ORCID Profile
0000-0002-4355-4498
Current Organisation
University of Tasmania
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Publisher: Wiley
Date: 24-10-2019
DOI: 10.1111/AJR.12556
Abstract: To describe the characteristics of hospital admissions for dental conditions, by Australian Statistical Geography Standard remoteness area for the 5 years 2010/2011 to 2014/2015. Retrospective analysis of preventable hospital admissions due to dental conditions. National data set provided by the Australian Institute of Health and Welfare. Every hospital admission for patients who were admitted for dental conditions over five financial years, from 2010/2011 to 2014/2015. The number (and rate per 1000 population) of hospital admissions due to dental conditions in each Australian Statistical Geography Standard remoteness area (major city, inner regional, outer regional, remote and very remote). There were 316 937 hospital admissions for dental conditions over the 5-year period. The rate of potentially preventable dental hospital admissions ranged from an average of 2.5 per 1000 population in major cities to 3.2 in inner regional areas, 3.1 in outer regional areas, and 4.1 per 1000 in remote and very remote areas. The rate of admissions was highest among those aged 0-14 years living in remote (9.0-10.0 per 1000) and very remote (9.8-12.5 per 1000) areas. Dental caries was the most common reason for admissions. There is an urgent need to address the social determinants of oral health in children aged 0-14 years living in remote and very remote Australia. The delivery of mobile primary dental care services needs to be expanded in remote and very remote areas to prevent and treat dental caries.
Publisher: MDPI AG
Date: 2020
DOI: 10.3390/TROPICALMED5010007
Abstract: Until the 1970s, infectious disease training in most medical schools was limited to those diseases common in the area of instruction. Those wishing to explore a more globalised curriculum were encouraged to undertake specialist postgraduate training at schools or institutes of tropical medicine. However, the increase in global trade and travel from the 1970s onward led to dramatic changes in the likelihood of returning travellers and new immigrants presenting with tropical infections in temperate regions. Furthermore, population growth and the changing relationships between animals, the environment, and man in agriculture accentuated the importance of a wider understanding of emerging infectious diseases, zoonotic diseases and parasitic infections. These epidemiological facts were not adequately reflected in the medical literature or medical curriculum at the time. The orientation on tropical infections needed specialised attention, including instruction on diagnosis and treatment of such infections. We describe key global health events and how the changing field of global medicine, from the 1970s to early 2000, impacted on medical education and research. We describe the impact of global health changes in the Tasmanian context, a temperate island state of Australia. We retrospectively analysed data of patients diagnosed with parasites and present a list of endemic and non-endemic parasites reported during this period. Finally, we reflect on the new approaches to the changing needs of global health and challenges that medical programmes, learners and educators face today.
Publisher: Mark Allen Group
Date: 02-09-2023
DOI: 10.12968/BJOM.2023.31.9.488
Abstract: Women worldwide experience post-childbirth morbidities such as incontinence and pain. While there is limited evidence of women's help-seeking behaviour, many do not seek treatment. This study aimed to explore the key influences on women's help-seeking behaviour 12 months after birth. Three different study approaches were used: a meta-aggregation systematic review, concept mapping and a directed qualitative content approach. Women often did not seek help because they accepted problems as a normal part of motherhood. They were more likely to share problems with family and friends. Online platforms allowed women to share their problems anonymously, but the support provided demonstrated some normalising of abnormal problems. The feminist pragmatic approach highlighted the ‘fallacy of normalcy’ as underpinning women's help-seeking behaviour after childbirth.
Publisher: Wildlife Disease Association
Date: 04-1997
DOI: 10.7589/0090-3558-33.2.352
Abstract: Tasmanian native marsupials were screened for the presence of Giardia spp. over a 3 yr period, revealing a 21% prevalence in the 295 animals tested. A pilot study of experimentally infected eastern barred bandicoots (Perameles gunnii) indicated susceptibility to infection with Giardia duodenalis from a human source.
Publisher: Wiley
Date: 03-08-2023
DOI: 10.1111/AJR.12912
Abstract: This research used systems leadership to explore stakeholder engagement regarding requirements, incentives and barriers to adopting a faecal source tracking method to identify contamination sources in surface waters. The research comprised two branches, one quantitative, conducted in a food and water laboratory the other qualitative, conducted within stakeholder organisations and meeting premises. Ten stakeholder representatives participated in semi‐structured interviews and ten in a focus group. Seven in iduals participated in both activities while three who were interviewed were replaced by alternate representatives for the focus group. A multimethod participatory action research project was completed, with a quantitative trial of a microbial source tracking method conducted concurrently with two iterations of qualitative research into the needs of the stakeholder system through semi‐structured interviews and a focus group. Thematic analysis of stakeholder interviews yielded key incentive and barrier themes, while the laboratory trial created a comparison library and tested the efficacy of the laboratory method. The focus group further explored key themes and identified requirements for collaborative effort across the system, and the need to address misinterpretation of statistical associations. Systems leadership was effective in exploring stakeholder interest in the proposed faecal source tracking method. Two iterations of qualitative research helped to identify the needs of in idual stakeholders, and then develop collective strategies for addressing the critical incentives and barriers.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.EPIDEM.2019.100377
Abstract: Ross River virus (RRV) is Australia's most epidemiologically important mosquito-borne disease. During RRV epidemics in the State of Victoria (such as 2010/11 and 2016/17) notifications can account for up to 30% of national RRV notifications. However, little is known about factors which can forecast RRV transmission in Victoria. We aimed to understand factors associated with RRV transmission in epidemiologically important regions of Victoria and establish an early warning forecast system. We developed negative binomial regression models to forecast human RRV notifications across 11 Local Government Areas (LGAs) using climatic, environmental, and oceanographic variables. Data were collected from July 2008 to June 2018. Data from July 2008 to June 2012 were used as a training data set, while July 2012 to June 2018 were used as a testing data set. Evapotranspiration and precipitation were found to be common factors for forecasting RRV notifications across sites. Several site-specific factors were also important in forecasting RRV notifications which varied between LGA. From the 11 LGAs examined, nine experienced an outbreak in 2011/12 of which the models for these sites were a good fit. All 11 LGAs experienced an outbreak in 2016/17, however only six LGAs could predict the outbreak using the same model. We document similarities and differences in factors useful for forecasting RRV notifications across Victoria and demonstrate that readily available and inexpensive climate and environmental data can be used to predict epidemic periods in some areas. Furthermore, we highlight in certain regions the complexity of RRV transmission where additional epidemiological information is needed to accurately predict RRV activity. Our findings have been applied to produce a Ross River virus Outbreak Surveillance System (ROSS) to aid in public health decision making in Victoria.
