Systemic isotretinoin in the management of acne – a patient questionnaire survey

Background: The primary aim was to investigate the appropriateness (as outlined in the South African Acne Treatment Guideline1) for the prescription of systemic isotretinoin in the management and counselling of acne in the Nelson Mandela Bay Metropole. Methods: A questionnaire was distributed to patients receiving systemic isotretinoin by 30 community pharmacies. The response rate was 29.2% (57 respondents). Results: The acne medication history revealed that commercial brands of beauty products were used by 57.9% of respondents, topical benzoyl peroxide by 22.8%, and systemic cotrimoxazole by 19.3%. Only nine females used an oral contraceptive as acne treatment prior to isotretinoin. The average daily dose of isotretinoin was 44.2 (SD=16.9) mg. Half of the respondents received a suboptimal cumulative dosage of isotretinoin. The average prescribed duration of isotretinoin therapy was 6.2 months. Adequate counselling was received by only 57.9% of patients. A third of the patients who were able to fall pregnant received recommendations for contraception. Pregnancy tests were conducted in only two females. Just over 40% of patients reported a complete clearance of acne lesions. Conclusions: Many prescribers did not follow the recommendations for isotretinoin prescription. The counselling of patients regarding isotretinoin therapy was substandard, especially with respect to pregnancy prevention

Challenges in Evaluating Aboriginal Healing Programs: Definitions, Diversity and Data

© 2017 Australasian Evaluation Society. Indigenous people around the world have long healing traditions. Contemporary Aboriginal and Torres Strait Islander healing projects are designed to empower individuals, families and communities; strengthen connections to culture; and reduce the damaging effects of colonisation and government policies such as the forcible removal of children (the Stolen Generations). Evidence on the conditions necessary for healing to occur, and how healing works for different people and in different contexts, is limited. Evaluations that will help identify good practice and document the full range of outcomes are sorely needed. This paper is based largely on experiences and learnings from Stolen Generations projects around Australia funded by the Aboriginal and Torres Strait Islander Healing Foundation, and the reflections of experienced scholar-practitioners. It argues that evaluations that are responsive to, and ultimately owned and led by, Aboriginal and Torres Strait Islander communities need to be designed and implemented differently to mainstream evaluations. Timeframes, methods, relationships between evaluators and stakeholders, and the identification and measurement of outcomes all need to be carefully considered. Challenges include definitions of healing, diversity of landscapes and programs, and data collection. Qualitative methods that preference and support Indigenous cultural frameworks and ways of creating and sharing knowledge work well. In addition to ensuring culturally sensitive methodologies and tools, working ethically and effectively in the Indigenous healing space means emphasising and enabling safety for participants, workers and organisations

Towards a national approach to telehealth evaluation: the work of the Australian New Zealand Telehealth Committee

Telehealth is a rapidly growing field, with developments in all Australian States and Territories and New Zealand. In the complex environment of the health system, strenuous efforts must be made to establish meaningful statistics and data against which the costs and benefits of new initiatives can be measured and compared with alternative approaches. Since its establishment in 1996 the Australian New Zealand Telehealth Committee has been actively engaged in developing a standard and system-wide approach to monitoring and evaluation that will meet both project and strategic needs. The Committee has developed a national telehealth evaluation framework that incorporates a standard approach to project evaluation, and conducts an annual survey of telehealth activity across Australia. In conjunction with the Department of Health and Aged Care, the Committee is currently pursuing the development and trial of a generic evaluation methodology to establish the relative clinical and cost-effectiveness of key telehealth applications. Important work is also being done in the area of data definitions, with elaboration of a telehealth data framework and development of a set of standard telehealth data definitions, and ongoing work towards a national minimum data set and performance indicators for telehealth

Psychological Distress in Iranian International Students at an Australian University

© 2017, Springer Science+Business Media New York. This study investigated psychological distress in Iranian international students at UNSW Australia, and explored the psychosocial factors associated with high levels of distress. A total of 180 Iranian international students pursuing undergraduate and postgraduate degrees during 2012/2013 completed an email questionnaire containing socio-demographic items and five standardized and validated scales. Multivariable logistic regression was used to analyse the predictors of psychological distress. Compared to domestic and international students at two other Australian universities, a significantly smaller proportion of Iranian international students scored as distressed on the Kessler Psychological Distress Scale (K10). Greater levels of psychological distress were associated with being female, poorer physical health, less social support, less religious involvement and spirituality, and negative attitudes towards seeking professional psychological help. Findings from this growing group of international students can help inform culturally competent mental health promotion and service provision in their host countries

Review of potentially useful tools and methods for evaluating healing programs for Aboriginal Australians affected by the Stolen Generations

This report used a systematic process to identify tools that could potentially be useful in the evaluation of healing programs of interest for delivery in the proposed Healing Centre being planned by KBHAC. Most of the tools that were identified in the Long and Short Lists fell short on many of the important desirable characteristics that emerged through projects undertaken with extensive consultation with members of the Stolen Generations and the Healing Centre.Some tools with desirable characteristics were developed for population surveys or for screening and/or clinical use for alcohol and other drug addictions or for mental health problems, and do not measure healing and growth in program settings.However, some tools met many of these criteria; these we identify as Recommended Tools that seemed most suitable for KBHAC’s interests, with or without adaptation and standalone or in combination with other tools. For adults, these included the Growth and Empowerment Measure, the Self-Evaluated Individual Quality of Life scale (SEIQoL) and the Caring for Country measure (adapted to suit specific Healing Centre Activities). Of these tools, only the GEM has been used in several evaluations of Aboriginal programs in different settings and had its appropriateness and sensitivity to change documented. The SEIQoL has also proven useful in alcohol and drug rehabilitation settings with Aboriginal people. The GEM is unique in being directly informed in its development by interviews of participants in a program developed by and for members of the Stolen Generation to assist Aboriginal healing and empowerment. Given the proposed Healing Centre may include programs that assist in improving connection to country, the Caring for Country measure may be considered for providing a model for measuring engagement in gardening and maintenance activities at the proposed Healing Centre. If modified and used, it would probably need to accompany another tool which measured healing more directly and holistically.The Stay Strong Plan also offers a number of advantages as a possible care-planning tool for counselling activities that may be delivered in a Healing Centre. However, it does not yet have a validated measurement dimension so its usefulness as an evaluation tool remains unknown. A combination of the Stay Strong Plan and the GEM is currently being trialled in Queensland as part of a therapeutic and outcome assessment toolkit for social and emotional wellbeing and mental health care

Videoconferencing in the Queensland health service

Videoconferencing was introduced in the Queensland health service in 1995. By the end of 1999, there were more than 150 videoconferencing units in health facilities around the state. Six audits of videoconferencing usage were conducted using similar methodology at six-month intervals from November 1997 to May 2000. Between November 1997 and November 1999, the number of calls more than doubled, from 566 to 1378. Hours of usage almost trebled, from 671 to 1724. The average duration of calls remained similar, at about I h 12 min. The proportion of calls involving more than two sites (multipoint videoconferences) increased from 44% to 65%. The majority of the activity was for education (including training). Videoconferencing was also used for administration and clinical care. Mental health staff were the heaviest users, but use by health professionals from other specialty areas increased during the study period. The Queensland health service has realized a number of important benefits from telehealth