76 results on '"Tavener M"'
Search Results
2. Too late for prevention: the search for printed health promotion materials within the Preventive Care Trial
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Francis, L, Byles, JE, McKernon, ME, and Tavener, M
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- 1999
Catalog
3. How prepared is the retirement and residential aged care sector in Western Australia for older non-heterosexual people?
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Horner, Barbara, McManus, A, Comfort, J, Freijah, R, Lovelock, G, Hunter, M, and Tavener, M
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- 2012
4. UPTAKE AND EFFECTIVENESS OF PREVENTIVE HEALTH ASSESSMENTS: A STUDY OF 11,726 OLDER AUSTRALIAN WOMEN
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Byles, J., primary, Dolja Gore, X., additional, Nair, K., additional, Tavener, M., additional, Chojenta, C., additional, and Mishra, G., additional
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- 2017
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5. Impairment of colour vision in aircraft maintenance workers
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Guest, M., D'Este, C., Attia, J., Boggess, M., Brown, A., Tavener, M., Gibson, R., Gardner, I., Horsley, K., Harrex, W., and Faculty of Spatial Sciences
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- 2010
6. Hearing impairment in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel (SHOAMP) general health and medical study
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Guest, M., Boggess, M., Attia, J., D'Este, C., Brown, A., Gibson, R., Tavener, M., Gardner, I., Horsley, K., Ross, J., and Faculty of Spatial Sciences
- Published
- 2010
7. We don't have any of those people here: Retirement accommodation and aged care issues for non-heterosexual populations
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Comfort, Judith, Freijah, Rita, Horner, Barbara, Hunter, M., Lovelock, G., McManus, Alexandra, Tavener, M., Comfort, Judith, Freijah, Rita, Horner, Barbara, Hunter, M., Lovelock, G., McManus, Alexandra, and Tavener, M. more...
- Published
- 2010
8. Mental health in F-111 maintenance workers: the Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study.
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Attia JR, D'Este C, Schofield PW, Brown AM, Gibson R, Tavener M, Horsley K, Harrex W, Ross J, and SHOAMP Team
- Published
- 2006
9. Randomised controlled trial of health assessments for older Australian veterans and war widows
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julie Byles, Tavener, M., O Connell, Rl, Nair, Br, Higginbotham, Nh, Jackson, Cl, Mckernon, Me, Francis, L., Heller, Rf, Newbury, Jw, Marley, Je, and Goodger, Bg
10. How prepared is the retirement and residential aged care sector in Western Australia for older non-heterosexual people?
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Horner, B., Alexandra McManus, Comfort, J., Freijah, R., Lovelock, G., Hunter, M., and Tavener, M.
11. AN X-RAY SIMULATOR AS A TREATMENT PLANNING MACHINE.
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Tavener, M
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- 1966
12. "Uncovering the unspoken": a narrative analysis of patients' experiences with testicular cancer.
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Bultz BD, Kelly B, Rosberger Z, Forbes C, Railton C, Tavener M, Lloyd C, Stukalin I, White B, and Schulte FSM
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- Humans, Male, Adult, Young Adult, Narration, Qualitative Research, Social Support, Testicular Neoplasms psychology, Testicular Neoplasms therapy, Focus Groups, Adaptation, Psychological
- Abstract
Background: The aim of this study was to understand the experiences of young men with a diagnosis of testicular cancer (TC) using a narrative approach, with the intention of informing models of care and support in clinical services., Methods: TC patients were recruited to participate in one of four focus groups examining their lived experiences from diagnosis. Focus groups were recorded and transcribed and analyzed using a narrative approach., Results: A total of 4 focus groups were held from March to May 2019, involving 21 participants. Participants were currently on treatment (n = 2), < 2 years from treatment completion (n = 7), or > 2 years from treatment completion (n = 12). Two overarching meta-themes were identified: Negotiating Identity (comprising "recovery, repair and control"; "breaking the news"; "threats to fertility and virility"; "multiple masculinities") and Needing to Adjust (comprising "trauma and post-traumatic growth"; "facing vulnerability"; "managing to cope"; "secrecy vs. privacy"). Shared themes relating to environments for support, conversations about cancer, and time stress were also identified., Conclusions: Despite the significant cure rates for testicular cancer, the psychosocial needs of patients diagnosed with TC are paramount and potentially long-lasting. Improved clinical care for these patients includes exploration of both physical and psychosocial concerns over multiple timepoints. Opportunities for peer support and mentorship may be essential to support these vulnerable patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) more...
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- 2024
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13. "Wasting time": a qualitative study of stroke survivors' experiences of boredom in non-therapy time during inpatient rehabilitation.
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Kenah K, Tavener M, Bernhardt J, Spratt NJ, and Janssen H
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- Humans, Male, Female, Aged, Middle Aged, Aged, 80 and over, Interviews as Topic, Recovery of Function, Stroke psychology, Adult, Boredom, Stroke Rehabilitation, Qualitative Research, Survivors psychology, Inpatients
- Abstract
Purpose: Stroke survivors regularly report experiencing boredom during inpatient rehabilitation which may detrimentally affect mood, learning and engagement in activities important for functional recovery. This study explores how stroke survivors meaningfully occupy their non-therapy time and their experiences of boredom, to further our understanding of this complex phenomenon., Methods: Secondary analysis of transcripts from semi-structured interviews with stroke survivors exploring activity during non-therapy time. Transcripts were coded and analysed using a hybrid approach of inductive and deductive thematic analysis, guided by a published boredom framework., Results: Analysis of 58 interviews of 36 males and 22 females, median age 70 years, revealed four main themes: (i) Resting during non-therapy time is valued, (ii) Managing "wasted" time, (iii) Meaningful environments support autonomy and restore a sense of normality, and (iv) Wired to be social. Whilst limited therapy, social opportunities and having "nothing to do" were common experiences, those individuals who felt in control and responsible for driving their own stroke recovery tended to report less boredom during their rehabilitation stay., Conclusion: Creating rehabilitation environments that support autonomy, socialisation and opportunities to participate in activity are clear targets to reduce boredom during non-therapy time, increase meaningful engagement and possibly improve rehabilitation outcomes post-stroke. more...
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- 2024
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14. Longitudinal analysis of the Alternative Healthy Eating Index-2010 and incident non-communicable diseases over 15 years in the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health.
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Hlaing-Hlaing H, Dolja-Gore X, Tavener M, and Hure AJ
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- Female, Humans, Longitudinal Studies, Diet, Healthy, Australia epidemiology, Women's Health, Noncommunicable Diseases epidemiology, Hypertension, Asthma epidemiology
- Abstract
In studies that contain repeated measures of variables, longitudinal analysis accounting for time-varying covariates is one of the options. We aimed to explore longitudinal association between diet quality (DQ) and non-communicable diseases (NCDs). Participants from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) were included, if they; responded to survey 3 (S3, 2003, aged 25-30 years) and at least one survey between survey 4 (S4, 2006) and survey 8 (S8, 2018), were free of NCDs at or before S3, and provided dietary data at S3 or S5. Outcomes were coronary heart disease (CHD), hypertension (HT), asthma, cancer (except skin cancer), diabetes mellitus (DM), depression and/or anxiety, and multimorbidity (MM). Longitudinal modelling using generalised estimation equation (GEE) approach with time-invariant (S4), time-varying (S4-S8) and lagged (S3-S7) covariates were performed. The mean (± standard deviation) of Alternative Healthy Eating Index-2010 (AHEI-2010) of participants ( n = 8022) was 51·6 ± 11·0 (range: 19-91). Compared to women with the lowest DQ (AHEI-2010 quintile 1), those in quintile 5 had reduced odds of NCDs in time-invariant model (asthma: OR (95 % CI): 0·77 (0·62-0·96), time-varying model (HT: 0·71 (0·50-0·99); asthma: 0·62 (0·51-0·76); and MM: 0·75 (0·58-0·97) and lagged model (HT: 0·67 (0·49-0·91); and asthma: 0·70 (0·57-0·85). Temporal associations between diet and some NCDs were more prominent in lagged GEE analyses. Evidence of diet as NCD prevention in women aged 25-45 years is evolving, and more studies that consider different longitudinal analyses are needed. more...
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- 2024
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15. 'Nothing About Us Without Us': exploring benefits and challenges of peer support for people with disability in peer support organisations - protocol paper for a qualitative coproduction project.
