ORCID Profile
0000-0001-6691-5420
Current Organisation
University of Queensland
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Publisher: MDPI AG
Date: 11-11-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Publisher: Elsevier BV
Date: 05-2011
Publisher: MDPI AG
Date: 03-08-2021
DOI: 10.3390/TROPICALMED6030145
Abstract: Ross River virus (RRV), the most common human arbovirus infection in Australia, causes significant morbidity and substantial medical costs. About half of Australian cases occur in Queensland. We describe the spatial and temporal patterns of RRV disease in Queensland over the past two decades. RRV notifications, human population data, and weather data from 2001 to 2020 were analysed by the Statistical Area Level 2 (SA2) area. Spatial interpolation or linear extrapolation were used for missing weather values and the estimated population in 2020, respectively. Notifications and incidence rates were analysed through space and time. During the study period, there were 43,699 notifications in Queensland. The highest annual number of notifications was recorded in 2015 (6182), followed by 2020 (3160). The average annual incidence rate was 5 per 10,000 people and the peak period for RRV notifications was March to May. Generally, SA2 areas in northern Queensland had higher numbers of notifications and higher incidence rates than SA2 areas in southern Queensland. The SA2 areas with high incidence rates were in east coastal areas and western Queensland. The timely prediction may aid disease prevention and routine vector control programs, and RRV management plans are important for these areas.
Publisher: SAGE Publications
Date: 03-2011
Abstract: Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather—related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change—prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.
Publisher: Wiley
Date: 07-2011
DOI: 10.1002/HPM.1052
Abstract: There is a need for nationally representative information on the affordability of health care by disability status to assist in the design of equitable health systems in developing countries. Using the Viet Nam National Health Survey (2001-2002), this paper analyses health care utilization, cost burden and coping strategies for people with disabilities versus the population at large. The results clearly show that the disabled population are more prone to hospitalization, and spend more on inpatient stays and pharmaceuticals. Households with disabled members are at greater risk of catastrophic health expenditures and debt financing, posing a serious threat to economic welfare.
Publisher: Cambridge University Press (CUP)
Date: 16-01-2015
DOI: 10.1017/S095026881400380X
Abstract: We aimed to reparameterize and validate an existing dengue model, comprising an entomological component (CIMSiM) and a disease component (DENSiM) for application in Malaysia. With the model we aimed to measure the effect of importation rate on dengue incidence, and to determine the potential impact of moderate climate change (a 1 °C temperature increase) on dengue activity. Dengue models (comprising CIMSiM and DENSiM) were reparameterized for a simulated Malaysian village of 10 000 people, and validated against monthly dengue case data from the district of Petaling Jaya in the state of Selangor. Simulations were also performed for 2008-2012 for variable virus importation rates (ranging from 1 to 25 per week) and dengue incidence determined. Dengue incidence in the period 2010–2012 was modelled, twice, with observed daily weather and with a 1 °C increase, the latter to simulate moderate climate change. Strong concordance between simulated and observed monthly dengue cases was observed (up to r = 0·72). There was a linear relationship between importation and incidence. However, a doubling of dengue importation did not equate to a doubling of dengue activity. The largest in idual dengue outbreak was observed with the lowest dengue importation rate. Moderate climate change resulted in an overall decrease in dengue activity over a 3-year period, linked to high human seroprevalence early on in the simulation. Our results suggest that moderate reductions in importation with control programmes may not reduce the frequency of large outbreaks. Moderate increases in temperature do not necessarily lead to greater dengue incidence.
Publisher: Elsevier BV
Date: 04-2016
Publisher: BMJ
Date: 08-2011
Publisher: BMJ
Date: 2012
Publisher: BMJ
Date: 07-2013
Publisher: Mary Ann Liebert Inc
Date: 06-2014
Abstract: Ross River virus (RRV) disease is the most widespread mosquito-borne disease in Australia. The disease is maintained in enzootic cycles between mosquitoes and reservoir hosts. During outbreaks and in endemic regions, RRV transmission can be sustained between vectors and reservoir hosts in zoonotic cycles with spillover to humans. Symptoms include arthritis, rash, fever and fatigue and can persist for several months. The prevalence and associated morbidity make this disease a medically and economically important mosquito-borne disease in Australia. Climate, environment, and RRV vector and reservoir host information were used to develop predictive models in four regions in NSW over a 13-year period (1991-2004). Polynomial distributed lag (PDL) models were used to explore long-term influences of up to 2 years ago that could be related to RRV activity. Each regional model consisted of a unique combination of predictors for RRV disease highlighting the differences in the disease ecology and epidemiology in New South Wales (NSW). Events up to 2 years before were found to influence RRV activity. The shorter-term associations may reflect conditions that promote virus lification in RRV vectors whereas long-term associations may reflect RRV reservoir host breeding and herd immunity. The models indicate an association between host populations and RRV disease, lagged by 24 months, suggesting two or more generations of susceptible juveniles may be necessary for an outbreak. Model sensitivities ranged from 60.4% to 73.1%, and model specificities ranged from 57.9% to 90.7%. This was the first study to include reservoir host data into statistical RRV models the inclusion of host parameters was found to improve model fit significantly. The research presents the novel use of a combination of climate, environment, and RRV vector and reservoir host information in statistical predictive models. The models have potential for public health decision-making.