Publisher: Frontiers Media SA
Date: 27-05-2014
Publisher: SAGE Publications
Date: 24-09-2016
Abstract: Timor-Leste is one of the poorest countries in the world. The aim of this article was to investigate the association between socioeconomic status (SES) and dental caries experience in children living in Dili. Four out of 6 Dili subdistricts and 40 schools were randomly selected. Equal numbers of school children from 4 age groups (6-8, 9-11, 12-14, 15-17 years) were invited to participate. Data were gathered via a questionnaire and an oral examination by dental practitioners. In bivariate analysis, decayed, missing, and filled teeth index for deciduous + permanent teeth (dmft) was higher in children from mid- to high-SES than low-SES schools (1.1, 2.2, P = .001). With age, having had a toothache and dental visiting in the past 12 months in the multivariable model, higher dmft was found in children from mid- to high- to low-SES schools ( P .001). The primary dental caries experience was greater among children from mid- to high- than low-SES schools, which may be explained by high sugar consumption.
Publisher: Elsevier BV
Date: 06-1997
DOI: 10.1016/S0147-9571(96)00033-1
Abstract: Growing concerns on the emergence of verotoxin producing Escherichia coli (VTEC) in Australia have focused our attention on the possible sources of VTEC within the island state of Tasmania. An analysis of 156 food s les and 194 water s les obtained from various areas revealed evidence of eight possible sources. Six strains, with serotypes Ont:Hnt, O86:H-, O88:H-, O126:H21 and O134:H-, were isolated from water s les. Two VTEC of serotypes Ont:H8, 081:H- were isolated from raw meat s les. The waterborne isolates produced verocytotoxin. VT1, while both foodborne isolates were strong producers of VT2. Three VTEC isolates produced haemolysins, only one produced enterohaemolysin (EntHly) and the remaining were reported with alpha-haemolysin (alpha-Hly) activity. An important feature in the majority of isolates from water was their lack of ability to ferment lactose these isolates are routinely overlooked in public health laboratories.
Publisher: Medknow
Date: 2016
Abstract: Timor-Leste faces an urgent set of challenges in oral health. The impact of oral diseases in terms of reduced quality of life and cost of treatment is considerable. This paper reviews progress on policy recommendations since the National Oral Health Survey in 2002, the first such national survey. Few proposals have been implemented to date, owing to (i) lack of local support for the recommendations, particularly on promotion of oral health (ii) lack of financial and budgetary provisions for oral health (iii) lack of focus on services, human resources and dental personnel (iv) poor focus, design and implementation of policy and planning in oral health and (v) lack of transport to facilitate health-care workers' access to remote areas. Based on this assessment, the present paper presents a reconfigured set of policies and recommendations for oral health that take into consideration the reasons for low uptake of previous guidance. Key priorities are promotion of oral health, legislative interventions, education of the oral-health workforce, dental outreach programmes, targeted dental treatment, dental infrastructure programmes, and research and evaluation. Interventions include promotion of oral health for schoolchildren, salt fluoridation, fluoride toothpaste and banning sweet stalls and use of tobacco and betel nut in, or near, schools. Timor-Leste should strengthen the availability and quality of outreach programmes for oral health. Dental therapists and dental nurses who can supply preventive and atraumatic restorative dental care should continue to be trained, and the planned dentistry school should be established. Ongoing research and evaluation is needed to ensure that the approach being used in Timor-Leste is leading to improved outcomes in oral health.
Publisher: MDPI AG
Date: 04-2020
DOI: 10.3390/TROPICALMED5020050
Abstract: Devil facial tumor disease (DFTD) encompasses two independent transmissible cancers that have killed the majority of Tasmanian devils. The cancer cells are derived from Schwann cells and are spread between devils during biting, a common behavior during the mating season. The Centers for Disease Control and Prevention (CDC) defines a parasite as “An organism that lives on or in a host organism and gets its food from, or at, the expense of its host.” Most cancers, including DFTD, live within a host organism and derive resources from its host, and consequently have parasitic-like features. Devil facial tumor disease is a transmissible cancer and, therefore, DFTD shares one additional feature common to most parasites. Through direct contact between devils, DFTD has spread throughout the devil population. However, unlike many parasites, the DFTD cancer cells have a simple lifecycle and do not have either independent, vector-borne, or quiescent phases. To facilitate a description of devil facial tumor disease, this review uses life cycles of parasites as an analogy.
