Medicine & Health
Medicine & Health
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(2010) Kelly, Angela; Worth, Heather; Man, N.; Nosi, S.; Emori, R.; Mek, A.; Akuani, F.; Kupul, M.; Kepa, B.; Walizopa, L.; Pirpir, L.; Cangah , B.; Siba , P.; Frankland, Andrew; Rawstorne, PatrickJournal ArticlePapua New Guinea (PNG) is in a phase of scaling up access to antiretroviral therapy (ART), and adherence to the newly available drug therapy is becoming an important issue. This paper examines adherence to ART in a sample of 374 HIV-positive people in six provinces in PNG. Participants were recruited to the study using non-probability sampling. Sixty-two % of participants reported complete adherence (no missed or late doses in the past week) and 79% reported not missing any doses in the last week. Revival church members were significantly more likely to report having missing a treatment dose(s) (66%). Those living in the Highlands and those attending Catholic health clinics were significantly more likely to be adherent to their treatment. Age, gender, marital status, education level and employment type did not show significant association with treatment adherence. Adherence rates in PNG are not alarming, indicating that people with HIV can adhere to treatment despite the challenges of living in PNG.
(2005) Brodaty, Henry; Cullen, Breda; Thompson, Claire; Mitchell, Philip; Parker, Gordon; Wilhelm, Kay; Austin, Marie-Paul; Mahli, GinJournal ArticleObjective: Authors investigated the effects of current age, age at onset, and gender on the phenomenology of depression. Methods: A mixed-age sample of 810 Mood Disorders Unit attendees with a diagnosis of unipolar major depressive episode at or near its nadir were interviewed by clinician-rated and self-report instruments assessing symptoms and severity of depression. Results: Differences were found in depressive phenomenology according to current age but not age at onset, confirming previous findings. Age differences on several variables were found in women only. Subjective ratings of depression severity decreased with age, whereas objective, clinician-rated severity increased. Conclusions: The pattern and severity of depression change with increasing age. Longitudinal prospective studies would further elucidate this age-gender relationship. Clinicians should be aware of the decreased likelihood of older patients' reporting of depressive symptoms themselves.
(2022) Macdonald, DianeThesisThe agency of women with disability is undermined by long-held ideas of what women with disability can or should be. These narrow, reductive views of their identity are limiting and harmful, and lead to exclusionary practices. My research used a feminist framework to challenge these views. My research addressed the social inclusion of women with physical disability in two stages. First, it investigated identity and inclusion through photographic self-portraits by women with physical disability. Second, my research examined the role of arts-based research in shifting negative community attitudes about disability. In the first stage, six women with physical disability photographed aspects of themselves using the photovoice method to focus on their strengths and issues affecting them. Photos, stories, interviews and discussions were analysed thematically. Findings from the first stage indicate that these six women engage in the ‘work of disability’. They articulated identity through their depictions of gender and disability. They challenged expectations through portraits of strength, sexuality and connection. They illustrated the gendered realities of daily life with disability that explain disability to non-disabled others. This research emphasised the personal capacity of the women to critically challenge how women with disability are portrayed. In the second stage, I explored the extent to which a public exhibition of disability self-portraits could be an effective platform to provoke social change. Audiences responded to open-ended questions about their thoughts and feelings after viewing the exhibition. I employed interpretive thematic analysis through a generic social processes framework to analyse responses. My findings indicate that audiences acknowledged underlying conscious or unconscious biases that contribute to their negative attitudes about disability. Audiences connected with the exhibition in ways that not only explored the women’s stories, but also led to better understandings of their own value sets. Audiences reassessed their assumptions about disability as a direct result of viewing the exhibition. My research findings demonstrate the valuable role of arts-based research. The agency expressed through self-portraits and stories helped shift negative attitudes and perceptions of disability to counter prejudice and promote equality. My research reveals a new pathway for the public to see women as they see themselves through art.
(2022) Joubert, AmyThesisTargeting and reducing the processes underlying the development and maintenance of depression and anxiety disorders, such as repetitive negative thinking (RNT), is a promising approach suggested to improve the efficacy and durability of psychological treatment. Delivering treatment online overcomes many of the barriers to accessing mental health treatment and improves treatment coverage. This thesis therefore involved the development and evaluation of a novel internet-delivered treatment targeting RNT. Study 1 involved an online qualitative survey to gain insight into how individuals define, experience, and understand rumination and worry. The findings from Study 1 were used to inform the development of the online intervention evaluated in subsequent chapters. Study 2 outlines the pilot evaluation of the online intervention. The results of Study 2 demonstrated the preliminary efficacy and acceptability of the intervention in adults, with significant reductions in participants self-reported levels of RNT, rumination, and worry, as well as symptoms of depression and generalised anxiety. Treatment effects were maintained at 1-month follow-up. Study 3 aimed to extend these preliminary findings using a randomised controlled trial design and compared the intervention when it was delivered with and without clinician guidance to a treatment-as-usual (TAU) control group. Participants in both the clinician guided and self-help groups had significantly lower levels of RNT, rumination, and worry, as well as symptoms of depression and anxiety compared to TAU at both post-treatment and 3-month follow-up. Treatment effects were significantly larger in the clinician guided group compared to self-help. This thesis provided the first evidence that targeting rumination and worry, both types of RNT, using an online intervention is efficacious, feasible, and acceptable in adults. This thesis also provided the first direct comparison of treatment outcomes and adherence between guided and self-help intervention formats and, in doing so, is the first to demonstrate the superiority of the clinician guided format. These findings add to the growing body of literature suggesting that internet-delivered interventions can successfully simultaneously target rumination and worry and that doing so is associated with significant improvements in depression and anxiety symptoms.
(2022) Shvetcov, ArturThesisRodents learn to fear a stimulus (e.g., a light) that signals the imminent arrival of an innate source of danger (typically an aversive foot shock). They also learn to fear a stimulus (e.g., a noise) that signals a learned source of danger (e.g., the already conditioned fear-eliciting light). Following Pavlov (1927), the former type of fear is termed first-order conditioned fear, because the stimulus is paired with an aversive unconditioned stimulus (US). The latter is termed second-order conditioned fear, because the stimulus is paired, not with a US, but with an already conditioned stimulus. There are both commonalities and differences in the neural substrates underlying these two forms of fear. Both require neuronal activity in the basolateral amygdala complex (BLA), including activation of NMDA receptors, for their encoding, and both require CaMK signalling, gene expression and DNA methylation for their consolidation. However, de novo protein synthesis is required for consolidation of first-order fear but not for consolidation of second-order fear.