Teacher reports of hypoactivity symptoms reflect slow cognitive processing speed in primary school children

The mediating effect of cognitive processing speed on the ability of a primary school child to achieve his/her full potential of intellectual functioning emphasizes the importance of methods to detect “slow” children. Primary school teachers may be the first to have concerns about inattentive pupils who show symptoms of hypoactivity, but may find the symptoms difficult to interpret. In the present study we ask if a primary school teacher’s report of hypoactivity symptoms can be explained by the child’s performance on tests of processing speed. The 255 children included in the present study were part of the first wave of the Bergen Child Study, in which teachers completed a questionnaire including two hypoactivity items from the Five to Fifteen (FTF) questionnaire. Processing speed was measured by the Processing Speed Index (PSI) from the WISC-III, 1–2 years after the teacher rating. Teachers reported “certainly true” on at least one FTF item of hypoactivity for 11.8% of the children. These children obtained lower scores on the PSI than the remaining children in the sample. The PSI accounted for a considerable proportion of the variance of teacher reports on the FTF item “difficulty getting started on a task/activity”. The risk of a PSI score below 85 was increased in children with teacher-reported hypoactivity symptoms. The results indicate that teacher reports of hypoactivity symptoms reflect slow cognitive processing speed and should be followed up by a psychometric examination. Still, future studies are needed to improve detection and treatment of children with slow processing speed

The role of depressive personality in determining clinical characteristics of chronic depression

Features of depressive personality as defined by Schneider (1958) were associated with high levels of depression severity in a cohort of 87 outpatients with chronic depression. Depressive personality was associated with higher levels of introversion and an earlier age of onset of depressive symptoms. However, as depressive personality did not predict outcome in terms of depression severity over a one year period, an additional diagnosis of depressive personality in patients with chronic depression may not add greatly to a clinical understanding of patients

Antipsychotic drug doses in the outpatient treatment of schizophrenia

Cherrie A. Galletly, George Tsourto

'It's just about the crime, not the victim': critical insights from Australian service providers working with people who have been trafficked

Published online: 29 Nov 2018Human trafficking is a global public health issue, prevalent in Australia. Our study aimed to gain in-depth understanding of human trafficking and related service provision from a range of sectors, from the perspective of service providers. Adopting a qualitative descriptive approach, in-depth semi-structured interviews were undertaken with 13 service providers from a range of organisations across three Australian states. Service providers emphasised the challenges posed by Australia's predominately criminal justice approach to trafficking, in both policy and service provision, with some suggesting the current process is re-traumatising. Results support refocusing policy and services away from a criminal justice response to a more comprehensive and holistic response that includes greater recognition of the social determinants of health and the provision of tailored services. This requires increased collaboration between service providers, some of whom have very different agendas. The findings provide support for recommendations with the Australian government inquiry into modern-day slavery and therefore have important implications for policy and health services nationally to become more holistic in responding to human trafficking.Emma George, George Tsourtos and Darlene McNaughto

Evidence of an early information processing speed deficit in unipolar major depression. Psychol Med

ABSTRACT Background. Slowing of the speed of information processing has been reported in geriatric depression, but it is not clear if the impairment is present in younger patients, if motor retardation is responsible, or if antidepressant medications play a role

A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people.

BACKGROUND:Incarcerated people are at increased risk of human immunodeficiency virus (HIV) infection relative to the general population. Despite a high burden of infection, HIV care use among prison populations is often suboptimal and varies among settings, and little evidence exists explaining the discrepancy. Therefore, this review assessed barriers to optimal use of HIV care cascade in incarcerated people. METHODS:Quantitative and qualitative studies investigating factors affecting linkage to care, ART (antiretroviral therapy) initiation, adherence and/or outcomes among inmates were systematically searched across seven databases. Studies published in English language and indexed up to 26 October 2018 were reviewed. We performed a narrative review for both quantitative and qualitative studies, and meta-analyses on selected quantitative studies. All retrieved quantitative studies were assessed for risk of bias. Meta-analyses were conducted using RevMan-5 software and pooled odds ratios were calculated using Mantel-Haenszel statistics with 95% confidence interval at a p<0.05. The review protocol has been published at the International Prospective Register of Systematic Reviews (PROSPERO; Number: CRD42019135502). RESULTS:Of forty-two studies included in the narrative review, eight were qualitative studies. Sixteen of the quantitative studies were eligible for meta-analyses. The narrative synthesis revealed structural factors such as: a lack of access to community standard of HIV care, particularly in resource limited countries; loss of privacy; and history of incarceration and re-incarceration as risk factors for poor HIV care use in prison populations. Among social and personal characteristics, lack of social support, stigma, discrimination, substance use, having limited knowledge about, and negative perception towards ART were the main determinants of suboptimal use of care in incarcerated people. In the meta-analyses, lower odds of ART initiation was noticed among inmates with higher baseline CD4 count (CD4 ≥500celss/mm3) (OR = 0.37, 95%CI: 0.14-0.97, I2 = 43%), new HIV diagnosis (OR = 0.07, 95%CI: 0.05-0.10, I2 = 68%), and in those who lacked belief in ART safety (OR = 0.32, 95%CI: 0.18-0.56, I2 = 0%) and efficacy (OR = 0.31, 95%CI: 0.17-0.57, I2 = 0%). Non-adherence was high among inmates who lacked social support (OR = 3.36, 95%CI: 2.03-5.56, I2 = 35%), had low self-efficiency score (OR = 2.50, 95%CI: 1.64,-3.80, I2 = 22%) and those with depressive symptoms (OR = 2.02, 95%CI: 1.34-3.02, I2 = 0%). Lower odds of viral suppression was associated with history of incarceration (OR = 0.40, 95%CI: 0.35-0.46, I2 = 0%), re-incarceration (OR = 0.09, 95%CI: 0.06-0.13, I2 = 64%) and male gender (OR = 0.55, 95%CI: 0.42-0.72, I2 = 0%). Higher odds of CD4 count <200cells/mm3 (OR = 2.01, 95%CI: 1.62, 2.50, I2 = 44%) and lower odds of viral suppression (OR = 0.20, 95%CI: 0.17-0.22, I2 = 0%) were observed during prison entry compared to those noticed during release. CONCLUSION:Given the high HIV risk in prison populations and rapid movements of these people between prison and community, correctional facilities have the potential to substantially contribute to the use of HIV treatment as a prevention strategy. Thus, there is an urgent need for reviewing context specific interventions and ensuring standard of HIV care in prisons, particularly in resource limited countries