Publisher: Wiley
Date: 22-09-2014
Publisher: Wiley
Date: 12-11-2015
Publisher: JSTOR
Date: 06-1998
DOI: 10.2307/3284719
Publisher: Wiley
Date: 25-06-2020
DOI: 10.1111/NEP.13607
Abstract: End-stage kidney disease patients have increased mortality compared to the general population. Haemodialysis (HD) of more frequent and of longer duration has been proposed to improve survival but it remains unclear if this is attributed to increased frequency, duration, or both. We aimed to examine the independent effects of session frequency and duration on mortality in incident HD patients. A retrospective cohort study was performed using data from the Australian and New Zealand Dialysis and Transplant Registry examining non-Indigenous patients aged ≥18 years who initiated HD of ≥3 sessions/week in Australia from 2001 to 2015. Initial dialysis prescription was categorized as session duration >5 h/session compared to ≤5 h/session and session frequency as >3 sessions/week compared to 3 sessions/week. Survival analysis was performed using Cox regression analysis, with multivariable analysis controlling for available covariates. We examined 16 944 patients of whom 757 (4.5%) received >3 sessions/week and 518 (3.1%) received >5 h/session. After controlling for frequency, patients initiated on HD sessions >5 h had a significantly reduced risk of mortality compared with patients with HD session ≤5 h (adjusted hazard ratio (HR) = 0.57 95% confidence interval (CI) = 0.44-0.74). In contrast, patients initiated on >3 sessions/week of HD had a similar risk of death when compared with patients on 3 sessions/week of HD (adjusted HR = 0.97 95% CI = 0.84-1.13), after controlling for duration. Limitations include potential residual confounding and changes in exposure over time. Longer duration rather than increased frequency of treatment appears to reduce mortality in HD patients. This has implications for management and requires further study.
Publisher: Cambridge University Press (CUP)
Date: 04-09-2017
DOI: 10.1017/S095026881700190X
Abstract: Health warnings of mosquito-borne disease risk require forecasts that are accurate at fine-temporal resolutions (weekly scales) however, most forecasting is coarse (monthly). We use environmental and Ross River virus (RRV) surveillance to predict weekly outbreak probabilities and incidence spanning tropical, semi-arid, and Mediterranean regions of Western Australia (1991–2014). Hurdle and linear models were used to predict outbreak probabilities and incidence respectively, using time-lagged environmental variables. Forecast accuracy was assessed by model fit and cross-validation. Residual RRV notification data were also examined against mitigation expenditure for one site, Mandurah 2007–2014. Models were predictive of RRV activity, except at one site (Capel). Minimum temperature was an important predictor of RRV outbreaks and incidence at all predicted sites. Precipitation was more likely to cause outbreaks and greater incidence among tropical and semi-arid sites. While variable, mitigation expenditure coincided positively with increased RRV incidence ( r 2 = 0·21). Our research demonstrates capacity to accurately predict mosquito-borne disease outbreaks and incidence at fine-temporal resolutions. We apply our findings, developing a user-friendly tool enabling managers to easily adopt this research to forecast region-specific RRV outbreaks and incidence. Approaches here may be of value to fine-scale forecasting of RRV in other areas of Australia, and other mosquito-borne diseases.
Publisher: Oxford University Press (OUP)
Date: 08-03-2006
Publisher: Oxford University Press (OUP)
Date: 09-1998
DOI: 10.1111/J.1708-8305.1998.TB00485.X
Abstract: Giardia infection is an ongoing problem in Tasmania and occurs throughout the state. It has been postulated that part of the problem is the reservoir of infection in native animals which is suggested to contribute to infections in humans. To date, however, no detailed study on the epidemiology of giardiasis in Tasmania has been carried out. Information regarding the prevalence of Giardia infection in humans and the risk of intrafamilial transmission was obtained from the Department of Community and Health Services and from the direct examination of human or animal fecal s les. Giardia has been found to be present in a wide range of native and domestic animals and in humans of all ages from all over the state. Giardiasis is endemic in Tasmania and poses a risk to locals as well as to visitors to the state, especially those who participate in wilderness activities such as bushwalking. These people must be aware of the possible risk of Giardia infection and should take precautionary measures to avoid infection.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2022
Publisher: Elsevier BV
Date: 03-2017
Publisher: Wiley
Date: 24-09-2008
DOI: 10.1111/J.1751-0813.2008.00349.X
Abstract: As the platypus (Ornithorhynchus anatinus), the Tasmanian devil (Sarcophilus harrisi) and the eastern barred bandicoot (Perameles gunni) are currently at risk of serious population decline or extinction from fatal diseases in Tasmania, the goal of the present study was to describe the normal immune response of these species to challenge using the lymphocyte proliferation assay, to give a solid basis for further studies. For this preliminary study, we performed lymphocyte proliferation assays on peripheral blood mononuclear cells (PBMC) from the three species. We used the common mitogens phytohaemagglutinin (PHA), concanavalin A (ConA), lipopolysaccharide (LPS) and pokeweed mitogen (PWM). All three species recorded the highest stimulation index (SI) with the T-cell mitogens PHA and ConA. Tasmanian devils and bandicoots had greater responses than platypuses, although variability between in idual animals was high. For the first time, we report the normal cellular response of the platypus, the Tasmanian devil and the eastern barred bandicoot to a range of commonly used mitogens.
