ORCID Profile
0000-0002-8033-6123
Current Organisations
University of Western Australia
,
University of Notre Dame Australia
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Nanomaterials | Urban And Regional Planning | Catalytic Process Engineering | Health Promotion | Public Health and Health Services | Nanotechnology | Statistics | Applied Statistics | Statistical Theory | Electrochemistry | Sustainable Development |
ANZSRC Socio-Economic Objective (SEO)
Measurement standards and calibration services not elsewhere classified | Solid Oxide Fuel Cells | Public health not elsewhere classified | Studies in human society | Manufacturing not elsewhere classified | Behaviour and health | Mathematical sciences
Related Links
Publications
Supplementary Table 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779466.V1
Abstract: Multivariable adjusted hazard ratios for all-cause and cause-specific hospitalisations, major cancer diagnostic group.
Maternal hypertensive diseases negatively affect offspring motor development
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.PREGHY.2014.04.003
Abstract: Hypertension in pregnancy and preecl sia have been linked to poor outcomes in cognitive, mental and psychomotor development however, few longitudinal studies have researched their effect on offspring motor development, particularly in late childhood and adolescence. The purpose of this study was to determine if maternal hypertensive diseases during pregnancy are a risk factor for compromised motor development at 10, 14, and 17years. Longitudinal cohort study using data from the Western Australian Pregnancy Cohort Study (Raine). Offspring (n=2868) were classified by their maternal blood pressure profiles during pregnancy: normotension (n=2133), hypertension (n=626) and preecl sia (n=109). Offspring motor development, at 10, 14, and 17years was measured by the Neuromuscular Developmental Index (NDI) of the McCarron Assessment of Motor Development (MAND). Linear mixed models were used to compare outcomes between pregnancy groups. Offspring from pregnancies complicated by preecl sia had poorer motor outcomes at all ages than offspring from either normotensive mothers (p⩽0.001) or those with hypertension (p=0.002). Hypertensive diseases during pregnancy, in particular preecl sia, have long term and possibly permanent consequences for motor development of offspring.
Relationship between cigarette smoking and blood pressure in adults in Nepal: A population-based cross-sectional study
Publisher: Public Library of Science (PLoS)
Date: 09-11-2021
DOI: 10.1371/JOURNAL.PGPH.0000045
Abstract: Smoking and hypertension are two major risk factors for cardiovascular disease, the leading cause of death in Nepal. The relationship between cigarette smoking and blood pressure (BP) in Nepal is unclear. This study analysed the data from the 2016 Nepal Demographic and Health Survey to explore the differences in systolic BP (SBP) and diastolic BP (DBP) between current daily cigarette smokers and non-smokers in Nepali adults aged 18 to 49 years. A total of 5518 women and 3420 men with valid BP measurements were included. Age, body mass index, wealth quintile (socio-economic status) and agricultural occupation (proxy for physical activity) were included as potential confounders in multivariable linear regression analysis. Women smokers were found to have significantly lower SBP (mean difference 2.8 mm, 95% CI 0.7–4.8 mm) and DBP (mean difference 2.2 mm, 95% CI 0.9–3.6 mm) than non-smokers after adjustment. There were no significant differences in BP between smokers and non-smokers in males, either before or after adjustment. The lower BP in female cigarette smokers in Nepal may be explained by the physiological effect of daily cigarette smoking per se in women, or unmeasured confounders associated with a traditional lifestyle that may lower BP (for ex le, diet and physical activity). In this nationally representative survey, daily cigarette smoking was not associated with increased BP in males or females in Nepal.