Publisher: Royal College of Psychiatrists
Date: 11-2020
DOI: 10.1192/BJO.2020.125
Abstract: Psychotropic medications are sometimes used off-label and inappropriately. This may cause harm to adolescents with intellectual disability. However, few studies have analysed off-label or inappropriate prescribing to this group. To examine the appropriateness of psychotropic prescribing to adolescents with intellectual disability living in the community in south-east Queensland, Australia. Off-label medication use was determined based on whether the recorded medical condition treated was approved by the Australian Therapeutic Goods Administration. Clinical appropriateness of medication use was determined based on published guidelines and clinical opinion of two authors who specialise in developmental disability medicine (J.N.T. and D.H.). We followed 429 adolescents for a median of 4.2 years. A total of 107 participants (24.9%) were prescribed psychotropic medications on at least one occasion. Of these, 88 (82.2%) were prescribed their medication off-label or inappropriately at least once. Off-label or inappropriate use were most commonly associated with challenging behaviours. Off-label or inappropriate use of psychotropic medications was common, especially for the management of challenging behaviours. Clinical decision-making accounts for in idual patient factors and is made based on clinical experience as well as scientific evidence, whereas label indications are developed for regulatory purposes and, although appropriate at a population level, cannot encompass the foregoing considerations. Education for clinicians and other staff caring for people with intellectual disability, and a patient-centred approach to prescribing with involvement of families should encourage appropriate prescribing. The effect of the National Disability Insurance Scheme on the appropriateness of psychotropic medication prescribing should be investigated.
Publisher: Oxford University Press (OUP)
Date: 19-01-2005
DOI: 10.1093/IJE/DYH411
Abstract: There are no analytical studies of in idual risks for Ross River virus (RRV) disease. Therefore, we set out to determine in idual risk and protective factors for RRV disease in a high incidence area and to assess the utility of the case-control design applied for this purpose to an arbovirus disease. We used a prospective matched case-control study of new community cases of RRV disease in the local government areas of Cairns, Mareeba, Douglas, and Atherton, in tropical Queensland, from January 1 to May 31, 1998. Protective measures against mosquitoes reduced the risk for disease. Mosquito coils, repellents, and citronella candles each decreased risk by at least 2-fold, with a dose-response for the number of protective measures used. Light-coloured clothing decreased risk 3-fold. C ing increased the risk 8-fold. These risks were substantial and statistically significant, and provide a basis for educational programs on in idual protection against RRV disease in Australia. Our study demonstrates the utility of the case-control method for investigating arbovirus risks. Such a risk analysis has not been done before for RRV infection, and is infrequently reported for other arbovirus infections.
Publisher: Springer Science and Business Media LLC
Date: 24-12-2015
DOI: 10.1007/S10393-014-1005-0
Abstract: Climate change is predicted to increase the transmission of many vector-borne pathogens, representing an increasing threat to a safe blood supply. In early 2011, Australia experienced catastrophic rainfall and flooding, coupled with increased arbovirus transmission. We used Ross River (RRV) and Barmah Forest (BFV) viruses as test cases to investigate the potential risk posed to Australia's blood supply after this period of increased rainfall . We estimated the risk of collecting an infected donation as one in 2,500-58,000 for RRV and one in 2,000-28,000 for BFV. Climate change may incrementally increase the arbovirus threat to blood safety.
Publisher: BMJ
Date: 06-2013
Publisher: Springer Science and Business Media LLC
Date: 24-11-2011
Abstract: Oral health in later life results from in idual's lifelong accumulation of experiences at the personal, community and societal levels. There is little information relating the oral health outcomes to risk factors in Asian middle-income settings such as Thailand today. Data derived from a cohort of 87,134 adults enrolled in Sukhothai Thammathirat Open University who completed self-administered questionnaires in 2005. Cohort members are aged between 15 and 87 years and resided throughout Thailand. This is a large study of self-reported number of teeth among Thai adults. Bivariate and multivariate logistic regressions were used to analyse factors associated with self-reported number of teeth. After adjusting for covariates, being female (OR = 1.28), older age (OR = 10.6), having low income (OR = 1.45), having lower education (OR = 1.33), and being a lifetime urban resident (OR = 1.37) were statistically associated (p 0.0001) with having less than 20 teeth. In addition, daily soft drink consumptions (OR = 1.41), current regular smoking (OR = 1.39), a history of not being breastfed as a child (OR = 1.34), and mother's lack of education (OR = 1.20) contributed significantly to self-reported number of teeth in fully adjusted analyses. This study addresses the gap in knowledge on factors associated with self-reported number of teeth. The promotion of healthy childhoods and adult lifestyles are important public health interventions to increase tooth retention in middle and older age.
