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Hanikeri M, Savundra J, Gillett D, Walters M, McBain W. Antenatal Transabdominal Ultrasound Detection of Cleft Lip and Palate in Western Australia from 1996 to 2003. Cleft Palate Craniofac J 2017; 43:61-6. [PMID: 16405376 DOI: 10.1597/04-101r.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To determine the frequency of detection of cleft lip with or without cleft palate and isolated cleft palate from antenatal ultrasound examinations conducted on mothers of infants born with cleft lip and/or palate and isolated cleft palate in Western Australia from 1996 to 2003. Design Review of patient records and purpose-designed questionnaire sent to parents of children born with cleft lip and/or palate and isolated cleft palate. Results There were 308 infants born with cleft lip and/or palate and isolated cleft palate in the study period. Of the 293 parents, 218 responses were available for the study (70.7%), and 2.9 ± 1.8 SD antenatal ultrasound scans were performed on 216 women. No such scans were performed on two women. Cleft lip and/or palate was detected in 22.2% of cases. There was no detection prior to 15 weeks gestational age in the 137 women screened. Between 15 and 19 weeks gestational age, 174 scans detected 30 cases. Between 20 and 29 weeks gestational age, 84 scans detected 11 cases. Between 30 and 40 weeks gestational age, 66 scans detected 7 cases. The detection rate for bilateral cleft lip and/or palate was 44.4% and for unilateral cleft lip and/or palate, 40.6%. Detection rate for isolated cleft lip was 33.3%. Antenatal ultrasound failed to detect any infants with an isolated cleft palate (n = 95). The rate of detection of cleft lip and/or palate increased through the study period. Conclusions The rate of detection of cleft lip and/or palate in Western Australia is comparable to that for referral centers worldwide and is increasing. The rate of detection of the various types of cleft anomalies using antenatal ultrasound ranged from 0% to 44%.
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Affiliation(s)
- M Hanikeri
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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152
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Foote A, Henderson R, Lindberg A, Grigg C, Greenfield C, Kirke AB, Auret K. The Australian Mid-West Coastal Marine Wound Infections Study. Aust Fam Physician 2017; 46:923-927. [PMID: 29464230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Marine organism wound infections are common in coastal regions of Western Australia. Local treatment guidelines are based on studies from elsewhere. The objective of this article was to identify the causative organisms in marine wounds sustained in the subtropical and tropical coastal waters of the Indian Ocean, Gascoyne region (north-west), Western Australia. METHODS This was a prospective study. A single wound swab was taken from 28 consenting patients who presented with a suppurating marine wound to the emergency departments of Carnarvon and Exmouth hospitals. RESULTS The wounds of 27 out of 28 patients returned a positive culture. The two most common organisms were Staphylococcus aureus (n = 18/28; 64.3%) and Vibrio species (n = 9/28; 32.1%). The culture was polymicrobial in 11 patients (39.3%). DISCUSSION S. aureus or Vibrio species were frequently seen in marine wounds, and infections were often polymicrobial. Our results suggest that flucloxacillin (or clindamycin) and doxycycline (or ciprofloxacin) would be a reasonable combination for empirical oral therapy in adults.
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153
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Dossetor PJ, Martiniuk ALC, Fitzpatrick JP, Oscar J, Carter M, Watkins R, Elliott EJ, Jeffery HE, Harley D. Pediatric hospital admissions in Indigenous children: a population-based study in remote Australia. BMC Pediatr 2017; 17:195. [PMID: 29166891 PMCID: PMC5700560 DOI: 10.1186/s12887-017-0947-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/14/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We analysed hospital admissions of a predominantly Aboriginal cohort of children in the remote Fitzroy Valley in Western Australia during the first 7 years of life. METHODS All children born between January 1, 2002 and December 31, 2003 and living in the Fitzroy Valley in 2009-2010 were eligible to participate in the Lililwan Project. Of 134 eligible children, 127 (95%) completed Stage 1 (interviews of caregivers and medical record review) in 2011 and comprised our cohort. Lifetime (0-7 years) hospital admission data were available and included the dates, and reasons for admission, and comorbidities. Conditions were coded using ICD-10-AM discharge codes. RESULTS Of the 127 children, 95.3% were Indigenous and 52.8% male. There were 314 admissions for 424 conditions in 89 (70.0%) of 127 children. The 89 children admitted had a median of five admissions (range 1-12). Hospitalization rates were similar for both genders (p = 0.4). Of the admissions, 108 (38.6%) were for 56 infants aged <12 months (median = 2.5, range = 1-8). Twelve of these admissions were in neonates (aged 0-28 days). Primary reasons for admission (0-7 years) were infections of the lower respiratory tract (27.4%), gastrointestinal system (22.7%), and upper respiratory tract (11.4%), injury (7.0%), and failure to thrive (5.4%). Comorbidities, particularly upper respiratory tract infections (18.1%), failure to thrive (13.6%), and anaemia (12.7%), were common. In infancy, primary cause for admission were infections of the lower respiratory tract (40.8%), gastrointestinal (25.9%) and upper respiratory tract (9.3%). Comorbidities included upper respiratory tract infections (33.3%), failure to thrive (18.5%) and anaemia (18.5%). CONCLUSION In the Fitzroy Valley 70.0% of children were hospitalised at least once before age 7 years and over one third of admissions were in infants. Infections were the most common reason for admission in all age groups but comorbidities were common and may contribute to need for admission. Many hospitalizations were feasibly preventable. High admission rates reflect disadvantage, remote location and limited access to primary healthcare and outpatient services. Ongoing public health prevention initiatives including breast feeding, vaccination, healthy diet, hygiene and housing improvements are crucial, as is training of Aboriginal Health Workers to increase services in remote communities.
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Affiliation(s)
- Philippa J Dossetor
- Clinical Medical School, College of Medicine, Biology & Environment, Australian National University, 97/2 Edinburgh Ave, Canberra, ACT, 2601, Australia.
- University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, Australia.
- Poche Centre for Indigenous Health, University of Sydney, Sydney, NSW, Australia.
| | - Alexandra L C Martiniuk
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- The George Institute for Global Health, PO Box M201, Missenden Rd, Sydney, 2050, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - James P Fitzpatrick
- University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, Australia
- Population Sciences Division, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia
- School of Arts and Science, University of Notre Dame, Broome, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia
| | - Rochelle Watkins
- Population Sciences Division, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Elizabeth J Elliott
- University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, Australia
- Poche Centre for Indigenous Health, University of Sydney, Sydney, NSW, Australia
- The Sydney Children's Hospital Network (Westmead), Westmead, Australia
| | - Heather E Jeffery
- RPA Newborn Care, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - David Harley
- Clinical Medical School, College of Medicine, Biology & Environment, Australian National University, 97/2 Edinburgh Ave, Canberra, ACT, 2601, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Building 62, Corner of Eggleston and Mills Roads, Canberra, ACT, 0200, Australia
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154
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Lopez D, Nedkoff L, Knuiman M, Hobbs MST, Briffa TG, Preen DB, Hung J, Beilby J, Mathur S, Reynolds A, Sanfilippo FM. Exploring the effects of transfers and readmissions on trends in population counts of hospital admissions for coronary heart disease: a Western Australian data linkage study. BMJ Open 2017; 7:e019226. [PMID: 29151055 PMCID: PMC5701992 DOI: 10.1136/bmjopen-2017-019226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To develop a method for categorising coronary heart disease (CHD) subtype in linked data accounting for different CHD diagnoses across records, and to compare hospital admission numbers and ratios of unlinked versus linked data for each CHD subtype over time, and across age groups and sex. DESIGN Cohort study. DATA SOURCE Person-linked hospital administrative data covering all admissions for CHD in Western Australia from 1988 to 2013. MAIN OUTCOME Ratios of (1) unlinked admission counts to contiguous admission (CA) counts (accounting for transfers), and (2) 28-day episode counts (accounting for transfers and readmissions) to CA counts stratified by CHD subtype, sex and age group. RESULTS In all CHD subtypes, the ratios changed in a linear or quadratic fashion over time and the coefficients of the trend term differed across CHD subtypes. Furthermore, for many CHD subtypes the ratios also differed by age group and sex. For example, in women aged 35-54 years, the ratio of unlinked to CA counts for non-ST elevation myocardial infarction admissions in 2000 was 1.10, and this increased in a linear fashion to 1.30 in 2013, representing an annual increase of 0.0148. CONCLUSION The use of unlinked counts in epidemiological estimates of CHD hospitalisations overestimates CHD counts. The CA and 28-day episode counts are more aligned with epidemiological studies of CHD. The degree of overestimation of counts using only unlinked counts varies in a complex manner with CHD subtype, time, sex and age group, and it is not possible to apply a simple correction factor to counts obtained from unlinked data.
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Affiliation(s)
- Derrick Lopez
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Michael S T Hobbs
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Thomas G Briffa
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - David B Preen
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Joseph Hung
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - John Beilby
- School of Biomedical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Sushma Mathur
- Health Group, Australian Institute of Health and Welfare, Canberra, Australia
| | - Anna Reynolds
- Health Group, Australian Institute of Health and Welfare, Canberra, Australia
| | - Frank M Sanfilippo
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
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155
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Nedkoff L, Lopez D, Goldacre M, Sanfilippo F, Hobbs M, Wright FL. Identification of myocardial infarction type from electronic hospital data in England and Australia: a comparative data linkage study. BMJ Open 2017; 7:e019217. [PMID: 29133337 PMCID: PMC5695341 DOI: 10.1136/bmjopen-2017-019217] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To determine the utility of International Classification of Diseases (ICD) codes in investigating trends in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) using person-linked electronic hospitalisation data in England and Western Australia (WA). METHODS All hospital admissions with myocardial infarction (MI) as the principal diagnosis were identified from 2000 to 2013 from both jurisdictions. Fourth-digit ICD-10 codes were used to delineate all MI types-STEMI, NSTEMI, unspecified and subsequent MI. The annual frequency of each MI type was calculated as a proportion of all MI admissions. For all MI and each MI type, age-standardised rates were calculated and age-adjusted Poisson regression models used to estimate annual percentage changes in rates. RESULTS In 2000, STEMI accounted for 49% of all MI admissions in England and 59% in WA, decreasing to 35% and 25% respectively by 2013. Less than 10% of admissions were recorded as NSTEMI in England throughout the study period, whereas by 2013, 70% of admissions were NSTEMI in WA. Unspecified MI comprised 60% of all MI admissions in England by 2013, compared with <1% in WA. Trends in age-standardised rates differed for all MI (England, -2.7%/year; WA, +1.7%/year), underpinned by differing age-adjusted trends in NSTEMI (England, -6.1%/year; WA, +10.2%/year). CONCLUSION Differences between the proportion and trends for MI types in English and WA data were observed. These were consistent with the coding standards in each country. This has important implications for using electronic hospital data for monitoring MI and identifying MI types for outcome studies.
