Developmental trajectories during the transition from adolescence to adulthood contribute to the establishment of stable, adult forms of operation. Understanding the neural mechanisms underlying this transition is crucial for identifying variability in normal development and the onset of psychiatric disorders, which typically emerge during this time. Habitual behaviors can serve as a model for understanding brain mechanisms underlying the stabilization of adult behavior, while also conferring risk for psychopathologies.
View Article and Find Full Text PDFEcological momentary assessment is increasingly leveraged to better understand affective processes underlying substance use disorder treatment and recovery. Research in this area has yielded novel insights into the roles of mean levels of positive affect (PA) and negative affect (NA) in precipitating drug craving and substance use in daily life. Little of the extant substance use disorder treatment research, however, considers dynamic patterns of PA and NA, separately or in relation to one another, or how such patterns may differ from those observed among nonclinical samples.
View Article and Find Full Text PDFHow best to model structurally heterogeneous processes is a foundational question in the social, health and behavioral sciences. Recently, Fisher et al. introduced the multi-VAR approach for simultaneously estimating multiple-subject multivariate time series characterized by common and individualizing features using penalized estimation.
View Article and Find Full Text PDFHealthcare systems in Canada are under pressure and require change-the status quo is no longer fit for purpose, if it ever was. Innovation is often held up as a cure for what ails us, but shiny new things or novel technologies alone have not been enough. This article will explore the concepts of differentiation and integration as being important drivers in the evolution of living organisms, ecosystems, and complex human organizations.
View Article and Find Full Text PDFBackground And Objectives: Previously published studies have consistently identified significant variation in red blood cell (RBC) transfusions during cardiac surgery. Clinical guidelines can be effective at improving the average quality of care; however, their impact on variation in practice is rarely studied. Herein, we estimated how variation in RBC use across cardiac surgeons changed after the publication of national patient blood management guidelines.
View Article and Find Full Text PDFObjectives: Critical/urgent X-ray findings are not always communicated in an appropriate time frame to ED physicians. The practice of radiographers alerting referrers to clinically significant image findings (verbally, via image flags or written comment) is noted internationally but risk assessment data is unavailable in the literature. A hybrid radiographer comment and alert model was piloted in New South Wales and a risk-benefit assessment conducted for timely and safe communication of abnormal X-ray appearances to ED physicians.
View Article and Find Full Text PDFPurpose: Prioritisation exercises seek out what matters to key stakeholders to inform the planning of research. Social media platforms are potentially useful data sources. The aim was to examine the content of tweets, short messages containing text and pictures, to ascertain the priorities of Twitter users regarding stroke recovery.
View Article and Find Full Text PDFMultiple myeloma is a haematological malignancy typically characterised by neoplastic plasma cell infiltration of the bone marrow. Treatment for multiple myeloma consists of multi-line chemotherapy with or without autologous stem cell transplantation and has been rapidly evolving in recent years. However, clinical trials are unable to provide patients and clinicians with long-term prognostic information nor policymakers with the full body of evidence needed to perform economic evaluation of new therapies or make reimbursement decisions.
View Article and Find Full Text PDFObjectives: Patients with hematological malignancies are likely to develop hypogammaglobulinemia. Immunoglobulin (Ig) is commonly given to prevent infections, but its overall costs and cost-effectiveness are unknown.
Methods: A systematic review was conducted following the PRISMA guidelines to assess the evidence on the costs and cost-effectiveness of Ig, administered intravenously (IVIg) or subcutaneously (SCIg), in adults with hematological malignancies.
Health disparities by socioeconomic status (SES) are potentially shaped by how an individual's health status and work capacity are affected by the incidence of illness, and how these effects vary across SES groups. We examine the impact of illness on the dynamics of health status, work activity and income in older Singaporeans to gain new insights on how ill health shapes the socioeconomic health gradient. Our data comprise of 60 monthly waves (2015-2019) of panel survey data containing 445,464 person-observations from 11,827 unique respondents from Singapore.
View Article and Find Full Text PDFObsessive-compulsive symptoms (OCS) are relatively common during adolescence although most individuals do not meet diagnostic criteria for obsessive-compulsive disorder (OCD). Nonetheless, OCS during adolescence are associated with comorbid psychopathologies and behavioral problems. Heightened levels of environmental stress and greater functional connectivity between the somatomotor network and putamen have been previously associated with elevated OCS in OCD patients relative to healthy controls.
View Article and Find Full Text PDFPatients with hematological malignancies are at high risk of developing hypogammaglobulinemia (HGG) and infections. Immunoglobulin (Ig) is one recommended option to prevent these infections, but it is expensive, and its cost-effectiveness compared with other prevention strategies remains unknown. We conducted a trial-based economic evaluation from the Australian health care system perspective to estimate the 12-month cost-effectiveness of prophylactic Ig vs prophylactic antibiotics in 63 adults with HGG and hematological malignancies participating in the RATIONAL feasibility trial.
View Article and Find Full Text PDFUnderstanding how cognitive biases, mental models, and mindsets impact leadership in health systems is essential. This article supports the notion of cognitive biases as flawed thinking or cognitive traps which negatively influence leadership. Mental models that do not fit with current evidence limit our ability to comprehend and respond to system issues.
View Article and Find Full Text PDFPurpose: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widely used disability-specific outcome measure.
View Article and Find Full Text PDFIntroduction: The timely communication of clinically significant image appearances to Emergency Department (ED) referrers is necessary for optimum patient care. Australian reliance on verbal communication only is time-limited, open to misinterpretation and lacks transparency. A combined radiographer alert and comment model was designed to reliably communicate image abnormalities to ED referrers in real-time.
View Article and Find Full Text PDFObjective: Employment can improve mental health among people with disability (PWD), however, little is known about how different levels of workforce participation influence mental healthcare use. The aim of this study was to estimate the extent to which different levels of working hours are associated with changes in mental healthcare use among PWD.
Methods: Data on working hours and healthcare use among working age PWD who were receiving government benefits (N=260 825) was obtained from Australian Census-linked administrative records between 2011 and 2019.
Background: Medicines are the most frequent health care intervention type; their safe use provides significant benefits, but inappropriate use can cause harm. Systemic primary care approaches can manage serious medication-related problems in a timely manner.
Objectives: ACTMed (ACTivating primary care for MEDicine safety) uses information technology and financial incentives to encourage pharmacists to work more closely with general practitioners to reduce the risk of harm, improve patients' experience of care, streamline workflows, and increase the efficiency of medical care.
Donations play a critical role in supporting the provision of public goods, yet how donating behaviour changes in response to health shocks is poorly understood. We investigate how the household's joint decision to donate time (volunteer) and money changes following a health shock. Using data from the United States Panel Study of Income Dynamics, and a within-household design that captures the dynamics of a post-health shock response, we find no overall change in the probability of households donating money but an overall reduction in the probability of donating time following a health shock.
View Article and Find Full Text PDFObjective: The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions.
Methods: We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher.
Objectives: This paper investigates the relationship between part-time and full-time employment and mental health for people with and without disability, as well as differences in the relationship by age and sex.
Methods: Using data from 13,219 working-aged people (15-64 years) in the labour force who participated in five annual waves of a longitudinal cohort study in Australia, the analysis used fixed effect regression models to examine within-person changes in mental health associated with changes in employment status (full-time; part-time; unemployed). Differences in the relationship between employment status and mental health by disability, sex, and age were assessed.