Publisher: Elsevier
Date: 2012
Publisher: Wiley
Date: 23-08-2022
DOI: 10.1111/JAR.13029
Abstract: In a cohort of adults with intellectual disability who were followed for up to 16‐years, we investigated characteristics associated with frequent emergency department (ED) presentations, hospitalisation, and psychiatric care. Community‐dwelling adults with intellectual disability residing in Queensland, Australia, were followed from 1999 to 2015. Healthcare presentations were extracted from administrative databases. Adults who presented frequently were identified and characteristics associated with frequent presentations were identified. Data from 445 adults were analysed. Chronic disease and challenging behaviour were associated with frequent ED presentations (adjusted odds ratio = 1.8, 95% confidence interval = 1.1–3.0 and aOR = 2.2, 95% CI = 1.2–3.9 respectively). Chronic disease and severe rofound intellectual disability were associated with frequent hospitalisations (aOR = 1.9, 95% CI = 1.2–3.2 and aOR = 2.0, 95% CI = 1.2–3.3 respectively). Psychotropic medication use was associated with frequent psychiatric presentations (aOR = 1.9, 95% CI = 1.0–3.4). Adults at high risk of frequent healthcare presentations should be identified for programmes of optimising health system use, and potentially improving health care quality.
Publisher: Public Library of Science (PLoS)
Date: 24-01-2017
Publisher: Elsevier BV
Date: 05-2008
Publisher: Public Library of Science (PLoS)
Date: 13-02-2014
Publisher: Public Library of Science (PLoS)
Date: 10-07-2015
Publisher: Japan Epidemiological Association
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: American Society for Microbiology
Date: 10-2001
DOI: 10.1128/CMR.14.4.909-932.2001
Abstract: Ross River virus (RRV) is a fascinating, important arbovirus that is endemic and enzootic in Australia and Papua New Guinea and was epidemic in the South Pacific in 1979 and 1980. Infection with RRV may cause disease in humans, typically presenting as peripheral polyarthralgia or arthritis, sometimes with fever and rash. RRV disease notifications in Australia average 5,000 per year. The first well-described outbreak occurred in 1928. During World War II there were more outbreaks, and the name epidemic polyarthritis was applied. During a 1956 outbreak, epidemic polyarthritis was linked serologically to a group A arbovirus (Alphavirus). The virus was subsequently isolated from Aedes vigilax mosquitoes in 1963 and then from epidemic polyarthritis patients. We review the literature on the evolutionary biology of RRV, immune response to infection, pathogenesis, serologic diagnosis, disease manifestations, the extraordinary variety of vertebrate hosts, mosquito vectors, and transmission cycles, antibody prevalence, epidemiology of asymptomatic and symptomatic human infection, infection risks, and public health impact. RRV arthritis is due to joint infection, and treatment is currently based on empirical anti-inflammatory regimens. Further research on pathogenesis may improve understanding of the natural history of this disease and lead to new treatment strategies. The burden of morbidity is considerable, and the virus could spread to other countries. To justify and design preventive programs, we need accurate data on economic costs and better understanding of transmission and behavioral and environmental risks.
Publisher: Elsevier BV
Date: 2012
Publisher: Oxford University Press (OUP)
Date: 09-2015
Abstract: Dengue occurred sporadically in Bangladesh from 1964 until a large epidemic in 2000 established the virus. We trace dengue from the time it was first identified in Bangladesh and identify factors favourable to future dengue haemorrhagic fever epidemics. The epidemic in 2000 was likely due to introduction of a dengue virus strain from a nearby endemic country, probably Thailand. Cessation of dichlorodiphenyltrichloroethane (DDT) spraying, climatic, socio-demographic, and lifestyle factors also contributed to epidemic transmission. The largest number of cases was notified in 2002 and since then reported outbreaks have generally declined, although with increased notifications in alternate years. The apparent decline might be partially due to public awareness with consequent reduction in mosquito breeding and increased prevalence of immunity. However, passive hospital-based surveillance has changed with mandatory serological confirmation now required for case reporting. Further, a large number of cases remain undetected because only patients with severe dengue require hospitalisation. Thus, the reduction in notification numbers may be an artefact of the surveillance system. Indeed, population-based serological survey indicates that dengue transmission continues to be common. In the future, the absence of active interventions, unplanned urbanisation, environmental deterioration, increasing population mobility, and economic factors will heighten dengue risk. Projected increases in temperature and rainfall may exacerbate this.
Publisher: Oxford University Press (OUP)
Date: 30-03-2010
Abstract: Climatic and ecological change threaten human health globally. Manifestations include lost species, vanishing glaciers and more frequent heavy rain. In the second half of this century, accelerating sea level rise is likely to cause crop loss, and population dislocation. These problems may be magnified by dysfunctional human responses, including conflict. The population health consequences of these events can be classified as primary, secondary and tertiary. Primary signs include the acute and chronic stress of heat waves, and trauma from increased bush fires and flooding. Secondary signs are indirect, such as an altered distribution of arthropod vectors, intermediate hosts and pathogens that will produce changes in the epidemiology of many infectious diseases. More severe future health consequences of climate change are classified here as tertiary effects. If moderate or severe climate change scenarios prove accurate then these manifestations will occur over large areas, and could include famine, war and significant population displacement. Such effects would threaten governance and health. The health professions must respond to these challenges, especially the task of recognising and seeking to minimise tertiary health consequences. The gap between what we know and what we need to know concerning these issues can be narrowed by a new field of medical practice. The framework for this emerging discipline includes climate change, ecology and global health. Combined, these dimensions may be called ecomedicine. Actions to reduce in idual emissions, to promote active transport (with its ‘co-benefit’ of preventing chronic disease), and involvement in group action to protect the environment and to prevent war, informed by understanding of the health of in idual patients and populations, will be central to the practice of ecomedicine.
Publisher: BMJ
Date: 2012
Publisher: World Health Organization, Western Pacific Regional Office
Date: 19-08-2015
Publisher: MDPI AG
Date: 19-10-2021
DOI: 10.3390/DISABILITIES1040026
Abstract: Background: Data on the health of adolescents with intellectual disability are scarce. This study describes carer-reported symptoms, chronic illnesses, level of functioning, and behaviour among Australian adolescents with intellectual disability. We compare students attending mainstream and special schools. Methods: Cross-sectional questionnaire data were obtained from a cohort of 592 adolescents (10–21 years) with intellectual disability attending school and living in South-East Queensland, Australia, in May 2007. We analysed data from a subset (176) who completed a health check before visiting their general practitioners. Results: Adolescents had significant health needs, and those in special education schools had worse health than those from mainstream schools. There was a discrepancy between the prevalence of significant psychopathology detected via the short form Developmental Behaviour Checklist (DBC-P24) and psychiatric conditions reported by carers. Conclusions: Given the significant health needs of this population, carefully designed and targeted programs, potentially including medical visits to these schools, are needed.
Publisher: Public Library of Science (PLoS)
Date: 19-09-2016
Publisher: Public Library of Science (PLoS)
Date: 10-04-2015
Publisher: Public Library of Science (PLoS)
Date: 24-09-2020
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: Wiley
Date: 16-05-2011
Publisher: BMJ
Date: 30-08-2012
Publisher: SAGE Publications
Date: 10-05-2011
Abstract: Poor self-rated health (SRH) correlates strongly with mortality. In developed countries, women generally report worse SRH than males. Few studies have reported on SRH in developing countries. The authors report on SRH in Thailand, a middle-income developing country.The data were derived from a large nationwide cohort of 87 134 adult Open University students (54% female, median age 29 years). The authors included questions on socioeconomic and demographic factors that could influence SRH. The Thai cohort in this study mirrors patterns found in developed countries, with females reporting more frequent “poor” or “very poor” SRH (odds ratio = 1.35 95% confidence interval = 1.26-1.44). Cohort males had better SRH than females, but levels were more sensitive to socioeconomic status. Income and education had little influence on SRH for females. Among educated Thai adults, females rate their health to be worse than males, and unlike males, this perception is relatively unaffected by socioeconomic status.
Publisher: Elsevier BV
Date: 12-2016
Publisher: Springer Science and Business Media LLC
Date: 06-10-2015
Publisher: MDPI AG
Date: 25-08-2023
Abstract: Adolescents with intellectual disability have substantial health needs. This retrospective analysis of data from the Ask Study describes reasons for primary care encounters and the prevalence and incidence of chronic physical and mental conditions among a cohort of community-dwelling adolescents with intellectual disability. Participants attended secondary schools in southern Queensland, Australia. Primary care data were extracted from primary care records. Demographic and health information was collected using carer-completed questionnaires. Reasons for primary care encounters, disease prevalence at age 16 years, and disease incidence through adolescence were reported. Data were obtained for 432 adolescents with intellectual disability (median follow-up: 4.1 years). Skin problems (29.4 per 100 encounters) were the most common reason patients presented for primary care, followed by psychological and behavioural problems (14.4 per 100 encounters) and musculoskeletal problems (13.8 per 100 encounters). Conditions with the highest prevalence were autism spectrum disorder (18.6%) and asthma (18.1%). The prevalence of epilepsy, visual impairment, and cerebral palsy were 14.7, 11.1, and 8.0%, respectively. Gastroesophageal reflux had the highest incidence (9.4 cases per 1000 person-years). Adolescents with intellectual disability have significant healthcare needs, which general practitioners need to be aware of and address. Study findings should inform the development of training programs for general practitioners.
Publisher: Royal Society of Chemistry (RSC)
Date: 2019
DOI: 10.1039/C8EN01167B
Abstract: Design and engineering of metal–organic frameworks for the adsorption/degradation of inorganic toxic gases, organic vapors and particulate matter.
Publisher: Springer Science and Business Media LLC
Date: 14-10-2012
Publisher: Oxford University Press (OUP)
Date: 11-2001
Publisher: Wiley
Date: 24-09-2009
Publisher: Royal Society of Chemistry (RSC)
Date: 2019
DOI: 10.1039/C8EN01291A
Abstract: The role of ˙OH and ˙O 2 − in the photocatalytic ozonation mechanism of gaseous n -hexane is disclosed based on experimental and theoretical methods.
