Half full or half empty: the measurement of mental health and mental illness in emerging Australian adults

Narrow approaches to the conceptualisation and measurement of ‘mental health’ are regularly but inconsistently adopted in research and practice. For example, an exclusive focus on the identification of mental illness or mental wellbeing runs the risk of failing to detect individuals with low or high levels of the other, and does nothing to represent an individual’s level of complete mental health (i.e., taking both mental wellbeing and illness into account). The current study compared three approaches to the measurement of mental health regularly applied in the literature - an exclusive mental wellbeing / an exclusive mental illness / and a complete mental health approach – to determine if they produce similar outcomes. South Australian emerging adults were recruited (N=117; M=24.4 years, SD=0.75) and categorised into four mental health groups according to the Complete State Model (CSM; Keyes & Lopez, 2002) of mental health: flourishing (complete mental health), languishing or struggling (incomplete mental health or illness), or floundering (complete mental illness) and categories were compared. Results showed that the ‘mental health’ of the sample differed depending on the measurement approach used, and lend support to a complete mental health approach to better inform, develop, and target health promotion strategies

Half full or half empty: the measurement of mental health and mental illness in emerging Australian adults

Narrow approaches to the conceptualisation and measurement of ‘mental health’ are regularly but inconsistently adopted in research and practice. For example, an exclusive focus on the identification of mental illness or mental wellbeing runs the risk of failing to detect individuals with low or high levels of the other, and does nothing to represent an individual’s level of complete mental health (i.e., taking both mental wellbeing and illness into account). The current study compared three approaches to the measurement of mental health regularly applied in the literature - an exclusive mental wellbeing / an exclusive mental illness / and a complete mental health approach – to determine if they produce similar outcomes. South Australian emerging adults were recruited (N=117; M=24.4 years, SD=0.75) and categorised into four mental health groups according to the Complete State Model (CSM; Keyes & Lopez, 2002) of mental health: flourishing (complete mental health), languishing or struggling (incomplete mental health or illness), or floundering (complete mental illness) and categories were compared. Results showed that the ‘mental health’ of the sample differed depending on the measurement approach used, and lend support to a complete mental health approach to better inform, develop, and target health promotion strategies

Alcohol prevention for school students: Results from a 1-year follow up of a cluster-randomised controlled trial of harm minimisation school drug education

Aims: The Drug Education in Victorian Schools (DEVS) programme taught about licit and illicit drugs over two years (2010–2011), with follow up in the third year (2012). It focussed on minimising harm and employed participatory, critical-thinking and skill-focussed pedagogy. This study evaluated the programme’s residual effectiveness at follow up in reducing alcohol-related risk and harm. Methods: A cluster-randomised, controlled trial was conducted with a student cohort during years eight (13–14 years old), nine (14–15 years old) and 10 (15–16 years old). Schools were randomly allocated to the DEVS programme (14 schools, n = 1163), or their usual drug education (7 schools, n = 589). Multi-level models were fitted to the data, which were analysed on an intent-to-treat basis. Statistically significant findings: Over the 3 years, there was a greater increase in intervention students’ knowledge about drugs, including alcohol. Their alcohol consumption did not increase as much as controls. Their alcohol-related harms decreased, while increasing for controls. There were fewer intervention group risky drinkers, and they reduced their consumption compared to controls. Similarly, harms decreased for intervention group risky drinkers, while increasing for controls. Conclusions: Skill-focussed, harm minimisation drug education can remain effective, subsequent to programme completion, in reducing students’ alcohol consumption and harm, even with risky drinkers

The impact of gender, socioeconomic status and locality on the development of student patterns of alcohol consumption and harm

Purpose. The consequences of problematic alcohol consumption fall heavily on Australian adolescents, with this population at increased risk of death, serious injury and other harm. Research regarding whether gender, socioeconomic status (SES) or locality play a role in young people’s alcohol consumption and related harm is limited in Australia. This study aimed to determine whether Victorian students’ patterns of alcohol uptake, consumption, and related harm differed between gender, SES and locality. Design/methodology/approach. The study involved secondary analysis of student data from the Drug Education in Victorian Schools (DEVS) harm minimization drug education program, undertaken in 21 Victorian government schools over three years The initial cohort of 1752 students was followed during years eight, nine and ten, when their average age would have respectively been 13, 14 and 15 years. Findings. There were no gender differences in drinking uptake, consumption or harm. Students with low SES were more likely to have consumed a full drink of alcohol and also experienced more alcohol related harm. Students living in a Regional/Rural area were more likely to have engaged in high alcohol consumption. Originality/value. The findings of this study highlighted that different student demographics have an impact on patterns of alcohol consumption, vulnerability and harm. Students with low SES, living in a Regional/Rural area, are more at risk than students with higher SES living in a Fringe Metro/Major Regional or Metro area. Future harm minimization drug education programs delivered in schools need toshould consider the needs of students with demographics that make them more susceptible to higher consumption and harm

How does reviewing the evidence change veterinary surgeons' beliefs regarding the treatment of ovine footrot? A quantitative and qualitative study

