Search

BackgroundTobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers. ObjectiveTo conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting. MethodsA trial was designed with 80% power based on the effect size observed in a published pilot study; 160 subjects were recruited (80 allocated to the control group and 80 to the intervention group) from 8 metropolitan community pharmacies located around Perth city center in Western Australia. All participants received standardized smoking cessation advice. The intervention group participants were also digitally photoaged by using the Internet-based APRIL Face Aging software so they could preview images of themselves as a lifelong smoker and as a nonsmoker. Due to the nature of the intervention, the participants and researcher could not be blinded to the study. The main outcome measure was quit attempts at 6-month follow-up, both self-reported and biochemically validated through testing for carbon monoxide (CO), and nicotine dependence assessed via the Fagerström scale. ResultsAt 6-month follow-up, 5 of 80 control group participants (6.3%) suggested they had quit smoking, but only 1 of 80 control group participants (1.3%) consented to, and was confirmed by, CO validation. In the intervention group, 22 of 80 participants (27.5%) reported quitting, with 11 of 80 participants (13.8%) confirmed by CO testing. This difference in biochemically confirmed quit attempts was statistically significant (χ21=9.0, P=.003). A repeated measures analysis suggested the average intervention group smoking dependence score had also significantly dropped compared to control participants (P

Poor comprehenders are a significant subgroup of poor readers who, due to their ability to read aloud accurately, are often difficult to identify. This study aimed to determine whether assessment using two oral language tasks, mapped onto the two components of the Simple View of Reading, would provide an efficient approach to identification. Children (N = 218) from School Years 3 to 6 (ages 7; 8-12; 1) attending two schools in Australia were assessed, and 45 identified as potential poor comprehenders, based on a profile of average phonological awareness but poor listening comprehension. Subsequent assessment of decoding and text reading comprehension confirmed 24 of these children to be poor comprehenders, consistent with reported prevalence rates. Five of these children were judged to be weak readers by their classroom teacher. The oral tasks alone overidentified this group; however, the findings suggest that using the tasks as an initial phase, followed up with a reading assessment, could be effective in identifying poor comprehenders, and reduce time spent in testing as this would only involve at-risk children.

This paper reports a preliminary evaluation of the [Talkable] 10-week language learning programme. This training programme aims to help caregivers provide a rich language learning environment in a child's first 3 years of life through the provision of evidence-based information and practical strategies to promote language development delivered primarily via mobile application. Participants in the study completed pre- and post-programme surveys on a range of questions relating to their knowledge and confidence in assisting their child's language learning. Results indicated significant improvements in participant's self-reported levels of knowledge about early language development and ways to assist their child's language learning, while level of concern about their child's language development remained fairly constant. These findings provide preliminary support for the use of [Talkable] in primary prevention, and direction for future development of the programme. Findings also add to the currently limited evidence-base for providing early language primary prevention programmes via mobile application.

Students occasionally experience difficulties during work-integrated learning and clinical placements. The authors reasoned that these placement difficulties might be related to the students' emotional intelligence (EI) being underdeveloped before they commence full-time clinical placements. A cross-sectional survey design was used to measure the EI of third-year undergraduate occupational therapy, physiotherapy, speech pathology and second-year business students (n = 369). Results showed that over 40% of therapy students reported scores that are considered low or markedly low in the EI domains of independence, problem-solving and stress tolerance. The EI scores for therapy students that were significantly higher than the Australian EI norms were self-actualization, interpersonal relationships, empathy, and impulse control. The mean scores of business students were within the normal range for all EI domains. A recommendation of our study is to include strategies that develop EI throughout the therapy curriculum and when preparing students for clinical placements.

People with disabilities in Australia face significant employment barriers. Research and policy initiatives over the past fifteen years have consistently emphasised the benefits of vocational education and training generally, and apprenticeship and traineeships specifically, as leading to positive vocational pathways and employment outcomes for people with disabilities. However, there is a dearth of evidence of graduate outcomes for apprentices and trainees with disabilities. This paper presents the employment outcomes including hours of work and salaries for a cohort of apprenticeship and traineeship graduates with and without disabilities across a three-year longitudinal Australian study. Overall, there are positive employment outcomes for the research participants although graduates without a disability achieved better outcomes than graduates with disabilities and participants in receipt of the disability support pension had significantly lower wages than other participants with disabilities. There are indications that the gap in outcomes between graduates with and without disabilities has reduced over time, although generalisability of the findings may be limited by the observational study design. Nevertheless, the study has confirmed positive employment and related outcomes for apprenticeship and traineeship graduates with disabilities, which were sustained, or arguably improved, over the three-year period covered by the study.

