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Publisher: Elsevier BV
Date: 06-2022
Publisher: Wiley
Date: 19-01-2017
DOI: 10.1071/HE16052
Publisher: JMIR Publications Inc.
Date: 17-09-2020
DOI: 10.2196/20160
Abstract: Chronic kidney disease (CKD) is a significant and growing health burden globally. Tasmania has the highest state prevalence for non-Indigenous Australians and it has consistently had the lowest incidence and prevalence of dialysis in Australia. To examine the gap between the high community prevalence of CKD in Tasmania and the low use of dialysis. This is a retrospective cohort study using linked data from 5 health and 2 pathology data sets from the island state of Tasmania, Australia. The study population consists of any person (all ages including children) who had a blood measurement of creatinine with the included pathology providers between January 1, 2004, and December 31, 2017. This study population (N=460,737) includes within it a CKD cohort, which was detected via pathology or documentation of kidney replacement therapy (KRT dialysis or kidney transplant). Kidney function (estimated glomerular filtration rate [eGFR]) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. In iduals with 2 measures of eGFR mL/min/1.73 m2, at least 90 days apart, were identified as having CKD and were included in the CKD cohort. In iduals treated with dialysis or transplant were identified from the Australia and New Zealand Dialysis and Transplant Registry. The study population consisted of 460,737 people (n=245,573 [53.30%] female, mean age 47.4 years) who were Tasmanian residents aged 18 years and older and were followed for a median of 7.8 years. During the later 5 years of the study period, 86.79% (355,622/409,729) of Tasmanian adults were represented. The CKD cohort consisted of 56,438 people (ie, 12.25% of the study population 53.87% (30,405/56,438) female, mean age 69.9 years) followed for a median of 10.4 years with 56,039 detected via eGFR and 399 people detected via documentation of KRT. Approximately half (227,433/460,737, 49.36%) of the study population and the majority of the CKD cohort (41,448/56,438, 73.44%) had an admission episode. Of the 55,366 deaths recorded in the study population, 45.10% (24,970/55,366) had CKD. Whole-of-population approaches to examine CKD in the community can be achieved by data linkage. Over this 14-year period, CKD affected 12.25% (56,438/460,737) of Tasmanian adult residents and was present in 45.10% (24,970/55,366) of deaths. DERR1-10.2196/20160
Publisher: Springer Science and Business Media LLC
Date: 22-12-2022
DOI: 10.1186/S12966-022-01394-X
Abstract: Partnering with a public transport (PT) provider, state government, and local government, the single-blinded randomised controlled trial, trips4health, investigated the impact of PT use incentives on transport-related physical activity (PA) in Tasmania, Australia. The intervention involved 16-weeks of incentives (bus trip credits) for achieving weekly PT use targets, supported by weekly text messages. This study objective was to conduct a process evaluation of the COVID-19 disrupted trips4health study. The Medical Research Council UK’s framework for complex public health interventions guided the process evaluation. Participant reach, acceptability, fidelity and feasibility were evaluated. Administrative and post-intervention survey data were analysed descriptively. Semi-structured interviews with intervention participants ( n = 7) and PT provider staff ( n = 4) were analysed thematically. Due to COVID-19, trips4health was placed on hold (March 2020) then stopped (May 2020) as social restrictions impacted PT use. At study cessation, 116 participants (approximately one third of target s le) had completed baseline measures, 110 were randomised, and 64 ( n = 29 in the intervention group n = 35 in the control group) completed post-intervention measures. Participants were 18 – 80 years (average 44.5 years) with females (69%) and those with tertiary education (55%) over-represented. The intervention was delivered with high fidelity with 96% of bus trip credits and 99% of behavioural text messages sent as intended. Interviewed PT staff said implementation was highly feasible. Intervention participant acceptability was high with 90% reporting bus trip incentives were helpful and 59% reporting the incentives motivated them to use PT more. From a total of 666 possible bus trip targets, 56% were met with 38% of intervention participants agreeing and 41% disagreeing that ‘Meeting the bus trip targets was easy’. Interviews and open-ended survey responses from intervention participants revealed incentives motivated bus use but social (e.g., household member commitments) and systemic (e.g., bus availability) factors made meeting bus trip targets challenging. trips4health demonstrated good acceptability and strong fidelity and feasibility. Future intervention studies incentivising PT use will need to ensure a broader demographic is reached and include more supports to meet PT targets. ACTRN12619001136190 .
