Browsing Research Flagships, Centres and Institutes by Subject "1103 Clinical Sciences"
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ItemThe analytical quality of point-of-care testing in the 'QAAMS' model for diabetes management in Australian Aboriginal medical services(2006) Shephard, Mark Douglas; Gill, Janice P ItemComparison of the Sydney Psychosocial Reintegration Scale (SPRS) with the Community Integration Questionnaire (CIQ): psychometric properties(2004) Kuipers, Willem (Pim); Tate, Robyn; Kendall, Melissa; Fleming, Jennifer ItemGPs and problem gambling: can they help with identification and early intervention?(2007) Thomas, Lyndall; Battersby, Malcolm Wayne; Tolchard, BarryBACKGROUND General Practitioners (GPs) are well placed to identify problem gamblers and provide early intervention. To date there is no evidence to suggest that GP’s are routinely screening patients for potential gambling problems. OBJECTIVE This paper discusses the prevalence of problem gambling, the links with other health problems and ways that GPs can assist. Results from a pilot project that provided educational resources to GPS are also discussed. DISCUSSION Suitable screening tools are available that could easily be used by GPs to assess the possibility of gambling problems in patients who may be at increased risk but do not seek help. Early identification and intervention may help prevent a gambling habit escalating to a serious problem. CONCLUSION More work needs to be done to increase awareness with GPs of the extent of problem gambling in our community and to alert patients to the fact that gambling can affect their health and that GPs can help. ItemThe mental health expert patient: findings from a pilot study of a generic chronic condition self-management programme for people with mental illness(SAGE Publications, 2007) Battersby, Malcolm Wayne; Pols, Rene Gaston; Lawrence, John Stephen; Lawn, Sharon Joy; Urukalo, Mick; Parry, TrevorBackground Less than optimal outcomes and escalating costs for chronic conditions including mental illness have prompted calls for innovative approaches to chronic illness management. Aims This study aimed to test the feasibility and utility of combining a generic, clinician administered and peer-led self-management group approach for people with serious mental illness. Method General practitioners and mental health case managers used a patient-centered care model (the Flinders Model) to assist 38 patients with serious mental illness to identify their self-management needs, and match these with interventions including Stanford peer-led, self-management groups and one-to-one peer support. Self-management and quality of life outcomes were measured and qualitative evaluation elicited feedback from all participants. Results Collaborative care planning, combined with a problems and goals focused approach, resulted in improved self-management and mental functioning at 3 to 6 months follow up. The Stanford self-management course was applicable and acceptable to patients with serious mental illnesses. Qualitative feedback was highly supportive of this approach. Conclusions Generic, structured assessment and care planning approaches, resulting in self-management education targeted to the individual, improved self-management and quality of life. Patients and service providers reported considerable gains despite the challenges associated with introducing a generic model within the mental health and general practice sector. ItemThe Needs of Strangers: Understanding Determinants of Mental Health.(Social Alternatives, 2008) Lawn, Sharon JoyThis article explores the social determinants of mental illness in order to stimulate debate and advocate for improved services, and greater understanding and acceptance for people with serious mental illness in their community. Systemic and broader social mechanisms that perpetuate stigma and inequity are briefly examined. Research findings from a study of the culture of smoking for psychiatric populations are used to demonstrate the complexity of these mechanisms and to show how they impact on the social determinants of mental illness for people with serious mental illness. From this discussion, broad system and policy options are offered. ItemOphthalmic nurse practitioner led diabetic retinopathy screening. Results of a 3-month trial(2006) Kirkwood, Bradley J; Coster, Douglas John; Essex, Rohan ItemPoint-of-care testing of HbA(1c) and blood glucose in a remote Aboriginal Australian community(2005) Martin, David; Shephard, Mark Douglas; Freeman, Hayley; Bulsara, Max; Jones, Timothy; Davis, Elizabeth A; Maguire, Graeme P ItemA pragmatic cluster randomised controlled trial to evaluate the safety, clinical effectiveness, cost effectiveness and satisfaction with point of care testing in a general practice setting rationale, design and baseline characteristics.