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Article ; Online: How do users with comorbidity perceive participation in social services? A qualitative interview study

Amanda Jones / Kari Jess / Ulla-Karin Schön

International Journal of Qualitative Studies on Health & Well-Being, Vol 16, Iss

2021 Volume 1

Abstract: Purpose: This study aims to construct a theoretical framework that explains how users with comorbidity of substance use and mental illness/neuropsychiatric disorders portray user participation in social work encounters. Methods: To construct this ... ...

Abstract	Purpose: This study aims to construct a theoretical framework that explains how users with comorbidity of substance use and mental illness/neuropsychiatric disorders portray user participation in social work encounters. Methods: To construct this framework a constructivist grounded theory approach was used with semi-structured qualitative interviews with 12 users. Results: The main concern of the participants was the low trust in the social services and perceiving that this lack of trust is mutual. Establishing mutual trust is a social process that cuts through the whole framework. In the framework, prerequisites for participation are explained. The prerequisites are users being motivated and having the willingness to stop using drugs and receiving support, making use of user and staff knowledge and decision-making abilities and accessing help and support. Conclusion: Unlike previous frameworks, the model describes participation as a social process and does not explain participation at different levels of power. The results suggest that staff need to be aware of low trust perceptions and work on establishing mutual trust. In addition, the staff need to see each user as an individual and consider how the user would prefer to be involved in decision-making.
Keywords	participation ; user knowledge ; substance use ; mental illness ; grounded theory ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Changes in health-related quality of life before and after a 12-month enhanced primary care model among chronically ill primary care patients in Australia

James Rufus John / W. Kathy Tannous / Amanda Jones

Health and Quality of Life Outcomes, Vol 18, Iss 1, Pp 1-

2020 Volume 11

Abstract: Abstract Purpose Evidence suggests that Patient-centred Medical Home (PCMH) model facilitates person-centred care and improves health-related quality of life for patients with chronic illness. This study aims to evaluate changes in health-related quality ...

Abstract	Abstract Purpose Evidence suggests that Patient-centred Medical Home (PCMH) model facilitates person-centred care and improves health-related quality of life for patients with chronic illness. This study aims to evaluate changes in health-related quality of life (HRQoL), before and after enrolment into a 12-month integrated care program called ‘WellNet’. Methods This study includes 616 eligible consented patients aged 40 years and above with one or more chronic conditions from six general practices across Sydney, Australia. The WellNet program included a team of general practitioners (GPs) and clinical coordinators (CCs) providing patient-tailored care plans configured to individual risk and complexity. HRQoL was recorded using the validated EuroQol five dimensions five levels (EQ-5D-5L) instrument at baseline and 12 months. Additionally, patients diagnosed with osteoarthritis also reported HRQoL using short versions of Knee and/or Hip disability and osteoarthritis outcome scores (KOOSjr and HOOSjr). A case-series study design with repeated measures analysis of covariance (ANCOVA) was used to assess changes in mean differences of EQ-5D index scores after controlling for baseline covariates. Additionally, backward stepwise multivariable linear regression models were conducted to determine significant predictors of EQ-5D index scores at follow-up. Results Out of 616 patients, 417 (68%) reported EQ-5D scores at follow-up. Almost half (48%) of the WellNet patients reported improved EQ-5D index scores at follow-up. After controlling for baseline covariates, the adjusted mean difference was statistically significant whilst also meeting the bare minimal clinically important difference (MCID) with a change of 0.03 (95% CI 0.01, 0.05). The multivariable regression models determined that baseline EQ-5D scores and positive diagnosis of a respiratory illness were significant predictors of HRQoL at follow-up. There were significant improvements across both KOOS and HOOS assessments, specifically, the pain and symptom scores in both scales met statistical significance in addition to meeting the MCID. Conclusion Patient-tailored chronic disease management (CDM) plans designed by team of GPs and CDM clinical coordinators could lead to better HRQoL among primary care patients.
Keywords	Quality of life ; EuroQol (EQ-5D) ; Multimorbidity ; Chronic disease ; Integrated care ; Collaborative care ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	310
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia

James Rufus John / W Kathy Tannous / Amanda Jones

BMC Family Practice, Vol 21, Iss 1, Pp 1-

a before-and-after study

2020 Volume 11

Abstract: Abstract Background Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate the ... ...