Publisher: Wildlife Disease Association
Date: 2000
DOI: 10.7589/0090-3558-36.1.141
Abstract: Wild-caught eastern barred bandicoots (Perameles gunnii) initially seronegative to Toxoplasma gondii, were inoculated orally with approximately 100 T. gondii oocysts. The bandicoots were maintained in indoor pens under laboratory conditions and observed daily. Serial blood s les were tested for agglutinating antibodies to T. gondii. Inoculated bandicoots died 15 and 17 days post infection. A rise in Direct Agglutination Test (DAT) titres was detected at the time of death (1:256, 1:64 respectively). Clinical observations, serological changes, gross findings at necropsy, and histopathological changes were consistent with acute toxoplasmosis. The findings indicate that eastern barred bandicoots are likely to die from primary T. gondii infection, often even before detectable antibodies are produced, reinforcing the significance of toxoplasmosis as a potential contributor to the reduction in numbers of wild populations of eastern barred bandicoots.
Publisher: SAGE Publications
Date: 23-01-2018
Abstract: Timor-Leste struggles with problems of poverty and inequalities that underlie many health disparities, including oral health. This study aimed to determine the association between parental education and dental caries in school children aged 6 to 17 years from 40 randomly selected schools in 4 Dili subdistricts. A questionnaire and oral examination collected data and multivariable log binomial models were used for data analysis. Results indicate no association between parental education level and the prevalence of untreated decay in deciduous teeth ( P = .96). There was an association between parental education level and untreated decay in permanent teeth ( P = .03) and untreated decay overall ( P = .01). Children whose parents had higher education levels have approximately half the relative risk (aRR 0.47, 95% CI 0.25-0.89) of decay compared with children whose parents had low levels of education.
Publisher: Oxford University Press (OUP)
Date: 08-03-2006
Abstract: With the inclusion of elective programs, often overseas, in many medical courses, it was decided that a preliminary retrospective analysis of health problems associated with these programs in medical students from the University of Tasmania would be desirable. A questionnaire covering general travel health issues was distributed to all medical students in the University of Tasmania, on return from their elective. They were asked to complete the questionnaire and return it on an anonymous and voluntary basis. In addition, student elective submissions were consulted for information relating to their chosen destination. Results of the study indicate that general practitioners were the most common source of pretravel advice for Tasmanian medical students. Overall, 64% of students experienced some sort of health problem of which travelers' diarrhea was the most common. Most problems were mild and self-limiting, but a number of serious infections were recorded, including acute leptospirosis, paratyphoid, and Staphylococcus aureus cellulitis. Of particular concern were the reports of assault and sexual harassment recorded by several students. Elective programs are an important part of many medical courses. With the widespread destinations chosen by students, it is important that they be given adequate pretravel health advice. Most of the health problems encountered by students from the University of Tasmania were mild, but exposure to serious infections was recorded. It is thus imperative that students take out travel health insurance and that they are counseled on how to avoid dangerous situations while abroad.
Publisher: Wildlife Disease Association
Date: 2000
DOI: 10.7589/0090-3558-36.1.145
Abstract: An experimental feeding study was designed to assess the role of earthworms in the transmission of Toxoplasma gondii infection to eastern barred bandicoots (Perameles gunnii). Six animals with no agglutinating antibodies to T. gondii were fed artificially cultured earthworms that had been maintained in autoclaved nutrient-enriched soil. Two animals were given earthworms that had been maintained in soil contaminated with T. gondii oocysts (P89/VEG strain) two animals were fed on earthworms, which initially had been exposed to soil containing T. gondii oocysts then transferred through three changes of sterile soil two control bandicoots were fed earthworms maintained in sterile soil. Both bandicoots fed earthworms maintained in T. gondii contaminated soil died 11 and 14 days after feeding. The necropsy findings were consistent with acute toxoplasmosis. Bandicoots fed earthworms exposed to oocysts but then transferred through changes of sterilized soil remained healthy as did control animals. All surviving animals remained seronegative over the 6 wk observation period after feeding. These findings confirm that earthworms, a major component of the natural diet of P. gunnii, can transmit T. gondii infection. It appears that oocysts present in the alimentary tracts of the worms, rather than infective stages of T. gondii in worm somatic tissues, are responsible for these infections.
Publisher: Wiley
Date: 19-01-2018
DOI: 10.1111/OBR.12668
Abstract: Obesity in young adults and adolescents is associated with chronic co-morbidities. This project investigated whether being overweight or obese is a risk factor for periodontitis in adolescents (13-17 years) and young adults (18-34 years). A search of 12 databases was conducted using Medical Subject Headings/Index and Emtree terms. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, articles published between 2003 and 2016 were screened that reported periodontal and anthropometric measures. The Newcastle-Ottawa Scale was used to appraise the quality of studies. Of 25 eligible studies from 12 countries, 17 showed an association between obesity and periodontitis (odds ratios ranged from 1.1 to 4.5). The obesity indicators of body mass index, waist circumference, waist-hip ratio and body fat percentage were significantly associated with measures of periodontitis of bleeding on probing, plaque index, probing depths, clinical attachment loss, calculus, oral hygiene index and community periodontal index. Two prospective cohort studies in the review showed no significant association between obesity and periodontitis, but these studies had limitations of study design and used inappropriate epidemiological diagnostic measures of periodontitis. There was evidence to suggest that obesity is associated with periodontitis in adolescents and young adults. Systematic Review Registration: PROSPERO Registration Number: CRD42016046507.
Publisher: Oxford University Press (OUP)
Date: 17-07-2020
Abstract: aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. people 60 years and older in residential aged care. the Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans, Staphylococcus aureus, methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included s ling size, no power and effect size calculations different oral health assessments how oral specimens were analysed and how aspiration pneumonia was diagnosed. pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care professional oral hygiene care is useful in reducing aspiration pneumonia risk.
