ORCID Profile
0000-0003-3368-0893
Current Organisations
University of Queensland
,
Queensland Children's Hospital
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Queensland University of Technology
Date: 2023
DOI: 10.5204/THESIS.EPRINTS.240005
Abstract: This thesis (1) examines the impact specialist respiratory outreach services operating in regional and remote Queensland is having on the lung function of children and adults seen and treated, (2) improves interpretation of lung function testing through the development of First Nations specific reference values and validation of existing reference equations, (3) describes associations between reduced lung function and future all-cause mortality and cardiovascular disease risk in First Nations peoples, and (4) describes the impact of early childhood respiratory infections on lifelong lung function both within Australia and across throughout the world.
Publisher: Springer Science and Business Media LLC
Date: 03-07-2021
DOI: 10.1007/S00408-021-00453-7
Abstract: Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18-40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function. Retrospective 8-year cohort study (February 2012-March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland. In the combined cohort, the forced expiratory volume in 1 s (FEV Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.
Publisher: Elsevier BV
Date: 03-2023
DOI: 10.1016/J.CHEST.2022.10.014
Abstract: Fractional exhaled nitric oxide (Feno), used as a biomarker, is influenced by several factors including ethnicity. Normative data are essential for interpretation, and currently single cutoff values are used in children and adults. Accounting for factors that influence Feno, (1) what are appropriate predicted and upper limit of normal (ULN) Feno values in an underserved population (First Nations Australians), (2) how do these values compare with age-based interpretive guidelines, and (3) what factors influence Feno and what is the size of the effect? Feno data of First Nations Australians (age < 16 years, n = 862 age ≥ 16 years, n = 348) were obtained. Medical history using participant questionnaires and medical records were used to define healthy participants. Flexible regression using spline functions, as used by the Global Lung Function Initiative, were used to generate predicted and ULN values. Look-up tables for predicted and ULN values using age (4-76 years) and height (100-200 cm) were generated and are supplied with a calculator for clinician use. In healthy First Nations children (age < 18 years), ULN values ranged between 25 and 60 parts per billion (ppb) when considering only biologically plausible age and height combinations. For healthy adults, ULN values ranged between 39 and 88 ppb. Neither the current Feno interpretation guidelines, nor the currently recommended cutoff of 50 ppb for First Nations children 16 years of age or younger were appropriate for use in this cohort. Our modelling revealed that predicted and ULN values of healthy participants varied nonlinearly with age and height. Because single pediatric, adult, or all-age Feno cutoff values used by current interpretive guidelines to define abnormality fail to account for factors that modify Feno values, we propose predicted and ULN values for First Nations Australians 4 to 76 years of age. Creating age- and height-adjusted predicted and ULN values could be considered for other ethnicities.
Publisher: Elsevier BV
Date: 08-2021
Publisher: European Respiratory Society (ERS)
Date: 09-2022
DOI: 10.1183/20734735.0144-2022
Abstract: The global burden of bronchiectasis in children and adolescents is being recognised increasingly. However, marked inequity exists between, and within, settings and countries for resources and standards of care afforded to children and adolescents with bronchiectasis compared with those with other chronic lung diseases. The European Respiratory Society (ERS) clinical practice guideline for the management of bronchiectasis in children and adolescents was published recently. Here we present an international consensus of quality standards of care for children and adolescents with bronchiectasis based upon this guideline. The panel used a standardised approach that included a Delphi process with 201 respondents from the parents and patients’ survey, and 299 physicians (across 54 countries) who care for children and adolescents with bronchiectasis. The seven quality standards of care statements developed by the panel address the current absence of quality standards for clinical care related to paediatric bronchiectasis. These internationally derived, clinician-, parent- and patient-informed, consensus-based quality standards statements can be used by parents and patients to access and advocate for quality care for their children and themselves, respectively. They can also be used by healthcare professionals to advocate for their patients, and by health services as a monitoring tool, to help optimise health outcomes.
Publisher: Wiley
Date: 28-09-2021
DOI: 10.1002/PPUL.25692
Abstract: Spirometry values of First Nations Australian children are lower than White children. One explanation relates to differences in the sitting‐height/standing‐height ratio (Cormic Index), as this accounts for up to half the observed differences in spirometry values between White children and other ethnicities. We investigated whether the Cormic Index of First Nations children differs from White children and if this explains the lower spirometry values of First Nations children. First Nations children ( n = 619) aged 8–16 years were recruited from nine Queensland communities. Their spirometry and Cormic Index data were compared to that of White children ( n = 907) aged 8–16 years from the NHANES III dataset. FEV 1 and FVC of First Nations children was 8% lower for children aged 8–11.9 years and 9%–10% lower for children aged 12–16 years. The Cormic Index was statistically lower in the First Nations 8–11.9 years group (median = 0.515, interquartile range [IQR]: 0.506–0.525) compared with White children (0.519, IQR: 0.511–0.527), and this difference was greater in the 12–16 years group (0.505, IQR: 0.492–0.516 0.520, IQR: 0.510–0.529). Adjusting for age, sex, and standing height, lower Cormic Index of First Nations children accounts for 14% (95% confidence interval [CI]: 7%–21%) of FEV 1 and 15% (95% CI: 8%–21%) of FVC differences in the younger group, and 26% (95% CI: 16%–37%) of FEV 1 and 31% (95% CI: 19%–42%) of FVC differences in the older group. Ethnic differences in Cormic Index partly account for why healthy First Nations Australian children have lower spirometry values than White children. As childhood spirometry values impact adult health, other contributing factors require attention.