Abstract	Abstract Background Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate the outcomes of a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on the activation levels of patients with one or more chronic diseases in general practices across Northern Sydney, Australia. Methods A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program which was delivered across six general practices in Northern Sydney, Australia. The WellNet intervention includes team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. The level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine the adjusted mean differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Additionally, the backward stepwise multivariable regression models were employed to identify significant predictors of activation at follow-up. Results Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores by increase of 6.5 (95% CI 5.0–8.1; p-value< 0.001) after controlling for baseline covariates. The multivariable regression models showed that older age (B = − 0.14; 95% CI -0.28, − 0.01) and private insurance (uninsured patients) (B = − 3.41; 95% CI -6.50, − 0.32) were significantly associated with lower PAM scores at 12 months whereas higher baseline PAM score (B = 0.48; 95% CI 0.37, 0.59) was significantly associated ...
Keywords	Patient activation ; Self-management ; Multimorbidity ; Chronic disease ; Integrated care ; Collaborative care ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparing health gains, costs and cost-effectiveness of 100s of interventions in Australia and New Zealand

Natalie Carvalho / Tanara Vieira Sousa / Anja Mizdrak / Amanda Jones / Nick Wilson / Tony Blakely

Population Health Metrics, Vol 20, Iss 1, Pp 1-

an online interactive league table

2022 Volume 10

Abstract: Abstract Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. ...

Abstract	Abstract Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. Methods A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising from the Australia Cost-Effectiveness research and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programmes, or using similar methodology, with: health gains quantified as health-adjusted life years (HALYs); net health system costs and/or incremental cost-effectiveness ratio; time horizon of at least 10 years; and 3% to 5% discount rates. Results We identified 384 evaluations that met the inclusion criteria, covering 14 intervention domains: alcohol; cancer; cannabis; communicable disease; cardiovascular disease; diabetes; diet; injury; mental illness; other non-communicable diseases; overweight and obesity; physical inactivity; salt; and tobacco. There were large variations in health gain across evaluations: 33.9% gained less than 0.1 HALYs per 1000 people in the total population over the remainder of their lifespan, through to 13.0% gaining > 10 HALYs per 1000 people. Over a third (38.8%) of evaluations were cost-saving. Conclusions League tables of comparably conducted evaluations illustrate the large health gain (and cost) variations per capita between interventions, in addition to cost-effectiveness. Further work can test the utility of this league table with policy-makers and researchers.
Keywords	Cost-effectiveness ; League table ; Priority-setting ; Costs ; Health gains ; Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cultural determinants of health for Aboriginal and Torres Strait Islander people – a narrative overview of reviews

Ebony Verbunt / Joanne Luke / Yin Paradies / Muriel Bamblett / Connie Salamone / Amanda Jones / Margaret Kelaher

International Journal for Equity in Health, Vol 20, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Introduction The cultural determinants of health centre an Indigenous definition of health, and have been linked to positive health and wellbeing outcomes. There is growing evidence for the importance of the cultural determinants of health; ... ...

Abstract	Abstract Introduction The cultural determinants of health centre an Indigenous definition of health, and have been linked to positive health and wellbeing outcomes. There is growing evidence for the importance of the cultural determinants of health; however, to date, no high-level overview of the evidence-base has been provided. Synthesising existing literature on cultural determinants of health for Aboriginal peoples in a single manuscript will highlight what we know, and what needs to be explored in future research. It will also contribute to global efforts to capture the evidence of cultural determinant approaches amongst Indigenous populations. We therefore endeavoured to identify cultural determinants and highlight their impact on Aboriginal health and wellbeing outcomes, and outline the relationship and interconnection of different cultural determinants of health. Methods An overview of reviews was conducted. Medline (Ovid) and Scopus were searched using terms related to ‘cultural determinants of health’ and an ‘Aboriginal definition of health’. The database search was complemented by a web-based search of grey literature. Nine reviews were retrieved and included in our overview. Results Family/community, Country and place, cultural identity and self-determination were strongly identified across reviews as having a positive impact on the health and wellbeing outcomes of Aboriginal peoples. Family/community and Country and place were found to be components of ‘culture’ that shaped cultural identity. Self-determination was outlined as a requirement for Aboriginal peoples to pursue their cultural, social, and economic rights. Discussion/conclusions Cultural determinants are associated with health benefits for Indigenous peoples. A causal framework, developed to discuss the relationship and interconnection of the cultural determinants of health, demonstrates that cultural identity at an individual-level is important to benefiting from other cultural determinants of health. While self-determination and ...
Keywords	Aboriginal and Torres Strait Islander ; Indigenous ; Cultural determinants of health ; Public aspects of medicine ; RA1-1270
Subject code	390 ; 360
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adapting clinical skills volunteer patient recruitment and retention during COVID-19

