Social and Behavioral Sciences Commons^™

The Challenge Of Overdiagnosis Begins With Its Definition, Stacy M. Carter, Wendy Rogers, I Heath, Chris Degeling, Jenny Doust, Alexandra Barratt

Faculty of Social Sciences - Papers (Archive)

The implicit social contract underpinning healthcare is that it will reduce illness and preventable death and improve quality of life. But sometimes these promises are not delivered. Sometimes health services take people who don't need intervention, subject them to tests, label them as sick or at risk, provide unnecessary treatments, tell them to live differently, or insist on monitoring them regularly. These interventions don't improve things for people; they produce complications or illness, reduce quality of life, or even cause premature death. Active health intervention is not always a good thing: it can be "too much medicine," or produce what …

Relational Conceptions Of Paternalism: A Way To Rebut Nanny-State Accusations And Evaluate Public Health Interventions, Stacy M. Carter, Vikki A. Entwistle, Miles Little

Faculty of Social Sciences - Papers (Archive)

Objectives 'Nanny-state' accusations can function as powerful rhetorical weapons against interventions intended to promote public health. Public health advocates often lack effective rebuttals to these criticisms. Nanny-state accusations are largely accusations of paternalism. They conjure up emotive concern about undue governmental interference undermining peoples' autonomy. But autonomy can be understood in various ways. We outline three main conceptions of autonomy, argue that these that can underpin three different conceptions of paternalism, and consider implications for responses to nanny-state accusations and the assessment of public health interventions. Study design and methods Detailed conceptual analysis. Results The conceptions of paternalism implicit in …

Why Do Smokers Try To Quit Without Medication Or Counselling? A Qualitative Study With Ex-Smokers, Andrea L. Smith, Stacy M. Carter, Simon Chapman, Sally M. Dunlop, Becky Freeman

Faculty of Social Sciences - Papers (Archive)

Objective When tobacco smokers quit, between half and two-thirds quit unassisted: that is, they do not consult their general practitioner (GP), use pharmacotherapy (nicotine-replacement therapy, bupropion or varenicline), or phone a quitline. We sought to understand why smokers quit unassisted. Design Qualitative grounded theory study (in-depth interviews, theoretical sampling, concurrent data collection and data analysis). Participants 21 Australian adult ex-smokers (aged 28-68 years; 9 males and 12 females) who quit unassisted within the past 6 months to 2 years. 12 participants had previous experience of using assistance to quit; 9 had never previously used assistance. Setting Community, Australia. Results Along …

Which Public And Why Deliberate? - A Scoping Review Of Public Deliberation In Public Health And Health Policy Research, Christopher J. Degeling, Stacy M. Carter, Lucie Rychetnik

Faculty of Social Sciences - Papers (Archive)

Deliberative methods are of increasing interest to public health researchers and policymakers. We systematically searched the peer-reviewed literature to identify public health and health policy research involving deliberative methods and report how deliberative methods have been used. We applied a taxonomy developed with reference to health policy and science and technology studies literatures to distinguish how deliberative methods engage different publics: citizens (ordinary people who are unfamiliar with the issues), consumers (those with relevant personal experience e.g. of illness) and advocates (those with technical expertise or partisan interests). We searched four databases for empirical studies in English published 1996-2013. This …

The Views And Experiences Of Smokers Who Quit Smoking Unassisted. A Systematic Review Of The Qualitative Evidence, Andrea L. Smith, Stacy M. Carter, Sally M. Dunlop, Becky Freeman, Simon Chapman

Faculty of Social Sciences - Papers (Archive)

Background Unassisted cessation - quitting without pharmacological or professional support - is an enduring phenomenon. Unassisted cessation persists even in nations advanced in tobacco control where cessation assistance such as nicotine replacement therapy, the stop-smoking medications bupropion and varenicline, and behavioural assistance are readily available. We review the qualitative literature on the views and experiences of smokers who quit unassisted. Method We systematically searched for peer-reviewed qualitative studies reporting on smokers who quit unassisted. We identified 11 studies and used a technique based on Thomas and Harden's method of thematic synthesis to discern key themes relating to unassisted cessation, and …

