Paul R Ward

• PhD
• Research Director at Torrens University Australia

UNSTRUCTURED Alcohol consumption remains a major societal problem, contributing to myriad health conditions and costing Australia $6.8 billion a year. Australian midlife women (45-64 years) consume more alcohol than ever – more than previous generations of midlife women and more than other age groups of women currently. Alcohol poses health risks u...

UNSTRUCTURED Alcohol consumption is socially accepted in Australia and places where alcohol is not served are rare. However, alcohol remains a major public health concern. Since COVID-19, alcohol consumption has increased even more, increasing non-communicable disease risks, social harms and economic costs. The socially engrained nature of alcohol...

Our perspective paper focuses on the sociology of hope and is a call to action for health promotion policy makers to create the conditions for hopefulness in alcohol reduction policy, advocacy and programs for/with midlife women. Alcohol is a major risk factor for breast cancer, and high proportions of midlife women in most high-income countries dr...

Background Population-level mammography screening for early detection of breast cancer is a secondary prevention measure well-embedded in developed countries, and the implications for women’s health are widely researched. From a public health perspective, efforts have focused on why mammography screening rates remain below the 70% screening rate re...

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries...

Objectives This systematic review aims to assess the available evidence on the prevention of type 2 diabetes mellitus (T2DM) among Middle Eastern (ME) populations residing in high-income countries (HICs). The review focuses on two key aspects: (1) evaluating the efficacy of interventions for improving health outcomes and (2) examining the barriers...

Background and Aims Organ donation is the last option for patients with end‐stage organ failure, but the number of people in need of transplantation outweighs the supply of donor organs. A thorough analysis of public understanding is required to design educational programs that increase public commitment to organ donation. Therefore, the present st...

Background As set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV...

Background Protecting doctors’ mental health has typically focused on individuals, rather than addressing organisational and structural-level factors in the work environment. Objectives This study uses the socioecological model (SEM) to illuminate and explore how these broader factors inform the mental health of individual doctors. Design Semi-st...

Background The increasing incidence of breast cancer and disease burden is a significant public health concern. While 30% of breast cancers could be prevented through addressing modifiable risk factors, misconceptions among women about breast cancer risks hamper primary prevention. In the absence of primary prevention, secondary prevention such as...

Objectives In areas with limited and unaffordable biomedical mental health services, such as sub-Saharan Africa (SSA), traditional healers are an incredibly well-used source of mental healthcare. This systematic review synthesises the available evidence on traditional healing practices, factors to access it and its effectiveness in improving people...

Background: Traditional Medicine (TM) is a culturally-rooted healthcare practice, and its use, including for treating illnesses among children, has been reported in many countries. Globally, Indonesia is in the top 10 countries with the highest child mortality rates. However, TM usage for treating illnesses among children in Indonesia has received...

University students may be particularly vulnerable to develop mental disorders, including depression, due to sudden and unexpected changes in their daily life during the COVID-19 pandemic. The present study aimed to assess depression among male smokers and non-smokers university students during the first wave of COVID-19 in Bangladesh. A web-based...

Summary Background Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injur...

Background Despite the fact that Sub-Saharan Africa bears a disproportionate burden of armed conflicts and HIV infection, there has been inadequate synthesis of the impact of armed conflict on HIV treatment outcomes. We summarized the available evidence on the impact of armed conflicts on HIV treatment outcomes in Sub-Saharan Africa from 2002 to 20...

Context The COVID-19 pandemic has reignited a commitment from the health policy and health services research communities to rebuilding trust in healthcare and created a renewed appetite for measures of trust for system monitoring and evaluation. The aim of the present paper was to develop a multidimensional measure of trust in healthcare that: (1)...

Introduction Despite substantial research and provision of dental care, significant morbidity remains for children’s oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health o...

Objective Governments use vaccination mandates, of different degrees of coerciveness, to encourage or require childhood vaccination. We elicited the views of well‐informed community members on the public acceptability of using childhood vaccination mandates in Australia. Methods Four community juries were conducted in Canberra, Launceston, Cairns...

Background Dengue fever, the most prevalent mosquito-borne viral infection, is a recurrent public health threat in Bangladesh. Despite the government’s efforts, dengue outbreaks are on the upswing, and people’s knowledge, belief, and preventive practices regarding the disease at the rural community level are unclear. Objective The objective of thi...

Practice theory-based research has been established theoretically as an answer to health and social problems, but its use in empirical research is still emerging. We conducted a scoping review in accordance with JBI guidelines for evidence synthesis to identify methodological characteristics of practice theory-based research concerning parenting. A...

Background Trust in government is associated with health behaviours and is an important consideration in population health interventions. While there is a reported decline in public trust in government across OECD countries, the tools used to measure trust are limited in their use for informing action to (re)build trust, and have limitations relate...

Background Vaccine hesitancy exists on a continuum ranging between complete adherence and complete refusal due to doubts or concerns within a heterogeneous group of individuals. Despite widespread acknowledgement of the contextual factors influencing attitudes and beliefs shaping COVID-19 vaccine hesitancy, qualitative research with equity-deservin...

