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Leung J.,Policy and Epidemiology Group | Leung J.,University of Queensland | Smith A.,University of Stirling | Atherton I.,Napier University | McLaughlin D.,University of Queensland
Journal of Cancer Education | Year: 2015

Patients have a right to privacy in a health care setting. This involves conversational discretion, security of medical records and physical privacy of remaining unnoticed or unidentified when using health care services other than by those who need to know or whom the patient wishes to know. However, the privacy of cancer patients who live in rural areas is more difficult to protect due to the characteristics of rural communities. The purpose of this article is to reflect on concerns relating to the lack of privacy experienced by cancer patients and health care professionals in the rural health care setting. In addition, this article suggests future research directions to provide much needed evidence for educating health care providers and guiding health care policies that can lead to better protection of privacy among cancer patients living in rural communities. © 2015 American Association for Cancer Education

Chan G.C.K.,University of Queensland | Leung J.,Policy and Epidemiology Group | Leung J.,University of Washington | Leung J.,University of Queensland | And 6 more authors.
Journal of Rural Health | Year: 2016

Purpose: Alcohol use is more prevalent in rural than urban areas in adult populations. Few studies have focused on adolescent drinking. This study investigated if adolescents in regional and rural areas of Australia were more likely to drink alcohol and if there were differences in parental drinking and alcohol supply across regions. Methods: A subsample from the National Drug Strategy Household Survey 2013, the largest nationally representative household survey on drug use in Australia, was used for this study. Participants who were aged 12-17 (N = 1,159) and participants who indicated they were parents or guardians of a dependent child (N = 7,059) were included in the analyses. Key measures were adolescent and parental alcohol use, parental supply of alcohol, and drinking location. Findings: Compared to those living in major cities, adolescents from inner regional and rural areas were at 85% and 121% higher odds, respectively, of obtaining their first alcohol from parents, and at 131% and 287% higher odds of currently obtaining their alcohol from their parents. Those from rural areas were at 126% higher odds of drinking in the past 12 months. Parents from inner regional and rural areas were at 45% and 63% higher odds, respectively, of heavy drinking; at 27% and 52% higher odds of weekly drinking; and at 26% and 37% higher odds of drinking at home. Conclusions: Adolescents from rural areas were at higher risk of alcohol use. Parents in rural areas were more likely to use alcohol in ways that encourage adolescent drinking. © 2015 National Rural Health Association

Leung J.,University of Queensland | Leung J.,Policy and Epidemiology Group | Leung J.,University of Washington | Atherton I.,Napier University | And 3 more authors.
Supportive Care in Cancer | Year: 2016

Purpose: The aim of this study is to examine the association between optimism and psychological distress in women with breast cancer after taking into account their self-rated general health. Methods: Data were aggregated from the Scottish Health Survey (2008 to 2011) to derive a nationally representative sample of 12,255 women (11,960 cancer-free controls, and 295 breast cancer cases identified from linked cancer registry data). The explanatory variables were optimism and general health, and the outcome variable was symptoms of psychological distress. Logistic regression analyses were conducted, with optimism entered in step 1 and general health entered in step 2. Results: In an unadjusted model, higher levels of optimism were associated with lower odds of psychological distress in both the control group (OR = 0. 57, 95 % CI = 0.51–0.60) and breast cancer group (OR = 0. 64, 95 % CI = 0.47–0.88). However, in a model adjusting for general health, optimism was associated with lower odds of psychological distress only in the control group (OR = 0.50, 95 % CI = 0.44–0.57), but not significantly in the breast cancer group (OR = 1.15, 95 % CI = 0.32–4.11). In the breast cancer group, poor general health was a stronger associate of psychological distress (OR = 4. 98, 95 % CI = 1.32–18.75). Results were consistent after adjusting for age, years since breast cancer diagnosis, survey year, socioeconomic status, education, marital status, body mass index, smoking status, and alcohol consumption. Conclusion: This research confirms the value of multicomponent supportive care interventions for women with breast cancer. Specifically, it suggests that following breast cancer diagnosis, health care professionals need to provide advice and signpost to services that assist women to maintain or improve both their psychological and general health. © 2015, Springer-Verlag Berlin Heidelberg.

Leung J.,University of Queensland | Leung J.,Policy and Epidemiology Group | Macleod C.,NHS Highland | McLaughlin D.,University of Queensland | And 7 more authors.
Preventive Medicine Reports | Year: 2015

Objective: To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Method: Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Results: Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). Conclusions: The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography. © 2015 The Authors.

Degenhardt L.,University of New South Wales | Degenhardt L.,University of Melbourne | Baxter A.J.,Policy and Epidemiology Group | Baxter A.J.,University of Queensland | And 11 more authors.
Drug and Alcohol Dependence | Year: 2014

Aims: To estimate the global prevalence of cocaine and amphetamine dependence and the burden of disease attributable to these disorders. Methods: An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years (DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010. Results: In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million amphetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for amphetamines. There were 37.6 amphetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between amphetamines and cocaine in the geographic distribution of crude DALYs. Over half of amphetamine dependence DALYs were in Asian regions (52%), whereas almost half of cocaine dependence DALYs were in the Americas (44%, with 23% in North America High Income). Conclusion: Dependence upon psychostimulants is a substantial contributor to global disease burden; the contribution of cocaine and amphetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden. © 2014 Elsevier Ireland Ltd.

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