventions to client groups in other policy sectors. Where intersectoral strategies did propose action on SDH (other than access to health-care), they were mostly limited to addressing proximal factors, rather than policy settings affecting the distribution of socioeconomic resources. There was little evidence of engagement between the health sector and those policy sectors most able to influence systemic socioeconomic inequalities in Australia
Use of telehealth for health care of Indigenous peoples with chronic conditions: a systematic review
Get PDF© Sarah Fraser, Tamara Mackean, Julian Grant, Kate Hunter, Kurt Towers, Rebecca Ivers 2017 A licence to publish this material has been given to James Cook University.
First published in Rural and Remote Health [https://www.rrh.org.au/]Introduction: Telehealth may be a cost effective modality in healthcare delivery, but how well used or how appropriate it is for the care of Indigenous peoples is unclear. This review examines the evidence for telehealth in facilitating chronic conditions management with Indigenous peoples.
Methods: Databases were systematically searched for qualitative or quantitative primary research studies that investigated telehealth use for chronic conditions management with Indigenous peoples worldwide. Evidence of effectiveness was by consumer health outcomes, evidence of acceptability was through consumer and user perception, and health service feasibility was evident by service impact. Data were assessed for quality and data extracted using pre-defined tools.
Results: Articles (n=32) examined effectiveness (n=11), critiqued telehealth from the perspectives of the client (n=10) and healthcare professionals (n=8), and examined feasibility (n=12). Studies reported Indigenous people tend to be satisfied with telehealth, but are sceptical about its cultural safety. Evidence for the effectiveness of telehealth from a western biomedical perspective was found.
Conclusions: Telehealth is promising; however, a lack of robust studies in this review make tangible conclusions difficult. A better overall understanding of telehealth use with Indigenous peoples, including delivery of culturally competent health care, true consultation and cultural competency of the professionals involved, would be helpful. Telehealth may have the potential to improve health care for Indigenous people, however the modality needs to be culturally competent and the care received must be culturally safe
Grid renationalisation - a discussion paper
Get PDF© [2017] Flinders University / Australian Industrial Transformation InstituteElectricity reform in Australia has been a comprehensive failure since the creation of the National Electricity Market (NEM) in the 1990s. None of the objectives of lower prices, greater system reliability or environmental sustainability have been met. The core aim of policy should be a genuine National Electricity Grid, driven by the goal of providing secure, affordable electricity to Australian households and businesses while reducing and ultimately eliminating emissions of carbon dioxide (CO2). The current NEM is not designed for this purpose and cannot achieve it. Rather, it is the product of a late 20th century ideological project, in which it was hoped that market incentives could outperform rational system design and management in the electricity supply industry. Nearly 20 years of unsatisfactory experience has proved that this is not the case, even for a traditional system based on coal-fired generation.
Until relatively recently, most attention has been paid to the dramatic increases in the cost of electricity, driven primarily by the increased rate of return required for commercial investments in distribution networks, as compared to the former statutory authority model. However, recent failures of the transmission network in South Australia, Victoria and Tasmania have focused attention on the inadequacy of the national grid itself, and the fragmentation of responsibility between the electricity generators, owners of state transmission networks and interconnectors and multiple regulators.
The appropriate policy solution is a unified, publicly owned, National Grid encompassing the ownership of physical transmission networks in each state and interconnectors between states, and responsibility for maintaining security of supply and planning the transition to a sustainable, zero emissions electricity supply industry. There is a strong case for extending the role of public ownership to include renationalisation of electricity distribution in addition to transmission, and for public investment in renewable energy
Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia
Get PDF© 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
This author accepted manuscript is made available following 24 month embargo from date of publication (August 2017) in accordance with the publisher’s archiving policy.Background
Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care.
Objective
The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia.
Design
Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis.
Findings
Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care.
Conclusion
The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women
A new global strategy for the elimination of schistosomiasis
No full textThis is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Mass drug administration utilising a single oral dose of 40 mg/kg of praziquantel (PZQ) has been endorsed and advocated by the World Health Organisation (WHO) for the global control and elimination of schistosomiasis. However, this strategy is failing primarily because the drugs are not getting to the people who need them the most. The current global coverage is 20%, the drug compliance rate is less than 50%, and the drug efficacy is approximately 50%. Thus in reality, only about 5% of the reservoir human population is actually receiving intermittent chemotherapy. Despite claims that more of the drug will soon be made available the current strategy is inherently flawed and will not lead to disease elimination. We discuss the many practical issues related to this global strategy, and advocate for an integrated control strategy targeting the life cycle and the most at-risk. Moreover, we discuss how an integrated control package for schistosomiasis should fit within a larger integrated health package for rural and remote villages in the developing world. A holistic health system approach is required to achieve sustainable control and ultimately disease elimination