Young people face significant challenges when managing a mental illness, such as acquiring treatment autonomy, being inexperienced users of the healthcare system and associated peer-related stigma. ...While medication use can be challenging in its own right, there is comparatively little information about the associated experiences and needs of young people with mental illness, particularly in the Australian context. This exploratory study will provide valuable insight into how this group is currently supported in relation to medication use.
Young people (aged 14-25 years) who had used a prescription medication for any mental illness for a minimum of 2 months were eligible to participate in this qualitative exploratory study. Semi-structured interviews were conducted between October 2017-September 2018 in consultation rooms at two youth-focused mental health support organisations in Brisbane, Queensland. Interview questions explored how participants managed their medication and related experiences. Interviews were transcribed verbatim and descriptively analysed using thematic analysis.
Eighteen young people discussed their lived experience during interviews averaging 50 min in duration. Finding the right medication that reduced symptom severity with minimal side-effects was identified as a complex experience for many, particularly when there was a lack of information, support or reduced financial capacity. Young people described a range of strategies to manage medication side-effects, changes and to support routine medication use.
Young people persevered with taking medication to manage a mental illness within a healthcare system that does not adequately support this vulnerable population. There remains a clear directive for healthcare professionals to provide credible information that proactively engages young people as healthcare participants, and for policy makers to consider financial burden for this population with limited financial capacity.
An increasing number of Australian parents of donor-conceived children are making contact with their child's donor relatives prior to their child reaching the age of majority. This process, often ...referred to as 'donor linking', can be achieved in Australia through either formal or informal mechanisms. Formal mechanisms exist in three states, each of which has legislation enabling donor linking in certain circumstances. Donor linking may also be achieved through informal mechanisms, such as online donor registries, social media searches, direct-to-consumer genetic testing, and fertility clinics which act as intermediaries between donors and recipients. Drawing on qualitative interview data, this article explores the donor linking practices of twentyfive single women who conceived using donated gametes. The findings suggest that early contact with donors is extremely popular among single women and that, even when formal legislative mechanisms are available, informal linking remains common.
Analgesics are commonly used over-the-counter (OTC) medicines readily available for purchase, sometimes without advice of a health professional. However, analgesics can cause harm even when taken ...according to dosing recommendations. Young adults may be more vulnerable to harm if they perceive low risk with OTC analgesic use, or struggle to interpret dosing instructions. This study aimed to explore factors affecting how young adults use OTC analgesics and associated perceptions of safety. An online survey was distributed to school-leavers and university students (17 to 25 years), in South-East Queensland, Australia, in the period November-December 2019. Most of the 302 respondents (school-leavers
= 147, university students
= 155) did not use analgesics frequently. School-leavers deferred to parents for analgesic information, while university students preferred the internet. The majority of respondents appeared safety conscious and did not take outside indicated use or instructions. However, a small proportion reported taking analgesics for an inappropriate indication. The difference in preferred source of analgesic information may reflect experience with analgesic use, increasing autonomy or decreased parental influence. Whilst it is encouraging that the majority of young adults appeared safety conscious, greater insight is needed into factors influencing decision making on OTC use, e.g., medicines knowledge, and changes with increasing age.
Issue addressedWith nearly half of all Australians likely to experience a mental illness, increasing community‐based mental health promotion is warranted. Community pharmacies are accessible health ...care destinations that effectively provide a range of public health services. This study explored consumer opinions of mental health promotion in the community pharmacy setting, the activities they have observed and the perceived role/s of pharmacy staff in this area.MethodsA survey was informed by five interviews with pharmacy consumers and a literature review. Adult pharmacy consumers were recruited nationwide via a Research Panel company between December 2018 and January 2019. Survey data were descriptively analysed and associations confirmed by chi‐square analysis.ResultsData were analysed from 537 of the 577 respondents; 34.3% of participants had a lived experience of mental illness. Just under a quarter of participants (23.3%) had observed mental health promotion in community pharmacy. Pharmacy was viewed as a suitable environment for this promotion by most respondents (n = 446/516), particularly those with lived experience, with a preference for in‐store leaflets, posters and linking with existing national mental health organisations/campaigns. Lack of privacy and the busy pharmacy environment were identified as barriers for promotion in this setting.ConclusionThere is a clear potential for mental health promotion within community pharmacies, although the uptake and impact of such activities require further investigation.So what?These findings highlight a missed opportunity for pharmacists to engage with consumers about mental health and well‐being, even though community pharmacies are accessible health care destinations.