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Duong J, Pryer S, Walsh C, Fitzpatrick A, Magill J, Simmonds S, Yang D, Baird-Peddie O, Rahman F, Hayter C, and Tavener M
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- Humans, Australia, New South Wales, Focus Groups, Language, Persons with Disabilities
- Abstract
Introduction: One in six people live with disability in Australia with higher levels of disability of people from diverse communities, such as those with culturally and linguistically diverse (CALD) backgrounds. In Australia, CALD refers to people from diverse ethnicity and cultures, nationalities, societal structures and religions that may or may not speak a language other than English. This study employs researchers with lived experience of disability and peer support to study the impact of peer support for people with disability, including people from CALD backgrounds, in two peer-led organisations in New South Wales (NSW) Australia., Methods and Analysis: This study uses participatory action research and inclusive research design with researchers with lived experience, having lived experience of disability and a peer in the disability community, leading the research.Over three years, three different groups will be recruited through Community Disability Alliance Hunter (CDAH) and Diversity and Disability Alliance (DDAlliance): (1) peers with disability, (2) peer leaders with disability and (3) researchers with lived experience of disability and peer support. Data collection and creation methods include semistructured interviews, surveys and focus groups. Qualitative data will be analysed using thematic analysis through the lens of the researchers with lived experience., Ethics and Dissemination: Ethical approval was granted by the University of Newcastle Human Research Ethics Committee (Approval No: H-2021-0088). Dissemination includes peer-reviewed publications, presentations at local, national and international conferences and written reports for user-led organisations, disability service providers, disability agencies and people with disability., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure at http://www.icmje.org/disclosure-of-interest/ and declare: financial support for the submitted work from the Australian Government Department of Social Services, Information Linkages and Capacity Building Program; MT has received an honorarium from DDAlliance and CDAH for academic input; CH was a consultant contracted by DDAlliance and CDAH to be a research adviser and project manager; JD, JM, DY, CW and FR were paid a casual salary as researchers with lived experience from DDAlliance; SP, AF, SS and OB-P were paid a casual salary as researchers with lived experience from CDAH., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) more...
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- 2023
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16. Using collaborative autoethnography to explore the teaching of qualitative research methods in medicine.
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Ibrahim K, Weller S, Elvidge E, and Tavener M
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- Humans, Qualitative Research, Students, Research Design, Teaching, Curriculum, Medicine
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This article explores experiences of teaching qualitative research (QR) broadly, and qualitative methods (QM) more specifically in medicine, highlighting the challenges faced, and offering recommendations for overcoming them. Using collective online interviews, collaborative autoethnography (CAE) was employed to generate data comprising educator's reflective accounts of teaching QM in medical schools across two continents. Three main themes were identified through collaborative thematic analysis: making meaningful contributions from a marginalized position; finding our pedagogical feet; and recognizing the translational applicability and value of QR. We reflected on the marginalized positioning of QM in medical curricula and the underestimation of the value of QR to understanding pressing health issues. Analysis of these reflections pointed to a lack of formal training for educators and curriculum space for qualitative approaches. Our teaching pedagogies, developed through our own research experiences, self-reflection and student feedback, were primarily student-centered employing a range of novel approaches designed to foster skills and interest in the craft of QR, and introduce a greater appreciation of the significance of QR approaches to medicine. CAE further allowed us to identify some key recommendations that could help medical educators plan for teaching QM and other research methods more effectively in medicine. Future curriculum development should consider the benefits of exposing learners to a range of methods and approaches from across the qualitative-quantitative spectrum., (© 2023. The Author(s).) more...
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- 2023
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17. Australian general practitioners' perspectives on integrating specialist diabetes care with primary care: qualitative study.
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Taylor R, Acharya S, Parsons M, Ranasinghe U, Fleming K, Harris ML, Kuzulugil D, Byles J, Philcox A, Tavener M, Attia J, Kuehn J, and Hure A
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- Adult, Humans, Australia epidemiology, Glycated Hemoglobin, Attitude of Health Personnel, Qualitative Research, Primary Health Care methods, General Practitioners, Diabetes Mellitus, Type 2 therapy
- Abstract
Background: Improving the coordination and integration of health services is recognised nationally and internationally as a key strategy for improving the quality of diabetes care. The Australian Diabetes Alliance Program (DAP) is an integrated care model implemented in the Hunter New England Local Health District (HNELHD), New South Wales (NSW), in which endocrinologists and diabetes educators collaborate with primary care teams via case-conferencing, practice performance review, and education sessions. The objective of this study was to report on general practitioners' (GPs) perspectives on DAP and whether the program impacts on their skills, knowledge, and approach in delivering care to adult patients with type 2 diabetes., Methods: Four primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and five practices with low rates of monitoring HbA1c levels (< 80% of patients annually) from HNELHD, NSW provided the sampling frame. A total of nine GPs were interviewed. The transcripts from the interviews were reviewed and analysed to identify emergent patterns and themes., Results: Overall, GPs were supportive of DAP. They considered that DAP resulted in significant changes in their knowledge, skills, and approach and improved the quality of diabetes care. Taking a more holistic approach to care, including assessing patients with diabetes for co-morbidities and risk factors that may impact on their future health was also noted. DAP was noted to increase the confidence levels of GPs, which enabled active involvement in the provision of diabetes care rather than referring patients for tertiary specialist care. However, some indicated the program could be time consuming and greater flexibility was needed., Conclusions: GPs reported DAP to benefit their knowledge, skills and approach for managing diabetes. Future research will need to investigate how to improve the intensity and flexibility of the program based on the workload of GPs to ensure long-term acceptability of the program., (© 2023. Crown.) more...
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- 2023
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18. Editorial: Home-based training to reduce upper limb functional impairment post-stroke.
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van Vliet P, Tavener M, van Wijck FM, and Alt Murphy M
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Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. more...
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- 2023
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19. Protocol paper for SMART OPS: Shared decision-making Multidisciplinary Approach - a Randomised controlled Trial in the Older adult Population considering Surgery.
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Ajitsaria P, Lott N, Baker A, Lacey J, Magnusson M, Douglas JL, Healey P, Tan-Gore E, Szwec SV, Barker D, Deeming S, Tavener M, Smith S, Gani J, and Attia J
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- Humans, Aged, Prospective Studies, Australia, Decision Making, Shared, Randomized Controlled Trials as Topic, Quality of Life, Surgeons
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Introduction: The Australian population presenting with surgical pathology is becoming older, frailer and more comorbid. Shared decision-making is rapidly becoming the gold standard of care for patients considering high-risk surgery to ensure that appropriate, value-based healthcare decisions are made. Positive benefits around patient perception of decision-making in the immediacy of the decision are described in the literature. However, short-term and long-term holistic patient-centred outcomes and cost implications for the health service require further examination to better understand the full impact of shared decision-making in this population., Methods: We propose a novel multidisciplinary shared decision-making model of care in the perioperative period for patients considering high-risk surgery in the fields of general, vascular and head and neck surgery. We assess it in a two arm prospective randomised controlled trial. Patients are randomised to either 'standard' perioperative care, or to a multidisciplinary (surgeon, anaesthetist and end-of-life care nurse practitioner or social worker) shared decision-making consultation. The primary outcome is decisional conflict prior to any surgical procedure occurring. Secondary outcomes include the patient's treatment choice, how decisional conflict changes longitudinally over the subsequent year, patient-centred outcomes including life impact and quality of life metrics, as well as morbidity and mortality. Additionally, we will report on healthcare resource use including subsequent admissions or representations to a healthcare facility up to 1 year., Ethics and Dissemination: This study has been approved by the Hunter New England Human Research Ethics Committee (2019/ETH13349). Study findings will be presented at local and national conferences and within scientific research journals., Trial Registration Number: ACTRN12619001543178., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) more...
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- 2023
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20. Task-specific training versus usual care to improve upper limb function after stroke: the "Task-AT Home" randomised controlled trial protocol.