Publisher: Informa UK Limited
Date: 17-02-2017
Publisher: Wiley
Date: 20-04-2017
DOI: 10.1111/COB.12195
Abstract: General practitioners (GPs) are increasingly managing patients with class 2 and 3 obesity (body mass index [BMI] > 35 and 40 kg/m
Publisher: Oxford University Press (OUP)
Date: 06-05-2016
Abstract: Research funding is increasingly supporting collaborations between knowledge users and researchers. Partnering Healthy@Work (pH@W), an inaugural recipient of funding through Australia's Partnership for Better Health Grants scheme, was a 5-year partnership between the Menzies Institute for Medical Research, University of Tasmania and the Tasmanian State Service (TSS). The partnerships purpose was to evaluate a comprehensive workplace health promotion programme (Healthy@Work) targeting 30 000 public sector employees generating new knowledge and influencing workplace health promotion policy and decision-making. This mixed methods study evaluates the partnership between policy-makers and academics and identifies strategies that enabled pH@W to deliver key project outcomes. A pH@W document review was conducted, two partnership assessment tools completed and semi-structured interviews conducted with key policy-makers and academics. Analysis of the partnership assessment tools and interviews found that pH@W had reached a strong level of collaboration. Policy-relevant knowledge was generated about the health of TSS employees and their engagement with workplace health promotion. Knowledge exchange of a conceptual and instrumental nature occurred and was facilitated by the shared grant application, clear governance structures, joint planning, regular information exchange between researchers and policy-makers and research student placements in the TSS. Flexibility and acknowledgement of different priorities and perspectives of partner organizations were identified as critical factors for enabling effective partnership working and research relevance. Academic-policy-maker partnerships can be a powerful mechanism for improving policy relevance of research, but need to incorporate strategies that facilitate regular input from researchers and policy-makers in order to achieve this.
Publisher: Informa UK Limited
Date: 18-03-2017
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S40814-021-00951-8
Abstract: Public transport users often accumulate more physical activity than motor vehicle users, but most studies have been conducted in large metropolitan areas with multiple public transport options with limited knowledge of the relationship in regional and rural areas. In a regional city, this pilot study aimed to (1) test the feasibility of preliminary hypotheses to inform future research, (2) test the utility of survey items, and (3) establish stakeholder engagement. Data were collected via a cross-sectional online survey of 743 Tasmanian adults. Physical activity outcomes were walking (min/week), total moderate- to vigorous-intensity physical activity (min/week) and attainment of physical activity guidelines (yes/no). Transport variables were frequency of public and private transport use per week. Truncated and log binomial regression examined associations between public rivate transport use and physical activity. Neither frequency of public nor private transport use was associated with minutes of walking (public transport: B − 24.4, 95% CI: − 110.7, 61.9 private transport: B − 1.1, 95% CI: − 72.4, 70.1), minutes of total physical activity (public transport: B − 90.8, 95% CI: − 310.0, 128.5 private transport: B 0.4, 95% CI: − 134.0, 134.9) or not meeting physical activity guidelines (public transport: RR 1.02, 95%CI: 0.95, 1.09 private transport: RR 1.02, 95%CI: 0.96, 1.08). The hypothesis that public transport users would be more physically active than private transport users was not supported in this pilot study. Stakeholders were engaged and involved in various phases of the research including development of research questions, participant recruitment, and interpretation of findings. Further studies using representative s les and refined measures are warranted to confirm or refute findings.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 04-2016
DOI: 10.1111/OBR.12400
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.ORCP.2018.07.003
Abstract: General practitioners (GPs) can positively impact upon patient intentions to lose weight and weight management, and are important in the referral pathway to specialist weight-loss programs and surgical interventions. The aim of this study was to investigate the characteristics and proportions of Australians who report talking to a GP about weight management. Cross-sectional data from 15,329 participants aged 15 years and over in the 2014-15 Australian National Health Survey were used. Proportions (with 95% confidence intervals (95%CI)) of respondents who reported discussing reaching a healthy weight with a GP in the previous 12 months were estimated, categorised by demographic, social and health characteristics. We found that 10.8% (95%CI:9.8-11.8) of overweight participants, 24.4% (95%CI:22.7-26.4) with Class 1 obesity (30≤BMI <35kg/m While discussions are more likely with increasing BMI and comorbidities, most Australians with overweight and obesity appear to be missing opportunities to discuss reaching a healthy weight with their GP. Policies, training and education programs to encourage this dialogue could lead to earlier and more beneficial weight-related interventions.