The ability of governments and nations to handle crises and protect the lives of citizens is heavily dependent on the public’s trust in their governments and related social institutions. The aim of the present research was to understand public trust in government during a time of crisis, drawing on interview data (N = 56) collected during the COVID...

The decline in students’ empathy during medical school is attributed in part to an informal curriculum that prioritises biomedical knowledge and lacks a patient perspective of illness. Transformation of medical professionalism to include socially accountable justice actions entails a theoretical shift in curriculum regulative discourse, and curricu...

Background Co‐produced research holds enormous value within the health sciences. Yet, there can be a heavy focus on what research participants think, do and know; while the researcher's responsibility to explore and re/work their own knowledge or praxis tends to escape from view. This is reflected in the limited use of co‐production to explore broa...

Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyaka...

Objective This study explored how cognitive labour as a form of unpaid, household labour is performed by people in same-gender couples. Background Excessive performance of unpaid labour has been associated with several health impacts. Cognitive labour (anticipating needs, identifying options for meeting needs, making decisions and monitoring progr...

HIV diagnosis and management have often caused disruptions to the everyday life and imagined futures of people living with HIV, both at individual and social levels. This has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper attempts to re-cast data from interviews with 40 men living with HIV (MLHIV) in Yogyak...

Background Traditional male circumcision (TMC) has a strong socio-cultural and religious context valued as a sacred and secret practice. In many parts of the world, it has traditionally been practiced in Africa, Asia, Australia, Polynesia, and South and North America. Besides as a rite of passage to manhood, TMC, compounded with male dominance cult...

Newcomers to Canada have been disproportionally affected by COVID-19, with higher rates of infection and severity of illness. Determinants of higher rates may relate to social and structural inequities that impact newcomers' capacity to follow countermeasures. Our aim was to describe and document factors shaping newcomers' acceptance of COVID-19 co...

Objectives To synthesise evidence to determine whether, in contrast to medical male circumcision, traditional male circumcision (TMC) practices may contribute to HIV transmission and what the impacts of TMC are on the initiates, their families and societies. Design Systematic review. Data source PubMed, CINHAL, SCOPUS, ProQuest, Cochrane database...

Background: Women during midlife are consuming larger quantities of alcohol than any other age group of women and any other generation of midlife women previously. This is concerning given alcohol related-health risks coalesce with age-related health risks for women, in particular, breast cancer. Methods: In-depth interviews with 50 Australian m...

The importance of measuring trust in health systems has been accentuated due to its correlation with important health outcomes aimed at reducing COVID‐19 transmission. A systematic review published almost a decade ago identified gaps in measures including the lack of focus on trust in systems, inconsistency regarding the dimensionality of trust and...

Background Acute Severe Hepatitis of Unknown Etiology (ASHUE) emerged as a new global outbreak in Indonesia early May 2022, coinciding with the COVID-19 pandemic. This study aimed to understand public reactions and responses to the emergence of ASHUE Indonesia and to Government-led disease prevention responses. Understanding how the public perceive...

Background Coronavirus disease (COVID-19) pandemic has a significant influence on the access to healthcare services. This study aimed to understand the views and experiences of people living with HIV (PLHIV) about barriers to their access to antiretroviral therapy (ART) service in Belu district, Indonesia, during the COVID-19 pandemic. Methods Thi...

Aim: This study aimed to identify how dietitians and other healthcare providers work to build trust in food systems in the course of providing dietary education. Methods: Qualitative semi-structured interviews were conducted with 15 purposefully sampled dietitians (n = 5), general practitioners (n = 5), and complementary and alternative medicine...

Alcohol is a modifiable breast cancer risk, increasing risk in a dose-dependent manner. Mid-life women (aged 45-64 years) consume alcohol at higher rates than younger women and this, combined with age, make them a high-risk group for breast cancer. This critical public health problem has a seemingly obvious solution (reduce drinking); however, wome...

HIV infection and its sequelae continue to be a significant challenge among women and their families in developing countries despite the progress that has been made in the prevention and treatment of HIV. This paper describes the strategies employed by mothers with HIV to cope with the various challenges experienced following their own and their ch...

Introduction The role of primary caregivers in setting the foundation for a child’s oral health throughout life is well recognised. Due to the dominant behaviour-based approach, research to date has mainly focused on exploring individual primary caregivers’ oral health knowledge and behaviours. A social science approach involving social practice th...

COVID-19 has rapidly impacted societies on a global scale, with older people among the most affected. To care for older people living in their own homes, female family caregivers play a pivotal role. The current study aimed to explore the actions of female family caregivers and the challenges they faced in taking care of older people living at home...

Background: The coronavirus disease (COVID-19) pandemic has a significant influence on access to healthcare services. This study aimed to understand the views and experiences of people living with HIV (PLHIV) about barriers to their access to antiretroviral therapy (ART) service in Belu district, Indonesia, during the COVID-19 pandemic. Methods: Th...

