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1.
Nutrition ; : 111794, 2022.
Article in English | ScienceDirect | ID: covidwho-1937059

ABSTRACT

Objective : To explore psychological distress, lifestyle, and demographic factors and the relationship to discretionary choices, in women of reproductive age during COVID-19 in Australia. Method : Reproductive aged women (18-50 y) in Australia participated in a national online survey. Psychological distress score (using the validated 10-item Kessler Psychological Distress Scale questionnaire) was the primary exposure of interest, and key outcomes were frequencies of discretionary choices (sugar-sweetened beverages (SSB), alcohol, and discretionary foods). Sociodemographic and physical activity data were also collected. Logistic regression was used to report adjusted odds ratios (95% CI) for predicting: SSBs (less than weekly;most days/daily), total discretionary foods (none/<2 times/d;≥3 times/d), and alcohol (never/less than monthly;most weeks/daily). Results : 1005 women were included of whom 40% had a high level of psychological distress. Women with high psychological distress (1.96;1.32, 2.91), and those who gained weight during the pandemic (1.71;1.10, 2.65), were more likely to consume discretionary foods ≥3 times/d. There was no association between psychological distress and SSB intake or alcohol;however, Australian, New Zealander, or Pacific Islander background (1.68;1.21, 2.33) and more hours of sitting time (1.88;1.07, 3.29) was associated with SSB consumption on most days/daily. Older age (1.70;1.00, 2.89), higher household income (1.44;1.08, 1.92), and moderate or high physical activity (1.75;1.10, 2.80), associated with alcohol intake on most weeks/daily. Conclusion : Public health messaging promoting healthy eating should take into account the impact of psychological distress on health behaviour. Messages aimed at maintaining a positive relationship between food intake and mental wellbeing, particularly among vulnerable groups, are warranted.

2.
Funct Integr Genomics ; 2022 Jul 05.
Article in English | MEDLINE | ID: covidwho-1919814

ABSTRACT

Type 2 diabetes (T2D) has a complex etiology which is not yet fully elucidated. The identification of gene perturbations and hub genes of T2D may deepen our understanding of its genetic basis. We aimed to identify highly perturbed genes and hub genes associated with T2D via an extensive bioinformatics analytic workflow consisting of five steps: systematic review of Gene Expression Omnibus and associated literature; identification and classification of differentially expressed genes (DEGs); identification of highly perturbed genes via meta-analysis; identification of hub genes via network analysis; and downstream analysis of highly perturbed genes and hub genes. Three meta-analytic strategies, random effects model, vote-counting approach, and p value combining approach, were applied. Hub genes were defined as those nodes having above-average betweenness, closeness, and degree in the network. Downstream analyses included gene ontologies, Kyoto Encyclopedia of Genes and Genomes pathways, metabolomics, COVID-19-related gene sets, and Genotype-Tissue Expression profiles. Analysis of 27 eligible microarrays identified 6284 DEGs (4592 downregulated and 1692 upregulated) in four tissue types. Tissue-specific gene expression was significantly greater than tissue non-specific (shared) gene expression. Analyses revealed 79 highly perturbed genes and 28 hub genes. Downstream analyses identified enrichments of shared genes with certain other diabetes phenotypes; insulin synthesis and action-related pathways and metabolomics; mechanistic associations with apoptosis and immunity-related pathways; COVID-19-related gene sets; and cell types demonstrating over- and under-expression of marker genes of T2D. Our approach provided valuable insights on T2D pathogenesis and pathophysiological manifestations. Broader utility of this pipeline beyond T2D is envisaged.