Publisher: Ubiquity Press, Ltd.
Date: 2021
DOI: 10.5334/IJIC.5581
Publisher: Elsevier BV
Date: 09-2021
Publisher: Informa UK Limited
Date: 20-04-2018
Publisher: Ubiquity Press, Ltd.
Date: 2022
DOI: 10.5334/CSTP.488
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
Publisher: Informa UK Limited
Date: 05-01-2020
DOI: 10.1080/09638288.2020.1867656
Abstract: We aimed to understand from the perspective of stroke survivors and their carers (1) factors contributing to sedentary time and physical activity during inpatient rehabilitation and the transition home, and (2) actual and perceived opportunities to reduce sedentary time and increase physical activity. Qualitative study with 7 stroke survivor/carer dyads and 8 stroke survivors. Semi-structured interviews were conducted 2-4 weeks after hospital discharge, audio recorded and transcribed prior to thematic analysis. Stroke survivors were mean age 69 [SD15] years (53% male). Carers were mean age 62 [SD15] years (86% were female). Five themes were identified: (1) Education and guidance about physical activity and sedentary behaviour after stroke is important to build understanding of recovery and secondary prevention, (2) Stroke survivors need clear communication about safety and risk, (3) Return to life participation supports motivation for and engagement in physical activity, 4) Social and professional influences and 5) Opportunities to be physically active. Stroke survivors and their carers need a clearer understanding of the role of physical activity and risks of sedentary time during stroke recovery. Physical activity enablers included consistent communication, building confidence and skills to self-manage activity before discharge.Implications for RehabilitationInpatient rehabilitation and early after discharge may be an important time-point to support stroke survivors to establish long term physical activity behaviours before contact with healthcare professionals reduces.To reduce sedentary behaviour, people need to understand the health benefits of breaking up sedentary time and people who need physical support to stand up will need greater support from health professionals.Being able to imagine a future post-stroke self is important motivation to get up and move. Rehabilitation should help develop a person's vision of their post-stroke self.Managing potential risks in hospital without overly restricting physical activity is important and requires consistent communication from the multi-disciplinary team.Building a person's confidence and skills to self-manage physical activity in the community prior to discharge home may be another key enabler for activity.
Publisher: Swansea University
Date: 03-08-2021
Abstract: ObjectiveTo report (using linked laboratory data) the incidence, prevalence and geographic variation of chronic kidney disease (CKD) across the whole island population of Tasmania, Australia. MethodsA retrospective cohort study (the Tasmanian Chronic Kidney Disease study (CKD.TASlink)) using linked data from five health and two pathology datasets from the island state of Tasmania, Australia between 1/1/2004 and 31/12/2017. We used data on 460,737 Tasmanian adults (aged 18 years and older, representing 86.8% of the state's population) who had a serum creatinine measured during the study period. We defined CKD as per Kidney Disease Outcomes Quality Initiative, requiring two measures of estimated glomerular filtration rate (eGFR) mL/min/1.73m2, at least three months apart. Kidney replacement therapy (KRT) included dialysis or kidney transplantation. ResultsWe identified 56,438 Tasmanians with CKD during the study period, equating to an age-standardised annual incidence of 1.0% and a prevalence of 6.5%. These figures were higher in women, older Tasmanians and people living in the North-West region of Tasmania. Testing for urinary albumin:creatinine ratio is increasing, with 28.5% of women and 30.8% of men with stage 3 CKD having both an eGFR and uACR in 2017. Use of KRT was consistently seen in % of Tasmanians with eGFR mL/min/1.73m2. ConclusionThere is geographic and gender variation in the incidence and prevalence of CKD, but it is reassuring to see that the majority of people with end-stage kidney failure are actually receiving treatment with dialysis or transplantation.