Pattern-recognition receptors (PRRs) promote host defenses against HCV infection by binding to their corresponding adapter molecules leading to the initiation of innate immune responses including ...cell death. We investigated the expression of PRR genes, biomarkers of liver cell-death, and T cell and NK cell activation/inhibition-related genes in liver and serum obtained from three experimentally infected chimpanzees with acute HCV infection, and analyzed the correlation between gene expression levels and clinical profiles. Our results showed that expression of hepatic RIG-I, TLR3, TLR7, 2OAS1, and CXCL10 mRNAs was upregulated as early as 7 days post-inoculation and peaked 12 to 83 days post-inoculation. All of the three HCV infected chimpanzees exhibited significant elevations of serum alanine aminotransferase (ALT) activity between 70 and 95 days after inoculation. Elevated levels of serum cytokeratin 18 (CK-18) and caspases 3 and 7 activity coincided closely with the rise of ALT activity, and were preceded by significant increases in levels of caspase 3 and caspase 7 mRNAs in the liver. Particularly we found that significant positive auto-correlations were observed between RIG-I, TLR3, CXCL10, 2OAS1, and PD-L1 mRNA and ALT activity at 3 to 12 days before the peak of ALT activity. However, we observed substantial negative auto-correlations between T cell and NK cell activation/inhibition-related genes and ALT activity at 5 to 32 days after the peak of ALT activity. Our results indicated cell death signaling is preceded by early induction of RIG-I, TLR3, 2OAS1, and CXCL10 mRNAs which leads to elevation of ALT activity and this signaling pathway occurs before the activation of NK and T cells during acute HCV infection. Our study suggests that PRRs and type I IFN response may play a critical role in development of liver cell injury related to viral clearance during acute HCV infection.
Pollan, Coregonus autumnalis pollan Thompson, requires an appropriate standardised sampling protocol for conservation assessments. The suitability of hydroacoustics with gillnetting was evaluated, ...and the effects of sampling design, effort and statistical analysis on the repeatability of results were tested. Summer hydroacoustic surveys appear appropriate as pollan were not abundant in acoustically unsampled areas. However, pollan density estimates were significantly affected by the gillnet sampling design used to ground‐truth the acoustic data. Density estimates from the >12‐ m layer were more robust to gillnet design than estimates from the 3‐ to 12‐ m layer. Estimates from different transect designs yielded some statistically significant results. Comparison of transects common to both transect designs suggests that observed differences reflect temporal changes rather than transect design effects. The reduction in the systematic parallel transect effort by half significantly affected target strength distributions but not pollan density estimates. Density estimates were affected by statistical analysis method where pollan density was highest, with geostatistical analysis providing higher estimates than the arithmetic mean. Hydroacoustic assessments may provide a reliable index of pollan abundance over time and between lakes but future research should investigate the effects of temporal and abiotic factors.
While Australia is a world leader in providing statutory donor-linking services - the practice whereby individuals connected through donor conception seek access to information about each other - ...there has been only limited exploration of how fertility clinics respond when approached with donor-linking requests. This article reports on 19 qualitative interviews conducted with Australian fertility clinic staff that explored how clinics manage requests to share identifying and non-identifying information about parties involved in donor conception. Our findings indicate that fertility clinics have experienced an increase in donor-linking requests in recent years, but that they are typically dealt with on an ad hoc basis. Two approaches to donor linking were identified: (1) an "active" approach where clinics supported donor linking and were willing to engage in outreach to see if the other party was open to information exchange; and (2) a "passive" approach whereby clinics were reluctant to facilitate linking and were unwilling to outreach to other parties. The variety of responses to donor-linking requests highlight the ways in which donor-conceived adults, parents and donors can have dramatically different access to information, depending on the clinic that provided treatment.
Many airway management guidelines include the use of airway exchange catheters (AECs). There are reports, however, of harm from their use, from both malpositioning and in particular from the ...administration of oxygen via an AEC leading to barotrauma.
We used an in vitro pig lung model to investigate the safety of administering oxygen at 4 different flow rates from a high-pressure source via 2 different AECs: a standard catheter and a soft-tipped catheter. Experiments were performed with the catheters positioned either above the carina or below it at the first point of resistance to advancement (hold-up). The experiments were then repeated to produce a series of 32 cases.
With an AEC positioned above the carina, we did not observe macroscopic lung damage after the administration of oxygen. The administration of oxygen through an AEC positioned below the carina resulted in macroscopic barotrauma regardless of the rate of oxygen delivery. Increasing speed of oxygen flow led to faster and more extensive damage. Use of an "injector" at 2.5 or 4 bar led to instantaneous macroscopic lung damage and advancement of the AEC through the lung tissue. Our observations were the same when both types of AECs were used.
Our results are consistent with reports of harm during the use of AECs and demonstrate the risk of administering oxygen through these devices when they are positioned below the carina. An indicator, ideally made on an AEC at the time of manufacture and designed to lie at the same level as the teeth, may be useful in preventing the insertion of that AEC beyond the level of the carina and improve the safety of using such devices.
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