Footrot is a widespread, infectious cause of lameness in sheep, with major economic and welfare costs. The aims of this research were: (i) to quantify how veterinary surgeons’ beliefs regarding the efficacy of two treatments for footrot changed following a review of the evidence (ii) to obtain a consensus opinion following group discussions (iii) to capture complementary qualitative data to place their beliefs within a broader clinical context. Grounded in a Bayesian statistical framework, probabilistic elicitation (roulette method) was used to quantify the beliefs of eleven veterinary surgeons during two one-day workshops. There was considerable heterogeneity in veterinary surgeons’ beliefs before they listened to a review of the evidence. After hearing the evidence, seven participants quantifiably changed their beliefs. In particular, two participants who initially believed that foot trimming with topical oxytetracycline was the better treatment, changed to entirely favour systemic and topical oxytetracycline instead. The results suggest that a substantial amount of the variation in beliefs related to differences in veterinary surgeons’ knowledge of the evidence. Although considerable differences in opinion still remained after the evidence review, with several participants having non-overlapping 95% credible intervals, both groups did achieve a consensus opinion. Two key findings from the qualitative data were: (i) veterinary surgeons believed that farmers are unlikely to actively seek advice on lameness, suggesting a proactive veterinary approach is required (ii) more attention could be given to improving the way in which veterinary advice is delivered to farmers. In summary this study has: (i) demonstrated a practical method for probabilistically quantifying how veterinary surgeons’ beliefs change (ii) revealed that the evidence that currently exists is capable of changing veterinary opinion (iii) suggested that improved transfer of research knowledge into veterinary practice is needed (iv) identified some potential obstacles to the implementation of veterinary advice by farmers

Drug education in victorian schools (DEVS): the study protocol for a harm reduction focused school drug education trial

<p>Abstract</p> <p>Background</p> <p>This study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons.</p> <p>Methods/Design</p> <p>A cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds) and eight in year nine (14-15 year olds) that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials.</p> <p>Discussion</p> <p>The benefits of this drug education study derive both from the knowledge gained by trialling an optimum combination of innovative, harm reduction approaches with a large, student sample, and the resultant product. The research will provide better understanding of what benefits can be achieved by harm reduction education. It will also produce an intervention, dealing with both licit and illicit drug use that has been thoroughly evaluated in terms of its efficacy, and informed by teacher and student feedback. This makes available to schools a comprehensive drug education package with prevention characteristics and useability that are well understood.</p> <p>Trial registration</p> <p>Australia and New Zealand Clinical Trials Register (ANZCTR): <a href="http://www.anzctr.org.au/ACTRN12612000079842.aspx">ACTRN12612000079842</a></p

Investigation of rheumatoid arthritis susceptibility loci in juvenile idiopathic arthritis confirms high degree of overlap

&lt;p&gt;Objectives: Rheumatoid arthritis (RA) shares some similar clinical and pathological features with juvenile idiopathic arthritis (JIA); indeed, the strategy of investigating whether RA susceptibility loci also confer susceptibility to JIA has already proved highly successful in identifying novel JIA loci. A plethora of newly validated RA loci has been reported in the past year. Therefore, the aim of this study was to investigate these single nucleotide polymorphisms (SNP) to determine if they were also associated with JIA.&lt;/p&gt; &lt;p&gt;Methods: Thirty-four SNP that showed validated association with RA and had not been investigated previously in the UK JIA cohort were genotyped in JIA cases (n=1242), healthy controls (n=4281), and data were extracted for approximately 5380 UK Caucasian controls from the Wellcome Trust Case–Control Consortium 2. Genotype and allele frequencies were compared between cases with JIA and controls using PLINK. A replication cohort of 813 JIA cases and 3058 controls from the USA was available for validation of any significant findings.&lt;/p&gt; &lt;p&gt;Results: Thirteen SNP showed significant association (p&#60;0.05) with JIA and for all but one the direction of association was the same as in RA. Of the eight loci that were tested, three showed significant association in the US cohort.&lt;/p&gt; &lt;p&gt;Conclusions: A novel JIA susceptibility locus was identified, CD247, which represents another JIA susceptibility gene whose protein product is important in T-cell activation and signalling. The authors have also confirmed association of the PTPN2 and IL2RA genes with JIA, both reaching genome-wide significance in the combined analysis.&lt;/p&gt

Clinical outcomes and response to treatment of patients receiving topical treatments for pyoderma gangrenosum: a prospective cohort study

Background: pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment. Objective: to estimate the effectiveness of topical therapies in the treatment of PG. Methods: prospective cohort study of UK secondary care patients with a clinical diagnosis of PG suitable for topical treatment (recruited July 2009 to June 2012). Participants received topical therapy following normal clinical practice (mainly Class I-III topical corticosteroids, tacrolimus 0.03% or 0.1%). Primary outcome: speed of healing at 6 weeks. Secondary outcomes: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality-of-life; treatment failure and recurrence. Results: Sixty-six patients (22 to 85 years) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28/66 (43.8%) of ulcers healed by 6 months. Median time-to-healing was 145 days (95% CI: 96 days, ∞). Initial ulcer size was a significant predictor of time-to-healing (hazard ratio 0.94 (0.88;80 1.00); p = 0.043). Four patients (15%) had a recurrence. Limitations: No randomised comparator Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone