Other UNSW

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Now showing 1 - 5 of 5
  • (2014) Hopwood, Max; Newman, Christy; Persson, Asha; Watts, Ian; Reynolds, Robert; Canavan, Peter; Kippax, Susan; Kidd, Michael
    Journal Article
    Aim: This paper explores cultural and professional dynamics of HIV general practice nursing in Australia. It highlights specific contributions that HIV general practice nurses make to HIV medicine and considers how nurses’ clinical practice has been shaped by past experiences of the AIDS crisis and subsequent developments in HIV medicine. Background: In international contexts, nurses in HIV medicine commonly work as part of shared-care teams. In recent years, HIV general practice nursing has become a prioritised area for primary health care in Australia. Methods: Data for this analysis were drawn from 45 in-depth, semi-structured interviews conducted with nurses and general practitioners (GPs) who provide HIV care in general practice, and key informants who work in policy, advocacy or education and training of the HIV general practice workforce. Findings: Viewed through a socio-ecological framework of social capital, descriptive content analysis highlights a unique and strong HIV health professional identity, which emerged out of the adverse conditions experienced by nurses, GPs and allied health professionals during the 1980s AIDS crisis. Participants reported that today, HIV general practice nursing includes information provision, HIV treatment side-effect management, teaching patients methods to increase adherence to HIV treatments and capacity building with allied health professionals. Participants reported that HIV general practice nurses can reduce the clinical burden on GPs, ameliorate patients’ exposure to HIV health care-related stigma and discrimination and facilitate the emergence of a comprehensive and personalised model of shared primary health care based on trust and rapport, which is desired by people with HIV. This study’s findings support the future expansion of the role of HIV general practice nurses in Australia and internationally. General practice nursing will become increasingly important in the scaling up of HIV testing and in caring for increasing numbers of people living with HIV.

  • (2014) Newman, Christy; de Wit, John; Crooks, Levinia; Reynolds, Robert; Canavan, Peter; Kidd, Michael
    Journal Article
    As the management of HIV changes and demand for HIV health services in primary care settings increases, new approaches to engaging the general practice workforce with HIV medicine are required. This paper reports on qualitative research conducted with 47 clinicians who provide HIV care in general practice settings around Australia, including accredited HIV s100 prescribers as well as other GPs and general practice nurses. Balanced numbers of men and women took part; less than a quarter were based outside of urban metropolitan settings. The most significant workforce challenges that participants said they faced in providing HIV care in general practice were keeping up with knowledge, navigating low caseload and regional issues, balancing quality care with cost factors, and addressing the persistent social stigma associated with HIV. Strategic responses developed by participants to address these challenges included thinking more creatively about business and caseload planning, pursuing opportunities to share care with specialist clinicians, and challenging prejudiced attitudes amongst patients and colleagues. Understanding and supporting the needs of the general practice workforce in both high and low HIV caseload settings will be essential in ensuring Australia has the capacity to respond to emerging priorities in HIV prevention and care.

  • (2014) Anderson, Amy; Hure, A; Forder, P; Powers, J; Kay-Lambkin, Frances; Loxton, D
    Journal Article

  • (2014) Lorenz, Ruth; Pitman, Andrew; Donat, Markus; Hirsch, Annette; Kala, Jatin; Kowalczyk, E; Law, R; Srbinovsky, J
    Journal Article
    Climate extremes, such as heat waves and heavy precipitation events, have large impacts on ecosystems and societies. Climate models provide useful tools for studying underlying processes and amplifying effects associated with extremes. The Australian Community Climate and Earth System Simulator (ACCESS) has recently been coupled to the Community Atmosphere Biosphere Land Exchange (CABLE) model. We examine how this model represents climate extremes derived by the Expert Team on Climate Change Detection and Indices (ETCCDI) and compare them to observational data sets using the AMIP framework. We find that the patterns of extreme indices are generally well represented. Indices based on percentiles are particularly well represented and capture the trends over the last 60 years shown by the observations remarkably well. The diurnal temperature range is underestimated, minimum temperatures (T-MIN) during nights are generally too warm and daily maximum temperatures (T-MAX) too low in the model. The number of consecutive wet days is overestimated, while consecutive dry days are underestimated. The maximum consecutive 1-day precipitation amount is underestimated on the global scale. Biases in T-MIN correlate well with biases in incoming longwave radiation, suggesting a relationship with biases in cloud cover. Biases in T-MAX depend on biases in net shortwave radiation as well as evapotranspiration. The regions and season where the bias in evapotranspiration plays a role for the T-MAX bias correspond to regions and seasons where soil moisture availability is limited. Our analysis provides the foundation for future experiments that will examine how land-surface processes contribute to these systematic biases in the ACCESS modelling system.

  • (2014) Mills, Katherine; Ewer, Phillipa; Dore, Glenys; Teesson, Maree; Baker, Amanda; Kay-Lambkin, Frances; Sannibale, Claudia
    Journal Article
    Background: Traumaexposure and post traumatic stress disorder (PTSD) are common among clients of substance use services. Existing treatments for these co-occurring conditions tend to be lengthy, treatment retention is relatively poor, and they require extensive training and clinical supervision. The aim of the present study was to conduct a preliminary examination of the feasibility and acceptability of a brief intervention for PTSD symptoms among individuals seeking substance use treatment. Methods: An uncontrolled open-label pilot study was conducted among 29 inpatients of a medicated detoxification unit in Sydney, Australia. All participants completed a baseline interview followed by the brief intervention. The intervention consists of a single, one-hourmanualised session providing psychoeducation pertaining to common trauma reactions and symptom management. PTSD and substance use outcomes were assessed at 1-week, 1-month and 3-month post-intervention. Results: PTSD symptom severity (assessed using the Clinicians Administered PTSD Scale) decreased significantly from baseline to 1-week follow up (β −10.87, 95%CI: −19.75 to −1.99) and again between the 1-week and 3-month follow-ups (β −15.38, 95%CI: −23.20 to −7.57). Despite these reductions, the majority of participants continued to meet criteria for a diagnosis of PTSD and there was no change in participants' negative post-traumatic cognitions. Participants expressed high levels of satisfaction with the intervention. Conclusions: Brief psychoeducation for traumatised clients attending substance use services appears to be feasible, acceptable, and may be of some benefit in reducing PTSD symptoms. However, participants continued to experience symptoms at severe levels; thus, brief intervention may best be conceptualised as a “stepping stone†to further trauma treatment.