Publisher: Elsevier BV
Date: 07-2014
Publisher: National Institute for Health and Care Research
Date: 04-2009
DOI: 10.3310/HTA13210
Abstract: To assess the effects and cost-effectiveness of haloperidol, risperidone and placebo on aggressive challenging behaviour in adults with intellectual disability. A double-blind randomised controlled trial of two drugs and placebo administered in flexible dosage, with full, independent assessments of aggressive and aberrant behaviour, global improvement, carer burden, quality of life and adverse drug effects at baseline, 4, 12 and 26 weeks, and comparison of total care costs in the 6 months before and after randomisation. At 12 weeks, patients were given the option of leaving the trial or continuing until 26 weeks. Assessments of observed aggression were also carried out with key workers at weekly intervals throughout the trial. Patients were recruited from all those being treated by intellectual disability services in eight sites in England, one in Wales and one in Queensland, Australia. Patients from all severity levels of intellectual disability recruitment was extended to include those who may have been treated with neuroleptic drugs in the past. treatment with depot neuroleptics/another form of injected neuroleptic medication within the last 3 months continuous oral neuroleptic medication within the last week those under a section of the Mental Health Act 1983 or Queensland Mental Health Act 2000. Randomisation to treatment with haloperidol (a typical neuroleptic drug), risperidone (an atypical neuroleptic drug) or placebo using a permuted blocks procedure. Dosages were: haloperidol 1.25-5.0 mg daily risperidone 0.5-2.0 mg daily. Primary: reduction in aggressive episodes between baseline and 4 weeks using Modified Overt Aggression Scale. Secondary: Aberrant Behaviour Checklist Uplift/Burden Scale 40-item Quality of Life Questionnaire Udvalg for Kliniske Undersøgelser scale Clinical Global Impressions scale. Economic costs recorded using a modified version of Client Service Receipt Inventory for 6 months before and after randomisation. There were considerable difficulties in recruitment because of ethical and consent doubts. Twenty-two clinicians recruited a total of 86 patients. Mean daily dosages were 1.07 mg rising to 1.78 mg for risperidone and 2.54 mg rising to 2.94 mg for haloperidol. Aggression declined dramatically with all three treatments by 4 weeks, with placebo showing the greatest reduction (79%, versus 57% for combined drugs) (p = 0.06). Placebo-treated patients showed no evidence of inferior response in comparison to patients receiving neuroleptic drugs. An additional study found that clinicians who had not participated in clinical trials before were less likely to recruit. Mean total cost of accommodation, services, informal care and treatment over the 6 months of the trial was 16,336 pounds for placebo, 17,626 pounds for haloperidol and 18,954 pounds for risperidone. There were no significant important benefits conferred by treatment with risperidone or haloperidol, and treatment with these drugs was not cost-effective. While neuroleptic drugs may be of value in the treatment of aggressive behaviour in some patients with intellectual disability, the underlying pathology needs to be evaluated before these are given. The specific diagnostic indications for such treatment require further investigation. Prescription of low doses of neuroleptic drugs in intellectual disability on the grounds of greater responsiveness and greater liability to adverse effects also needs to be re-examined.
Publisher: Public Library of Science (PLoS)
Date: 31-03-2015
Publisher: Springer Science and Business Media LLC
Date: 13-06-2011
Abstract: Oral health has been of interest in many low and middle income countries due to its impact on general health and quality of life. But there are very few population-based reports of adult Oral Health Related Quality of Life (OHRQoL) in developing countries. To address this knowledge gap for Thailand, we report oral health findings from a national cohort of 87,134 Thai adults aged between 15 and 87 years and residing all over the country. In 2005, a comprehensive health questionnaire was returned by distance learning cohort members recruited through Sukhothai Thammathirat Open University. OHRQoL dimensions included were discomfort speaking, swallowing, chewing, social interaction and pain. We calculated multivariate (adjusted) associations between OHRQoL outcomes, and sociodemographic, health behaviour and dental status. Overall, discomfort chewing (15.8%), social interaction (12.5%), and pain (10.6%) were the most commonly reported problems. Females were worse off for chewing, social interaction and pain. Smokers had worse OHRQoL in all dimensions with Odds Ratios (OR) ranging from 1.32 to 1.51. Having less than 20 teeth was strongly associated with difficulty speaking (OR = 6.43), difficulty swallowing (OR = 6.27), and difficulty chewing (OR = 3.26). Self-reported adverse oral health correlates with in idual function and quality of life. Outcomes are generally worse among females, the poor, smokers, drinkers and those who have less than 20 teeth. Further longitudinal study of the cohort analysed here will permit assessment of causal determinants of poor oral health and the efficacy of preventive programs in Thailand.
Publisher: SAGE Publications
Date: 03-2011
Abstract: Climate change will have significant and erse impacts on human health. These impacts will include changes in infectious disease incidence. In this article, the authors review the current situation and potential future climate change impacts for respiratory, diarrheal, and vector-borne diseases in Australia. Based on this review, the authors suggest adaptive strategies within the health sector and also recommend future research priorities.
