ORCID Profile
0000-0003-1476-5744
Current Organisations
Queensland University of Technology
,
Queensland Health
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Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.APPET.2018.07.008
Abstract: Consuming a healthy diet characterised by a variety of nutritious foods is essential for promoting and maintaining health and wellbeing, yet the diets of Australian children continue to fall well short of national healthy eating recommendations. This research endeavours to identify patterns of dietary intake in Australian children at three and five years of age and investigate associations between early childhood dietary patterns and socio-economic and demographic indicators and Body Mass Index (BMI), as well as identify changes in children's dietary patterns over time. Cross-sectional dietary patterns were derived for 1565 and 631 children aged three and five years, respectively using Latent Class Analysis (LCA), with changes over time analysed with Latent Transition Analysis (LTA). Demographic variables of interest included child sex, parental age, family status, and use of childcare services and socio-economic variables included education, income and employment status. Three patterns of dietary intake were identified at three years (Highly Unhealthy, Healthier and Moderately Unhealthy) and two patterns at five years (Unhealthy and Healthier). Children with younger mothers, working mothers, fathers with a higher BMI and living in a two-carer household were more likely to have unhealthy eating patterns at three years, and children with working mothers and living in a two-carer household were more likely to have unhealthy patterns of dietary intake at five years. Approximately one eighth of the s le transitioned from the healthier to unhealthy pattern of dietary intake from three to five years. The quality of Australian children's diets appears to be declining through the early childhood years, continuing to highlight the importance of nutrition policies and interventions targeted towards the early years of life.
Publisher: Springer Science and Business Media LLC
Date: 02-05-2006
Publisher: JMIR Publications Inc.
Date: 13-01-2022
Abstract: here is an urgent need to reduce preventable deaths and hospitalizations from prescription opioid harms and minimize the negative effect opioid misuse can have on injured in iduals, families, and the wider community. Data linkage between administrative hospitalization records for injured patients and community opioid dispensing can improve our understanding of the health and surgical trajectories of injured persons and generate insights into corresponding opioid dispensing patterns. he Community Opioid Dispensing after Injury (CODI) study aims to link inpatient hospitalization data with opioid dispensing data to examine the distribution and predictive factors associated with high or prolonged community opioid dispensing among adults, for 2 years following an injury-related hospital admission. his is a retrospective population-based cohort study of adults aged 18 years or older hospitalized with an injury in Queensland, Australia. The study involves the linkage of statewide hospital admissions, opioid prescription dispensing, and mortality data collections. All adults hospitalized for an injury between January 1, 2014, and December 31, 2015, will be included in the cohort. Demographics and injury factors are recorded at the time of the injury admission. Opioid dispensing data will be linked and extracted for 3 months prior to the injury admission date to 2 years after the injury separation date (last date December 31, 2017). Deaths data will be extracted for the 2-year follow-up period. The primary outcome measure will be opioid dispensing (frequency and quantity) in the 2 years following the injury admission. Patterns and factors associated with community opioid dispensing will be examined for different injury types, mechanisms, and population subgroups. Appropriate descriptive statistics will be used to describe the cohort. Regression models will be used to examine factors predictive of levels and duration of opioid use. Nonparametric methods will be applied when the data are not normally distributed. he project is funded by the Royal Brisbane and Women’s Hospital Foundation. As of November 2021, all ethics and data custodian approvals have been granted. Data extraction and linkage has been completed. Data management and analysis is underway with results relating to an analysis for blunt chest trauma patients expected to be published in 2022. ittle is currently known of the true prevalence or patterns of opioid dispensing following injury across Queensland. This study will provide new insights about factors associated with high and long-term opioid dispensing at a population level. This information is essential to inform targeted public policy and interventions to reduce the risk of prolonged opioid use and dependence for those injured. The novel work undertaken for this project will be vital to planning, delivering, monitoring, and evaluating health care services for those injured. The findings of this study will be used to inform key stakeholders as well as clinicians and pain management services. R1-10.2196/36357
Publisher: Wiley
Date: 13-09-2023
DOI: 10.1111/DAR.13744
Publisher: SAGE Publications
Date: 07-12-2022
DOI: 10.1177/00048674211061684
Abstract: Young people with a mental disorder often perform poorly at school and can fail to complete high school. This study aims to compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder health condition by gender. A population-based matched case-comparison cohort study of young people aged ⩽18 years hospitalised for a mental disorder during 2005–2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers. Young males with a mental disorder had over a 1.7 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.71 95% confidence interval: [1.35, 2.15]) and reading (adjusted relative risk: 1.99 95% confidence interval: [1.80, 2.20]) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.50 95% confidence interval: [1.14, 1.96]) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a sixfold increased risk and young females with multiple disorders had up to an eightfold increased risk of not completing high school compared to peers. Early recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.BURNS.2016.09.017
Abstract: With the popularity of the Internet as a primary source of health-related information, the aim of this website content analysis was to assess the accuracy and quality of burn first aid information available on the Internet. Using the search term 'burn first aid' in four popular search engines, the first 10 websites from each search engine were recorded. From a total of 40 websites recorded, 14 websites were evaluated after removing duplicates. Websites were assessed on content accuracy by four independent reviewers with checks conducted on inter-rater reliability. Website quality was recorded based on Health on the Net Code of Conduct (HONcode) principles. Country of origin for the 14 websites was the US (7), Australia (6), and New Zealand (1). The mean content accuracy score was 5.6 out of 10. The mean website quality score was 6.6 out of 12. Australasian websites scored lower for quality but higher for accuracy. The US websites scored higher for quality than accuracy. Website usability and accuracy in a crisis situation were also assessed. The median crisis usability score was 3 out of five, and the median crisis accuracy score was 3.5 out of five. The inaccurate and inconsistent burn first aid treatments that appear online are reflected in the often-incorrect burn first aid treatments seen in patients attending emergency departments. Global consistency in burn first aid information is needed to avoid confusion by members of the public.
Publisher: JMIR Publications Inc.
Date: 10-03-2018
Abstract: ew technologies, widespread availability of the internet, the rise of social media and increased ownership of smartphones provide new opportunities for health researchers to communicate and engage with target audiences. his new technology was used to recruit mothers of young children to a smartphone application (app) to increase their knowledge about childhood burns (specifically hot beverage scalds) and correct burn first-aid. This six-month intervention deployed on the Cool Runnings app, used gamification techniques to reinforce intervention messages and engage participants. two-group, parallel, single blinded, randomized controlled trial (RCT) to evaluate the efficacy of a smartphone app-based burn prevention intervention. Participants were women aged 18+, living in Queensland, Australia, with at least one child aged 5-12 months at the time of enrolment. The primary outcome measure was change in knowledge around burn risk and correct burn first-aid assessed via two methods: overall score and categorised as adequate (score =4) vs inadequate (score less than 4). The secondary outcome measure was the efficacy of gamification techniques (measured by: app opens, photo uploads, pop quiz completions and content views). n total, 498 participants were recruited via social media and enrolled. At 6-month follow-up, 244 participants completed the post-test questionnaire. Attrition rates in both groups were similar. Participants who remained in the study did not differ from those who were lost to follow up on any characteristics except for education level. Although similar at baseline, intervention group participants achieved significantly greater improvement in overall knowledge post-test than control group participants on both primary outcome measures (overall knowledge intervention: mean=2.68± 1.00 vs control mean:2.13±1.03 intervention: 20.47% adequate vs control: 7.3%). Consequently, the NNT was 7.46. Logistic regression showed participants exposed to the highest level of disadvantage were 7.3 times more likely to improve overall knowledge scores than participants in other levels of disadvantage. There were also significant correlations between each of the four gamification techniques and knowledge change (p .001). In addition, participants with low/moderate ‘app activity’ were 8.59 times more likely to have improved knowledge between baseline and 6-month follow-up than those who had no app activity (95%CI=2.9-25.02) participants with high app activity were 18.26 times more likely to have improved knowledge (95%CI=7.1-46.8). espite substantial loss to follow-up, this RCT demonstrates the Cool Runnings app was an effective intervention for improving knowledge about hot beverage scald risks and burn first-aid in mothers of young children. The benefits of combining gamification elements in the intervention were also highlighted. Given the low cost and large reach of smartphone apps to deliver content to, and engage with targeted populations, results from this RCT provides important information on how smartphone applications can be used for widespread injury prevention c aigns, and public health c aigns generally. his trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000019404)
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.BURNS.2017.05.008
Abstract: Hot beverage scalds are a leading cause of burns in young children. The aim of this study was to look at the circumstances surrounding these injuries in terms of setting, mechanism, supervision and first aid to inform a prevention c aign. A cross-sectional study was delivered via iPad to parents and caregivers presenting with a child aged 0-36 months with a hot beverage scald at a major paediatric burns centre. Of the 101 children aged 0-36 months that presented with a hot beverage scald over a 12-month period, 54 participants were included. The scald aetiology was as expected with the peak prevalence in children aged 6-24 months, pulling a cup of hot liquid down over themselves. The majority of injuries occurred in the child's home and were witnessed by the caregiver or parent. The supervising adult was often in close proximity when the scald occurred. Less than a third (28%) of participants received recommended first aid treatment at the scene, with an additional 18% receiving this treatment with three hours of the injury-usually at an emergency department. While the aetiology of these scalds were as expected, the low use of recommended burn first aid was of concern. Although supervision was present in almost all cases, with the parent/caregiver close-by, this proximity still permitted injury. Attentiveness and continuity of supervision, which can be difficult with competing parental demands, appear to play a more important role role as do considerations of other safety mechanisms such as hazard reduction through keeping hot drinks out of reach and engineering factors such as improved cup design. By incorporating the findings from this study and other research into a hot beverage scald prevention c aign, we hope to see a change in knowledge and behaviour in parents and caregivers of young children, and ultimately a reduction in the incidence of hot beverage scalds.