Supplementary Table 3 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Supplementary Table 3 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Comparing an eHealth Program (My Hip Journey) With Standard Care for Total Hip Arthroplasty: Randomized Controlled Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 02-08-2020
Abstract: he role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. he aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. his study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. ustralian New Zealand Clinical Trial Registry ACTRN12617001433392 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657
Supplementary Table 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 06-07-2023
DOI: 10.1158/1055-9965.EPI-22-1313
Abstract: The long-term effects of childhood cancer are unclear in the Australian context. We examined hospitalization trends for physical diseases and estimated the associated inpatient care costs in all 5-year childhood cancer survivors (CCS) diagnosed in Western Australia (WA) from 1982 to 2014. Hospitalization records for 2,938 CCS and 24,792 comparisons were extracted from 1987 to 2019 (median follow-up = 12 years, min = 1, max = 32). The adjusted hazard ratio (aHR) of hospitalization with 95% confidence intervals (CI) was estimated using the Andersen–Gill model for recurrent events. The cumulative burden of hospitalizations over time was assessed using the mean cumulative count method. The adjusted mean cost of hospitalization was estimated using the generalized linear models. We identified a higher risk of hospitalization for all-cause (aHR, 2.0 95% CI, 1.8–2.2) physical disease in CCS than comparisons, with the highest risk for subsequent malignant neoplasms (aHR, 15.0 95% CI, 11.3–19.8) and blood diseases (aHR, 6.9 95% CI, 2.6–18.2). Characteristics associated with higher hospitalization rates included female gender, diagnosis with bone tumors, cancer diagnosis age between 5 and 9 years, multiple childhood cancer diagnoses, multiple comorbidities, higher deprivation, increased remoteness, and Indigenous status. The difference in the mean total hospitalization costs for any disease was significantly higher in survivors than comparisons (publicly funded $11,483 United States Dollar, P & 0.05). The CCS population faces a significantly higher risk of physical morbidity and higher cost of hospital-based care than the comparisons. Our study highlights the need for long-term follow-up healthcare services to prevent disease progression and mitigate the burden of physical morbidity on CCS and hospital services.
Supplementary Figure 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779472.V1
Abstract: The mean cumulative count of hospitalisations for any physical-health disease by attained age, in childhood cancer survivors and their matched comparisons.
Supplementary Table 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779469
Abstract: Major diagnostic groups of physical-health diseases based on the International Classification of Diseases (ICD), 9th (Clinical modification) and 10th (Australian Modification) revisions.
Supplementary Figure 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Supplementary Table 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779466
Abstract: Multivariable adjusted hazard ratios for all-cause and cause-specific hospitalisations, major cancer diagnostic group.
Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-046600
Abstract: There are personal and societal benefits from caregiving however, caregiving can jeopardise caregivers’ health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers’ health-related quality of life (HRQOL) after care recipients’ hospital discharge. A multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient’s discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30–45 min telephone support sessions over 6 months. The primary outcome is caregivers’ HRQOL measured using the Assessment of Quality of Life—eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements. Participants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences. ACTRN12620000060943.
Supplementary Table 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Automated CT Perfusion Detection of the Acute Infarct Core in Ischemic Stroke: A Systematic Review and Meta-Analysis
Publisher: S. Karger AG
Date: 03-06-2023
DOI: 10.1159/000524916
Abstract: b i Introduction: /i /b In patients with acute ischemic stroke, the location and volume of an irreversible infarct core determine prognosis and treatment. We aimed to determine if automated CT perfusion (CTP) is non-inferior to diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) in predicting the acute infarct core. b i Methods: /i /b In this systematic review and meta-analysis, we searched MEDLINE and EMBASE from 1960 to December 2020. Five outcome measures were examined: volumetric difference, volumetric correlation, sensitivity and specificity at the patient level, Dice coefficient, and sensitivity and specificity at the voxel level. A random-effects meta-analysis was performed for volumetric difference and correlation. b i Results: /i /b From 3,986 studies retrieved, 48 studies met our inclusion criteria with 46 studies on anterior circulation, one study on posterior circulation, and one study on lacunar infarct strokes. In anterior circulation stroke, there were no significant mean volumetric differences between CTP and acute DWI (cerebral blood flow [CBF] 0.52 mL, 95% CI [−0.07, 1.11], i I /i sup /sup 0.0% relative CBF [rCBF] 3.01 mL, 95% CI [−0.46, 6.48], i I /i sup /sup 82.6% relative cerebral blood volume [rCBV] −12.84 mL, 95% CI [−38.56, 12.88], i I /i sup /sup 96.2%) and between CTP and delayed DWI or FLAIR (rCBF −1.29 mL, 95% CI [−6.49, 3.92], i I /i sup /sup 91.8% rCBV −5.80 mL, 95% CI [−16.20, 4.60], i I /i sup /sup 84.2%). Mean correlation between CTP and acute DWI was 0.90 (95% CI [0.80, 0.95], i I /i sup /sup 60.0%) for rCBF and 0.84 (95% CI [0.58, 0.94], i I /i sup /sup 93.5%) for rCBV. Mean correlation between CTP and delayed DWI or FLAIR was 0.74 (95% CI [0.57, 0.85], i I /i sup /sup 94.6%) for rCBF and 0.90 (95% CI [0.69, 0.97], i I /i sup /sup 93.1%) for rCBV. Sensitivity and specificity at the patient level were reported by three studies and Dice coefficient by four studies. Statistical analysis could not be performed for sensitivity and specificity at the voxel level. Limited evidence was available for posterior circulation or lacunar infarct strokes. b i Conclusion: /i /b Due to significant heterogeneity and insufficient high-quality studies reporting each outcome, there is insufficient evidence to reliably determine the accuracy of CTP prediction of the infarct core compared to DWI or FLAIR.
Supplementary Table 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Supplementary Table 3 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779463
Abstract: Adjusted annual mean costs of privately funded hospitalisations per in idual, by all-cause and cause-specific physical diseases.
Increasing use of CT requested by emergency department physicians in tertiary hospitals in Western Australia 2003–2015: an analysis of linked administrative data
Publisher: BMJ
Date: 03-2021
DOI: 10.1136/BMJOPEN-2020-043315
Abstract: This study aimed to examine trends in number of CT scans requested by tertiary emergency department (ED) physicians in Western Australia (WA) from 2003 to 2015 across broad demographic and presentation characteristics, anatomical areas and presented symptoms. An observational cross-sectional study over study period from 2003 to 2015. Linked administrative health service data at in idual level from WA. A total of 1 666 884 tertiary hospital ED presentations of people aged 18 years or older were included in this study Number of CT scans requested by tertiary ED physicians in an ED presentation. Poisson regression models were used to assess variation and trends in number of CT scans requested by ED physicians across demographic characteristics, clinical presentation characteristics and anatomical areas. Over the entire study duration, 71 per 1000 ED episodes had a CT requested by tertiary ED physicians. Between 2003 and 2015, the rate of CT scanning almost doubled from 58 to 105 per 1000 ED presentations. After adjusted for all observed characteristics, the rate of CT scans showed a downward trend from 2009 to 2011 and subsequent increase. Males, older in iduals, those attending ED as a result of pain, those with neurological symptoms or injury or with higher priority triage code were the most likely to have CT requested by tertiary ED physicians. Noticeable changes in the number of CTs requested by tertiary ED physicians corresponded to the time frame of major health reforms happening within WA and nationally.
Comparing an eHealth Program (My Hip Journey) With Standard Care for Total Hip Arthroplasty: Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 03-03-2021
DOI: 10.2196/22944
Abstract: The role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. The aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. A prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. A total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. This study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. Australian New Zealand Clinical Trial Registry ACTRN12617001433392 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657
Targeted Intraoperative Radiotherapy Tumour Bed Boost during Breast-Conserving Surgery after Neoadjuvant Chemotherapy - a Subgroup Analysis of Hormone Receptor-Positive HER2-Negative Breast Cancer
Publisher: S. Karger AG
Date: 2017
DOI: 10.1159/000479424
Abstract: b i Introduction: /i /b In a previous study our group showed a beneficial effect of targeted intraoperative radiotherapy (TARGIT-IORT) as an intraoperative boost on overall survival after neoadjuvant chemotherapy (NACT) compared to an external boost (EBRT). In this study we present the results of a detailed subgroup analysis of the hormone receptor (HR)-positive HER2-negative patients. b i Methods: /i /b In this cohort study involving 46 patients with HR-positive HER2-negative breast cancer after NACT, we compared the outcomes of 21 patients who received an IORT boost to those of 25 patients treated with an EBRT boost. All patients received whole breast radiotherapy. b i Results: /i /b Median follow-up was 49 months. Whereas disease-free-survival and breast cancer-specific mortality were not significantly different between the groups, the 5-year Kaplan-Meier estimate of overall mortality was significantly lower by 21% with IORT, p = 0.028. Non-breast cancer-specific mortality was significantly lower by 16% with IORT, p = 0.047. b i Conclusion: /i /b Although our results have to be interpreted with caution, we have shown that the improved overall survival demonstrated previously could be reproduced in the HR-positive HER2-negative subgroup. These data give further support to the inclusion of such patients in the TARGIT-B (Boost) randomised trial that is testing whether IORT boost is superior to EBRT boost.
Supplementary Table 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Injuries in mothers hospitalised for domestic violence-related assault: a whole-population linked data study
Publisher: BMJ
Date: 05-2021
DOI: 10.1136/BMJOPEN-2020-040600
Abstract: To retrospectively assess a cohort of mothers for characteristics of injuries that they have suffered as a result of family and domestic violence (FDV) and which have required admission to a hospital during both the intrapartum and postpartum periods. Retrospective, whole-population linked data study of FDV in Western Australia using the Western Australia birth registry from 1990 to 2009 and Hospital Morbidity Data System records from 1970 to 2013. Number of hospitalisations, and mode, location and type of injuries recorded, with particular focus on the head and neck area. There were 11 546 hospitalisations for mothers due to FDV. 8193 hospitalisations recorded an injury code to the head and/or neck region. The upper and middle thirds of the face and scalp were areas most likely to receive superficial injuries (58.7% or 4158 admissions), followed by the mouth and oral cavity (9.7% or 687 admissions). Fracture to the mandible accounted for 479 (4.2%) admissions and was almost equal to the sum of the next three most common facial fractures (nasal, maxillary and orbital floor). Mothers more likely to be hospitalised due to a head injury from FDV included those with more than one child (OR=1.17, 95% CI 1.03 to 1.30) and those with infants ( year old) (OR=1.40, 95% CI 1.04 to 1.90) and young children ( years old) (OR=1.15, 95% CI 1.01 to 1.30). FDV is a serious and ongoing problem and front-line clinicians are in need of evidence-based guidelines to recognise and assist victims of FDV. Mothers with children in their care are a particularly vulnerable group.
Supplementary Figure 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Supplementary Figure 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Supplementary Figure 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779475.V1
Abstract: The mean cumulative count of hospitalisations for any physical-health disease by time since index cancer diagnosis, in childhood cancer survivors.
The effects of pre-operative menopausal status and hormone replacement therapy (HRT) on sexuality and quality of life after risk-reducing salpingo-oophorectomy
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.MATURITAS.2015.12.004
Abstract: Investigate the effects of pre-operative menopausal status and HRT use on sexual outcomes following risk-reducing salpingo-oophorectomy (RRSO). Cross-sectional study of 119 women who underwent RRSO between 2009 and 2014. Data was collected via a questionnaire and serum test for testosterone and free androgen index (FAI). The questionnaire comprised demographic data and validated measures of sexual function, sexual distress, relationship satisfaction, body image, psychological stress, menopause quality of life and general quality of life. Rates of sexual issues were similar despite menopause status at operation. Women who were pre-menopausal at operation (mean age=44 years ± 5) had significantly higher rates of sexual distress (p=0.020), dissatisfaction with sex life (p=0.011) and bothersome sexual menopause symptoms (p=0.04) than women who were post-menopausal (mean age=55 years ± 7). Pre-menopausal women reported higher psychological distress from surgery (p=0.005) and poorer emotional (p=0.052) wellbeing. HRT use reduced the rates of dyspareunia (p=0.027) and the severity of sexual menopausal symptoms (p=0.030). Androgen levels were not significantly associated with desire or arousal scores. Regardless of menopausal status at operation, women experienced the same sexual issues at equivalent rates. However, pre-menopausal women reported higher sexual distress and dissatisfaction with sex life. Pre-menopausal women also had greater psychological distress and poorer emotional function.
Supplementary Figure 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Factors driving CT utilisation in tertiary hospitals: a decomposition analysis using linked administrative data in Western Australia
Publisher: BMJ
Date: 11-2021
DOI: 10.1136/BMJOPEN-2021-052954
Abstract: While CT scanning plays a significant role in healthcare, its increasing use has raised concerns about inappropriate use. This study investigated factors driving the changing use of CT among people admitted to tertiary hospitals in Western Australia (WA). A repeated cross-sectional study of CT use in WA in 2003–2005 and 2013–2015 using linked administrative heath data at the in idual patient level. A total of 2 375 787 tertiary hospital admissions of people aged 18 years or older. Rate of CT scanning per 1000 hospital admissions. A multivariable decomposition model was used to quantify the contribution of changes in patient characteristics and changes in the probability of having a CT over the study period. The rate of CT scanning increased by 112 CT scans per 1000 admissions over the study period. Changes in the distribution of the observed patient characteristics were accounted for 62.7% of the growth in CT use. However, among unplanned admissions, changes in the distribution of patient characteristics only explained 17% of the growth in CT use, the remainder being explained by changes in the probability of having a CT scan. While the relative probability of having a CT scan generally increased over time across most observed characteristics, it reduced in young adults (−2.8%), people living in the rural/remote areas (−0.8%) and people transferred from secondary hospitals (−0.8%). Our study highlights potential improvements in practice towards reducing medical radiation exposure in certain high risk population. Since changes in the relative probability of having a CT scan (representing changes in scope) rather than changes in the distribution of the patient characteristics (representing changes in need) explained a major proportion of the growth in CT use, this warrants more in-depth investigations in clinical practices to better inform health policies promoting appropriate use of diagnostic imaging tests.
Prevalence of frailty and pain in hospitalised adult patients in an acute hospital: a protocol for a point prevalence observational study
Publisher: BMJ
Date: 03-2021
DOI: 10.1136/BMJOPEN-2020-046138
Abstract: Frailty and pain are associated with adverse patient clinical outcomes and healthcare system costs. Frailty and pain can interact, such that symptoms of frailty can make pain assessment difficult and pain can exacerbate the progression of frailty. The prevalence of frailty and pain and their concurrence in hospital settings are not well understood, and patients with cognitive impairment are often excluded from pain prevalence studies due to difficulties assessing their pain. The aim of this study is to determine the prevalence of frailty and pain in adult inpatients, including those with cognitive impairment, in an acute care private metropolitan hospital in Western Australia. A prospective, observational, single-day point prevalence, cross-sectional study of frailty and pain intensity of all inpatients (excluding day surgery and critical care units) will be undertaken. Frailty will be assessed using the modified Reported Edmonton Frail Scale. Current pain intensity will be assessed using the PainChek smart-device application enabling pain assessment in people unable to report pain due to cognitive impairment. Participants will also provide a numerical rating of the intensity of current pain and the worst pain experienced in the previous 24 hours. Demographic and clinical information will be collected from patient files. The overall response rate of the survey will be reported, as well as the percentage prevalence of frailty and of pain in the s le (separately for PainChek scores and numerical ratings). Additional statistical modelling will be conducted comparing frailty scores with pain scores, adjusting for covariates including age, gender, ward type and reason for admission. Ethical approval has been granted by Ramsay Health Care Human Research Ethics Committee WA/SA (reference: 2038) and Edith Cowan University Human Research Ethics Committee (reference: 2020–02008-SAUNDERS). Findings will be widely disseminated through conference presentations, peer-reviewed publications and social media. ACTRN12620000904976.
Supplementary Figure 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779475
Abstract: The mean cumulative count of hospitalisations for any physical-health disease by time since index cancer diagnosis, in childhood cancer survivors.
