ORCID Profile
0000-0003-0010-2640
Current Organisation
Flinders University
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Publisher: Elsevier BV
Date: 04-2020
Publisher: Wiley
Date: 10-03-2016
DOI: 10.1111/COA.12641
Abstract: Long-term quality-of-life (QOL) outcomes, complications and clinical effectiveness in patients undergoing treatment with upper airway surgery (UAS), continuous positive airway pressure (CPAP) and mandibular advancement splints (MAS) for adult obstructive sleep apnoea (OSA). Retrospective cohort study. Multidisciplinary OSA clinic in University teaching hospital. Consecutive, simultaneously treated patients with OSA undergoing UAS (n = 83), CPAP (n = 83) and MAS (n = 79). Glasgow Benefit Inventory (GBI), Snoring Severity Scale (SSS), Epworth Sleepiness Score (ESS) and side-effects in all three groups were recorded at a mean of 34.5 months following start of treatment and compared via anova with Bonferroni's adjustment for pairwise comparisons. Upper airway surgery demonstrated a statistically significant QOL benefit over MAS. All three groups showed a significant improvement in SSS with CPAP significantly better than MAS, but equivalent to UAS. Uncomplicated UAS provided a greater QOL outcome than compliant MAS, non-compliant CPAP (P < 0.05) and comparable to compliant CPAP. Patients undergoing UAS with recorded complications still reported equivalent QOL outcomes to compliant CPAP and MAS, suggesting these surgical complications are relatively minor compared to the QOL benefit of OSA treatment. Upper airway surgery showed a significant improvement in QOL outcomes compared to non-compliant CPAP or MAS and equivalent benefit to compliant CPAP. This study strongly supports the role for contemporary UAS in OSA when CPAP is not or no longer an option.
Publisher: BMJ
Date: 07-08-2014
Publisher: Wiley
Date: 05-07-2017
DOI: 10.1111/AJR.12314
Abstract: To determine differences in walking for recreation and transport between Accessibility/Remoteness Index of Australia (ARIA) categories, in South Australian adults. Cross-sectional self-reported data from adult telephone survey respondents between April and May in 2012 and 2013. Population of South Australia. A total of 4004 adults (aged over 18 years) participated: n = 1956 men and n = 2048 women. Area of residence was categorised using ARIA (major city, inner regional, outer regional and remote/very remote). Self-reported participation in walking for transport and recreation/exercise as the number of times and minutes per week. Data were analysed using Kruskal-Wallis test for median minutes and negative binomial regression for times walked with adjustment for socioeconomic status, age and body mass index. Average age was 47.8 ± 18.5 years, 51.1% were women, 70.9% lived in the major cities, 14.6% in inner regional, 10.8% in outer regional and 3.6% in remote/very remote areas. Relative to major city, times walked for recreation was lower for only remote/very remote residents (incidence rate ratio (IRR) 0.74 (95%CI 0.59-0.92), P = 0.008). This difference was only observed for men (IRR 0.54 (95%CI 0.39-0.73), P < 0.001). Relative to major city, times walked for transport was less for inner regional (IRR 0.74 (95%CI 0.67-0.85), P < 0.001) and outer regional (IRR 0.64 (95%CI 0.56-0.74), P < 0.001) only. This difference in transport walking was seen in both men and women. Frequency of walking varied by purpose, level of remoteness and sex. As walking is the focus of population-level health promotion, more detailed understanding of the aetiology of regular walking is needed.
Publisher: Public Library of Science (PLoS)
Date: 23-07-2020
Publisher: Wiley
Date: 18-09-2015
DOI: 10.1111/JAN.12810
Abstract: This article reports on the quantitative findings from a large mixed method study that determined the extent to which the provision of alternatives to an Emergency Department and Index of Relative Social Disadvantage score influenced non-urgent paediatric Emergency Department use. In Australia, there is an increasing use of Emergency Departments for the provision of non-urgent care that may be better serviced in the community. Further, despite the plethora of literature describing the characteristics of non-urgent users of Emergency Departments the link to social and community characteristics remains under explored. This 2010 retrospective analysis of the Hospital Admission Status data from the paediatric Emergency Department provided the information on attendance types and numbers along with postcode details. The postcodes in conjunction with Australia Bureau of Statistics data provided the levels of deprivation from the Index of Relative Social Deprivation scores. A logistic regression analysis determined the levels of influence of deprivation and General Practitioner or Nurse Practitioner provision on the use of Emergency Departments for non-urgent care. Rates of use for non-urgent care is higher for populations who come from areas of deprivation and have limited primary care services, such as low levels of General Practitioners. Children from areas of high deprivation and limited access to primary care were up to six times more likely to use Emergency Department for non-urgent care. Deprivation impacts on the use of paediatric Emergency Departments for non-urgent care even in countries like Australia where there is government subsidized health care.
Publisher: Informa UK Limited
Date: 03-07-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-06-2019
DOI: 10.1161/CIRCULATIONAHA.118.038505
Abstract: Cardiovascular morbidity and mortality remain high in recipients of a kidney transplant. The persistence of a patent arteriovenous fistula (AVF) after transplantation may contribute to ongoing maladaptive cardiovascular remodeling. The ability to reverse this maladaptive remodeling by ligation of this AVF is unknown. We conducted the first randomized controlled trial to evaluate the effect of AVF ligation on cardiac structure and function in stable kidney transplant recipients. In this randomized controlled trial, kidney transplant recipients ( months after transplantation with stable graft function) were randomized to AVF ligation or no intervention. All participants underwent cardiac magnetic resonance imaging at baseline and at 6 months. The primary outcome was the change in left ventricular (LV) mass. Secondary outcomes included changes in LV volumes, left and right atrial areas, LV ejection fraction, NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels, cardiac output/index, brachial flows (ipsilateral to AVF), and pulmonary artery velocity. A total of 93 patients were screened, of whom 64 met the inclusion criteria and were randomized to the AVF ligation (n=33) or control (n=31) group. Fifty-four participants completed the study: 27 in the AVF ligation group and 27 in the control group. On the second cardiac magnetic resonance scan, a mean decrease of 22.1 g (95% CI, 15.0–29.1) was observed in LV mass in the AVF ligation group compared with a small increase of 1.2 g (95% CI, −4.8 to 7.2) in the control group ( P .001). Significant decreases in LV end-diastolic volumes, LV end-systolic volumes, cardiac output, cardiac index, atrial volumes, and NT-proBNP were also seen in the AVF closure group ( P .01). No significant changes were observed in LV ejection fraction ( P =0.93) and pulmonary artery velocity ( P =0.07). No significant complications were noted after AVF ligation. No changes in estimated glomerular filtration rate or systolic and diastolic blood pressures were observed between cardiac magnetic resonance scans. Elective ligation of patent AVF in adults with stable kidney transplant function resulted in clinically significant reduction of LV myocardial mass. Australian and New Zealand Clinical Trials Registry URL: www.anzctr.org.au . Unique Identifier: ACTRN12613001302741.
Publisher: Wiley
Date: 20-04-2015
DOI: 10.1002/ALR.21490
Abstract: Endoscopic sinus surgery (ESS) is indicated for patients with recalcitrant chronic rhinosinusitis symptoms. However, surgical revision can be required because of adhesion formation and middle turbinate lateralization. We investigate the efficacy of a middle meatal silastic stent in reducing these complications after ESS. Thirty-six patients were randomized to receive a silastic stent in the middle meatus unilaterally after ESS. The surgeon was blinded to the side receiving the stent until completion of the ESS. The contralateral side, with no stent, was the control side. Patients completed a 7-day, postoperative, visual analog scale symptom diary and were blinded to the stent side until its removal at the first postoperative visit. Patients were followed up after 2, 8, and 24 weeks. Endoscopic video of the sinus cavities were recorded at all visits and 2 blinded, independent ear/nose/throat (ENT) surgeons assessed the videos using a modified Lund-Kennedy scoring system. Thirty-five of 36 patients completed 6-months' follow-up. Middle turbinate lateralization was observed in 13 sides without a stent vs 1 side with a stent. There was a significant reduction in adhesions at weeks 2 and 8 (p < 0.001) and crusting (p < 0.01) in the stent side compared to control. Video scores at 6 months after surgery for stent and control sides remained unchanged from the 8-week visit. There was no difference between sides for symptom scores, edema, or nasal discharge. Middle meatal silastic stents are well tolerated by patients and effective in reducing middle turbinate lateralization, adhesions, and crusting postoperatively in ESS.
Publisher: Wiley
Date: 27-02-2023
DOI: 10.1111/AJAG.13170
Abstract: To assess the observed pain behaviours of Aboriginal residents with cognitive impairment in aged care facilities and compare these results with a matched national s le of non‐Aboriginal residents. Observed pain behaviours of Aboriginal residents ( N = 87) with cognitive impairment in aged care facilities across the Northern Territory of Australia were assessed using PainChek® Adult and compared with data from a matched national s le of non‐Aboriginal residents ( N = 420). Pain scores were derived from inbuilt automated facial recognition and analysis software plus a series of digital checklists requiring manual input by care staff. The median total pain score for the Aboriginal residents was 2 (IQR 1–4) and for the matched external residents was 3 (IQR 2–5). In a multivariable negative binomial regression model, this difference in total pain score was statistically significant ( p 0.001). The pain score derived from the automated facial recognition and analysis component of the PainChek® Adult app was not statistically different between the two groups when adjusted for multiple observations and context of observation (odds ratio = 1.06, 95% confidence interval 0.97–1.16, p = 0.169). We found under‐reporting of observed pain signs and behaviours for Aboriginal aged care residents by assessors. Further training in the assessment of pain in Aboriginal and Torres Strait Islander aged care residents may be necessary and a continuing shift in clinical practice to using technology and point‐of‐care assessment.
Publisher: Informa UK Limited
Date: 17-11-2018
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.HPB.2017.11.007
Abstract: The International Study Group for Liver Surgery (ISGLS) definition of post hepatectomy liver failure (PHLF) was developed to be consistent, widely applicable, and to include severity stratification. This international multicentre collaborative study aimed to prospectively validate the ISGLS definition of PHLF. 11 HPB centres from 7 countries developed a standardised reporting form. Prospectively acquired anonymised data on liver resections performed between 01 July 2010 and 30 June 2011 was collected. A multivariate analysis was undertaken of clinically important variables. Of the 949 patients included, 86 (9%) met PHLF requirements. On multivariate analyses, age ≥70 years, pre-operative chemotherapy, steatosis, resection of >3 segments, vascular reconstruction and intraoperative blood loss >300 ml significantly increased the risk of PHLF. Receiver operator curve (ROC) analysis of INR and serum bilirubin relationship with PHLF demonstrated post-operative day 3 and 5 INR performed equally in predicting PHLF, and day 5 bilirubin was the strongest predictor of PHLF. Combining ISGLS grades B and C groups resulted in a high sensitivity for predicting mortality compared to the 50-50 rule and Peak bilirubin >7 mg/dl. The ISGLS definition performed well in this prospective validation study, and may be the optimal definition for PHLF in future research to allow for comparability of data.
Publisher: Wiley
Date: 03-03-2021
DOI: 10.1002/CNR2.1342
Abstract: Chemotherapy can cause premature menopause which may result in adverse effects such as fertility loss, osteoporosis, cardiovascular disease and menopausal symptoms. It is thus very important that women are provided with accurate information regarding their risk of premature menopause as a consequence of proposed chemotherapy. Unfortunately, at present there are no reliable tools which can be applied in clinical practice to estimate the risk of premature menopause in women undergoing chemotherapy, beyond age of the patient and form of chemotherapy utilized. This was a pilot study to determine whether AMH levels pre and during chemotherapy are able to predict for chemotherapy induced menopause, and to assess quality of life and menopausal symptoms. Premenopausal women between 18 to 45 who were planned to undergo gonadotoxic chemotherapy with curative intent for either breast cancer or haematologic malignancy were recruited from a single centre. AMH, FSH, LH and oestradiol levels were recorded prior to commencement of therapy, during and following completion of chemotherapy. Menstrual status, menopausal symptoms and quality of life data were collected at baseline and during follow‐up. Twenty two women were recruited. The baseline AMH was higher in women who regained menses post‐chemotherapy (median 23.1 vs 9.9 pM ( P = .06). Menopausal symptoms were significantly higher at 1 year post diagnosis than at baseline however quality of life was similar. AMH may be useful for predicting chemotherapy induced menopause. Further research is still required to determine the place of such testing for patient counselling and management.
Publisher: Wiley
Date: 20-04-2023
DOI: 10.1111/ANS.18482
Abstract: Colorectal cancer with synchronous liver‐only metastasis is managed with a multimodal approach, however, optimal sequencing of modalities remains unclear. A retrospective review of all consecutive rectal or colon cancer cases with synchronous liver‐only metastasis was conducted from the South Australian Colorectal Cancer Registry from 2006 to 2021. This study aimed to investigate how order and type of treatment modality affects overall survival. Data of over 5000 cases were analysed ( n = 5244), 1420 cases had liver‐only metastasis. There were a greater number of colon than rectal primaries ( N = 1056 versus 364). Colonic resection was the preferred initial treatment for the colon cohort (60%). In the rectal cohort, 30% had upfront resection followed by 27% that had chemo‐radiotherapy as 1st line therapy. For the colon cohort, there was an improved 5‐year survival with surgical resection as initial treatment compared to chemotherapy (25% versus 9%, P 0.001). In the rectal cohort, chemo‐radiotherapy as the initial treatment was associated with an improved 5‐year survival compared to surgery or chemotherapy (40% versus 26% versus 19%, P = 0.0015). Patients who were able to have liver resection had improved survival, with 50% surviving over 5 years compared to 12 months in the non‐resected group ( P 0.001). Primary rectal KRAS wildtype patients who underwent liver resection and received Cetuximab had significantly worse outcomes compared to KRAS wildtype patients who did not ( P = 0.0007). Where surgery is possible, resection of liver metastasis and primary tumour improved overall survival. Further research is required on the use of targeted treatments in patients undergoing liver resection.