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van Vliet P, Carey LM, Turton A, Kwakkel G, Palazzi K, Oldmeadow C, Searles A, Lavis H, Middleton S, Galloway M, Dimech-Betancourt B, O'Keefe S, and Tavener M
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Background: Sixty percent of people have non-functional arms 6 months after stroke. More effective treatments are needed. Cochrane Reviews show low-quality evidence that task-specific training improves upper limb function. Our feasibility trial showed 56 h of task-specific training over 6 weeks resulted in an increase of a median 6 points on the Action Research Arm test (ARAT), demonstrating the need for more definitive evidence from a larger randomised controlled trial. Task-AT Home is a two-arm, assessor-blinded, multicentre randomised, controlled study, conducted in the home setting., Aim: The objective is to determine whether task-specific training is a more effective treatment than usual care, for improving upper limb function, amount of upper limb use, and health related quality of life at 6 weeks and 6 months after intervention commencement. Our primary hypothesis is that upper limb function will achieve a ≥ 5 point improvement on the ARAT in the task-specific training group compared to the usual care group, after 6 weeks of intervention., Methods: Participants living at home, with remaining upper limb deficit, are recruited at 3 months after stroke from sites in NSW and Victoria, Australia. Following baseline assessment, participants are randomised to 6 weeks of either task-specific or usual care intervention, stratified for upper limb function based on the ARAT score. The task-specific group receive 14 h of therapist-led task-specific training plus 42 h of guided self-practice. The primary outcome measure is the ARAT at 6 weeks. Secondary measures include the Motor Activity Log (MAL) at 6 weeks and the ARAT, MAL and EQ5D-5 L at 6 months. Assessments occur at baseline, after 6 weeks of intervention, and at 6 months after intervention commencement. Analysis will be intention to treat using a generalised linear mixed model to report estimated mean differences in scores between the two groups at each timepoint with 95% confidence interval and value of p ., Discussion: If the task-specific home-based training programme is more effective than usual care in improving arm function, implementation of the programme into clinical practice would potentially lead to improvements in upper limb function and quality of life for people with stroke., Clinical Trial Registration: ANZCTR.org.au/ACTRN12617001631392p.aspx., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 van Vliet, Carey, Turton, Kwakkel, Palazzi, Oldmeadow, Searles, Lavis, Middleton, Galloway, Dimech-Betancourt, O'Keefe and Tavener.) more...
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- 2023
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21. Alternative Healthy Eating Index-2010 and Incident Non-Communicable Diseases: Findings from a 15-Year Follow Up of Women from the 1973-78 Cohort of the Australian Longitudinal Study on Women's Health.
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Hlaing-Hlaing H, Dolja-Gore X, Tavener M, James EL, and Hure AJ
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- Humans, Female, Adult, Middle Aged, Longitudinal Studies, Diet, Healthy, Prospective Studies, Cross-Sectional Studies, Follow-Up Studies, Australia epidemiology, Women's Health, Risk Factors, Noncommunicable Diseases epidemiology, Asthma epidemiology
- Abstract
Non-communicable diseases (NCDs) and multimorbidity (≥two chronic conditions), are increasing globally. Diet is a risk factor for some NCDs. We aimed to investigate the association between diet quality (DQ) and incident NCDs. Participants were from the Australian Longitudinal Study on Women's Health 1973-78 cohort with no NCD and completed dietary data at survey 3 (2003, aged 25-30 years) who responded to at least one survey between survey 4 (2006) and survey 8 (2018). DQ was measured by the Alternative Healthy Eating Index-2010 (AHEI-2010). Outcomes included coronary heart disease (CHD), hypertension (HT), asthma, cancer (excluding skin cancer), diabetes mellitus (DM), depression and/or anxiety, multimorbidity, and all-cause mortality. Repeated cross-sectional multivariate logistic regressions were performed to investigate the association between baseline DQ and NCDs over 15 years. The AHEI-2010 mean (±sd) for participants (n = 8017) was 51.6 ± 11.0 (range: 19-91). There was an inverse association between AHEI-2010 and incident asthma at survey 4 (OR
Q5-Q1 : 0.75, 95% CI: 0.57, 0.99). Baseline DQ did not predict the occurrence of any NCDs or multimorbidity between the ages of 25-45 years. Further well-planned, large prospective studies conducted in young women are needed to explore dietary risk factors before the establishment of NCDs. more...- Published
- 2022
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22. Food Insecurity and Functional Disability Among Older Adults in Ghana: The Role of Sex and Physical Activity.
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Awuviry-Newton K, Amoah D, Tavener M, Afram AA, Dintrans PV, Byles J, and Kowal P
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- Aged, Cross-Sectional Studies, Female, Food Insecurity, Ghana epidemiology, Humans, Male, Exercise, Food Supply
- Abstract
Objectives: We examined the associations between food insecurity and functional disability among older adults in Ghana and, the roles of sex and physical activity on the relationship., Design: A cross-sectional study design was employed., Setting and Participants: A total of 4446 older adults (50+ years of age) from the Study on Global Aging and Adult Health Ghana Wave 2, a countrywide study, was completed in 2015., Methods: Logistic regression models were used to examine the associations between measures of food insecurity and functional disability using data from Study on Global Aging and Adult Health Ghana Wave 2. Functional disability was assessed using World Health Organization Disability Assessment Schedule 2.0 composed of 12 items in 6 domains of cognition, mobility, self-care, getting along, life activities, and participation in society. Food insecurity was assessed from 12-month food sufficiency and experience of hunger over the last 12 months., Results: Approximately 11% were identified as having functional disability. The prevalence of food insecurity was 23.8% for insufficient food intake and 18.3% for hunger. Adjusting for all variables, older adults who reported consuming insufficient food (OR 2.27; 95% CI 1.57, 3.28), and those who experienced hunger (OR 2.35; 95% CI 1.59, 3.46) had higher odds of functional disability, compared with those not reporting these issues. Sex differences modified the association between hunger and functional disability. Physical activity served as a protective factor (OR 0.60; 95% CI 0.38, 0.95) on the association implying that older adults who engaged in physical activity were 40% less likely to experience food insecurity-induced functional disability., Conclusions and Implications: Food insecurity is associated with functional disability among older adults. Results highlight the usefulness of tackling the social determinants of health and promoting financial/social security in older age in a changing Ghanaian society., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.) more...
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- 2022
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23. Using ethics of care as the theoretical lens to understand lived experiences of caregivers of older adults experiencing functional difficulties.
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Awuviry-Newton K, Tavener M, Wales K, and Byles J
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- Aged, Ghana, Humans, Caregivers
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The lived experiences of caregivers of older adults in Ghana are not well understood. The purpose of this study was to explore and discuss the lived experiences of these caregivers using the Ethics of Care as a theoretical lens and Interpretative phenomenological analysis as the methodological approach. Ten caregivers in receipt of social welfare services on behalf of older adults were recruited from the Social Welfare Unit at the Komfo Anokye Teaching Hospital (KATH) in southern Ghana. The analysis identified five interrelated themes: 1) committing the Self to caregiving; 2) caregiving impacting the Self; 3) motivating factors to caregiving; 4) caregiving burdens, and 5) thinking about personal affairs. Their experiences demonstrate that caregivers value the caregiving relationship, as posited by Ethics of Care, and tend to care for their health and well-being. Caregivers' expression of commitment to caring for older adults is mainly influenced by reciprocity, despite internal and external stressors, and desire to fulfil unmet personal needs. Ethics of care offers an understanding of the lived experiences of caregivers of older adults in Ghana. The findings draw attention to the state to develop specific programs to ensure the health, social and financial well-being of older adults' caregivers., Competing Interests: The authors have declared that no competing interests exist. more...
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- 2022
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24. C-reactive protein-guided use of procalcitonin in COVID-19.
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Houghton R, Moore N, Williams R, El-Bakri F, Peters J, Mori M, Vernet G, Lynch J, Lewis H, Tavener M, Durham T, Bowyer J, Saeed K, and Pollara G
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Background: A low procalcitonin (PCT) concentration facilitates exclusion of bacterial co-infections in COVID-19, but high costs associated with PCT measurements preclude universal adoption. Changes in inflammatory markers, including C-reactive protein (CRP), can be concordant, and predicting low PCT concentrations may avoid costs of redundant tests and support more cost-effective deployment of this diagnostic biomarker., Objectives: To explore whether, in COVID-19, low PCT values could be predicted by the presence of low CRP concentrations., Methods: Unselected cohort of 224 COVID-19 patients admitted to hospital that underwent daily PCT and CRP measurements as standard care. Both 0.25 ng/mL and 0.5 ng/mL were used as cut-offs for positive PCT test results. Geometric mean was used to define high and low CRP values at each timepoint assessed., Results: Admission PCT was <0.25 ng/mL in 160/224 (71.4%), 0.25-0.5 ng/mL in 27 (12.0%) and >0.5 ng/mL in 37 (16.5%). Elevated PCT was associated with increased risk of death ( P = 0.0004) and was more commonly associated with microbiological evidence of bacterial co-infection ( P < 0.0001). For high CRP values, significant heterogeneity in PCT measurements was observed, with maximal positive predictive value of 50% even for a PCT cut-off of 0.25 ng/mL. In contrast, low CRP was strongly predictive of low PCT concentrations, particularly <0.5 ng/mL, with a negative predictive value of 97.6% at time of hospital admission and 100% 48 hours into hospital stay., Conclusions: CRP-guided PCT testing algorithms can reduce unnecessary PCT measurement and costs, supporting antimicrobial stewardship strategies in COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.) more...
