ORCID Profile
0000-0001-7440-8154
Current Organisation
University of Adelaide
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Publisher: Public Library of Science (PLoS)
Date: 21-06-2018
Publisher: Wiley
Date: 09-2014
DOI: 10.1111/PPE.12149
Abstract: There is limited longitudinal data from high-income countries on the sequelae of anaemia during pregnancy. The aim of this study is to examine whether anaemia of pregnancy is associated with adverse perinatal outcomes and with children's developmental vulnerability. We conducted a population-based study to link routinely collected government administrative data that involved all live births in the state of South Australia 1999-2005 (n = 124 061) and a subset for whom developmental data were collected during a national census of children attending their first year of school in 2009 (n = 13 654). Perinatal outcomes were recorded by midwives using a validated, standardised form. Development was recorded by schoolteachers using the Australian Early Development Index (AEDI). Children in the lowest 10% of AEDI scores are indicative of developmental vulnerability. There were 8764/124 061 (7.1%) cases of anaemia. After adjustment for a range of potentially confounding factors, anaemia of pregnancy was associated with a higher risk of fetal distress [incident rate ratio (IRR) 1.20 [95% CI 1.13, 1.27]] and preterm birth <37 weeks gestation (IRR 1.23 [1.15, 1.31]), slightly higher birthweight [14 g (2, 26)] and newborns were less likely to require resuscitation (IRR 0.94 [0.91, 0.097]). Anaemia of pregnancy was not associated with children's developmental vulnerability after adjustment for maternal, obstetric and sociodemographic covariables, either in complete case analyses (n = 11 949) or after imputation for missing data (n = 13 654). Anaemia of pregnancy is associated with perinatal complications but not with children's developmental vulnerability at school entry.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.JPEDS.2014.06.011
Abstract: To examine the association between domain-specific qualities of formal childcare at age 2-3 years and children's task attentiveness and emotional regulation at age 4-5 and 6-7 years. We used data from the Longitudinal Study of Australian Children (n = 1038). Three domain-specific aspects of childcare quality were assessed: provider and program characteristics of care, activities in childcare, and carer-child relationship. Two self-regulatory abilities were considered: task attentiveness and emotional regulation. Associations between domain-specific qualities of childcare and self-regulation were investigated in linear regression analyses adjusted for confounding, with imputation for missing data. There was no association between any provider or program characteristics of care and children's task attentiveness and emotional regulation. The quality of activities in childcare were associated only with higher levels of emotional regulation at age 4-5 years (β = 0.24 95% CI, 0.03-0.44) and 6-7 years (β = 0.26 95% CI, 0.04-0.48). Higher-quality carer-child relationships were associated with higher levels of task attentiveness (β = 0.20 95% CI, 0.05-0.36) and emotional regulation at age 4-5 years (β = 0.19 95% CI, 0.04-0.34) that persisted to age 6-7 years (β = 0.26 95% CI, 0.10-0.42 β = 0.31 95% CI, 0.16-0.47). Among children using formal childcare, those who experienced higher-quality relationships were better able to regulate their attention and emotions as they started school. Higher emotional regulation was also observed for children engaged in more activities in childcare. Beneficial effects were stable over time.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2007
Abstract: The aim of this study was to assess the impact that Academic Detailing (AD) had on General Practitioners' use of diagnostic imaging for shoulder complaints in general practice and their knowledge and confidence to manage shoulder pain. One-to-one Academic Detailing (AD) for management of shoulder pain was delivered to 87 General Practitioners (GPs) in metropolitan Adelaide, South Australia, together with locally developed clinical guidelines and a video/DVD on how to examine the shoulder. Three months after the initial AD a further small group or an in idual follow up session was offered. A 10-item questionnaire to assess knowledge about the shoulders was administered before, immediately after, and 3 months after AD, together with questions to assess confidence to manage shoulder complaints. The number of requests for plain film (X-ray) and ultrasound (US) imaging of the shoulder was obtained for the intervention group as well as a random comparison group of 90 GP's from the same two Divisions. The change in the rate of requests was assessed using a log Poisson GEE with adjustment for clustering at the practice level. A linear mixed effects model was used to analyse changes in knowledge. In an average week 54% of GPs reported seeing fewer than 6 patients with shoulder problems. Mean (SD) GP knowledge score before, immediately after and 3-months after AD, was 6.2/10 (1.5) 8.6/10 (0.96) and 7.2/10 (1.5) respectively (p 0.0001). Three months after AD, GPs reported feeling able to take a more meaningful history, more confident managing shoulder pain, and felt their management of shoulder pain had improved. Requests for ultrasound imaging were approximately 43.8% higher in the period 2 years before detailing compared to six months after detailing (p 0.0001), but an upward trend toward baseline was observed in the period 6 months to 1 year after AD. There was no statistically significant change in the rate of requests from before to after AD for plain-radiographs (p = 0.11). No significant changes in the rate of requests over time were observed in the control groups. These results provide evidence that AD together with education materials and guidelines can improve GPs' knowledge and confidence to manage shoulder problems and reduce the use of imaging, at least in the short term.