Publisher: Cambridge University Press (CUP)
Date: 04-1994
DOI: 10.1017/S095026880005768X
Abstract: The general bacterial flora of 38 Tasmanian SIDS infants was examined together with faecal flora of 134 comparison infants ranging in age from birth to 6 months. The microflora of all specimens received was investigated with special emphasis on the toxigenic Escherichia coli (TEC). S les were examined for verocytotoxigenic E. coli , free faecal verocytotoxin (FVT), heat labile toxin (LT) and heat stable toxin (ST) producers with the use of a Vero cell assay and commercial kits. The findings of this study revealed a high isolation rate (39%) of TEC from SIDS infants as compared to 1.5% from the healthy comparison infants. Atypical E. coli strains were also identified during the study, including E. coli A–D. An analysis of the same specimens for rotaviral and adenoviral antigens indicated that 30% of the SIDS cases were positive as compared to 20% in the comparison group.
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.JCF.2009.12.003
Abstract: Two recent studies have demonstrated the presence of biologically significant amounts of cyanide within the airways of cystic fibrosis (CF) patients infected with Pseudomonas aeruginosa. Whilst environmental strains of P. aeruginosa are known to synthesise cyanide, there has been a relative lack of investigation into bacterial cyanogenesis from a medical viewpoint, despite the role P. aeruginosa plays in many serious infection settings and especially in CF lung disease. This review discusses the implications of cyanogenesis in the CF airway in terms of bacterial ecology, host immune response, progression of lung disease and potential treatment options.
Publisher: BMJ
Date: 04-09-2015
DOI: 10.1136/ARCHDISCHILD-2015-308431
Abstract: Short stature is associated with increased risk of ill health and mortality and can negatively impact on an in idual's economic opportunity and psychological well-being. The aim of this study was to investigate the association between height and area-level deprivation by ethnic group in children in England. Cross-sectional analysis of data gathered from the National Child Measurement Programme 2008/2009 to 2012/2013. Children (n=1 213 230) aged 4–5 and 10–11 years attending state-maintained primary schools in England. Mean height SD score (SDS) (based on the British 1990 growth reference) was calculated for children by Income Deprivation Affecting Children Index as a measure of area-level deprivation. Analyses were performed by sex and age group for white British, Asian and black ethnicities. For white British children mean height decreased 0.2 SDS between the least and the most deprived quintile. For Asian children the relationship was weaker and varied between 0.08 and 0.18 SDS. For white British boys the magnitude of association was similar across age groups for Asian boys the magnitude was higher in the age group of 10–11 years and in white British girls aged 10–11 years the association decreased. Height SDS was similar across all levels of deprivation for black children. Social inequalities were shown in the height of children from white British and Asian ethnic groups. Further evaluation of height in black children is warranted. Action is needed to reduce inequalities in height by addressing the modifiable negative environmental factors that prevent healthy growth and development of children.
Publisher: Springer Science and Business Media LLC
Date: 10-02-2021
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1111/IDJ.12480
Abstract: To determine the association of overweight/obesity, dental caries and dietary sugars in Australian adults. The National Survey of Adult Oral Health (NSAOH) 2004-2006 provided data for analysis of dental caries experience. Self-reported body weight and height were used to calculate body mass index (BMI) for a subs le (n = 3,745, 89.8%) of the NSAOH data. A self-report questionnaire of 13 food items estimated the daily intake of added sugar, total sugars and total carbohydrate, using food composition estimates from the AUSNUT2011-2013. Bivariate analyses (Pearson's Chi-square with Rao-Scott adjustment and Student's t-tests) were used to determine the association of overweight/obesity, dental caries, sugar variables and putative confounders. Poisson regression models for the Decayed, Missing and Filled Teeth Index and in idual measures of decayed, missing and filled teeth were constructed, with models containing BMI, dietary added sugar, total sugar and total carbohydrate, controlling for putative confounders. There was a positive association between dental caries experience and being overweight or obese compared with having normal weight or being underweight as well as between sugar consumption with all four dental caries outcome measures. When controlled for putative confounders where sugar consumption was identified as a key determinant, the statistical significance between dental caries experience and being overweight or obese disappeared. The demographic and socioeconomic factors associated with dental caries experience were age, sex, education, smoking status and usual reason for dental visit. Analysis of the relationship between dental caries and obesity must include data about sugar and carbohydrate consumption.
Publisher: SAGE Publications
Date: 13-12-2017
Abstract: Numerous suicide risk factors have been proposed but not adequately validated for epidemiology, treatment and prevention efforts. Exposures to suicidal behaviors (ESB), from family and friend suicide attempts and completions, were tested for validity as a suicidal risk factor and also for measurement and construct adequacy. An anonymous online survey yielded 713 participants (aged 18–71), who reported ESB, completed the Suicidal Affect-Behavior-Cognition Scale (SABCS), and comprised a broad spectrum on those variables. Tests of dimensionality and internal consistency showed the four ESB variables (attempts/completions through family/friends) were independent and did not form a common factor or an identifiable ESB latent trait. ESB variables were, however, associated with demographic and psychiatric histories. A battery of tests revealed no meaningful associations between ESB and total suicidality or suicide risk factors (social support, depression, anxiety, stress, satisfaction with life and emotional stability). In addition, in contrast to previous reports, young adults ( n = 200 aged 18–20) showed no increased suicidality due to ESB. Results showed no validity for ESB as a common risk factor for suicidality or other psychopathology, or as a latent trait. ESB showed evidence as a personal negative life event with in idual effects and interpretations.