Publisher: Wiley
Date: 29-07-2022
DOI: 10.1111/IMJ.15534
Abstract: Severe community‐acquired pneumonia (SCAP) is highly prevalent in the Aboriginal population. Few pneumonia severity scores are validated in this population. To assess the prediction accuracy of pneumonia severity scores in Aboriginal patients with SCAP and to identify risk factors for poor prognosis. Retrospective cohort study examining Aboriginal patients admitted to the intensive care unit with confirmed SCAP between January 2011 and December 2014. Severity scores were calculated for SMARTCOP (systolic blood pressure, multi‐lobar, albumin, respiratory rate, tachycardia, confusion, oxygenation and arterial pH), SMARTACOP (systolic blood pressure, multi‐lobar, albumin, respiratory rate, tachycardia, Aboriginal status, confusion, oxygenation and arterial pH), CURB‐65 (confusion, urea, respiratory rate, blood pressure and age ≥65 years), pneumonia severity index, Infectious Diseases Society of America and American Thoracic Society SCAP, and Acute Physiology and Chronic Health Evaluation (APACHE) II/III using medical records. Prediction accuracy of 30‐day mortality and requirement for intensive respiratory and/or vasoactive support (IRVS) were assessed using logistic regression and the area under the receiver operating characteristic curve (AUROC). Multivariate analysis was used to test associations between poor prognosis and demographic/clinical variables. A total of 203 cases (49% women) was identified. Thirty‐day mortality was 6.4% ( n = 13), and 53% ( n = 107) required IRVS. None of the tested pneumonia severity scores accurately predicted mortality. SMARTCOP and SMARTACOP predicted IRVS requirement with the highest diagnostic accuracy, but only achieved acceptable discrimination ( P .001 and .001 AUROC = 0.74 and 0.75 respectively). APACHE II/III predicted both mortality ( P = 0.003 and 0.001 AUROC = 0.74 and 0.73 respectively) and IRVS requirement ( P .001 and .001 AUROC = 0.72 and 0.73 respectively). Multivariate analysis associated mortality with male gender, cirrhosis, immunosuppression and acidaemia, and IRVS requirement with multi‐lobar pneumonia, hypotension and tachypnoea. Multivariate analysis for mortality and IRVS requirement achieved an AUROC of 0.93 and 0.87 respectively. None of the pneumonia severity scores accurately predicted mortality. We recommend SMARTACOP to predict IRVS requirement in Aboriginal patients with SCAP. Given Aboriginal patients are over‐represented in Australian intensive care units, a new score is warranted for this understudied population.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH18004
Abstract: Objective The aims of the present study were to establish rates of resuscitation order documentation of patients aged ≥65 years from both psychogeriatric and general medical units and to compare patients on predictors of resuscitation status, particularly examining the effect of depression. Methods A retrospective case note audit of psychogeriatric (n=162) and general medical (n=135) unit admissions within a tertiary teaching hospital was performed. Multivariate logistic regression was used to determine significant clinical and demographic predictors of resuscitation status. Results Resuscitation orders were documented in more psychogeriatric (94.4%) than general medical (48.1%) files. Depression did not significantly predict resuscitation status in either group. Having undergone competency assessment significantly predicted resuscitation status for the total s le and separately for psychogeriatric and medical patients. Older age (overall s le), poorer prognosis (overall s le), living in residential care (overall s le and medical group) and self-consenting to resuscitation status (overall s le and medical group) significantly predicted resuscitation status. Conclusions Resuscitation orders were more frequently documented on the psychogeriatric unit. Further prospective analysis is needed of how resuscitation orders are made before depression is discounted as a predictor of end-of-life decision-making. What is known about the topic? Despite increased community, media and research attention to end-of-life decision-making, resuscitation preferences of older patients are often poorly documented. Existing research into patient clinical and demographic factors that influence end-of-life decision-making have largely focused on general medical rather than psychogeriatric settings. There is a need to investigate rates of resuscitation documentation in psychogeriatric and general medical units and specific factors associated with having a ‘do not attempt resuscitation’ order in place, particularly the effect of current depression on decision-making. What does this paper add? Resuscitation orders were more frequently documented on the psychogeriatric than medical unit. Depression was not a significant predictor of resuscitation status in either group of patients. Although having undergone a competency assessment, older age and poorer prognosis predicted not being for resuscitation for the total s le, living in residential care and self-consenting to resuscitation status predicted not being for resuscitation for the overall s le and the medical group specifically. What are the implications for practitioners? This paper suggests that the need for clinicians to ensure documentation of preferences is a focus of day-to-day work with older patients. Clinicians should consider patient competency in end-of-life decision-making and how factors associated with depression, such as helplessness, may be more closely related to resuscitation decision-making in older patients.
Publisher: Wiley
Date: 22-12-2017
DOI: 10.1111/AJCO.12654
Abstract: Limited data are available on how spiritual needs of patients with cancer care are addressed by Australian oncologists. The objectives of this study were to explore the current practice, preparedness and education of Australian oncologists and oncology trainees on the provision of spiritual care for their patients with cancer. Participants were recruited through oncology professional organizations and data collected through an anonymous online survey using a validated questionnaire. Responses from a total of 69 medical professionals were suitable for data analysis. The majority of the respondents had encountered patients with spiritual care needs during clinical consultations. Only 45% of the respondents perceived that they were able to meet the spiritual needs of their patients. Barriers to providing spiritual care identified a lack of time, education and understanding of spirituality and spiritual care in the context of health. Only 25% stated they had received some form of education on spiritual care with 7% of these stated that the education was adequate. Participants believed that they learnt how to provide spiritual care on the job or because of their self-interest, and not as formal training. The results of this study indicate that Australian oncology professionals often encounter patients with spiritual care needs in their clinical practice. Despite this finding, only a small proportion of the medical professionals had education on spiritual care during their professional training. Forty-five percent of the medical practitioners believed that they were able to partly or completely meet their patients' spiritual care needs.
Publisher: Informa UK Limited
Date: 02-09-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2019
Publisher: Elsevier BV
Date: 08-2014
Publisher: Springer Science and Business Media LLC
Date: 19-03-2013
Publisher: MDPI AG
Date: 28-01-2022
Abstract: Insight into differences in seeking medical care for chest pain among migrant populations is limited. This study aimed to determine ethnic differences in seeking care behaviors and using ambulances among migrants compared to an Australian-born group. A total of 607 patients presenting with chest pain to a tertiary hospital between 1 July 2012 and 30 June 2014 were randomly selected. Data from the emergency department dataset and medical record reviews were collected and linked for analysis. The migrant group was stratified into nine ethnic groups for analysis based on the Australian Standard Classification of Cultural and Ethnic Groups. The overall median prehospital delay time was 3.7 (1.5, 10.7) h, which ranged from 2.5 (1.0, 10.7) (Southern and Eastern European group) to 6.0 (2.3, 20.6) (Sub-Saharan African group). The median decision time was 2.0 (0.8, 7.9) h, which ranged from 1.5 (Australian-born group) to 4.5 h (Sub-Saharan African group). Five ethnic groups had significantly longer decision times compared to the Australian-born group. Decision time accounted for 58.4% of pre-hospital delay time. Migrant patients were 60% less likely to seek care for chest pain within one hour (odds ratio 0.40, (0.23–0.68), p = 0.001). There was no significant difference in ambulance utilization between migrant and Australian-born groups. In conclusion, ethnic differences in seeking care for chest pain do exist, and ethnicity plays a vital role in a longer delay in seeking care. To reduce the delays and improve patient outcomes, appropriate health c aigns focusing on ethnic differences among migrant populations and normalizing cultural competency into practice are recommended.
Publisher: Springer Science and Business Media LLC
Date: 16-07-2018
Publisher: Elsevier BV
Date: 06-2012
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.CLCC.2015.07.005
Abstract: Colorectal cancer (CRC) is a common malignancy. There is growing evidence that CRC incidence is increasing in the younger population. There is controversy surrounding the prognosis of young patients with CRC. In this study we reviewed Australian patients with metastatic CRC (mCRC) who were younger than 40 years of age at the time of diagnosis of metastatic disease. To our knowledge this is the first study to focus on this age group with mCRC. This was a retrospective study using data from the South Australian Metastatic Colorectal Cancer database. We compared patient and disease characteristics, management approaches, and outcomes for age groups < 40 and ≥ 40. A multivariate Cox proportional hazards model was fitted to compare the survival outcomes (death from all causes) between the 2 groups. From 3318 patients, 46 (1.4%) were younger than 40 years of age. In a comparison of patients in the younger than 40-year-old group with the older group, a greater proportion had synchronous metastatic disease (80.4% vs. 64.4%, respectively P = .04) and disease originating from the left colon (71.7% vs. 61.7%, respectively P = .035) also a larger proportion in the younger than 40-year-old group received chemotherapy compared with the older group (82.6% vs. 58.7%, respectively P < .01). In the adjusted multivariate model, survival was not significantly different between the 2 groups (hazard ratio, 0.81 95% confidence interval, 0.56-1.16 log rank P = .25). Young-onset mCRC patients, when defined as aged younger than 40 years, have equivalent survival compared with their older counterparts. This is despite differences in disease characteristics and management approach between the 2 groups.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 27-09-2021
Publisher: Springer Science and Business Media LLC
Date: 25-10-2018
Publisher: Elsevier BV
Date: 08-2015
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.NEDT.2016.10.016
Abstract: The lack of dementia education programmes for health professionals in primary care is one of the major factors contributing to the unmet demand for dementia care services. To determine the effectiveness of a nurse-led dementia education and knowledge translation programme for health professionals in primary care participants' satisfaction with the programme and to understand participants' perceptions of and experiences in the programme. A cluster randomized controlled trial was used as the main methodology to evaluate health professionals' knowledge, attitudes and care approach. Focus groups were used at the end of the project to understand health professionals' perceptions of and experiences in the programme. Fourteen community health service centres in a province in China participated in the study. Seven centres were randomly assigned to the intervention or control group respectively and 85 health professionals in each group completed the programme. A train-the-trainer model was used to implement a dementia education and knowledge translation programme. Outcome variables were measured at baseline, on the completion of the programme and at 3-month follow-up. A mixed effect linear regression model was applied to compare the significant differences of outcome measures over time between the two groups. Focus groups were guided by four semi-structured questions and analysed using content analysis. Findings revealed significant effects of the education and knowledge translation programme on participants' knowledge, attitudes and a person-centred care approach. Focus groups confirmed that the programme had a positive impact on dementia care practice. A dementia education and knowledge translation programme for health professionals in primary care has positive effects on their knowledge, attitudes, care approach and care practice.
Publisher: American Geophysical Union (AGU)
Date: 07-2023
DOI: 10.1029/2023JB026890
Abstract: Editors of JGR‐Solid Earth express their appreciation to those who served as peer reviewers for the journal in 2022.
Publisher: Springer Science and Business Media LLC
Date: 11-01-2022
DOI: 10.1038/S41598-021-04636-3
Abstract: Airway surgery presents a unique environment for operating room fire to occur. This study aims to explore the factors of combustion when using KTP laser with high flow oxygen in an ex-vivo model. The variables tested were varying tissue type, tissue condition, oxygen concentration, laser setting, and smoke evacuation in a stainless-steel model. Outcome measures were time of lasing to the first spark and/or flame. A multivariate Cox proportional hazard model was used to determine the risk of spark and flame across the different risk factors. For every 10% increase in oxygen concentration above 60% the risk of flame increased by a factor of 2.3. Continuous laser setting at 2.6 W increased the risk by a factor of 72.8. The risk of lasing adipose tissue is 7.3 times higher than that of muscle. Charred tissue increases the risk of flame by a factor of 92.8. Flame occurred without a preceding spark 93.6% of the time. Using KTP laser in the pulsed mode with low wattages, minimising lasing time, reducing the oxygen concentration and avoiding lasing adipose or charred tissue produce a relatively low estimated risk of spark or flame.
Publisher: Wiley
Date: 11-2020
DOI: 10.1111/AJCO.13497
Publisher: Informa UK Limited
Date: 04-04-2017
Publisher: Wiley
Date: 11-2020
DOI: 10.1111/AJCO.13498
Publisher: Springer Science and Business Media LLC
Date: 12-2022
DOI: 10.1186/S12882-022-03011-2
Abstract: Royal Darwin Hospital (RDH) is the main tertiary hospital that has performed more than 600 biopsies since its establishment. Although Indigenous people in Australia’s Northern Territory (NT) has the highest rate of renal replacement therapy, the histopathology pattern of their renal diseases is still under discussed. We aimed to analyse the histopathology pattern of patients undergoing renal biopsy in RDH from June 2007 to June 2020. Secondary aims include clinical indication and survival analysis of patients with kidney biopsies. We conducted a retrospective cohort study on all native kidney biopsy reports from patients over the age of 16, from June 2007 to June 2020. Descriptive statistics was used to summarise age, sex, indigeneity, histopathological pattern, and mortality. Categorical values were expressed as absolute frequencies and percentages. Survival analysis was performed using multivariate analyses and Cox proportional hazard regression model. There were 364 native renal biopsies included in the analysis. Sub-nephrotic proteinuria was the most common clinical indication for kidney biopsy ( n = 160,47.8%). Diabetes nephropathy (DN) was the most common pathological finding ( n = 71,12.8%). Indigenous population who had dialysis performs poorly compared to their non-indigenous counterpart (HR 2.37,95% CI 1.53–3.67, p 0.001). Diabetic nephropathy is the most common native kidney biopsy in the NT with higher mortality among indigenous patients. This study supports the previous findings of indigenous female excess, younger age of kidney disease requiring kidney biopsy, and excess of diabetic nephropathy in the top-end of the NT. It can be speculated that some diabetic patients had atypical features prompting a biopsy.
Publisher: SAGE Publications
Date: 05-2014
DOI: 10.2500/AJRA.2014.28.4031
Abstract: Nasal douching is commonly performed after endoscopic sinus surgery (ESS). There is a lack of studies comparing the clinical effect of various douching solutions after ESS. This study investigated the clinical effects of normal saline, lactated Ringer's, and hypertonic saline nasal douching solutions after ESS. Adult patients (41.8 ± 12.9 years) undergoing bilateral ESS for chronic rhinosinusitis at a single tertiary referral center e blindly randomized to one of the three study solutions and reviewed on postoperative weeks 1, 3, and 6. The 20-item Sino-Nasal Outcome Test (SNOT-20) scores, visual analog scale (VAS) symptom scores, digital video capture of the sinus cavities, and mucociliary clearance (MCC) times were performed at each visit. The mucosa appearances were scored by a second investigator, blinded to the douching solution. Seventy-four patients were recruited. All groups showed an improvement with treatment in SNOT-20 scores and VAS scores, as well as endoscopic evaluation of mucosa appearance over time. There was no improvement of MCC during the treatment period. Irrigation with lactated Ringer's solution resulted in better symptom scores in SNOT-20 (p 0.05) and VAS (p 0.05), compared with irrigation with normal saline or hypertonic saline solutions. Patients receiving hypertonic saline solutions had less polypoidal mucosa at week 6. Douching with lactated Ringer's solution after ESS results in better improvement in sinonasal symptoms, compared with normal saline or hypertonic saline solutions.