Publisher: Oxford University Press (OUP)
Date: 2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2010
Publisher: Wiley
Date: 02-10-2021
DOI: 10.1111/CEA.14022
Abstract: There is inconclusive evidence of the effect of asthma on the academic performance of young people. This study aims to compare scholastic performance and high school completion of young people hospitalized with asthma compared to matched peers not hospitalized with asthma. A population‐based matched case‐comparison cohort study of young people aged ≤18 years hospitalized for asthma during 2005–2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalized linear mixed‐modelling examined risk of school performance below the national minimum standard (NMS) and generalized linear regression examined risk of not completing high school for young people hospitalized with asthma compared to matched peers. Young males hospitalized with asthma had a 13% and 15% higher risk of not achieving the NMS for numeracy (95%CI 1.04–1.22) and reading (95%CI 1.07–1.23), respectively, compared to peers. Young males hospitalized with asthma had a 51% (95%CI 1.22–1.86) higher risk of not completing year 10, and around a 20% higher risk of not completing year 11 (ARR: 1.25 95%CI 1.15–1.36) or year 12 (ARR: 1.27 95%CI 1.17–1.39) compared to peers. Young females hospitalized with asthma showed no difference in achieving numeracy or reading NMSs, but did have a 21% higher risk of not completing year 11 (95%CI 1.09–1.36) and a 33% higher risk of not completing year 12 (95%CI 1.19–1.49) compared to peers. Educational attainment is worse for young people hospitalized with asthma compared to matched peers. Early intervention and strategies for better management of asthma symptoms may enhance academic performance for students.
Publisher: AMPCo
Date: 05-2013
DOI: 10.5694/MJA12.11455
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.CHIABU.2017.10.010
Abstract: Violence against children (VAC) in Afghanistan is a serious issue in the context of many decades of conflict and poverty. To date, limited studies have explored the extent of VAC in Afghanistan and the settings where VAC takes place. To understand (i) the extent of VAC, (ii) settings where VAC takes place, (iii) parental forms of VAC and (iv) regional differences, an interview administered cross-sectional survey was employed among a community s le of 145 children and 104 parents living within Kabul, Torkham, and Jalalabad. Demographic information was collected as well as items from the International Child Abuse Screening Tool (ICAST-CH). In this study, 71% of children reported experiencing physical violence is some form in the past year. Home was the most likely location of violence. The overwhelming majority of parents reported using physical violence as a discipline method. Parents who attained higher levels of education and had more skilled occupations used violence less as a discipline method. However, consistent with international research, children cited their parents as their preferred source of support in situations of violence. Interestingly, parents did not see violent forms of discipline as more effective than non-violent strategies. The results offer a disturbing yet 'on the ground' insight into VAC in Afghanistan from the experience of children and parents. The results have important implications for programming design and provide a focus for stopping and preventing VAC in Afghanistan and similar contexts.
Publisher: Springer Science and Business Media LLC
Date: 02-02-2017
Publisher: Wiley
Date: 31-10-2019
DOI: 10.1111/JPC.14288
Abstract: To describe the relationship between emergency department (ED) diagnosis of infectious disease and immunisation status in children ≤5 years. We also aimed to demonstrate feasibility of proof-of-concept linkage between disparate databases. Data from a cohort of 3404 children born in Southeast Queensland/Far North New South Wales between 2006 and 2011 were linked to Australian Childhood Immunisation Registry data and Emergency Department Information System data for presentations between 2006 and 2014. Immunisation status was assigned using the 2009 National Immunisation Program schedule. Of 1490 children (79% of those consented) with data on immunisation status, 87.2 and 84.6% were fully immunised by 12 and 24 months, respectively. Adding partially immunised children increased this to 93.2 and 91.4% at 12 and 24 months, respectively. Nearly two-thirds of all children made at least one ED presentation. Children presenting to ED with an infectious disease did not differ in immunisation status compared to children with other (non-infectious disease type) presentations but were younger, more likely to live with other children and had a longer ED stay and higher admission rate. Respiratory syncytial virus (RSV) was more frequently diagnosed in unimmunised children. In an existing birth cohort, immunisation rates were lower than the national average. RSV was more prevalent in unimmunised children presenting to ED, but immunisation status was not significantly associated with other infectious disease presentations. Linkage between national immunisation data and Australian ED data is feasible and has the potential to identify previously unrecognised factors related to child immunisation status and health-care utilisation.
Publisher: SAGE Publications
Date: 08-03-2018
Abstract: Violence against children (VAC) is a significant international problem and, in Afghanistan, is particularly complex given the country has suffered armed conflict and extreme poverty for more than 30 years. The aim of this study was to examine the level of knowledge and observation of VAC by community leaders, professional groups, and business owners in three Afghan districts. A survey of community and religious leaders health, socio-legal, and education professionals and business owners from Kabul, Jalalabad, and Torkham ( n = 182) was conducted. Structured interviews included qualitative and quantitative components. Questions related to knowledge and experience of VAC, and to perceptions of consequences, causes, and strategies for preventing VAC. The statistical significance of differences between participant groups and measures of association were assessed by Pearson’s chi-square test, the Mann–Whitney test, and the Kruskall–Wallis one-way ANOVA. Qualitative responses were analyzed thematically. VAC was reported to occur mostly in the home, community, and workplace. The scale of the problem varied, with religious and community leaders underreporting VAC by 30% to 40% compared with other participant groups ( p .001). Business owners also significantly underreported VAC in the workplace, despite admitting to acts of discipline that included physical contact. There were some regional differences, with lower reporting of violence in Jalalabad compared with the two other locations ( p .001). Causes of VAC were consistently attributed to poverty, lack of education, and the effects of war. The findings of this study indicate that VAC is a serious and complex problem in Afghanistan. Decades of armed conflict and entrenched poverty influence how violence is perceived and recognized. Consideration should be given to initiatives that build on the existing strengths within the community while raising awareness and recognition of the nature, extent, and burden of VAC in the community.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14108
Abstract: Objective The aim of the present study was to examine the relationship between socioeconomic status (SES) and child general practitioner (GP) visits in the first 12 months of life. Methods A longitudinal analysis of 1202 mother and child dyads was conducted as part of the Environments for Healthy Living study from south-east Queensland, Australia, for participants enrolled between 2006 and 2009. Maternally reported survey data (sociodemographic and child health information) were linked with in idual Medical Benefits Scheme data from birth to 12 months, identifying GP service use. Results On average, children visited the GP 10.2 times in the first 12 months of life. An inverse relationship was found for SES and child GP visits, with maternal education and child gender the strongest predictors of the total number of GP visits. Almost 70% of participants had all GP consultations bulk billed and only 3.5% paid more than A$100 in total. Conclusions Children from lower SES families may have a greater need for health services due to higher rates of illness and injury. Bulk billing and low-cost access to GP services, regardless of length of consultation, improve equity of access however, indirect costs may prevent low-income mothers from accessing care for their child when needed. What is known about the topic? The relationship between health and SES, and the influence that health service use can have on this relationship, are well recognised. Previous studies on adult populations in Australia suggest that people of lower SES have more frequent GP consultations due to greater exposure to health risk. However, consultation times are often shorter because short consultations are more likely to be bulk billed, which is resulting in ongoing unmet need. Early childhood visits to the GP can strongly influence long-term health outcomes however, relatively few studies have examined GP service use among children in Australia. What does this paper add? This paper builds on current knowledge by providing valuable insights into GP service use in the first 12 months of life. It provides evidence to suggest that the relationship between SES and health risk already exists in the first 12 months of life and that bulk billing and low-cost access to GP services improves equity of access. It also highlights the importance of health policy and practice that enables GP service utilisation based on need rather than ability to pay. What are the implications for practitioners? Policies and practice that promote equity of access, such as bulk billing for lower SES families, can assist in improving long-term health outcomes for disadvantaged populations. Greater equity with regard to length of consultation and bulk billing for adults may assist in reducing the disparities in health outcomes between the higher and lower SES populations. Furthermore, indirect costs and the availability of appropriate services for specific groups, such as low income, rural and remote and linguistically and culturally erse populations, may also be important barriers to access.