Publisher: Japan Epidemiological Association
Date: 2013
Publisher: MDPI AG
Date: 18-12-2020
Abstract: Background: Dengue, a febrile illness, is caused by a Flavivirus transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Climate influences the ecology of the vectors. We aimed to identify the influence of climatic variability on the occurrence of clinical dengue requiring hospitalization in Zone-5, a high incidence area of Dhaka City Corporation (DCC), Bangladesh. Methods and Findings: We retrospectively identified clinical dengue cases hospitalized from Zone-5 of DCC between 2005 and 2009. We extracted records of the four major catchment hospitals of the study area. The Bangladesh Meteorological Department (BMD) provided data on temperature, rainfall, and humidity of DCC for the study period. We used autoregressive integrated moving average (ARIMA) models for the number of monthly dengue hospitalizations. We also modeled all the climatic variables using Poisson regression. During our study period, dengue occurred throughout the year in Zone-5 of DCC. The median number of hospitalized dengue cases was 9 per month. Dengue incidence increased sharply from June, and reached its peak in August. One additional rainy day per month increased dengue cases in the succeeding month by 6% (RR = 1.06, 95% CI: 1.04–1.09). Conclusions: Dengue is transmitted throughout the year in Zone-5 of DCC, with seasonal variation in incidence. The number of rainy days per month is significantly associated with dengue incidence in the subsequent month. Our study suggests the initiation of c aigns in DCC for controlling dengue and other Aedes mosquito borne diseases, including Chikunguniya from the month of May each year. BMD rainfall data may be used to determine c aign timing.
Publisher: Japan Epidemiological Association
Date: 2014
Publisher: Public Library of Science (PLoS)
Date: 05-2014
Publisher: SAGE Publications
Date: 05-05-2012
Abstract: Studies on socioeconomic and epidemiological effects of hearing impairment in middle-income countries of Southeast Asia are still quite scarce. This study examines the association between hearing impairment and health outcomes in Thailand. Data derived from a cohort of 87 134 Open University adults aged 15 to 87 years residing throughout Thailand. Approximately 8.5% of cohort members reported trouble hearing and 0.13% reported being deaf. After adjusting for age and gender, poor self-assessed health was strongly associated with some trouble hearing (odds ratio [OR] = 2.70, 95% confidence interval [CI] = 2.48-2.93) and deafness (OR = 3.08, 95% CI = 1.73-5.50). Population attributable fractions for hearing impairment were 12.9% for poor self-assessed health, 9.8% for poor psychological health, 3.3% for metabolic disorders, and 4.1% for cardiovascular conditions. More attention needs to be paid on hearing impairment with regular check-ups and early detections.
Publisher: Wiley
Date: 02-09-2019
DOI: 10.1111/JIR.12685
Abstract: Longitudinal data on medication use in adults with intellectual disability (ID) are scarce. We describe the longitudinal use of and factors associated with psychotropic medication prescribing in adults with ID living in the Australian community. Longitudinal data were obtained from adults with ID in the community in Queensland, Australia, between 1999 and 2015. Participant characteristics and medication use information were extracted from baseline questionnaires and health check booklets. Logistic regression was used to investigate the associations between participant characteristics and psychotropic medication use, commencement or cessation. Longitudinal data were available for 138 participants on 697 reviews. The proportion of participants prescribed psychotropic medications increased from 43% to 54% between 1999 and 2015. The rates of commencement and cessation of psychotropic medications between consecutive time periods ranged from 9% to 18% and 7% to 15%, respectively. Challenging behaviour was associated with psychotropic medication use (adjusted odds ratio = 4.1 95% confidence interval: 2.1-7.9). Presence of challenging behaviour, either consistent or newly identified, was positively associated with ongoing use or commencement of psychotropic medications. Psychotropic medications are commonly prescribed to adults with ID. Challenging behaviour is positively associated with ongoing use and commencement.
Publisher: Springer Science and Business Media LLC
Date: 2014
Publisher: Canadian Center of Science and Education
Date: 05-2013
Publisher: Oxford University Press (OUP)
Date: 03-2011
DOI: 10.1603/ME10193
Abstract: Ross River virus (RRV) causes the most common human arbovirus disease in Australia. Although the disease is nonfatal, the associated arthritis and postinfection fatigue can be debilitating for many months, impacting on workforce participation. We sought to create an early-warning system to notify of approaching RRV disease outbreak conditions for major townships in the Northern Territory. By applying a logistic regression model to meteorologic factors, including rainfall, a postestimation analysis of sensitivity and specificity can create rainfall cut-points. These rainfall cut-points indicate the rainfall level above which previous epidemic conditions have occurred. Furthermore, rainfall cut-points indirectly adjust for vertebrate host data from the agile wallaby (Macropus agilis) as the life cycle of the agile wallaby is intricately meshed with the wet season. Once generated, cut-points can thus be used prospectively to allow timely implementation of larval survey and control measures and public health warnings to preemptively reduce RRV disease incidence. Cut-points are location specific and have the capacity to replace previously used models, which require data management and input, and rarely provide timely notification for vector control requirements and public health warnings. These methods can be adapted for use elsewhere.