Publisher: Oxford University Press (OUP)
Date: 06-08-2010
Abstract: despite availability of effective treatments for osteoporosis, impact on fracture rates may be suboptimal because of failure to adhere to recommended anti-resorptive therapy. to identify randomized controlled trials (RCTs) evaluating interventions intended to improve persistence with anti-resorptive therapy for treating women with osteoporosis or osteopenia. The design of the study is a systematic review and meta-analysis of RCTs. included trials were those reporting interventions to improve persistence with or adherence to anti-resorptive treatment compared to a control medication or usual care. A search of MEDLINE, EMBASE, CINAHL and the Cochrane Library was supplemented by review of cited literature. Reports were reviewed and data pooled where appropriate. The primary outcome was duration of persistence with medication. six trials met inclusion criteria, including four reporting persistence as an outcome measure indicating a relative reduction in non-persistence of 22% (pooled relative risk: 0.78, 95% confidence interval 0.65-0.95) for active compared to control interventions. Heterogeneity between the trial effects was present but not significant (I(2) = 47%, P = 0.11). Interventions were varied in design, and some measurements of adherence were subject to self-report bias. Two trials included the majority of participants (3386/3497), accounting for >90% of the weight in the pooled estimate. trials to date suggest potential for improving persistence with medication taking thus improving treatment outcomes and reducing fracture risk. More precise measurement of medication taking and promoting fidelity to a precisely defined intervention protocol may lead to better assessment of impact on clinically important outcomes.
Publisher: Wiley
Date: 29-07-2023
DOI: 10.1111/CDOE.12900
Abstract: To explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy. A qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation s ling. Semi‐structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach. Fifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy barriers to oral health care during and after pregnancy and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health. This study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy‐level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.
Publisher: Wiley
Date: 24-02-2023
DOI: 10.1111/AJR.12973
Abstract: To explore the water fluoridation status of rural Victorian towns over 1000 population and document the oral health profile in the local government areas (LGAs) currently with no water fluoridation. To assist/inform future LGA planning, we describe a case study of a community‐based co‐design approach to increase access to fluoridated water in rural communities. A descriptive design and a case study. Rural Victorian towns over 1000 population. Twenty‐nine LGAs in rural areas. LGA water fluoridation status and oral health profiles. Sixty‐six (33%) of the 203 Victorian rural towns with population, representing 149 251 people, did not have access to fluoridated water. Towns in 29 rural LGAs were included with 62% without water fluoridation with many having higher than the Victorian average of preventable hospital admissions due to dental conditions in children aged 0–9 years. Over 50% of children aged 0–12 years living in these rural nonfluoridated LGAs had above‐the‐state average rates of decayed, missing and filled teeth (dmft/DMFT). In those aged 0–5 years, this was the highest with 78% above‐the‐state average. In the case study, meetings were well attended, and the group resolved to lobby for water fluoridation, which was successful. Many Victorian rural towns do not have access to fluoridated water. A community‐based co‐design approach can dispel ill‐informed concerns about dangers of water fluoridation to successfully lobby the state government to fluoridate the local water supply.
Publisher: SAGE Publications
Date: 29-08-2017
Publisher: Health Libraries Australia
Date: 04-06-2023
Abstract: Introduction: This study examines the main characteristics of dental informatics research using bibliometric analysis of articles in the online journal database PubMed, to identify the main trends of research in dental informatics. The study aims to identify trends, geographic distribution of papers and authors, rates of collaboration, and performances of journals and institutions. Methods: Information on dental informatics was extracted solely from the PubMed online journal database from January 1989 to September 2019. A three-phase search approach was employed. Bibliometrics was used to examine the growth and progress of dental informatics over time. Results: A total of n=236 papers on dental informatics were identified, with an average of 7.9 papers per year. The trend of papers published increased over time with 41 countries represented in this study. There were only 15 countries which had 10 or more representatives, seven of which came from Europe. North America produced the most research in dental informatics, with 149 paper affiliations and ten were cross regional, in 61% of the total papers. Discussion: The topic of dental informatics began in the mid to late 1980s, with the most productive years in the last decade, reaching a high point in the mid 2010s. There was a low level of international collaboration, and few conducted across different continents. Conclusion: There is steady increase in the pace of research in dental informatics, with growing interest in exploring various implementation methods. Collaboration has become a product of a globalised world, with the potential to share data and exchange ideas using cutting-edge technologies. As these trends continue, the field of dental informatics may see further growth and development, with more technology available to provide communication and share data points and methods becoming widespread.
Publisher: Elsevier BV
Date: 11-1989
DOI: 10.14219/JADA.ARCHIVE.1989.0287
Abstract: Stroke induction in immunologically competent mice not only produces local ischemia and brain damage, but also induces early inflammatory changes in brain and peripheral immune responses. Although immune elements clearly are activated after brain vascular occlusion, the relative contribution of T and B lymphocytes to the developing lesion has not been quantified. We evaluated effects 22 h after middle cerebral artery occlusion (90 mins) on histologic injury and peripheral immune activation in severe combined immunodeficient (SCID) mice lacking T and B cells. Cortical and total infarct volumes were strikingly reduced in male SCID mice (n=14, 33+/-4% of contralateral cortex, n=10, 52+/-3% of contralateral hemisphere) versus immunologically intact C57BL/6 mice (wild type, n=9, 57+/-5% of contralateral cortex, 57+/-4% of contralateral hemisphere) (P<0.01). Striatal infarction was not altered (77+/-7% of contralateral striatum in SCID, 84+/-7% in wild type), suggesting that the core of the evolving ischemic lesion was not impacted by lack of T and B cells. As expected, inflammatory factors from immune cells in ischemic SCID brains were essentially absent, with the exception of interleukin-1beta increase in both SCID and wild type tissue. Spleen cell numbers were low in SCID mice, but were further reduced 22 h after stroke, with substantial reduction in most inflammatory factors except for increased expression of interferon-gamma and macrophage inflammatory protein (MIP)-2. These data quantify the damaging effect of T and B lymphocytes on early, evolving ischemic brain injury, and further implicate interleukin-1beta in brain and interferon-gamma and MIP-2 in spleen as inflammatory factors produced by cells other than T and B cells.