Publisher: European Respiratory Society (ERS)
Date: 06-2022
Publisher: Springer Science and Business Media LLC
Date: 20-02-2020
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 09-2023
Publisher: American Academy of Sleep Medicine (AASM)
Date: 09-2023
DOI: 10.5664/JCSM.10626
Publisher: Springer Science and Business Media LLC
Date: 22-10-2022
DOI: 10.1007/S00408-022-00580-9
Abstract: Low diffusing capacity of the lung for carbon monoxide ( D LCO ) and spirometry values are associated with increased mortality risk. However, associations between mortality risk and cardiovascular disease with the transfer coefficient of the lung for carbon monoxide ( K CO ) and alveolar volume ( V A ) are unknown. This cohort study: (i) evaluated whether D LCO , K CO , and V A abnormalities are independently associated with cardiovascular morbidity and/or elevated mortality risk and, (ii) compared these associations with those using spirometry values. Gas-diffusing capacity and spirometry data of 1165 adults seen at specialist respiratory outreach clinics over an 8-year period (241 with cardiovascular disease 108 deceased) were analysed using multivariable Cox and logistic regression. D LCO , K CO , and V A values below the lower limit of normal ( − 1.64 Z -scores) were associated with elevated cardiovascular disease prevalence [respective odds ratios of 1.83 (95% CI 1.31–2.55), 1.56 (95% CI 1.08–2.25), 2.20 (95% CI 1.60–3.01)] and increased all-cause mortality risk [respective hazard ratios of 2.99 (95% CI 1.83–4.90), 2.14 (95% CI 1.38–3.32), 2.75 (95% CI 1.18–2.58)], after adjustment for factors including age, personal smoking, and respiratory disease. Compared to similar levels of spirometry abnormality, D LCO , K CO , and V A were associated with similar or greater mortality risk, and similar cardiovascular disease prevalence. Analysis of only those patients with clinical normal spirometry values ( n = 544) showed these associations persisted for D LCO . Low D LCO , K CO , and V A measurements are associated with cardiovascular disease prevalence. As risk factors of all-cause mortality, they are more sensitive than spirometry even among patients with no diagnosed respiratory disease.
Publisher: Springer Science and Business Media LLC
Date: 23-09-2020
DOI: 10.1038/S41467-020-18624-0
Abstract: Artemisinins have revolutionized the treatment of Plasmodium falciparum malaria however, resistance threatens to undermine global control efforts. To broadly explore artemisinin susceptibility in apicomplexan parasites, we employ genome-scale CRISPR screens recently developed for Toxoplasma gondii to discover sensitizing and desensitizing mutations. Using a sublethal concentration of dihydroartemisinin (DHA), we uncover the putative transporter Tmem14c whose disruption increases DHA susceptibility. Screens performed under high doses of DHA provide evidence that mitochondrial metabolism can modulate resistance. We show that disrupting a top candidate from the screens, the mitochondrial protease DegP2, lowers porphyrin levels and decreases DHA susceptibility, without significantly altering parasite fitness in culture. Deleting the homologous gene in P. falciparum, PfDegP , similarly lowers heme levels and DHA susceptibility. These results expose the vulnerability of heme metabolism to genetic perturbations that can lead to increased survival in the presence of DHA.
Publisher: MDPI AG
Date: 07-12-2021
DOI: 10.3390/JCM10245727
Abstract: Background: Some but not all previous studies report that pneumonia in children aged less than five years is associated with lower lung function and elevated risk of respiratory disease. To date, none have explored these associations in at-risk populations such as First Nations Australians, whose incidence of early childhood pneumonia is among the highest reported in the world. Methods: This cross-sectional study included 1276 First Nations Australian children/young adults aged 5–25 years recruited from regional/remote Queensland and Northern Territory communities and schools. Associations between pneumonia and both spirometry values and asthma were investigated using linear and logistic regression. Results: Early childhood pneumonia was associated with lower FEV1 and FVC Z-scores, but not FEV1/FVC% Z-scores, when occurring before age three (FEV1 β = −0.42, [95%CI −0.79, −0.04] FVC β = −0.62, [95%CI −1.14, −0.09]), and between three and five years (β = −0.50, [95%CI −0.88, −0.12] β = −0.63, [95%CI −1.17, −0.10]), compared to those who never had pneumonia. Similarly, pneumonia occurring when aged before age three years (OR = 3.68, 95%CI 1.96–6.93) and three to five years (OR = 4.81, 95%CI 1.46–15.8) was associated with increased risk of asthma in later childhood. Conclusions: Early childhood pneumonia is associated with lung function deficits and increased asthma risk in later childhood/early adulthood in First Nations Australians. The disproportionate impact of pneumonia on at-risk children must be addressed as a priority.
Publisher: Elsevier BV
Date: 09-2023
Location: United States of America
Start Date: 2021
End Date: 2023
Funder: National Health and Medical Research Council
View Funded Activity