3.
JAMA Intern Med ; 182(2): 106-114, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1838104

ABSTRACT

IMPORTANCE: Excessive gestational weight gain (GWG) is common and associated with adverse pregnancy outcomes. Antenatal lifestyle interventions limit GWG; yet benefits of different intervention types and specific maternal and neonatal outcomes are unclear. OBJECTIVE: To evaluate the association of different types of diet and physical activity-based antenatal lifestyle interventions with GWG and maternal and neonatal outcomes. DATA SOURCES: A 2-stage systematic literature search of MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted from February 1, 2017, to May 31, 2020. Search results from the present study were integrated with those from a previous systematic review from 1990 to February 2017. STUDY SELECTION: Randomized trials reporting GWG and maternal and neonatal outcomes. DATA EXTRACTION AND SYNTHESIS: Data were extracted for random-effects meta-analyses to calculate the summary effect estimates and 95% CIs. MAIN OUTCOMES AND MEASURES: Outcomes were clinically prioritized, with mean GWG as the primary outcome. Secondary outcomes included gestational diabetes, hypertensive disorders of pregnancy, cesarean section, preterm delivery, large or small for gestational age neonates, neonatal intensive care unit admission, or fetal death. RESULTS: A total of 117 randomized clinical trials of antenatal lifestyle interventions (involving 34 546 women) were included. Overall lifestyle intervention was associated with reduced GWG (-1.15 kg; 95% CI, -1.40 to -0.91), risk of gestational diabetes (odds ratio [OR], 0.79; 95% CI, 0.70-0.89), and total adverse maternal outcomes (OR, 0.89; 95% CI, 0.84-0.94) vs routine care. Compared with routine care, diet was associated with less GWG (-2.63 kg; 95% CI, -3.87 to -1.40) than physical activity (-1.04 kg; 95% CI, -1.33 to -0.74) or mixed interventions (eg, unstructured lifestyle support, written information with weight monitoring, or behavioral support alone) (-0.74 kg; 95% CI, -1.06 to -0.43). Diet was associated with reduced risk of gestational diabetes (OR, 0.61; 95% CI, 0.45-0.82), preterm delivery (OR, 0.43; 95% CI, 0.22-0.84), large for gestational age neonate (OR, 0.19; 95% CI, 0.08-0.47), neonatal intensive care admission (OR, 0.68; 95% CI, 0.48-0.95), and total adverse maternal (OR, 0.75; 95% CI, 0.61-0.92) and neonatal outcomes (OR, 0.44; 95% CI, 0.26-0.72). Physical activity was associated with reduced GWG and reduced risk of gestational diabetes (OR, 0.60; 95% CI, 0.47-0.75), hypertensive disorders (OR, 0.66; 95% CI, 0.48-0.90), cesarean section (OR, 0.85; 95% CI, 0.75-0.95), and total adverse maternal outcomes (OR, 0.78; 95% CI, 0.71-0.86). Diet with physical activity was associated with reduced GWG (-1.35 kg; 95% CI, -1.95 to -0.75) and reduced risk of gestational diabetes (OR, 0.72; 95% CI, 0.54-0.96) and total adverse maternal outcomes (OR, 0.81; 95% CI, 0.69-0.95). Mixed interventions were associated with reduced GWG only. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis found level 1 evidence that antenatal structured diet and physical activity-based lifestyle interventions were associated with reduced GWG and lower risk of adverse maternal and neonatal outcomes. The findings support the implementation of such interventions in routine antenatal care and policy around the world.


Subject(s)
Diabetes, Gestational , Gestational Weight Gain , Hypertension , Premature Birth , Cesarean Section , Diabetes, Gestational/epidemiology , Diabetes, Gestational/prevention & control , Diet , Exercise , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Premature Birth/prevention & control , Weight Gain
4.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327495

ABSTRACT

Introduction: Type 2 diabetes (T2D) has a complex etiology which is not fully elucidated. Identification of gene perturbations and hub genes of T2D may assist in personalizing care. Objectives: We aimed to identify highly perturbed genes and hub genes associated with T2D in different tissues of adult humans via an extensive workflow. Methods: Workflow comprised five sequential steps: systematic review of NCBI GEO database;identification and classification of differentially expressed genes (DEG);identification of highly perturbed genes via meta-analysis;identification of hub genes via network analysis;downstream analyses. Three meta-analytic strategies: random effects model (REM);vote counting approach (VC);p-value combining approach (CA), were applied. Nodes having above average betweenness, closeness, and degree in the network were defined as hub genes. Downstream analyses included gene ontologies, Kyoto Encyclopedia of Genes and Genomes pathways, metabolomics, COVID-19 related genes, and Genotype-Tissue Expression profiles. Results: Analysis of 27 eligible microarrays identified 6284 DEG (4592 down-regulated and 1692 up-regulated) within four tissue types. Tissue-specific gene expression was significantly greater than tissue non-specific (shared) gene expression. Meta-analysis of DEG identified 49, 27, and 8 highly perturbed genes via REM, VC, and CA, respectively, producing a compiled set of 79 highly perturbed (41 down-regulated and 38 up-regulated) genes. The 28 hub genes comprised 13 up-regulated, 9 down-regulated, and 6 predicted genes. Downstream analyses identified enrichments of: shared genes with other diabetes phenotypes;insulin synthesis and action related pathways and metabolomics;mechanistic associations with apoptosis and immunity-related pathways, COVID-19 related gene sets;and cell types demonstrating over- and under-expression of marker genes of T2D. Conclusions: We identified highly perturbed genes and hub genes of T2D and revealed their associations with other diabetes phenotypes and COVID-19 as well as pathophysiological manifestations such as those related to insulin, immunity, and apoptosis. Broader utility of the proposed pipeline is envisaged.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-322102