Framing Overdiagnosis In Breast Screening: A Qualitative Study With Australian Experts, Lisa M. Parker, Lucie Rychetnik, Stacy M. Carter

Faculty of Social Sciences - Papers (Archive)

Background The purpose of this study was to identify how the topic of overdiagnosis in breast cancer screening is framed by experts and to clarify differences and similarities within these frames in terms of problems, causes, values and solutions. Methods We used a qualitative methodology using interviews with breast screening experts across Australia and applying framing theory to map and analyse their views about overdiagnosis. We interviewed 33 breast screening experts who influence the public and/or policy makers via one or more of: public or academic commentary; senior service management; government advisory bodies; professional committees; non-government/consumer organisations. Experts were currently …

Values In Breast Cancer Screening: An Empirical Study With Australian Experts, Lisa M. Parker, Lucie Rychetnik, Stacy M. Carter

Faculty of Social Sciences - Papers (Archive)

Objective To explore what Australian experts value in breast screening, how these values are conceptualised and prioritised, and how they inform experts' reasoning and judgement about the Australian breast-screening programme. Design Qualitative study based on interviews with experts. Participants 33 experts, including clinicians, programme managers, policymakers, advocates and researchers selected for their recognisable influence in the Australian breast-screening setting. Setting Australian breast-screening policy, practice and research settings. Results Experts expressed 2 types of values: ethical values (about what was good, important or right) and epistemological values (about how evidence should be created and used). Ethical values included delivering benefit, avoiding …

The Role Of Communication In Breast Cancer Screening: A Qualitative Study With Australian Experts, Lisa M. Parker, Lucie Rychetnik, Stacy M. Carter

Faculty of Social Sciences - Papers (Archive)

Background One well-accepted strategy for optimising outcomes in mammographic breast cancer screening is to improve communication with women about screening. It is not always clear, however, what it is that communication should be expected to achieve, and why or how this is so. We investigated Australian experts' opinions on breast screening communication. Our research questions were: 1 What are the views of Australian experts about communicating with consumers on breast screening? 2 How do experts reason about this topic? Methods We used a qualitative methodology, interviewing 33 breast screening experts across Australia with recognisable influence in the Australian mammographic breast …

The Purpose And Value For Students Of Pbl Groups For Learning, Vicki Skinner, Annette J. Braunack-Mayer, Tracey J. Winning

Faculty of Social Sciences - Papers (Archive)

Groups are central to problem-based learning (PBL) and educational and professional outcomes relevant to clinical education. However, PBL groups in practice may differ from theoretical conceptions of groups. Therefore, this study explored students’ understandings of the purpose and value of PBL groups for their learning. We conducted a naturalistic study with novice (first-year) students at two dental schools (Australia, Ireland), using observation and interviews analyzed thematically. Students constructed PBL learning as individual knowledge gain, and group purpose as information gathering and exchange; few students acknowledged the learning potential of group processes. Group value depended on assessment and curriculum context. Findings …

Unintended Outcomes Of University-Community Partnerships: Building Organizational Capacity With Pace International Partners, Kate Lloyd, Lindie Clark, Laura Ann Hammersley, Michaela Baker, Felicity Rawlings-Sanaei, Emily D'Ath

Faculty of Social Sciences - Papers (Archive)

Professional and Community Engagement (PACE) at Macquarie University provides experiential opportunities for students and staff to contribute to more just, inclusive and sustainable societies by engaging in activities with partner organizations. PACE International offers a range of opportunities with partners overseas. Underpinning PACE is a commitment to mutually beneficial learning and engagement. To align with this commitment, PACE-related research engages partner perspectives and those of students and academics. The dearth of scholarly research on partner perspectives of community engagement (Bringle, Clayton & Price, 2009) underscores this imperative. Drawing on interviews and focus groups with partner representatives this article examines some …

