Melbourne School of Population and Global Health - Research Publications

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    Comparing sexual behaviours and knowledge between domestic students and Chinese international students in Australia: findings from two cross-sectional studies
    Douglass, CH ; Qin, C ; Martin, F ; Xiao, Y ; El-Hayek, C ; Lim, MSC (SAGE PUBLICATIONS LTD, 2020-06-03)
    Few studies investigate sexual health among Chinese international students in Australia. We recruited domestic (n = 623) and Chinese international (n = 500) students for separate online surveys on sexual behaviours and knowledge. Samples were compared using Chi square, Fisher's exact and equality of medians tests. Domestic students were more likely than international students to have ever touched a partner's genitals (81% vs. 53%, p < 0.01), had oral sex (76% vs. 44%, p < 0.01), vaginal intercourse (67% vs. 41%, p < 0.01) and anal intercourse (31% vs. 6%, p < 0.01). Domestic students were younger when they first touched a partner's genitals (16 vs. 18 years, p < 0.01), had oral sex (17 vs. 18 years, p < 0.01) and vaginal intercourse (17 vs. 18 years, p < 0.01). Domestic students were less likely than Chinese international students to report only one lifetime partner for touching genitals (22% vs. 50%, p < 0.01), oral sex (25% vs. 55%, p < 0.01), vaginal intercourse (30% vs. 58%, p < 0.01) and anal intercourse (54% vs. 88%, p < 0.01). Domestic students were more likely than Chinese international students to use the oral contraceptive pill (48% vs. 16%, p < 0.01) and long-acting reversible contraceptives (19% vs. 1%, p < 0.01). Domestic students scored higher than international students on a contraception and chlamydia quiz (4/5 vs. 2/5, p < 0.01). Domestic and Chinese international students differed in sexual behaviours and knowledge highlighting the need for relevant sexual health promotion for both groups.
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    Cluster-based Diversity Over-sampling: A Density and Diversity Oriented Synthetic Over-sampling for Imbalanced Data
    Yang, Y ; Khorshidi, H ; Aickelin, U (SCITEPRESS - Science and Technology Publications, 2022)
    In many real-life classification tasks, the issue of imbalanced data is commonly observed. The workings of mainstream machine learning algorithms typically assume the classes amongst underlying datasets are relatively well-balanced. The failure of this assumption can lead to a biased representation of the models’ performance. This has encouraged the incorporation of re-sampling techniques to generate more balanced datasets. However, mainstream re-sampling methods fail to account for the distribution of minority data and the diversity within generated instances. Therefore, in this paper, we propose a data-generation algorithm, Cluster-based Diversity Over-sampling (CDO), to consider minority instance distribution during the process of data generation. Diversity optimisation is utilised to promote diversity within the generated data. We have conducted extensive experiments on synthetic and real-world datasets to evaluate the performance of CDO in comparison with SMOTE-based and diversity-based methods (DADO, DIWO, BL-SMOTE, DB-SMOTE, and MAHAKIL). The experiments show the superiority of CDO.
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    Longitudinal association between informal unpaid caregiving and mental health amongst working age adults in high-income OECD countries: A systematic review.
    Ervin, J ; Taouk, Y ; Fleitas Alfonzo, L ; Peasgood, T ; King, T (Elsevier BV, 2022-11)
    Background: Informal unpaid caregivers provide most of the world's care needs, experiencing numerous health and wealth penalties as a result. As the COVID-19 pandemic has highlighted, informal care is highly gendered. Longitudinal evidence is needed to assess the causal effect of caregiving on mental health. This review addresses a gap by summarising and appraising the longitudinal evidence examining the association between unpaid caregiving and mental health among working age adults in high-income Organisation for Economic Co-operation and Development (OECD) countries and examining gender differences. Methods: Six databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science, Econlit) from Jan 1, 2000 to April 1, 2022. Population-based, peer-reviewed quantitative studies using any observational design were included. Population of interest was working age adults. Exposure was any unpaid caregiving, and studies must have had a non-caregiving comparator for inclusion. Mental health outcomes (depression, anxiety, psychological distress/wellbeing) were measurable by validated self-report tools or professional diagnosis. Screening, data extraction and quality assessment (ROBINS-E) were conducted by two reviewers. The study was prospectively registered with PROSPERO (CRD42022312401). Findings: Of the 4536 records screened; 13 eligible studies (133,426 participants) were included. Overall quality of evidence was moderate. Significant between-study heterogeneity precluded meta-analysis, so albatross and effect-direction plots complement the narrative synthesis. Results indicate a negative association between informal unpaid care and mental health in adults of working age. Importantly, all included studies were longitudinal in design. Where studies were stratified by gender, caregiving had a consistently negative impact on the mental health of women. Few studies examined men but revealed a negative effect where an association was found. Interpretation: Our review highlights the need to mitigate the mental health risks of caregiving in working age adults. Whilst men need to be included in further scholarship, reducing the disproportionate caregiving load on women is a crucial requirement for policy development. Funding: Melbourne School of Population and Global Health, Targeted Research Support Grant.
