ORCID Profile
0000-0002-0080-1487
Current Organisations
King's College London - Waterloo Campus
,
Universidade Anhanguera de São Paulo
,
National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases
,
King's College London
,
Macquarie University
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Publisher: CSIRO Publishing
Date: 16-03-2023
DOI: 10.1071/PY22026
Publisher: Japanese Society of Tropical Medicine
Date: 2015
DOI: 10.2149/TMH.2014-21
Publisher: Springer Science and Business Media LLC
Date: 15-05-2012
DOI: 10.1038/BJC.2012.160
Publisher: SAGE Publications
Date: 06-08-2016
Abstract: The DRIP-SWICCH (Developing Research and Innovative Policies Specific to the Water-related Impacts of Climate Change on Health) project aimed to increase the resilience of Cambodian communities to the health risks posed by climate change–related impacts on water. This article follows a review of climate change and water-related diseases in Cambodia and presents the results of a time series analysis of monthly weather and diarrheal disease data for 11 provinces. In addition, correlations of diarrheal disease incidence with selected demographic, socioeconomic, and water and sanitation indicators are described, with results suggesting education and literacy may be most protective against disease. The potential impact of climate change on the burden of diarrheal disease in Cambodia is considered, along with the implications of these findings for health systems adaptation.
Publisher: JMIR Publications Inc.
Date: 08-07-2022
Abstract: A. This is a research letter not requiring abstract
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-07-2018
Publisher: Elsevier BV
Date: 09-2020
Publisher: AMPCo
Date: 23-06-2021
DOI: 10.5694/MJA2.51147
Publisher: Informa UK Limited
Date: 12-08-2014
DOI: 10.3402/GHA.V7.24413
Publisher: MDPI AG
Date: 07-12-2011
Publisher: JMIR Publications Inc.
Date: 18-10-2022
DOI: 10.2196/40876
Publisher: Springer Science and Business Media LLC
Date: 04-08-2016
Publisher: Springer Science and Business Media LLC
Date: 07-09-2021
DOI: 10.1186/S12961-021-00772-4
Abstract: Health systems around the world have been forced to make choices about how to prioritize care, manage infection control and maintain reserve capacity for future disease outbreaks. Primary healthcare has moved into the front line as COVID-19 testing transitions from hospitals to multiple providers, where tracking testing behaviours can be fragmented and delayed. Pooled general practice data are a valuable resource which can be used to inform population and in idual care decision-making. This project aims to examine the feasibility of using near real-time electronic general practice data to promote effective care and best-practice policy. The project will utilize a design thinking approach involving all collaborators (primary health networks [PHNs], general practices, consumer groups, researchers, and digital health developers, pathology professionals) to enhance the development of meaningful and translational project outcomes. The project will be based on a series of observational studies utilizing near real-time electronic general practice data from a secure and comprehensive digital health platform [POpulation Level Analysis and Reporting (POLAR) general practice data warehouse]. The study will be carried out over 1.5 years (July 2020–December 2021) using data from over 450 general practices within three Victorian PHNs and Gippsland PHN, Eastern Melbourne PHN and South Eastern Melbourne PHN, supplemented by data from consenting general practices from two PHNs in New South Wales, Central and Eastern Sydney PHN and South Western Sydney PHN. The project will be developed using a design thinking approach, leading to the building of a meaningful near real-time COVID-19 geospatial reporting framework and dashboard for decision-makers at community, state and nationwide levels, to identify and monitor emerging trends and the impact of interventions olicy decisions. This will integrate timely evidence about the impact of the COVID-19 pandemic related to its diagnosis and treatment, and its impact across clinical, population and general practice levels.