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- 2021
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25. Mixed Method Evaluation of a Graduate Student Teaching and Learning Internship Program.
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Tavener M, Majeed T, Bagade T, Weaver N, Reeves P, Dsilva S, and James EL
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- Clinical Competence, Curriculum, Humans, Students, Surveys and Questionnaires, Internship and Residency
- Abstract
In recognition of the need to better prepare doctoral candidates with teaching and learning competencies, we devised an innovative internship program in the form of a structured apprenticeship and trialed it in public health higher education. The paid internship was comprised of: (i) Mentoring from an experienced educator, (ii) Structured program of education in pedagogy and curriculum design, and (iii) Opportunities for applied experience. Eleven interns completed the apprenticeship in its first 2 years. The mixed method evaluation assessed the impact of the internship on knowledge, skills, and confidence of interns throughout the internship, and included a cost-consequence analysis. Data collection included surveys and face-to-face interviews with interns and mentors. Changes in intern knowledge and skills were analyzed by intern self-ratings pre- and post-internship on 11 performance descriptors. All interns indicated improvement in at least one area of teaching. Interviews indicated general satisfaction, however raised incompatibilities between the unstructured nature of mentoring and intern expectations and preferences. The economic analysis calculated a cost-offset associated with intern-delivered teaching activities of $58,820 (AUD, 2019). The total cost of the program was calculated to be $70,561 (comprising mentor investment AUD$20,436, intern investment AUD$15,126, scholarship "top-up" payment of $5,000 paid to each of the 7 interns AUD $35,000). This Internship is associated with positive impacts for interns across a range of domains at a net total investment of $11,741., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tavener, Majeed, Bagade, Weaver, Reeves, Dsilva and James.) more...
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- 2021
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26. Diet Quality and Incident Non-Communicable Disease in the 1946-1951 Cohort of the Australian Longitudinal Study on Women's Health.
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Hlaing-Hlaing H, Dolja-Gore X, Tavener M, James EL, Hodge AM, and Hure AJ
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- Adult, Australia epidemiology, Diet, Female, Humans, Longitudinal Studies, Middle Aged, Women's Health, Diet, Mediterranean, Noncommunicable Diseases epidemiology
- Abstract
Diet quality indices (DQIs) can be useful predictors of diet-disease relationships, including non-communicable disease (NCD) multimorbidity. We aimed to investigate whether overall diet quality (DQ) predicted NCD, multimorbidity, and all-cause mortality. Women from the 1945-51 cohort of the Australia Longitudinal Study on Women's Health (ALSWH) were included if they: responded to S3 in 2001 and at least one survey between 2004 (S4) and 2016 (S8), and had no NCD history and complete dietary data at S3. DQ was summarized by the Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), Mediterranean Diet Score (MDS), and Alternative Healthy Eating Index-2010 (AHEI-2010). Outcomes included each NCD (diabetes mellitus (DM), coronary heart disease (CHD), hypertension (HT), asthma, cancer (except skin cancer), depression and/or anxiety) independently, multimorbidity, and all-cause mortality. Repeated multivariate logistic regressions were used to test associations between DQIs and NCD outcomes across the 15 years of follow-up. The mean (±sd) of DQIs of participants ( n = 5350) were 57.15 ± 8.16 (HEIFA-2013); 4.35 ± 1.75 (MDS), and 56.01 ± 10.32 (AHEI-2010). Multivariate regressions indicated that women reporting the highest quintile of AHEI-2010 had lower odds of DM (42-56% (S5-S8)), HT (26% (S8)), asthma (35-37% (S7, S8)), and multimorbidity (30-35% (S7, S8)). The highest quintile of HEIFA-2013 and MDS had lower odds of HT (26-35% (S7, S8); 24-27% (S6-S8), respectively) and depression and/or anxiety (30% (S6): 30-34% (S7, S8)). Our findings support evidence that DQ is an important predictor of some NCDs and a target for prevention in middle-aged women. more...
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- 2021
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27. The roles and capacities of social workers in the lives of older adults seeking healthcare and their caregivers in Ghana.
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Awuviry-Newton K, Tavener M, Wales K, and Byles J
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- Aged, Delivery of Health Care, Ghana, Humans, Qualitative Research, Caregivers, Social Workers
- Abstract
As Ghana's older population increases in number and proportion, the social and healthcare needs of older adults and their caregivers become more critical highlighting the relevance of social workers' contribution in assisting older adults and their caregivers. The purpose of this study was to explore social workers' contributions, discussed against the International Federation of Social Workers (IFSW) Policy on Ageing and Older Person framework. The study employed a descriptive qualitative approach making use of semi-structured interviews to collect information from eight social workers at the Social Welfare Unit in Komfo Anokye Teaching Hospital in Ghana. Themes and codes were developed from the interviews using thematic analysis, employing In-vivo and descriptive coding, and N-Vivo v12 as a management tool. Analysis of interviews revealed three interrelated themes; (a) "We provide it accordingly": Talking about their contributions as systematic, (b) "I think we can do more": Talking about their contributions as insufficient, and (c) "Our efforts are being hampered": Complaints of inadequate resources for working with older adults and their caregivers. The study offers areas of opportunities for social workers per the IFSW policy framework to reflect and examine their current knowledge and skill to address the challenges population ageing presents in Ghana. While social workers contribute towards helping older adults seeking healthcare and their caregivers, their needs cannot be ignored. The findings draw attention to effective policies and programs that can provide social workers with the needed resources to be independent and be able to devise novel approaches unique to older adults and their caregivers., (© 2020 John Wiley & Sons Ltd.) more...
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- 2021
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28. Diet Quality Indices Used in Australian and New Zealand Adults: A Systematic Review and Critical Appraisal.
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Hlaing-Hlaing H, Pezdirc K, Tavener M, James EL, and Hure A
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- Adult, Australia, Humans, New Zealand, Diet Surveys methods, Diet, Healthy methods, Nutrition Assessment, Nutrition Policy
- Abstract
Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critically appraise all DQI used within Australian and New Zealand adult populations. Twenty-five existing DQI were identified by electronic searching in Medline and hand searching of reference lists. DQI were constructed based on the respective national dietary guidelines and condition-specific recommendations. For preferable features of DQI, six captured the dimensions of adequacy, moderation and balance; five had a nested structure; 12 consisted of foods, food groups and nutrients; 11 used metric scoring systems and most of those with metric scales used normative cutoff points. Food frequency questionnaires, either alone or with other methods, were the most common dietary assessment method used in 20 DQI. For evaluation of DQI, construct validity and relative validity are reported. Based on our critical appraisal, Dietary Guideline Index (DGI), Dietary Guideline Index-2013 (DGI-2013), Total Diet Score (TDS), Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), and Aussie-Diet Quality Index (Aussie-DQI) were the preferred DQI used in Australian adults according to dimension, indicator selection, scoring criteria and evaluation. Further work is needed to enhance the construction of all Australian and New Zealand DQI, especially in terms of dimension and structure, for alignment with recommended construction criteria. more...
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- 2020
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29. A 15-year follow-up study on long-term adherence to health behaviour recommendations in women diagnosed with breast cancer.