Alasdair Nazerali-Maitland / Reed Holden / Amanda Jones / Jenni Uitto Cardoso / Kelly Levido / Christina Douglas

Canadian Medical Education Journal, Vol 12, Iss

2021 Volume 3

Abstract: Implication Statement Institutions have been faced with the unique challenge of continuing to deliver medical education to students in a COVID-19 environment.1,2 Clinical skills teaching must be adapted to the pandemic environment, which begins with ... ...

Abstract	Implication Statement Institutions have been faced with the unique challenge of continuing to deliver medical education to students in a COVID-19 environment.1,2 Clinical skills teaching must be adapted to the pandemic environment, which begins with retaining Volunteer Patient (VP) engagement to facilitate the development of students’ patient care aptitudes. The number of available VPs has been significantly reduced by the pandemic. We propose actionable solutions to recruit, engage, and retain VPs that can be easily adopted at any site. The SLIM-COVID framework can assist programs in altering curricula to deliver clinical skills with patient involvement in a pandemic environment.
Keywords	Education (General) ; L7-991 ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Canadian Medical Education Journal
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Maternal Under- and Over-Nutrition during Gestation Causes Islet Hypertrophy and Sex-Specific Changes to Pancreas DNA Methylation in Fetal Sheep

Maria Peterson / Mary Gauvin / Sambhu Pillai / Amanda Jones / Katelyn McFadden / Katelynn Cameron / Sarah Reed / Steven Zinn / Kristen Govoni

Animals, Vol 11, Iss 2531, p

2021 Volume 2531

Abstract: The mechanisms by which fetal programming predisposes offspring to reduced β-cell function later in life are poorly understood. We hypothesized that maternal under- and over-nutrition during gestation would negatively affect offspring pancreas ... ...

Abstract	The mechanisms by which fetal programming predisposes offspring to reduced β-cell function later in life are poorly understood. We hypothesized that maternal under- and over-nutrition during gestation would negatively affect offspring pancreas development and alter DNA methylation patterns. Pregnant ewes ( n = 78) were fed 100, 60, or 140% of NRC requirements beginning at d 30.2 ± 0.2 of gestation. The fetuses are referred to as CON, RES, and OVER, respectively. Fetal pancreas tissue was collected at d 90 or 135 of gestation or within 24 h of birth. Tissue was preserved for histological ( n = 8 to 9 offspring per treatment per time point) and DNA methylation analyses ( n = 3 to 4 fetuses per treatment per sex). At d 135, OVER exhibited an increased islet size, reduced islet number, and greater insulin positive area compared with CON ( p ≤ 0.03). An increased islet size was also observed at d 135 in RES ( p ≤ 0.03) compared with CON. Cellular proliferation was reduced at birth in OVER vs. CON ( p = 0.01). In the RES vs. CON females, 62% of the differentially methylated regions (DMRs) were hypomethylated ( p ≤ 0.001). In the RES vs. CON males, 93% of the DMRs were hypermethylated ( p ≤ 0.001). In OVER, 66 and 80% of the DMRs were hypermethylated in the female and male offspring compared with CON ( p ≤ 0.001). In conclusion, changes to maternal diet during pregnancy affects the islet hypertrophy and cellular proliferation of the offspring at early post-natal time points. Additionally, changes in DNA methylation patterns appear to be in a diet-specific and sex-dependent manner.
Keywords	beta cell function ; fetal programming ; DNA methylation ; endocrine pancreas ; sheep ; Veterinary medicine ; SF600-1100 ; Zoology ; QL1-991
Subject code	610
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exocrine pancreas proteases regulate β-cell proliferation in zebrafish ciliopathy models and in murine systems

Timothy L. Hostelley / Jessica E. Nesmith / Emily Larkin / Amanda Jones / Daniel Boyes / Carmen C. Leitch / Magali Fontaine / Norann A. Zaghloul

Biology Open, Vol 10, Iss

2021 Volume 6

Abstract: Pancreatic β-cells are a critical cell type in the pathology of diabetes. Models of genetic syndromes featuring diabetes can provide novel mechanistic insights into regulation of β-cells in the context of disease. We previously examined β-cell mass in ... ...