The First Shared Online Curriculum Resources For Veterinary Undergraduate Learning And Teaching In Animal Welfare And Ethics In Australia And New Zealand, Jane Johnson, Teresa Collins, Christopher J. Degeling, Anne Fawcett, Andrew D. Fisher, Rafael Freire, Susan J. Hazel, Jennifer Hood, Janice Lloyd, Clive J. C Phillips, Kevin Stafford, Vicky Tzioumis, Paul Mcgreevy

Faculty of Social Sciences - Papers (Archive)

The need for undergraduate teaching of Animal Welfare and Ethics (AWE) in Australian and New Zealand veterinary courses reflects increasing community concerns and expectations about AWE, global pressures regarding food security and sustainability, the demands of veterinary accreditation, and fears that, unless students encounter AWE as part of their formal education, as veterinarians they will be relatively unaware of the discipline of animal welfare science. To address this need we are developing online resources to ensure Australian and New Zealand veterinary graduates have the knowledge, and the research, communication and critical reasoning skills, to fulfill the AWE role demanded of …

Citizens' Perspectives On Disinvestment From Publicly Funded Pathology Tests: A Deliberative Forum, Jackie M. Street, Peta Callaghan, Annette J. Braunack-Mayer, Janet E. Hiller

Faculty of Social Sciences - Papers (Archive)

Background

Deliberative forums can be useful tools in policy decision making for balancing citizen voice and community values against dominant interests.

Objective

To describe the use of a deliberative forum to explore community perspectives on a complex health problem—disinvestment.

Methods

A deliberative forum of citizens was convened in Adelaide, South Australia, to develop criteria to support disinvestment from public funding of ineffective pathology tests. The case study of potential disinvestment from vitamin B₁₂/folate pathology testing was used to shape the debate. The forum was informed by a systematic review of B₁₂/folate pathology test effectiveness and expert …

Hpv.Edu Study Protocol: A Cluster Randomised Controlled Evaluation Of Education, Decisional Support And Logistical Strategies In School-Based Human Papillomavirus (Hpv) Vaccination Of Adolescents, S R. Skinner, Collette Davies, Spring Cooper, Tanya Stoney, Helen S. Marshall, Jane Jones, Joanne Collins, Heidi Hutton, Adriana Parrella, Gregory Zimet, David Regan, Patty Whyte, Julia Brotherton, Peter Richmond, Kristen Mccaffrey, Susan Garland, Julie Leask, Melissa Kang, Annette J. Braunack-Mayer, John M. Kaldor, Kevin Mcgeechan

Faculty of Social Sciences - Papers (Archive)

Background

The National Human Papillomavirus (HPV) Vaccination Program in Australia commenced in 2007 for females and in 2013 for males, using the quadrivalent HPV vaccine (HPV 6,11,16,18). Thus far, we have demonstrated very substantial reductions in genital warts and in the prevalence of HPV among young Australian women, providing early evidence for the success of this public health initiative. Australia has a long history of school-based vaccination programs for adolescents, with comparatively high coverage. However, it is not clear what factors promote success in a school vaccination program. The HPV.edu study aims to examine: 1) student knowledge about HPV vaccination; …

Social Marketing Ethical Dilemmas: Pursuing Practical Solutions For Pressing Problems, Lynne Eagle, Stephan Dahl, Stacy M. Carter, David Low

Faculty of Social Sciences - Papers (Archive)

We discuss calls, and apparent support, for ethical resources to support social marketing practitioners, in the light of research findings from a study of actual ethical dilemmas encountered by social marketing practitioners and resources used to resolve them. We highlight nine key ethical challenges facing social marketers, and highlight the prominence of social marketers' concerns about funders' influence on social marketing activity. The low use of existing general resources indicates the need for social marketing- focussed resources, the need to ensure that any resources developed offer practical decision-making support rather than broad general principles, and the need to advocate for …