Publisher: Informa UK Limited
Date: 12-2005
DOI: 10.1080/17457300500172891
Abstract: Injury indicators are used for monitoring the impact of injury prevention initiatives on the population burden of injury. The object of the present study was to identify the types of injury responsible for the major component of the population health burden of injury in a large cohort in Manitoba, Canada. Injury cases (ICD-9-CM 800-995) aged 18-64 years were identified from all Manitoba hospital data between 1988 and 1991. Morbidity data were obtained from hospital discharge abstracts 12 months prior to date of injury and for 12 months post-injury. Outcomes for in iduals were calculated as the difference pre- and post-injury in hospital inpatient days. Death outcomes in the 12 months post-injury were obtained by linking the cohort with the population registry. Summed outcomes across the population were stratified into injury types based on the International Code of Diseases (ICD) code of the index injury. Outcomes were also stratified by injury severity score categories where the injury severity score was obtained using ICDMAP-90. When ranked by contribution to the cohort's cumulative hospital inpatient days in the 12 months post-injury, the six most common ICD subchapter groups accounted for 65% of the total inpatient days. These six injury types also accounted for 62% of the total number of deaths in this cohort in 12 months after injury. The suggested injury types to use as indicators of burden include fracture of the lower limb, fracture of the head and neck, poisonings, intracranial injury, fracture of the upper limb, and fracture of skull.
Publisher: Cambridge University Press (CUP)
Date: 07-06-2017
DOI: 10.1017/S1368980017001069
Abstract: Systematic reviews investigating associations between objective measures of the food environment and dietary behaviours or health outcomes have not established a consistent evidence base. The present paper aims to synthesise qualitative evidence regarding the influence of local food environments on food and purchasing behaviours. A systematic review in the form of a qualitative thematic synthesis. Urban localities. Adults. Four analytic themes were identified from the review including community and consumer nutrition environments, other environmental factors and in idual coping strategies for shopping and purchasing decisions. Availability, accessibility and affordability were consistently identified as key determinants of store choice and purchasing behaviours that often result in less healthy food choices within community nutrition environments. Food availability, quality and food store characteristics within consumer nutrition environments also greatly influenced in-store purchases. In iduals used a range of coping strategies in both the community and consumer nutrition environments to make optimal purchasing decisions, often within the context of financial constraints. Findings from the current review add depth and scope to quantitative literature and can guide ongoing theory, interventions and policy development in food environment research. There is a need to investigate contextual influences within food environments as well as in idual and household socio-economic characteristics that contribute to the differing use of and views towards local food environments. Greater emphasis on how in idual and environmental factors interact in the food environment field will be key to developing stronger understanding of how environments can support and promote healthier food choices.
Publisher: Springer Science and Business Media LLC
Date: 30-06-2015
DOI: 10.1007/S10995-015-1771-5
Abstract: To describe the relationship between maternal education and child health outcomes at 12 months of age in a cohort of children in urban Australia, and to determine whether this relationship could be explained by the intermediate factors of maternal health behaviour and the social environmental context. Data were derived from The Environments for Health Living Griffith Birth Cohort Study. Women attending their third trimester antenatal appointment at one of three public hospitals were recruited between 2006 and 2010 and invited to complete a 48-item, baseline self-administered questionnaire. Twelve months following the birth of their baby, a follow-up questionnaire consisting of 63 items was distributed. Women for whom complete follow-up data were not available were different from women who did complete follow-up data. The children of women with follow-up data-whom at the time of their pregnancy had not completed school or whose highest level of education was secondary school or a trade-had respectively a 59 and 57 % increased chance of having had a respiratory/infectious disease or injury in the first year of life (according to parent proxy-reports), compared to children of women with a tertiary education. When maternal behavioural and social environmental factors during pregnancy were included in the model (n=1914), the effect of secondary education was still evident but with a reduced odds ratio of 1.35 (95 % CI 1.07-1.72) and 1.19 (95 % CI 0.87-1.64), respectively. The effect of not having completed school was no longer significant. Results indicate that the relationship between maternal education and child outcomes may be mediated by maternal social environmental and behavioural factors. Results are likely an underestimation of the effect size, given the under representation in our cohort of participants with maternal characteristics associated with elevated risk of infant morbidity.
Publisher: Wiley
Date: 31-05-2022
DOI: 10.1111/JPC.16028
Abstract: This study aims to identify the hospitalised morbidity associated with three common chronic health conditions among young people using a population‐based matched cohort. A population‐level matched case‐comparison retrospective cohort study of young people aged ≤18 years hospitalised with asthma, type 1 diabetes (T1D) or epilepsy during 2005–2018 in New South Wales, Australia using linked birth, health and mortality records. The comparison cohort was matched on age, sex and residential postcode. Adjusted rate ratios (ARR) were calculated by sex and age group. There were 65 055 young people hospitalised with asthma, 6648 with epilepsy, and 2209 with T1D. Young people with epilepsy (ARR 10.95 95% confidence interval (CI) 9.98–12.02), T1D (ARR 8.64 95% CI 7.72–9.67) or asthma (ARR 4.39 95% CI 4.26–4.53) all had a higher risk of hospitalisation than matched peers. Admission risk was highest for males (ARR 11.00 95% CI 9.64–12.56) and females with epilepsy (ARR 10.83 95% CI 9.54–12.29) compared to peers. The highest admission risk by age group was for young people aged 10–14 years (ARR 5.50 95% CI 4.77–6.34) living with asthma, children aged ≤4 years (ARR 12.68 95% CI 11.35–14.17) for those living with epilepsy, and children aged 5–9 years (ARR 9.12 95% CI 7.69–10.81) for those living with T1D compared to peers. The results will guide health service planning and highlight opportunities for better management of chronic health conditions, such as further care integration between acute, primary and community health services for young people.
Publisher: WHO Press
Date: 10-2006
Abstract: To quantify long-term health service use (HSU) following non-fatal injury in adults. A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured comparison group (n = 21 032) from linked administrative data from Manitoba, Canada. HSU data (on hospitalizations, cumulative length of stay, physician claims and placements in extended care services) were obtained for the 12 months before and 10 years after the injury. Negative binomial and Poisson regressions were used to quantify associations between injury and long-term HSU. Statistically significant differences in the rates of HSU existed between the injured and non-injured cohorts for the pre-injury year and every year of the follow-up period. After controlling for pre-injury HSU, the attributable risk percentage indicated that 38.7% of all post-injury hospitalizations (n = 25 183), 68.9% of all years spent in hospital (n = 1031), 21.9% of physician claims (n = 269 318) and 77.1% of the care home placements (n = 189) in the injured cohort could be attributed to being injured. Many people who survive the initial period following injury, face long periods of inpatient care (and frequent readmissions), high levels of contact with physicians and an increased risk of premature placement in institutional care. Population estimates of the burden of injury could be refined by including long-term non-fatal health consequences and controlling for the effect of pre-injury comorbidity.
Publisher: JMIR Publications Inc.