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.3109/00313020903494045
Abstract: To assess the level of agreement between international normalised ratio (INR) results obtained from pathology laboratories and point of care testing (PoCT) devices used in a general practice setting. INR pathology results were collected from multiple pathology laboratories and CoaguChek S PoCT devices over a 6 month period. Agreement was assessed using both clinically relevant agreement and the Bland Altman method. Analysis was based on 1664 dual measurements collected on 417 patients from 26 general practices across Australia. The percentage of dual measurements satisfying the expanded and narrow agreement criteria were 91% and 89%, respectively. The mean difference in results and the 95% limits of agreement depended on the average INR result: mean difference = -0.30 + 0.08 x average 95% limits of agreement = -0.30 + 0.08 x average +/- 0.77. The current study provides further evidence that PoCT is an acceptable alternative to pathology laboratory testing in a general practice setting. The Bland Altman method is a useful and flexible tool for assessing agreement. Limits of agreement should be reported in future method comparison studies to assist clinicians in patient management.
Publisher: Royal College of General Practitioners
Date: 03-2010
Publisher: Oxford University Press (OUP)
Date: 06-12-2010
Abstract: Point-of-care testing (PoCT) is increasingly being used in the general practice setting and has the potential to provide improved health outcomes for patients. The aim of the study was to systematically assess the literature relating to the analytical performance, clinical effectiveness, cost and satisfaction of patients and health professionals with PoCT for monitoring patients with diabetes, with hyperlipidaemia or requiring anticoagulant therapy in general practice. Systematic review and synthesis of randomized and quasi-randomized trials during 1966-2007 was performed. PubMed, EMBASE, CINAHL, Current Contents, BIDS and the Cochrane Library databases were searched using key terms relating to PoCT for diabetes (glycosylated haemoglobin, urine albumin creatinine ratio), hyperlipidaemia (total cholesterol, triglycerides and high-density lipoprotein) and anticoagulant therapy (international normalized ratio) in the general practice setting. Nine papers from six randomized or quasi-randomized trials were included in the review. Large between-study heterogeneity made pooling of the data inappropriate. In terms of clinical effectiveness, no study found a significant difference between PoCT and pathology laboratory testing. There was a similar lack of data in relation to the analytical performance of PoCT, to cost outcomes and to patient and health professional satisfaction, making conclusions difficult to infer. This systematic review does not provide robust evidence that PoCT in general practice improves patient health outcomes, that it has comparable analytical quality to pathology laboratory testing, that it is cost-effective compared to usual care or that patients and health professionals find PoCT satisfactory. The number of trials is low, the follow-up of patients is short and many of the trials did not investigate PoCT as a separate intervention.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.CLINBIOCHEM.2009.11.014
Abstract: Investigate agreement between lipid pathology results from point-of-care testing (PoCT) devices and laboratories. Agreement was assessed using the Bland-Altman method. : Mean difference (limits of agreement) were: -0.28 mmol/L (-1.04, 0.48) for total cholesterol, -0.09 mmol/L, (-0.55, 0.36) for HDL-C. Median difference (nonparametric limits of agreement) were 0.07 mmol/L, (-0.40, 3.04) for triglycerides. The clinical acceptability of the variation between lipid PoCT and laboratory test results is debatable but our work provides baseline data for further research.
Publisher: Springer Science and Business Media LLC
Date: 13-07-2023
DOI: 10.1007/S10461-022-03790-7
Abstract: HIV is a manageable chronic illness, due to advances in biomedical management. However, many people living with HIV (PLHIV) continue to experience psychosocial challenges, which have been associated with poorer quality of life (QoL). This study aimed to explore how psychosocial factors contributed to the QoL of PLHIV in Australia specifically, the relationship between HIV-related stigma, social connectedness, mental health, and QoL. Participants were 122 PLHIV attending The Albion Centre (a tertiary HIV clinic in Sydney, Australia), who completed questionnaires which measured HIV-related stigma, social support, mental health symptomology and QoL. Results indicated that HIV-related stigma predicted poorer QoL, as did mental health symptomology. Conversely, social connectedness improved QoL. Additionally, social connectedness was found to mediate the relationship between HIV-related stigma and QoL, whereas the hypothesized moderating role of mental health symptomology on this model was not significant. These findings provide insight into the impact of psychosocial factors on QoL, offering practitioners various points of clinical intervention.
Publisher: BMJ
Date: 09-09-2015
DOI: 10.1136/ARCHDISCHILD-2014-306626
Abstract: To investigate whether the total amount of time in childcare through the first 3 years of life was associated with children's receptive vocabulary, externalising and internalising problem behaviours at age 4–5 years, and whether this association varied for different types of childcare. We used data from the prospective, population-based Longitudinal Study of Australian Children (n=3208–4066, depending on outcome). Parental reports of the time spent in different types of childcare were collected at face-to-face interviews at age 0–1years and at age 2–3 years. Children's receptive vocabulary was directly assessed in the child's home, and externalising and internalising behaviours were measured by questionnaire, completed by parents and teachers at age 4–5 years. At 3 years of age, 75% of the s le spent regular time in the care of someone other than the parent. After adjustment, more time in childcare was not associated with children's receptive vocabulary ability but was associated with higher levels of parent-reported (β=0.10 (95% CI 0.00 to 0.21)) and teacher-reported (β=0.31 (0.19 to 0.44)) externalising problem behaviours and lower levels of parent-reported internalising problem behaviours (β=−0.08 (−0.15 to −0.00)). Compared with children who did not attend any type of childcare, children in centre-based care had higher parent-reported and teacher-reported externalising and lower internalising problem behaviours. More time in centre-based childcare (but not other types of care) through the first 3 years of life was associated with higher parent-reported and teacher-reported externalising problem behaviours, and lower parent-reported internalising problem behaviours but not with children's receptive vocabulary ability at school entry.
Publisher: BMJ
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 06-08-2008
Publisher: BMJ
Date: 31-03-2015
Abstract: Higher quality childcare in the years before school may help narrow developmental gaps between the richest and poorest children in our societies, but specific evidence is limited and inconsistent. We address this issue by examining whether higher quality childcare is associated with better developmental outcomes at school entry for children from lower than higher income families. The s le from the Longitudinal Study of Australian Children included children attending childcare from 2 to 3 years (n=980-1187, depending on outcome). Childcare quality was measured using carers assessment of their relationship with the child. Children's receptive vocabulary was directly assessed in the child's home, and behavioural difficulties were measured by teachers and parents at 4-5 years. We assessed additive and multiplicative income-related effect measure modification of the quality of carer-child relationship on developmental outcomes. After adjusting for confounding, there was some evidence of effect measure modification on the additive and multiplicative scales of childcare quality by income. Children experiencing higher quality relationships and lower income had almost the same risk of poorer receptive vocabulary as children in higher quality relationships and higher incomes (relative excess risk due to interaction=0.18 95% CI -0.20 to 0.52), ratio of relative risks=1.11 (1.04 to 1.17)). These patterns were similar for teacher-reported and parent-reported behavioural difficulties. The effects of higher quality childcare, in terms of quality relationships with carers, on children's cognitive and behavioural development at school entry were stronger among children from lower income families. This provides some evidence that higher quality relationships in childcare may be especially important in helping reduce developmental gaps for children from lower income families.