Background: Smoking and resulting health problems disproportionately impact low socioeconomic status (SES) individuals. Building resilience presents an approach to 'closing the gap'. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online an...

Introduction: Rural generalist anaesthetists (RGAs) are central to the delivery of health care in much of rural and remote Australia. This article details a systematic review of the literature specifically asking the question, 'What is the current evidence of the 'safety' of anaesthesia delivered by RGAs?' Methods: Six databases were searched us...

Introduction Although traditional male circumcision (TMC) is still practiced in a number of countries, and its healing process may have a high risk of HIV and other STIs transmission, there have been no published systematic reviews on TMC, HIV risk, and impacts on circumcised men and their families. The aim of this study is to synthesise evidence o...

The COVID-19 pandemic highlighted and exacerbated inequities in health for structurally marginalised Canadians. Their location on society's hierarchies constrained their ability to access healthcare and follow recommended health behaviours. The aim of this article is to identify, from the perspective of marginalised populations, factors influencing...

Obesity is a medical label for people with “larger bodies” (variously defined) which has taken hold in the lay populace. Epidemiological studies link obesity to various noncommunicable diseases such as diabetes and heart disease, often leading to higher death rates. Quantitative sociological studies show how obesity is socioeconomically patterned (...

Human Immunodeficiency Virus (HIV) is a major global public health issue that affects the quality of life (QoL) of people living with HIV (PLHIV) globally and in Indonesia. As a part of a large-scale qualitative study investigating HIV risk factors and impacts on PLHIV and facilitators of and barriers to their access to HIV care services in Yogyaka...

Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustaina...

Background The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to try to save the lives of everyone affected. The present study aimed to explore th...

Background: Urgent action is required to identify socially acceptable alcohol reduction options for heavy-drinking midlife Australian women. This study represents innovation in public health research to explore how current trends in popular wellness culture toward 'sober curiosity' (i.e., an interest in what reducing alcohol consumption would or c...

Migrant populations are one of the vulnerable groups to HIV transmission and its consequences. They are also reported to experience delayed entry or linkage into HIV services and have poorer HIV-related health outcomes. This study aimed to understand barriers to accessing HIV care services in host countries among Indonesian, male, former (returned)...

The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on individual and social activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design usin...

HIV infection is a major public health concern, with a range of negative impacts on People Living with HIV (PLHIV). A qualitative study in Yogyakarta, Indonesia, using in-depth interviews with 26 Women Living with HIV (WLHIV) was conducted to understand HIV risk factors and impact and their access to HIV care services. This paper describes the self...

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age gr...

The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth...

Background High rates of alcohol consumption by midlife women, despite the documented risks associated with breast cancer, varies according to social class. However, we know little about how to develop equitable messaging regarding breast cancer prevention that takes into consideration class differences in the receipt and use of such information....

Background Despite measures to reduce the spread of COVID-19 in the world, it is increasing day by day. Countries that implement good prevention strategies are less likely to be infected with COVID-19 than those that do not. Therefore, the aim of this study was to assess knowledge, attitude, and preventive practices toward COVID-19 early in the out...

Background The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people worldwide and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to save the life of everyone affected. The present study aimed to explore...

COVID-19 has rapidly impacted societies on a global scale, with older people among the most affected. To care for older people living in their own homes, female family caregivers play a pivotal role. The current study aimed to explore the actions of female family caregivers and the challenges they faced in taking care of older people living at home...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Background Even though the emergence of the coronavirus disease 2019 (COVID-19) vaccine and the increasing vaccination rates are promising, there are reports of refusal to get vaccinated in a different segment of the population, including health care workers. Objective This study determines the acceptance/refusal of the COVID-19 vaccination and it...

Alcohol consumption by Australian women during midlife has been increasing. Health promotion efforts to reduce alcohol consumption in order to reduce alcohol-related disease risk compete with the social contexts and value of alcohol in women’s lives. This paper draws on 50 qualitative interviews with midlife women (45–64 years of age) from differen...

Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as...

This study aimed to understand Indonesian healthcare professionals’ (HCPs) perceptions and experiences regarding barriers to both HCP and community adherence to COVID-19 prevention guidelines in their social life. This methodologically qualitative study employed in-depth interviewing as its method for primary data collection. Twenty-three HCP parti...

Sarker R, Islam MS, Moonajilin MS, Rahman M, Gesesew HA, et al. (2022) Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study. PLOS ONE 17(6): e0270417. https://doi.org/10.1371/journal.pone.0270417

Sarker R, Islam MS, Moonajilin MS, Rahman M, Gesesew HA, et al. (2022) Knowledge of breast cancer and breast self-examination practices and its barriers among university female students in Bangladesh: Findings from a cross-sectional study. PLOS ONE 17(6): e0270417. https://doi.org/10.1371/journal.pone.0270417

Early diagnosis of breast cancer is the best approach towards its control that may result in alleviating related mortality and morbidity. This study aimed to evaluate knowledge about breast cancer and both practices and perceived barriers to breast self-examination among female university students in Bangladesh. A cross-sectional study was carried...