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Mass drug administration and the sustainable control of schistosomiasis: an evaluation of treatment compliance in the rural Philippines
Get PDFThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Preventive chemotherapy is the current global control strategy for schistosomiasis. The WHO target coverage rate is at least 75% for school-aged children. In the Philippines, the reported national coverage rate (43.5%) is far below the WHO target. This study examined the factors associated with non-compliance to mass drug administration.
Methods
A cross-sectional survey was conducted in 2015 among 2189 adults in the province of Northern Samar, the Philippines using a structured face-to-face survey questionnaire.
Results
The overall rate of non-compliance to mass drug administration (MDA) in the last treatment round was 27%. Females (aOR = 1.67, P = 0.033) were more likely to be non-compliant. Respondents who believed that schistosomiasis was acquired by open defecation and poor sanitation (aOR = 1.41, P = 0.015), and by drinking unclean water (aOR = 2.09, P = 0.001) were more likely to refuse treatment. Uncertainties on whether schistosomiasis can be treated (aOR = 2.39, P = 0.033), their fear of adverse reactions to praziquantel (aOR = 1.94, P = 0.021), misconceptions about alternative forms of treatment (aOR = 1.45, P = 0.037), and that praziquantel is used for purposes other than deworming (aOR = 2.15, P = 0.021) were all associated with a higher odd of non-compliance. In contrary, being a farmer (aOR = 0.62, P =0.038), participation in past MDA (aOR = 0.30, P < 0.001), informed about impending MDA (aOR = 0.08, P < 0.001), and having heard of schistosomiasis (aOR = 0.22, P = 0.045) were all significantly associated with reduced non-compliance.
Conclusions
To improve drug compliance for schistosomiasis there is an urgent need for intensive health education campaigns before conducting MDA that would not only provide disease specific information, but also deal with prevailing misconceptions about transmission, prevention, treatment, and drug side-effects.This work was supported by Australian National Health and Medical Research Council
Embedding fundamental care in the pre-registration nursing curriculum: Results from a pilot study
Get PDF© 2018 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 12 month embargo from date of publication (May 2018) in accordance with the publisher’s archiving policyInternational evidence suggests nursing is not providing fundamental care consistently or adequately, resulting in poor outcomes for patients and healthcare systems. One possible reason for this inadequate care delivery is nursing education, with fundamental care often implicit or invisible in nursing curricula. To understand how best to teach fundamental care to pre-registration (pre-licensure) students, we developed and piloted a six-week intervention that incorporated into the first-year curriculum a more explicit focus on fundamental care. A conceptual fundamental care framework was used to guide students' learning, and clinical skills sessions were structured to reinforce the framework's conceptual understanding and enable students to practice delivering fundamental care in an integrated manner. The intervention's impact was explored via a pre-post survey and focus groups. The survey demonstrated that the intervention did not affect students' ability to identify patients' fundamental care needs; however, focus groups showed the intervention assisted students in understanding the complexity of fundamental care and its importance to patients' experiences. The pilot provides preliminary evidence on the importance of embedding fundamental care into nursing curricula early and explicitly, and emphasising the integrated nature of such care, particularly through structured debriefs, consistent terminology, and opportunities for students to experience care as a patient
Factors influencing management of chronic respiratory diseases in general and chronic obstructive pulmonary disease in particular in Saudi Arabia: an overview
Get PDFThis is an open access journal, and articles are
distributed under the terms of the Creative Commons
Attribution‑NonCommercial‑ShareAlike 4.0 License, which
allows others to remix, tweak, and build upon the work
non‑commercially, as long as appropriate credit is given and
the new creations are licensed under the identical terms.The prevalence of chronic obstructive pulmonary disease in Saudi Arabia is 4.2% among the general population and 14.2% among smokers. Studies showed that management of respiratory diseases is inadequate. In this article, we have elaborated on how factors as health economic factors, lack of health-care providers, culture, attitude, lifestyle (such as smoking and physical inactivity), and lack of adherence to the evidence-based practice guidelines may influence chronic respiratory disease management in Saudi Arabia. We have to conclude that these factors should be taken into account while seeking to improve and optimize the quality of care for patients with respiratory diseases in Saudi Arabia
A citizens’ jury on regulation of McDonald’s products and operations in Australia in response to a corporate health impact assessment
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: 1) To report outcomes from a citizens’ jury examining regulatory responses to the health impacts of McDonald's Australia; 2) To determine the value of using citizens’ juries to develop policy recommendations based on the findings of health impact assessment of transnational corporations (TNCs).