Date: 03-05-2021
Abstract: merging adulthood is a distinct segment of an in idual’s life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a valuable resource for improving the understanding of the multifaceted elements and unique challenges that contribute to the health and well-being of emerging adults. he main aim of this pilot study was to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform the understanding of emerging adulthood. his pilot study was conducted among graduates at a large university. It involved collecting web-based survey data at baseline (ie, graduation) and 12 months post baseline, and linking survey responses to health records from administrative data collections. The feasibility outcome measures of interest included the recruitment rate, response rate, retention rate, data linkage opt-out rate, and availability of linked health records. Descriptive statistics were used to evaluate the representativeness of the s le, completeness of the survey responses, and data linkage characteristics. nly 2.8% of invited graduates (238/8532) agreed to participate in this pilot cohort study, of whom 59.7% (142/238) responded to the baseline survey. The retention rate between the baseline and follow-up surveys was 69.7% (99/142). The completeness of the surveys was excellent, with the proportion of answered questions in each survey domain ranging from 87.3% to 100% in both the baseline and follow-up surveys. The data linkage opt-out rate was 32.4% (77/238). he overall recruitment rate was poor, while the completeness of survey responses among respondents ranged from good to excellent. There was reasonable acceptability for conducting data linkage of health records from administrative data collections and survey responses. This pilot study offers insights and recommendations for future research aiming to establish a longitudinal cohort study to investigate health and well-being in emerging adults. ustralian New Zealand Clinical Trials Registry number ACTRN12618001364268 eec8wh R2-10.2196/16108
Publisher: Wiley
Date: 31-08-2023
DOI: 10.1111/DAR.13534
Abstract: The aim was to determine the prevalence of alcohol‐related presentations to an emergency department (ED) in a major Australian hospital, through a novel surveillance approach using two biomarkers, blood ethanol and phosphatidylethanol (PEth). Observational study using secondary testing of blood s les collected during routine clinical care of ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, between 22 January and 2 February 2021. Data were collected from 1160 patients during the 10‐day study period. The main outcomes were the prevalence of acute alcohol intake, as determined by blood ethanol, and recent use over 2–4 weeks, as determined by PEth concentrations, for all ED presentations and different diagnostic groups. The overall prevalence for blood ethanol was 9.3% (95% confidence interval [CI] 7.8%, 11.1%), 5.3% for general medical presentations, increasing four‐fold to 22.2% for injury presentations. The overall prevalence of PEth positive s les was 32.5% (95% CI 29.9%, 35.3%) and 41.4% for injury presentations. There were 263 (25.3%) cases that tested negative for acute blood ethanol but positive for PEth concentrations indicative of significant to heavy medium‐term alcohol consumption. This novel surveillance approach demonstrates that using blood ethanol tests in isolation significantly underestimates the prevalence of medium‐term alcohol consumption in ED presentations. Prevalence of alcohol use was higher for key diagnostic groups such as injury presentations. Performing periodic measurement of both acute and medium‐term alcohol consumption accurately and objectively in ED presentations, would be valuable for informing targeted public health prevention and control strategies.
Publisher: JMIR Publications Inc.
Date: 23-04-2020
DOI: 10.2196/16108
Abstract: Emerging adulthood is a unique segment of an in idual’s life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between adolescence and adulthood, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a unique and valuable resource for improving the understanding of the multi-faceted elements and unique challenges that contribute to the health and well-being of emerging adults. The main aim of this pilot study is to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform our understanding of emerging adulthood. This is a pilot longitudinal cohort study of Australian university graduates. It will involve collecting information via online surveys (baseline and 12-month follow-up) and data linkage with health records. Recruitment, response, and retention rates will be calculated. Descriptive analysis of the representativeness of recruited participants and completeness of survey responses will be conducted. Participant recruitment was completed in October 2018, and data collection for the baseline and follow-up surveys was completed in November 2019. As of April 2020, the process of acquiring health records from administrative data collections has commenced. The findings from this pilot study will identify areas for improvement and inform the development of a future longitudinal cohort study of emerging adults. Australian New Zealand Clinical Trials Registry ACTRN12618001364268 eec8wh DERR1-10.2196/16108
Publisher: Informa UK Limited
Date: 03-2007
DOI: 10.1080/17457300600890103
Abstract: Priorities for prevention activities and planning for services depend on comprehensive knowledge of the distribution of the injury-related burden in the community. The aim of this systematic review was to quantify the effect of being injured, compared with not being injured, on long-term mortality in working age adults. Cohort studies were selected that were population-based, measured mortality post-discharge from inpatient treatment, included a non-injured comparison group and related to working-age adults. Data synthesis was in tabular and text form with a meta-analysis not being possible because of the heterogeneity between studies. Eleven studies met the inclusion criteria. All studies found an overall positive association between injury and increased mortality. While the greatest excess mortality was evident during the initial period post-injury, increased mortality was shown in some studies to persist for up to 40 years after injury. Due to the limited number of injury types studied and heterogeneity between studies, there is insufficient published evidence on which to calculate population estimates of long-term mortality, where injury is a component cause. The review does suggest there is considerable excess mortality following injury that is not accounted for in current methods of quantifying injury burden, and is not used to assess quality and effectiveness of trauma care.
Publisher: BMJ
Date: 12-2016
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/02699050802060621
Abstract: To quantify the 10 year health service use (HSU) and mortality outcomes for people with a traumatic brain injury (TBI). A population-based matched cohort study using linked administrative data from Manitoba, Canada (Manitoba Injury Outcome Study). An inception cohort (1988-1991) of hospitalized cases with TBI aged 18-64 years (n = 1290) was identified and matched to a non-injured comparison group (n = 1290). Survival analysis, Negative binomial and Poisson regression were used to quantify associations between injury and HSU/mortality outcomes for 10 years following the TBI event. The majority of deaths (47.2%) occurred in the first 60 days following injury. Excluding the first 60 days, the adjusted 10 year mortality remained elevated (mortality rate ratio = 1.48, 95% CI = 1.02-2.15). After adjusting for demographic characteristics and pre-existing health status, the TBI cohort had more post-injury hospitalizations (rate ratio (RR) = 1.54, 95% CI = 1.39-1.71), greater cumulative lengths of stay (RR = 5.14, 95% CI = 3.29-8.02) and a greater post-injury physician claims rate (RR = 1.44, 95% CI = 1.35-1.53) than the non-injured cohort. People who sustain a TBI and survive the initial acute phase of care experience substantially increased long-term morbidity compared to the general population, regardless of the level of injury severity.
Publisher: JMIR Publications Inc.
Date: 24-10-2017
DOI: 10.2196/RESPROT.8189
Publisher: JMIR Publications Inc.
Date: 10-10-2018
DOI: 10.2196/10361
Publisher: Springer Science and Business Media LLC
Date: 19-07-2017
DOI: 10.1007/S11657-017-0359-7
Abstract: With an ageing population, the burden of hip fractures is expected to increase in the coming decades. Older in iduals with hip fracture are more than 3.5 times more likely to die within 12 months compared to non-injured in iduals. The main priority for reducing mortality should be prevention of hip fracture. The aim of this study is to quantify and describe the 12-month mortality of older persons presenting to hospitals in Australia with a hip fracture. Population-based matched cohort study using linked hospital and mortality data from four Australian states (New South Wales, Queensland, South Australia, and Tasmania). In iduals aged 65 years and older who had a hospital admission with a primary diagnosis of hip fracture in 2009 (n = 9748) and a matched comparison cohort of non-injured in idual were selected from the electoral roll (n = 9748). The comparison group was matched 1:1 on age, sex, and postcode of residence. Adjusted mortality rate ratios (MRR) and attributable risk percent were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. The hip fracture cohort experienced significantly worse survival at the 12-month post-fracture hospitalisation (P < 0.0001). In iduals with hip fracture were more than 3.5 times more likely to die within 12 months compared to their non-injured counterparts (MRR 3.62 [95%CI 3.23-4.05]). Hip fracture was likely to be a contributory factor in 72% of mortality within 12 months after the index hospital admission. Excess mortality risk at 12 months was higher in males than that in females and in the 65-74-year age group. With an ageing population in Australia, the burden of hip fractures is expected to increase in the coming decades. Because incident hip fracture is the main predictor of subsequent mortality, the main priority for reducing excess mortality after hip fracture is primary and secondary prevention of hip fracture.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2019
Publisher: Informa UK Limited
Date: 12-2005
DOI: 10.1080/17457300500172735
Abstract: There is an acknowledged need for valid and reliable injury scores, suitable for use at the population level, which can accurately predict the long-term outcome of injury. The objective was to quantify the extent to which the abbreviated injury severity score (AIS) and the functional capacity index score (FCI) predict use of health services in the 12 months following an injury event. A cohort of injured people (ICD-9-CM 800-995) aged 18 - 64 years was identified from Manitoba hospital discharge abstracts from January 1988 to December 1991. For each member of the cohort whose injuries could be mapped to an abbreviated injury scale unique identifier, a maximum AIS (maxAIS) and a maximum FCI (maxFCI) were obtained. The cohort was linked with hospital discharge abstracts, physicians' claims and deaths from the population registry for the 12 months following injury. Negative binomial regression was used to model the relationships between the severity scores and the three outcome measures, while controlling for potential confounding variables. In total, 20 677 (97%) eligible cases were identified, of which 16 834 (81%) could be assigned a maxAIS and 15 823 (77%) a maxFCI. MaxAIS and maxFCI were significantly associated with total days in hospital following injury, but explained little of the variation in any of the health service use outcome variables (maxAIS, partial pseudo r2 ranging from < 0.001 to 0.041 and maxFCI, partial pseudo r2 ranging from < 0.001 to 0.018). It was concluded that anatomical damage is only partly responsible for long-term injury outcome. Additional variables would need to be included in predictive models of health outcomes of injury before these models could be reliable.
Publisher: Elsevier BV
Date: 08-2022
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/AH16151
Abstract: Objective The aim of the present study was to assess the effects of a community intervention aimed at general practitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to the intervention and controls that were not. Methods A comparison was made of primary care consultation and pathology data of people with SMI from intervention and control areas. Negative binomial regression models were used to compare the frequency and length of GP consultations, as well as the number and type of pathology examinations. Results Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areas were not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting for gender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rate ratio 1.56 95% confidence interval 1.28–1.91). They also had more pathology screening for chronic diseases, in accordance with implemented guideline recommendations. These benefits persisted after the end of the intervention. Conclusion These findings suggest that the ACTIVATE program aimed at training GPs to screen and better manage chronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changes in medical management practices by GPs in the intervention area during that time. What is known about the topic? People with an SMI have higher mortality and poorer physical health than the general population. What does this paper add? The community intervention had a significant and sustained effect, with demonstrated desired changes in screening and medical management by GPs for adults with SMI in the intervention area. What are the implications for practitioners? GPs are ideally placed to assist in the prevention and better management of health conditions, thereby reducing avoidable illness and deaths in vulnerable populations, such as adults with SMI. Ongoing professional training and dissemination of clinical guidelines are critical for raising awareness about the physical and oral health care needs of people with SMI.
Publisher: BMJ
Date: 31-01-2019
DOI: 10.1136/INJURYPREV-2017-042650
Abstract: The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive c aigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention c aign ‘Cool Runnings’. This paper provides baseline data for this randomised controlled trial (RCT). Queensland-based mothers aged 18+ years with at least one child aged 5–12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32 95% CI 1.8 to 6.1) and smoking status (OR=0.17 95% CI 0.04 to 0.7). In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6–24 months, it is important to target future burn prevention/first aid c aigns at parents of young children. ACTRN12616000019404 Pre-results.
Publisher: Hindawi Limited
Date: 03-02-2022
DOI: 10.1111/PEDI.13317
Abstract: The impact of type 1 diabetes mellitus (T1D) on academic performance is inconclusive. This study aims to compare scholastic performance and high-school completion in young people hospitalized with T1D compared to matched peers not hospitalized with diabetes. Retrospective case-comparison cohort study. A population-level matched case-comparison study of people aged ≤18 hospitalized with T1D during 2005-2018 in New South Wales, Australia using linked health-related and education records. The comparison cohort was matched on age, gender, and residential postcode. Generalized linear mixed modeling examined risk of school performance below the national minimum standard (NMS) and generalized linear regression examined risk of not completing high school for young people hospitalized with T1D compared to peers. Adjusted relative risks (ARR) were calculated. Young females and males hospitalized with T1D did not have a higher risk of not achieving the NMS compared to peers for numeracy (ARR: 1.19 95%CI 0.77-1.84 and ARR: 0.74 95%CI 0.46-1.19) or reading (ARR: 0.98 95%CI 0.63-1.50 and ARR: 0.85 95%CI 0.58-1.24), respectively. Young T1D hospitalized females had a higher risk of not completing year 11 (ARR: 1.73 95%CI 1.19-2.53) or 12 (ARR: 1.65 95%CI 1.17-2.33) compared to peers, while hospitalized T1D males did not. There was no difference in academic performance in youth hospitalized with T1D compared to peers. Improved glucose control and T1D management may explain the absence of school performance decrements in students with T1D. However, females hospitalized with T1D had a higher risk of not completing high school. Potential associations of this increased risk, with attention to T1D and psycho-social management, should be investigated.
Publisher: BMJ
Date: 28-04-2021
DOI: 10.1136/INJURYPREV-2020-044098
Abstract: Treatment and recovery times following injury can be lengthy, comprising multiple interactions with the hospital system for initial acute care, subsequent rehabilitation and possible re-presentation due to complications. This article aims to promote the use of consistent terminology in injury data linkage studies, suggest important factors to consider when managing linked injury data, and encourage thorough documentation and a robust discourse around different approaches to data management to ensure reproducibility, consistency and comparability of analyses arising from linked injury data. This paper is presented in sections describing: (1) considerations for identifying injury cohorts, (2) considerations for grouping Episodes into Encounters and (3) considerations for grouping Encounters into Events. Summary tools are provided to aid researchers in the management of linked injury data. Careful consideration of decisions made when identifying injury cohorts and grouping data into units of analysis (Episodes/Encounters/Events) is essential when using linked injury data. Choices made have the potential to significantly impact the epidemiological and clinical findings derived from linked injury data studies, which ultimately affect the quality of injury prevention initiatives and injury management policy and practice. It is intended that this paper will act as a call to action for injury linkage methodologists, and those using linked data, to critique approaches, share tools and engage in a robust discourse to further advance the use of linked injury data, and ultimately enhance the value of linked injury data for clinicians and health and social policymakers.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 06-2001
DOI: 10.1111/J.1467-842X.2001.TB00574.X
Abstract: To identify the number of people younger than 65 years with acquired brain injury (ABI) living in aged care facilities in Queensland, and to evaluate the appropriateness of this accommodation option. A cross-sectional descriptive study of all 493 Commonwealth Department of Health and Aged Care registered aged care facilities in Queensland. Associations between a range of demographic factors, resources, care provision and client needs were examined, from the perspective of service providers. The response rate was 75%. Twenty-six per cent of facilities (n=97) were providing care for 209 people younger than 65 years with ABI. The social, cognitive and rehabilitation aspects of client care were found to be inadequate in facilities where staffing levels, training and funding resources were limited (p< 0.05). Smaller facilities (<60 beds) reported higher levels of family participation in specific aspects of client care (p<0.05). Almost 40% of the facilities indicated they did not adequately meet the specific and complex rehabilitation needs of these clients. Aged care facilities were the least favoured model of care for this client group (8%) compared with the most favoured model of small group homes (46%). The current use of aged care facilities for housing younger people with high-level care needs resulting from ABI is inappropriate and does not meet client needs.
Publisher: JMIR Publications Inc.