Publisher: Macquarie University
Date: 2021
DOI: 10.25949/5Z8Y-2E49
Publisher: CSIRO Publishing
Date: 21-11-2022
DOI: 10.1071/PY22174
Abstract: The onset of the coronavirus disease 2019 (COVID-19) pandemic, caused by SARS-CoV-2, and the ensuing implementation of response measures directly impacted the delivery of Australian primary care services. Understanding how these measures affected practice activity is important for gauging both their effectiveness and implications for future service planning. During the first 2 years of the COVID-19 pandemic, a research project was undertaken to determine the impact of the pandemic on Australian general practice activity as a collaborative undertaking between researchers, general practitioners, data custodians, and five primary health networks from New South Wales and Victoria, Australia. The project methodology was based on an established research approach called action research, which involves participatory involvement from key stakeholders throughout the research process. The strength and success of the project’s methodological approach stemmed from the synergistic interrelationship between the four key elements of: collaboration, repeated action research cycles (utilising electronic general practice data), engaged governance, and the production and dissemination of apposite knowledge outcomes. The project approach, knowledge outputs and lessons learned can be adapted to future research undertakings across any primary care setting and highlight the utility of action research and interdisciplinary research collaboration to produce knowledge directly relevant to clinical practice.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-08-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 06-2017
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2018
Publisher: Royal College of General Practitioners
Date: 24-11-2021
Abstract: Since the World Health Organization declared COVID-19 a pandemic on 11 March 2020, health technologies have been rapidly scaled up to ensure access to care. A significant innovation has been telehealth in general practice. Now widespread, it remains unknown how this shift to virtual care has impacted on quality-of-care indicators such as pathology testing and diagnosis. To undertake a comparison of telehealth and face-to-face general practice consultations to: identify if there were differences in the proportion of pathology test referrals from 2019–2020 and quantify any change in pathology test collection and follow-up patterns. Retrospective observational study of routinely collected electronic patient data from 807 general practices across New South Wales (NSW) and Victoria, Australia. Multivariate generalised estimating equation models were used to estimate the proportion of pathology test referrals for overall, face-to-face, and telehealth consultations. Pathology test follow-up was described through median (and interquartile range [IQR]) time. Pathology test referrals declined during periods of high COVID-19 cases, falling from 10.8% in February 2020 to a low of 4.5% during the first peak in April. Overall, pathology test referrals were lower for telehealth than face-to-face consultations. Median time between referral and test collection was 3 days (IQR 1–14) for telehealth and 1 day (IQR 0–7) for face to face. For telehealth to become part of routine care, it is crucial that gaps in functionality, including difficulty in test referral processes, be addressed. Quality improvements supporting care practices will ensure clinicians’ workflows are supported and patients receive diagnostic testing.
Publisher: Royal College of General Practitioners
Date: 07-04-2022
Abstract: The Australian government introduced temporary government-subsidised telehealth service items (phone and video-conference) in mid-March 2020 in response to the COVID-19 pandemic. The uptake of telehealth by patients with type 2 diabetes (T2DM) for consulting with GPs is unknown. To evaluate the uptake of telehealth consultations and associated patient characteristics in Australian general practice, including the frequency of haemoglobin A1c (HbA1c) tests and change in HbA1c levels by telehealth use, compared with guideline recommendations. This exploratory study used electronic patient data from approximately 800 general practices in Victoria and New South Wales (NSW), Australia. A pre-COVID-19 period from March 2019–February 2020 was compared with a pandemic period from March 2020–February 2021. Patients diagnosed with T2DM before March 2018 were included. Telehealth uptake patterns were examined overall and by patient characteristics. Generalised estimating equation models were used to examine patient probability of 6-monthly HbA1c testing and change in HbA1c levels, comparing between patients who did and patients who did not use telehealth. Of 57 916 patients, 80.8% had telehealth consultations during the pandemic period. Telehealth consultations were positively associated with patients with T2DM who were older, female, had chronic kidney disease (CKD), prescribed antidiabetic medications, and living in remote areas. No significant difference was found in 6-monthly HbA1c testing and HbA1c levels between telehealth users and patients who had face-to-face consultations only. Telehealth GP consultations were well utilised by patients with T2DM. Diabetes monitoring care via telehealth is as effective as face-to-face consultations.