ABSTRACT

Background: COVID-19 has caused a global public health emergency. In the absence of an effective vaccine, governments have implemented a series of behaviour-based prevention policies including physical distancing and preventive hygiene measures. These strategies are likely to impact the spread of other contagious respiratory illnesses, such as seasonal influenza. Our aim was to explore how the 2019-2020 influenza tracked with the COVID-19 pandemic and its mitigation methods. A secondary aim was to explore claims that the impact of COVID-19 is no different to influenza. Methods: We linked the WHO flu database (FluNet: containing influenza virological surveillance data) and COVID-19 confirmed cases (Johns Hopkins Coronavirus Resources Center) for four countries across the northern (Canada, United States) and southern hemispheres (Australia, Brazil) for the period 2016-2020. The datasets were merged and graphical presentations of the longitudinal data were provided. Findings: There was a notable reduction in influenza cases for the 2019-2020 season. Northern hemisphere countries experienced a quicker ending to the early year seasonal influenza cases (shortened by 4-7 weeks). Countries from the southern hemisphere experienced drastically low levels of seasonal influenza, with consistent trends that were approaching zero cases after the introduction of COVID-19 mitigation measures. Interpretation: COVID-19 mitigation measures are likely driving a marked decrease in influenza, including little to no 2020 influenza activity in the southern hemisphere. In spite of this reduction in influenza, there was still community spread of COVID-19, highlighting the contagiousness of SARS-CoV-2 compared to influenza. These results, together with the higher mortality rate from SARS-CoV-2 compared to influenza, provide clear evidence that the impact of COVID-19 is far greater than influenza. Another key consequence of these findings is the importance to instigate widespread influenza vaccination programmes to avoid a concomitant COVID-19 wave and influenza surge.Funding Statement: Funding for this project has come from a Canadian Institutes of Health Research-Strategy for Patient Oriented Research Mentoring Chair (SMC-151518, PI: Dr. Simon L. Bacon), a Fonds de Recherche du Québec: Santé Chair (251618, PI: Dr. Simon L. Bacon), Fonds de Recherche du Québec: Santé Senior Research Award (34757, PI: Dr. Kim L Lavoie), and a Canadian Institutes of Health Research COVID-19 grant (MS3‐ 173099, PI: Simon L. Bacon).Declaration of Interests: Dr. Bacon has received consultancy fees from Merck for the development of behavior change continuing education modules, speaker fees from Novartis and Janssen, and has served on advisory boards for Bayer, Sanofi, and Sojecci Inc none of which are related to the current article. Dr Lavoie has served on the advisory board for Schering-Plough, Takeda, AbbVie, Almirall, Janssen, GSK, Boehringer Ingelheim (BI), and Sojecci Inc, and received sponsorship for investigator-generated research grants from GlaxoSmithKline (GSK) and AbbVie, speaker fees from GSK, Astra-Zeneca, Astellas, Novartis, Takeda, AbbVie, Merck, Boehringer Ingelheim, Bayer, Pfizer and Air Liquide, and support for educational materials from Merck, none of which are related to the current article. Dr. Stojanovic and Mr. Gosselin-Boucher have nothing to declare.

6.
BMJ Open ; 12(1): e057127, 2022 01 03.
Article in English | MEDLINE | ID: covidwho-1604731

ABSTRACT

OBJECTIVE: To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. DESIGN AND SETTING: Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. PARTICIPANTS: Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). MAIN OUTCOME MEASURES: Primary outcome: responses to question 'If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'.Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. RESULTS: Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. CONCLUSIONS: Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates.