Publisher: Public Library of Science (PLoS)
Date: 09-03-2021
DOI: 10.1371/JOURNAL.PNTD.0009252
Abstract: Statistical models are regularly used in the forecasting and surveillance of infectious diseases to guide public health. Variable selection assists in determining factors associated with disease transmission, however, often overlooked in this process is the evaluation and suitability of the statistical model used in forecasting disease transmission and outbreaks. Here we aim to evaluate several modelling methods to optimise predictive modelling of Ross River virus (RRV) disease notifications and outbreaks in epidemiological important regions of Victoria and Western Australia. We developed several statistical methods using meteorological and RRV surveillance data from July 2000 until June 2018 in Victoria and from July 1991 until June 2018 in Western Australia. Models were developed for 11 Local Government Areas (LGAs) in Victoria and seven LGAs in Western Australia. We found generalised additive models and generalised boosted regression models, and generalised additive models and negative binomial models to be the best fit models when predicting RRV outbreaks and notifications, respectively. No association was found with a model’s ability to predict RRV notifications in LGAs with greater RRV activity, or for outbreak predictions to have a higher accuracy in LGAs with greater RRV notifications. Moreover, we assessed the use of factor analysis to generate independent variables used in predictive modelling. In the majority of LGAs, this method did not result in better model predictive performance. We demonstrate that models which are developed and used for predicting disease notifications may not be suitable for predicting disease outbreaks, or vice versa . Furthermore, poor predictive performance in modelling disease transmissions may be the result of inappropriate model selection methods. Our findings provide approaches and methods to facilitate the selection of the best fit statistical model for predicting mosquito-borne disease notifications and outbreaks used for disease surveillance.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1111/IDJ.12514
Abstract: Obesity and periodontitis are public health issues in Australia. This study aimed to determine the association between overweight/obesity and periodontitis in Australian adults. The cross-sectional National Survey of Adult Oral Health 2004-2006 data were analysed. Body mass index was calculated, and a self-reported questionnaire was used to measure the estimated daily intake of added sugar. The mean number of sites with probing depth (PD) ≥ 4 mm and clinical attachment loss (CAL) ≥ 4 mm and presence of periodontitis were used as outcome measures. CDC/AAP periodontitis case definition was adopted. Bivariate analyses and multiple variable regression models were constructed. The study s le was 4,170 participants. The proportion of people that were overweight/obese was 51.9% [95% confidence interval (CI): 48.1%, 54.1%]. Overall 21.3% (95% CI: 19.3%, 23.5%) people experienced periodontitis. The mean number of sites with PD ≥ 4 mm and CAL ≥ 4 mm were recorded as 0.7 (95% CI: 0.5, 0.9) and 2.4 (95% CI: 2.1, 2.6), respectively. Multiple variable analysis suggested that periodontal parameters [sites with PD ≥ 4 mm (0.13, 95% CI: -0.86, 0.35) and sites with CAL ≥ 4 mm (0.11, 95% CI: -0.58, 0.35) and presence of periodontitis (1.23, 95% CI: 0.96, 1.57)] were not associated with overweight/obesity when controlled for putative confounders. A positive association was found between overweight/obesity and periodontitis (PD and CAL). However, the statistical significance disappeared in the multiple variable regression analysis, where age, sex, smoking and dental visiting behaviour were found to be key determinants of periodontitis.
Publisher: Springer Science and Business Media LLC
Date: 08-11-2006
Abstract: This paper provides an overview of the regulation of quality assurance for genetic testing in Australia and New Zealand and outlines the steps currently being taken to critically appraise and improve the regulatory framework in each country. It aims to contextualize this framework within the broader context of quality and patient safety concerns and to draw together the concerns and recommendations of the various organizations that have been working to improve quality assurance in this area.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.APPET.2017.09.029
Abstract: In Australia, children are not eating according to the Australian Dietary Guidelines despite the incorporation of numerous public health initiatives in the school setting. Literature regarding children's views about what influences their food choice is limited. Incorporating children in the creation of strategies to build healthy public policy aligns with the World Health Organisation (WHO) Ottawa Charter framework. In this qualitative study we used participatory action research to determine why children make the food choices they do. Five action cycles were used to collect data from school children and the school canteen. Two of the action cycles, which are the focus of this paper, used Discovery Days (where children worked in groups to design a canteen menu) to collect data from 100 students on each day across grades two to six. Each group recorded and presented the reasons they made the food choices for the menu. Each day was captured by video and audio recordings were transcribed then analysed using a Conventional Content Analysis to identify themes and then theoretical concepts. Emerging theoretical concepts describing children's decision-making criteria included pleasure, texture, social acceptability, versatility and eating context. Our study found children are reliable informants about factors that influence their food choice. Using theoretical concepts as reported by children could be the foundation required to build more effective programs to facilitate healthy decision-making, supportive environments and health policy in the school setting to create healthy food that is desirable to children.