Publisher: Macquarie University
Date: 2021
DOI: 10.25949/Q9BE-BJ06
Publisher: Macquarie University
Date: 2021
DOI: 10.25949/ZPW2-WJ80
Publisher: Springer Science and Business Media LLC
Date: 29-11-2019
DOI: 10.1038/S41598-019-53838-3
Abstract: Although there have been enormous demands and efforts to develop an early warning system for malaria, no sustainable system has remained. Well-organized malaria surveillance and high-quality climate forecasts are required to sustain a malaria early warning system in conjunction with an effective malaria prediction model. We aimed to develop a weather-based malaria prediction model using a weekly time-series data including temperature, precipitation, and malaria cases from 1998 to 2015 in Vhembe, Limpopo, South Africa and apply it to seasonal climate forecasts. The malaria prediction model performed well for short-term predictions (correlation coefficient, r 0.8 for 1- and 2-week ahead forecasts). The prediction accuracy decreased as the lead time increased but retained fairly good performance (r 0.7) up to the 16-week ahead prediction. The demonstration of the malaria prediction process based on the seasonal climate forecasts showed the short-term predictions coincided closely with the observed malaria cases. The weather-based malaria prediction model we developed could be applicable in practice together with skillful seasonal climate forecasts and existing malaria surveillance data. Establishing an automated operating system based on real-time data inputs will be beneficial for the malaria early warning system, and can be an instructive ex le for other malaria-endemic areas.
Publisher: Macquarie University
Date: 2021
DOI: 10.25949/ZX36-8S49
Publisher: BMJ
Date: 17-05-2023
DOI: 10.1136/ARCHDISCHILD-2022-325000
Abstract: To describe changing primary care ordering of serum 25-hydroxyvitamin D (25OHD) tests in Australian children. Longitudinal, population-based descriptive study of 25OHD testing using a large administrative dataset of pathology orders and results, 2003–2018. Three primary health networks in Victoria, Australia. Patients aged ≤18 years with a serum 25OHD test ordered by the general practitioner (GP). Trends over 15 years in the number of 25OHD tests ordered, proportion indicating low levels or vitamin D deficiency and details of repeat testing. Of 970 816 laboratory tests, 61 809 (6.4%) included an order for a 25OHD test. The 61 809 tests were performed in 46 960 children or adolescents. The odds of ordering a 25OHD test in 2018 was 30.4 times higher compared with 2003 (95%CI 22.6 to 40.8, p .001). The odds of detecting a low 25OHD ( nmol/L) compared with the baseline in 2003 remained steady (adjusted OR .5) over time. Repeat tests (14 849) were undertaken in 9626 patients (median intertest interval 357 days, IQR 172–669 days). A total of 4603 test results indicated vitamin D deficiency ( nmol/L), but in only 180 (3.9%) of these was a repeat test performed within 3 months as recommended. Testing volumes increased 30-fold, but the odds of detecting low 25OHD remained steady. Current Australian policy and the Global Consensus Recommendations for the prevention and management of nutritional rickets do not support routine 25OHD testing. Education and electronic pathology ordering tools may assist GPs to better align practice with current recommendations.
Publisher: Elsevier BV
Date: 09-2018
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.ENVRES.2015.06.040
Abstract: Time series regression has been developed and long used to evaluate the short-term associations of air pollution and weather with mortality or morbidity of non-infectious diseases. The application of the regression approaches from this tradition to infectious diseases, however, is less well explored and raises some new issues. We discuss and present potential solutions for five issues often arising in such analyses: changes in immune population, strong autocorrelations, a wide range of plausible lag structures and association patterns, seasonality adjustments, and large overdispersion. The potential approaches are illustrated with datasets of cholera cases and rainfall from Bangladesh and influenza and temperature in Tokyo. Though this article focuses on the application of the traditional time series regression to infectious diseases and weather factors, we also briefly introduce alternative approaches, including mathematical modeling, wavelet analysis, and autoregressive integrated moving average (ARIMA) models. Modifications proposed to standard time series regression practice include using sums of past cases as proxies for the immune population, and using the logarithm of lagged disease counts to control autocorrelation due to true contagion, both of which are motivated from "susceptible-infectious-recovered" (SIR) models. The complexity of lag structures and association patterns can often be informed by biological mechanisms and explored by using distributed lag non-linear models. For overdispersed models, alternative distribution models such as quasi-Poisson and negative binomial should be considered. Time series regression can be used to investigate dependence of infectious diseases on weather, but may need modifying to allow for features specific to this context.