Subject(s)
COVID-19 , Health Communication , Vaccines , Adult , Attitude , Australia , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Intention , Male , Public Health , SARS-CoV-2 , Vaccination
7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-295075

ABSTRACT

Background. COVID-19 research has relied heavily on convenience-based observational samples, which—though often necessary—are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. Methods. We analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected in Canada within the International COVID-19 Awareness and Responses Evaluation Study (www.icarestudy.com). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impact sampling discrepancies on these outcomes. Results. Significant discrepancies emerged between samples on 73% of outcomes, such that participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Conclusion. Our results suggest that convenience samples may hold more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-293329

ABSTRACT

Background. COVID-19 research has relied heavily on convenience-based observational samples, which—though often necessary—are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. Methods. We analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected in Canada within the International COVID-19 Awareness and Responses Evaluation Study (www.icarestudy.com). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impact sampling discrepancies on these outcomes. Results. Significant discrepancies emerged between samples on 73% of outcomes, such that participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Conclusion. Our results suggest that convenience samples may hold more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.

9.
Nutrients ; 13(12)2021 Nov 26.
Article in English | MEDLINE | ID: covidwho-1542686

ABSTRACT

This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18-50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59-15.03). Those who were renting were 2.10 (95% CI: 1.09-4.05) times likely to experience very low food-security than those owning their own home. The COVID-19 pandemic may have contributed to an increased prevalence of household food insecurity. This study supports the need for a range of responses that address mental health, financial, employment and housing support to food security in Australia.


Subject(s)
COVID-19/epidemiology , Food Insecurity , Mental Health , Pandemics , Adolescent , Adult , Australia/epidemiology , Cross-Sectional Studies , Female , Humans , Middle Aged , Prevalence , SARS-CoV-2 , Socioeconomic Factors
10.
International Journal of Epidemiology ; 50:1-2, 2021.
Article in English | CINAHL | ID: covidwho-1416101
11.
J Clim Chang Health ; 3: 100032, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1322227

ABSTRACT

Australia experienced two public health emergencies in 2020 - the catastrophic bushfires and the global coronavirus (COVID-19) pandemic. Whilst these were separate events, both have similar drivers arising from human pressures on the natural environment. Here we report on relative personal concerns of Australians in a survey implemented during the global COVID-19 pandemic. The study design was a cross sectional online survey administered between 11 August and 11 November 2020. The setting was an Australia-wide online population involving 5483 individuals aged ≥18 residing in Australia. Recruitment occurred in two stages: unrestricted self-selected community sample through mainstream and social media (N = 4089); and purposeful sampling using an online panel company (N = 1055). The sample was predominantly female (N = 3187); mean age of 52.7 years; and approximately representative of adults in Australia for age, location, state and area disadvantage (IRSD quintiles). Climate change was very much a problem for 66.3% of the sample, while COVID-19 was ranked at the same level by only 25.3%. Three times as many participants reported that climate change was very much a problem than COVID-19, despite responding at a time when Australians were experiencing Stage 2 through 4 lockdowns. Demographic differences relating to relative personal concerns are discussed. Even in the midst of the uncertainty of a public health pandemic, Australians report that climate change is their most significant personal problem. Australia needs to apply an evidence-based public health approach to climate change, like it did for the pandemic, which will address the climate change concerns of Australians.

12.
Front Public Health ; 9: 630189, 2021.
Article in English | MEDLINE | ID: covidwho-1278465

ABSTRACT

Objective: To assess and share learnings on the motivators and behavioural adherence across sex and age to evolving strategies in public policy to prevent the spread of SARS-CoV-2 at the end of a first COVID-19 wave and the beginning of a second COVID-19 wave in Australia. Design and Setting: A national longitudinal survey using a framework based on evidence-based behaviour change models. The survey was administered to a national sample representative across sex, age and location was undertaken at two time points: May 1st to 5th, 2020, and July 1st to 7th, 2020. Results: Overall 2,056 surveys were completed across the first and second rounds, with 63% (1,296/2,056) completing both. Age range was 18-99 years (median 53, IQR: 34-64). Suboptimal physical distancing and self-quarantining if unwell/diagnosed was reported in one in four respondents and not getting a test at onset of symptoms reported in one in three. Those non-adherent to all three behaviours (19%, 60/323), were mainly male, younger, lived in major cities and reported fewer concerns or motivators to change behaviour. Overall, government lockdown measures were considered very important by 81% (835/1,032) and appropriate by 75% (772/1,029). Conclusions: Prior to the suppression of a second COVID-19 wave, a significant minority of Australians reported suboptimal behavioural adherence to vital policy strategies to limit SARS-CoV-2 spread, mostly young adults and men. Successful wave 2 suppression required consistent communication from political and health leaders and supportive public health and economic strategies. Additional lockdown and punitive strategies were needed in Victoria and were generally well-supported and adhered to. To limit subsequent lockdown, this work reinforces the need for a mix of communication around saving lives of the vulnerable, and other strategies targeting high risk groups, facilitation of easy testing and minimisation of financial impacts.