Publisher: SAGE Publications
Date: 30-01-2017
Abstract: Alcohol-related accidents and injuries occur disproportionately within young people – especially when gathering at social events. This study represents a partnership between a faith-based group of volunteers specifically trained to counsel and support young people to reduce their risk of alcohol-related harm, Adelaide City Council, and the South Australian Police Force aimed at reducing risk-related alcohol consumption in a metropolitan nightclub district area. It posits that supporting young people to party safely, alongside positive community engagement, may deter unsafe consumption practices – such as pre-loading and binge-drinking. Retrospective online survey evaluated the impact on attitudes of young people who received the intervention. Findings suggest volunteers were perceived as positive role models who demonstrated a genuine sense of care and ability to support. As a result, one-third of respondents identified potentially more carefully pre-plan their drinking behaviour on their next night out. This study demonstrates that young people are responsive to positive interventions and that future pre-planning may become a more natural part of their party routine – resulting in less likelihood of alcohol-related risk. The outcome measure, that young people’s intentions to moderate their drinking as a result of positive encounters, is an important one.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.JSAMS.2014.12.008
Abstract: Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Prospective, cohort. Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR=3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR=1.41, 95% CI: 1.19, 1.69). Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.
Publisher: Informa UK Limited
Date: 31-03-2014
DOI: 10.1080/13607863.2014.899976
Abstract: To investigate caregiver burden in dementia and explore factors associated with different types of burden in a country without formal caregiver support using a province in China as a case. Cross-sectional questionnaire survey was used to collect data. One hundred and fifty-two family caregivers of people with dementia in community settings were recruited from 2012 to 2013 using convenience s ling. Objective burden was measured by caregiving hours and dementia-related financial burden. Subjective burden was measured and analysed using the Caregiver Burden Inventory and the Neuropsychiatric Inventory-Questionnaire. Multivariate regression models were employed to analyse factors associated with each type of subjective burden. Five types of subjective burden were measured by the Caregiver Burden Inventory, namely, physical burden, emotional burden, time-dependence burden, developmental burden, and social burden. Caregiver distress, as a subjective burden, was measured by the Neuropsychiatric Inventory-Questionnaire and reported by relating to the severity of care recipients' behavioural and psychological symptoms of dementia. This caregiver cohort showed a high level of physical, time-dependence, and developmental burdens, but a low level of emotional and social burdens. Factors contributing to each type of subjective burden measured by the Caregiver Burden Inventory differed from each other. The high level of objective and subjective burdens identified in this study suggests that government-funded formal caregiver support should be established and services should be designed to target different types of burdens and factors contributing to these burdens.
Publisher: Informa UK Limited
Date: 09-2012
DOI: 10.1080/02640414.2012.710760
Abstract: We investigated the relationship between skill qualities and contact injury risk in professional rugby league players. Sixty-six professional rugby league players aged 23 ± 4 years (mean ± s) participated in this three-year prospective study. Players underwent assessments of tackling proficiency, dual-task draw-and-pass proficiency, reactive agility, pattern recall, and pattern prediction. The frailty model was applied to calculate the adjusted risk ratios of injury. When the players' age and playing position were adjusted in the frailty model, the risk ratios showed that reactive agility was a predictor for the risk of injury. Players with reactive agility decision times of >80 ms had a lower incidence (relative risk = 0.68, 95% CI 0.47-0.98, P = 0.04) of injuries than players with reactive agility decision times of ≤ 80 ms. Although there was no relationship between injury and the majority of skill qualities (P = 0.47-0.93), players with poor reactive agility performances (specifically longer decision times) had a lower risk of injury, suggesting that poor perceptual skill is protective against contact injuries in professional rugby league players. These players might inadvertently avoid the heavy collisions that result in injury, or at best result in partial contact that does not result in exposure to the full force of a tackle.
Publisher: SAGE Publications
Date: 11-07-2011
Abstract: The aim of this paper is to report the inter-rater reliabilities and intra-rater reliabilities of the Clegg hammer, penetrometer, and studded-boot apparatus used for measuring the mechanical properties of natural turf, and to determine whether the level of experience influences the reliability. Three experienced and three novice testers measured the surface hardness and rotational traction at nine locations on a community-level Australian football oval. A repeated-measures analysis of variance tested for significant differences between the six testers for all equipment, and intra-class correlation coefficients (ICCs) were calculated to determine the inter-rater reliabilities and intra-rater reliabilities. The ICCs for the reliability between the six testers ranged between 0.77 and 0.87 for the Clegg hammer, ranged between 0.55 and 0.73 for the penetrometer, and equalled 0.51 for the studded-boot apparatus. The inter-rater reliabilities and intra-rater reliabilities were greater for the experienced testers than for the novice testers for the Clegg hammer and penetrometer but the novice testers produced greater inter-rater reliabilities for the studded-boot apparatus. This study highlights the potential variability that can exist between testers using the ground hardness and traction equipment, which has implications for future research involving multiple testers both in agronomic-based studies and in linking the surface properties to the injury risk across multiple venues.
Publisher: Cold Spring Harbor Laboratory
Date: 30-10-2022
DOI: 10.1101/2022.10.27.22281631
Abstract: The aim of this study was to describe the characteristics and outcomes of remote-dwelling pregnant people with threatened labour referred for aeromedical retrieval to a regional birthing centre, as well as factors associated with birth within 48 hours. This was a retrospective observational study of all pregnant people in the remote Central Australian region referred to the Medical Retrieval Consultation and Coordination Centre for labour weeks gestation, between 12 February 2018 – 12 February 2020. Data was extracted manually from written medical records on maternal, neonatal and retrieval mission characteristics. Univariate and multivariate statistical analysis was performed. There were 116 people referred for retrieval for labour. There were no births during transport and less than half of the cases in this cohort resulted in birth within 48 hours of retrieval. Tocolysis was frequently used. Predictors of birth with 48 hours were cervical dilatation 5cm or more, preterm gestational age and ruptured membranes in the univariate analysis. Nearly one-third of this cohort required intervention or had complications during birth. Birth during transport for threatened labour did not occur in this cohort, and more than half of retrievals did not result in birth within 48 hours, however the high risk of birth complications may offset any benefit of avoiding aeromedical transport from remote regions. Retrieval clinicians should have a lower threshold for urgent transfer in cases of ruptured membranes, cervical dilatation of 5cm or more, or gestational age is less than 37 weeks.
Publisher: Oxford University Press (OUP)
Date: 14-12-2019
DOI: 10.1093/NDT/GFY340
Abstract: A number of peritoneal dialysis (PD) systems are available but there have been few studies comparing them. The aim of this study was to examine technique failure and patient survival between different PD company systems. The study included all patients who commenced PD between 1995 and 2014 in Australia and New Zealand. Groups were compared according to the initial PD company system that they received. The primary outcome was a composite of PD technique failure and death. A total of 16 575 patients commenced PD using systems manufactured by Baxter [n = 13 438 (81%)], Fresenius Medical Care [n = 2848 (17%)] or Gambro [n = 289 (2%)]. Of these, 11 870 (72%) developed technique failure, including 5421 (33%) who died. The median time to technique failure or death for all patients was 625 [interquartile range (IQR) 318-1114] days: 629.5 (IQR 321-1121) days with Baxter, 620.5 (IQR 311-1069) days with Fresenius Medical Care and 538 (IQR 272-1001) days with Gambro systems (P = 0.023). There was a statistically significant increase in technique failure or mortality rates in patients on Gambro {adjusted incidence rate ratio [IRR] 1.46 [95% confidence interval (CI) 1.33-1.62]} and Fresenius [adjusted IRR 1.10 (95% CI 1.01-1.19)] systems compared with Baxter systems. No difference in patient survival was observed between the three PD systems. PD systems manufactured by different companies may be associated with important differences in PD technique survival. This needs to be confirmed with adequately powered, prospective randomized controlled clinical trials.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 19-01-2022
Publisher: Elsevier BV
Date: 09-2023
Publisher: S. Karger AG
Date: 2015
DOI: 10.1159/000382140
Publisher: Elsevier BV
Date: 05-2023
Publisher: Cambridge University Press (CUP)
Date: 21-11-2016
DOI: 10.1017/S1368980016002883
Abstract: As numerous factors in the home environment have been related to children’s fruit and vegetable (F& V) consumption as a component of a healthy diet, the purpose of the present systematic review was to examine these factors specifically for children aged 6–12 years. Relevant observational studies published in English between January 2007 and December 2015 were obtained through electronic database searches. Studies were included if the researchers reported on a potentially modifiable measure of the home physical, political and sociocultural environment related to child F& V consumption. Of the thirty-three articles reviewed, overall methodological quality was poor with twenty studies rated as weak, mainly due to cross-sectional design (majority of studies), selection bias, convenience s ling and voluntary participation. Half of the studies had strong–moderate ratings for using valid and/or reliable tools while for the other half, psychometric properties were either not reported or weak. The most consistent evidence for children’s combined F& V consumption was found for availability and accessibility of F& V, parental role modelling of F& V and maternal intake of F& V. A vast array of home environment components and their influence on children’s consumption of fruits and/or vegetables have been studied in recent years. Specific components of the home environment may have more influence than others, but more compelling evidence is needed to draw strong conclusions. Recommendations are made for future studies to be based upon conceptual/theoretical models to provide consistency in defining the home environment and investigation of potential moderators, such as personal or contextual factors.
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/NEP.13904
Abstract: Hyperphosphataemia is associated with increased adverse outcomes, including mortality. Re‐examining this association using up‐to‐date data reflecting current and real‐world practices, across different global regions and in both haemodialysis and peritoneal dialysis patients, is important. We describe the association between serum phosphate and all‐cause and cardiovascular mortality in incident dialysis patients between 2008 and 2018 using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Time‐dependent Cox proportionate hazards models were used. Models were adjusted for available covariates and fitted for the overall cohort, and also each dialysis modality. 31 989 patients were followed over 97 122 person‐years at risk (mean age at first dialysis 61 years, 38% female, 67% haemodialysis). We observed a U‐shaped association between serum phosphate and all‐cause mortality. In the fully adjusted model, categories of serum phosphate above and below 1.25–1.99 mmol/L were associated with progressively higher risk, reaching a hazard ratio of 2.13 (95% CI 1.93–2.36, p .001) for serum phosphate ≥2.75 mmol/L, and 1.56 (95% CI 1.44–1.69, p .001) for serum phosphate .00 mmol/L. Low and high levels of serum phosphate were also associated with increased risk of cardiovascular mortality, however the association with high serum phosphate was more pronounced (“J‐shaped relationship”). The associations were consistent across sub‐analyses of patients receiving haemodialysis and peritoneal dialysis treatment. In this large contemporary dialysis cohort, both high and low levels of serum phosphate were independently associated with increased risk of mortality. Future studies are required to determine whether treatment of abnormal serum phosphate levels improves mortality.
Publisher: Springer Science and Business Media LLC
Date: 11-2017
DOI: 10.1007/S10995-017-2386-9
Abstract: Introduction The home and school environments play important roles in influencing children's health behaviours. However, their simultaneous influence on childhood obesity has not yet been examined. We explore the relationship of the home and school environments with childhood obesity, to determine whether this relationship is mediated by children's fruit and vegetable intake and physical behaviours. Methods This study uses baseline data from 9 to 11 year old children, their parents and school principals (matched data n = 2466) from the Obesity Prevention and Lifestyle Project. Child-reported behaviours, parent-reported home environment and principal-reported school environment data were collected via questionnaires. Trained researchers measured children's height and weight, and Body Mass Index (BMI, kg/m
Publisher: BMJ
Date: 27-03-2011
Publisher: Springer Science and Business Media LLC
Date: 09-06-2022
DOI: 10.1007/S11764-021-01068-W
Abstract: Determine whether a erse set of problems experienced by breast cancer survivors (BCS) following curative treatment can be formulated into a reduced number of clusters, potentially simplifying the conceptualization of these problems. Female BCS were recruited from four cancer hospitals in China. The Chinese translation of the Cancer Survivor Profile (CSPro) was used to measure 18 common problem areas, as supported by epidemiological and phenomenological research. The Functional Assessment of Cancer Therapy–Breast (FACT-B) was used to measure quality of life, as a validation of any observed groupings. Hierarchical clustering using multiple distance criteria and aggregation methods to detect patterns of problems was used. A total of 1008 BCS (mean 46.51 years old) living in both urban and rural areas were investigated. Hierarchical cluster analysis identified two major clusters of problems. One set was classified as “functional limitations,” while the other cluster was labeled “multi-problems.” Those who fell into the multi-problem cluster experienced poorer quality of life. Eighteen non-medical problems were broken down into two major clusters: (1) limitations in higher level functions required of daily life and (2) limitations in health care–seeking skills, problems with certain symptoms, unhealthy behaviors, and financial problems related to cancer. The breakdown of problem areas into these two clusters may help identify common mechanisms. In the future, the search for common clusters and the mechanisms for the many problems that breast cancer survivors and other cancer survivors can experience following primary treatment may improve how we help manage these problems in the future.
Publisher: Wiley
Date: 14-03-2022
DOI: 10.1111/JAN.15216
Abstract: To describe a nurse‐led multicentre randomized controlled trial protocol developed to evaluate the effectiveness and cost‐effectiveness of a Chinese iSupport for Dementia program in Australia and Greater China including mainland China, Taiwan, Hong Kong and Macau. A multicentre randomized controlled trial following the SPIRIT checklist. Participants in the study will be recruited from Australia and Greater China and will be randomly assigned to the intervention group or the usual care group. Interventions will include self‐learning of the iSupport program, virtual peer support and nurse program facilitator support for 6 months. Primary outcome measures will be the 12‐Item Short‐Form Health Survey. Secondary outcome measures will include: Revised Scale for Caregiving Self‐efficacy Quality of Social Support Scale Revised Memory and Behaviour Problem Checklist the Quality of Life in Alzheimer's Disease‐Proxy usages of care services and cost‐effectiveness of the intervention. Outcomes will be measured at baseline, 6 months and 9 months from the baseline. Caregivers' experiences of the peer support will be explored. This project was funded by the National Foundation for Australia‐China Relations, Australian Government (Project ID: NFACR216). The total amount is $440,000 Australian dollars (or £ 236,231). Approximately, 20% of people living with dementia in the world live in Australia and Greater China. Older Chinese are usually cared for by family caregivers at home due to the influence of Confucianism. However, free and online psychoeducation programs for this large cohort of caregivers are not available or accessible. The World Health Organization iSupport for Dementia is an evidence‐based online psychoeducation program for caregivers. Implementing a culturally adapted Chinese iSupport program will address this gap in supporting caregivers. This study will provide research evidence on effectiveness and cost‐effectiveness of an online psychoeducation program for caregivers. Findings will inform policy and practice development.
