ORCID Profile
0000-0001-6317-5594
Current Organisations
University of Tasmania Menzies Institute for Medical Research
,
Cardiff Metropolitan University
,
Menzies Research Institute
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Publisher: Elsevier BV
Date: 11-2020
Publisher: Oxford University Press (OUP)
Date: 10-2021
Abstract: Guidelines for cardiovascular disease (CVD) prevention recommend assessment of absolute CVD risk to guide clinical management. Despite this, use among general practitioners (GPs) remains limited. Pathology services may provide an appropriate setting to assess and report absolute CVD risk in patients attending for cholesterol measurement. This study aimed to explore GPs perceptions of such a service. A focus group and semi-structured interviews were conducted with GPs (n = 18) in Tasmania, Australia, to identify perceptions of assessment and reporting of absolute CVD risk via pathology services. An ex le pathology report including absolute CVD risk was provided and discussed. Audio-recordings were transcribed and thematically coded by two researchers. Almost all GPs identified that absolute CVD risk assessed and reported via pathology services could address deficits in practice. First, by reducing the number of appointments required to collect risk factors. Second, by providing a systematic (rather than opportunistic) approach for assessment of absolute CVD risk. Third, by reducing misclassification of patient CVD risk caused by overreliance on clinical intuition. All GPs reported they would order absolute CVD risk when issuing a cholesterol referral if such a service was offered. GPs recommended improving the service by providing information on methods used to measure risk factors on the pathology report. Absolute CVD risk assessed and reported via pathology services may address challenges of screening CVD risk experienced by GPs in practice and encourage dedicated follow-up care for CVD prevention.
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2020-036977
Abstract: Obtaining informed consent is a cornerstone requirement of conducting ethical research. Traditional paper-based consent is often excessively lengthy and may fail to achieve the desired participant understanding of study requirements. Multimedia tools including video and audio may be a useful alternative. This study aimed to determine the efficacy, usability and acceptability of self-directed multimedia delivery of participant consent. It is a single-centre, randomised, prospective study to determine the efficacy, usability and acceptability of a self-directed multimedia consent process (intervention) compared with the traditional paper-based approach (control). The intervention was free of research staff, with computer-based finger-signed consent. Pathology blood collection services in Tasmania, Australia. 298 participants (63±8 years 51% female in iduals) referred from general practice were randomised to intervention (n=146) and control (n=152). Efficacy, usability and acceptability of the allocated consent process were assessed by a questionnaire. All participants successfully completed the allocated interventions. Efficacy parameters were higher among intervention participants, including a better understanding of study requirements compared with controls (p .05 all). Intervention participants were more likely to engage with the study information and spend more time on the consent process (p= .001 and p=0.006, respectively). Both groups reported similar levels of acceptability, although more control participants reported that the study information was too long (24% vs 14% p=0.020). A self-directed multimedia consent process is effective for achieving participant understanding and obtaining consent free of research staff. Thus, multimedia represents a viable method to reduce the burden on researchers, meet participant needs and achieve informed consent in clinical research.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2023
DOI: 10.1161/HYPERTENSIONAHA.122.20448
Abstract: Hypertension is the leading risk factor for cardiovascular disease and premature death among women globally. However, there is a fundamental lack of knowledge regarding the sex-specific pathophysiology of the condition. In addition, risk factors for hypertension and cardiovascular disease unique to women or female sex are insufficiently acknowledged in clinical guidelines. This review summarizes the existing evidence on women and female-specific risk factors and clinical management of hypertension, to identify critical knowledge gaps relevant to research, clinical practice, and women’s heart health awareness. Female-specific risk factors relate not only to reproduction, such as the association of gynecological conditions, adverse pregnancy outcomes or menopause with hypertension, but also to the specific roles of women in society and science, such as gender differences in received medical care and the underrepresentation of women in both the science workforce and as participants in research, which contribute to the limited evidence-based, gender- or sex-specific recommendations. A key point is that the development of hypertension starts in young, premenopausal women, often in association with disorders of reproductive organs, and therefore needs to be managed early in life to prevent future cardiovascular disease. Considering the lower blood pressure levels at which cardiovascular disease occurs, thresholds for diagnosis and treatment of hypertension may need to be lower for women.