Publisher: BMJ
Date: 05-06-2014
Publisher: SAGE Publications
Date: 13-01-2012
Abstract: To date, more than 300 million people worldwide live with low vision and blindness, imposing social and economic burdens on in iduals and families. This study analyzes a cohort of 87 134 Thai adults, reporting odds ratios (ORs) and calculating population attributable fractions (PAFs). PAF estimates the proportion of the disease or condition that would not occur if no one in the population had the risk factor. Approximately 28% and 8% reported having refractive errors and vision impairment not correctable by visual aids. Both types of vision impairment were positively associated with poor self-assessed health (adjusted ORs = 1.23 to 2.03) and poor psychological health (adjusted ORs = 1.13 to 1.63). PAFs show that refractive errors explain 6.1% of poor self-assessed health, 3.5% of poor psychological health, and 2.2% of falls in the last year. PAFs for vision impairment not correctable by visual aids explain 7.5%, 4.7%, and 3.1%, respectively. Incorporating early detection and prevention of vision impairment at the primary health care level will contribute to promoting the health of Thais.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Oxford University Press (OUP)
Date: 04-07-2012
Abstract: This article reviews the theoretical basis and methods for disability measurement. Different methods arise from different theoretical perspectives. Recent efforts to develop a general international disability measure consistent with the social model of disability aim to produce an internationally comparable measure of disability with which to assess the equalisation of opportunities. Such a measure cannot consistently identify disabled people in need of health and social services. Correctly identifying those in need of these services particularly concerns developing countries where government revenues and disability services are severely limited. This review highlights the need for multiple disability measures to meet different purposes of measurement. The Washington Group general measure on disability and Katz's Activities of Daily Living Index are recommended as valid measures of varying functioning level consistent with the International Classification of Functioning, Disability and Health.
Publisher: MDPI AG
Date: 26-11-2014
Publisher: Wiley
Date: 26-02-2015
DOI: 10.1111/TMI.12462
Abstract: To better inform local management of TB-diabetes collaborative activities, we aimed to determine the prevalence of diabetes among persons with and without TB and to determine the association between TB and diabetes in Kiribati, a Pacific Island nation. We compared consecutively enrolled TB cases to a group of randomly selected community controls without evidence of TB. Diabetes was diagnosed by HbA1c, and clinical and demographic data were collected. A tuberculin skin test was administered to controls. The chi-square test was used to assess significance in differences between cases and controls. We also calculated an odds ratio, with 95% confidence intervals, for the odds of diabetes among cases relative to controls. Unweighted multivariate logistic regression was performed to adjust for the effects of age and sex. A total of 275 TB cases and 499 controls were enrolled. The diabetes prevalence in cases (101, 37%) was significantly greater than in controls (94, 19%) (adjusted odds ratio: 2.8 95% CI 2.0-4.1). Fifty-five percent (108) of all diabetic diagnoses were new this proportion was higher among controls (64.8%) than cases (46.5%). Five patients with TB were screened to detect one patient with diabetes. There is a strong association between TB and diabetes in Kiribati and bidirectional screening should be conducted in this setting.
Publisher: Wiley
Date: 18-02-2015
DOI: 10.1111/TMI.12468
Publisher: Springer Science and Business Media LLC
Date: 23-04-2014
Publisher: Public Library of Science (PLoS)
Date: 13-02-2023
DOI: 10.1371/JOURNAL.PGPH.0001140
Abstract: In Australia, there is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. The aim was to conduct a scoping review to identify publications in the academic and grey literature and describe 1) Existing health services for Indigenous children in remote Australia and service use, 2) Workforce challenges in remote settings, 3) Characteristics of an effective health service, and 4) Models of care and solutions. Electronic databases of medical/health literature were searched (Jan 1990 to May 2021). Grey literature was identified through investigation of websites, including of local, state and national health departments. Identified papers (n = 1775) were screened and duplicates removed. Information was extracted and summarised from 116 papers that met review inclusion criteria (70 from electronic medical databases and 45 from the grey literature). This review identified that existing services struggle to meet demand. Barriers to effective child health service delivery in remote Australia include availability of trained staff, limited services, and difficult access. Aboriginal and Community Controlled Health Organisations are effective and should receive increased support including increased training and remuneration for Aboriginal Health Workers. Continuous quality assessment of existing and future programs will improve quality as will measures that reflect aboriginal ways of knowing and being, that go beyond traditional Key Performance Indicators. Best practice models for service delivery have community leadership and collaboration. Increased resources with a focus on primary prevention and health promotion are essential.
Publisher: BMJ
Date: 02-01-2023
DOI: 10.1136/ARCHDISCHILD-2022-324940
Abstract: There is an expectation among the public and within the profession that the performance and outcome of neonatal intensive care units (NICUs) should be comparable between centres with a similar setting. This study aims to benchmark and audit performance variation in a regional Australian network of eight NICUs. Cohort study using prospectively collected data. All eight perinatal centres in New South Wales and the Australian Capital Territory, Australia. All live-born infants born between 23 +0 and 31 +6 weeks gestation admitted to one of the tertiary perinatal centres from 2007 to 2020 (n=12 608). Early and late confirmed sepsis, intraventricular haemorrhage, medically and surgically treated patent ductus arteriosus, chronic lung disease (CLD), postnatal steroid for CLD, necrotising enterocolitis, retinopathy of prematurity (ROP), surgery for ROP, hospital mortality and home oxygen. NICUs showed variations in maternal and neonatal characteristics and resources. The unadjusted funnel plots for neonatal outcomes showed apparent variation with multiple centres outside the 99.8% control limits of the network values. The hierarchical model-based risk-adjustment accounting for differences in patient characteristics showed that discharged home with oxygen is the only outcome above the 99.8% control limits. Hierarchical model-based risk-adjusted estimates of morbidity rates plotted on funnel plots provide a robust and straightforward visual graphical tool for presenting variations in outcome performance to detect aberrations in healthcare delivery and guide timely intervention. We propose using hierarchical model-based risk adjustment and funnel plots in real or near real-time to detect aberrations and start timely intervention.