Publisher: Wiley
Date: 24-07-2015
DOI: 10.1002/ALR.21604
Abstract: Saline-based irrigation solutions are evidence-based rhinological treatments however, the formulation of these solutions could theoretically alter the function of innate antimicrobial peptides. The aim of this study was to determine if the antimicrobial activity of normal human nasal secretions in vivo is altered by commercially available large volume irrigation solutions. Minimally manipulated sinonasal secretions were collected from patients with chronic rhinosinusitis (CRS n = 10) and normal healthy volunteers (n = 20). In a subset of control patients (n = 10) secretions were collected prior to, and at 1 hour, 6 hours, and 24 hours after nasal irrigation with 4 commercial irrigation solutions. Lysozyme and lactoferrin levels were analyzed and the antimicrobial activity of secretions determined using a radial diffusion assay. The antimicrobial activity of nasal secretions was reduced in CRS patients compared to healthy volunteers (p < 0.01), but there was no significant difference in antimicrobial peptide concentrations. Isotonic nasal irrigation reduced lysozyme and lactoferrin levels, which returned to baseline levels by 6 hours in addition to a sustained decrease in antimicrobial activity before returning to baseline at 24 hours. Low-salt solution stimulated peptide secretion by approximately 40% at 6 hours and 24 hours, but produced a transient decrease in antimicrobial activity, returning to baseline levels by 6 hours. Hypertonic solution initially decreased lysozyme and lactoferrin levels but maintained baseline levels of antimicrobial activity and increased peptide secretion by approximately 30% at 24 hours. The formulation of nasal irrigation solutions significantly affects the measured levels and functionality of sinonasal antimicrobial peptides.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.JAMDA.2021.12.019
Abstract: To reach consensus on a minimum list of long-term care (LTC) interventions to be included in a service package delivered through universal health coverage (UHC). A multistep expert consensus process. Multinational and multidisciplinary experts in LTC and ageing. The consensus process was composed of 3 stages: (1) a preconsultation round that built on an initial list of LTC interventions generated by a previous scoping review (2) 2-round surveys to reach consensus on important, acceptable, and feasible interventions for LTC (3) a panel meeting to finalize the consensus. The preconsultation round generated an initial list of 117 interventions. In round 1, 194 experts were contacted and 92 (47%) completed the survey. In round 2, the same experts contacted for round 1 were invited, and 115 (59%) completed the survey. Of the 115 respondents in round 2, 80 participated in round 1. Experts representing various disciplines (eg, geriatricians, family doctors, nurses, mental health, and rehabilitation professionals) participated in round 2, representing 42 countries. In round 1, 81 interventions achieved the predetermined threshold for importance, and in round 2, 41 interventions achieved the predetermined threshold for acceptability and feasibility. Nine conflicting interventions between rounds 1 and 2 were discussed in the panel meeting. The recommended list composed of 50 interventions were from 6 domains: unpaid and paid carers' support and training, person-centered assessment and care planning, prevention and management of intrinsic capacity decline, optimization of functional ability, interventions needing focused attention, and palliative care. An international discussion and consensus process generated a minimum list of LTC interventions to be included in a service package for UHC. This package will enable actions toward a more robust framework for integrated services for older people in need of LTC across the continuum of care.
Publisher: Springer Science and Business Media LLC
Date: 22-10-2019
DOI: 10.1186/S12889-019-7710-4
Abstract: Childhood obesity is a serious public health concern worldwide . Community-based obesity prevention interventions offer promise due to their focus on the broader social, cultural and environmental contexts rather than in idual behaviour change and their potential for sustainability and scalability. This paper aims to determine the effectiveness of a South Australian community-based, multi-setting, multi-strategy intervention, OPAL (Obesity Prevention and Lifestyle), in increasing healthy weight prevalence in 9 to 11-year-olds. A quasi-experimental repeated cross-sectional design was employed. This paper reports on the anthropometric, health-related quality of life (HRQoL) and behaviour outcomes of primary school children (9–11 years) after 2–3 years of intervention delivery. Consenting children from primary schools (20 intervention communities, INT 20 matched comparison communities, COMP) completed self-report questionnaires on diet, activity and screen time behaviours. HRQoL was measured using the Child Health Utility 9D. Body Mass Index (BMI) z-score and weight status were determined from children’s measured height and weight. A multilevel mixed-effects model, accounting for clustering in schools, was implemented to determine intervention effect. Sequential Bonferroni adjustment was used to allow for multiple comparisons of the secondary outcomes. At baseline and final, respectively, 2611 and 1873 children completed questionnaires and 2353 and 1760 had anthropometric measures taken. The prevalence of children with healthy weight did not significantly change over time in INT (OR 1.11, 95%CI 0.92–1.35, p = 0.27) or COMP (OR 0.85, 95%CI 0.68–1.06, p = 0.14). Although changes in the likelihood of obesity, BMI z-score and HRQoL favoured the INT group, the differences were not significant after Bonferroni adjustment. There were also no significant differences between groups at final for behavioural outcomes. OPAL did not have a significant impact on the proportion of 9 to 11-year-olds in the healthy weight range, nor children’s BMI z-score, HRQoL and behaviours. Long-term, flexible community-based program evaluation approaches are required . ACTRN12616000477426 (12th April 2016, retrospectively registered).
Publisher: MDPI AG
Date: 19-08-2022
Abstract: (1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping review describes the psychometric and community engagement processes for PROMs and surveys developed for Aboriginal and Torres Strait Islander communities. (2) Methods: The PRISMA ScR guidelines for scoping reviews were followed, aimed at those PROMs and surveys that underwent psychometric assessment. The Aboriginal and Torres Strait Islander Quality Appraisal Tool and a narrative synthesis approach were used. (3) Results: Of 1080 articles, 14 were eligible for review. Most articles focused on a validity assessment of PROMs and surveys, with reliability being less common. Face validity with Aboriginal and Torres Strait Islander communities was reported in most studies, with construct validity through exploratory factor analyses. Methodological design risks were identified in the majority of studies, notably the absence of explicit Indigenous knowledges. Variability existed in the development of PROMs and surveys for Aboriginal and Torres Strait Islander communities. (4) Conclusions: Improvement in inclusion of Indigenous knowledges and research approaches is needed to ensure relevance and appropriate PROM structures. We provide suggestions for research teams to assist in future design.
Publisher: SAGE Publications
Date: 17-09-2013
Abstract: The Clegg hammer is currently used to measure hardness of natural turf surfaces to inform performance and safety decisions. However, the number of Clegg hammer drops reported in natural grass testing varies from one to four drops, and the impact of the choice of the number of drops is unknown. The aim of this article is to determine whether significant differences exist between the four Clegg hammer drops on natural grass across a variety of conditions. Hardness readings (using a 2.25 kg Clegg hammer), soil moisture and botanical composition were recorded at nine different sites on seven football fields during an 18-week playing season. A total of 1255 hardness readings were collected for each of four consecutive Clegg hammer drops. Overall, there were significant differences between drop 1 and the other three consecutive drops, on all fields and on all sites. Deep soil moisture was the only factor that significantly influenced the hardness readings. The results of this study demonstrate that the decision regarding the number of drops recorded needs careful consideration as conclusions drawn on playability of a ground or the association with injury risk may vary considerably depending on the number of drops.
Publisher: Cambridge University Press (CUP)
Date: 08-2019
DOI: 10.1017/JIE.2017.37
Abstract: Socially accountable health curricula, designed to decrease Aboriginal health inequities through the transformation of health professional students into culturally safe practitioners, has become a focal point for health professional programmes. Despite this inclusion in health curricula there remains the question of how to best assess students in this area in relation to the concept, of cultural safety and transformative unlearning, to facilitate attitudinal change. To address this question, this study developed a research questionnaire to measure thematic areas of transformative unlearning, cultural safety and critical thinking in Aboriginal Health for application on undergraduate and postgraduate students and faculty staff. The Likert-scale questionnaire was developed and validated through face and content validity. Test–retest methodology was utilised to determine stability and reliability of the questionnaire with 40 participants. The extent of agreement and reliability were determined through weighted kappa and intraclass correlation coefficient. Exploratory factor analysis was calculated to determine construct validity for questionnaire items. For the overall population subset the tool met good standards of reliability and validity, with 11 of the 15 items reaching moderate agreement (κ 0.6) and an intraclass correlation coefficient of 0.72, suggesting substantial agreement. Cronbach's alpha was calculated above 0.7 for the thematic areas. The majority of items provided high factor loadings, low loading items will be reviewed to strengthen the tool, where validations of the revised tool with a larger cohort will allow future use to compare and determine effective teaching methodologies in Aboriginal health and cultural safety curricula.
Publisher: BMJ
Date: 23-01-2014
DOI: 10.1136/BJSPORTS-2012-091987
Abstract: Coaches play a major role in encouraging and ensuring that participants of their teams adopt appropriate safety practices. However, the extent to which the coaches undertake this role will depend upon their attitudes about injury prevention, their perceptions of what the other coaches usually do and their own beliefs about how much control they have in delivering such programmes. Fifty-one junior netball coaches were surveyed about incorporating the teaching of correct (safe) landing technique during their delivery of training sessions to junior players. Overall, >94% of coaches had strongly positive attitudes towards teaching correct landing technique and >80% had strongly positive perceptions of their own control over delivering such programmes. Coaches' ratings of social norms relating to what others think about teaching safe landing were more positive (>94%) than those relating to what others actually do (63-74%). In conclusion, the junior coaches were generally receptive towards delivering safe landing training programmes in the training sessions they led. Future coach education could include role modelling by prominent coaches so that more community-level coaches are aware that this is a behaviour that many coaches can, and do, engage in.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
DOI: 10.1097/01.AOA.0000482640.41679.64
Abstract: ( BJOG. 2015 Jun (7):983–992) Pethidine (meperidine) is the most commonly administered opioid for labor pain in women unable or unwilling to undergo epidural analgesia. It has a slow onset and the potential for adverse effects, due in part to the active metabolite norpethidine (normeperidine), which has been associated with neuronal depression in the neonate for up to 60 hours after birth. The faster-acting opioid fentanyl has shown promise as an alternative to pethidine, with the advantages of rapid onset, short duration, and no active metabolite. In studies comparing intravenous (IV) fentanyl with IV pethidine in the obstetric setting, IV fentanyl resulted in fewer adverse effects in both mother and baby. Less invasive intranasal (IN) and subcutaneous (SC) fentanyl have been shown to be efficacious in nonobstetric settings, but few studies have examined the administration of fentanyl by these routes in laboring parturients. This randomized-controlled trial compared the efficacy of fentanyl administered intranasally or subcutaneously with intramuscular (IM) pethidine for labor analgesia, as measured by pain scores 30 minutes after treatment. Important secondary maternal outcomes included the rating of perceived feelings of control during labor using the Labor Agentry Scale (LAS) questionnaire, and satisfaction with the treatment intervention, determined by the participant’s willingness to use the treatment again.
Publisher: Frontiers Media SA
Date: 24-03-2022
DOI: 10.3389/FENDO.2022.832678
Abstract: Obesity in pregnancy is a known risk factor for adverse maternal and neonatal outcomes. Few studies have compared adverse pregnancy-related outcomes according to obesity severity. Hence, we aimed to examine the impact of obesity class on maternal and perinatal outcomes. We retrospectively analysed data from all singleton births from mothers with obesity from 2013-2017 in Northern Sydney Local Health District in Sydney, Australia. Women were categorised into obesity class I (BMI 30-34.9kg/m2), class II (BMI 35-39.9 kg/m2) or class III (BMI 40+ kg/m2). Across BMI classes, we compared maternal outcomes including mode of delivery, gestational diabetes mellitus (GDM), and preecl sia, and neonatal outcomes including large- and small-for-gestational age (SGA, LGA), neonatal hypoglycaemia, birth defects and timing of birth. Logistic analyses were performed to explore the impact of maternal obesity class on these outcomes, adjusting for maternal age, country of birth, parity, diabetes (both pre-existing and gestational) and hypertension. There were 2466 births to women with obesity, class (69.1%), class II (21.8%), and class III (9.2%). 42.5% delivered by Caesarean section, 22.3% developed GDM and 11.2% had a hypertensive disorder in pregnancy, and Caesarean section and GDM were more common in women with higher class obesity. LGA occurred in 27.3% and SGA occurred in 4.0% of women across all classes of obesity. LGA rates were 49% more likely in women with class III compared to women with class I obesity (OR=1.49, CI 1.06-2.09, p=0.02). The presence of diabetes in the index pregnancy did not significantly impact risk of neonatal LGA between maternal obesity classes. Other neonatal adverse outcomes such as stillbirth and birth defects were more common in women with higher class obesity. SGA, neonatal hypoglycaemia, gestational age at delivery, APGAR 5-minute score and NICU admissions were similar across obesity classes, after adjustment for covariates. Obesity class increases the risk of many adverse maternal and neonatal outcomes. Obesity class is independently associated with LGA incidence in the neonate, independent of maternal factors including GDM. Ongoing efforts must be made to reduce obesity incidence in women of reproductive age to circumvent the adverse perinatal outcomes associated with obesity.
Publisher: Springer Science and Business Media LLC
Date: 21-12-2022
Publisher: JMIR Publications Inc.
Date: 09-03-2023
Abstract: nformal caregivers of people living with dementia experience a higher level of physical and mental stress compared with other types of caregivers. Psychoeducation programs are viewed as beneficial for building caregivers’ knowledge and skills and for decreasing caregiver stress. his review aimed to synthesize the experiences and perceptions of informal caregivers of people with dementia when participating in web-based psychoeducation programs and the factors that enable and impede informal caregivers’ engagement in web-based psychoeducation programs. his review followed the Joanna Briggs Institute protocol of systematic review and meta-aggregation of qualitative studies. We searched 4 English databases, 4 Chinese databases, and 1 Arabic database in July 2021. total of 9 studies written in English were included in this review. From these studies, 87 findings were extracted and grouped into 20 categories. These categories were further synthesized into 5 findings: web-based learning as an empowering experience, peer support, satisfactory and unsatisfactory program content, satisfactory and unsatisfactory technical design, and challenges encountered in web-based learning. igh-quality and carefully designed web-based psychoeducation programs offered positive experiences for informal caregivers of people living with dementia. To meet broader caregiver education and support needs, program developers should consider information quality and relevancy, the support offered, in idual needs, flexibility in delivery, and connectedness between peers and program facilitators. >
Publisher: Cambridge University Press (CUP)
Date: 2017
DOI: 10.1017/S0022215116009221
Abstract: To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia. A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated. Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection ( p 0.001), with no significant difference between general anaesthesia and local anaesthesia ( p 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively. Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PYV26N4ABS
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2017
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.AAP.2009.08.018
Abstract: Falls and their injury outcomes have count distributions that are highly skewed toward the right with clumping at zero, posing analytical challenges. Different modelling approaches have been used in the published literature to describe falls count distributions, often without consideration of the underlying statistical and modelling assumptions. This paper compares the use of modified Poisson and negative binomial (NB) models as alternatives to Poisson (P) regression, for the analysis of fall outcome counts. Four different count-based regression models (P, NB, zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB)) were each in idually fitted to four separate fall count datasets from Australia, New Zealand and United States. The finite mixtures of P and NB regression models were also compared to the standard NB model. Both analytical (F, Vuong and bootstrap tests) and graphical approaches were used to select and compare models. Simulation studies assessed the size and power of each model fit. This study confirms that falls count distributions are over-dispersed, but not dispersed due to excess zero counts or heterogeneous population. Accordingly, the P model generally provided the poorest fit to all datasets. The fit improved significantly with NB and both zero-inflated models. The fit was also improved with the NB model, compared to finite mixtures of both P and NB regression models. Although there was little difference in fit between NB and ZINB models, in the interests of parsimony it is recommended that future studies involving modelling of falls count data routinely use the NB models in preference to the P or ZINB or finite mixture distribution. The fact that these conclusions apply across four separate datasets from four different s les of older people participating in studies of different methodology, adds strength to this general guiding principle.
Publisher: Wiley
Date: 21-07-2023
DOI: 10.1111/JOCN.16836
Abstract: To explore stakeholders' perceptions of a facilitator's role in supporting carers when embedding iSupport for Dementia psychoeducation program, in care services. A qualitative descriptive study design was applied. Data were collected from workshops and interviews with carers of people living with dementia (PLWD)and with health and social care professionals from two tertiary hospitals and two community aged care organisations across three Australian states between October 2021 and March 2022. A thematic analysis was used to analyse data. The COREQ guideline was followed to report our findings. A total of 30 family carers and 45 health and social care professionals participated in the study. Three main themes and seven subthemes were identified from the data. We described the main themes as (1) the facilitator's role at the time of dementia diagnosis, (2) the facilitator's role throughout the everyday dementia care journey and (3) the facilitator's role during transition moments. Caring for family members with dementia is demanding and stressful for carers. Embedding a facilitator‐enabled iSupport for Dementia program in hospital and community aged care settings has the potential to mitigate sources of stress associated with care recipient factors, carer factors and care service factors, and improve the health and well‐being of carers and those for whom they care. Our findings will inform the establishment of iSupport facilitators appointed by dementia care providers in hospital and community care settings and help determine their roles and responsibilities in delivering the iSupport program. Our findings relate to nurse‐led and coordinated dementia care in hospital and community aged care settings. This study was co‐designed with stakeholders from two aged care organisations and two tertiary hospitals. The study participants were staff employed by these organisations and carers of PLWD who were service users.
Publisher: Wiley
Date: 26-09-2015
DOI: 10.1111/GGI.12339
Abstract: The present study aimed to establish a nurse-led cognitive screening model for community-dwelling older adults with subjective memory complaints from seven communities in Chongqing, China, and report the findings of this model. Screenings took place from July 2012 to June 2013. Cognitive screening was incorporated into the annual health assessment for older adults with subjective memory complaints in a primary care setting. Two community nurses were trained to implement the screening using the Mini-Mental State Examination and Montreal Cognitive Assessment. Of 733 older adults, 495 (67.5%) reported having subjective memory complaints. Of the 249 in iduals who participated in the cognitive screening, 102 (41%) had mild cognitive impairment, whereas 32 (12.9%) had cognitive impairment. A total of 80 participants (78.4%) with mild cognitive impairment agreed to participate in a memory support program. Participants with cognitive impairment were referred to specialists for further examination and diagnosis only one reported that he had seen a specialist and had been diagnosed with dementia. Incorporating cognitive screening into the annual health assessment for older adults with subjective memory complaints was feasible, though referral rates from primary care providers remained unchanged. The present study highlights the urgent need for simple screenings as well as community-based support services in primary care for older adults with cognitive or mild cognitive impairments.
Publisher: Human Kinetics
Date: 2014
Abstract: Enjoyment and play during school lunchtime are correlated with children’s physical activity. Despite this, there is an absence of studies reporting children’s enjoyment of play during school lunchtime breaks. The purpose of this study was to examine the intraday and interday reliability of children’s enjoyment of school lunchtime play. Surveys used to assess children’s enjoyment of lunchtime play were distributed to and completed by 197 children (112 males, 85 females), aged 8–12 years attending an elementary school in Victoria, Australia. Children completed the surveys during class before lunch (expected enjoyment) and after lunch (actual enjoyment) for 5 days. The intra- and interday enjoyment of school lunchtime play reliability were determined using a weighted kappa. Intraday kappa values ranged from fair (0.31) to substantial (0.75) within each of the 5 days (median kappa = 0.41). In comparison, “expected” (0.09–0.40 median 0.30) and “actual” (0.05–0.46 median 0.28) interday enjoyment of lunchtime play displayed low reliability. Children’s enjoyment of lunchtime play appears to be more consistent within days than across days. The findings suggest that assessment of children’s enjoyment of lunchtime play once on a single day would be representative of a particular day but not necessarily that particular school week.
Publisher: Springer Science and Business Media LLC
Date: 2011
DOI: 10.2165/11537260-000000000-00000
Abstract: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm) and (ii) intrinsic (in idual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2014
Publisher: Elsevier BV
Date: 2015
DOI: 10.1111/HPB.12322
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.JSAMS.2011.08.004
Abstract: Behavioural factors and beliefs are important determinants of the adoption of sports injury interventions. This study aimed to understand behavioural factors associated with junior community netball players' intentions to learn correct landing technique during coach-led training sessions, proposed as a means of reducing their risk of lower limb injury. Cross-sectional survey. 287 female players from 58 junior netball teams in the 2007/2008-summer competition completed a 13-item questionnaire developed from the Theory of Planned Behaviour (TPB). This assessed players' attitudes (four items), subjective norms (four), perceived behavioural control (four) and intentions (one) around the safety behaviour of learning correct landing technique at netball training. All items were rated on a seven-point bipolar scale. Cluster-adjusted logistic regression was used to assess which TPB constructs were most associated with strong intentions. Players had positive intentions and attitudes towards learning safe landing technique and perceived positive social pressure from significant others. They also perceived themselves to have considerable control over engaging (or not) in this behaviour. Players' attitudes (p<0.001) and subjective norms (p<0.001), but not perceived behavioural control (p=0.49), were associated with strong intentions to learn correct landing technique at training. Injury prevention implementation strategies aimed at maximising junior players' participation in correct landing training programs should emphasise the benefits of learning correct landing technique (i.e. change attitudes) and involve significant others and role models whom junior players admire (i.e. capitalise on social norms) in the promotion of such programs.
Publisher: Elsevier BV
Date: 10-2023
Publisher: BMJ
Date: 09-03-2011
Abstract: To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. 374 male senior Australian Football players, aged 17-38 years. Beliefs about lower-limb injury causation revention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.
Publisher: Springer Science and Business Media LLC
Date: 02-2023
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.JSAMS.2012.03.017
Abstract: Well-developed physical qualities may protect against contact injuries. However, the potential contribution of physical qualities as risk or protective factors to contact injury risk is yet to be determined for rugby league. This study applied a frailty survival model that accounts for recurrent injury to identify risk factors for all physiotherapist-reported contact injury in professional rugby league players. Prospective cohort study. Sixty-six professional rugby league players participated in this three successive year prospective study. At the start of each season, all players underwent measurements of standard anthropometry (height, body mass, and sum of seven skinfolds), speed (10 m and 40 m sprint), muscular strength (1 repetition maximum [RM] bench press, 1RM squat, 1RM weighted chin-ups), power (vertical jump, bench throw, 1RM power clean, jump squat), and endurance (maximum repetition bench press with 60 kg resistance), repeated-sprint ability (12 × 20 m sprints performed on a 20s cycle), prolonged high-intensity intermittent running ability (8 × 12 s maximal effort shuttles performed on a 48 s cycle), and maximal aerobic power (multi-stage fitness test). Data was used to demonstrate the application of the frailty model extension of the Cox proportional regression model for recurrent events to identify factors associated with a high hazard ratio (HR) of injury. Heavier (body mass, HR=2.6, 95% CI=1.2-5.7), and faster (40 m sprint, HR=2.1, 95% CI=1.0-4.2) players, and those with poorly developed prolonged high-intensity intermittent running ability (HR=2.9, 95% CI=1.7-5.0) and upper-body strength (chin-up, HR=2.2, 95% CI=1.3-3.7) had a higher incidence of contact injuries. This study demonstrates application of a novel statistical approach for the analysis of injury data that is recurrent in nature. This approach identified that the greater impact forces generated from heavier players with faster speed may result in an increase in recurrent contact injury rates. However, the development of prolonged high-intensity intermittent running ability and upper-body strength and power may assist to reduce the risk of contact injury in professional rugby league players.
Publisher: Springer Science and Business Media LLC
Date: 04-03-2010
DOI: 10.1007/S00198-010-1189-2
Abstract: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific ex le of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions.
Publisher: Mary Ann Liebert Inc
Date: 06-2015
Abstract: The Indurometer is a tool designed by the Flinders Biomedical Engineering Department to replace the Tissue Tonometer. It measures the resistance to an applied force to quantify the amount of fibrosis present within the epifascial compartment of tissue. The aim of the study was to compare the current model of the Indurometer with the Tonometer to determine the level of variability and repeatability between the two devices and how the variability differs when compared to an in idual's ISL stage. Data were gathered on a total of 180 participants with unilateral arm lymphedema as part of an international multicenter trial. For each participant three repeat measurements were obtained with the Indurometer and Tonometer at the anterior mid forearm and anterior mid upper arm. The Indurometer gave lower measurement values than the Tonometer. The Tonometer was found to be less variable than the Indurometer when measurements were taken from the anterior mid upper arm and the anterior mid forearm site. The Tonometer values were significantly less variable than the Indurometer values in ISL stages 1 and 2. No significant variability was found in stage 3. The Indurometer is easier to use as compared to the Tonometer. Modification of the Indurometer needs to take place in order to improve its variability before it can be considered as a replacement for the Tonometer in the assessment of lymphedema. The lack of understanding of the ISL classification system is a significant issue.
Publisher: BMJ
Date: 19-07-2010
Abstract: To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development. An epidemiological and economic model for estimating population-level effectiveness of tai-chi. Australia, 2009. Patients or subjects Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects. Intervention Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period. Main outcome measure Total falls and fall-related hospitalisation prevented in 2009. Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall-related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $A4414 (€3013) and $A220,712 (€150,684), respectively. A total investment of $A24.01 million (€16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31,998 people and achieve this effect. Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost-effective falls-prevention portfolio for Australia and other countries.
Publisher: SAGE Publications
Date: 20-06-2022
DOI: 10.1177/14713012221110003
Abstract: Home-based dementia care is common in the Chinese-Australian community. However, dementia education programs for Chinese-Australians in the language of their choice are scarce. The World Health Organization has developed iSupport for Dementia, an online education program for informal caregivers. Cultural adaptation of the program for Chinese-Australian caregivers is an opportunity to address this gap in caregiver support. The aims of the study were (1) to understand stakeholders’ perspectives on the cultural and linguistic appropriateness of the Chinese iSupport for Dementia content and design and (2) to explore factors affecting the future implementation of the Chinese iSupport program in Australia. A qualitative descriptive design was applied to address the aims of the study. Focus group discussions with Chinese-Australian caregivers and community aged care workers were conducted to collect data. Thematic analysis was used to analyse data. In total, six focus groups were conducted with 18 Chinese-Australian caregivers and 17 care workers. Six themes were identified and described as follows: (1) appropriateness of the Chinese iSupport content (2) acceptability of the online Chinese iSupport design (3) motivations to engage in the iSupport program (4) desire to interact with peers and professional facilitators (5) concerns about program accessibility and (6) the need to extend the iSupport program to care workers. Engagement with Chinese-Australian caregivers and care workers will inform further revisions of the Chinese iSupport program contents to ensure the program is culturally congruent to Chinese-Australian caregivers. Factors affecting the implementation of the program identified in the study will be considered in the intervention phase of the program.
Publisher: MDPI AG
Date: 06-01-2022
Abstract: Background & Aims: Globally, there has been a concerning rise in the incidence of young-onset cancers. The aim of this study was to provide trends in the incidence and survival of gastrointestinal adenocarcinomas (oesophagus, stomach, pancreas, and colorectal) in South Australia over a 27-year period. Methods: This is a cross-sectional analysis of a prospective longitudinal database including all cases of gastrointestinal adenocarcinomas prospectively reported to the South Australian (State) Cancer Registry from 1990 to 2017. Results: A total of 28,566 patients diagnosed with oesophageal, stomach, pancreatic, or colorectal adenocarcinoma between 1990 and 2017 were included in the study. While the overall incidence for gastrointestinal adenocarcinomas in in iduals years has decreased since 2000 (IRR of 0.97 (95% CI 0.94–1.00 p = 0.06)) compared to 1990–1999, the rate amongst in iduals aged 18–50 has significantly increased (IRR 1.41 (95% CI 1.27–1.57 p 0.001)) during the same reference time period. Although noted in both sexes, the rate of increase in incidence was significantly greater in males (11.5 to 19.7/100,000 p 0.001). The overall survival from adenocarcinomas across all subsites improved in the -year cohort in the last decade (HR 0.89 (95% CI 0.86–0.93 p 0.001)) compared to 1990–1999. In in iduals aged 18–50 years, there has only been a significant improvement in survival for colorectal cancer (HR 0.82 (95% CI 0.68–0.99 p 0.04)), but not the other subsites. A lower overall survival was noted for males in both age cohorts (18–50 years—HR 1.24 (95% CI 1.09–1.13 p 0.01) and years—HR 1.13 (95% CI 1.10–1.16 p 0.001), respectively) compared to females. Conclusions: This study from South Australia demonstrates a significant increase in young-onset gastrointestinal adenocarcinomas over the last 28 years, with a greater increase in the male sex. The only significant improvement in survival in this cohort has been noted in colorectal cancer patients.