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Affiliation(s)
- Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Derrick Lopez
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Michael Goldacre
- Unit of Health-Care Epidemiology, Nuffield Department of Public Health, University of Oxford, Oxford, UK
| | - Frank Sanfilippo
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Michael Hobbs
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - F Lucy Wright
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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156
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Blekkenhorst LC, Bondonno CP, Lewis JR, Devine A, Zhu K, Lim WH, Woodman RJ, Beilin LJ, Prince RL, Hodgson JM. Cruciferous and Allium Vegetable Intakes are Inversely Associated With 15-Year Atherosclerotic Vascular Disease Deaths in Older Adult Women. J Am Heart Assoc 2017; 6:JAHA.117.006558. [PMID: 29066442 PMCID: PMC5721860 DOI: 10.1161/jaha.117.006558] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Higher vegetable intake is consistently associated with lower atherosclerotic vascular disease (ASVD) events. However, the components responsible and mechanisms involved are uncertain. Nonnutritive phytochemicals may be involved. The objective of this study was to investigate the associations of total vegetable intake and types of vegetables grouped according to phytochemical constituents with ASVD mortality. METHODS AND RESULTS The cohort consisted of 1226 Australian women aged 70 years and older without clinical ASVD or diabetes mellitus at baseline (1998). Vegetable intakes were calculated per serving (75 g/d) and were also classified into prespecified types relating to phytochemical constituents. ASVD-related deaths were ascertained from linked mortality data. During 15 years (15 947 person-years) of follow-up, 238 ASVD-related deaths occurred. A 1-serving increment of vegetable intake was associated with a 20% lower hazard of ASVD-related death (multivariable-adjusted hazard ratio, 0.80; 95% confidence interval, 0.69-0.94 [P=0.005]). In multivariable-adjusted models for vegetable types, cruciferous (per 10-g/d increase: hazard ratio, 0.87; 95% confidence interval, 0.81-0.94 [P<0.001]) and allium (per 5-g/d increase: hazard ratio, 0.82; 95% confidence interval, 0.73-0.94 [P=0.003]) vegetables were inversely associated with ASVD-related deaths. The inclusion of other vegetable types, as well as lifestyle and cardiovascular risk factors, did not alter these associations. Yellow/orange/red (P=0.463), leafy green (P=0.063), and legume (P=0.379) vegetables were not significant. CONCLUSIONS Consistent with current evidence, higher cruciferous and allium vegetable intakes were associated with a lower risk of ASVD mortality. In addition, cruciferous and allium vegetables are recognized to be a good source of several nonnutritive phytochemicals such as organosulfur compounds. CLINICAL TRIAL REGISTRATION URL: http://www.anzctr.org.au. Unique identifier: ACTRN12617000640303.
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Affiliation(s)
- Lauren C Blekkenhorst
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Joshua R Lewis
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, The University of Western Australia, Nedlands, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Australia
- School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kun Zhu
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, The University of Western Australia, Nedlands, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Wai H Lim
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, The University of Western Australia, Nedlands, Western Australia, Australia
- Renal Medicine Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
| | - Richard L Prince
- School of Medicine and Pharmacology, Queen Elizabeth Medical Centre Unit, The University of Western Australia, Nedlands, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jonathan M Hodgson
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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157
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Too LS, Pirkis J, Milner A, Spittal MJ. Clusters of suicides and suicide attempts: detection, proximity and correlates. Epidemiol Psychiatr Sci 2017; 26:491-500. [PMID: 27278418 PMCID: PMC6998993 DOI: 10.1017/s2045796016000391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/12/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND A suicide cluster is defined as a higher number of observed cases occurring in space and/or time than would typically be expected. Previous research has largely focused on identifying clusters of suicides, while there has been comparatively limited research on clusters of suicide attempts. We sought to identify clusters of both types of behaviour, and having done that, identify the factors that distinguish suicide attempts inside a cluster from those that were outside a cluster. METHODS We used data from Western Australia from 2000 to 2011. We defined suicide attempts as admissions to hospital for deliberate self-harm and suicides as deaths due to deliberate self-harm. Using an analytic strategy that accounted for the repetition of attempted suicide within a cluster, we performed spatial-temporal analysis using Poisson discrete scan statistics to detect clusters of suicide attempts and clusters of suicides. Logistic regression was then used to compare clustered attempts with non-clustered attempts to identify risk factors for an attempt being in a cluster. RESULTS We detected 350 (1%) suicide attempts occurring within seven spatial-temporal clusters and 12 (0.6%) suicides occurring within two spatial-temporal clusters. Both of the suicide clusters were located within a larger but later suicide attempt cluster. In multivariate analysis, suicide attempts by individuals who lived in areas of low socioeconomic status had higher odds of being in a cluster than those living in areas of high socioeconomic status [odds ratio (OR) = 29.1, 95% confidence interval (CI) = 6.3-135.5]. A one percentage-point increase in the proportion of people who had changed address in the last year was associated with a 60% increase in the odds of the attempt being within a cluster (OR = 1.60, 95% CI = 1.29-1.98) and a one percentage-point increase in the proportion of Indigenous people in the area was associated with a 7% increase in the suicide being within a cluster (OR = 1.07, 95% CI = 1.00-1.13). Age, sex, marital status, employment status, method of harm, remoteness, percentage of people in rented accommodation and percentage of unmarried people were not associated with the odds of being in a suicide attempt cluster. CONCLUSIONS Early identification of and responding to suicide clusters may reduce the likelihood of subsequent clusters forming. The mechanisms, however, that underlie clusters forming is poorly understood.
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Affiliation(s)
- L. S. Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - J. Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - A. Milner
- Deakin Population Health SRC, School of Health and Social Development, Deakin University, Victoria, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - M. J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
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158
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Chan YX, Knuiman MW, Divitini ML, Brown SJ, Walsh J, Yeap BB. Lower TSH and higher free thyroxine predict incidence of prostate but not breast, colorectal or lung cancer. Eur J Endocrinol 2017; 177:297-308. [PMID: 28684452 DOI: 10.1530/eje-17-0197] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/09/2017] [Accepted: 07/06/2017] [Indexed: 12/28/2022]
Abstract
CONTEXT Thyroid hormones modulate proliferative, metabolic and angiogenic pathways. However few studies have examined associations of thyroid hormones with cancer risk. OBJECTIVES To explore associations of thyrotropin (TSH), free thyroxine (FT4) and anti-thyroperoxidase antibodies (TPOAb) with the incidence of all (non-skin) cancers and specific common cancers. DESIGN AND SETTING A prospective cohort study of a community-dwelling population aged 25-84 years in Western Australia. MAIN OUTCOME MEASURES Archived sera from 3649 participants in the 1994/1995 Busselton Health Survey were assayed for TSH, FT4 and TPOAb. Cancer outcomes until 30 June 2014 were ascertained using data linkage. Longitudinal analyses were performed using Cox proportional hazards regression. RESULTS During 20-year follow-up, 600 participants were diagnosed with non-skin cancer, including 126, 100, 103 and 41 prostate, breast, colorectal and lung cancers respectively. Higher TSH was associated with a lower risk of prostate cancer after adjusting for potential confounders, with a 30% lower risk for every 1 IU/L increase in TSH (adjusted hazard ratio (HR): 0.70, 95% confidence interval (CI): 0.55-0.90, P = 0.005). Similarly, higher FT4 was associated with an increased risk of prostate cancer (adjusted HR: 1.11 per 1 pmol/L increase, 95% CI: 1.03-1.19, P = 0.009). There were no associations of TSH, FT4 or TPOAb with all non-skin cancer events combined, or with breast, colorectal or lung cancer. CONCLUSION In a community-dwelling population, lower TSH and higher FT4 were associated with an increased risk of prostate cancer. Further studies are required to assess if thyroid function is a biomarker or risk factor for prostate cancer.
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Affiliation(s)
- Yi X Chan
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Western Australia, Australia
| | - Matthew W Knuiman
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Mark L Divitini
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - John Walsh
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Bu B Yeap
- School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Western Australia, Australia
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159
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Kousoulis AA, Tsoucalas G. Infection, contagion and causality in Colonial Britain: the 1889-90 influenza pandemic and the British Medical Journal. Infez Med 2017; 25:285-291. [PMID: 28956550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The influenza pandemic of 1889 was the first truly global flu outbreak in scope. Characterised by high morbidity and low mortality, it spread rapidly across Europe and the rest of the world along trading routes. It reached mainland Britain in December 1889. The responses of medical practitioners in Britain and the British colonies to the pandemic were heavily featured in the British Medical Journal and reveal a confusing picture around causality, contagion and infection. Cases from the colonies (Cape Town, India, Australia, Samoan Islands, Hong Kong) as presented in the journal are explored in an attempt to reconstruct the mainstream medical belief of the time. The evidence sadly shows a lack of confidence in contagionism, almost complete absence of monocausalism and a vague picture of the epidemic constitution. Original case studies from colonial medical officers as well as editorials triggered a debate in the pages of the BMJ. In this context, the journal succeeded in playing a key role in recording the first thoroughly documented attack of influenza. In a world that was only learning to be interconnected, the BMJ became the point of reference for the British medical establishment, which ranged from London to Scotland and from Africa and India to Oceania.
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Affiliation(s)
- Antonis A Kousoulis
- London School of Hygiene and Tropical Medicine, London, UK; Society of Junior Doctors, Athens, Greece
| | - Gregory Tsoucalas
- Society of Junior Doctors, Athens, Greece; History of Medicine Department, School of Medicine, National and Kapodistrian University of Athens, Greece
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160
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Mowlaboccus S, Jolley KA, Bray JE, Pang S, Lee YT, Bew JD, Speers DJ, Keil AD, Coombs GW, Kahler CM. Clonal Expansion of New Penicillin-Resistant Clade of Neisseria meningitidis Serogroup W Clonal Complex 11, Australia. Emerg Infect Dis 2017; 23:1364-1367. [PMID: 28609259 PMCID: PMC5547816 DOI: 10.3201/eid2308.170259] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In Western Australia, Neisseria meningitidis serogroup W clonal complex 11 became the predominant cause of invasive meningococcal disease in 2016. We used core-genome analysis to show emergence of a penicillin-resistant clade that had the penA_253 allele. This new penicillin-resistant clade might affect treatment regimens for this disease.
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161
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Collins DA, Selvey LA, Celenza A, Riley TV. Community-associated Clostridium difficile infection in emergency department patients in Western Australia. Anaerobe 2017; 48:121-125. [PMID: 28807622 DOI: 10.1016/j.anaerobe.2017.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 02/03/2023]
Abstract
Clostridium difficile infection (CDI) is primarily associated with hospitalised patients, however, community-associated CDI (CA-CDI) has increased in Australia. We aimed to investigate the epidemiology and outcomes of CA-CDI cases presenting to hospital emergency departments in Western Australia (WA). A retrospective case-control study of CA-CDI cases presenting at six emergency departments in WA from July 2013 to June 2014 was performed. Clinical signs, recent medication, hospitalisations and potential risk factors for CA-CDI were investigated for cases (n = 34) and unmatched controls (n = 62) who were infected with another gastrointestinal pathogen, including Campylobacter spp., Salmonella spp., Aeromonas spp., Shigella sonnei and Escherichia coli O157. Elevated white cell count (31.3% vs 8.2%, p < 0.01), female gender (67.6% vs 41.9%, p < 0.05), age ≥65 years (41.2% vs 21.0%, p < 0.05) and antimicrobial use in the previous month (41.2% vs 11.3%, p < 0.01) were significantly more frequent among cases compared to controls. After multivariable analysis, antibiotic use (odds ratio 8.49, 95% confidence interval 2.75-26.21) and age ≥65 years (3.03, 1.05-8.75) were significantly associated with CA-CDI. Ribotype (RT) 014/020 was most common (40.7%) among 27 C. difficile isolates followed by RTs 002 (14.8%), 001, 056 and 244 (all 7.4%). CA-CDI was associated with advanced age and recent antibiotic use compared to those infected with other gastrointestinal pathogens. RT 014 has also recently been found at high prevalence in public lawn spaces, and previously RT 014 strains from humans and pigs in Australia were closely genetically related, suggesting CA-CDI may be linked with these community reservoirs.
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Affiliation(s)
- Deirdre A Collins
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Linda A Selvey
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Antonio Celenza
- Division of Emergency Medicine, School of Medicine, University of Western Australia, Australia
| | - Thomas V Riley
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Department of Microbiology, PathWest Laboratory Medicine (WA), Perth, Australia
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162
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Whitworth SR, Bruce DG, Starkstein SE, Davis WA, Davis TME, Skinner TC, Bucks RS. Depression symptoms are persistent in Type 2 diabetes: risk factors and outcomes of 5-year depression trajectories using latent class growth analysis. Diabet Med 2017; 34:1108-1115. [PMID: 28453875 DOI: 10.1111/dme.13372] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 11/27/2022]
Abstract
AIMS To describe the long-term trajectories of depression symptom severity in people with Type 2 diabetes, and to identify predictors and associates of these trajectories. METHODS A community-dwelling cohort of 1201 individuals with Type 2 diabetes from the Fremantle Diabetes Study Phase II was followed for 5 years. The nine-item version of the Patient Health Questionnaire was administered annually to assess depression symptoms, and biomedical and psychosocial measures were assessed at baseline and biennially. Latent class growth analysis was used to identify classes of depression severity trajectories and associated outcomes, and logistic regression models were used to determine predictors of class membership. RESULTS Three trajectories of depression symptoms were identified: continuously low depression symptoms (85.2%); gradually worsening symptoms that then began to improve (persistent depression - low-start; 7.3%); and gradually improving symptoms which later worsened (persistent depression - high-start; 7.5%). Younger age, being a woman, and a lifetime history of major depressive disorder, were associated with greater risk of persistent depression symptoms. Persistent depression was associated with consistently higher BMI over time, but not with changes in HbA1c or self-monitoring of blood glucose. CONCLUSIONS A subset of individuals with Type 2 diabetes is at risk of depression symptoms that remain elevated over time. Younger, overweight individuals with a history of depression may benefit from early and intensive depression management and ongoing follow-up as part of routine Type 2 diabetes care.
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Affiliation(s)
- S R Whitworth
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
| | - D G Bruce
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - S E Starkstein
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Western Australia
| | - W A Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - T M E Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - T C Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
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163
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Hafekost K, Lawrence D, O’Leary C, Bower C, Semmens J, Zubrick SR. Maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia: a population cohort record linkage study. BMJ Open 2017; 7:e015650. [PMID: 28701410 PMCID: PMC5734575 DOI: 10.1136/bmjopen-2016-015650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Examine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia. DESIGN Population cohort study. SETTING Routinely collected linked administrative health, education and child protection data. PARTICIPANTS Those in-scope for the study were women with a birth recorded on the Western Australian Midwives Notification System (1989-2007). Women who had an alcohol-related diagnosis (International Classification of Diseases Revisions 9/10) recorded on the Hospital Morbidity, Mental Health Inpatients and Outpatients, and Drug and Alcohol Office data sets formed the exposed group. The comparison cohort was frequency-matched to the exposed cohort based on maternal age within Indigenous status and child's year of birth. PRIMARY OUTCOME MEASURE Child's school attendance was obtained from the Department of Education (2008-2012). Poor attendance was defined as <80% attendance for non-Indigenous children and <60% attendance for Indigenous children. RESULTS 11 430 exposed children and 26 850 unexposed children had a linked attendance record. Maternal alcohol use disorder was significantly associated with increased odds of poor attendance (non-Indigenous: OR=1.61, 95% CI 1.50 to 1.74; Indigenous: OR=1.66, 95% CI 1.54 to 1.79). With adjustment for maternal and child factors, there was no significant difference between the timing of alcohol diagnosis relative to pregnancy and attendance outcomes. The population attributable fraction was higher in the Indigenous cohort than the non-Indigenous cohort (6.0% vs 1.3%). CONCLUSIONS Maternal alcohol use disorder was associated with a significantly increased odds of poor school attendance for non-Indigenous and Indigenous children. There was no significant difference between the timing of diagnoses and odds of poor school attendance. This suggests that the effect of maternal alcohol use disorder may not be driven by the neurodevelopmental effects of alcohol exposure in utero, but may be mediated through family or social factors for which we were unable to adjust.
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Affiliation(s)
- Katherine Hafekost
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, Perth, Australia
| | - Colleen O’Leary
- Office of the Chief Psychiatrist, Western Australian Department of Health, Perth, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - James Semmens
- Faculty of Health Science, Centre for Population Health Research, Curtin University, Perth, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Graduate School of Education, The University of Western Australia, Perth, Australia
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164
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Ing C, Wall MM, DiMaggio CJ, Whitehouse AJO, Hegarty MK, Sun M, von Ungern-Sternberg BS, Li G, Sun LS. Latent Class Analysis of Neurodevelopmental Deficit After Exposure to Anesthesia in Early Childhood. J Neurosurg Anesthesiol 2017; 29:264-273. [PMID: 27077892 PMCID: PMC5757537 DOI: 10.1097/ana.0000000000000303] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Although some studies have reported an association between early exposure to anesthesia and surgery and long-term neurodevelopmental deficit, the clinical phenotype of children exposed to anesthesia is still unknown. METHODS Data were obtained from the Western Australian Pregnancy Cohort Study (Raine) with neuropsychological tests at age 10 years measuring language, cognition, motor function, and behavior. Latent class analysis of the tests was used to divide the cohort into mutually exclusive subclasses of neurodevelopmental deficit. Multivariable polytomous logistic regression was used to evaluate the association between exposure to surgery and anesthesia and each latent class, adjusting for demographic and medical covariates. RESULTS In our cohort of 1444 children, latent class analysis identified 4 subclasses: (1) Normal: few deficits (n=1135, 78.6%); (2) Language and Cognitive deficits: primarily language, cognitive, and motor deficits (n=96, 6.6%); (3) Behavioral deficits: primarily behavioral deficits, (n=151, 10.5%); and (4) Severe deficits: deficits in all neuropsychological domains (n=62, 4.3%). Language and cognitive deficit group children were more likely to have exposure before age 3 (adjusted odds ratio [aOR], 2.11; 95% confidence interval [CI], 1.17-3.81), whereas a difference in exposure was not found between Behavioral or Severe deficit children (aOR, 1.00; 95% CI, 0.58-1.73, and aOR, 0.85; 95% CI, 0.34-2.15, respectively) and Normal children. CONCLUSIONS Our results suggest that in evaluating children exposed to surgery and anesthesia at an early age, the phenotype of interest may be children with deficits primarily in language and cognition, and not children with broad neurodevelopmental delay or primarily behavioral deficits.
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Affiliation(s)
- Caleb Ing
- Departments of *Anesthesiology ††Anesthesiology and Pediatrics, Columbia University College of Physicians and Surgeons Departments of †Psychiatry and Biostatistics ‡Anesthesiology and Epidemiology ¶Anesthesiology and Biostatistics **Anesthesiology and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, NY §Telethon Kids Institute #School of Medicine and Pharmacology, The University of Western Australia ∥Department of Anaesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, WA, Australia
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165
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Gauci R, Hunter M, Bruce DG, Davis WA, Davis TME. Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis. J Diabetes Complications 2017; 31:1169-1174. [PMID: 28433448 DOI: 10.1016/j.jdiacomp.2017.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/15/2017] [Accepted: 04/03/2017] [Indexed: 12/19/2022]
Abstract
AIMS To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes. METHODS Data from the Fremantle Diabetes Study Phase II (FDS2; n=1551, mean age 65.7years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130g/L males, ≤120g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modeling identified predictors of death during 4.3±1.2years post-recruitment. RESULTS The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B12<140pmol/L, serum ferritin <30μg/L and/or transferrin saturation<20%, serum testosterone <10nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60mL/min 1.73m2, malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, marital status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015). CONCLUSIONS Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.
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Affiliation(s)
- Richard Gauci
- Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Murdoch and Fremantle, Western Australia, Australia
| | - Michael Hunter
- Busselton Population Medical Research Institute, Busselton, Western Australia, Australia; School of Population Health, University of Western Australia, Nedlands, Australia
| | - David G Bruce
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Wendy A Davis
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Timothy M E Davis
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia.
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166
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Ha NT, Harris M, Robinson S, Preen D, Moorin R. Stratification strategy for evaluating the influence of diabetes complication severity index on the risk of hospitalization: a record linkage data in Western Australia. J Diabetes Complications 2017; 31:1175-1180. [PMID: 28427838 DOI: 10.1016/j.jdiacomp.2017.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study aimed to develop a risk stratification strategy for evaluating the relationship between complications of diabetes and the risk of diabetic-related hospitalization to accurately classify diabetes severity. METHODS The study used administrative health records for 40,624 individuals with diabetes aged ≥18years in Western Australian. The adapted Diabetes Complication Severity Index (DCSI), socio-demographic and clinical characteristics were used in random effects negative binomial and threshold effect models to determine the optimal stratification strategy for diabetes severity based on the homogeneity of the risk of hospitalization in response to variation of the DCSI. RESULTS The optimal stratification of people with diabetes was specified by four sub-populations. The first sub-population was no complications with an inverse association with the risk of hospitalizations (coefficient-0.247, SE 0.03). Further three sub-populations with DCSI at one (coefficient 0.289, SE 0.01), two (coefficient 0.339, SE 0.01) and three or more (coefficient 0.381, SE 0.01) were used to accurately describe the impact of DCSI on the risk of hospitalization. CONCLUSION A stratification into four subpopulations based on the homogeneous impact of diabetes DCSI on the risk of hospitalization may be more suitable for evaluating health care interventions and planning health care provision.
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Affiliation(s)
- Ninh Thi Ha
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia.
| | - Mark Harris
- School of Economics and Finance, Curtin University, Perth, Western Australia 6845, Australia.
| | - Suzanne Robinson
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia.
| | - David Preen
- Centre for Health Services Research, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
| | - Rachael Moorin
- School of Public Health, Curtin University, Perth, Western Australia 6845, Australia; Centre for Health Services Research, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
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167
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Seaman KL, Sanfilippo FM, Roughead EE, Bulsara MK, Kemp-Casey A, Bulsara C, Watts GF, Preen D. Impact of consumer copayments for subsidised medicines on health services use and outcomes: a protocol using linked administrative data from Western Australia. BMJ Open 2017; 7:e013691. [PMID: 28637723 PMCID: PMC5577882 DOI: 10.1136/bmjopen-2016-013691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Across the world, health systems are adopting approaches to manage rising healthcare costs. One common strategy is a medication copayments scheme where consumers make a contribution (copayment) towards the cost of their dispensed medicines, with remaining costs subsidised by the health insurance service, which in Australia is the Federal Government.In Australia, copayments have tended to increase in proportion to inflation, but in January 2005, the copayment increased substantially more than inflation. Results from aggregated dispensing data showed that this increase led to a significant decrease in the use of several medicines. The aim of this study is to determine the demographic and clinical characteristics of individuals ceasing or reducing statin medication use following the January 2005 Pharmaceutical Benefit Scheme (PBS) copayment increase and the effects on their health outcomes. METHODS AND ANALYSIS This whole-of-population study comprises a series of retrospective, observational investigations using linked administrative health data on a cohort of West Australians (WA) who had at least one statin dispensed between 1 May 2002 and 30 June 2010. Individual-level data on the use of pharmaceuticals, general practitioner (GP) visits, hospitalisations and death are used.This study will identify patients who were stable users of statin medication in 2004 with follow-up commencing from 2005 onwards. Subgroups determined by change in adherence levels of statin medication from 2004 to 2005 will be classified as continuation, reduction or cessation of statin therapy and explored for differences in health outcomes and health service utilisation after the 2005 copayment change. ETHICS AND DISSEMINATION Ethics approvals have been obtained from the Western Australian Department of Health (#2007/33), University of Western Australia (RA/4/1/1775) and University of Notre Dame (0 14 167F). Outputs from the findings will be published in peer reviewed journals designed for a policy audience and presented at state, national and international conferences.