Publisher: Wiley
Date: 13-04-2021
DOI: 10.1111/JEP.13569
Abstract: Absolute cardiovascular disease (aCVD) risk assessment is recommended in CVD prevention guidelines. Yet, General Practitioners (GPs) often focus on single risk factors, including blood pressure (BP). Pathology services may be suitable to undertake high‐quality automated unobserved BP (AOBP) measurement and aCVD risk assessment. This study explored GP attitudes towards AOBP measurement via pathology services and the role of BP in aCVD risk management. A brief survey was completed, after which a focus group (n = 8 GPs) and interviews (n = 10 GPs) explored attitudes to AOBP and aCVD risk via pathology services with an ex le pathology report discussed. Verbatim transcripts were thematically coded. GPs predominantly used doctor‐measured BP despite low levels of confidence. High BP measured by AOBP reported with aCVD risk via pathology services, would prompt a follow‐up response. However, GPs focused on BP management. GPs were concerned about AOBP equivalency to routine BP measurements. After protocol explanation, GPs reported AOBP could value‐add to care delivery. GPs lacked familiarity of AOBP and maintained a focus on BP management in the context of absolute CVD risk. Targeted education on AOBP and BP management as part of absolute CVD risk is needed to support guideline‐directed care in practice.
Publisher: S. Karger AG
Date: 2020
DOI: 10.1159/000506646
Abstract: b i Background: /i /b Blood collection and blood pressure (BP) measurements are routinely performed during the same consultation to assess absolute cardiovascular disease (CVD) risk. This study aimed to determine the effect of blood collection on BP and subsequent calculation of the absolute CVD risk. b i Methods: /i /b Forty-five participants aged 58 ± 9 years (53% male) had systolic BP (SBP) measured using clinical guideline methods (clinic SBP). Then, on a separate visit, BP was measured immediately before, during, and after blood collection. Absolute CVD risk scores were calculated (Framingham equation) using SBP from each measurement condition and compared. b i Results: /i /b The prevalence of low (& #x3c %), moderate (10–15%), and high (≥15%) absolute CVD risks among the participants was 67%, 22%, and 11%, respectively, using clinic SBP. SBP values before and during blood collection were significantly higher compared to values after blood collection (130 ± 18 and 132 ± 19 vs. 126 ± 18 mm Hg i /i = 0.010 and i /i = 0.003, respectively). However, there were no significant differences between clinic SBP (128 ± 18 mm Hg) and blood collection SBP ( i /i = 0.99) or the absolute CVD risk scores (7.3 ± 6.5 7.6 ± 5.9 7.7 ± 6.1 and 7.1 ± 5.7%, respectively i /i = 0.995 for all). The mean intraclass correlation (95% CI) indicated good agreement between absolute CVD risk scores calculated with clinic SBP and each blood collection SBP (0.86 [95% CI 0.74–0.92], 0.85 [95% CI 0.71–0.91], and 0.87 [95% CI 0.76–0.93], respectively i /i & #x3c 0.001, for all). b i Conclusion: /i /b Absolute CVD risk calculation is not affected by use of SBP measurements recorded at the time of blood collection. Therefore, it is acceptable to collect blood and measure BP during the same consultation for absolute CVD risk assessment.