Citizens, Consumers And Animals: What Role Do Experts Assign To Public Values In Establishing Animal Welfare Standards?, Christopher J. Degeling, Jane Johnson

Faculty of Social Sciences - Papers (Archive)

The public can influence animal welfare law and regulation. However what constitutes 'the public' is not a straightforward matter. A variety of different publics have an interest in animal use and this has implications for the governance of animal welfare. This article presents an ethnographic content analysis of how the concept of a public is mobilized in animal welfare journals from 2003 to 2012. The study was undertaken to explore how experts in the discipline define and regard the role of the public in determining animal welfare standards. Analysis indicates that experts in animal welfare constitute different types of citizen …

Policies On Pets For Healthy Cities: A Conceptual Framework, Melanie Rock, Cindy L. Adams, Christopher J. Degeling, Alessandro Massolo, Gavin Mccormack

Faculty of Social Sciences - Papers (Archive)

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of nonhuman animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary …

Impure Politics And Pure Science: Efficacious Ebola Medications Are Only A Palliation And Not A Cure For Structural Disadvantage, Christopher J. Degeling, Jane Johnson, Christopher Mayes

Faculty of Social Sciences - Papers (Archive)

Caplan and colleagues (2015) present a strong argument for using alternative trial designs for experimental treatments for Ebola virus disease (EVD). This argument is, of course, not new. There is a significant body of work in the philosophy of medicine that highlights the moral authority given to randomized controlled trials (RCTs) and the fact that RCTs are often chosen not because these are needed but because people simply do not recognize that they can get evidence that is just as useful from other trial designs (Kerridge 2010).

Public Health Ethics And More-Than-Human Solidarity, Melanie Rock, Christopher J. Degeling

Faculty of Social Sciences - Papers (Archive)

This article contributes to the literature on One Health and public health ethics by expanding the principle of solidarity. We conceptualise solidarity to encompass not only practices intended to assist other people, but also practices intended to assist non-human others, including animals, plants, or places. To illustrate how manifestations of humanist and more-than-human solidarity may selectively complement one another, or collide, recent responses to Hendra virus in Australia and Rabies virus in Canada serve as case examples. Given that caring relationships are foundational to health promotion, people's efforts to care for non-human others are highly relevant to public health, even …

Nrl Graduates Of League @ Western Sydney University: Evaluation Report, Jioji Ravulo

Faculty of Social Sciences - Papers (Archive)

Australian culture has long celebrated its sporting heroes as role models and inspirational figures, embodying the hard-work ethic of its people. Given the prowess of some of our top athletes, it is little wonder that many younger players aspire to these same levels of professionalism and athleticism in their own careers. It is also well recognised that one false move can drastically alter an athlete's life, seen perhaps most potently in the experience of Alex McKinnon, where one tragic tackle rendered him paralysed (Connell, July 4, 2015). Although this is an extreme example, such realities have prompted younger and older …

Delivering The Mental Health First Aid (Mhfa) Course Within The National Rugby League (Nrl): Evaluation Report, Jioji Ravulo

Faculty of Social Sciences - Papers (Archive)

Mental illness is a reality for many Australians. The National Survey of Mental Health and Wellbeing, conducted in 2007 with people aged 16-85, revealed that one in five Australians, or 3.2 million people, had a 12-month mental disorder (a mental illness occurring 12 months before the survey took place) (ABS, 2007). The survey further revealed that 16 million Australians (45%) within this age bracket suffered with a mental illness at some point in their lives. While these findings are slowly becoming public knowledge, there is still a limited understanding amongst laypeople regarding the overt and more covert symptoms of mental …

Aboriginal And Torres Strait Islander Reconnection Project Evaluation Report, Jioji Ravulo