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    Vaccine hesitancy among working-age adults with/without disability in the UK
    Emerson, E ; Totsika, V ; Aitken, Z ; King, T ; Hastings, RP ; Hatton, C ; Stancliffe, RJ ; Llewellyn, G ; Kavanagh, A (Elsevier, 2021-11)
    Objectives: To estimate levels of COVID-19 vaccine hesitancy among working-age adults with disabilities in the United Kingdom. Study design: Cross-sectional survey. Methods: Secondary analysis of data collected on a nationally representative sample of 10,114 respondents aged 16–64 years . Results: The adjusted relative risk for hesitancy among respondents with a disability was 0.92 (95% CI 0.67–1.27). There were stronger associations between gender and hesitancy and ethnic status and hesitancy among participants with a disability. The most common reasons cited by people with disabilities who were hesitant were: concern about the future effects of the vaccine, not trusting vaccines and concern about the side effects of vaccination. Conclusions: The higher rates of vaccine hesitancy among women with disabilities and among people from minority ethnic groups with disabilities are concerning.
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    Predictors of vaccine hesitancy among disability support workers in Australia: A cross-sectional survey.
    Kavanagh, A ; Dickinson, H ; Dimov, S ; Shields, M ; McAllister, A (Elsevier BV, 2022-09-02)
    BACKGROUND: Achieving high levels of vaccination among disability support workers (DSWs) is critical to protecting people with disability from COVID-19 and other vaccine-preventable diseases. OBJECTIVE: To identify how demographic factors, risk perceptions of COVID-19 and the COVID-19 vaccine, and views about COVID-19 vaccination are associated with COVID-19 vaccine hesitancy among DSWs. METHODS: Survey of 252 Australian DSWs conducted in March and early April 2021. Participants were classified as vaccine hesitant if they had not been vaccinated and would not have the vaccine when offered it. Logistic regression analysis was used to control for confounders. RESULTS: 52.4% of DSWs were hesitant with females being more likely to be hesitant than males (58.2% female, 38.1% male). Hesitancy was more frequent among DSWs who were not worried about COVID-19 for themselves or their family (adjusted odds ratio (AOR) 1.86, 95% CI 1.0-3.45); did not agree they were at more risk than the rest of the community (AOR 2.29, 95% 1.25-4.20); were concerned about vaccine safety (AOR 22.86, 95% CI 10.59-49.13) and were not confident the vaccine would protect them (AOR 6.06, 95% CI 3.21-11.41) or the clients from COVID-19 (AOR 6.03, 95% CI 3.19-11.41). DSWs who thought vaccination was a personal choice were more likely to be hesitant (82.1%) than those who thought it was a community responsibility (27.6%). CONCLUSIONS: The study shows that increasing vaccination rates among DSWs requires targeted strategies that emphasise the seriousness of the infection; the potential for vaccines to reduce transmission; and vaccine safety and efficacy.
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    A new code of practice for specialist family violence services.
    Davis, E (Council to Homeless Persons, 2020)
    Domestic Violence Victoria (DV Vic) recently published the new Code of Practice: Principles and Standards for Specialist Family Violence Services for Victim-Survivors (2nd edition, 2020).1 This article looks into what went into developing the Code and what it means in the post-Royal Commission specialist family violence service environment.
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    The effectiveness of an Australian community suicide prevention networks program in preventing suicide: a controlled longitudinal study
    Morgan, AJ ; Roberts, R ; Mackinnon, AJ ; Reifels, L (BMC, 2022-10-19)
    BACKGROUND: Suicide is a major issue affecting communities around the world. Community-based suicide prevention approaches can tailor activities at a local level and are recognised as a key component of national suicide prevention strategies. Despite this, research exploring their effects on completed suicides is rare. This study examined the effect of a national program of community suicide prevention networks on suicide rates in catchment areas across Australia. METHODS: Australian suicide data from the National Coronial Information System for 2001-2017 were mapped to geographic catchment areas of community suicide prevention networks and matched control areas with similar characteristics. The effect of network establishment on suicide rates was evaluated using longitudinal models including fixed effects for site type (network or control), time, season, and intervention (network establishment), with site included as a random intercept. RESULTS: Sixty suicide prevention networks were included, servicing areas with a population of 3.5 million. Networks varied in when they were established, ranging from 2007 to 2016. Across the time-period, suicide rates per 100,000 per quarter averaged 3.73 (SD = 5.35). A significant reduction in the suicide rate of 7.0% was found after establishment of networks (IRR = 0.93, 95% CI 0.87 to 0.99, p = .025). CONCLUSION: This study found evidence of an average reduction in suicide rates following the establishment of suicide prevention networks in Australian communities. These findings support the effectiveness of empowering local communities to take action to prevent suicide.