(2008) Laurence, Caroline O; Gill, Janice P; Yelland, Lisa N; Ryan, Philip; Shephard, Mark Douglas; Bubner, Tanya; Willson, Kristyn; Glastonbury, Briony; Beilby, Justin; Gialamas, Angela ItemSequence variation in DDAH1 and DDAH2 genes is strongly and additively associated with serum ADMA concentrations in individuals with type 2 diabetes(2010) Kuot, Abraham; Javadiyan, Shahrbanou; Abhary, Sotoodeh; Burdon, Kathryn Penelope; Whiting, Malcolm John; Kasmeridis, Nicholas; Petrovsky, Nikolai; Craig, Jamie EAsymmetric dimethylarginine (ADMA), present in human serum, is an endogenous inhibitor of nitric oxide synthase and contributes to vascular disease. Dimethylarginine dimethylaminohydrolase (DDAH) is an ADMA degrading enzyme that has two isoforms: DDAHI and DDAHII. We sought to determine whether serum ADMA levels in type 2 diabetes are influenced by common polymorphisms in the DDAH1 and DDAH2 genes. ItemSkills for person-centred care: Health Professionals Supporting Chronic Condition Prevention and Self-Management(Ashgate Publishing, 2009) Lawn, Sharon Joy; Battersby, Malcolm WayneWith the growing burden of chronic conditions, and the sheer volume of expected demand for health services over the coming decades, it will become increasingly important for health service providers to work smarter and more collaboratively with one another and with service users. Building cooperative models of practice that overcome traditional turf sensitivities between professionals, and that overcome structural boundaries between services, will be challenging. Underpinning this, and arguably more important and elusive, is the challenge for health professionals to truly understand how their input impacts on service consumers. ItemSmoking bans in psychiatric inpatient settings? a review of the research(SAGE Publications, 2005) Lawn, Sharon Joy; Pols, Rene GastonObjective: This article reviews the findings from 26 international studies that report on the effectiveness of smoking bans in inpatient psychiatric settings. The principle aim is to identify which processes contribute to successful implementation of smoking bans and which processes create problems for implementation in these settings. Method: After performing an electronic search of the literature, the studies were compared for methods used, subjects involved, type of setting, type of ban, measures and processes used, and overall results. Total bans were distinguished from partial bans. All known studies of smoking bans in psychiatric inpatient units from 1988 to the present were included. Results: Staff generally anticipated more smoking-related problems than actually occurred. There was no increase in aggression, use of seclusion, discharge against medical advice or increased use of prn medication following the ban. Consistency, co-ordination, and full administrative support for the ban were seen as essential to success, with problems occurring where this was not the case. Nicotine Replacement Therapy (NRT) was widely used by patients as part of coping with bans. However, many patients continued to smoke post-admission indicating that bans were not necessarily effective in assisting people to quit in the longer term. Conclusions: The introduction of smoking bans in psychiatric inpatient settings is possible but would need to be a clearly and carefully planned process involving all parties affected by the bans. Imposing bans in inpatient settings is seen as only part of a much larger strategy needed to overcome the high rates of smoking amongst mental health populations. Key Words: Smoking bans, psychiatric inpatient settings ItemTobacco control policies, social inequality and mental health populations: time for a comprehensive treatment response(SAGE Publications, 2008) Lawn, Sharon JoyA recent report conducted by Access Economics for SANE Australia has comprehensively reviewed the economic costs of smoking for Australian smokers with mental illness and found that the financial cost to these smokers is $33 billion (AUST) per year . Internationally, research has estimated the economic costs of smoking to reach $500 billion (US) by 2010 . This prompts a long-standing debate about tobacco control initiatives and their effectiveness and consequences for vulnerable populations. Chapman  has argued for increased tobacco control, stating that those who see tobacco as a legitimate product and tobacco control as jeopardising the financial benefits gained through tobacco excise are ill-informed regarding its social costs and the ethics of continuing to support its revenue-raising role. However, the price and demand relationship of some commodities may be very elastic for some groups within the population, that is, raising taxes on them will not necessarily lead to reduced demand for those commodities. It is time to unpack the debate and advocate for more to be done for smokers with mental illness, beyond mere broad population-based tobacco control strategies and policies and piecemeal support to quit.