Long-term mortality trends in functionally-dependent adults following severe traumatic-brain injury

Abstract Primary objective: To investigate mortality trends in functionally dependent adults following traumatic brain injury (TBI). Methods: Data for 966 consecutive admissions to a specialist TBI rehabilitation service were reviewed. Details for 69 subjects who were functionally dependent at rehabilitation discharge were cross-referenced against the State Government Death Register. The observed mortality rate was compared to an equivalent population sample derived from Australian Life Tables. Results: Twenty-five subjects (36%) were deceased at an average 10.5 years post-injury (SD 5 years; range 1.7-18.8 years). The observed numbers of deaths far exceeded the expected population figure (1.9) for the same period (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) yielding a standardized mortality rate of 13.2. Mortality trends suggested a bimodal distribution, with more deaths in the first 5 years post-injury followed by no further deaths until 9 years post-injury. Conclusions: Mortality in this functionally-dependent group was significantly associated with age, male sex and degree of disability at discharge. The bimodal distribution of mortality data suggests different contributory mechanisms to early vs. late mortality in this group

Mental illness stigma and associated factors among Arabic-speaking religious and community leaders

Evidence suggests that Arabic-speaking refugees in Australia seek help from informal sources, including religious and community leaders, when experiencing mental health issues. Despite their significant influence, there is scarce research exploring attitudes of Arabic-speaking leaders toward mental illness. The current exploratory study explored mental illness stigma and various factors among Arabic-speaking religious and community leaders. This study uses a subset of data from an evaluation trial of mental health literacy training for Arabic-speaking religious and community leaders. Our dataset contains the pre-intervention survey responses for 52 Arabic-speaking leaders (69.2% female; mean age = 47.1, SD = 15.3) on the ability to recognise a mental disorder, beliefs about causes for developing mental illness, and two stigma measures, personal stigma, and social distance. Being female was associated with a decrease in personal stigma. An increase in age was associated with an increase in personal stigma. Correct recognition of a mental disorder was associated with decreased personal stigma, and after adjusting for age and gender, significance was retained for the I-would-not-tell-anyone subscale. Endorsing the cause “being a person of weak character” was associated with an increase in personal stigma. There is an urgent need for future research to elucidate stigma to develop effective educational initiatives for stigma reduction among Arabic-speaking leaders

Professional mental health help-seeking amongst Afghan and Iraqi refugees in Australia : understanding predictors five years post resettlement

The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed

Do practices such as dowry and bride prices relate to violence among migrants in OECD countries? : a mixed methods systematic review protocol

This systematic review aims to make a significant contribution to knowledge on dowry and bride price practices in Organisation for Economic Co-operation and Development (OECD) countries, with a focus on Sudan, Zimbabwe and India. While, existing research evidences the ongoing prevalence of dowry and bride price among some migrant communities, there remains substantial gaps in research. The protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. It highlights the scope and methodology for the systematic review to be conducted. Studies will be included if they: (i) were conducted in English; (ii) if they were published between December 1993 and December 2019 because this is the period the dowry-related violence was included into the Declaration on the Elimination of Violence Against Women (iii) used qualitative, quantitative methods or mixed methods; were peer reviewed or grey literature; and (iv) covered analysed dowry and bride price practices and its impact among migrant communities in the OECD countries. Data extraction will be informed by the Joanna Briggs Institute Review for Systematic Reviews and Research Syntheses. The quality of evidence of the studies included will be assessed using the Joanna Briggs Institute tool for qualitative and quantitative studies, the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) tool for grey literature and the Mixed Methods Appraisal Tool (MMAT) tool for mixed methods studies. Kappa statistics agreement will be used as an additional step to ensure quality ratings are fair and valid. The findings will be summarised into themes and narrated

Predictors of professional help-seeking for emotional problems in Afghan and Iraqi refugees in Australia : findings from the Building a New Life in Australia Database

ackground: Refugees are particularly vulnerable to poor mental health outcomes due to exposure to pre migration trauma and post migration stressors. Research has demonstrated evidence to suggest that the professional help-seeking among refugee groups is low or problematic. This study seeks to examine help-seeking for emotional problems in two large samples of Iraqi and Afghan refugees in Australia. Methods: This study uses data from two waves of the Building a New Life in Australia, the longitudinal study of Humanitarian migrants. The data was collected face-To-face between 2013 and 2016, among humanitarian migrants. All participants held a permanent protection visa and had arrived in Australia or been granted their visa between period of May to December 2013. The study sample included 1288 participants born in Iraq and Afghanistan (aged 15 and over). In the Wave 3 interview (2015-2016) participants reported on professional help received to deal with emotional problems. Results: Approximately 36 and 37% of the Iraqi and Afghan groups respectively, reported seeking help for emotional problems. Within the Iraqi group, associations between mental health status, namely general psychological distress and PTSD and help-seeking were found but this was not present in the Afghan group, where age seemed to play a role in help-seeking. Frequency of help received was low with approximately 47% of the Iraqi and 57% of the Afghan groups reporting having received help 5 times or less in the last 12 months. Conclusions: Findings from this study provide clear directions on areas where culturally tailored mental health promotion programs should target in these two refugee communities. Further, the differences in help-seeking behaviour of these communities should be noted by both clinicians and policy makers as efforts to provide culturally responsive mental health services

Nurse-identified patient care and health services research priorities in the United Arab Emirates: a Delphi study