Publisher: Medknow
Date: 06-2017
Publisher: Wiley
Date: 15-03-2013
DOI: 10.1111/JOSH.12025
Abstract: Enjoyment of physical activity is as an important determinant of children's participation in physical activity. Despite this, there is an absence of reliable measures for assessing children's enjoyment of play activities during school lunchtime. The purpose of this study was to develop and assess the reliability of the Lunchtime Enjoyment of Activity and Play (LEAP) Questionnaire. Questionnaire items were categorized employing a social-ecological framework including intrapersonal (20 items), interpersonal (2 items), and physical environment olicy (17 items) components to identify the broader influences on children's enjoyment. An identical questionnaire was administered on 2 occasions, 10 days apart, to 176 children aged 8-12 years, attending a government elementary school in regional Victoria, Australia. Test-retest reliability confirmed that 35 of 39 LEAP Questionnaire items had at least moderate kappa agreement ranging from .44 to .78. Although 4 in idual kappa values were low, median kappa scores for each aggregated social-ecological component reached at least moderate agreement (.44-.60). This study confirms the LEAP Questionnaire to be a reliable, context-specific instrument with sound content, and face validity that employs a social-ecological framework to assess children's enjoyment of school play and lunchtime activities.
Publisher: BMJ
Date: 08-06-2011
Abstract: To examine the appropriateness of different statistical models in analysing falls count data. Six count models (Poisson, negative binomial (NB), zero-inflated Poisson (ZIP), zero-inflated NB (ZINB), hurdle Poisson (HP) and hurdle NB (HNB)) were used to analyse falls count data. Empirical evaluation of the competing models was performed using model selection criteria and goodness-of-fit through simulation. Data used were from a prospective cohort study of women aged 40-80 years. Of the 465 women analysed, 330 (71%) did not fall at all. The analyses identified strong evidence of overdispersion in the falls data. The NB-based regression models (HNB, ZINB, NB) were better performed than the Poisson-based regression models (Poisson, ZIP, HP). Vuong tests favoured the HNB model over the NB and ZINB models and the NB model over the ZINB model. Model accuracy measures and Monte Carlo simulation of goodness-of-fit confirmed the lack of fit of the Poisson-based regression models and demonstrated the best fit for the HNB model with comparable good fit for the ZINB and NB models. Falls count data consisting of a considerable number of zeros can be appropriately modelled by the NB-based regression models, with the HNB model offering the best fit. The evaluation procedure presented in this paper provides a defensible guideline to appropriately model falls or similar count data with excess zeros.
Publisher: Springer Science and Business Media LLC
Date: 22-09-2021
DOI: 10.1007/S00520-021-06567-1
Abstract: To investigate if comorbidity predicts mortality and functional impairment in middle-aged in iduals with cancer (50-64 years) as compared to older in iduals. A prospective cohort study. Outcomes were mortality and functional impairment at 5 years follow-up. Comorbidity was assessed using adjusted Charlson comorbidity index and polypharmacy (≥ 5 drugs) as surrogate for comorbidity. Multivariate Cox-proportional hazards and binary logit models were used to assess the risk of 5-year mortality and functional impairment respectively. We included 477 middle-aged (50-64 years) and 563 older (65 + years) in iduals with cancer. The prevalence of comorbidity (at least one disease in addition to cancer) was 29% for middle-aged and 45% for older in iduals, with polypharmacy observed in 15% and 31% respectively. Presence of ≥ 3 comorbidities was associated with nearly three times as high a risk of mortality in middle-aged in iduals (HR 2.97, 95% CI: 1.43-6.16). In older in iduals, the HR was 1.7 (95% CI 1.1-2.8). Polypharmacy was associated with a higher risk of mortality in middle-aged (HR 2.35, 95% CI 1.32-4.16) but not in older in iduals (HR 1.2, 95% CI 0.9-1.8). Polypharmacy was associated with the four time the risk of functional impairment in middle-aged (OR 4.0, 95% CI 1.59-10.06) and older in iduals (OR 4.4, 95% CI 1.6-11.7). This study of middle-aged and older adults with cancer shows that comorbid disease is common in younger and older in iduals with cancer and are associated with inferior outcomes. Assessment and management of comorbidity should be a priority for cancer care across all age groups.
Publisher: Wiley
Date: 03-08-2020
DOI: 10.1111/JAN.14466
Publisher: Elsevier BV
Date: 2022
DOI: 10.1053/J.AJKD.2021.05.021
Abstract: Patients on home hemodialysis (HHD) may eventually return to in-center hemodialysis (ICHD) for clinical, technical, or psychosocial reasons. We studied the mortality of patients returning to ICHD after HHD, comparing it with the mortality experience among patients receiving HHD and patients receiving ICHD without prior treatment with HHD. Retrospective cohort study. All patients represented in the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) who commenced HD during 2005-2015 and were treated for >90 days. ICHD and/or HHD, and clinical characteristics at study entry. Mortality and cause of death. A time-varying multivariate Cox proportional hazards analysis with shared frailty was implemented to explore the association between patient treatment states and mortality. Patients were censored at the time of transplantation or change in treatment modality to peritoneal dialysis. A total of 19,306 patients initiated HD and were treated for >90 days. The mean age of patients was 60.8 ± 15.4 (SD) years, 62% were male, and 49% had diabetes. After HHD treatment failure, adjusted mortality was increased compared with continued HHD at 0-30 days (HR, 3.93 [95% CI, 2.09-7.40] P < 0.001), 30-90 days (HR, 3.34 [95% CI, 1.98-5.62] P 90 days (HR, 2.29 [95% CI, 1.84-2.85] P 90 days) periods after HHD treatment failure. Further investigation into the specific causes of treatment failure and death may highlight specific high-risk patients.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.JVS.2014.03.277
Abstract: Endovascular intervention has become a frequently used treatment of critical limb ischemia (CLI) in recent times. The recent Bypass vs Angioplasty in Severe Ischaemia of the Leg (BASIL) trial consensus recommended endovascular treatment as a first-line treatment in patients who have a life expectancy that was limited to <2 years. Despite these recommendations, there still remains limited data available to clinicians when seeking to risk stratify patients who present with CLI. The neutrophil-lymphocyte ratio (NLR) has been suggested to be a marker for predicting mortality and patency. This study aimed to investigate the use of the NLR as a prognostic marker for primary patency and mortality after an infrapopliteal endovascular intervention in patients with CLI. All patients who underwent tibial angioplasty for CLI were retrospectively analyzed. Demographics, degrees of stenosis, vessel patency rates, mortality, and comorbidities were recorded. NLRs were calculated from preoperative blood s les. Primary end points were all-cause mortality, primary patency, and utation-free survival (AFS) within the follow-up period of 12 months. Multivariate Cox proportional hazard models were used to identify independent predictors. Overall survival, AFS, and the probability of a vessel remaining patent were evaluated by standard Kaplan-Meier survival curves and groups compared by the log-rank test. Eighty-three patients were monitored for 12 months. Ninety limbs were identified, with 104 procedural events and 127 vessels undergoing successful angioplasty. The technical success rate was 86%, and patency at 1 year was 19%. Survival at 1 year was 76% and AFS was 61%. Patients with a NLR ≥5.25 had an increased risk of death (hazard ratio, 1.97 95% confidence interval, 1.08-3.62 P = .03) compared with those with a NLR of <5.25. Furthermore, those with lymphocytes counts of 1.5 × 10(9)/L. The NLR and absolute lymphocyte counts are potentially valuable prognostic indicators for risk stratification of patient's presenting with CLI undergoing infrapopliteal angioplasty.
Publisher: Wiley
Date: 05-01-2015
Abstract: To compare the efficacy of fentanyl administered via the subcutaneous (s.c.) or intranasal (i.n.) route with intramuscular (i.m.) pethidine in labouring women requesting analgesia. A randomised controlled trial three-armed, parallel-design. A regional hospital and the largest tertiary maternity centre in South Australia. One hundred and fifty-six healthy parturients birthing at term. Women were randomised to receive s.c. fentanyl (n = 53), i.n. fentanyl (n = 52), or i.m. pethidine (n = 51). The outcomes were analysed by intention-to-treat. Pain scores measured before and 30 minutes after opioid administration. All groups reported clinically significant reductions in pain scores (mean range 1.2-1.6 P < 0.001), with no significant differences between groups. Significantly more women in the fentanyl groups reported satisfaction with using the study drug again, compared with women receiving i.m. pethidine (82.9% i.n. fentanyl, 80.6% s.c. fentanyl, and 44.0% i.m. pethidine P < 0.01). Women in the fentanyl groups experienced less sedation (i.n. fentanyl 7.3%, s.c. fentanyl 2.9%, i.m. pethidine 44% P ≤ 0.03), shorter labours by at least 2 hours (P < 0.05), and fewer difficulties establishing breastfeeding (78.8% i.m. pethidine, 39.4% i.n. fentanyl, and 44.0% s.c. fentanyl P < 0.01). Neonates in the pethidine group were more likely to require nursery admission (P < 0.02). Fentanyl administered by s.c. and i.n. routes is as efficacious in relieving labour pain as i.m. pethidine, but resulted in greater satisfaction, less sedation, shorter labour, fewer nursery admissions, and fewer difficulties in establishing breastfeeding. Fentanyl appears to be a suitable alternative to pethidine when providing parenteral pain relief to labouring women.
Publisher: Cambridge University Press (CUP)
Date: 20-05-2016
DOI: 10.1017/S1368980016000999
Abstract: The mechanism by which the home food environment (HFE) influences childhood obesity is unclear. The present study aimed to investigate the relationship between HFE and childhood obesity as mediated by diet in primary-school children. Cross-sectional data collected from parents and primary-school children participating in the Obesity Prevention and Lifestyle Evaluation Project. Only children aged 9–11 years participated in the study. Matched parent/child data ( n 3323) were analysed. Exploratory factor analysis underlined components of twenty-one HFE items these were linked to child diet (meeting guidelines for fruit, vegetable and non-core food intakes) and measured child BMI, in structural equation modelling, adjusting for confounders. Twenty geographically bounded metropolitan and regional South Australian communities. School children and their parents from primary schools in selected communities. In the initial exploratory factor analysis, nineteen items remaining extracted eight factors with eigenvalues ·0 (72·4 % of total variance). A five-factor structure incorporating ten items described HFE. After adjusting for age, gender, socio-economic status and physical activity all associations in the model were significant ( P ·05), explaining 9·3 % and 4·5 % of the variance in child diet and BMI, respectively. A more positive HFE was directly and indirectly associated with a lower BMI in children through child diet. The robust statistical methodology used in the present study provides support for a model of direct and indirect dynamics between the HFE and childhood obesity. The model can be tested in future longitudinal and intervention studies to identify the most effective components of the HFE to target in childhood obesity prevention efforts.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-02-2019
Abstract: Patients with ESRD experience a substantially increased incidence of cancer, but few studies have examined patterns of cancer mortality among such patients. This population-based cohort study of Australian patients who initiated dialysis or received a kidney transplant from 1980 to 2014 found that the risk of cancer-related death among 52,936 patients on dialysis and 16,820 kidney transplant recipients was 2.5 times higher than that of age- and sex-matched controls in the general population. For patients on dialysis, increased cancer mortality is primarily from cancers that caused ESRD among transplant recipients, the increase is largely due to de novo cancers. Additional efforts are required to clarify factors and mechanisms involved in increased cancer risk and to improve early detection and management of cancer in this population. Patients with ESRD have a substantially increased cancer risk, but few studies have examined the patterns of cancer mortality along a patient's journey from dialysis to transplantation. We identified all Australian patients on dialysis and patients with transplants from 1980 to 2014 from the Australia and New Zealand Dialysis and Transplant Registry. Using standardized mortality ratios (SMRs), we compared cancer mortality among patients on dialysis and patients with transplants versus the general population (overall and by age, sex, year, and site) we also performed a subgroup analysis excluding patients with preexisting cancers. We followed 52,936 patients on dialysis and 16,820 transplant recipients for 170,055 and 128,352 patient-years, respectively. There were 2739 cancer deaths among patients on dialysis and 923 cancer deaths among transplant recipients. Overall, cancer SMRs were 2.6 for patients on dialysis and 2.7 for transplant recipients. For patients on dialysis, SMRs were highest for multiple myeloma (30.5), testicular cancer (17.0), and kidney cancer (12.5) for transplant recipients, SMRs were highest for non-Hodgkin lymphoma (10.7), kidney cancer (7.8), and melanoma (5.8). Some 61.0% of patients on dialysis and 9.6% of transplant recipients who experienced cancer death had preexisting cancer. The SMRs for de novo cancer was 1.2 for patients on dialysis and 2.6 for transplant recipients. Patients on dialysis and transplant recipients experienced .5-fold increased risk of cancer death compared with the general population. This increased risk was largely driven by preexisting cancers in patients on dialysis and de novo cancers in patients with transplants.
Publisher: Wiley
Date: 06-11-2015
DOI: 10.1002/CNCR.29129
Abstract: Previous reports have described differences in biology and outcome for colorectal cancer based on whether the primary is right or left sided. Further ision by right, left, and rectum or even exact primary site has also been explored. Possible differences in response to biological agents have also been reported based on side of primary lesion. We explored the South Australian registry for metastatic colorectal cancer to assess if there were any differences in patient characteristics, prognostic markers, and treatment received and outcomes based on whether the primary was right or left sided. We also explored if differences exist based on left colon and rectum and by exact primary site. Two thousand nine hundred seventy-two patients were analyzed. Thirty-five percent had a right-sided primary. The median overall survival for the entire group right versus left was 9.6 versus 20.3 months (P < .001). Multivariate analysis confirmed side of primary as an independent prognostic factor. For the group that had active therapy, defined as chemotherapy (± metastasis resection), median overall survival was right, 18.2 months and left, 29.4 months (P < .001). Importantly, we found no suggestion of major differences if left side was ided by left colon and rectum, and trends by in idual site still supported a left and right ision. Patients with a right-sided primary have more negative prognostic factors and indeed have inferior outcomes compared with those with a left-sided primary. Our data with further breakdown by exact site still favor a simple left-versus-right ision moving forward for metastatic colorectal cancer.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.JMOLDX.2022.03.007
Abstract: PCR is widely used to measure minimal residual disease (MRD) in lymphoid neoplasms, but its sensitivity is limited. High Adenine/Thymine PCR and High Annealing Temperature PCR (HAT-PCR) is a modified PCR designed to minimize nonspecificity and hence increase sensitivity. It was evaluated in the laboratory and the clinic, using s les from 58 patients. Of these patients, 57 were adolescents or young adults who were participating in the Australasian Leukemia and Lymphoma Group ALL06 trial in which MRD was measured in blood principally by HAT-PCR and in marrow by conventional PCR. HAT-PCR produced significantly less nonspecificity than conventional PCR, and its limit of detection was <10
Publisher: SAGE Publications
Date: 24-04-2023
DOI: 10.1177/00048674231167327
Abstract: Indigenous suicide prevention is an important focus for national health policies. Indigenous suicide rates in formerly colonial English-speaking countries such as the United States, Australia and New Zealand are considerably higher than the general population, particularly in young males. Given the similarities in their sociocultural history, a time series analysis was conducted to assess recent sex and age trends of suicide in the Indigenous and general populations in the United States, Australia and New Zealand. Using the number of deaths by intentional self-harm and estimated resident population, suicide incidence rates were calculated for the years 2006–2019 and stratified by Indigenous status, year, time period, sex and age group (above 15 years). Incidence rates were plotted. Using the Poisson regression model, calculated suicide incidence rate ratios were used to make comparisons for sex and age. Across all countries studied, Indigenous suicide rates have increased over time, with Indigenous males having higher suicide rates than Indigenous females. However, the increase in Indigenous female suicides was greater than that for Indigenous males in Australia and New Zealand. Indigenous males aged 15–44 years have the highest suicide rates across all countries. Indigenous suicide rates have remained consistently high in the United States, Australia and New Zealand, with Indigenous males aged 15–44 years showing the highest rate. However, suicide rates for Indigenous females in Australia and New Zealand are increasing more rapidly than males. Given this, it is critical that further research is dedicated to understanding and addressing the issues driving this problem, particularly in youth.
Publisher: Springer Science and Business Media LLC
Date: 25-06-2019
Publisher: Wiley
Date: 11-2020
DOI: 10.1111/NEP.13798
Publisher: CSIRO Publishing
Date: 18-05-2021
DOI: 10.1071/AH20299
Abstract: Objective Out-of-pocket healthcare expenditure (OOPHE) has a significant impact on marginalised households. The purpose of this study was to modify a pre-existing OOPHE survey for Aboriginal and Torres Strait Islander households with children. Methods The OOPHE survey was derived through a scoping review, face and content validity, including judgement quantification with content experts. Exploratory factor analyses determined factor numbers for construct validity. Repeatability through test–retest processes and reliability was assessed through internal consistency. Results The OOPHE survey had 168 items and was piloted on 67 Aboriginal and Torres Strait Islander parents. Construct validity assessment generated a 62-item correlation matrix with a three-factor model. Across these factors, item loadings varied, 10 items with high correlations ( .70) and 20 with low correlations ( .40). OOPHE survey retest was conducted with 47 families, where 43 items reached slight to fair levels of agreement. Conclusion The low level of item loadings to factors in the OOPHE survey indicates interconnectedness across the three-factor model, and reliability results suggest systemic differences. Impeding factors may include cohort homogeneity and survey length. It is unknown how cultural and social nuances specific to Aboriginal and Torres Strait Islander households impacts on results. Further work is warranted. What is known about the topic? Out-of-pocket healthcare expenditure (OOPHE) are expenses not covered by universal taxpayer-funded health insurance. In elderly Australians or those with chronic conditions, OOPHE can cause substantial burden and financial hardship and, in the most extreme cases, induce bankruptcy. Despite higher hospital admissions and disease burden, little is known about how OOPHE impacts Aboriginal and Torres Strait Islander families. Additionally, in Australia, no OOPHE survey tools have been appropriately assessed this includes for use with Aboriginal and Torres Strait Islander families. What does this paper add? This pilot study modified a pre-existing Australian OOPHE survey for use with Aboriginal and Torres Strait Islander households with children. Knowledge interface methodology was used to bring together Indigenous knowledges with quantitative survey methods. This was critical to ensuring Indigenous knowledges were central to the overall pilot study across item creation, participant focus, outcome contextualisation, interpretation, and resetting dominant norms. Outcomes have demonstrated pertinent points for future work in this area, such as the complexities in developing robust, culturally safe and specific surveys, which reach ideal psychometric levels of validity and reliability for Aboriginal and Torres Strait Islander communities. Certainly, it raises questions for current and future research using surveys in Aboriginal and Torres Strait Islander communities, which are generic and not purpose-built. What are the implications for practitioners? We recommend that OOPHE surveys should be developed with Aboriginal and Torres Strait Islander families from the outset, so they can include important contextual factors for Aboriginal and Torres Strait Islander households.
Publisher: Springer Science and Business Media LLC
Date: 1996
DOI: 10.1007/BF02823878
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.PUHE.2016.06.022
Abstract: To identify current prevalence and sociodemographic distribution of adherence to national diet and physical activity and sedentary behaviour guidelines among Australian primary school children. Cross-sectional survey of children (n = 4637, 9-11 years) participating at baseline in the South Australian Obesity Prevention and Lifestyle (OPAL) programme evaluation. Self-reported diet, physical activity (PA) and screen time (ST) behaviours were assessed via questionnaire. Children were classified as meeting or not meeting each guideline (two or more serves of fruit, five or more serves of vegetables, two or less serves of discretionary food, ≥60 min of PA, and ≤2 h of ST per day). Although 65% of children met fruit recommendations, only 22% met vegetable recommendations (17% consumed no vegetables). Approximately one-quarter (28%) of children met discretionary food recommendations. Only 17% of children met the ST recommendations and 33% met PA recommendations. Less than 1% of children met all five recommendations. Rural children were more likely to meet both PA (OR = 1.45, 95% CI: 1.21-1.74, P < 0.001) and ST (OR = 1.37, 95% CI: 1.14-1.66, P < 0.01) recommendations than urban counterparts. Children at least socio-economic disadvantage performed better than those at greatest disadvantage for most behaviours. Improvement in Australian children's diet and physical activity and sedentary behaviours, particularly urban children and those at greatest socio-economic disadvantage, is urgently warranted.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.JPSYCHIRES.2022.09.048
Abstract: Locus of control (LoC) is a social cognition, that relates to the level of self-control that people have over their personal environment that influences their life. In this context, LoC is frequently associated with work-related behavioral outcomes, ranging from job attitudes, career behaviors, stress, and burnout. To investigate the association between LoC, and work-related behavioral factors, socio-cultural factors, and personal factors among Australian General Practitioners (GPs). This study utilized data from the 2010 Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors. Locus of control (LoC) was measured by a 7-point Likert scale based on Pearlin-Schooler Mastery/Self-efficacy 7-item Scale. Higher score indicated lower internal LoC. Multivariate linear regression model was performed to determine the independent predictors of LoC. Of 3,664 GP participants, LoC did not differ by gender. Poor/fair self-rated health, working in urban location, running a stressful practice, poor balance of professional and personal commitments, poor support network, financial circumstances after retirement, and perception of unrealistic expectation by patients were significant predictors for a lower Internal LoC in a multivariate linear regression model. Adjusted R LoC of Australian GPs is negatively affected by poor work-life balance, inadequate support, and unrealistic patient expectation. These work-place specific factors could be targeted by interventions to improve GPs wellbeing.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2013
DOI: 10.1200/JCO.2013.31.15_SUPPL.3592
Abstract: 3592 Background: Preclinical data suggest that adiposity activates pro-inflammatory and insulin-dependent pathways which may lead to resistance to TT, e.g., bevacizumab (Bev) or cetuximab (Cet). Only two retrospective trials have studied the relationship between BMI and outcome for mCRC pts who received TT, with conflicting results. Our aim was to compare OS across BMI groups for mCRC pts treated with TT. Methods: Retrospective data, pertaining to clinical characteristics and outcome, were obtained from the South Australian Registry for mCRC from Feb 2006-Oct 2012. The BMI at first treatment was grouped as Normal (N) = 18.5- , Overweight (OW) = 25- , Obese I(Ob1) = 30- , Obese II (Ob2)≥35. Results: Of 1,174 pts, 39% were OW, 15% Ob1 and 7% Ob2. 352 pts received chemo+TT (Bev, Cet, panitumumab (Pan) and/or regorafenib) and 814 chemo alone. Baseline characteristics were similar across all BMI groups except for type of mCRC: N pts were more likely than obese pts to have synchronous CRC (77.9% vs 56-69.7% for obese). On adjustment for age, sex, synchronous disease, metastatic sites, number of lines of chemo and TT, median OS was longer for N versus OW or Ob1 pts with chemo+TT (35.4 vs 24.9 or 22.7 mons, Table) with no difference in OS for chemo alone. Only N gp pts had an improvement in OS on the addition of TT to chemo. On breakdown by type of TT, OW and Ob1 pts had a poorer outcome with Bev but not with EGFR TT. Conclusions: The BMI is an independent predictor for a poorer outcome for OW and OB1 pts with chemo+TT, specifically for pts receiving Bev. The OW and OB1 patients may be a target group for lifestyle and nutrition advice to improve OS with TT. Prospective studies are required to validate this finding. [Table: see text]
Publisher: Wiley
Date: 09-10-2013
DOI: 10.1111/AJAG.12105
Abstract: To explore general practitioners (GPs)knowledge of ageing, attitudes towards older people and factors affecting their knowledge and attitudes in a Chinese context. Four hundred GPs were surveyed using the Chinese version of the Aging Semantic Differential (CASD) and the Chinese version of the Facts on Aging Quiz (CFAQ1) scale. The CASD scores indicated that GPs had a neutral attitude towards older people. The CFAQ1 scores indicated a low level of knowledge about ageing. GPs' awareness of the mental and social facts of ageing was poorer compared to that of physical facts. Male GPs had a significantly higher negative bias score than female GPs. No other variables had a statistically significant influence on knowledge and attitudes. The findings suggest the need for education interventions for GPs regarding knowledge of ageing and also provide evidence to guide future development of continuing medical programs for this group of medical doctors.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-09-2021
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.ORCP.2014.04.001
Abstract: The glomerular filtration rate (GFR) can be estimated by an equation that incorporates patients' age, gender, creatinine and weight or, ideally, lean body mass (LBM). However, measuring LBM is not easy if the patient is obese. The aim was to determine an acceptable bedside method for GFR estimation in obese patients. In 82 obese Caucasian outpatients, anthropometric and other characteristics were collected including LBM by impedance analysis. Estimates of GFR were compared with a reference equation (CCGLBM) using Bland-Altman plots, correlation analysis and an independent s le t-test. The patients (72% female) were aged 43.1±12.7 years with BMI 47.0±8.0 kg/m(2), height 168.4±9.4 cm and serum creatinine 70.3±25.7 μM. The GFR estimated by the CCGLBM equation was 98.2±33.6 ml/min compared to other equations which ranged from 100.0±22.8 to 218.4±85.5 ml/min. Any equation incorporating actual body weight overestimated the GFR by >120 ml/min (p<0.001) with a significant fixed proportional bias (p<0.001). For GFRs between 20 and 180 ml/min, an equation using ideal body weight (CCGIBW) equated to the CCGLBM estimate. The Modified Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations performed as well as the CCGLBM in estimating GFR but with proportional bias (p<0.001). Considering the ease of calculation of the CCGIBW at the bedside, it has a role in GFR estimation of obese inpatients.
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.PEC.2021.07.020
Abstract: To evaluate the effects of a nurse-led health coaching programme for stroke survivors and family caregivers in hospital-to-home transition care. A total of 140 dyads of stroke survivors and their family caregivers were recruited and randomly assigned to either the intervention group (received a 12-week nurse-led health coaching programme) or the usual care group. The primary outcome was self-efficacy, and secondary outcomes were quality of life (QoL), stroke-related knowledge, and caregiver-related burden. The outcomes were measured at baseline, 12 and 24 weeks. Stroke survivors in the intervention group demonstrated a significant improvement in self-efficacy at 12 weeks (x̅: 24.9, 95%CI: 20.2-29.6, p < 0.001) and at 24 weeks (x̅: 23.9, 95%CI: 19.2-28.6, p < 0.001) compared to the usual care group. Findings also demonstrated significant increases in stroke survivors' QoL, stroke-related knowledge, and reduction in unplanned hospital readmissions and caregiver-related burden. There were no statistically significant changes in other outcomes between the two groups. The nurse-led health coaching programme improved health outcomes for both stroke survivors and their caregivers. Findings from the study suggest that nurse-led health coaching should be incorporated into routine practice in hospital-to-home transitional care for stroke survivors and their caregivers.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Springer Science and Business Media LLC
Date: 07-02-2023
DOI: 10.1186/S12877-023-03800-W
Abstract: Studies revealed that supporting residents fulfilling self-determination is positively associated with their health, wellbeing and quality of life. Cross-cultural care poses significant challenges for nursing home residents to fulfil their self-determination in control of own care and maintaining meaningful connections with others. The aim of the study was to compare factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes. A qualitative descriptive approach was applied to the study. Culturally competent care and person-centred care were employed as guiding frameworks. In idual interviews or a focus group with residents and family members were conducted to collect data. In total, 29 participants participated in the study. Three main themes were identified: communicating needs and preferences mastering own care and maintaining meaningful relationships. Each theme includes sub-themes that detail similarities and differences of factors affecting residents fulfilling self-determination in the two type nursing homes. Findings indicate that residents from both types of nursing homes experienced challenges to communicate their care needs and preferences in daily care activities. Moreover, residents or their representatives from both types of nursing homes demonstrated motivation and competence to master residents’ care based on their in idual preferences, but also perceived that their motivation was not always supported by staff or the nursing home environment. Residents’ competence in mastering their care activities in ethno-specific nursing homes was based on the condition that they were given opportunities to use a language of choice in communication and staff and the nursing home demonstrated culturally competent care for them. In addition, ethno-specific nursing homes showed more recourse to support residents to maintain meaningful relationships with peers and others. Culturally competent care created by staff, nursing homes and the aged care system is a basic condition for residents from ethnic minority groups to fulfil self-determination. In addition, person-centred care approach enables residents to optimise self-determination.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: Springer Science and Business Media LLC
Date: 10-06-2022
DOI: 10.1186/S12913-022-08148-2
Abstract: The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protocol introduces the ‘Partnership in iSupport program’ that includes five interventional components: managing transitions, managing dementia progression, psychoeducation, carer support group and feedback on services. This health services research is built on family carer and dementia care service provider partnerships. The aims of the study are to evaluate the effectiveness, cost-effectiveness and family carers’ experiences in the program. A multicentre randomised controlled trial will be conducted with family carers of people living with dementia from two tertiary hospitals and two community aged care providers across three Australian states. The estimated s le size is 185 family carers. They will be randomly assigned to either the intervention group or the usual care group. Outcomes are measurable improvements in quality of life for carers and people with dementia, caregiving self-efficacy, social support, dementia related symptoms, and health service use for carers and their care recipients. Data will be collected at three time points: baseline, 6 months and 12 months post-initiation of the intervention. This is the first large randomised controlled trial of a complex intervention on health and social care services with carers of people living with dementia in real-world practice across hospital and community aged care settings in three Australian states to ascertain the effectiveness, cost-effectiveness and carers’ experiences of the innovative program. We expect that this study will address gaps in supporting dementia carers in health and social care systems while generating new knowledge of the mechanisms of change in the systems. Findings will strengthen proactive health management for both people living with dementia and their carers by embedding, scaling up and sustaining the ‘Partnership in iSupport program’ in the health and social care systems. The Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12622000199718 . Registered February 4 th , 2022.