Trend in CT utilisation and its impact on length of stay, readmission and hospital mortality in Western Australia tertiary hospitals: an analysis of linked administrative data 2003–2015
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-059242
Abstract: High use of CT scanning has raised concern due to the potential ionising radiation exposure. This study examined trends of CT during admission to tertiary hospitals and its associations with length of stay (LOS), readmission and mortality. Retrospective observational study from 2003 to 2015. West Australian linked administrative records at in idual level. 2 375 787 episodes of tertiary hospital admission in adults aged 18+ years. LOS, 30-day readmissions and mortality stratified by CT use status (any, multiple (CTs to multiple areas during episode), and repeat (repeated CT to the same area)). Multivariable regression models were used to calculate adjusted rate of CT use status. The significance of changes since 2003 in the outcomes (LOS, 30-day readmission and mortality) was compared among patients with specific CT imaging status relative to those without. Between 2003 and 2015, while the rate of CT increased 3.4% annually, the rate of repeat CTs significantly decreased −1.8% annually and multiple CT showed no change. Compared with 2003 while LOS had a greater decrease in those with any CT, 30-day readmissions had a greater increase among those with any CT, while the probability of mortality remained unchanged between the any CT/no CT groups. A similar result was observed in patients with multiple and repeat CT scanning, except for a significant increase in mortality in the recent years in the repeat CT group. The observed pattern of increase in CT utilisation is likely to be activity-based funding policy-driven based on the discordance between LOS and readmissions. Meanwhile, the repeat CT reduction aligns with a more selective strategy of use based on clinical severity. Future research should incorporate in-hospital and out-of-hospital CT to better understand overall CT trends and potential shifts between settings over time.
Data from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
Data from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.C.6760427.V1
Abstract: AbstractBackground: The long-term effects of childhood cancer are unclear in the Australian context. We examined hospitalization trends for physical diseases and estimated the associated inpatient care costs in all 5-year childhood cancer survivors (CCS) diagnosed in Western Australia (WA) from 1982 to 2014. Methods: Hospitalization records for 2,938 CCS and 24,792 comparisons were extracted from 1987 to 2019 (median follow-up = 12 years, min = 1, max = 32). The adjusted hazard ratio (aHR) of hospitalization with 95% confidence intervals (CI) was estimated using the Andersen–Gill model for recurrent events. The cumulative burden of hospitalizations over time was assessed using the mean cumulative count method. The adjusted mean cost of hospitalization was estimated using the generalized linear models. Results: We identified a higher risk of hospitalization for all-cause (aHR, 2.0 95% CI, 1.8–2.2) physical disease in CCS than comparisons, with the highest risk for subsequent malignant neoplasms (aHR, 15.0 95% CI, 11.3–19.8) and blood diseases (aHR, 6.9 95% CI, 2.6–18.2). Characteristics associated with higher hospitalization rates included female gender, diagnosis with bone tumors, cancer diagnosis age between 5 and 9 years, multiple childhood cancer diagnoses, multiple comorbidities, higher deprivation, increased remoteness, and Indigenous status. The difference in the mean total hospitalization costs for any disease was significantly higher in survivors than comparisons (publicly funded $11,483 United States Dollar, i P /i 0.05). Conclusions: The CCS population faces a significantly higher risk of physical morbidity and higher cost of hospital-based care than the comparisons. Impact: Our study highlights the need for long-term follow-up healthcare services to prevent disease progression and mitigate the burden of physical morbidity on CCS and hospital services. /
Supplementary Figure 2 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779472
Abstract: The mean cumulative count of hospitalisations for any physical-health disease by attained age, in childhood cancer survivors and their matched comparisons.
Supplementary Table 1 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779469.V1
Abstract: Major diagnostic groups of physical-health diseases based on the International Classification of Diseases (ICD), 9th (Clinical modification) and 10th (Australian Modification) revisions.
Supplementary Table 3 from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 26-07-2023
DOI: 10.1158/1055-9965.23779463.V1
Abstract: Adjusted annual mean costs of privately funded hospitalisations per in idual, by all-cause and cause-specific physical diseases.