There is a significant variability in the prevalence of psychotropic medication use among young autistic persons worldwide and this is under-studied in Australia. Apart from risperidone, approved by the Therapeutic Goods Administration to manage challenging behaviour, the appropriateness of other psychotropic medications prescribed to young autistic persons warrants scrutiny. This retrospective study aims to gain initial insight into the magnitude, types and indications of psychotropic medication use in autistic children and adolescents in Western Australia. We analysed de-identified data from 239 autistic children and adolescents (⩽21 years) who participated in the Western Australian Autism Biological Registry between 2011 and 2015 and who completed a questionnaire regarding medication use. One-quarter (n = 66, 28%) of young autistic people reported using a total of 137 medications. Most (n = 46, 70%) of those medicated were under 12 years of age; half (n = 33) were 6–12 years and a fifth (n = 13) were under 6 years. The most used medications were stimulants (n = 35, 53.0%), followed by antidepressants (n = 24, 36.4%), antiepileptics (n = 21, 31.8%), sedatives (n = 15, 22.7%) and antipsychotics (n = 14, 21.2%). These medications were mainly to manage attention deficit hyperactivity disorder, challenging behaviours, seizures, insomnia, undefined anxiety, depression and mood instability. While most autistic young people in the Western Australian Autism Biological Registry did not report using psychotropic medication, over a quarter were prescribed medications, primarily stimulants, to manage symptoms of attention deficit hyperactivity disorder. Various medications, including risperidone, were used to help manage challenging behaviours. Medication use should be studied more comprehensively in a larger cohort of autistic persons to confirm our current preliminary observations. Further, future studies should monitor the effectiveness and safety outcomes of such medications due to a limited understanding of their effectiveness in managing the atypical presentation of co-occurring disorders in young autistic persons. Prescriptions and use of medications to treat mental health conditions in young autistic populations are inconsistent worldwide. This makes it hard to compare findings from international studies to the Australian autistic population, where there are limited relevant studies. Apart from risperidone, there are no other medications specified for direct use in autistic persons. This study aims to gain initial broad understanding of the use of medications, commonly prescribed for mental health conditions, specifically by autistics under the age of 21 years. We analysed data that were previously collected as part of the Western Australian Autism Biological Registry between 2011 and 2015 which amounted to 239 surveys completed on young persons with diagnosed autism. The questionnaires included information on co-occurring conditions, current or previous use of medications and reasons for use of the medications. Only one-quarter of the participants in this study reported using at least one mental health–related medication in their lifetime. The most reported medications were stimulants, antidepressants and antiepileptics. The reasons for using medication included managing attention deficit hyperactivity disorder, challenging behaviours, seizures, sleep difficulties and symptoms of anxiety and depression. The number of individuals reporting medication use in this study was lower compared to other developed countries. Nevertheless, these medications should be monitored due to limited understanding of their use to manage co-occurring symptoms in young autistic persons. The findings highlight the importance of ongoing research to better understand mental health–related medications and inform best practice. [ABSTRACT FROM AUTHOR]

Social impact assessment as a concept and practice is generally framed as a process for delivering socially equitable outcomes, and in particular, a vehicle for improving the lives of society's most vulnerable and marginalised people. For example, the International Association for Impact Assessment 2015 guidance document makes the normative statement that projects should benefit local communities and be a 'force for positive social change and beneficial social development'. Yet most guidance provides little prescription for what this looks like in practice. More recently, the New South Wales 2021 guideline includes distributive equity as a principle for social impact assessment, but its application is yet to be tested. This article discusses key dimensions of equity concepts, drawing on international social impact assessment guidance documents, academic literature on equity, fairness and justice, and case studies in Australia. We elaborate process/procedural/participative and outcome/distributive dimensions of equity. We further argue that, to reflect the International Association for Impact Assessment position, social impact assessment needs to defend its normative purpose of advancing equity, rather than simply 'considering' equity impacts. [ABSTRACT FROM AUTHOR]