Date: 06-01-2022
DOI: 10.2196/30027
Abstract: Emerging adulthood is a distinct segment of an in idual’s life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a valuable resource for improving the understanding of the multifaceted elements and unique challenges that contribute to the health and well-being of emerging adults. The main aim of this pilot study was to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform the understanding of emerging adulthood. This pilot study was conducted among graduates at a large university. It involved collecting web-based survey data at baseline (ie, graduation) and 12 months post baseline, and linking survey responses to health records from administrative data collections. The feasibility outcome measures of interest included the recruitment rate, response rate, retention rate, data linkage opt-out rate, and availability of linked health records. Descriptive statistics were used to evaluate the representativeness of the s le, completeness of the survey responses, and data linkage characteristics. Only 2.8% of invited graduates (238/8532) agreed to participate in this pilot cohort study, of whom 59.7% (142/238) responded to the baseline survey. The retention rate between the baseline and follow-up surveys was 69.7% (99/142). The completeness of the surveys was excellent, with the proportion of answered questions in each survey domain ranging from 87.3% to 100% in both the baseline and follow-up surveys. The data linkage opt-out rate was 32.4% (77/238). The overall recruitment rate was poor, while the completeness of survey responses among respondents ranged from good to excellent. There was reasonable acceptability for conducting data linkage of health records from administrative data collections and survey responses. This pilot study offers insights and recommendations for future research aiming to establish a longitudinal cohort study to investigate health and well-being in emerging adults. Australian New Zealand Clinical Trials Registry number ACTRN12618001364268 eec8wh RR2-10.2196/16108
Publisher: SAGE Publications
Date: 04-07-2018
Abstract: Prior and repeated self-harm hospitalisations are common risk factors for suicide. However, few studies have accounted for pre-existing comorbidities and prior hospital use when quantifying the burden of self-harm. The aim is to quantify hospitalisation in the 12 months preceding and re-hospitalisation and mortality risk in the 12 months post a self-harm hospitalisation. A population-based matched cohort using linked hospital and mortality data for in iduals ⩾18 years from four Australian jurisdictions. A non-injured comparison cohort was matched on age, gender and residential postcode. Twelve-month pre- and post-index self-harm hospitalisations and mortality were examined. The 11,597 in iduals who were hospitalised following self-harm in 2009 experienced 21% higher health service use in the 12 months pre and post the index admission and a higher mortality rate (2.9% vs 0.3%) than their matched counterparts. There were 133 (39.0%) deaths within 2 weeks of hospital discharge and 342 deaths within 12 months of the index hospitalisation in the self-harm cohort. Adjusted rate ratios for hospital readmission were highest for females (2.86 95% confidence interval: [2.33, 2.52]) and in iduals aged 55–64 years (3.96 95% confidence interval: [2.79, 5.64]). Improved quantification of the burden of self-harm-related hospital use can inform resource allocation for intervention and after-care services for in iduals at risk of repeated self-harm. Better assessment of at-risk self-harm behaviour, appropriate referrals and improved post-discharge care, focusing on care continuity, are needed.
Publisher: Future Medicine Ltd
Date: 09-2023
Abstract: Aim: To examine the impact of concussion on objective measures of school performance. Materials & methods: Population-based matched cohort study using linked health and education records of young people aged ≤18 years hospitalized with concussion in New South Wales, Australia, during 2005–2018, and matched comparisons not hospitalized with any injury. Results: Young people with concussion had higher risk of not achieving the national minimum standards for literacy and numeracy assessments, ranging from 30% for numeracy to 43% for spelling, and not completing high school, ranging from 29% for year 10 to 77% for year 12, compared with matched peers. Conclusion: Young people hospitalized with concussion have impaired school performance compared with uninjured matched peers.
Publisher: Springer Science and Business Media LLC
Date: 25-07-2014
DOI: 10.1038/IJO.2014.148
Abstract: To examine the association of maternal pregravid body mass index (BMI) and child offspring, all-cause hospitalisations in the first 5 years of life. Prospective birth cohort study. From 2006 to 2011, 2779 pregnant women (2807 children) were enrolled in the Environments for Healthy Living: Griffith birth cohort study in South-East Queensland, Australia. Hospital delivery record and self-report baseline survey of maternal, household and demographic factors during pregnancy were linked to the Queensland Hospital Admitted Patients Data Collection from 1 November 2006 to 30 June 2012, for child admissions. Maternal pregravid BMI was classified as underweight (<18.5 kg m(-)(2)), normal weight (18.5-24.9 kg m(-)(2)), overweight (25.0-29.9 kg m(-)(2)) or obese (⩾30 kg m(-)(2)). Main outcomes were the total number of child hospital admissions and ICD-10-AM diagnostic groupings in the first 5 years of life. Negative binomial regression models were calculated, adjusting for follow-up duration, demographic and health factors. The cohort comprised 8397.9 person years (PYs) follow-up. Children of mothers who were classified as obese had an increased risk of all-cause hospital admissions in the first 5 years of life than the children of mothers with a normal BMI (adjusted rate ratio (RR) =1.48, 95% confidence interval 1.10-1.98). Conditions of the nervous system, infections, metabolic conditions, perinatal conditions, injuries and respiratory conditions were excessive, in both absolute and relative terms, for children of obese mothers, with RRs ranging from 1.3-4.0 (PYs adjusted). Children of mothers who were underweight were 1.8 times more likely to sustain an injury or poisoning than children of normal-weight mothers (PYs adjusted). RESULTS suggest that if the intergenerational impact of maternal obesity (and similarly issues related to underweight) could be addressed, a significant reduction in child health care use, costs and public health burden would be likely.
Publisher: Springer Science and Business Media LLC
Date: 03-08-2016
Publisher: Elsevier BV
Date: 10-2007
DOI: 10.1111/J.1753-6405.2007.00118.X
Abstract: The Australian National Collaborative Research Infrastructure Strategy supports development of a national research capability in population health and clinical data linkage. This paper illustrates the importance of incorporating a population registry within such a system using an ex le provided by the Manitoba Injury Outcome Study (MIOS) that quantified the long-term burden of mortality attributable to injury in working-age adults. MIOS is a population-based matched cohort study that used administrative health data from Manitoba, Canada. An inception cohort of injured cases (ICD-9-CM 800-995) aged 18-64 years was identified from all Manitoba hospital admissions between 1988 and 1991. A matched non-injured comparison group was randomly selected from the total provincial population using the Manitoba Population Registry. Mortality outcomes were obtained by linking the two cohorts with the deaths data over 10 years. Mortality rate ratios (MRRs) were calculated to compare the injured and non-injured cohorts. A total of 21,032 matched pairs were identified. Using the population registry, the 10-year adjusted all-cause MRR comparing injured and non-injured cohort was 1.80 (95% CI 1.65-1.98). Without the registry, the unadjusted standardised morality ratio was 2.76 (95% CI 2.52-3.02). The effect of injury on mortality outcomes was over-estimated using only the injured cases, without use of the population registry. Use of the population registry enabled the selection of a matched non-injured group for comparison purposes, ensured comprehensive follow-up of almost all participants, and provided more accurate estimates of exposure time, incidence of mortality and relative risk.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.SEIZURE.2022.05.014
Abstract: To compare academic performance and high school completion of young people admitted to hospital with epilepsy and matched peers from the general population not admitted to hospital with epilepsy during the study period. A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised with epilepsy during 2005-2018 in New South Wales, Australia, using linked birth, health, education, and mortality records. The comparison cohort was matched on age, sex, and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard (NMS), and generalised linear regression examined risk of not completing high school for young people hospitalised with epilepsy compared to matched peers not hospitalised with epilepsy during the study period. Adjusted relative risks (ARRs) with 95% confidence intervals (CIs) were derived from the final models. Young people hospitalised with epilepsy had more than 3 times higher risk of not achieving the NMS for numeracy (ARR: 3.40 95%CI 2.76‒4.18) and reading (ARR: 3.15 95%CI 2.60‒3.82), compared to matched peers. Young people hospitalised with epilepsy had a 78% higher risk of not completing year 10 (ARR: 1.78 95%CI 1.14‒2.79), 18% higher risk of not completing year 11 (ARR: 1.18 95%CI 0.97‒1.45), and 38% higher risk of not completing year 12 (ARR: 1.38 95%CI 1.14‒1.67), compared to matched counterparts. Young people hospitalised with epilepsy have higher risk of not achieving minimum standards for numeracy and reading and not completing high school compared to matched peers. There is a need for effective strategies and interventions (e.g., early seizure control and improved multidisciplinary management and care coordination) to minimise the potential adverse effect of epilepsy on education and its sequelae such as early school leaving, unemployment and poverty in adulthood.