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Affiliation(s)
- Karla L Seaman
- School of Health Sciences, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Frank M Sanfilippo
- Cardiovasular Research, School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Elizabeth E Roughead
- Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, The University of South Australia, Adelaide, South Australia, Australia
| | - Max K Bulsara
- School of Health Sciences, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Anna Kemp-Casey
- Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, The University of South Australia, Adelaide, South Australia, Australia
- Center of Health Services Research, School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Caroline Bulsara
- School of Health Sciences, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - Gerald F Watts
- Department of Cardiology, Lipid Disorders Clinic, Royal Perth Hospital, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - David Preen
- Center of Health Services Research, School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
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168
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Fitzpatrick JP, Latimer J, Olson HC, Carter M, Oscar J, Lucas BR, Doney R, Salter C, Try J, Hawkes G, Fitzpatrick E, Hand M, Watkins RE, Tsang TW, Bower C, Ferreira ML, Boulton J, Elliott EJ. Prevalence and profile of Neurodevelopment and Fetal Alcohol Spectrum Disorder (FASD) amongst Australian Aboriginal children living in remote communities. Res Dev Disabil 2017; 65:114-126. [PMID: 28499185 DOI: 10.1016/j.ridd.2017.04.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/23/2017] [Accepted: 04/01/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD). AIMS This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE. METHODS AND PROCEDURES Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N=134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned. OUTCOMES AND RESULTS Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children (95% CI=131.0-279.0). CONCLUSIONS AND IMPLICATIONS Neurodevelopmental impairment with or without PAE is highly prevalent among children in the Fitzroy Valley. Rates of diagnoses on the FASD spectrum are among the highest worldwide. Early intervention services are needed to support developmentally vulnerable children in remote communities.
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Affiliation(s)
- James P Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - Heather Carmichael Olson
- The University of Washington School of Medicine, Seattle, Washington, USA; Seattle Children's Research Institute, Seattle, Washington, USA.
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia.
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia.
| | - Barbara R Lucas
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - Robyn Doney
- School of Public Health, Curtin University, Perth, Australia.
| | - Claire Salter
- Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
| | - Julianne Try
- Department of Education and Early Childhood Development, Government of Victoria, Australia.
| | - Genevieve Hawkes
- Derby Allied Health Service, Western Australian Country Health Services, Derby, Australia.
| | - Emily Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
| | | | - Rochelle E Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Tracey W Tsang
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Manuela L Ferreira
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
| | - John Boulton
- Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; The George Institute for Global Health, Sydney Medical School, University of Sydney, Australia.
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169
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Henze M, Alfonso H, Flicker L, George J, Chubb SAP, Hankey GJ, Almeida OP, Golledge J, Norman PE, Yeap BB. Profile of diabetes in men aged 79-97 years: the Western Australian Health in Men Study. Diabet Med 2017; 34:786-793. [PMID: 27761946 DOI: 10.1111/dme.13274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 01/22/2023]
Abstract
AIMS To investigate behavioural, physical and biochemical characteristics associated with diabetes in the oldest age group of elderly men. METHODS We conducted a cross-sectional analysis of community-dwelling men aged 79-97 years from Perth, Western Australia. Lifestyle behaviours, self-rated health, physical function, and fasting glucose and HbA1c levels were assessed. RESULTS Of 1426 men, 315 had diabetes (22%). Men with diabetes were of similar age to men without (84.9 vs 84.5 years; P = 0.14). Only 26.5% of men with diabetes self-rated their health as excellent or very good, compared with 40.6% of men without diabetes (P < 0.001). Diabetes was associated with less involvement with recreational walking (32.7 vs 41.0%; P < 0.01) and leisure activities (19.0 vs 26.5%; P < 0.01). Men with diabetes had poorer physical function on multiple measures, including longer times for the Timed Up-and-Go test (15.0 ± 6.9 s vs 13.4 ± 5.3 s; P < 0.001) and weaker knee extension (20.2 vs 21.9 kg; P < 0.001). In multivariate analyses, diabetes was associated with an increased prevalence of myocardial infarction (odds ratio 1.80, 95% CI 1.25-2.60; P < 0.001) and falls resulting in injury (odds ratio 1.55, 95% CI 1.06-2.26; P = 0.02). Average HbA1c was 49 ± 8 mmol/mol (6.6 ± 0.8%) in men with diabetes, with 90.6% of these men on diet or oral hypoglycaemic therapy. CONCLUSIONS In older men, diabetes is associated with poorer self-perceived health, reduced healthy lifestyle behaviours and physical function, heart disease and injurious falls. The majority of these men with diabetes had good glycaemic control. Encouraging healthy lifestyle behaviours and improving physical function should be evaluated as interventions to improve quality-of-life and health outcomes.
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Affiliation(s)
- M Henze
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - H Alfonso
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - L Flicker
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
| | - J George
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
| | - S A P Chubb
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - G J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - O P Almeida
- Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - J Golledge
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine, James Cook University, Townsville, Queensland, Australia
- Department of Vascular and Endovascular Surgery, Townsville Hospital, Townsville, Queensland, Australia
| | - P E Norman
- School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - B B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
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170
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O’Donnell M, Sims S, Maclean MJ, Gonzalez-Izquierdo A, Gilbert R, Stanley FJ. Trends in alcohol-related injury admissions in adolescents in Western Australia and England: population-based cohort study. BMJ Open 2017; 7:e014913. [PMID: 28554923 PMCID: PMC5623454 DOI: 10.1136/bmjopen-2016-014913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Alcohol-related harm in young people is now a global health priority. We examined trends in hospital admissions for alcohol-related injuries for adolescents in Western Australia (WA) and in England, identified groups most at risk and determined causes of injuries. METHODS Annual incidence rates for alcohol-related injury rates were calculated using population-level hospital admissions data for WA and England. We compared trends in different types of alcohol-related injury by age and gender. RESULTS Despite a decrease in the overall rate of injury admissions for people aged 13-17 years in WA, alcohol-related injuries have increased significantly from 1990 to 2009 (from 8 to 12 per 10 000). Conversely, alcohol-related injury rates have declined in England since 2007. In England, self-harm is the most frequently recorded cause of alcohol-related injury. In WA, unintentional injury is most common; however, violence-related harm is increasing for boys and girls. CONCLUSION Alcohol-related harm of sufficient severity to require hospital admission is increasing among adolescents in WA. Declining trends in England suggest that this trend is not inevitable or irreversible. More needs to be done to address alcohol-related harm, and on-going monitoring is required to assess the effectiveness of strategies.
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Affiliation(s)
- Melissa O’Donnell
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Scott Sims
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Miriam J Maclean
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | | | - Ruth Gilbert
- Institute of Child Health, University College London, London, UK
| | - Fiona J Stanley
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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171
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Johnson SE, O’Leary C, Bower C, Lawrence D, Cunningham N, Semmens J, Zubrick SR. Maternal alcohol disorders and school achievement: a population cohort record linkage study in Western Australia. BMJ Open 2017; 7:e014599. [PMID: 28490556 PMCID: PMC5623360 DOI: 10.1136/bmjopen-2016-014599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Maternal alcohol use disorder is a risk factor for a range of developmental outcomes in children. This study examines school achievement in children of Indigenous and non-Indigenous mothers with an alcohol-related diagnosis. DESIGN, SETTING AND PARTICIPANTS This is a Western Australian population cohort study of mothers with a record of an alcohol-related diagnosis classified by the International Classification of Diseases Revisions 9/10 codes as recorded on administrative databases, and of their offspring born between 1989 and 2007 (n=18 486 exposed children), with a frequency matched comparison cohort of mothers with no record of alcohol diagnosis and their offspring (n=48 262 comparison children). OUTCOMES Records were linked with school achievement data for numeracy and literacy from Years 3, 5, 7 and 9 (age range: ~8-14 years) based on statewide and national testing. Mixed multivariate models with a random intercept per child were used to assess the relationship between exposure and the timing of exposure with failure to meet minimum standardised benchmarks. RESULTS Academic achievement was lower in all testing domains (reading, writing, spelling and numeracy) among children of mothers with an alcohol diagnosis and persisted across all year groups examined. The highest ORs at Year 9 for non-Indigenous children were in reading (adjusted OR (aOR) 1.6, 95% CI 1.4 to 1.8) and in writing for Indigenous children (aOR 2.0, 95% CI 1.8 to 2.3). CONCLUSION Children of mothers with alcohol use disorders are at risk of not meeting minimum educational benchmarks in numeracy and literacy, with the risk highest among Indigenous children.
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Affiliation(s)
- Sarah E Johnson
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Colleen O’Leary
- Department of Health, Office of the Chief Psychiatrist, East Perth, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - David Lawrence
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Graduate School of Education, The University of Western Australia, Perth, Australia
| | - Nadia Cunningham
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- School of Psychology, The University of Western Australia, Perth, Australia
| | - James Semmens
- Centre for Population Health Research, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Graduate School of Education, The University of Western Australia, Perth, Australia
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172
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Hu N, Taylor CL, Li J, Glauert RA. The impact of child maltreatment on the risk of deliberate self-harm among adolescents: A population-wide cohort study using linked administrative records. Child Abuse Negl 2017; 67:322-337. [PMID: 28347932 DOI: 10.1016/j.chiabu.2017.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 03/07/2017] [Accepted: 03/17/2017] [Indexed: 05/24/2023]
Abstract
Adolescents exposed to maltreatment have an elevated risk of deliberate self-harm (DSH). The aim of this study was to investigate longitudinally the effects of the number, timing, and type of maltreatment allegations on adolescent risk of having a DSH-related hospital admission, using linked data in Western Australia. A total of 351,372 children born between 1986 and 2000 were followed from birth up to the year 2010. Cox regression models were utilized, while controlling for a range of psychosocial covariates. Compared to children without allegations of maltreatment, children with unsubstantiated allegations only (aHR=1.04, 95%CI: 1.00-1.08, p<.01) and children with a substantiated allegation (aHR=1.10, 95%CI: 1.06-1.15, p<.001) all had significantly increased risk of DSH in adolescence. Among children with a substantiated allegation of maltreatment, the greater the number of allegations, the longer the exposure to maltreatment, and the more types of maltreatment experienced by a child, the higher the child's risk of DSH. However, this dose-response pattern was not found among children with unsubstantiated allegations only. This study calls for the early identification of children who are vulnerable to maltreatment, the better identification of the duration and severity of maltreatment experiences, and the provision of continued care and support, to reduce the child's DSH risk in adolescence.
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Affiliation(s)
- Nan Hu
- Telethon Kids Institute, the University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia; The School of Population Health, the University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia.
| | - Catherine L Taylor
- Telethon Kids Institute, the University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia.
| | - Jianghong Li
- Telethon Kids Institute, the University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia; WZB Berlin Social Research Center, Reichpietschufer 50, D-10785 Berlin, Germany; Centre for Population Health Research, the Faculty of Health Sciences, Curtin University, Building 400 Level 4, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Rebecca A Glauert
- Telethon Kids Institute, the University of Western Australia, PO Box 855, West Perth, Western Australia 6872, Australia.
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173
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Cooper MN, de Bock MI, Carter KW, de Klerk NH, Jones TW, Davis EA. Incidence of and risk factors for hospitalisations due to vascular complications: A population-based type 1 diabetes cohort (n=1316) followed into early adulthood. J Diabetes Complications 2017; 31:843-849. [PMID: 28242271 DOI: 10.1016/j.jdiacomp.2016.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 01/01/2023]
Abstract
AIM To determine the incidence of hospitalisations and risk factors for vascular complications experienced during early adulthood in patients with childhood onset type 1 diabetes. METHODS A population-based childhood onset type 1 diabetes cohort was identified from a statewide register (1992-2012). Data linkage was used to identify a matched comparison cohort. Hospital admissions data were extracted to follow up both cohorts into early adulthood (1975-2012). RESULTS The type 1 diabetes cohort (n=1316) had a mean age of diagnosis of 9.5years, 49.5% were women and mean age at the end of follow-up was 26.3years (range 18-38). Within the type 1 diabetes cohort 32 (2.4%) were hospitalised with a vascular complication during early adulthood. Poor glycaemic control during paediatric management was associated with a significant increase in risk for ophthalmic complication with 19.4% (n=12/62) of those with a mean HbA1c >12% (108mmol/mol) diagnosed compared to 0.72% (n=5/696) of those with mean HbA1c <9% (75mmol/mol), adjusted hazard ratio 8.4 (95% CI 2.0, 34.7). CONCLUSION Severe vascular complications requiring hospital admission continue to be observed during early adulthood. Both women and those with poor glycaemic control are at increased risk of requiring a hospital admission for these complications during early adulthood.