Publisher: JSTOR
Date: 10-1996
DOI: 10.2307/3283898
Publisher: Public Library of Science (PLoS)
Date: 03-02-2022
DOI: 10.1371/JOURNAL.PONE.0263444
Abstract: To review the content of recommendations within antenatal oral healthcare guidance documents and appraise the quality of their methodology to inform areas of development, clinical practice, and research focus. A systematic search of five electronic databases, Google search engine, and databases from relevant professional and guideline development groups published in English, developed countries, and between 2010 and 2020 was undertaken to identify guidance documents related to antenatal oral healthcare. Quality of documents was appraised using the Appraisal of Guidelines Research and Evaluation II tool, and a 3-step quality cut-off value was used. Inductive thematic analysis was employed to categories discreet recommendations into themes. Six guidelines and one consensus statement were analysed. Two documents developed within Australia scored ≥60% across five of the six domains of the quality appraisal tool and were recommended for use. Four documents (developed in the United States and Canada) were recommended for use with modifications, whilst one document (developed in Europe) was not recommended. A total of 98 discreet recommendations were identified and demonstrated considerable unanimity but differed in scope and level of information. The main content and number of recommendations were inductively categorised within the following clinical practice points: risk factor assessments (n = 2), screening and assessment (n = 10), pre-pregnancy care (referral, n = 1), antenatal care (health education and advice, n = 14 management of nausea and vomiting, n = 7 referral, n = 2), postnatal care (health education and advice, n = 1 anticipatory guidance, n = 6), documentation (n = 4), coordinated care (n = 4), capacity building (n = 6), and community engagement (n = 1). The methodological rigour of included guidance documents revealed areas of strengths and limitations and posit areas for improvement. Further research could centre on adapting antenatal oral healthcare guidelines and consensus statements to local contexts. More high-quality studies examining interventions within antenatal oral healthcare are needed to support the development of recommendations.
Publisher: Wiley
Date: 22-09-2005
DOI: 10.1111/J.1600-0854.2005.00348.X
Abstract: The intracellular protozoan Toxoplasma gondii is auxotrophic for low-density lipoprotein (LDL)-derived cholesterol (C). We previously showed that T. gondii scavenges this essential lipid from host endolysosomal compartments and that C delivery to the parasitophorous vacuole (PV) does not require transit through host Golgi or endoplasmic reticulum. In this study, we explore the itinerary of C from the host endolysosomes to the PV. Labeled C incorporated into LDL is rapidly detected in intravacuolar parasites and partially esterified by the parasites. In contrast to erse mammalian organelles, the post-endolysosomal transfer of C to the PV does not involve the host plasma membrane as an intermediate. Nevertheless, the PV membrane is accessible to extracellular sterol acceptors, suggesting C trafficking from intracellular parasites to host plasma membrane. C movement to the PV requires temperatures permissive for vesicular transport, metabolic energy and functional microtubules. Host caveolae vesicles and the sterol carrier protein-2 do not participate in this process. Proteolytic treatment of purified PV or free parasites abolishes C acquisition by the parasites. Altogether, these results support a vesicular transport system from host endolysosomes to the PV, and a requirement for PV membrane and parasite plasma membrane proteins in C delivery to T. gondii.
Publisher: Wiley
Date: 03-07-2020
Abstract: To help prevent future morbidity and mortality, this study examined Australian Antarctic expeditioners' first aid credentials and self-efficacy in providing emergency first aid in extreme environments. A mixed method survey assessed Australian personnel working on Antarctic stations. Volunteer participants (n = 83) provided data on first aid training, self-confidence of first aid readiness, and first aid preparations. The Extreme Conditions First Aid Confidence Scale (EC-FACS) was developed and validated for this study. Multivariate analyses tested associations between first aid background, demographics and EC-FACS. Open-ended comments were subjected to thematic analysis. Over one-third of participants did not hold current first aid certificates at expedition commencement. Factor analysis demonstrated the EC-FACS was unidimensional, and internal consistency was high (α = 0.94), and showed first aid self-efficacy was moderately high, but participants' confidence decreased as first aid scenarios became more complex. Experience providing emergency first aid and level of first aid qualification were the strongest predictors of overall first aid self-efficacy. Thematic analysis revealed expeditioners support higher first aid qualifications and want Antarctic-specific wilderness first aid training. These findings revealed that many Antarctic expeditioners may not be adequately prepared for first aid emergencies and have low confidence in handling complex medical situations. Based on these findings, we recommend higher first aid qualifications and training tailored to the Antarctic context. These modest steps can help prevent unnecessary and costly morbidity and mortality for extreme-condition expeditioners.
Publisher: Oxford University Press (OUP)
Date: 26-10-2018
DOI: 10.1093/ICB/ICY118
Abstract: The Tasmanian devil, a marsupial carnivore, has been restricted to the island state of Tasmania since its extinction on the Australian mainland about 3000 years ago. In the past two decades, this species has experienced severe population decline due to the emergence of devil facial tumor disease (DFTD), a transmissible cancer. During these 20 years, scientists have puzzled over the immunological and evolutionary responses by the Tasmanian devil to this transmissible cancer. Targeted strategies in population management and disease control have been developed as well as comparative processes to identify variation in tumor and host genetics. A multi-disciplinary approach with multi-institutional teams has produced considerable advances over the last decade. This has led to a greater understanding of the molecular pathogenesis and genomic classification of this cancer. New and promising developments in the Tasmanian devil’s story include evidence that most immunized, and some wild devils, can produce an immune response to DFTD. Furthermore, epidemiology combined with genomic studies suggest a rapid evolution to the disease and that DFTD will become an endemic disease. Since 1998 there have been more than 350 publications, distributed over 37 Web of Science categories. A unique endemic island species has become an international curiosity that is in the spotlight of integrative and comparative biology research.
Publisher: Wiley
Date: 16-07-2020
DOI: 10.1111/IDH.12450
No related grants have been discovered for silvana bettiol.