Methods: A citizens’ jury engaged 15 randomly selected and demographically representative jurors from metropolitan Adelaide to deliberate on the findings of a Corporate Health Impact Assessment, and to decide on appropriate policy actions.
Results: Jurors unanimously called for government regulation to ensure that transnational fast food corporations pay taxes on profits in the country of income. A majority (two‐thirds) also recommended government regulation to reduce fast food advertising, and improve standards of consumer information including a star‐ratings system. A minority held the view that no further regulation is required of the corporate fast food industry in Australia.
Conclusion: The jury's recommendations can help inform policy makers about the importance of ending the legal profit‐shifting strategies by TNCs that affect taxation revenue. They also endorse regulating the fast food industry to provide healthier food, and employing forms of community education and awareness‐raising.
Implications for public health: Citizens’ juries can play an important role in providing feedback and policy recommendations in response to the findings of a health impact assessment of transnational corporations
Blunting the Cutting Edge? Analogue Memorabilia and Digitised Memory
Get PDFAll authors and readers have the right to download, copy, distribute, modify, create derivative works and display publicly the articles in electronic, digital, or print form, provided that the post-print version of the articles are not sold for a profit and the first Publication by KOME, with a URL link and complete bibliographic details, is referenced.What happens to disintermediated, flattened, plural and resistive popular culture when classic rock is corporatized and the audience is middle aged white men? This article is provoked by Bob Dylan’s The Cutting Edge, the expensive reissuing of his albums from 1965 and 1966 in 2015, to offer a theorization of digital recording and sharing of analogue unboxing cultures. My interest particularly focuses on the audience of this affluent product and the odd cultural responses from the male audience. How do scholars of popular culture understand this shared enthusiasm for unpackaging consumerist items? The solution posed in this article is the deployment of Jean Baudrillard’s theories to understand and manage the cascading simulacrum
Artificial barriers prevent genetic recovery of small isolated populations of a low-mobility freshwater fish
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Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as
long as you give appropriate credit to the original author(s) and the
source, provide a link to the Creative Commons license, and indicate if
changes were made. The images or other third party material in this
article are included in the article’s Creative Commons license, unless
indicated otherwise in a credit line to the material. If material is not
included in the article’s Creative Commons license and your intended
use is not permitted by statutory regulation or exceeds the permitted
use, you will need to obtain permission directly from the copyright
holder. To view a copy of this license, visit http://creativecommons.