Publisher: BMJ
Date: 09-06-2020
Abstract: To investigate whether time spent in educational activities at 2–3 years and developmental outcomes at school entry differ among children from different socioeconomic backgrounds. Participants were from the Longitudinal Study of Australian Children (n=4253). Time spent in educational activities was collected using 24-hour time-use diaries. Income was measured using parent self-report. Receptive vocabulary was assessed using the Peabody Picture Vocabulary Test, and problem behaviours were measured by the Strengths and Difficulties Questionnaire. Marginal structural models were used to test whether the effects of educational activities on outcomes differed by income. Children exposed to both min/day in educational activities and being in a low-income household were at greater risk of poorer outcomes at school entry than the simple sum of their independent effects. Compared with children who spent ≥30 min/day in educational activities from high-income households, children who experienced min/day in educational activities from low-income households had a 2.30 (95% CI 1.88 to 2.80) higher risk of having a receptive vocabulary score in the lowest quartile at school entry. The Relative Excess Risk due to Interaction of 0.15 (95% CI −0.38 to 0.67) was greater than 0, indicating a super-additive effect measure modification by income. These patterns were similar for behavioural outcomes. Our findings suggest that if there was an intervention of sufficient dose to increase the amount of time spent in educational activities to at least 30 min/day for children in the lower-income group, the risk of children having sub-optimal receptive vocabulary would be reduced by 45% and the risk of teacher-reported conduct and hyperactivity problems reduced by 67% and 70%, respectively.
Publisher: Wiley
Date: 18-04-2016
DOI: 10.1111/JPC.13132
Abstract: The aim of this study was to examine the identification of Aboriginal children in multiple administrative datasets and how this may affect estimates of health and development. Data collections containing a question about Aboriginal ethnicity: birth registrations, perinatal statistics, Australian Early Development Census and school enrolments were linked to datasets recording developmental outcomes: national literacy and numeracy tests (National Assessment Program - Literacy and Numeracy), Australian Early Development Census and perinatal statistics (birthweight) for South Australian children born 1999-2005 (n = 13 414-44 989). Six algorithms to derive Aboriginal ethnicity were specified. The proportions of children thus quantified were compared for developmental outcomes, including those scoring above the national minimum standard in year 3 National Assessment Program - Literacy and Numeracy reading. The proportion of Aboriginal children identified varied from 1.9% to 4.7% when the algorithm incremented from once to ever identified as Aboriginal, the latter using linked datasets. The estimates of developmental outcomes were altered: for ex le, the proportion of Aboriginal children who performed above the national minimum standard in year 3 reading increased by 12 percentage points when the algorithm incremented from once to ever identified as Aboriginal. Similar differences by identification algorithm were seen for all outcomes. The proportion of South Australian children identified as Aboriginal in administrative datasets, and hence inequalities in developmental outcomes, varied depending on which and how many data sources were used. Linking multiple administrative datasets to determine the Aboriginal ethnicity of the child may be useful to inform policy, interventions, service delivery and how well we are closing developmental gaps.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2009
Publisher: Informa UK Limited
Date: 22-10-2014
Start Date: 2017
End Date: 2018
Funder: Channel 7 Children's Research Foundation
View Funded ActivityStart Date: 2008
End Date: 2010
Funder: Primary Health Care Research, Evaluation and Development
View Funded Activity