Publisher: Cold Spring Harbor Laboratory
Date: 08-02-2022
DOI: 10.1101/2022.02.06.22270563
Abstract: Recent evidence indicates that high numbers of cardiovascular (CV) researchers have considered leaving the research and academic sector due to lack of job security and low funding success. Thus, there is an urgent need to develop solutions to support the retention of early- and mid-career researchers (EMCRs). Here, we aimed to explore the current challenges faced by CV EMCRs, identify solutions to support their career progression and retention, and define a pathway forward to provide a thriving CV EMCR culture in Australia. Australian CV EMCRs ( years post-PhD n=34) participated in 90-minute online focus groups (n=7) to examine current CV research culture, equity in career progression and solutions (including a timeframe and level of priority) to overcome challenges to career success. Participants were purposefully grouped based on socio-demographic information, including years post-PhD, gender, ethnicity, sexual orientation and caring responsibilities. Participants identified that current metrics only rewarded a narrow set of successes and did not support a collaborative culture. The current appraisal of career disruption in grant applications was identified as inadequate to address underrepresented researchers, such as women and those from culturally- erse backgrounds. EMCRs proposed 92 solutions aimed at interpersonal, organisational or external levels, with capacity building and equitable opportunities as key focus areas. Pragmatic, cost-effective and implementable opportunities were identified to support the career progression of CV EMCRs to create a more sustainable, equitable and supportive workforce. This information can be used to strategically engage key stakeholders to enable CV EMCRs to thrive.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2022
DOI: 10.1038/S41371-022-00723-8
Abstract: Blood pressure(BP) management interventions have been shown to be more effective when accompanied by appropriate patient education. As high BP remains poorly controlled, there may be gaps in patient knowledge and education. Therefore, this study aimed to identify specific content and delivery preferences for information to support BP management among Australian adults from the general public. Given that BP management is predominantly undertaken by general practitioners(GPs), information preferences to support BP management were also ascertained from a small s le of Australian GPs. An online survey of adults was conducted to identify areas of concern for BP management to inform content preferences and preferred format for information delivery. A separate online survey was also delivered to GPs to determine preferred information sources to support BP management. Participants were recruited via social media. General public participants ( n = 465) were mostly female (68%), years (57%) and 49% were taking BP-lowering medications. The management of BP without medications, and role of lifestyle in BP management were of concern among 30% and 26% of adults respectively. Most adults (73%) preferred to access BP management information from their GP. 57% of GPs (total n = 23) preferred information for supporting BP management to be delivered via one-page summaries. This study identified that Australian adults would prefer more information about the management of BP without medications and via lifestyle delivered by their GP. This could be achieved by providing GPs with one-page summaries on relevant topics to support patient education and ultimately improve BP management.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Oxford University Press (OUP)
Date: 12-07-2022
Publisher: Oxford University Press (OUP)
Date: 16-04-2020
Abstract: Absolute cardiovascular disease (CVD) risk assessment is recommended for primary prevention of CVD, yet uptake in general practice is limited. Cholesterol requests at pathology services provide an opportunity to improve uptake by integrating absolute CVD risk assessment with this service. This study aimed to assess the feasibility of such an additional service. Two-hundred and ninety-nine patients (45–74 years) referred to pathology services for blood cholesterol had measurement of all variables required to determine absolute CVD risk according to Framingham calculator (blood pressure, age, sex, smoking and diabetes status via self-report). Data were recorded via computer-based application. The absolute risk score was communicated via the report sent to the referring medical practitioner as per usual practice. Evaluation questionnaires were completed immediately post visit and at 1-, 3- and 6-month follow-up via telephone (n = 262). Absolute CVD risk reports were issued for 90% of patients. Most patients (95%) reported that the length of time for the pathology service assessment was acceptable, and 91% that the self-directed computer-based application was easy to use. Seventy-eight per cent reported a preference for pathology services to conduct absolute CVD risk assessment. Only 2% preferred a medical practitioner. Of follow-up patients, 202 (75%) had a consultation with a medical practitioner, during which, aspects of CVD risk prevention were discussed (cholesterol and blood pressure 74% and 69% of the time, respectively). Measurement of absolute CVD risk in pathology services is feasible, highly acceptable among middle-to-older adults and may increase uptake of guideline-directed care in general practice.
Publisher: Springer Science and Business Media LLC
Date: 16-05-2022
DOI: 10.1038/S41569-022-00700-1
Abstract: Cardiovascular disease remains the leading cause of death worldwide. Cardiovascular research has therefore never been more crucial. Cardiovascular researchers must be provided with a research environment that enables them to perform at their highest level, maximizing their opportunities to work effectively with key stakeholders to address this global issue. At present, cardiovascular researchers face a range of challenges and barriers, including a decline in funding, job insecurity and a lack of ersity at senior leadership levels. Indeed, many cardiovascular researchers, particularly women, have considered leaving the sector, highlighting a crucial need to develop strategies to support and retain researchers working in the cardiovascular field. In this Roadmap article, we present solutions to problems relevant to cardiovascular researchers worldwide that are broadly classified across three key areas: capacity building, research funding and fostering ersity and equity. This Roadmap provides opportunities for research institutions, as well as governments and funding bodies, to implement changes from policy to practice, to address the most important factors restricting the career progression of cardiovascular researchers.
Location: United Kingdom of Great Britain and Northern Ireland
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Niamh Chapman.