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Affiliation(s)
- Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Martin I de Bock
- Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Kim W Carter
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Nicholas H de Klerk
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; The School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Timothy W Jones
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; The School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth A Davis
- Telethon Kids Institute, The University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; The School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
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Abstract
The aim of this study was to create an Urban Dental Index (UDI) for Perth, Western Australia, adapting a method utilised by the World Health Organisation. Dental health indicators were derived from the 2011 census, standardised on a (0,1) interval, amalgamated using a geometric mean, and mapped to identify dental health inequity. The validity of the UDI was tested by comparison with oral cellulitis data. Dental health disparities were examined using a ratio of the mean of the highest to lowest decile and slope of the eight middle deciles. The robustness of the UDI was tested using indicator correlation, weighting, and systematic indicator removal. There were a high proportion of low UDI census areas outside the inner city. Adult public dental clinics were unevenly distributed across these low UDI areas. The UDI was significantly correlated with oral cellulitis data and had a moderate disparity ratio (1.69) and slope (0.23). All dental indicators were highly correlated, and UDIs calculated with weighted indicators and indicators removed were significantly correlated with the original UDI. These results indicate that the UDI is a robust tool which can be used by policy makers to target dental health initiatives to high-risk areas.
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Affiliation(s)
- Emily Coles
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Perth, 6009, Western Australia, Australia.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Perth, 6009, Western Australia, Australia
| | - Abed Aktam Anjrini
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Perth, 6009, Western Australia, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Perth, 6009, Western Australia, Australia
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Babyak JM, Sharp CR. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital. J Am Vet Med Assoc 2017; 249:65-71. [PMID: 27308883 DOI: 10.2460/javma.249.1.65] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.
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176
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Shi JW, MacInnis RJ, Boyle T, Vallance JK, Winkler EAH, Lynch BM. Physical Activity and Sedentary Behavior in Breast and Colon Cancer Survivors Relative to Adults Without Cancer. Mayo Clin Proc 2017; 92:391-398. [PMID: 28185657 DOI: 10.1016/j.mayocp.2016.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/22/2016] [Accepted: 12/19/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess differences in accelerometer-assessed moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity, and sedentary time between cancer survivors and adults without cancer. PATIENTS AND METHODS Accelerometer data collected from 241 breast cancer survivors (ACCEL-Breast study, 2013) and 171 colon cancer survivors (ACCEL-Colon study, 2012-2013) were pooled with data collected from adults without cancer (Australian Diabetes, Obesity and Lifestyle accelerometer substudy, 2011-2012). Linear regression was used to estimate differences in physical activity and sedentary behavior levels between cancer survivors and adults without cancer, adjusted for potential confounding factors. RESULTS The mean MVPA was significantly higher among breast cancer survivors than among females who had not had cancer (29 vs 22 min/d; P<.001). Colon cancer survivors had significantly lower levels of light activity than did adults without cancer (311 vs 338 min/d; P<.001), more sedentary time (532 vs 507 min/d; P=.003), and more prolonged sedentary time (210 vs 184 min/d; P=.002). CONCLUSION Contrary to findings from previous research (based on self-reported physical activity), cancer survivors engaged in more (breast) or equivalent (colon) MVPA compared with adults without cancer. Differences between colon cancer survivors and adults without cancer for light activity and sedentary behavior highlight the importance of considering the full activity spectrum in the context of cancer control.
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Affiliation(s)
- Joyce W Shi
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Terry Boyle
- School of Public Health, Curtin University, Perth, Western Australia, Australia; Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Elisabeth A H Winkler
- School of Public Health, Cancer Prevention Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
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177
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Hamilton E, Davis WA, Bruce DG, Davis TME. Influence of Premature Mortality on the Link Between Type 2 Diabetes and Hip Fracture: The Fremantle Diabetes Study. J Clin Endocrinol Metab 2017; 102:551-559. [PMID: 27880070 DOI: 10.1210/jc.2016-3570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/22/2016] [Indexed: 02/13/2023]
Abstract
CONTEXT Studies of hip fracture complicating diabetes have not considered the effect of premature mortality. OBJECTIVE The aim of our study was to determine influence of the competing risk of death on the association between type 2 diabetes and hip fracture. DESIGN The study was designed as a longitudinal observational study. SETTING The study setting was an urban community. PATIENTS Participants included 1291 patients with type 2 diabetes (mean age 64.0 years) and 5159 matched residents without diabetes. MAIN OUTCOME MEASURES Primary outcome measures were incident hip fracture hospitalizations and deaths. Hip fracture risk was assessed using proportional hazards and competing risk regression modeling. RESULTS During a mean of 14.1 years of follow-up, the incidence rate ratio for first hip fracture hospitalization in participants with vs without diabetes was 1.33 [95% confidence interval (CI), 1.05 to 1.68; P = 0.013]. Type 2 diabetes was associated with a cause-specific hazard ratio (csHR) for hip fracture of 1.50 (95% CI, 1.19 to 1.89; P < 0.001) and a subdistribution hazard ratio (sdHR) of 1.21 (95% CI, 0.96 to 1.52; P = 0.11) after adjustment for age, sex, and comorbidities. In patients with diabetes, significant csHRs for incident hip fracture were male sex (protective), body mass index (protective), insulin use, and renal impairment. These variables, with increasing age, also had significant sdHRs. CONCLUSIONS The diabetes-associated risk of hip fracture is attenuated after allowing for the competing risk of death. Risk factors for hip fracture in diabetes were those in reported in general population studies plus insulin use.
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Affiliation(s)
- Emma Hamilton
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia 6009, Australia; and
| | - Wendy A Davis
- Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, Western Australia 6959, Australia
| | - David G Bruce
- Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, Western Australia 6959, Australia
| | - Timothy M E Davis
- Department of Endocrinology and Diabetes, Fremantle Hospital, Fremantle, Western Australia 6959, Australia
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Strobel NA, Peter S, McAuley KE, McAullay DR, Marriott R, Edmond KM. Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: a population-based data linkage study. BMJ Open 2017; 7:e013492. [PMID: 28100563 PMCID: PMC5253619 DOI: 10.1136/bmjopen-2016-013492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. DESIGN Prospective population-based linked data set. SETTING AND PARTICIPANTS All preterm babies born in Western Australia during 2010 and 2011. MAIN OUTCOME MEASURES All-cause hospitalisations and emergency department presentations. RESULTS There were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22). CONCLUSIONS In Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.
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Affiliation(s)
- Natalie A Strobel
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Sue Peter
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Kimberley E McAuley
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel R McAullay
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
- Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Western Australia, Australia
| | - Rhonda Marriott
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia
| | - Karen M Edmond
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
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179
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Al-Habsi K, Yang R, Ryan U, Jacobson C, Miller DW. Morphological and molecular characterization of an uninucleated cyst-producing Entamoeba spp. in captured Rangeland goats in Western Australia. Vet Parasitol 2017; 235:41-46. [PMID: 28215866 DOI: 10.1016/j.vetpar.2017.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 11/17/2022]
Abstract
Uninucleated Entamoeba cysts measuring 7.3×7.7μm were detected in faecal samples collected from wild Rangeland goats (Capra hircus) after arrival at a commercial goat depot near Geraldton, Western Australia at a prevalence of 6.4% (8/125). Sequences were obtained at the 18S rRNA (n=8) and actin (n=5) loci following PCR amplification. At the 18S locus, phylogenetic analysis grouped the isolates closest with an E. bovis isolate (FN666250) from a sheep from Sweden with 99% similarity. At the actin locus, no E. bovis sequences were available, and the isolates shared 94.0% genetic similarity with E. suis from a pig in Western Japan. This is the first report to describe the morphology and molecular characterisation of Entamoeba from Rangeland goats in Western Australia and the first study to produce actin sequences from E. bovis-like Entamoeba sp.
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Affiliation(s)
- Khalid Al-Habsi
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Rongchang Yang
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Una Ryan
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia.
| | - Caroline Jacobson
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - David W Miller
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, 6150, Australia
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180
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Abstract
BACKGROUND Prior studies have suggested a relationship between atopy and mental health, although methodological barriers have limited the generalizability of these findings. The objective of this study was to investigate the relationship between early-life atopy and vulnerability to mental health problems among youth in the community. METHOD Data were drawn from the Raine Study (N = 2868), a population-based birth cohort study in Western Australia. Logistic regression and generalized estimating equations were used to examine the relationship between atopy at ages 1-5 years [using parent report and objective biological confirmation (sera IgE)], and the range of internalizing and externalizing mental health problems at ages 5-17 years. RESULTS Atopy appears to be associated with increased vulnerability to affective and anxiety problems, compared to youth without atopy. These associations remained significant after adjusting for a range of potential confounders. No relationship was evident between atopy and attention deficit hyperactivity disorder or externalizing problems. CONCLUSIONS Findings are the first linking atopy (measured by both parent report and objective verification) with increased vulnerability to affective and anxiety problems. Therefore, replication is required. If replicated, future research aimed at understanding the possible biological and/or social and environmental pathways underlying these links is needed. Such information could shed light on shared pathways that could lead to more effective treatments for both atopy and internalizing mental health problems.
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Affiliation(s)
- R D Goodwin
- Department of Psychology,Queens College and The Graduate Center,City University of New York (CUNY),Queens,NY,USA
| | - M Robinson
- Telethon Kids Institute,The University of Western Australia,West Perth,WA,Australia
| | - P D Sly
- Telethon Kids Institute,The University of Western Australia,West Perth,WA,Australia
| | - P G Holt
- Telethon Kids Institute,The University of Western Australia,West Perth,WA,Australia
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181
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Hall S, Holman CD, Sheiner H, Hendrie D. The influence of socio-economic and locational disadvantage on survival after a diagnosis of lung or breast cancer in Western Australia. J Health Serv Res Policy 2016; 9 Suppl 2:10-6. [PMID: 15511320 DOI: 10.1258/1355819042248116] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives The effects of demographic, locational and socio-economic disadvantage, and the influence of private health care on five-year mortality rates in patients with lung cancer or after breast cancer surgery in Western Australia were examined. Methods The Western Australian Record Linkage Project was used to extract all hospital morbidity, cancer and death records of all people with lung or breast cancer in Western Australia from 1982 to 1996. Mortality rate ratios after a diagnosis of lung cancer or breast cancer surgery were estimated using Cox regression. Two sets of analyses were carried out: demographically adjusted from 1982 to 1996; and demographically and disadvantage adjusted from 1992 to 1996. Results Overall, 87.7% of lung cancer and 17.8% of breast cancer patients were deceased by five years. Lung and breast cancer patients treated in rural hospitals had higher mortality rates (1992-1996: relative risk (RR) 1.24, 95% confidence interval (CI) 1.07-1.44, and RR 1.20, 95% CI 0.92-1.56, respectively; 1982-1996: RR 1.20, 95% CI 1.11- 1.30, and RR 1.19, 95% CI 1.06-1.33, respectively), whereas location of residence had little effect. Lung and breast cancer patients treated in private hospitals had lower mortality (1992-1996: RR 0.85, 95% CI 0.76-0.95, and RR 0.90, 95% CI 0.77-1.05, respectively; 1982-1996: RR 0.91, 95% CI 0.84-0.97, and RR 0.92, 95% CI 0.85-0.99, respectively), although insurance status was not a factor. Women with breast cancer had significantly worse survival in the more socio-economically disadvantaged groups (1992-1996: RR 1.41 to 1.26; 1982-1996: RR 1.45 to 1.29). Conclusions Survival was poorer in patients treated in the public hospital system, but the possession of private health insurance was not predictive of better outcomes. People treated in rural hospitals had worse survival, whereas location of residence was not an independent factor. Women in more socio-economically advantaged groups who underwent breast cancer surgery had improved survival.