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.AJIC.2019.07.024
Abstract: A high prevalence of working while ill (presenteeism) has been documented among health care workers (HCWs). However, previous evidence is primarily based on nonspecific causes of sickness and self-reported data. Our study examined presenteeism among HCWs with laboratory-confirmed influenza. The data pertaining to laboratory-confirmed influenza cases and history of sick leave among HCWs in Queensland, Australia, were collected from 2009-2015. The incidence and duration of sick leave around the time of disease confirmation were analyzed. The associations of factors, such as job category and employment status, on presenteeism were assessed with regression analyses. The overall sick leave incidence was 85.9% in the laboratory-confirmed periods, which translates that 14.1% of HCWs were working while ill with influenza. Among medical doctors, approximately one-quarter of them were attending work in the period. A shorter duration of leave was also observed among medical doctors and full-time employees compared with other HCWs and part-time employees. Presenteeism among HCWs with influenza put both HCWs and patients at risk by increasing potential for transmission. Our findings emphasize the importance of an integrated approach including both HCW sick leave management and vaccination for strategic prevention and control of nosocomial influenza infection.
Publisher: Public Library of Science (PLoS)
Date: 12-12-2013
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 04-2018
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 05-2020
Publisher: Public Library of Science (PLoS)
Date: 07-06-2018
Publisher: MDPI AG
Date: 28-04-2016
Publisher: BMJ
Date: 04-02-2021
DOI: 10.1136/BMJQS-2020-012026
Abstract: Clinical practice guidelines emphasise the role of regular monitoring of glycated haemoglobin A1c (HbA1c) for patients with type 2 diabetes, with most recommending 6-monthly testing. Nonetheless, there are few in-depth studies evaluating the clinical impact of the recommended testing frequency for patients to underpin the significance of guideline adherence. This study aimed to examine associations between patient outcomes and adherence to HbA1c testing frequencies recommended by Australian guidelines (6-monthly for patients with adequate glycaemic control and 3-monthly for patients with inadequate glycaemic control). The primary and secondary outcomes of interest were longitudinal changes in HbA1c values and development of ischaemic heart disease (IHD) and chronic kidney disease (CKD). This 5-year retrospective cohort study (July 2013–June 2018) evaluated HbA1c testing frequency in a subset of patients with type 2 diabetes identified within data collected from approximately 250 Australian general practices. The study included patients who were aged ≥18 in 2013 and had a record of HbA1c testing in study practices during the study period. Each patient’s adherence rate was defined by the proportion of HbA1c tests performed within the testing intervals recommended by Australian guidelines. Based on the adherence rate, adherence level was categorised into low (≤33%), moderate (34%–66%) and high ( %). Generalised additive mixed models were used to examine associations between adherence to the recommended HbA1c testing frequency and patient outcomes. In the 6424 patients with diabetes, the overall median HbA1c testing frequency was 1.6 tests per year with an adherence rate of 50%. The estimated HbA1c levels among patients with low adherence gradually increased or remained inadequately controlled, while HbA1c values in patients with high adherence remained controlled or improved over time. The risk of developing CKD for patients with high adherence was significantly lower than for patients with low adherence (OR: 0.42, 95% CI 0.18 to 0.99). No association between IHD and adherence to the recommended HbA1c frequency was observed. Better adherence to guideline-recommended HbA1c testing frequency was associated with better glycaemic control and lower risk of CKD. These findings may provide valuable evidence to support the use of clinical guidelines for better patient outcomes in patients with type 2 diabetes.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Chisato Imai.