Publisher: JMIR Publications Inc.
Date: 12-05-2020
Abstract: hronic kidney disease (CKD) is a significant and growing health burden globally. Tasmania has the highest state prevalence for non-Indigenous Australians and it has consistently had the lowest incidence and prevalence of dialysis in Australia. o examine the gap between the high community prevalence of CKD in Tasmania and the low use of dialysis. his is a retrospective cohort study using linked data from 5 health and 2 pathology data sets from the island state of Tasmania, Australia. The study population consists of any person (all ages including children) who had a blood measurement of creatinine with the included pathology providers between January 1, 2004, and December 31, 2017. This study population (N=460,737) includes within it a CKD cohort, which was detected via pathology or documentation of kidney replacement therapy (KRT dialysis or kidney transplant). Kidney function (estimated glomerular filtration rate [eGFR]) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. In iduals with 2 measures of eGFR& mL/min/1.73 m sup /sup , at least 90 days apart, were identified as having CKD and were included in the CKD cohort. In iduals treated with dialysis or transplant were identified from the Australia and New Zealand Dialysis and Transplant Registry. he study population consisted of 460,737 people (n=245,573 [53.30%] female, mean age 47.4 years) who were Tasmanian residents aged 18 years and older and were followed for a median of 7.8 years. During the later 5 years of the study period, 86.79% (355,622/409,729) of Tasmanian adults were represented. The CKD cohort consisted of 56,438 people (ie, 12.25% of the study population 53.87% (30,405/56,438) female, mean age 69.9 years) followed for a median of 10.4 years with 56,039 detected via eGFR and 399 people detected via documentation of KRT. Approximately half (227,433/460,737, 49.36%) of the study population and the majority of the CKD cohort (41,448/56,438, 73.44%) had an admission episode. Of the 55,366 deaths recorded in the study population, 45.10% (24,970/55,366) had CKD. hole-of-population approaches to examine CKD in the community can be achieved by data linkage. Over this 14-year period, CKD affected 12.25% (56,438/460,737) of Tasmanian adult residents and was present in 45.10% (24,970/55,366) of deaths. ERR1-10.2196/20160
Publisher: Wiley
Date: 18-10-2020
DOI: 10.1002/HPJA.428
Abstract: Physical activity is lower and rates of preventable common diseases are higher in regional/rural than urban Australia. Active commuting (walking/bicycling to get from one place to another) may benefit health through increased physical activity, but most evidence of its correlates come from urban studies. This study aimed to investigate associations between active commuting, socio‐demographic characteristics, behaviours, total physical activity and health in a regional/rural Australian state. This study used data from the 2016 Tasmanian Population Health Survey, a representative cross‐sectional self‐report survey of 6,300 adults in Tasmania, Australia. Logistic regression modelling investigated associations between socio‐demographic, behavioural and health characteristics and past week active commuting frequency. In multivariable models, being younger, having tertiary qualifications, living in a socio‐economically advantaged area, being physically active, having a healthy body mass index and good/excellent self‐rated health were associated with engaging in more active commuting. Inner regional dwellers were no more likely than outer regional dwellers to actively commute after covariate adjustment. Strategies to promote active commuting in regional/rural areas might consider targeting older adults, those less educated, those living in socio‐economically disadvantaged areas, those less physically active, those with poorer health and those with higher body mass index. Research could further investigate why these groups appear to be less active for commuting purposes. Increasing physical activity and active commuting may help to reduce rates of preventable common diseases in regional/remote areas.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Wiley
Date: 14-12-2016
DOI: 10.1111/COB.12169
Abstract: The objective of this study was to investigate the experience of waiting for publicly funded bariatric surgery in an Australian tertiary healthcare setting. Focus groups and in idual interviews involving people waiting for or who had undergone publicly funded bariatric surgery were audio-recorded, transcribed and analysed thematically. A total of 11 women and 6 men engaged in one of six focus groups in 2014, and an additional 10 women and 9 men were interviewed in 2015. Mean age was 53 years (range 23-66) mean waiting time was 6 years (range 0-12), and mean time since surgery was 4 years (range 0-11). Waiting was commonly reported as emotionally challenging (e.g. frustrating, depressing, stressful) and often associated with weight gain (despite weight-loss attempts) and deteriorating physical health (e.g. development of new or worsening obesity-related comorbidity or decline in mobility) or psychological health (e.g. development of or worsening depression). Peer support, health and mental health counselling, integrated care and better communication about waitlist position and management (e.g. patient prioritization) were identified support needs. Even if wait times cannot be reduced, better peer and health professional supports, together with better communication from health departments, may improve the experience or outcomes of waiting and confer quality-of-life gains irrespective of weight loss.