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Affiliation(s)
- Sonja Hall
- School of Population Health, University of Western Australia, Crawley, WA 6009, Australia
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Whitworth SR, Bruce DG, Starkstein SE, Davis WA, Davis TME, Bucks RS. Lifetime depression and anxiety increase prevalent psychological symptoms and worsen glycemic control in type 2 diabetes: The Fremantle Diabetes Study Phase II. Diabetes Res Clin Pract 2016; 122:190-197. [PMID: 27865961 DOI: 10.1016/j.diabres.2016.10.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/21/2016] [Accepted: 10/30/2016] [Indexed: 01/30/2023]
Abstract
AIMS To determine the contribution of lifetime major depressive disorder (L-MDD) and lifetime generalized anxiety disorder (L-GAD) to current psychological symptom severity, health behaviour and glycaemic control in type 2 diabetes. METHODS 1285 community-dwelling people with type 2 diabetes (Fremantle Diabetes Study Phase-II; FDS2) completed the PHQ-9 and Brief Life-Time Depression Scale (BLDS) to assess current and past MDD. The Generalized Anxiety Disorder Scale (GADS) and the Generalized Anxiety Disorder Scale-Lifetime (GAD-LT), designed for FDS2, assessed current and past anxiety. Data were analysed using analysis of covariance and multiple mediation models, controlling for age, gender, marital status, and diabetes duration. RESULTS L-MDD and L-GAD were independently associated with more severe current depression (both P<0.001) and anxiety (both P<0.001) symptoms. Mediation models revealed that, through increasing the severity of current depressive symptoms, L-MDD was associated with higher HbA1c and body mass index (BMI), greater likelihood of current smoking, and reduced self-monitoring of blood glucose (SMBG) (indirect regression path ab, all P<0.001). In combination, L-MDD+L-GAD additionally elevated the risk of higher HbA1c and worse diabetes management, by increasing the severity of current depressive symptoms (indirect regression path ab, all P<0.001). CONCLUSIONS Lifetime depression and anxiety increase risk of more severe psychological symptoms, hyperglycaemia, and difficulties with health behaviour in type 2 diabetes. Early screening for these disorders at diabetes diagnosis may be warranted to maximize long-term health outcomes.
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Affiliation(s)
- S R Whitworth
- School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia.
| | - D G Bruce
- School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - S E Starkstein
- School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - W A Davis
- School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - T M E Davis
- School of Medicine & Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - R S Bucks
- School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia
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183
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Collaborative Aneurysm Screening Study Group (CASS Group), Chichester Aneurysm Screening Group (UK), Viborg Aneurysm Screening Study (Denmark), Western Australia Abdominal Aortic Aneurysm Program (Australia), Multicentre Aneurysm Screening Study (MASS)(UK). A comparative study of the prevalence of abdominal aortic aneurysms in the United Kingdom, Denmark, and Australia. J Med Screen 2001; 8:46-50. [PMID: 11373850 DOI: 10.1136/jms.8.1.46] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives To compare attendance and prevalence of abdominal aortic aneurysm (AAA) in population based randomised trials of sonographic screening in the United Kingdom, Western Australia, and Denmark. Methods 65 290 men were randomised to screening in the four trials, and data were collected and analysed from 46 397 aortic scans for men aged between 64 and 83 years who attended one of four community screening programmes. Comparisons were made for age standardised populations (65–74 years). Results Age standardised attendance varied between 74% and 81%, and was highest in the United Kingdom and lowest in Western Australia. Age standardised prevalence of AAAs of 3.0 cm or more varied significantly between 4.5% and 7.7%, and was highest in the United Kingdom and lowest in Denmark. Conclusions Participation in the four programmes compares favourably with other reported screening studies. The possibility that variations may reflect the different recruitment methods used is discussed. The prevalence of AAA in central Denmark would appear to be significantly different from that in southern England and Western Australia.
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Abstract
INTRODUCTION Heart failure (HF) is a chronic, debilitating and progressive disease associated with high morbidity and mortality. Evidence-based medications (EBMs) are the cornerstone of management of patients with HF. In Australia, these EBMs are subsidised by the Commonwealth Government under the Pharmaceutical Benefits Scheme. Suboptimal dispensing and non-adherence to these EBMs have been observed in patients with HF. Our study will investigate trends in dispensing patterns, as well as adherence and persistence of EBMs for HF. We will also identify factors influencing these patterns and their impact on long-term clinical outcomes. METHODS AND ANALYSIS This whole population-based cohort study will use longitudinal data for people aged 65-84 years who were hospitalised for HF in Western Australia between 2003 and 2008. Linked state-wide and national data will provide patient-level information on medication dispensing, medical visits, hospitalisations and death. Drug dispensing trends will be described, drug adherence and persistence estimated and the association with all-cause/cardiovascular death and hospitalisations reported. ETHICS AND DISSEMINATION This project has received approvals from the Western Australian Department of Health Human Research Ethics Committee and the Western Australian Aboriginal Health Ethics Committee. Results will be published in relevant cardiology journals and presented at national and international conferences.
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Affiliation(s)
- Xiwen Qin
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Tiew-Hwa Katherine Teng
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
- National Heart Centre Singapore, Singapore, Singapore
| | - Joseph Hung
- Sir Charles Gairdner Hospital Unit, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Tom Briffa
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Frank M Sanfilippo
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
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185
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Jelley L, Levy A, Deng YM, Spirason N, Lang J, Buettner I, Druce J, Blyth C, Effler P, Smith D, Barr IG. Influenza C infections in Western Australia and Victoria from 2008 to 2014. Influenza Other Respir Viruses 2016; 10:455-461. [PMID: 27373693 PMCID: PMC5059950 DOI: 10.1111/irv.12402] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Influenza C is usually considered a minor cause of respiratory illness in humans with many infections being asymptomatic or clinically mild. Large outbreaks can occur periodically resulting in significant morbidity. OBJECTIVES This study aimed at analyzing the available influenza C clinical samples from two widely separated states of Australia, collected over a 7-year period and to compare them with influenza C viruses detected in other parts of the world in recent years. PATIENTS/METHODS Between 2008 and 2014, 86 respiratory samples that were influenza C positive were collected from subjects with influenza-like illness living in the states of Victoria and Western Australia. A battery of other respiratory viruses were also tested for in these influenza C-positive samples. Virus isolation was attempted on all of these clinical samples, and gene sequencing was performed on all influenza C-positive cultures. RESULTS AND CONCLUSIONS Detections of influenza C in respiratory samples were sporadic in most years studied, but higher rates of infection occurred in 2012 and 2014. Many of the patients with influenza C had coinfections with other respiratory pathogens. Phylogenetic analysis of the full-length hemagglutinin-esterase-fusion (HE) gene found that most of the viruses grouped in the C/Sao Paulo/378/82 clade with the remainder grouping in the C/Kanagawa/1/76 clade.
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Affiliation(s)
- Lauren Jelley
- WHO Collaborating Centre for Reference and Research, Melbourne, Vic., Australia
| | - Avram Levy
- PathWest Laboratory Medicine WA, Nedlands, WA, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - Yi-Mo Deng
- WHO Collaborating Centre for Reference and Research, Melbourne, Vic., Australia
| | - Natalie Spirason
- WHO Collaborating Centre for Reference and Research, Melbourne, Vic., Australia
| | - Jurissa Lang
- PathWest Laboratory Medicine WA, Nedlands, WA, Australia
| | - Iwona Buettner
- WHO Collaborating Centre for Reference and Research, Melbourne, Vic., Australia
| | - Julian Druce
- Victorian Infectious Disease Reference Laboratory, Melbourne, Vic., Australia
| | - Chris Blyth
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
- Princess Margaret Hospital for Children, Subiaco, Perth, WA, Australia
- Wesfarmers Centre for Vaccines and infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Paul Effler
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
- Communicable Disease Control Directorate, Department of Health, Shenton Park, WA, Australia
| | - David Smith
- PathWest Laboratory Medicine WA, Nedlands, WA, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - Ian G Barr
- WHO Collaborating Centre for Reference and Research, Melbourne, Vic., Australia.
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Vic., Australia.
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186
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Stevenson AW, Randall SM, Boyd JH, Wood FM, Fear MW, Duke JM. Burn leads to long-term elevated admissions to hospital for gastrointestinal disease in a West Australian population based study. Burns 2016; 43:665-673. [PMID: 27720266 DOI: 10.1016/j.burns.2016.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND While the most obvious impact of burn is on the skin, systemic responses also occur after burn, including intestinal inflammation. The objective of this study was to assess if burns are associated with increased long-term admissions for gastrointestinal diseases. METHODS A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of adults aged at least 15 years when hospitalized for a first burn (n=20,561) in 1980-2012. A frequency matched non-injury comparison cohort was randomly selected from Western Australia's birth registrations and electoral roll (n=80,960). Crude admission rates and summed days in hospital for digestive diseases were calculated. Negative binomial and Cox proportional hazards regression modeling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. RESULTS After adjustment for demographic factors and pre-existing health status, the burn cohort had 1.54 times (95% confidence interval (CI): 1.47-1.62) as many admissions and almost three times the number of days in hospital with a digestive system diagnosis (IRR, 95% CI: 2.90, 2.60-3.25) than the uninjured cohort. Significantly elevated adjusted post-burn incident rates were identified, with the risk decreasing with increasing time: in the first month (HR, 95% CI: 3.02, 1.89-4.82), from one month to five years (HR, 95% CI: 1.42, 1.31-1.54), and from five to twenty years after burn (HR, 95% CI: 1.13, 1.06-1.20). CONCLUSIONS Findings of increased hospital admission rates and prolonged length of hospital stay for gastrointestinal diseases in the burn cohort provide evidence to support that burns have effects that persist long after the initial injury.
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Affiliation(s)
- Andrew W Stevenson
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
| | - Sean M Randall
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia.
| | - James H Boyd
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia.
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia; Burns Service of Western Australia, Fiona Stanley Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia.
| | - Mark W Fear
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
| | - Janine M Duke
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
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187
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Demmer DL, Beilin LJ, Hands B, Burrows S, Pennell CE, Lye SJ, Mountain JA, Mori TA. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished? PLoS One 2016; 11:e0162164. [PMID: 27622523 PMCID: PMC5021262 DOI: 10.1371/journal.pone.0162164] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/30/2016] [Indexed: 11/19/2022] Open
Abstract
Background and Aims Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. Methods and Results 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Conclusion Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults.