Publisher: Canadian Center of Science and Education
Date: 24-02-2015
DOI: 10.5539/GJHS.V7N5P59
Publisher: Elsevier BV
Date: 2008
Publisher: Wiley
Date: 09-12-2010
DOI: 10.1111/J.1365-2788.2009.01195.X
Abstract: Aggressive challenging behaviour in people with intellectual disability (ID) is frequently treated with antipsychotic drugs, despite a limited evidence base. A multi-centre randomised controlled trial was undertaken to investigate the efficacy, adverse effects and costs of two commonly prescribed antipsychotic drugs (risperidone and haloperidol) and placebo. The trial faced significant problems in recruitment. The intent was to recruit 120 patients over 2 years in three centres and to use a validated aggression scale (Modified Overt Aggression Scale) score as the primary outcome. Despite doubling the period of recruitment, only 86 patients were ultimately recruited. Variation in beliefs over the efficacy of drug treatment, difficulties within multidisciplinary teams and perceived ethical concerns over medication trials in this population all contributed to poor recruitment. Where appropriate to the research question cluster randomised trials represent an ethically and logistically feasible alternative to in idually randomised trials.
Publisher: Cambridge University Press (CUP)
Date: 26-07-2016
DOI: 10.1017/S095026881600162X
Abstract: Dengue is the world's most prevalent mosquito-borne disease, with more than 200 million people each year becoming infected. We used a mechanistic virus transmission model to determine whether climate warming would change dengue transmission in Australia. Using two climate models each with two carbon emission scenarios, we calculated future dengue epidemic potential for the period 2046–2064. Using the ECHAM5 model, decreased dengue transmission was predicted under the A2 carbon emission scenario, whereas some increases are likely under the B1 scenario. Dengue epidemic potential may decrease under climate warming due to mosquito breeding sites becoming drier and mosquito survivorship declining. These results contradict most previous studies that use correlative models to show increased dengue transmission under climate warming. Dengue epidemiology is determined by a complex interplay between climatic, human host, and pathogen factors. It is therefore naive to assume a simple relationship between climate and incidence, and incorrect to state that climate warming will uniformly increase dengue transmission, although in general the health impacts of climate change will be negative.
Publisher: American Society of Tropical Medicine and Hygiene
Date: 09-01-2013
Publisher: Japan Epidemiological Association
Date: 2016
Publisher: Elsevier BV
Date: 03-2016
Publisher: Elsevier BV
Date: 08-2019
Publisher: Springer Science and Business Media LLC
Date: 17-05-2014
Publisher: Informa UK Limited
Date: 04-07-2015
DOI: 10.1080/10376178.2015.1081256
Abstract: This study explores the experiences and perceptions of academic nurse mentors supporting early career nurse academics (ECNAs). Interviews were undertaken with mentors following a mentoring partnership with ECNAs. Data were transcribed verbatim and analysed using a process of thematic analysis. Four themes emerged from the data, namely motivation for mentoring constructing the relationship establishing safe boundaries and managing expectations. This study provides a unique insight into the experiences of mentoring within the context of an academic leadership programme for nurses. Such insights highlight the issues facing academics from professional disciplines and can inform strategies to support their career development. A sustainable academic nursing workforce is crucial to ensure that effective preparation of future generations of expert clinical nurses. Therefore, it is important to consider strategies that could strengthen the academic nursing workforce.
Publisher: Springer Science and Business Media LLC
Date: 17-05-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2004
DOI: 10.1097/01.RHU.0000147052.11190.36
Abstract: : Corticosteroid use during acute viral arthritis is considered to be contraindicated as a result of the risk of immunosuppression causing enhanced infection and disease exacerbation. : The objective of this study was to analyze the effect of oral corticosteroid therapy on symptoms of the viral arthritic disease, Ross River virus disease (RRVD). : Patients with RRVD were enrolled in 2 prospective longitudinal studies. Medications and comorbidities were recorded and the patients' health was assessed using 2 validated quality-of life-questionnaires, the Comparison of Clinical Health Assessment Questionnaire (CLINHAQ) and the Medical Outcomes Study Short Form (SF-36). : Six patients taking corticosteroids showed no exacerbation of RRVD compared with patients not taking steroids. The CLINHAQ Functional Disability Index also indicated that corticosteroid users recovered faster compared with patients using nonsteroidal antiinflammatory drugs. : Conventional concern that corticosteroid treatment will exacerbate disease appears unjustified for alphaviral arthritides once serodiagnosis has demonstrated antiviral immunity.
Start Date: 2010
End Date: 2014
Funder: National Health and Medical Research Council
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