org/licenses/by/4.0/.Habitat loss and fragmentation often result in small, isolated populations vulnerable to environmental disturbance and loss of
genetic diversity. Low genetic diversity can increase extinction risk of small populations by elevating inbreeding and
inbreeding depression, and reducing adaptive potential. Due to their linear nature and extensive use by humans, freshwater
ecosystems are especially vulnerable to habitat loss and fragmentation. Although the effects of fragmentation on genetic
structure have been extensively studied in migratory fishes, they are less understood in low-mobility species. We estimated
impacts of instream barriers on genetic structure and diversity of the low-mobility river blackfish (Gadopsis marmoratus)
within five streams separated by weirs or dams constructed 45–120 years ago. We found evidence of small-scale (<13 km)
genetic structure within reaches unimpeded by barriers, as expected for a fish with low mobility. Genetic diversity was lower
above barriers in small streams only, regardless of barrier age. In particular, one isolated population showed evidence of a
recent bottleneck and inbreeding. Differentiation above and below the barrier (FST = 0.13) was greatest in this stream, but in
other streams did not differ from background levels. Spatially explicit simulations suggest that short-term barrier effects
would not be detected with our data set unless effective population sizes were very small (<100). Our study highlights that,
in structured populations, the ability to detect short-term genetic effects from barriers is reduced and requires more genetic
markers compared to panmictic populations. We also demonstrate the importance of accounting for natural population
genetic structure in fragmentation studies.This work was supported by an Australian
Research Council Linkage Grant (LP110200017) to Monash University,
Flinders University of South Australia, the University of
Canberra, and University of Montana. Funding and other support was
also contributed by industry partner organizations namely, Melbourne
Water Corporation, ACTEW Corporation, Victorian Department of
Sustainability and Environment (now Department of Environment,
Land, Water and Planning) and Fisheries Victoria (now Department of
Economic Development, Jobs, Transport and Resources). L.B.B. was
supported by an ARC FT130101068 grant. This publication has
been written with the support of the AgreenSkills+fellowship programme,
which has received funding from the EU’s Seventh Framework
Programme under grant agreement N° FP7-609398
(AgreenSkills+contract). Part of this work was carried out by using
the resources of the INRA MIGALE (http://migale.jouy.inra.fr) and
GENOTOUL (Toulouse Midi-Pyrénées) bioinformatics platforms and
the Montpellier Bioinformatics Biodiversity platform services. RL was
supported by the Agence Nationale de la Recherche (project GENOSPACE
ANR-16-CE02-0008)
A needs-based workforce model to deliver tertiary-level community mental health care for distressed infants, children, and adolescents in South Australia: a mixed-methods study
Get PDFThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background
High-quality mental health services for infants, children, adolescents, and their families can improve outcomes for children exposed to early trauma. We sought to estimate the workforce needed to deliver tertiary-level community mental health care to all infants, children, adolescents, and their families in need using a generalisable model, applied to South Australia (SA).
Methods
Workforce estimates were determined using a workforce planning model. Clinical need was established using data from the Longitudinal Study of Australian Children and the Young Minds Matter survey. Care requirements were derived by workshopping clinical pathways with multiprofessional panels, testing derived estimates through an online survey of clinicians.
Findings
Prevalence of tertiary-level need, defined by severity and exposure to childhood adversities, was estimated at 5–8% across infancy and childhood, and 16% in mid-adolescence. The derived care pathway entailed reception, triage, and follow-up (mean 3 h per patient), core clinical management (mean 27 h per patient per year), psychiatric oversight (mean 4 h per patient per year), specialised clinical role (mean 12 h per patient per year), and socioeconomic support (mean 12 h per patient per year). The modelled clinical full-time equivalent was 947 people and budget was AU$126 million, more than five times the current service level.
Interpretation
Our novel needs-based workforce model produced actionable estimates of the community workforce needed to address tertiary-level mental health needs in infants, children, adolescents, and their families in SA. A considerable expansion in the skilled workforce is needed to support young people facing current distress and associated family-based adversities. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits.This research was funded by a National Health & Medical Research Council (Australia) Partnership Grant (GNT1055351) with the Department of Health South Australia
Evaluation and management of patients with acute chest pain in China (EMPACT): protocol for a prospective, multicentre registry study
Get PDFNo commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Introduction Acute chest pain represents a major healthcare burden in emergency departments (ED) throughout the world. Among these patients, rapidly determining whether an acute coronary syndrome (ACS) is evolving remains difficult. In China, there are limited data correlating the baseline characteristics, evaluation and management of ED patients with acute chest pain and ACS-related symptoms with clinical outcomes. Nor has there been an evaluation of outcomes at different levels of hospitals. The Evaluation and Management of Patients with Acute ChesT pain in China (EMPACT) study will address this evidence gap through a regional representative prospective registry.