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Affiliation(s)
- Denise L. Demmer
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia
- * E-mail:
| | - Lawrence J. Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia
| | - Beth Hands
- Institute for Health Research, The University of Notre Dame Australia, Perth, Australia
| | - Sally Burrows
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia
| | - Craig E. Pennell
- School of Women’s and Infants Health, The University of Western Australia, Perth, Australia
| | - Stephen J. Lye
- Lunenfeld-Tanenbaum Research Institute, University of Toronto, Toronto, Canada
| | - Jennifer A. Mountain
- School of Population Health, The University of Western Australia, Perth, Australia
| | - Trevor A. Mori
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia
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188
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Abstract
OBJECTIVE To investigate if children and adults who are hospitalised for a burn injury have increased long-term hospital use for nervous system diseases. DESIGN A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. PARTICIPANTS Records of 30 997 persons hospitalised for a first burn injury in Western Australia during the period 1980-2012, and 123 399 persons who were age and gender frequency matched with no injury admissions randomly selected from Western Australia's birth registrations and electoral roll. MAIN OUTCOME MEASURES Admission rates and summed length of stay for nervous system diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRRs) and HRs with 95% CIs, respectively. RESULTS After adjustment for demographic factors and pre-existing health status, the burn injury cohort had 2.20 times (95% CI 1.86 to 2.61) as many nervous system admissions and 3.25 times the number of days in hospital (95% CI: 2.28 to 4.64) than the uninjured cohort. This increase was found for those who had sustained burns during childhood (<15 years: IRR, 95% CI: 1.97, 1.49 to 2.61) and early to mid-adulthood (15-45 years: IRR, 95% CI: 2.70, 2.06 to 3.55) and older adults (≥45 years: IRR, 95% CI: 1.62, 1.33 to 1.97). Significantly elevated first-time postburn admissions were observed for children for 15 years postburn discharge (0-5 years: HR, 95% CI: 1.97, 1.75 to 2.22; 5-15 years: HR, 95% CI: 1.44, 1.28 to 1.63) and for adults 45 years and older at index burn for 5 years postburn only (HR, 95% CI: 1.72, 1.42 to 2.09). CONCLUSIONS Burn injury appears to be associated with increased nervous system-related morbidity for many years after burn injury. Further work into the mechanisms and possible treatments to reduce this morbidity are warranted in light of these findings.
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Affiliation(s)
- Thirthar P Vetrichevvel
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Sean M Randall
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia
| | - Mark W Fear
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
- Burns Service of Western Australia, Fiona Stanley Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia
| | - James H Boyd
- Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia
| | - Janine M Duke
- Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia
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189
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Giles-Corti B, Macintyre S, Clarkson JP, Pikora T, Donovan RJ. Environmental and Lifestyle Factors Associated with Overweight and Obesity in Perth, Australia. Am J Health Promot 2016; 18:93-102. [PMID: 13677967 DOI: 10.4278/0890-1171-18.1.93] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine associations between environmental and lifestyle factors and overweight or obesity. Design. A cross-sectional survey and an environmental scan of recreational facilities. Setting. Metropolitan Perth, Western Australia. Subjects. Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. Measures. Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). Results. After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62–11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03–1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08–1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11–2.55) and sidewalks (OR, 1.62; 95% CI, .98–2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01–3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32–.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. Conclusion. Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.
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Affiliation(s)
- Billie Giles-Corti
- School of Population Health, University of Western Australia, Crawley 6009, Western Australia
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190
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Genoni A, Lo J, Lyons-Wall P, Devine A. Compliance, Palatability and Feasibility of PALEOLITHIC and Australian Guide to Healthy Eating Diets in Healthy Women: A 4-Week Dietary Intervention. Nutrients 2016; 8:nu8080481. [PMID: 27509519 PMCID: PMC4997394 DOI: 10.3390/nu8080481] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/22/2016] [Accepted: 08/02/2016] [Indexed: 11/20/2022] Open
Abstract
(1) Background/Objectives: The Paleolithic diet has been receiving media coverage in Australia and claims to improve overall health. The diet removes grains and dairy, whilst encouraging consumption of fruits, vegetables, meat, eggs and nuts. Our aim was to compare the diet to the Australian Guide to Healthy Eating (AGHE) in terms of compliance, palatability and feasibility; (2) Subjects/Methods: 39 healthy women (age 47 ± 13 years, BMI 27 ± 4 kg/m2) were randomised to an ad-libitum Paleolithic (n = 22) or AGHE diet (n = 17) for 4-weeks. A food checklist was completed daily, with mean discretionary consumption (serves/day) calculated to assess compliance. A 12-item questionnaire was administered post intervention to assess palatability and feasibility; (3) Results: The AGHE group reported greater daily consumption of discretionary items (1.0 + 0.6 vs. 0.57 + 0.6 serves/day, p = 0.03). Compared to the AGHE group, the Paleolithic group reported a significantly greater number of events of diarrhoea (23%, 0%, p = 0.046), costs associated with grocery shopping (69%, 6% p < 0.01) and belief that the diet was not healthy (43%, 0% p < 0.01); (4) Conclusions: Compliance to both diets was high but the potential side effects and increased cost suggest that the Paleolithic diet may not be practical in clinical/public health settings. Further studies are required to assess longer term feasibility.
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Affiliation(s)
- Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, WA, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth 6027, WA, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, WA, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, WA, Australia.
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191
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Doney R, Lucas BR, Watkins RE, Tsang TW, Sauer K, Howat P, Latimer J, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Visual-motor integration, visual perception, and fine motor coordination in a population of children with high levels of Fetal Alcohol Spectrum Disorder. Res Dev Disabil 2016; 55:346-357. [PMID: 27228005 DOI: 10.1016/j.ridd.2016.05.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. METHODS VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5-9.6 years, n=108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. RESULTS Mean VMI scores were 'below average' (M=87.8±9.6), and visual perception scores were 'average' (M=97.6±12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M=87.9±12.5; 66.7%) than children without PAE (M=95.1±10.7; 23.3%) and PAE (no FASD) (M=96.1±10.9; 15.4%). CONCLUSIONS Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments.
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Affiliation(s)
- Robyn Doney
- School of Public Health, Curtin University, Perth, Australia.
| | - Barbara R Lucas
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; Poche Center for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia; Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia.
| | - Rochelle E Watkins
- Telethon Kids Institute, University of Western Australia, Perth, Australia.
| | - Tracey W Tsang
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
| | - Kay Sauer
- School of Public Health, Curtin University, Perth, Australia; Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Australia.
| | - Peter Howat
- School of Public Health, Curtin University, Perth, Australia; Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Australia.
| | - Jane Latimer
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
| | - James P Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; Telethon Kids Institute, University of Western Australia, Perth, Australia.
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia; University of Notre Dame, Broome, Australia.
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia.
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, Australia; The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia; The Sydney Children's Hospitals Network (Westmead), Sydney, Australia.
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192
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Regan AK, Klerk ND, Moore HC, Omer SB, Shellam G, Effler PV. Effectiveness of seasonal trivalent influenza vaccination against hospital-attended acute respiratory infections in pregnant women: A retrospective cohort study. Vaccine 2016; 34:3649-56. [PMID: 27216758 DOI: 10.1016/j.vaccine.2016.05.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/06/2016] [Accepted: 05/12/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pregnant women are at risk of serious influenza infection. Although previous studies indicate maternal influenza vaccination can prevent hospitalisation in young infants, there is limited evidence of the effect in mothers. METHODS A cohort of 34,701 pregnant women delivering between 1 April 2012 and 31 December 2013 was created using birth records. Principal diagnosis codes from hospital emergency department (ED) and inpatient records were used to identify episodes of acute respiratory illness (ARI) during the 2012 and 2013 southern hemisphere influenza seasons. Cox regression models were used to calculate adjusted hazard ratios (aHRs) by maternal vaccination status, controlling for Indigenous status, socioeconomic level, medical conditions, and week of delivery. RESULTS 3,007 (8.7%) women received a seasonal influenza vaccine during pregnancy. Vaccinated women were less likely to visit an ED during pregnancy for an ARI (9.7 visits per 10,000 person-days vs. 35.5 visits per 10,000 person-days; aHR: 0.19, 95% CI: 0.05-0.68). Vaccinated women were also less likely to be hospitalised with an ARI compared to unvaccinated women (16.2 hospitalisations per 10,000 person-days vs. 34.0 hospitalisations per 10,000 person-days; aHR: 0.35, 95% CI: 0.13-0.97). CONCLUSIONS Influenza vaccination during pregnancy was associated with significantly fewer hospital attendances for ARI in pregnant women.
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Affiliation(s)
- Annette K Regan
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, 6009, Australia; Communicable Disease Control Directorate, Western Australia Department of Health, Perth, WA, 6008, Australia.
| | - Nicholas de Klerk
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia, 6008, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia, 6008, Australia
| | - Saad B Omer
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - Geoffrey Shellam
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, 6009, Australia
| | - Paul V Effler
- School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, 6009, Australia; Communicable Disease Control Directorate, Western Australia Department of Health, Perth, WA, 6008, Australia
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Chapple SNJ, Sarovich DS, Holden MTG, Peacock SJ, Buller N, Golledge C, Mayo M, Currie BJ, Price EP. Whole-genome sequencing of a quarter-century melioidosis outbreak in temperate Australia uncovers a region of low-prevalence endemicity. Microb Genom 2016; 2:e000067. [PMID: 28348862 PMCID: PMC5343139 DOI: 10.1099/mgen.0.000067] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/11/2016] [Indexed: 12/22/2022] Open
Abstract
Melioidosis, caused by the highly recombinogenic bacterium Burkholderia pseudomallei, is a disease with high mortality. Tracing the origin of melioidosis outbreaks and understanding how the bacterium spreads and persists in the environment are essential to protecting public and veterinary health and reducing mortality associated with outbreaks. We used whole-genome sequencing to compare isolates from a historical quarter-century outbreak that occurred between 1966 and 1991 in the Avon Valley, Western Australia, a region far outside the known range of B. pseudomallei endemicity. All Avon Valley outbreak isolates shared the same multilocus sequence type (ST-284), which has not been identified outside this region. We found substantial genetic diversity among isolates based on a comparison of genome-wide variants, with no clear correlation between genotypes and temporal, geographical or source data. We observed little evidence of recombination in the outbreak strains, indicating that genetic diversity among these isolates has primarily accrued by mutation. Phylogenomic analysis demonstrated that the isolates confidently grouped within the Australian B. pseudomallei clade, thereby ruling out introduction from a melioidosis-endemic region outside Australia. Collectively, our results point to B. pseudomallei ST-284 being present in the Avon Valley for longer than previously recognized, with its persistence and genomic diversity suggesting long-term, low-prevalence endemicity in this temperate region. Our findings provide a concerning demonstration of the potential for environmental persistence of B. pseudomallei far outside the conventional endemic regions. An expected increase in extreme weather events may reactivate latent B. pseudomallei populations in this region.
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Affiliation(s)
- Stephanie N. J. Chapple
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Derek S. Sarovich
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Matthew T. G. Holden
- School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, UK
- Wellcome Trust Sanger Institute, University of Cambridge, Cambridge, UK
| | - Sharon J. Peacock
- Wellcome Trust Sanger Institute, University of Cambridge, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - Nicky Buller
- Department of Agriculture and Food Western Australia, Perth, Western Australia, Australia
| | - Clayton Golledge
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Mark Mayo
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Bart J. Currie
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
- Department of Infectious Diseases and Northern Territory Medical Program, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Erin P. Price
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
- Correspondence Erin P. Price ()
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194
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Dadd G, McMinn P, Monterosso L. Protective Isolation in Hemopoietic Stem Cell Transplants: A Review of the Literature and Single Institution Experience. J Pediatr Oncol Nurs 2016; 20:293-300. [PMID: 14738161 DOI: 10.1177/1043454203254985] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Princess Margaret Hospital for Children, Perth, Western Australia, is a pediatric bone marrow transplant center. This center has both laminar flow and HEPA- (high-efficiency particulate air-)filtered rooms for children under-going allogeneic and autologous transplantation. HEPA-filtered rooms on negative pressure are used to nurse oncology children with infectious diseases. Over the winter months of 2001, there was an increased demand for single rooms for children with infectious diseases. Over the same period, a number of transplants were planned. Consequently, to guide practice decisions, a review of the literature and a survey of nursing practice in Australian and North American pediatric oncology units were undertaken. Findings showed that protective isolation measures such as positive-pressure single rooms, low microbial diets, and strict hand washing should be used only for children requiring allogeneic transplants. Use of other isolation measures were found to be of no added value for transplantation. As autologous transplants are increasingly performed in outpatient clinics, these children should not require the same level of protective isolation.