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Tollosa DN, Holliday E, Hure A, Tavener M, and James EL
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- Body Mass Index, Breast Neoplasms diagnosis, Breast Neoplasms rehabilitation, Breast Neoplasms therapy, Female, Follow-Up Studies, Humans, Longitudinal Studies, Middle Aged, Prognosis, Survival Rate, Women's Health, Breast Neoplasms psychology, Cancer Survivors psychology, Exercise, Health Behavior, Healthy Lifestyle
- Abstract
Background: Whilst a cancer diagnosis may prompt health behaviour change, there is limited evidence regarding whether such changes are maintained in the long-term. We aimed to investigate the impact of cancer diagnosis on health behaviour changes over the long-term survivorship period among breast cancer survivors (BCSs)., Methods: The sample comprised 153 BCSs and 4778 cancer-free women, aged 49-55 years in 2001 (our baseline), from the 1946-1951 birth cohort of the Australian Longitudinal Study on Women's Health. Health behaviours (physical activity, smoking, alcohol, diet and Body Mass Index), recommended by the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR), were assessed in five survivorship periods: ≤ 3 years, 3 to ≤ 6 years, 6 to ≤ 9 years, 9 to ≤ 12 years, and 12 to 15 years since diagnosis. A validated semi-quantitative Food Frequency Questionnaire was used for dietary assessment. Pre-diagnosis (baseline) health behaviours of BCSs and cancer-free women were compared (using Generalized Linear Models (GLM)). Multilevel (mixed effect) models were used for longitudinal data in BCSs., Results: There was no significant difference in health behaviours between BCSs (prior to diagnosis) and cancer-free women. Following diagnosis, BCSs were significantly more physically active (≥ 600 MET min/week; 50.8% to 63.3%; p = 0.02) and consumed more fruit (≥ 2 serves/day; 57.4% to 66.4%; p = 0.01) in the recent survivorship period, but were less likely to be classified in the healthy weight range (p < 0.01). The proportion of non-drinkers and non-smokers slightly increased over the survivorship period. Whole-vegetable intake did not significantly change; however, the intake of non-starchy vegetables significantly increased from pre-diagnosis (LS mean = 89.1 g/day) to post-diagnosis, 6 to ≤ 9 years (LS mean = 137.1 g/day), and 9 to ≤ 12 years (LS mean = 120.8 g/day). There were no significant changes in the total intake of fibre, carotenoids, calcium, fat, saturated fat, vitamin C, or vitamin E observed, except for increased total energy intake (p = 0.012)., Conclusion: Before diagnosis, BCSs had similar adherence to health behaviours compared to cancer-free women. Initial positive changes to health behaviours were observed post BC diagnosis, except healthy body weight, but maintenance of such changes over the long-term was poor. BCSs may benefit from additional advice and support to make healthy lifestyle choices throughout survivorship. more...
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- 2020
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30. Do factors across the World Health Organisation's International Classification of Functioning, Disability and Health framework relate to caregiver availability for community-dwelling older adults in Ghana?
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Awuviry-Newton K, Wales K, Tavener M, and Byles J
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- Aged, Female, Ghana, Humans, Male, Surveys and Questionnaires, Caregivers statistics & numerical data, Independent Living, International Classification of Functioning, Disability and Health
- Abstract
Introduction: In Ghana, the care needs of older adults in the later years has become a critical issue given population ageing and increased proportions of older adults with difficulties with functional abilities. However, factors related to caregiver availability is unknown. The purpose of this study was to examine how the World Health Organisation's International Classification of Functioning, Disability and Health (WHO-ICF) framework relates to caregiver availability for community-dwelling older adults in Ghana. This evidence will strengthen our understanding of the perceived unmet care needs of older adults in Ghana in Africa., Materials and Methods: A hospital-based survey was conducted among 400 consecutively recruited older adult in-patients using a questionnaire at Komfo Anokye Teaching Hospital in southern Ghana. Multivariate logistic regression tested associations between caregiver availability and other factors as related to the WHO-ICF conceptual framework., Results: Eighty-six per cent of the participants reported having an available caregiver. In the final parsimonious model, the environmental factors were highly related to caregiver availability, seconded by personal factors, and then health conditions. Body function and structure, activity, and participation variables were not statistically significant. Overall, the variables that were associated with caregiver availability were age, being a widow, having a single chronic condition, being hardly understood by friends and family, receiving no neighbourhood support, and having 2-4 children. Interaction existed between being a widow and living as a couple in relation to caregiver availability., Conclusions: Caregiver availability is associated with variables under the personal, health and environmental components of the WHO-ICF. Increased effort to strengthen the current and future welfare programs, including the health of older adults and their caregivers is relevant., Competing Interests: The authors have declared that no competing interests exist. more...
- Published
- 2020
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31. Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross-sectional analysis over 15 years.
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Tollosa DN, Holliday E, Hure A, Tavener M, and James EL
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- Aged, Cross-Sectional Studies, Exercise, Female, Follow-Up Studies, Humans, Life Style, Longitudinal Studies, Middle Aged, Neoplasms diagnosis, Prognosis, Prospective Studies, Surveys and Questionnaires, Survival Rate, Time Factors, Cancer Survivors psychology, Health Behavior, Neoplasms psychology, Quality of Life, Women's Health
- Abstract
Background: Cancer diagnosis may be a cue for health behavior change. Previous research that assessed the impact of a cancer diagnosis on multiple health behavior (MHB) change is limited by small sample size, cross-sectional study design, and a focus on individual rather than multiple behaviors. This study investigated the impact of a cancer diagnosis on compliance with MHB recommendations., Methods: Data from Australian Longitudinal Study on Women's Health (ALSWH) were utilized. Compliance with MHB was assessed by cancer survivorship period; 0-3 years pre-diagnosis, 0-3 years postdiagnosis, 4-12 years postdiagnosis, and compared to controls. A MHB score based on the WCRF/AICR guidelines was calculated for six behaviors (physical activity, smoking, alcohol, BMI, fruit, and vegetable intake); scores ranged from 0 to 6, with a higher score indicating higher compliance. Generalized estimating equation (GEE) was used for statistical analysis., Results: Participants comprised 7585 women from the 2001 ALSWH survey, of whom 2285 developed cancer during 15 years of follow-up. Compared to controls, the mean MHB score was slightly lower (Mean Difference (MD) = -0.015, P > .05) in survivors pre-diagnosis, after adjusting for confounders; however, the compliance score increased during postdiagnosis, with the mean difference score being significantly higher in recent survivors (0-3 years post diagnosis; MD = 0.055, P < .01). Likewise, within cancer survivors, the mean compliance score significantly increased 0-3 years postdiagnosis (MD = 0.07, P < .05) compared to pre-diagnosis, but this significant improvement was not maintained over the longer term (MD = 0.037, P > .05)., Conclusion: In this sample, survivors had higher MHB score than controls. A cancer diagnosis may provide a teachable moment for health behavior change in the period immediately following diagnosis, but this effect was not sustained during longer-term survivorship., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.) more...
- Published
- 2020
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32. Interpretative Phenomenological Analysis of the Lived Experiences of Older Adults Regarding Their Functional Activities in Ghana.
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Awuviry-Newton K, Tavener M, Wales K, and Byles J
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- Aged, Ghana, Humans, Persons with Disabilities, Health Status
- Abstract
Introduction: Research on disability largely draws on epidemiological data, often conducted in more developed countries. To date, there is little research related to older adults in Ghana, Africa. The purpose of this study was to strengthen understanding of how older adults in Ghana perform functional activities, referenced against the World Health Organization's International Classification of Functioning, Disability and Health (WHO-ICF) framework. Methods: Interpretative phenomenological analysis (IPA) of semistructured interview data was employed as the methodological approach. Using purposive criterion sampling, 8 older adults admitted to Komfo Anokye Teaching Hospital in Ghana, presenting with any identified health condition and/or frailty were recruited. Results: Analysis of interview data identified 5 interrelated themes: (1) feeling anxious, (2) feeling restricted, (3) understanding and admitting difficulty, (4) striving to be healthy and being productive, and (5) managing functional difficulty. These concerns were classified and related to the WHO-ICF, particularly the contextual factors. Discussion: This study examined in detail experiences of older adults performing functional activities. Our study highlights the relevance of the WHO-ICF framework for understanding the health needs of older adults, emphasizing the functional, social, and environmental factors influencing the functional status of older adults. The findings offer unique insight into the health needs of older adults, drawing attention to the implications for policy and care. more...
- Published
- 2020
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33. Adherence to multiple health behaviours in cancer survivors: a systematic review and meta-analysis.