Abstract	Pancreatic β-cells are a critical cell type in the pathology of diabetes. Models of genetic syndromes featuring diabetes can provide novel mechanistic insights into regulation of β-cells in the context of disease. We previously examined β-cell mass in models of two ciliopathies, Alström Syndrome (AS) and Bardet-Biedl Syndrome (BBS), which are similar in the presence of metabolic phenotypes, including obesity, but exhibit strikingly different rates of diabetes. Zebrafish models of these disorders show deficient β-cells with diabetes in AS models and an increased β-cells absent diabetes in BBS models, indicating β-cell generation or maintenance that correlates with disease prevalence. Using transcriptome analyses, differential expression of several exocrine pancreas proteases with directionality that was consistent with β-cell numbers were identified. Based on these lines of evidence, we hypothesized that pancreatic proteases directly impact β-cells. In the present study, we examined this possibility and found that pancreatic protease genes contribute to proper maintenance of normal β-cell numbers, proliferation in larval zebrafish, and regulation of AS and BBS β-cell phenotypes. Our data suggest that these proteins can be taken up directly by cultured β-cells and ex vivo murine islets, inducing proliferation in both. Endogenous uptake of pancreatic proteases by β-cells was confirmed in vivo using transgenic zebrafish and in intact murine pancreata. Taken together, these findings support a novel proliferative signaling role for exocrine pancreas proteases through interaction with endocrine β-cells.
Keywords	β-cells ; ciliopathies ; diabetes ; zebrafish ; Science ; Q ; Biology (General) ; QH301-705.5
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	The Company of Biologists
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia

Sandra Eades / Lina Gubhaju / Margaret Kelaher / David Thomas / Amanda Jones / Joanne Luke / Ebony Verbunt / Angela Zhang / Muriel Bamblett / Gabrielle Johnson / Connie Salamone

BMJ Global Health, Vol 7, Iss

2022 Volume 6

Keywords	Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health Care in the Age of Mass Incarceration

Julia Gips / Alina Spiegel / Alexandra Norton / Priyal Gandhi / Dylan Hardenbergh / John Gatti / Laura Pugh / Amanda Jones / Carolyn Sufrin

MedEdPORTAL, Vol

A Selective Course for Medical Students in Their Preclinical Years

2020 Volume 16

Abstract: Introduction While medical school curricula increasingly address health disparities, content regarding health care for persons impacted by incarceration is a persistent and notable gap. There is a high burden of disease among incarcerated populations, ... ...

Abstract	Introduction While medical school curricula increasingly address health disparities, content regarding health care for persons impacted by incarceration is a persistent and notable gap. There is a high burden of disease among incarcerated populations, and health care challenges continue postincarceration. We developed a course to introduce medical students to the current landscape of mass incarceration in the US and implications for health and health care delivery to people impacted by this system. Methods We developed a 3.5-hour elective course taken by 19 first-year medical students in its first year and 20 students in its second. The course utilized lecture, case-based discussion, and guest speaker modalities to introduce students to the history of mass incarceration, health care delivery within the carceral system, and challenges in accessing care during and following incarceration. Results Students received two surveys after completing the course. In the first, 100% of respondents reported outstanding, excellent, or good levels of satisfaction with various elective components, including organization, learning activities, and student discussion. The second found significant increases in knowledge about mass incarceration and incarceration health issues, in addition to significant increases in interest in advocating or providing health care for incarcerated populations. Discussion Given current mass incarceration practices, students will encounter patients impacted by this system. This elective course sought to better prepare students to effectively care for these patients. We were limited by time availability, and future directions include incorporating a standardized patient exercise, trauma-informed care principles, and providers working within the carceral system.
Keywords	Incarceration ; Health Care ; Disparity ; Prison ; Preclinical ; Diversity ; Medicine (General) ; R5-920 ; Education ; L
Subject code	360
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Association of American Medical Colleges
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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