Methods and analysis Twenty-two public hospitals with ED in Shandong province have been selected based on a stratified random sampling approach. A total of 10 000 patients with acute chest pain or suspected ACS presenting to the ED will be consecutively enrolled from January 2016 to September 2017. Episodes of care will be evaluated for key performance measures such as the time to first ECG, receipt of troponin testing, receipt of reperfusion therapy for ST segment elevation ACS and provision of angiography for troponin-positive patients. All patients will be assessed for the composite endpoint of adjudicated major adverse cardiac events in 30 days after presentation, including death from all causes, non-fatal myocardial infarction, urgent revascularisation, stroke, cardiac arrest and cardiogenic shock. The secondary outcomes include revisit to ED and rehospitalisation within 30 days.This work was supported by Taishan Scholar Program of Shandong
Province (ts20130911), Taishan Young Scholar Program of Shandong Province
(tsqn20161065), Key Technology Research and Development Program of Science
and Technology of Shandong Province (2014kjhm0102), Department of Science
and Technology of Shandong Province (2014GSF118111, 2016GSF201235,
2016ZDJS07A14)
Gaslighting in the context of clinical interactions with parents of transgender children
Get PDF“This is an Accepted Manuscript of an article published
by Taylor & Francis in Sexual and Relationship Therapy on
28 February 2018, available online: https://
www.tandfonline.com/doi/
full/10.1080/14681994.2018.1444274”
This manuscript version is made available under the CCBY-
NC-ND 4.0 license http://creativecommons.org/
licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policyUnderstood as a type of identity-related abuse, gaslighting is a form of manipulation where the perpetrator attempts to convince someone that their thoughts, perceptions, or beliefs are mistaken. In the clinical context, gaslighting is often seen as part of a broader constellation of abuse and violence between adults. However, it can also happen in more subtle ways, and can present in ways that are difficult to detect. This paper explores instances where gaslighting may potentially occur in clinical interactions involving parents of transgender children. Three fictionalised case studies are presented drawing on the first author's clinical work, and demonstrate three overarching forms of gaslighting: (1) deferred action, (2) intentional forgetting, and (3) placing an emotional burden on the child. Having presented the three cases, the paper concludes by discussing how clinicians might identify and respond to gaslighting, emphasising (1) speaking with children on their own, (2) speaking on behalf of children to parents, (3) modelling advocacy to parents, (4) correcting misgendering in the clinical context, and (5) using peer supervision to discuss cases. In sum, the paper argues that whilst clinicians should not rush to “diagnose” gaslighting, clinicians should also not overlook its powerful effects upon transgender young people
Transgender young people’s narratives of intimacy and sexual health: Implications for sexuality education
Get PDF“This is an Accepted Manuscript of an article
published by Taylor & Francis in the journal of Sex
Education on 19 July 2017, available online:
https://doi.org/10.1080/14681811.2017.1355299”
This manuscript version is made available under the
CC-BY-NC-ND 4.0 license http://
creativecommons.org/licenses/by-nc-nd/4.0/ which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
This author accepted manuscript is made available following 18 month embargo from date of publication (July 2017) in accordance with the publisher’s archiving policySexuality education as pedagogy is often fraught by the perceived need to
balance the informational needs of young people with an investment in notions of
childhood innocence. Nowhere is this perhaps more evident than in sexuality
education that seeks to be inclusive of transgender young people, often resulting
in the failure of such education to address the needs of such students. In an
attempt at addressing the relative dearth of information about what transgender
young people would like to see covered in sexuality education, in this article we
explore transgender young people’s accounts of intimacy and sexual health and
consider what this means for school-based sexuality education. To do this we
analyse discussions of intimacy from the perspectives of transgender young
people as narrated in a sample of YouTube videos. We conclude by advocating
for an approach to sexuality education that largely eschews the gendering of body
parts and gametes, and which instead focuses on function, so as to not only
address the needs of transgender young people (who may find normative
discussions of genitals distressing), but to also provide cisgender young people
with a more inclusive understanding of their own and other people’s bodies and
desires.This work was supported by the Australian Research Council [grant number FT130100087]