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Tollosa DN, Tavener M, Hure A, and James EL
- Subjects
- Adult, Female, Healthy Lifestyle, Humans, Middle Aged, Risk Assessment, Survival Analysis, Cancer Survivors psychology, Health Behavior physiology, Neoplasms mortality, Quality of Life psychology
- Abstract
Purpose: Multiple health behaviours (not smoking, minimal alcohol consumption, and maintaining a healthy weight by having a healthy diet and regular physical activity) improve quality of life and longevity of cancer survivors. Despite international guidelines, there are no existing reviews that synthesise cancer survivors' adherence to healthy lifestyle recommendations., Method: Five databases (Embase, MEDLINE, PsycINFO, Web of Science, and Google Scholar) were searched for relevant articles published from 2007 until January 2018. Studies reporting adult cancer survivors' adherence to at least two lifestyle behaviours (body mass index, physical activity, smoking, fruit and vegetable intake, fiber intake, red meat intake, caloric intake, sodium intake, and alcohol consumption) based on the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations were included in the review. The pooled prevalence of adherence to single and multiple behaviours was calculated using a random-effects model. Subgroup analysis (mean years of survival and publication year) was undertaken., Results: A total of 3322 articles were identified. Of these, 51 studies matched the inclusion criteria, presenting data from 2,620,586 adult cancer survivors. Adherence to single behaviours, which was estimated from studies that assessed at least two health behaviours, was highest for not smoking (PE 87%; 95% CI, 85%, 88%) and low or no alcohol intake (PE 83%; 95% CI, 81%, 86%), and lowest for fiber intake (PE 31%; 95% CI, 21%, 40%). Adherence to multiple healthy behaviours (13 studies), ranged from 7 to 40% (pooled estimate (PE) 23%; 95% CI, 17%, 30%). Recent survivors (< 5-year survival time) had relatively better adherence to multiple behaviours (PE 31%; 95% CI, 27%, 35%) than long-term (> 5 years) survivors (PE 25%; 95% CI, 14%, 36%). Adherence to multiple behaviours improved over time since 2007., Conclusion: Adherence to physical activity, dietary, and multiple lifestyle behaviours recommendations was low amongst cancer survivors. Recent cancer survivors were relatively more adherent to WCRF/AICR recommendations compared to long-term survivors., Implications for Cancer Survivors: Health promotion programs help support healthy lifestyle behaviours of cancer survivors. PROSPERO registration number: CRD42018091663. more...
- Published
- 2019
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34. Compliance with Multiple Health Behaviour Recommendations: A Cross-Sectional Comparison between Female Cancer Survivors and Those with no Cancer History.
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Tollosa DN, Tavener M, Hure A, and James EL
- Subjects
- Aged, Australia, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Middle Aged, Cancer Survivors statistics & numerical data, Health Behavior, Patient Compliance statistics & numerical data, Women's Health statistics & numerical data
- Abstract
Lifestyle behaviours have an important role in preventing cancer, reducing treatment side effects, and improving survival and quality of life for cancer survivors. This study investigated adherence to multiple lifestyle behaviours among women with and without a cancer history. From the Australian Longitudinal Study on Women's Health (ALSWH) surveys, 2407 cancer survivors and 3896 controls (cancer free population) were identified. Based on the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations, adherence to six health behaviours (smoking, physical activity, fruit and vegetable intake, alcohol consumption, sugary drink intake, and Body Mass Index [BMI]) were assessed. Overall adherence was low, and there were no differences between survivors and controls on adherence to any of the six individual health behaviours. However, both recent and long-term cancer survivors were more likely than controls to adhere to multiple health behaviours ( p < 0.05). When participants with melanoma or non-melanoma skin cancer were excluded, adherence was less likely (but not significant) in the cancer group than controls. Higher education ( p < 0.01), being married ( p < 0.01), and lower comorbidity of chronic illnesses ( p < 0.01) were significantly associated with adherence to multiple lifestyle behaviours. Overall, the findings suggest that a cancer diagnosis may result in increased compliance with multiple health behaviour guidelines. more...
- Published
- 2019
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35. Patterns of geriatric health assessment use among community dwelling older Australian women over a 14-year period.
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Majeed T, Tavener M, Dolja-Gore X, Nair B, Chojenta C, and Byles J
- Subjects
- Aged, Aged, 80 and over, Australia, Female, Humans, Patient Acceptance of Health Care, Prospective Studies, Geriatric Assessment methods, Health Status, Independent Living, Women's Health
- Abstract
Objective: To assess which older Australian women had Medicare subsidized health assessments between 1999 and 2013., Methods: This study used prospective, longitudinal survey data from the 1921 to 1926 birth cohort of Australian Longitudinal Study on Women's Health (ALSWH) linked with Medicare Australia data on health services use. Over 11,000 Australian women were included in the study. Latent class analysis was used to identify assessment patterns over time, accounting for death, and based on three categories ('no assessment'; 'assessment; 'deceased') for each year between 1999 and 2013. Further analysis explored the impact of health and sociodemographic characteristics on class membership., Results: Of the women included in the latent class analysis, 37% never had any assessment and the remainder had had at least one assessment. After a steady uptake from 1999 to 2003, there was decline in uptake from 2003 onwards. A six-class model with sufficient homogeneity and reliable estimation was selected to represent assessment patterns and mortality risk, labelled as: 'high mortality' rate with little chance for assessment (12.4%), 'intermediate mortality, low assessment' (14.1%), 'later mortality/low assessment' (13.1%), 'later mortality, high assessment' (7.0%), 'low mortality, low assessment' (31.8%), 'low mortality, high assessment' (21.6%). Older women with certain conditions (such as diabetes, depression, heart disease) were more likely to be in the low assessment groups, and women with difficulty managing on income were more likely to be in low assessment groups., Conclusion: Distinct assessment and mortality patterns were seen, with many women not having assessment, in particular those who had certain health conditions, were taking 3+ medications, had difficulty in managing on income, needed help or were in respite care, and had caring responsibilities. The findings point to a need to promote these assessments among older women, and to reduce financial barriers, even within the context of a heavily subsidized health care system. more...
- Published
- 2019
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36. Postural Orthostatic Tachycardia Syndrome during pregnancy: A systematic review of the literature.
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Morgan K, Chojenta C, Tavener M, Smith A, and Loxton D
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- Female, Humans, Pregnancy, Delivery, Obstetric methods, Postural Orthostatic Tachycardia Syndrome therapy, Pregnancy Complications therapy
- Abstract
Purpose: Postural Orthostatic Tachycardia Syndrome is most commonly seen in women of child bearing age, however little is known about its effects in pregnancy., Method: A systematic review was conducted in March 2015 and updated in February 2018. Medline, Embase, PsychInfo, CINHAL, and the Cochrane Library were searched from database inception. The ClinicalTrials.gov site and bibliographies were searched. MeSH and Emtree headings and keywords included; Postural Orthostatic Tachycardia Syndrome, Postural Tachycardia Syndrome, and were combined with pregnancy and pregnancy related subject headings and keywords. Searches were limited to English. Eligible articles contained key words within the title and or abstract. Articles were excluded if Postural Orthostatic Tachycardia Syndrome was not pre-existing., Results: Eleven articles were identified as eligible for inclusion. Studies were appraised using the PRISMA 2009 guidelines. The overall quality of evidence was poor using the NHMRC Evidence Grading Matrix, which was attributed to small sample sizes and mostly observational studies, emphasizing the need for future high quality research. Findings in this review must be used with caution due to the poor quality of the literature available., Conclusions: Postural Orthostatic Tachycardia Syndrome should not be a contraindication to pregnancy. Symptom course is variable during pregnancy and the post-partum period. Continuing pre-conception medication may help symptoms, with no significant risks reported. Obstetric complications, not Postural Orthostatic Tachycardia Syndrome, should dictate mode of delivery. Postural Orthostatic Tachycardia Syndrome did not appear to affect the rate of adverse events. These results are important in determining appropriate management and care in this population., (Copyright © 2018 Elsevier B.V. All rights reserved.) more...
- Published
- 2018
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37. Contextualizing urban living as a determinant of women's health in Jakarta, Indonesia.
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Christiani Y, Tavener M, and Byles JE
- Subjects
- Adolescent, Adult, Aged, Arthritis, Female, Focus Groups, Health Status, Health Status Indicators, Humans, Hypertension, Indonesia epidemiology, Middle Aged, Qualitative Research, Young Adult, Cities, Social Determinants of Health, Urban Health, Women's Health
- Abstract
Big cities can offer great opportunities for women to have a better life. At the same time, however, the physical and social environment in cities can negatively affect their health. We conducted focus groups with 24 women (aged 18-72 years) living in Jakarta, Indonesia from October to November 2014. Our aim was to elicit women's experiences of living in Jakarta, including their health and accessing health care. The most frequent health problems reported by women in this study were hypertension and arthritis. Women often gave priority to their family, particularly their children, over themselves and their own health. Discussants also thought that the city's physical and social conditions could affect their health, and that women were more prone to feel stress than men. The results of this study highlight the importance of addressing social determinants of health across the life course, including gender, to improve women's health status. Moreover, multi-sectoral collaboration at the municipal and national level is needed for urban planning to create better living conditions for women in the cities. more...