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    How structural and symbolic violence during resettlement impacts the social and mental wellbeing of forced migrant women: the lived experiences of Arabic speaking survivors of IPV resettled in Melbourne, Australia
    Hourani, J ; Jarallah, Y ; Block, K ; Murray, L ; Chen, J ; Hach, M ; Vaughan, C (Springer Science and Business Media LLC, 2022)
    Forced migrant women experience high levels of violence across their journeys and violence can be characterised as having three overarching forms: structural, symbolic, and interpersonal. It is important to understand the intersecting nature of gendered forms of symbolic, structural and interpersonal violence, and their impact on the mental health of forced migrant women in order to develop holistic IPV and resettlement programs and interventions. This article adopts an ecological framework of violence and qualitative methods with mental health service providers and survivors of IPV to understand the intersections of different forms of violence and their impact on mental health as they relate to the lived experiences of Arabic-speaking forced migrant survivors currently residing in Melbourne, Australia. Our research has three key findings: (1) that forced migrant women living in Melbourne, Australia experience intersecting forms of violence during resettlement (2) Structural and symbolic violence against forced migrant women persists regardless of marital status (3) Autonomy and independence plays a vital role in the mental health and wellbeing of forced migrant women. Our findings reveal that structural and symbolic violence increase the risk of IPV for forced migrant women during resettlement and that even when forced migrant women leave IPV situations, structural and symbolic violence persist and exacerbate mental ill-health. This article also reveals the importance autonomy and independence in both the perpetration of violence and in healing and recovery.
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    Expert-Machine Collaborative Decision Making: We Need Healthy Competition
    Aickelin, U ; Maadi, M ; Khorshidi, HA (Institute of Electrical and Electronics Engineers (IEEE), 2022-01-01)
    Much has been written and discussed in previous years about human-AI interaction. However, the debate so far has mainly concentrated on "Aaverage" decision makers, neglecting important differences when it is experts who require support. In this article, we are going to talk about expert-machine collaboration for decision-making. We investigate the current approaches for expert decision support and exemplify the inefficiency of this approach for a real clinical decision-making problem. We propose two solutions for expert-machine collaboration to overcome the shortcomings of the current state of the art. We think that the proposed approaches open new horizons for expert-machine collaborative decision-making.
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    Real-time Repatriation: Data Governance for Social Anthropology in the 21st Century
    Rose, JWW (Paris Nanterre University, 2022)
    Social Anthropologists are currently grappling with complex simultaneous changes in research ethics and data governance regimes across diverse jurisdictions. Internationally, repatriation of unethically acquired ethnographic collections is becoming common-place, resulting in the return of both tangible and intangible cultural assets to their rightful owners. In Europe, the open data movement and the recent implementation of the General Data Protection Regulation appears to challenge social anthropologists’ commitment to protect the confidentiality of oftenvulnerable research participants. Meanwhile, in Australia, New Zealand, Canada and elsewhere, the popular refrain ‘Indigenous data sovereignty’ is compelling many social anthropologists to face discomforting aspects of their field’s involvement in colonial administrative regimes. In this paper I present a model for how social anthropology might reconcile three interrelated factors contributing to this complex situation: 1) Repatriation of data collected from research participants without clear or sufficiently comprehensive consent; 2) Risks and opportunities presented by legislated instances of the open data movement and; 3) Relevant and operable features of the Indigenous data sovereignty movement. Drawing on my 20-year career as a forensic and expert social anthropologist working with Indigenous community organisations on land rights and cultural heritage preservation cases in the Australian Federal Court and under Northern Territory statutory regimes, I illustrate how this model of social anthropological data governance can be put into effect. ‘Real-time repatriation’ describes the synthesis of leading ethical, legal and technological standards in proactively upholding and safeguarding the interests and decision-making autonomy of participants in social anthropological research.