Publisher: BMJ
Date: 04-2006
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.INJURY.2021.08.029
Abstract: Opiates are frequently used in the inpatient management of chest wall injury following blunt trauma. However, the daily sum of opiates used during acute care, and the impact that additional injuries or rib fracture displacement may have on daily opiate requirement is unknown. A retrospective s le of 85 adult patients admitted to a tertiary trauma centre between April 2018 and October 2019 after a major chest wall injury (Abbreviated Injury Scale >2) and referral to Acute Pain Management Service was used in this study. Daily opiate usage was calculated each day for the first seven days following initial admission and converted to morphine milliequivalents (MME). Additional adjunct analgesia therapy was also recorded each day. The presence of rib fracture displacement and concurrent clavicle/scapular fractures was also noted. A comparison of the average daily MME for the various subgroups of interest was performed. The maximum average MME in patients with rib fractures typically occurs at day 2 post injury and admission, with the highest day 2 average MME being in the Patient Controlled Analgesia (PCA) and ketamine subgroup. Presence of rib displacement delayed the onset of maximal MME to day 3 and resulted in higher average MME over the total seven days. Patients with concurrent clavicle or scapular fractures also had higher average MME each day, regardless of the addition of a regional block. This study has demonstrated the daily opioid requirement is maximal on day 2 post-admission following isolated major chest wall injury. The addition of a regional block resulted in a reduction of the average MME used each day over the first seven days post-admission, compared to ketamine when added to PCA. The presence of displaced rib fractures or clavicle/scapular fractures increased the MME used each day, changed the day of peak consumption and increased the average daily opioid requirement during acute hospitalisation.
Publisher: Springer Science and Business Media LLC
Date: 22-05-2018
Publisher: Springer Science and Business Media LLC
Date: 25-09-2021
DOI: 10.1186/S12887-021-02891-X
Abstract: Exploring the impact of injury and injury severity on academic outcomes could assist to identify characteristics of young people likely to require learning support services. This study aims to compare scholastic performance and high school completion of young people hospitalised for an injury compared to young people not hospitalised for an injury by injury severity and to examine factors influencing scholastic performance and school completion. A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised for an injury during 2005–2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of performance below the national minimum standard (NMS) on the National Assessment Plan for Literacy and Numeracy (NAPLAN) and generalised linear regression examined risk of not completing high school for injured young people compared to matched peers. Injured young people had a higher risk of not achieving the NMS compared to their matched peers for numeracy (ARR: 1.12 95%CI 1.06–1.17), reading (ARR: 1.09 95%CI 1.04–1.13), spelling (ARR: 1.13 95%CI 1.09–1.18), grammar (ARR: 1.11 95%CI 1.06–1.15), and writing (ARR: 1.07 95%CI 1.04–1.11). As injury severity increased from minor to serious, the risk of not achieving the NMS generally increased for injured young people compared to matched peers. Injured young people had almost twice the risk of not completing high school at year 10 (ARR: 2.17 95%CI 1.73–2.72), year 11 (ARR: 1.95 95%CI 1.78–2.14) or year 12 (ARR: 1.93 95%CI 1.78–2.08) compared to matched peers. The identification of characteristics of young people most likely to encounter problems in the academic environment after sustaining an injury is important to facilitate the potential need for learning support. Assessing learning needs and monitoring return-to-school progress post-injury may aid identification of any ongoing learning support requirements.
Publisher: Elsevier BV
Date: 12-2014
Abstract: To compare sun protection by Australian-born and migrant mothers of three-year-old children. Australian-born and migrant mothers taking part in the Environments for Healthy Living prospective birth-cohort study were asked standard questions about their child's sun protection. Children were given a skin cancer susceptibility score based on grandparents' ethnic origin. Logistic regression was used to estimate odds ratios (ORs) to measure the association of sun protection of children according to mothers' migrant status adjusted for socio-demographic characteristics. A total of 613 Australian-born and 224 migrant mothers of three-year-old children were studied. Mothers who had migrated less than four years ago were more likely to allow their three-year-old to spend more than two hours outdoors between 10 am and 3 pm compared to Australian-born mothers (OR=2.80, 95%CI 1.20-6.57). Mothers from high latitude countries (>45 degrees) were more likely to apply sunscreen to their child than those from lower latitude countries (OR=3.15, 95%CI 1.03-9.61). Strategies should aim to increase general awareness about the need for sun protection of young children, and recent migrants should be alerted to the harms of excessive sun exposure.
Publisher: Elsevier BV
Date: 08-2015
Abstract: To describe the practical issues that need to be overcome to conduct national data linkage projects in Australia and propose recommendations to improve efficiency. Review of the processes, documentation and applications required to conduct national data linkage in Australia. The establishment of state and national data linkage centres in Australia has placed Australia at the forefront of research linking health-related administrative data collections. However, improvements are needed to reduce the clerical burden on researchers, simplify the process of obtaining ethics approval, improve data accessibility, and thus improve the efficiency of data linkage research. While a sound state and national data linkage infrastructure is in place, the current complexity, duplication and lack of cohesion undermines any attempts to conduct research involving national record linkage in a timely manner. Data linkage applications and Human Research Ethics Committee approval processes need to be streamlined and duplication removed, in order to reduce the administrative and financial burden on researchers if national data linkage research is to be viable.
Publisher: Wiley
Date: 16-10-2023
DOI: 10.5694/MJA2.52129
Publisher: Springer Science and Business Media LLC
Date: 08-09-2014
Publisher: Wiley
Date: 11-04-2022
Abstract: This study aimed to examine patterns of injury, the impact of these injuries on patients and identification of potentially modifiable contributing factors through industry regulation reforms and education. Food delivery rider (FDR)‐related presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre for a year from September 2020 were identified. Data collected included patient and incident demographics: time, type and location of injuries, investigations and care required, length of stay, admission requirements and follow up. The cohort included 81.8% male with a mean age of 25.2 years. Most injuries occurred on the road from a collision with a vehicle. The most common injury was fractures. Incidence increased on weekends and during the evening. More than half the cohort were admitted to hospital. Only 22.7% of patients were eligible for workers compensation and less than half were covered by Medicare. The majority (72.7%) of cases involved non‐resident riders from other countries. The majority of FDRs presenting with injuries are not Australian citizens and less than half were Medicare eligible potentially contributing to inadequate access to care especially fracture follow up. There were spikes in injuries occurring at night, weekends and during periods of pandemic associated lockdowns demonstrating an increased usage of delivery services during these times. Results highlight injury patterns experienced by delivery riders and potentially modifiable risk factors for this rapidly growing area of employment within the gig economy.
Publisher: Wiley
Date: 25-07-2017
DOI: 10.1111/JPC.13617
Abstract: Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants. A prospective birth cohort from Queensland and New South Wales (Environments for Healthy Living) was used to understand infant health service use. Baseline and 12-month questionnaire data pertaining to children born between 2006 and 2011 were used to identify predictors of ED presentation, using multiple regression analysis. Of the 2184 children in the cohort with available baseline and 12-month data, 579 (27%) presented at least once to an ED during their first 12 months of life. Statistically significant predictors of ED presentation in the multivariate analysis included the mother having asthma (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.15-2.39) and a higher Kessler-6 score (a measure of psychological distress) of the primary carer at baseline (OR 1.04, 95% CI 1.01-1.08). Maternal education level was not associated with ED presentations of infants. This study describes maternal and child factors of children who present to the ED in the first year of life. Factors related to an infant's support system were found to be predictors for an ED presentation in the first year of life. This study emphasises the need to review the maternal medical history and psychosocial situation. There may be benefits for health-care practitioners to take the opportunity (such as during routine childhood immunisation) to perform a brief screening tool (such as the Kessler-6) to understand psychological distress experienced by mothers. This may influence the likelihood of a child presenting to an ED within the first 12 months of life.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: BMJ
Date: 19-10-2021
DOI: 10.1136/INJURYPREV-2021-044222
Abstract: Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) is an immersive 1 day in-hospital injury awareness and prevention programme designed to educate high-school students on the consequences of a variety of risk-taking behaviours. This multisite contemporary analysis examined differences in programme effect and temporal changes on participant knowledge and attitudes. Metropolitan and rural schools were invited to attend the programme at one of the 11 hospital sites throughout Queensland, Australia. Pre–post study design with participant questionnaires provided at three time periods: immediately preprogramme and postprogramme, and 4 months later. The questionnaire used scenarios to determine a participant’s opinion on the safety of drugs/alcohol, driving and risk-taking activities, using Likert scales. A total of 5999 students participated in the programme between 1 January 2018 and 31 December 2019. Responses to all questions related to safety, harm or risk followed a similar pattern. The immediate postcourse responses demonstrated significant increased awareness of risk or change in action, followed by a decay at 4 months to within 10% of preprogramme levels. Public school students, males and students from Central and North Queensland demonstrated lower risk-aversion (p .05). This study demonstrated across more than 100 school sites, the positive change in knowledge and student participant attitudes towards risk-taking behaviours after attending the P.A.R.T.Y. programme. The need to address the significant decay at the 4-month follow-up was identified. Findings offered potential for tailoring of messaging to target key demographic groups/topics where the decay was greatest.