- Published
- 2017
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38. Uptake, prevalence and predictors of first-time use for the 75+ Health Assessment Scheme.
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Dolja-Gore X, Tavener M, Majeed T, Nair BR, and Byles JE
- Subjects
- Aged, Aged, 80 and over, Australia, Female, Health Behavior, Health Status, Humans, Life Tables, Longitudinal Studies, Multivariate Analysis, National Health Programs, Patient Acceptance of Health Care psychology, Private Sector, Health Status Indicators, Patient Acceptance of Health Care statistics & numerical data, Women's Health statistics & numerical data
- Abstract
In 1999, the Australian Federal Government introduced Medicare items for Health Assessments for people aged 75 years and older (75+ health assessments). This research examined uptake of these assessments and identified predictors of use by women from the Australian Longitudinal Study on Women's Health (ALSWH). Assessments were identified for each year from 1999 to 2013 using linked Medicare data. Time to first assessment was examined, as well as social and health factors associated with having an assessment. From 1999 to 2013, 61.8% of women had at least one assessment. Almost one-third had an assessment within 2 years of their introduction, 25% of women died before having an assessment and 13% survived but did not have an assessment. Factors associated with assessment included being widowed, private health insurance, marital status, education, having arthritis and urinary incontinence, and less difficulty managing on income. Many women never received an assessment, and many only received one. Promotion of the 75+ health assessments is necessary among older women to increase uptake. more...
- Published
- 2017
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39. Work after age 65: A prospective study of Australian men and women.
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Majeed T, Forder PM, Tavener M, Vo K, and Byles J
- Subjects
- Age Factors, Aged, Aged, 80 and over, Educational Status, Female, Health Status, Humans, Male, Prospective Studies, Employment
- Abstract
Objective: This study describes hours in paid work for Australian men and women aged over 65, focusing on associations between work and education., Methods: Data were analysed separately for men and women, from baseline and first follow-up surveys of the 45 and Up Study. Generalised estimating equation models were used to identify associations between work, education and other factors over time., Results: The odds of doing paid work increased with higher education level and decreased with time, age, poorer physical function and having health conditions (high blood pressure, diabetes, stroke and breast cancer). Un-partnered women were more likely to work in later life than partnered women., Conclusion: This study quantifies the importance of education and health factors in determining continued participation of Australian men and women in paid work in later life. These factors need to be considered for policies aiming to increase workforce participation beyond 65 years of age., (© 2017 AJA Inc.) more...
- Published
- 2017
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40. The dynamic of non-communicable disease control policy in Indonesia.
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Christiani Y, Dugdale P, Tavener M, and Byles JE
- Subjects
- Developing Countries, Humans, Indonesia epidemiology, Interviews as Topic, Noncommunicable Diseases epidemiology, Health Policy, Noncommunicable Diseases prevention & control
- Abstract
Objective The aim of the present study was to examine non-communicable disease (NCD) policy formation and implementation in Indonesia. Methods Interviews were conducted with 13 Indonesian health policy workers. The processes and issues relating to NCD policy formation were mapped, exploring the interactions between policy makers, technical/implementation bodies, alliances across various levels and the mobilisation of non-policy actors. Results Problems in NCD policy formation include insufficient political interest in NCD control, disconnected policies and difficulty in multisectoral coordination. These problems are well illustrated in relation to tobacco control, but also apply to other control efforts. Nevertheless, participants were optimistic that there are plentiful opportunities for improving NCD control policies given growing global attention to NCD, increases in the national health budget and the growing body of Indonesia-relevant NCD-related research. Conclusion Indonesia's success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries. What is known about the topic? The burden of NCD in Indonesia has increased gradually. Nationally, NCD-related mortality accounted for 65% of deaths in 2010. Indonesia is also a country with the highest burden of tobacco smoking in the world. However, the government has not instituted sufficient policy action to tackle NCDs, including tobacco control. What does this paper add? This paper deepens our understanding of current NCD control policy formation in Indonesia, including the possible underlying reason why Indonesia has weak tobacco control policies. It describes the gaps in the current policies, the actors involved in policy formation, the challenges in policy formation and implementation and potential opportunities for improving NCD control. What are the implications for practitioners? An effective NCD control program requires strong collaboration, including between government and health professionals. Health professionals can actively engage in policy formation, for example through knowledge production. more...
- Published
- 2017
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41. Health insurance coverage among women in Indonesia's major cities: A multilevel analysis.
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Christiani Y, Byles JE, Tavener M, and Dugdale P
- Subjects
- Adolescent, Adult, Aged, Cities, Female, Health Services Needs and Demand, Health Surveys, Healthcare Disparities, Humans, Indonesia, Middle Aged, Socioeconomic Factors, Young Adult, Health Services Accessibility statistics & numerical data, Insurance Coverage statistics & numerical data, Insurance, Health statistics & numerical data, Women's Health economics
- Abstract
We examined women's access to health insurance in Indonesia. We analyzed IFLS-4 data of 1,400 adult women residing in four major cities. Among this population, the health insurance coverage was 24%. Women who were older, involved in paid work, and with higher education had greater access to health insurance (p < .05). We also found there were disparities in the probability of having health insurance across community levels (Median Odds Ratios = 3.40). Given the importance of health insurance for women's health, strategies should be developed to expand health insurance coverage among women in Indonesia, including the disparities across community levels. Such problems might also be encountered in other developing countries with low health insurance coverage. more...
- Published
- 2017
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42. Beyond widowhood: Do prior discovered themes that describe the experiences of older Australian widowed women persist over time?
- Author
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Kennaugh R, Byles J, and Tavener M
- Subjects
- Adaptation, Psychological, Aged, Aged, 80 and over, Australia, Cross-Sectional Studies, Female, Humans, Life Change Events, Longitudinal Studies, Socioeconomic Factors, Women's Health, Aging psychology, Health Status, Quality of Life, Social Support, Widowhood psychology
- Abstract
In previous cross-sectional studies researchers have explored the experiences of widowed women in the 1921-1926 cohort of the Australian Longitudinal Study on Women's Health and identified three major themes: health, social relationships and support, and financial and structural issues. In the current study the authors examine longitudinal data collected over 15 years to assess whether these themes persisted and/or evolved over time. The sample included 162 widowed women aged 70-90 years. Thematic analysis was used with a constant comparison method. Many women reported good health despite managing comorbidities. Social relationships frequently shifted from friends to family to more formal support. Most financial and structural issues related to managing increasing health costs as women aged. These results confirmed that the three major themes previously reported persisted over time, and underscore the importance of continuing to support women, and their changing needs, well beyond the initial period of bereavement. more...
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- 2016
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43. Exploring the implementation of poslansia, Indonesia's community-based health programme for older people.
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Christiani Y, Byles JE, Tavener M, and Dugdale P
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Aging, Community-Institutional Relations, Female, Health Behavior, Health Care Surveys, Health Knowledge, Attitudes, Practice, Humans, Indonesia, Male, Middle Aged, Patient Acceptance of Health Care, Program Evaluation, Community Health Services organization & administration, Delivery of Health Care, Integrated organization & administration, Health Promotion organization & administration, Health Services for the Aged organization & administration, Preventive Health Services organization & administration
- Abstract
Aim: To explore the implementation of poslansia, a community-based integrated health service implemented across Indonesia to improve the health status of older people through health promotion and disease prevention., Methods: Data analysis of 307 poslansia surveyed in the 4th wave of Indonesia Family Life Survey (IFLS-4). We examined the services provided in the programme, resources and perceived problems., Results: The services provided by poslansia focused mostly on risk factor screening and treatment for minor illness, and less on health promotion activities. Lack of support from community health centres, no permanent place for holding poslansia and lack of participant interest in joining the programme were associated with fewer services provided in the programme (P < 0.05)., Conclusion: The findings indicate existing support from the community, community health centres and related institutions for poslansia is not adequate for optimal service function. Health awareness among the older population should also be increased for programme sustainability., (© 2016 AJA Inc.) more...
- Published
- 2016
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44. Generating qualitative data by design: the Australian Longitudinal Study on Women's Health qualitative data collection.