Faculty of Social Sciences - Papers (Archive)

The Australian Museum, in partnership with The Street University Mount Druitt, Fairfield Museum, Juvenile Justice (Cobham and Juniperina centres) and ICE (Information and Cultural Exchange) Parramatta, facilitated the Aboriginal and Torres Strait Islander Reconnection Project from 2014 to 2015, which sought to address the potential link between the overrepresentation of Aboriginal young people in Juvenile Justice alongside the possible cultural dislocation which may lead to a compromised sense of self identity. The project, which took place within the Museum and as outreach programs at Juvenile Justice centres, community centres and events, were held as one-day workshops/events or as a series …

Pacific Communities In Australia, Jioji Ravulo

Faculty of Social Sciences - Papers (Archive)

This report strives to provide a greater understanding and awareness of Pacific communities in Australia. Through the compilation of data gained from the 2011 Census of Population and Housing conducted by the Australian Bureau of Statistics, this document is the first of its kind on reviewing the human geography of Pacific people across various life domains in an Australian context.

Introduction, Madeleine Boyd, Matthew Chrulew, Christopher J. Degeling, Agata Mrva-Montoya, Fiona S. Probyn-Rapsey, Nikki Savvides, Dinesh J. Wadiwel

Faculty of Social Sciences - Papers (Archive)

Much of the focus of discussion on the Anthropocene has centred upon anthropogenic global warming and climate change and the urgency of political and social responses to this problem. However, we argue that there is an equally important challenge in thinking about our relationships with non-human animals.

C-Reactive Protein, Physical Activity And Cardiorespiratory Fitness In Portuguese Adolescents: A Cross-Sectional Study, Cesar A. Agostinis-Sobrinho, Carla Moreira, Jorge Mota, Rute Santos

Faculty of Social Sciences - Papers (Archive)

The goal of this study was to investigate the association of physical activity (PA) and cardiorespiratory fitness with C-reactive protein (CRP) concentration in adolescents. The sample included 386 Portuguese adolescents (n = 207, female), age 12-18 years, assessed in the year 2012. The PA was assessed with the use of accelerometers, and the cardiorespiratory fitness was assessed by the Fitnessgram Pacer test. Blood samples were collected after a 10-hour fasting, and high-sensitivity PCR concentration was further assessed. Significant associations between CRP and cardiorespiratory fitness were found for females (r = -0.313; p < 0.001) and males (r = -0.163; p < 0.05); however, when adjusted by the BMI, the associations remained significant only for females (r = -0.215; p < 0.001). Regarding the association between CRP and PA, no significant associations were found for both genders. Therefore, CRP is apparently negatively associated with cardiorespiratory fitness, with differences between males and females; for females it seems less dependent than BMI.

Correlates Of Total Sedentary Time And Screen Time In 9-11 Year-Old Children Around The World: The International Study Of Childhood Obesity, Lifestyle And The Environment, Allana G. Leblanc, Peter T. Katzmarzyk, Tiago Barreira, Stephanie Broyles, Jean-Phillipe Chaput, Timothy S. Church, Mikael Fogelholm, Deirdre Harrington, Gang Hu, Rebecca Kuriyan, Anura Kurpad, Estelle V. Lambert, Carol Maher, José Maia, Victor Matsudo, Timothy S. Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Catrine Tudor-Locke, Pei Zhao, Mark S. Tremblay, Rebecca M. Stanley

Faculty of Social Sciences - Papers (Archive)

Purpose Previously, studies examining correlates of sedentary behavior have been limited by small sample size, restricted geographic area, and little socio-cultural variability. Further, few studies have examined correlates of total sedentary time (SED) and screen time (ST) in the same population. This study aimed to investigate correlates of SED and ST in children around the world.