Publisher: Springer Science and Business Media LLC
Date: 18-11-2020
DOI: 10.1007/S10643-020-01130-9
Abstract: School readiness is a construct used by educators and policy makers to describe a range of abilities that are beneficial for children transitioning to school. The association of socioeconomic disadvantage with developmental vulnerability when children start school is well established. Parents play a crucial role in supporting children’s transition to school and are acknowledged as their child’s first and foremost teacher. The aim of this study was to explore how parents experience and support their children’s transition to school. This study presents findings from an ethnographic study with 39 parents living in two Australian communities characterised by high area-level socioeconomic disadvantage. The study reports on how parents experience and support their child for transition to school, specifically through their understanding of the concept of ‘readiness’. The role of early childhood services in supporting parents is also explored. Parents conceptualised school readiness as the child’s capacity to function effectively and independently in the hitherto unfamiliar physical and social world of school. Parents considered early childhood services supportive of their children's transition to school, particularly the development of social skills.
Publisher: Wiley
Date: 07-09-2021
DOI: 10.1002/AJS4.186
Abstract: This study investigated patterns of universal health and education service use from birth through Kindergarten (age 4 years) and estimated associations between cumulative risk and service use patterns, and between service use patterns and children's developmental vulnerability in the Preparatory Year (age 5 years). The study used population‐wide linkage of health and education administrative data records for 5168 children who had a 2018 AEDC instrument collected in Tasmania and were born in Tasmania (2011–2013). Latent class analysis (LCA) identified three service use patterns: Regular (72.2 per cent of children reference group), Low (15.6 per cent of children) and High service use (12.2 per cent of children). The patterns of Regular, Low and High service use were consistent across health and education services used at different ages and stages of child development. Membership of the Low and High service use groups was associated with higher cumulative risk and increased odds of developmental vulnerability, relative to the Regular service use group. This population‐wide view of universal service use can be used by the health and education sectors to explore ways in which their specialist expertise, resources and referral processes can be further integrated within and across services to meet the developmental needs of children and families.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2019
Publisher: Oxford University Press (OUP)
Date: 14-09-2023
Publisher: Cold Spring Harbor Laboratory
Date: 12-09-2021
DOI: 10.1101/2021.09.08.21263308
Abstract: Using a new approach to the analysis and synthesis of a clinically focused mixed-methods multiple case study of aneurysmal subarachnoid haemorrhage (aSAH), we explored barriers and facilitators to timely treatment. In this paper we provide guidance for the multiple steps of analysis and synthesis of qualitative and quantitative data from across and within 27 case studies. Results showed that median (IQR) time to treatment was 15.1 (9.0, 24.1) hours. Only 37% of cases had treatment within 12-hours of onset. Early recognition of aSAH, good coordination, and availability of resources for treatment were main facilitators for treatment within 12 hours from onset. Lack of recognition of aSAH at onset and lack of resources for immediate in-hospital treatment were major barriers.