Publisher: SAGE Publications
Date: 24-03-2016
Abstract: Most caregiver interventions in a multicultural society are designed to target caregivers from the mainstream culture and exclude those who are unable to speak English. This study addressed the gap by testing the hypothesis that personalized caregiver support provided by a team led by a care coordinator of the person with dementia would improve competence for caregivers from minority groups in managing dementia. A randomised controlled trial was utilised to test the hypothesis. Sixty-one family caregivers from 10 minority groups completed the trial. Outcome variables were measured prior to the intervention, at 6 and 12 months after the commencement of trial. A linear mixed effect model was used to estimate the effectiveness of the intervention. The intervention group showed a significant increase in the caregivers’ sense of competence and mental components of quality of life. There were no significant differences in the caregivers’ physical components of quality of life.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2012
Publisher: Elsevier BV
Date: 06-2013
Publisher: AME Publishing Company
Date: 10-2019
Publisher: Springer Science and Business Media LLC
Date: 12-07-2023
DOI: 10.1007/S00268-023-07114-1
Abstract: Minimally-invasive pancreatoduodenectomy (MIPD) is fraught with the risk of complication-related deaths (LEOPARD-2), a significant volume-outcome relationship and a long learning curve. With rates of conversion for MIPD approaching 40%, the impact of these on overall patient outcomes, especially, when unplanned, are yet to be fully elucidated. This study aimed to compare peri-operative outcomes of ( unplanned ) converted MIPD against both successfully completed MIPD and upfront open PD. A systematic review of major reference databases was undertaken. The primary outcome of interest was 30-day mortality. Newcastle–Ottawa scale was used to judge the quality of the studies. Meta-analysis was performed using pooled estimates, derived using random effects model. Six studies involving 20,267 patients were included in the review. Pooled analysis demonstrated ( unplanned ) converted MIPD were associated with an increased 30-day (RR 2.83, CI 1.62- 4.93, p = 0.0002, I 2 = 0%) and 90-day (RR 1.81, CI 1.16- 2.82, p = 0.009, I 2 = 28%) mortality and overall morbidity (RR 1.41, CI 1.09 1.82, p = 0.0087, I 2 = 82%) compared to successfully completed MIPD. Patients undergoing ( unplanned ) converted MIPD experienced significantly higher 30-day mortality (RR 3.97, CI 2.07 7.65, p 0.0001, I 2 = 0%), pancreatic fistula (RR 1.65, CI 1.22- 2.23, p = 0.001, I 2 = 0%) and re-exploration rates (RR 1.96, CI 1.17- 3.28, p = 0.01, I 2 = 37%) compared upfront open PD. Patient outcomes are significantly compromised following unplanned intraoperative conversions of MIPD when compared to successfully completed MIPD and upfront open PD. These findings stress the need for objective evidence-based guidelines for patient selection for MIPD.
Publisher: Springer Science and Business Media LLC
Date: 03-10-2023
Publisher: Informa UK Limited
Date: 23-03-2023
Publisher: MDPI AG
Date: 10-06-2022
Abstract: Background and Aims: A concerning rise in incidence of young-onset cancers globally led to the examination of trends in incidence and survival of gastrointestinal (GI) adenocarcinomas in the Northern Territory (NT), Australia, over a 28-year period, with a special emphasis on Indigenous peoples. Methods: This cross-sectional analysis of a prospective longitudinal database, NT Cancer Registry (1990–2017), includes all reported cases of GI (oesophagus, gastric, small intestinal, pancreas, colon, and rectum) adenocarcinomas. Poisson regression was used to estimate incidence ratio ratios, and survival was modelled using Cox proportional hazard models separately for people aged 18–50 years and years. Results: A total of 1608 cases of GI adenocarcinoma were recorded during the time of the study. While the overall incidence in people 18–50 years remained unchanged over this time (p = 0.51), the rate in in iduals aged years decreased (IRR = 0.65 (95% CI 0.56–0.75 p 0.0001)). Incidence rates were significantly less in females years (IRR = 0.67 95% CI 0.59–0.75 p 0.0001), and their survival was significantly better (HR = 0.84 (95%CI 0.72–0.98 p 0.03)) compared to males. Overall survival across all GI subsites improved in both age cohorts, especially between 2010 and 2017 (HR = 0.45 (95%CI 0.29–0.72 p 0.0007) and HR = 0.64 (95%CI 0.52–0.78 p 0.0001), respectively) compared to 1990–1999, driven by an improvement in survival in colonic adenocarcinoma alone, as the survival remained unchanged in other GI subsites. The incidence was significantly lower in Indigenous patients compared to non-Indigenous patients, in both age cohorts (18–50 years IRR = 0.68 95% CI 0.51–0.91 p 0.009 and years IRR = 0.48 95% CI 0.40–0.57 p 0.0001). However, Indigenous patients had worse survival rates (18–50 years HR = 2.06 95% CI 1.36–3.11 p 0.0007 and years HR = 1.66 95% CI 1.32–2.08 p 0.0001). Conclusions: There is a trend towards an increased incidence of young-onset GI adenocarcinomas in the NT. Young Indigenous patients have lower incidence but worse survival across all GI subsites, highlighting significant health inequities in life expectancy. Targeted, culturally safe Indigenous community-focussed programs are needed for early detection and patient-centred management of GI adenocarcinomas.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-05-2013
DOI: 10.1200/JCO.2013.31.15_SUPPL.1581
Abstract: 1581 Background: Patients considered for liver resection (LR) for hepatic metastases from metastatic colorectal cancer (mCRC) have an 18 FDG-PET CT scan (PET) to exclude extrahepatic disease (EHD). The prognostic significance of an equivocal PET on overall survival (OS) for patients who proceed to LR is not entirely clear. The aim of the study is to compare OS for patients with equivocal PET prior to LR to those with a PET negative for EHD. Methods: The South Australian Metastatic Colorectal Cancer Registry collects data for mCRC patients diagnosed after February 1, 2006. Patients were included if they had LR and a PET prior to LR. PETs were coded as no EHD and possible EHD. The Cox proportional hazard model was applied to analyse the outcome of patients with an equivocal PET for EHD on OS, adjusting for possible confounders. Results: Of the 2,480 patients on the registry, 273 had had LR. Of these, 183 (67.0%) had a PET prior to LR, with 137 having no EHD and 46 having possible EHD. The no EHD and possible EHD groups were well balanced for patient, tumour and treatment characteristics – mean age: 66.7 yrs-vs-68.4 yrs, male gender: 61.3%-vs-63.0%, KRAS wildtype: 11.0%-vs-16.3%, stage IV disease at initial diagnosis: 49.6%-vs-54.3%, colonic primary: 74.4%-vs-65.2%, one LR: 82.5%-vs-89.1%, one line of chemotherapy: 52.4%-vs-48.6% and well-moderate tumour differentiation: 85.7%-vs-86.4%. The median follow-up was 32.9 months for no EHD and 33.6 months for possible EHD (P-value = 0.84). The OS for no EHD compared with possible EHD at 1-year was 98.5%-vs-93.5%, at 2-years was 87.6%-vs-88.0%, and at 5-years was 61.5%-vs-59.4%. The unadjusted hazard ratio for OS was 1.22 (95% CI 0.64–2.34, P-value = 0.54) for possible EHD. On adjustment for age, gender, stage at diagnosis, primary site, number of LRs, lines of chemotherapy and tumour differentiation, the hazard ratio remained non-significant however lower (HR=0.76 (95% CI 0.37–1.59, P-value = 0.47)), for possible EHD. Conclusions: A PET was only performed in 67.0% of patients who had LR for mCRC. There was no difference in OS between patients with no EHD and possible EHD on PET who proceed to LR.
Publisher: Informa UK Limited
Date: 15-02-2016
Publisher: Springer Science and Business Media LLC
Date: 21-02-2012
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.GERINURSE.2015.04.013
Abstract: The aim of this study was to investigate caregiver distress in reacting to the care recipient's behavioral and psychological symptoms of dementia (BPSD) and factors contributing to caregiver distress in the community setting in China. One hundred and fifty-two family caregivers of people with dementia in community settings were assessed using the Chinese version of the Neuropsychiatric Inventory-Questionnaire and the Social Support Rating Scale. The prevalence of BPSD and caregiver distress in reacting to BPSD was higher in China than those reported in high income countries. The most common in idual BPSD were apathy/indifference, depression/dysphoria and night-time behaviors. Delusions, hallucinations and apathy/indifference were rated as the most distressing to caregivers. BPSD contributed most to caregiver distress. The high level of caregiver distress identified in this study suggests that dementia services and caregiver support should be established in the public healthcare system to target the needs of people with dementia and their caregivers.
Publisher: JMIR Publications Inc.
Date: 29-05-2023
DOI: 10.2196/47152
Abstract: Informal caregivers of people living with dementia experience a higher level of physical and mental stress compared with other types of caregivers. Psychoeducation programs are viewed as beneficial for building caregivers’ knowledge and skills and for decreasing caregiver stress. This review aimed to synthesize the experiences and perceptions of informal caregivers of people with dementia when participating in web-based psychoeducation programs and the factors that enable and impede informal caregivers’ engagement in web-based psychoeducation programs. This review followed the Joanna Briggs Institute protocol of systematic review and meta-aggregation of qualitative studies. We searched 4 English databases, 4 Chinese databases, and 1 Arabic database in July 2021. A total of 9 studies written in English were included in this review. From these studies, 87 findings were extracted and grouped into 20 categories. These categories were further synthesized into 5 findings: web-based learning as an empowering experience, peer support, satisfactory and unsatisfactory program content, satisfactory and unsatisfactory technical design, and challenges encountered in web-based learning. High-quality and carefully designed web-based psychoeducation programs offered positive experiences for informal caregivers of people living with dementia. To meet broader caregiver education and support needs, program developers should consider information quality and relevancy, the support offered, in idual needs, flexibility in delivery, and connectedness between peers and program facilitators.
Publisher: Elsevier BV
Date: 05-1994
Publisher: Wiley
Date: 11-2021
DOI: 10.1111/AJCO.13716
Publisher: Wiley
Date: 07-07-2023
DOI: 10.1111/JOCN.16440
Abstract: To explore and compare staff perceived challenges and facilitators in supporting resident self‐determination in ethno‐specific and mainstream nursing homes. Staff and residents in ethno‐specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic ersity. This socio‐demographic change poses significant challenges for staff to support resident self‐determination of their own care. In‐depth understanding of those challenges in the two types of nursing homes is much needed to inform practice in nurse‐led nursing home care settings. A qualitative description approach with thematic analysis was used in the study. Data were collected through five focus groups with 29 various direct care workers from two ethno‐specific nursing homes and a mainstream nursing home in Australia between March–September 2020. The study report followed the COREQ checklist. Four themes were identified from focus group data. First, participants perceived communication challenges in identifying residents' preferences, especially in ethno‐specific nursing homes. Second, team efforts that included residents and their family members were highly valued as a way to meet residents' preferences. Third, participants described various levels of staff engagement in residents' care planning. In addition, staff in ethno‐specific nursing homes possessed richer resources to maintain meaningful relationships for residents compared with their counterparts in the mainstream nursing home. Staff in ethno‐specific nursing homes experience more challenges in supporting resident self‐determination but have richer resources to develop culturally safe and culturally competent care compared with their counterparts in the mainstream nursing home. Findings provide new insights into challenges and practical solutions in supporting residents to self‐determine their own care in cross‐cultural aged care. This study was co‐designed with three aged care organisations who funded the study. Staff employed by these organisations participated in the study.
Publisher: BMJ
Date: 11-03-2014
Publisher: Elsevier BV
Date: 10-1994
DOI: 10.1016/0010-7824(94)90023-X
Abstract: An attempt has been made to study the use pattern of traditional and modern methods of fertility control among currently married women of reproductive ages utilizing the 1989 BFS data. Bivariate analysis has been employed to study the differentials in the use pattern by some selected demographic and socio-economic characteristics. Also, multivariate logistic regression analysis has been used to identify independent contributions of each selected covariate. It has been observed, however, that there is universality of knowledge about contraceptive methods. Of the total 31 percent, about 23 percent were using modern methods and the rest, 8 percent, traditional methods. Analysis using a logistic regression model showed that visits of family planning workers have very strong and positive influence on the current use of modern contraceptives as compared to traditional methods. Duration of effective marriage also emerged as a strong determinant of modern versus traditional methods use but it influenced modern methods use negatively. Also, administrative ision is an important variable. Residents of Rajshahi ision were significantly more (relative odds of 2.5) likely to be using modern methods than residents of Chittagong ision. The likelihood of women having electricity in their household of being a current user of modern contraceptives is almost 2 times higher compared to women without electricity in their households. Education and occupation of husbands also exerts effect on current use of modern contraceptives. The odds of current use of modern methods among women whose husbands have secondary and higher level of education is one-and-a-half times higher than that of women with husbands having no formal education. However, wives of landowners were less (relative odds of 0.72) likely to use these methods as compared to traditional methods than wives of labourers or farmers. The probability of current use of modern contraceptives was higher (relative odds of 1.5) among women who discussed family planning with their husbands than those who did not.
Publisher: Elsevier BV
Date: 12-2015
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
No related grants have been discovered for Shahid Ullah.