Background: Oral antineoplastic agents have caused a paradigm shift in cancer treatment, however, they produce many unique challenges. Although oral antineoplastics can have complex administration regimes, low adherence rates and high possibilities of drug-drug interactions, they are administered unsupervised at home. Cancer services pharmacists have the required skillsets to improve patient outcomes associated with oral antineoplastic treatment by increasing patient health literacy, improving concordance and optimising administration protocols. Aim: To evaluate patients' perceptions, experiences and overall satisfaction with dedicated clinical pharmacist consultations in patients treated with oral antineoplastic agents at a major public hospital. Method: In this retrospective cross-sectional study at a quaternary hospital in Western Australia, data were collected by a paper questionnaire (mailed in March 2022) to a random sample of 191 patients initiated on oral antineoplastic drugs between January 2021 and February 2022. Demographics, prescribed antineoplastic drug/s, cancer type data were collected including using 5-point Likert scale questions assess patients' overall satisfaction with the clinical pharmacist consultations. Results: The questionnaire response rate was 27.7% (52/188) (mean age 63.2 years; 57.5% female). Most patients (42/52; 80.8%) were satisfied with pharmacist consultations, trusted the pharmacist's advice (45/52; 86.5%), considered that the pharmacist improved their understanding of how to manage side effects (43/52; 82.7%) and they provided an important service in outpatient care (45/52; 86.5%). Conclusion: Overall, patients reported positive perceptions, experiences, and satisfaction with the cancer services pharmacist counselling services during their oral antineoplastic treatment. [ABSTRACT FROM AUTHOR]

Autism is associated with differences in sensory processing and motor coordination. Evidence from electroencephalography suggests individual perturbation evoked response (PER) components represent specific aspects of postural disturbance processing; P1 reflects the detection and N1 reflects the evaluation of postural instability. Despite the importance of these cortical responses to postural control, PERs to a perturbation in adults with autism spectrum disorder (ASD) have yet to be reported. The aim was to compare PERs to visual perturbation under varied postural stability conditions in adults with and without ASD. This study is the first to report that while the assessment of postural set is intact, adults with ASD use more cortical resources to integrate and interpret visual perturbations for postural control.

Background: Adults with intellectual disability (ID) experience poorer overall health than the wider population. Identification of personal, support service and lifestyle factors affecting health status will provide opportunities to improve health outcomes. Methods: The study was a cross-sectional survey of adults with ID. Interviews were conducted between January and July 2013. Univariate and multivariate analyses were performed using self- or proxy-reported general health as the dependent variable. Results: "Not good" health was independently associated with increasing age, financial hardship, smoking, and living in a home of their own. Physical exercise was inversely associated with not good health. Conclusions: Subjective health may be improved by attention to the factors identified in this study. This could include closer monitoring of the health of people with ID as they age and if they live in a home of their own. Similarly, targeted programs promoting physical activity and smoking reduction could improve general health for adults with ID.

Dyadic coping strategies may play a pivotal role in relationship satisfaction and explain why some couples adapt positively to the challenges associated with raising a child with ASD and others do not. Survey data from 127 caregivers of a child with ASD were used in generalized estimating equation analyses to investigate the factors associated with relationship satisfaction, including socio-demographics, parenting stress and dyadic coping. Results showed that over two-thirds of the sample reported satisfaction, which was associated with low parenting stress, increased use of positive and decreased use of negative dyadic coping strategies. Positive dyadic coping was found to have a greater influence than negative dyadic coping, supporting a strengths-based approach to interventions promoting family resilience.

Background Early in the coronavirus disease 2019 (COVID-19) pandemic, peak viral loads coincided with symptom onset. We hypothesized that in a highly immune population, symptom onset might occur earlier in infection, coinciding with lower viral loads. Methods We assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A viral loads relative to symptom duration in symptomatic adults (≥16 years) presenting for testing in Georgia (4/2022–4/2023; Omicron variant predominant). Participants provided symptom duration and recent testing history. Nasal swabs were tested by Xpert Xpress SARS-CoV-2/Flu/RSV assay and cycle threshold (Ct) values recorded. Nucleoprotein concentrations in SARS-CoV-2 polymerase chain reaction (PCR)-positive samples were measured by single molecule array. To estimate hypothetical antigen rapid diagnostic test (Ag RDT) sensitivity on each day after symptom onset, percentages of individuals with Ct value ≤30 or ≤25 were calculated. Results Of 348 newly-diagnosed SARS-CoV-2 PCR-positive individuals (65.5% women, median 39.2 years), 317/348 (91.1%) had a history of vaccination, natural infection, or both. By both Ct value and antigen concentration measurements, median viral loads rose from the day of symptom onset and peaked on the fourth/fifth day. Ag RDT sensitivity estimates were 30.0%–60.0% on the first day, 59.2%–74.8% on the third day, and 80.0%–93.3% on the fourth day of symptoms. In 74 influenza A PCR-positive individuals (55.4% women; median 35.0 years), median influenza viral loads peaked on the second day of symptoms. Conclusions In a highly immune adult population, median SARS-CoV-2 viral loads peaked around the fourth day of symptoms. Influenza A viral loads peaked soon after symptom onset. These findings have implications for ongoing use of Ag RDTs for COVID-19 and influenza. [ABSTRACT FROM AUTHOR]