Subject(s)
COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , Communicable Disease Control , Health Knowledge, Attitudes, Practice , Humans , Longitudinal Studies , Male , Middle Aged , SARS-CoV-2 , Self Report , Victoria , Young Adult
13.
Front Public Health ; 9: 628479, 2021.
Article in English | MEDLINE | ID: covidwho-1154263

ABSTRACT

Background: COVID-19 has caused a global public health emergency. Government mitigation strategies included a series of behavior-based prevention policies that had a likely impact on the spread of other contagious respiratory illnesses, such as seasonal influenza. Our aim was to explore how 2019-2020 influenza tracked onto COVID-19 pandemic and its mitigation methods. Materials and Methods: We linked the WHO FluNet database and COVID-19 confirmed cases (Johns Hopkins University) for four countries across the northern (Canada, the United States) and southern hemispheres (Australia, Brazil) for the period 2016-2020. Graphical presentations of longitudinal data were provided. Results: There was a notable reduction in influenza cases for the 2019-2020 season. Northern hemisphere countries experienced a quicker ending to the 2019-2020 seasonal influenza cases (shortened by 4-7 weeks) and virtually no 2020 fall influenza season. Countries from the southern hemisphere experienced drastically low levels of seasonal influenza, with consistent trends that were approaching zero cases after the introduction of COVID-19 measures. Conclusions: It is likely that the COVID-19 mitigation measures played a notable role in the marked decrease in influenza, with little to no influenza activity in both the northern and southern hemispheres. In spite of this reduction in influenza cases, there was still community spread of COVID-19, highlighting the contagiousness of SARS-CoV-2 compared to influenza. These results, together with the higher mortality rate from SARS-CoV-2 compared to influenza, highlight that COVID-19 is a far greater health threat than influenza.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Influenza, Human/epidemiology , Influenza, Human/physiopathology , Internationality , Pandemics/statistics & numerical data , Symptom Assessment/statistics & numerical data , Australia/epidemiology , Brazil/epidemiology , Canada/epidemiology , Female , Humans , Male , Public Health/statistics & numerical data , SARS-CoV-2 , United States/epidemiology
14.
Australas Psychiatry ; 29(2): 157-162, 2021 04.
Article in English | MEDLINE | ID: covidwho-838698

ABSTRACT

OBJECTIVE: A spreadsheet-based model for supporting equitable mental health resource distribution in Australia was developed, based on the Australian Health Survey (AHS) psychological distress findings associated with area socio-economic disadvantage (SED). An illustrative application is presented. METHOD: Stratum-specific psychological-distress rates for area SED quintiles are applied to local government areas, catchment areas and local health networks (LHNs). A case study applies the model to Victoria, including examining recommendations in the Royal Commission into Victoria's Mental Health Services (RCVMHS) 2019 interim report for increases to bed stock in two LHNs. RESULTS: Need-adjusted demand estimates considered as a ratio of raw population proportions for catchments range between 0.6 to 1.4 in Victoria. Applying the formula to the Royal Commission recommendations suggests the proposed distribution of beds is a reasonable correction for these two LHNs and indicates next expansion priorities for more equitable distribution to other LHNs. CONCLUSIONS: The spreadsheet, adaptable for other states and territories, could complement National Mental Health Services Planning Framework outputs and assist in evaluation, for instance, determining potential supply shortages in the tele-mental-health response to COVID-19. We outline research directions including consideration of the moral bases of value judgements and identification of other variables including their use in parameterisation and calibration.


Subject(s)
Health Services Accessibility/organization & administration , Healthcare Disparities/organization & administration , Mental Health Services/supply & distribution , Poverty Areas , Social Determinants of Health , Stress, Psychological , Vulnerable Populations/psychology , Adult , Health Surveys , Humans , Models, Organizational , Social Class , Social Justice , Stress, Psychological/economics , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/therapy , Victoria
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