Publisher: Wiley
Date: 13-04-2021
DOI: 10.1111/JEP.13569
Abstract: Absolute cardiovascular disease (aCVD) risk assessment is recommended in CVD prevention guidelines. Yet, General Practitioners (GPs) often focus on single risk factors, including blood pressure (BP). Pathology services may be suitable to undertake high‐quality automated unobserved BP (AOBP) measurement and aCVD risk assessment. This study explored GP attitudes towards AOBP measurement via pathology services and the role of BP in aCVD risk management. A brief survey was completed, after which a focus group (n = 8 GPs) and interviews (n = 10 GPs) explored attitudes to AOBP and aCVD risk via pathology services with an ex le pathology report discussed. Verbatim transcripts were thematically coded. GPs predominantly used doctor‐measured BP despite low levels of confidence. High BP measured by AOBP reported with aCVD risk via pathology services, would prompt a follow‐up response. However, GPs focused on BP management. GPs were concerned about AOBP equivalency to routine BP measurements. After protocol explanation, GPs reported AOBP could value‐add to care delivery. GPs lacked familiarity of AOBP and maintained a focus on BP management in the context of absolute CVD risk. Targeted education on AOBP and BP management as part of absolute CVD risk is needed to support guideline‐directed care in practice.
Publisher: Wiley
Date: 20-09-2020
DOI: 10.1002/HPJA.292
Abstract: Public transport (PT) users typically accumulate more physical activity (PA) than motor vehicle users. This mixed methods study aimed to determine acceptability and perceived effectiveness of strategies to increase bus use for PA gain in a regional Australian setting. In a 2017 online survey, Tasmanian adults (n = 1091) rated the likelihood of increasing their bus use according to ten hypothetical strategies (fare-, incentives-, information- or infrastructure-based). Three focus groups and five interviews (n = 31) included infrequent bus users from the survey to determine reasons for strategy preferences and potential impact on PA. The top three strategies in the survey, with supporting rationale from qualitative data, were: provision of real-time bus information ("…because I can better plan…") bus-only lanes ("…it just speeds the whole thing up…") and employee incentives/rewards for ex le bus fare credits ("…it really comes down to money…"). Full-time students favoured cost-saving strategies most and residents in outer suburbs favoured infrastructure-based strategies most. Qualitative data indicated that potential for enhanced certainty, efficiency or cost-savings drove strategy preferences and some strategies may lead to PA gain (eg through the location of Park and Ride facilities). Real-time information, bus-only lanes and employee incentives/rewards appear most promising for increasing bus use in this population, but tailoring strategies may be required. Discrete PT enhancement strategies may result in PA gain. SO WHAT?: Increasing PA through transport behaviour has been underexplored. The potential for PA gain through greater PT use and discrete PT use enhancement strategies is an important public health consideration.
Publisher: Elsevier BV
Date: 2020
Publisher: SAGE Publications
Date: 31-05-2020
Abstract: Background. Many Australian primary schools have established school breakfast clubs (SBCs) to address concerns about children arriving at school hungry and the subsequent impact on learning but their effectiveness is uncertain. This study aimed to identify the perceived benefits, impacts, operational practices, and challenges of running SBCs. Method. Case studies with 10 Australian primary schools from different socioeconomic and geographic areas. Focus groups or interviews were held with 142 participants including students, parents/carers, school staff, and funding body representatives between July 2016 and October 2017. Results. There were no eligibility criteria to attend SBCs with all students able to attend, regardless of household income. Thus, participating in the SBC was often reported as a matter of choice rather than a consequence of food insecurity. Participants, including children, discussed the many social benefits of SBCs (i.e., social eating, relationship building, school connection, and engagement) as well as perceived improved classroom behavior. Challenges for program delivery included resource limitations, particularly, the reliance on volunteers and sourcing food. Discussion/Conclusion. SBCs offered a range of benefits beyond their primary goal of addressing food security. SBCs were highly valued by members of the school community for their social, welfare, well-being, and educational benefits, but program sustainability is constrained by resource limitations.
Publisher: Wiley
Date: 16-01-2021
DOI: 10.1111/AJR.12683
No related organisations have been discovered for Kim Jose.
Start Date: 2008
End Date: 2008
Funder: Physiotherapy Research Foundation
View Funded ActivityStart Date: 2016
End Date: 2016
Funder: Menzies Institute for Medical Research
View Funded Activity