The Medical journal of Australia
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Randomized Controlled Trial
Practitioner-supported delivery of internet-based cognitive behaviour therapy: evaluation of the feasibility of conducting a cluster randomised trial.
To determine the feasibility of conducting a cluster randomised trial in Australia of the effectiveness of general practitioner-supported delivery of internet-based cognitive behaviour therapy (CBT) and enhanced psychological care. ⋯ Our capacity to conduct a definitive trial was limited by available resources. Preliminary data suggest that primary care patients with depression may derive additional benefits from an internet-based CBT program delivered in conjunction with enhanced psychological care from GPs.
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To identify and describe current internet-based prevention and treatment programs for anxiety and depression in children and adolescents. ⋯ Our findings provide early support for the effectiveness of internet-based programs for child and adolescent anxiety and depression. More extensive and rigorous research is needed to further establish the conditions through which effectiveness is enhanced, as well as to develop additional programs to address gaps in the field.
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To compare changes in the costs of statins following patent expiry in Australia and England, and to estimate projected savings for Australia based on the government and consumers paying prices equivalent to those in England and increased use of generics. ⋯ The current arrangement for pricing statins places a considerable burden on the Australian community. Alternative pricing arrangements that provide incentives to lower statin prices and increase the proportion of generic prescriptions could be highly advantageous.
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Self-help delivered through online websites has been found to be beneficial for people with mental health problems, and consumers find internet support groups helpful. The Australian National University e-hub group delivers automated web interventions (BluePages, MoodGYM, e-couch) and an online bulletin board (BlueBoard) to the public for mental health self-help. The evidence-based web interventions require no direct therapist or other human involvement, while the bulletin board is moderated by trained consumers under the supervision of a clinical psychologist. ⋯ These services provide programs for prevention and early intervention and are particularly suited to people who prefer anonymous services, live in rural and remote areas, or have a preference for self-help methods, as well as for use in school and workplace settings. A range of best-practice measures have been developed and put in place to ensure high-quality service delivery. Evaluation and quality control are enabled by a database and associated software.
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Reach Out Central (ROC) is a serious game drawing on the principles of cognitive behaviour theory that has been designed to improve the mental health and wellbeing of young people, particularly men. ROC was developed over a 3-year period from 2003 to 2006, in consultation with young people aged 16-25 years who use the Reach Out mental health website http://www.reachout.com). ROC was launched online in September 2007. ⋯ Young women reported reduced psychological distress and improved life satisfaction, problem solving and help seeking; however, no significant changes were observed for young men. Although ROC was successful in attracting young men, demonstrating that the concept resonates with them, the service failed to keep them engaged. Further research is needed to explore how (or what changes need to be made) to sustain young men's engagement in the game.