Background: The need for improved research on ill health has been recognized internationally and locally in the United Arab Emirates (UAE). The UAE Nursing and Midwifery Council recently committed to enhancing the status and contributions of nursing in healthcare research across the UAE by establishing a National Committee for Research Development. This study using a Delphi method to identify research priorities from the perspective of nurses delivering frontline healthcare. Methods: A two-phase Delphi design was implemented with 1032 nurses participating in phase one of the study and 1339 in phase two. Results: The most important priority was patient safety and healthcare professionals’ awareness of international patient safety goals (including staffing levels and shift length) and potential effects on patient safety. Other important priorities were infection control practices and management of communicable diseases. Conclusions: These priorities may inform nursing research programs to improve patient care and health outcomes in the UAE and similar contexts worldwide

Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments

BACKGROUND Criticisms that generic measures of health-related quality of life (HRQoL) are not sensitive to impairment in anorexia nervosa (AN) has spurred the development of disease-specific measures. This study aimed to compare the psychometric properties of a generic to a disease-specific measure of HRQoL. METHODS 63 participants with AN completed measures of a generic HRQoL (SF-12), disease-specific HRQoL (Eating Disorders Quality of Life Questionnaire; EDQOL), functional impairment (days out of role; DOR; Work and Social Adjustment Scale; WSAS), and eating disorder severity (Eating Disorder Examination; EDE) at baseline, post-treatment, and 6- and 12-months follow-up. Cronbach's α was computed for the SF-12 and EDQOL (internal consistency). Correlations were assessed between SF-12/EDQOL scores and DOR, WSAS, and EDE scores (convergence validity). Three sets of three multiple linear regressions were performed using SF-12 and EDQOL scores as predictors and change in DOR, WSAS, and EDE global scores from baseline to (i) post-treatment, (ii) 6-month follow-up, (iii) and 12-month follow-up as dependent variables (predictive validity and sensitivity). RESULTS The EDQOL displayed stronger internal consistency (α = 0.92) than the SF-12 (α = 0.80). The SF-12 converged more strongly with DOR and the WSAS (r(p) = -0.31 to -0.63 vs. 0.06 to 0.70), while the EDQOL converged more strongly with the EDE (r(p) = -0.01 to 0.48 vs. -0.01 to -0.37). The SF-12 demonstrated stronger predictive validity (β = -0.55 to 0.29) and sensitivity to changes in ED severity (β = -0.47 to 0.32). CONCLUSIONS The SF-12 is a valid and sensitive measure of HRQoL impairment in patients with AN. While the SF-12 may be preferred in research comparing EDs to other populations, and in research and practice as an indicator of functional impairment; the EDQOL may be preferred by clinicians and researchers interested in HRQoL impairment specifically associated with an ED and as an additional indicator of ED severity.Funding from a National Health and Medical Research Congress program grant (no. 457419) to Chief Investigators Prof Touyz (University of Sydney), Prof Lacey (University of London), Prof Le Grange (University of Chicago), Prof Hay (University of Western Sydney)

Conceptualisations of mental illness and stigma in Congolese, Arabic-speaking and Mandarin-speaking communities : a qualitative study

Background Australia is an ethnically diverse nation. Research has demonstrated an elevated risk of developing a mental illness in culturally and linguistically diverse (CaLD) communities yet uptake of mental health services is low. To improve mental health treatment seeking and outcomes for CaLD individuals in Australia there is an urgent need to deeply understand barriers to treatment such as stigma. Using an exploratory qualitative approach, the aim of the study was to explore how CaLD communities' conceptualise and interpret mental illness and associated beliefs and experiences of stigma. MethodsThe study focused on three key CaLD groups: the Congolese, Arabic-speaking and Mandarin-speaking communities residing in Sydney, Australia. A series of eight focus group discussions (n = 51) and 26 key informant interviews were undertaken online using Zoom during the period of November to December 2021. Focus group discussions and key informant interviews were digitally recorded, transcribed, and analysed using NVivo software. Results Three major themes were identified. The first theme related to mental illness terminology used in the three communities. Despite variation in the terms used to refer to 'mental illness' all three communities generally distinguished between 'mental illness', a more severe condition and 'mental health problems', considered to arise due to stressors. The second theme centred on beliefs about mental illness; with all three communities identifying migration-related stressors as contributing to mental illness. Culturally related beliefs were noted for the Congolese participants with the perception of a link between mental illness and supernatural factors, whereas Mandarin-speaking participants highlighted lack of inter and intrapersonal harmony and failure to adhere to values such as filial piety as contributing to mental illness. The final theme related to mental illness related stigma and the various ways it manifested in the three communities including presence of collectivist public stigma felt across all three groups and affiliate (family) stigma reported by the Arabic and Mandarin-speaking groups. Conclusions We found rich diversity in how these communities view and respond to mental illness. Our findings provide some possible insights on both service provision and the mental health system with a view to building effective engagement and pathways to care

A qualitative exploration of sources of help for mental illness in Arabic-, Mandarin-, and Swahili-speaking communities in Sydney, Australia

Despite being disproportionately affected by poor mental health, culturally and linguistically diverse (CaLD) individuals seek help from mental health services at lower rates than others in the Australian population. The preferred sources of help for mental illness amongst CaLD individuals remain poorly understood. The aim of this study was to explore sources of help in Arabic-, Mandarin-, and Swahili-speaking communities in Sydney, Australia. Eight focus-group discussions (n = 51) and twenty-six key informant interviews were undertaken online using Zoom. Two major themes were identified: informal sources of help and formal sources of help. Under the informal sources of help theme, three sub-themes were identified: social, religious, and self-help sources. All three communities strongly recognised the role of social sources of help, with more nuanced roles held by religion and self-help activities. Formal sources of help were described by all communities, although to a lesser extent than informal sources. Our findings suggest that interventions to support help-seeking for all three communities should involve building the capacity of informal sources of help, utilising culturally appropriate environments, and the collaboration between informal and formal sources of help. We also discuss differences between the three communities and offer service providers insights into unique issues that require attention when working with these groups

運動情報の可聴化に関する研究

電気通信大学201