Use of CT, ED presentation and hospitalisations 12 months before and after a diagnosis of cancer in Western Australia: a population-based retrospective cohort study
Publisher: BMJ
Date: 10-2023
Effectiveness of nurse-led volunteer support and technology-driven pain assessment in improving the outcomes of hospitalised older adults
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-059388
Abstract: Hospitalised older adults are prone to functional deterioration, which is more evident in frail older patients and can be further exacerbated by pain. Two interventions that have the potential to prevent progression of frailty and improve patient outcomes in hospitalised older adults but have yet to be subject to clinical trials are nurse-led volunteer support and technology-driven assessment of pain. This single-centre, prospective, non-blinded, cluster randomised controlled trial will compare the efficacy of nurse-led volunteer support, technology-driven pain assessment and the combination of the two interventions to usual care for hospitalised older adults. Prior to commencing recruitment, the intervention and control conditions will be randomised across four wards. Recruitment will continue for 12 months. Data will be collected on admission, at discharge and at 30 days post discharge, with additional data collected during hospitalisation comprising records of pain assessment and volunteer support activity. The primary outcome of this study will be the change in frailty between both admission and discharge, and admission and 30 days, and secondary outcomes include length of stay, adverse events, discharge destination, quality of life, depression, cognitive function, functional independence, pain scores, pain management intervention (type and frequency) and unplanned 30-day readmissions. Stakeholder evaluation and an economic analysis of the interventions will also be conducted. Ethical approval has been granted by Human Research Ethics Committees at Ramsay Health Care WA|SA (number: 2057) and Edith Cowan University (number: 2021-02210-SAUNDERS). The findings will be disseminated through conference presentations, peer-reviewed publications and social media. ACTRN12620001173987.
Data from Hospitalizations and Cost of Inpatient Care for Physical Diseases in Survivors of Childhood Cancer in Western Australia: A Longitudinal Matched Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 09-2023
DOI: 10.1158/1055-9965.C.6760427
Abstract: AbstractBackground: The long-term effects of childhood cancer are unclear in the Australian context. We examined hospitalization trends for physical diseases and estimated the associated inpatient care costs in all 5-year childhood cancer survivors (CCS) diagnosed in Western Australia (WA) from 1982 to 2014. Methods: Hospitalization records for 2,938 CCS and 24,792 comparisons were extracted from 1987 to 2019 (median follow-up = 12 years, min = 1, max = 32). The adjusted hazard ratio (aHR) of hospitalization with 95% confidence intervals (CI) was estimated using the Andersen–Gill model for recurrent events. The cumulative burden of hospitalizations over time was assessed using the mean cumulative count method. The adjusted mean cost of hospitalization was estimated using the generalized linear models. Results: We identified a higher risk of hospitalization for all-cause (aHR, 2.0 95% CI, 1.8–2.2) physical disease in CCS than comparisons, with the highest risk for subsequent malignant neoplasms (aHR, 15.0 95% CI, 11.3–19.8) and blood diseases (aHR, 6.9 95% CI, 2.6–18.2). Characteristics associated with higher hospitalization rates included female gender, diagnosis with bone tumors, cancer diagnosis age between 5 and 9 years, multiple childhood cancer diagnoses, multiple comorbidities, higher deprivation, increased remoteness, and Indigenous status. The difference in the mean total hospitalization costs for any disease was significantly higher in survivors than comparisons (publicly funded $11,483 United States Dollar, i P /i 0.05). Conclusions: The CCS population faces a significantly higher risk of physical morbidity and higher cost of hospital-based care than the comparisons. Impact: Our study highlights the need for long-term follow-up healthcare services to prevent disease progression and mitigate the burden of physical morbidity on CCS and hospital services. /
Related Organisations
University Of Kent
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
Linkage Projects - Grant ID: LP0455453
Start Date: 12-2004
End Date: 09-2008
Amount: $382,098.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP0219322
Start Date: 07-2002
End Date: 01-2007
Amount: $67,635.00
Funder: Australian Research Council
View Funded ActivityDiscovery Projects - Grant ID: DP190101782
Start Date: 07-2019
End Date: 12-2023
Amount: $390,000.00
Funder: Australian Research Council
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