Publisher: MDPI AG
Date: 18-05-2017
Publisher: JMIR Publications Inc.
Date: 12-04-2022
DOI: 10.2196/36357
Abstract: There is an urgent need to reduce preventable deaths and hospitalizations from prescription opioid harms and minimize the negative effect opioid misuse can have on injured in iduals, families, and the wider community. Data linkage between administrative hospitalization records for injured patients and community opioid dispensing can improve our understanding of the health and surgical trajectories of injured persons and generate insights into corresponding opioid dispensing patterns. The Community Opioid Dispensing after Injury (CODI) study aims to link inpatient hospitalization data with opioid dispensing data to examine the distribution and predictive factors associated with high or prolonged community opioid dispensing among adults, for 2 years following an injury-related hospital admission. This is a retrospective population-based cohort study of adults aged 18 years or older hospitalized with an injury in Queensland, Australia. The study involves the linkage of statewide hospital admissions, opioid prescription dispensing, and mortality data collections. All adults hospitalized for an injury between January 1, 2014, and December 31, 2015, will be included in the cohort. Demographics and injury factors are recorded at the time of the injury admission. Opioid dispensing data will be linked and extracted for 3 months prior to the injury admission date to 2 years after the injury separation date (last date December 31, 2017). Deaths data will be extracted for the 2-year follow-up period. The primary outcome measure will be opioid dispensing (frequency and quantity) in the 2 years following the injury admission. Patterns and factors associated with community opioid dispensing will be examined for different injury types, mechanisms, and population subgroups. Appropriate descriptive statistics will be used to describe the cohort. Regression models will be used to examine factors predictive of levels and duration of opioid use. Nonparametric methods will be applied when the data are not normally distributed. The project is funded by the Royal Brisbane and Women’s Hospital Foundation. As of November 2021, all ethics and data custodian approvals have been granted. Data extraction and linkage has been completed. Data management and analysis is underway with results relating to an analysis for blunt chest trauma patients expected to be published in 2022. Little is currently known of the true prevalence or patterns of opioid dispensing following injury across Queensland. This study will provide new insights about factors associated with high and long-term opioid dispensing at a population level. This information is essential to inform targeted public policy and interventions to reduce the risk of prolonged opioid use and dependence for those injured. The novel work undertaken for this project will be vital to planning, delivering, monitoring, and evaluating health care services for those injured. The findings of this study will be used to inform key stakeholders as well as clinicians and pain management services. RR1-10.2196/36357
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2020-047887
Abstract: Alcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED. This is an observational prevalence study involving the secondary use of routinely collected blood s les from patients presenting to the Royal Brisbane and Women’s Hospital (RBWH) Emergency and Trauma Centre (ETC). S les will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10–12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study s le. The correlation between acute and medium-term alcohol intake levels will also be examined. This study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.
Publisher: AMPCo
Date: 09-2013
DOI: 10.5694/MJA12.11723
Abstract: To describe the prevalence and distribution of alcohol consumption during pregnancy in an Australian population over a 5-year period. Cross-sectional repeated s le, trend analysis of aggregated and stratified alcohol consumption patterns during pregnancy. Pregnant women were enrolled from 2007 to 2011 in the Griffith Study of Population Health: Environments for Healthy Living, a birth cohort study being conducted in south-east Queensland and north-east New South Wales. Sociodemographic and alcohol consumption data were self-reported at enrollment. Alcohol measures included alcohol consumption (any level) and high-risk alcohol consumption, both during pregnancy (at any stage) and after the first trimester of pregnancy. Of 2731 pregnant women for whom alcohol consumption data were available, a decrease in alcohol consumption was observed over the study period 52.8% reported alcohol use in 2007 compared with 34.8% in 2011 (P< 0.001). The proportion of women who drank alcohol after the first trimester of pregnancy declined from 42.2% in 2007 to 25.8% in 2011. However, high-risk drinking patterns - at all or after the first trimester - did not change over the 5 years (P = 0.12). Low-level alcohol consumption was associated with older women (P < 0.001), more highly educated women (P = 0.01), and women from higher-income households (P < 0.001). In contrast, high-risk consumption after the first trimester was associated with lower levels of education (P = 0.011) and single-parent status (P = 0.001). This study showed a steady and statistically significant decline in the proportion of women who reported drinking alcohol during pregnancy from 2007 to 2011. To further reduce these levels, we need broad public health messages for the general population and localised strategies for high-risk subpopulations. Australian New Zealand Clinical Trials Registry ACTRN12610000931077.
Publisher: Elsevier BV
Date: 06-2014
Abstract: To outline some of the key issues for injury-related data linkage studies in Australia and describe potential applications of data linkage for injury surveillance and research. Narrative review of data linkage capacity and injury-related data collection quality in Australia. The establishment of national and state-based data linkage centres in Australia has been a great leap forward for data linkage capacity for injury research. However, there are still limitations of using data linkage for injury surveillance and research. These are highlighted in the form of key perils and pitfalls, with ex les provided. There is still much to be gained for injury research by using data linkage techniques to enhance the information available across the injury continuum, but data quality issues should always be acknowledged. Obtaining authorisation to link injury data collections for national research remains cumbersome. Streamlining of the application process is needed to ensure that injury research is able to be conducted in a timely fashion. Data quality and data linkage rates need to be considered when interpreting research findings. Streamlining of the application process for research that involves linking data collections would help ensure that research is conducted in a timely fashion.
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJPO-2019-000530
Abstract: Children who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to be affected and the use of objective measures of education performance. This may highlight educational disparities that could be addressed with learning support. This study aims to examine education performance, school completion and health outcomes of children in New South Wales (NSW), Australia, who were hospitalised with an injury or a chronic health condition compared with children who have not been hospitalised for these conditions. This research will be a retrospective population-level case-comparison study of hospitalised injured or chronically ill children (ie, diabetes, epilepsy, asthma or mental health conditions) aged ≤18 years in NSW, Australia, using linked health and education administrative data collections. It will examine the education performance, school completion and health outcomes of children who have been hospitalised in NSW with an injury or a chronic health condition compared with children randomly drawn from the NSW population (matched on gender, age and residential postcode) who have not been hospitalised for these conditions. The study received ethics approval from the NSW Population Health Services Research Ethics Committee (2018HRE0904). Findings from the research will be published in peer-reviewed journals and presented at scientific conferences.
Publisher: Springer Science and Business Media LLC
Date: 02-03-2018
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.INJURY.2017.04.014
Abstract: Healthcare use by traumatically injured in iduals prior to and subsequent to their injury are not often explored for different types of injuries. This study aims to describe health care use 12 months preceding and 12 months following a traumatic injury by injury type and injury severity. Hospital and mortality data from three Australian states were linked in a population-based matched cohort study. In iduals ≥18 years who had an injury-related hospital admission in 2009 were identified as the injured cohort. A comparison cohort of non-injured people, matched 1:1 on age, gender and postcode of residence, was randomly selected from the electoral roll. Twelve-month pre- and post-index injury health service use was examined. Rates, adjusted rate ratios and attributable risk proportions were calculated by injury type and severity. The injury cohort experienced higher 12-month pre- and post-injury hospital admissions than the non-injured group. By 6 to 7 months post-injury, the injury cohort had largely returned to their pre-injury health service use levels, except for injuries involving dislocations, sprains and strains and injury to nerves and spinal cord. Hip fracture (17.69 per 100 person-months) and poisoning (16.09 per 100 person-months) had the highest rates of post-injury hospitalisation in the injured cohort. The adjusted rate ratios (ARR) for post-injury hospitalisation were highest for poisoning (ARR: 3.77 95% CI: 3.38-4.21) and injury to nerves and spinal cord (ARR: 2.73 95% CI: 2.27-3.28). Poisoning also had the highest ARR for post-injury LOS (ARR: 5.31 95% CI: 4.51-6.27). After sustaining a traumatic injury, many in iduals are readmitted to hospital and require ongoing care up to 12 months post-injury. That injured in iduals post-injury largely return to their pre-index injury hospital use by 6 to 7 months could imply a return to pre-injury function and/or that other measures of health service use should be explored. Trauma services should consider long-term follow-up and support services for seriously injured patients post-hospital discharge.
No related grants have been discovered for Cate Cameron.