Salvaging Democracy For West Papuans In The Face Of Australia-Indonesia Obstruction, Camellia B. Webb-Gannon

Faculty of Social Sciences - Papers (Archive)

This article argues that the democratic ideals espoused by Australia and Indonesia fall short in application to West Papua and West Papuans, and notes that such shortcomings are legitimated by mainstream media's exoticist portrayals of West Papuans, particularly in Australia. The antidemocratic policies and processes of each government with regard to West Papua actually enable the (by and large) "good" bilateral relations at the state level to remain intact. However, this article contends that democracy, as practiced by civil society actors at the grassroots and digital network level in Australia and West Papua, creates cracks in the official Australia-Indonesia state …

Beyond The Spectacle Of Suffering: Representations Of Rape In Online Anti-Rape Activism, Rachel E. Loney-Howes

Faculty of Social Sciences - Papers (Archive)

From vigilante street politics, to consciousness raising, speak outs, and now online spaces, the mediums through which representations of rape are transmitted by anti-rape activists have transformed over time. Although activists have made concerted efforts to broaden the representation of rape, narratives about women's sexual suffering and vulnerability continue to dominate popular assumptions about rape. The internet purportedly offers a more complex and networked platform for activists to engage with and challenge these representations propagated by a culture which condones sexual violence, due to a proliferation of fluid public and counter-public spaces. By examining the ways in which rape is …

Factors Associated With The Development Of Depression In Chronic Non-Cancer Pain Patients Following The Onset Of Opioid Treatment For Pain, Kimberley Smith, Richard P. Mattick, Raimondo Bruno, Suzanne Nielsen, Milton Cohen, Gabrielle Campbell, Briony K. Larance, Michael P. Farrell, Louisa Degenhardt

Faculty of Social Sciences - Papers (Archive)

Background and aims Pharmaceutical opioid prescription rates are increasing globally, however knowledge of their long-term effects on mental health, in particular depression remains limited. This study aimed to identify factors associated with the onset of depression post-opioid use that differ to factors associated with depression post-pain. Method Participants (N=1 418) were a national sample prescribed opioids for chronic non-cancer pain. Age at onset of depression, pain and commencement of opioid medications were collected via structured interview. Results Six in 10 (61%) reported lifetime depression; of those, almost half developed depression after pain and after they started opioid medications (48%). Variables …

Injecting Buprenorphine‐Naloxone Film: Findings From An Explorative Qualitative Study, Nancy White, Ian Flaherty, Peter Higgs, Briony K. Larance, Suzanne Nielsen, Louisa Degenhardt, Robert Ali, Nicholas Lintzeris

Faculty of Social Sciences - Papers (Archive)

Introduction and Aims Experiences of buprenorphine‐naloxone (BNX) sublingual film injection are not well documented or understood. We examined how people who inject BNX film seek and share information about this practice, document the methods used to prepare BNX film for injection, and report participants' experiences of this practice. Design and Methods Interviews were (n = 16) conducted with people who indicated that they had injected BNX film since its introduction onto the Australian market. Semistructured interviews were recorded and transcribed. NVivo10 program (QSR International) was used to analyse the data using qualitative description methodology. Results Participants largely reported similar BNX …

The Poppy Research Programme Protocol: Investigating Opioid Utilisation, Costs And Patterns Of Extramedical Use In Australia, Louisa Degenhardt, Bianca Blanch, Natasa Gisev, Briony K. Larance, Sallie-Anne Pearson

Faculty of Social Sciences - Papers (Archive)

Introduction Opioid prescribing is increasing in many countries. In Australia, there is limited research on patterns of prescribing and access, or the outcomes associated with this use. The aim of this research programme is to use national dispensing data to estimate opioid use and costs, including problematic or extramedical use in the Australian population. Methods and analysis In a cohort of persons dispensed at least one opioid in 2013, we will estimate monthly utilisation and costs of prescribed opioids, overall and according to individual opioid formulations and strengths. In a cohort of new opioid users, commencing therapy between 1 July …