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Tavener M, Chojenta C, and Loxton D
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- Australia, Female, Humans, Longitudinal Studies, Software, Surveys and Questionnaires, Data Collection methods, Health Surveys, Qualitative Research, Research Design, Women's Health
- Abstract
Unlabelled: Objectives and importance of study: The purpose of this study was to illustrate how qualitative free-text comments, collected within the context of a health survey, represent a rich data source for understanding specific phenomena., Study Type: Work conducted with data from the Australian Longitudinal Study on Women's Health (ALSWH) was used to demonstrate the breadth and depth of qualitative information that can be collected. The ALSWH has been collecting data on women's health since 1996, and represents a unique opportunity for understanding lived experiences across the lifecourse., Methods: A multiple case study design was used to demonstrate the techniques that researchers have used to manage free-text qualitative comments collected by the ALSWH., Results and Conclusions: Eleven projects conducted using free-text comments are discussed according to the method of analysis. These methods include coding (both inductively and deductively), longitudinal analyses and software-based analyses. This work shows that free-text comments are a data resource in their own right, and have the potential to provide rich and valuable information about a wide variety of topics. more...
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- 2016
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45. The effect of motherhood and work on women's time pressure: A cohort analysis using the Australian Longitudinal Study on Women's Health.
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Otterbach S, Tavener M, Forder P, Powers J, Loxton D, and Byles J
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- Adult, Australia epidemiology, Employment, Female, Humans, Longitudinal Studies, Socioeconomic Factors, Time Factors, Women's Health, Women, Working psychology, Mothers psychology, Mothers statistics & numerical data, Women, Working statistics & numerical data
- Abstract
Objectives: The aim of this study was to analyze the prevalence and determinants of time pressure among younger Australian women born between 1973 and 1978 over a 17-year period., Methods: Using six surveys (N=14 247 at baseline in 1996) from the Australian Longitudinal Study on Women`s Health (ALSWH), we estimated fixed-effects ordered logistic regression models., Results: More than two thirds of women felt rushed, pressured, too busy every day or a few times a week, and time pressure substantially increased over the observed 17-year period. Baseline estimates show that time pressure is significantly (P<0.001) associated with being employed and being a mother with coefficients ranging from 0.255 [95% confidence interval (95% CI) 0.188-0.322] for being employed to 0.273 (95% CI 0.168-0.377) for having children. The multivariate analysis further indicates that time pressure is significantly related to a number of personal, family, and work characteristics such as number and age of children, economic insecurity such as having financial difficulties, concern about employment stability, or the length of the working week., Conclusions: Understanding the sources of time pressure and identification of certain groups which are particularly vulnerable to it is important if policy-makers aim to design and successfully implement health policies, and family-friendly parental leave and child-care policies. more...
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- 2016
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46. Gender Inequalities in Noncommunicable Disease Risk Factors Among Indonesian Urban Population.
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Christiani Y, Byles JE, Tavener M, and Dugdale P
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- Adolescent, Adult, Female, Humans, Indonesia epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Sex Distribution, Smoking psychology, Social Determinants of Health, Socioeconomic Factors, Young Adult, Health Status Disparities, Hypercholesterolemia epidemiology, Hypertension epidemiology, Obesity epidemiology, Smoking epidemiology, Urban Population statistics & numerical data
- Abstract
Gender is an important determinant of health. We conducted a study to examine hypertension, obesity, hypercholesterolemia, and smoking behavior among adults aged >15 years in urban Indonesia. We compared the prevalence, predicted socioeconomic factors, the gender inequalities, and the contributing factors to the inequalities. Women had a higher risk of obesity and hypercholesterolemia and raised blood pressure in later life (P< .001). In contrast, men had a higher risk of being a current smoker and raised blood pressure at younger age (P< .001). The gender inequalities in hypertension, obesity, and hypercholesterolemia can be accounted for by disparities in socioeconomic factors between men and women, particularly involvement in paid work. However, the inequalities were also accounted for by different effects of the socioeconomic factors in men and women. Gender is interlinked with socioeconomic and biological factors in determining health. This emphasizes the need of gender responsive policies to control and prevent chronic disease., (© 2015 APJPH.) more...
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- 2016
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47. The Australian Longitudinal Study on Women's Health: Using Focus Groups to Inform Recruitment.
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Tavener M, Mooney R, Thomson C, and Loxton D
- Abstract
Background: Recruitment and retention of participants to large-scale, longitudinal studies can be a challenge, particularly when trying to target young women. Qualitative inquiries with members of the target population can prove valuable in assisting with the development of effective recruiting techniques. Researchers in the current study made use of focus group methodology to identify how to encourage young women aged 18-23 to participate in a national cohort online survey., Objective: Our objectives were to gain insight into how to encourage young women to participate in a large-scale, longitudinal health survey, as well as to evaluate the survey instrument and mode of administration., Methods: The Australian Longitudinal Study on Women's Health used focus group methodology to learn how to encourage young women to participate in a large-scale, longitudinal Web-based health survey and to evaluate the survey instrument and mode of administration. Nineteen groups, involving 75 women aged 18-23 years, were held in remote, regional, and urban areas of New South Wales and Queensland., Results: Focus groups were held in 2 stages, with discussions lasting from 19 minutes to over 1 hour. The focus groups allowed concord to be reached regarding survey promotion using social media, why personal information was needed, strategies to ensure confidentiality, how best to ask sensitive questions, and survey design for ease of completion. Recruitment into the focus groups proved difficult: the groups varied in size between 1 and 8 participants, with the majority conducted with 2 participants., Conclusions: Intense recruitment efforts and variation in final focus group numbers highlights the "hard to reach" character of young women. However, the benefits of conducting focus group discussions as a preparatory stage to the recruitment of a large cohort for a longitudinal Web-based health survey were upheld. more...
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- 2016
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48. Inadequate collaboration: A challenge to reaching global targets for non-communicable disease control and prevention.
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Christiani Y, Tavener M, Byles JE, and Dugdale P
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- Humans, Chronic Disease prevention & control, Global Health
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- 2016
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49. Do women in major cities experience better health? A comparison of chronic conditions and their risk factors between women living in major cities and other cities in Indonesia.
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Christiani Y, Byles JE, Tavener M, and Dugdale P
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- Adolescent, Adult, Chronic Disease therapy, Female, Health Surveys, Humans, Hypertension, Indonesia epidemiology, Middle Aged, Prevalence, Risk Factors, Tobacco Use adverse effects, Young Adult, Chronic Disease epidemiology, Cities, Health Status Indicators, Urban Health
- Abstract
Background: Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments., Design: We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors - systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use - among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities., Results: Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages., Conclusions: Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age. more...
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- 2015
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50. Socioeconomic related inequality in depression among young and middle-adult women in Indonesia׳s major cities.
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Christiani Y, Byles J, Tavener M, and Dugdale P
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- Adult, Cities, Cross-Sectional Studies, Depression, Educational Status, Female, Humans, Indonesia epidemiology, Marital Status, Mental Health Services, Middle Aged, Poverty statistics & numerical data, Prevalence, Residence Characteristics, Smoking epidemiology, Smoking psychology, Socioeconomic Factors, Young Adult, Depressive Disorder epidemiology, Depressive Disorder psychology, Poverty psychology, Urban Population statistics & numerical data
- Abstract
Purpose: Difficult living conditions in urban areas could result in an increased risk of developing depression, particularly among women. One of the strong predictors of depression is poverty, which could lead to inequality in risk of depression. However, previous studies found conflicting results between poverty and depression. This study examines whether depression was unequally distributed among young and middle-adult women in Indonesia׳s major cities and investigate the factors contributed to the inequality., Methods: Data from 1117 young and middle-adult women in Indonesia׳s major cities (Jakarta, Surabaya, Medan, and Bandung) were analysed. Concentration Index (CI) was calculated to measure the degree of the inequality. The CI was decomposed to investigate the factor contributing most to the inequality., Results: The prevalence of depression was 15% and more concentrated among lower economic group (CI=-0.0545). Compared to the middle-adult group, the prevalence of depression among women in the young-adult group was significantly higher (18% vs 11%, p<0.05) and more equally distributed (CI=-0.0343 vs CI=-0.1001). Household consumption expenditure was the factor that contributed most to inequality in both group. Other factors contributing to inequality were smoking in young-adult group and marital status in middle-adult group. Contribution of education to inequality varied for different age groups., Conclusion: Depression is more concentrated among the lower economic groups, with household expenditure being the major factor contributing to the inequality. This finding emphasises the importance of primary care level mental health services, particularly in poorer urban communities., Limitation: This study is based on a cross-sectional data, and only assesses social determinants of depression. These determinants are important to address in addition to biological determinants and other factors., (Copyright © 2015 Elsevier B.V. All rights reserved.) more...
- Published
- 2015
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