An ecological analysis of factors associated with food insecurity in South Australia, 2002-7

Objective: To estimate the extent of food insecurity in South Australia and its relationship with a variety of socio-economic variables. Design: Data collected routinely from 2002 to 2007 by SA Health were analysed to explore food security in the State’s population. An ecological analysis of data collected by the South Australian Monitoring and Surveillance System (SAMSS) that collects data on key health indicators. Questions on food security are asked periodically from July 2002 to December 2007. Setting: South Australia. Subjects: Over 37 000 interviewees took part in SAMSS surveys. Questions about food security were asked of 19 037 subjects. The sample was weighted by area, age and gender so that the results were representative of the South Australian population. Results: Seven per cent (1342/19 037) of subjects reported running out of food during the previous year and not having enough money to buy food (food insecurity). Logistic regression analysis found food insecurity to be highest in households with low levels of education, limited capacity to save money, Aboriginal households, and households with three or more children. Conclusions: The study confirms that food insecurity is strongly linked to economic disadvantage. Increasing cost of food is likely to exacerbate food insecurity. This is of concern given that food insecurity is associated with poor health, especially obesity and chronic disease. Comprehensive action at all levels is required to address root causes of food insecurity. Regular surveillance is required to continue to monitor levels of food security, but more in-depth understandings, via qualitative research, would be useful.Wendy Foley, Paul Ward, Patricia Carter, John Coveney, George Tsourtos and Anne Taylo

Investigating Australians' trust: findings from a national survey

Trust has been identified as an indicator within Social Quality theory. As an important component of social quality, trust has become increasingly important in modern society because literature suggests that trust in a number of democratic countries is declining. Modern technologies and specialties are often beyond the understanding of lay individuals and thus, the need for trusting relations between lay individuals and organizations/individuals has grown. The purpose of the study was to examine the extent to which Australians (dis)trust individuals and organizations/institutions. A national postal survey was conducted with 1,044 respondents recruited using the electronic white pages directory. Findings from multivariate analyses suggest that income, age, sex, and health status are associated with trust in groups of individuals and trust in organizations/institutions. The findings highlight populations where trust needs to be (re)built. Future government policy and practice should utilize these findings as a means of facilitating social quality.Samantha B Meyer, Tini C N Luong, Paul R Ward, George Tsourtos, and Tiffany K Gil

'I just saw it as something that would pull you down, rather than lift you up': resilience in never-smokers with mental illness

Why people smoke despite the health risks is an important public health question. Equally important is why and how some people resist smoking in spite of circumstances that clearly place them at high risk of becoming smokers. This study used in-depth interviews to explore the narratives of 12 people diagnosed with mental illness, who had made conscious decisions not to smoke. This was despite most of them growing up in smoking families or being from population groups at high risk of smoking. A qualitative grounded theory methodology was used to analyse common themes around protective behaviours and attitudes within a model of resilience. Themes included strong negative reactions to smoking as children which have persisted into adulthood, strong lasting associations with smoking, a clear sense of ‘self’ separate from peers from an early age (internal resilience) and developing a range of coping strategies and external supports not related to smoking (external resilience). Understanding resilience holds potential lessons for health promotion and primary health care professionals supporting the prevention of smoking uptake and supporting smoking cessation by at risk groups.Sharon Lawn, Deborah Hersh, Paul R. Ward, George Tsourtos, Robert Muller, Anthony Winefield and John Covene