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Affiliation(s)
- Gaye Dadd
- Oncology Total Care Unit at Princess Margaret Hospital for Children in Perth, Western Australia
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195
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Passmore HM, Giglia R, Watkins RE, Mutch RC, Marriott R, Pestell C, Zubrick SR, Rainsford C, Walker N, Fitzpatrick JP, Freeman J, Kippin N, Safe B, Bower C. Study protocol for screening and diagnosis of fetal alcohol spectrum disorders (FASD) among young people sentenced to detention in Western Australia. BMJ Open 2016; 6:e012184. [PMID: 27334884 PMCID: PMC4932283 DOI: 10.1136/bmjopen-2016-012184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/01/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Prenatal alcohol exposure can cause lifelong disability, including physical, cognitive and behavioural deficits, known as fetal alcohol spectrum disorders (FASD). Among individuals with FASD, engagement with justice services is common. Little is known about the prevalence of FASD among young people engaged with the Australian justice system. This study aims to establish FASD prevalence among sentenced young people in detention in Western Australia (WA), and use the findings to develop a screening tool for use among young people entering detention. Translation of these results will guide the management and support of young people in detention and will have significant implications on the lives of young people with FASD and the future of Australian youth justice services. METHODS AND ANALYSIS Any sentenced young person in WA aged 10-17 years 11 months is eligible to participate. Young people are assessed for FASD by a multidisciplinary team. Standardised assessment tools refined for the Australian context are used, acknowledging the language and social complexities involved. Australian diagnostic guidelines for FASD will be applied. Information is obtained from young people, responsible adults, teachers and custodial officers. Individualised results and management plans for each young person are communicated to the young person and responsible adult. Prevalence of FASD will be reported and multivariate methods used to identify variables most predictive of FASD and to optimise the predictive value of screening. ETHICS AND DISSEMINATION Approvals have been granted by the WA Aboriginal Health Ethics Committee, University of WA Human Research Ethics Committee, Department of Corrective Services, and Department for Child Protection and Family Support. Anonymised findings will be disseminated through peer-reviewed manuscripts, presentations and the media. Extensive consultation with stakeholders (including government agencies, detention centre staff, community service providers, the young people and their families or carers) will be ongoing until findings are disseminated and translated.
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Affiliation(s)
- Hayley M Passmore
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Roslyn Giglia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
| | - Rochelle E Watkins
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
| | - Raewyn C Mutch
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
- Department of Health Western Australia, Child and Adolescent Health Service, Perth, Australia
| | - Rhonda Marriott
- School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia
| | - Carmela Pestell
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Psychology, The University of Western Australia, Perth, Western Australia, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
- Faculty of Education, The University of Western Australia, Perth, Western Australia, Australia
| | - Candice Rainsford
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Noni Walker
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - James P Fitzpatrick
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
| | - Jacinta Freeman
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Natalie Kippin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Bernadette Safe
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Carol Bower
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- National Health and Medical Research Council Centre of Research Excellence “Reducing the Effects of Antenatal Alcohol on Child Health”, Perth, Western Australia, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
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196
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Colville LA, Lee AH. Retrospective Analysis of Catheter-Related Infections in a Hemodialysis Unit. Infect Control Hosp Epidemiol 2016; 27:969-73. [PMID: 16941325 DOI: 10.1086/507821] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Accepted: 06/30/2005] [Indexed: 11/03/2022]
Abstract
Objective.To compare the incidence rates of catheter-related bloodstream infection associated with different vascular access methods in patients receiving hemodialysis.Setting.Tertiary care public hospital in Western Australia.Design.Retrospective analysis of surveillance data collected by the hospital's infection control department.Methods.The number of confirmed bloodstream infections for each type of vascular access was identified for the period from July 2002 through June 2003. The corresponding number of patient-days was determined to calculate the infection incidence rates. The serially correlated data were then analyzed using Poisson generalized estimating equations.Results.A total of 32 confirmed bloodstream infections were identified. Infection rates, in number of infections per 1,000 patient-days, were as follows: 0.4 for native arteriovenous fistulae; 2.86 for synthetic arteriovenous grafts; 4.02 for permanent, tunneled, cuffed central venous catheters; and 20.2 for temporary, nontunneled, noncuffed central venous catheters. Compared with permanent catheters, the monthly infection rate associated with the temporary catheters was significantly higher (incident rate ratio [IRR], 5.025 [95% confidence interval {CI}, 1.532-16.484]; P = .008) and that of arteriovenous fistulae was significantly lower (IRR, 0.099 [95% CI, 0.030-0.324]; P = .001). The monthly infection rate for arteriovenous grafts was not significantly different from that for permanent central venous catheters (IRR, 0.702 [95% CI, 0.246-2.008]; P = .510).Conclusions.A hierarchy of infection risk associated with vascular access type is evident. Native arteriovenous fistulae should be recommended for all patients receiving chronic hemodialysis, to minimize infection.
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Affiliation(s)
- Linda A Colville
- School of Public Health, Curtin University of Technology, Perth, Australia
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197
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Abstract
BACKGROUND/OBJECTIVES Delayed presentation of symptomatic cancer is associated with poorer survival. Aboriginal patients with cancer have higher rates of distant metastases at diagnosis compared with non-Aboriginal Australians. This paper examined factors contributing to delayed diagnosis of cancer among Aboriginal Australians from patient and service providers' perspectives. METHODS In-depth, open-ended interviews were conducted in two stages (2006-2007 and 2011). Inductive thematic analysis was assisted by use of NVivo looking around delays in presentation, diagnosis and referral for cancer. PARTICIPANTS Aboriginal patients with cancer/family members (n=30) and health service providers (n=62) were recruited from metropolitan Perth and six rural/remote regions of Western Australia. RESULTS Three broad themes of factors were identified: (1) Contextual factors such as intergenerational impact of colonisation and racism and socioeconomic deprivation have negatively impacted on Aboriginal Australians' trust of the healthcare professionals; (2) health service-related factors included low accessibility to health services, long waiting periods, inadequate numbers of Aboriginal professionals and high staff turnover; (3) patient appraisal of symptoms and decision-making, fear of cancer and denial of symptoms were key reasons patients procrastinated in seeking help. Elements of shame, embarrassment, shyness of seeing the doctor, psychological 'fear of the whole health system', attachment to the land and 'fear of leaving home' for cancer treatment in metropolitan cities were other deterrents for Aboriginal people. Manifestation of masculinity and the belief that 'health is women's domain' emerged as a reason why Aboriginal men were reluctant to receive health checks. CONCLUSIONS Solutions to improved Aboriginal cancer outcomes include focusing on the primary care sector encouraging general practitioners to be proactive to suspicion of symptoms with appropriate investigations to facilitate earlier diagnosis and the need to improve Aboriginal health literacy regarding cancer. Access to health services remains a critical problem affecting timely diagnosis.
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Affiliation(s)
- Shaouli Shahid
- Centre for Aboriginal Studies, Curtin University
- Western Australian Centre for Rural Health, University of Western Australia
| | | | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, University of Western Australia
| | - Samar Aoun
- School of Nursing, Midwifery and Paramedicine, Curtin University
| | | | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia
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198
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Genoni A, Lyons-Wall P, Lo J, Devine A. Cardiovascular, Metabolic Effects and Dietary Composition of Ad-Libitum Paleolithic vs. Australian Guide to Healthy Eating Diets: A 4-Week Randomised Trial. Nutrients 2016; 8:E314. [PMID: 27223304 PMCID: PMC4882726 DOI: 10.3390/nu8050314] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 01/22/2023] Open
Abstract
(1) BACKGROUND: The Paleolithic diet is popular in Australia, however, limited literature surrounds the dietary pattern. Our primary aim was to compare the Paleolithic diet with the Australian Guide to Healthy Eating (AGHE) in terms of anthropometric, metabolic and cardiovascular risk factors, with a secondary aim to examine the macro and micronutrient composition of both dietary patterns; (2) METHODS: 39 healthy women (mean ± SD age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to either the Paleolithic (n = 22) or AGHE diet (n = 17) for four weeks. Three-day weighed food records, body composition and biochemistry data were collected pre and post intervention; (3) RESULTS: Significantly greater weight loss occurred in the Paleolithic group (-1.99 kg, 95% CI -2.9, -1.0), p < 0.001). There were no differences in cardiovascular and metabolic markers between groups. The Paleolithic group had lower intakes of carbohydrate (-14.63% of energy (E), 95% CI -19.5, -9.7), sodium (-1055 mg/day, 95% CI -1593, -518), calcium (-292 mg/day 95% CI -486.0, -99.0) and iodine (-47.9 μg/day, 95% CI -79.2, -16.5) and higher intakes of fat (9.39% of E, 95% CI 3.7, 15.1) and β-carotene (6777 μg/day 95% CI 2144, 11410) (all p < 0.01); (4) CONCLUSIONS: The Paleolithic diet induced greater changes in body composition over the short-term intervention, however, larger studies are recommended to assess the impact of the Paleolithic vs. AGHE diets on metabolic and cardiovascular risk factors in healthy populations.
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Affiliation(s)
- Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia.
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Bourke J, de Klerk N, Smith T, Leonard H. Population-Based Prevalence of Intellectual Disability and Autism Spectrum Disorders in Western Australia: A Comparison With Previous Estimates. Medicine (Baltimore) 2016; 95:e3737. [PMID: 27227936 PMCID: PMC4902360 DOI: 10.1097/md.0000000000003737] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
To investigate the prevalence of intellectual disability (ID) and/or autism spectrum disorders (ASDs) in Western Australia (WA).A cohort of children born from 1983 to 2010 in WA with an ID and/or ASD were identified using the population-based IDEA (Intellectual Disability Exploring Answers) database, which ascertains cases through the Disability Services Commission (DSC) as well as education sources. Information on race, gender, mother's residence at birth and deaths was obtained through linkage to the Midwives Notification System and the Mortality Register. Diagnostic information on the cause of ID was obtained through review of medical records where available and children were classified as biomedical cause, ASD, or unknown cause.An overall prevalence of ID of 17.0/1000 livebirths (95% CI: 16.7, 17.4) showed an increase from the 10-year previous prevalence of 14.3/1000. The prevalence for mild or moderate ID was 15.0 (95% CI: 14.6, 15.3), severe ID was 1.2 (95% CI: 1.1, 1.3), and unknown level of ID was 0.9 (95% CI: 0.8, 1.0)/1000 livebirths. The prevalence for Aboriginal children was 39.0/1000 compared with 15.7/1000 for non-Aboriginal children, giving a prevalence ratio of 2.5 (95% CI: 2.4, 2.6). Prevalence of all ASD was 5.1/1000 of which 3.8/1000 had ASD and ID.The prevalence of ID has risen in WA over the last 10 years with most of this increase due to mild or moderate ID. Whilst the prevalence of ASD has also increased over this time this does not fully explain the observed increase. Aboriginal children are at a 2.5-fold risk of ID but are less likely to be accessing disability services.
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Affiliation(s)
- Jenny Bourke
- From the Telethon Kids Institute, University of Western Australia (JB, NDK, HL), and Disability Services Commission, Perth, Western Australia, Australia (TS)
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200
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Pang J, Chan DC, Hamilton SJ, Tenneti VS, Watts GF, Barrett PHR. Effect of niacin on triglyceride-rich lipoprotein apolipoprotein B-48 kinetics in statin-treated patients with type 2 diabetes. Diabetes Obes Metab 2016; 18:384-91. [PMID: 26679079 DOI: 10.1111/dom.12622] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/05/2015] [Accepted: 12/14/2015] [Indexed: 11/28/2022]
Abstract
AIM To investigate the effects of extended-release (ER) niacin on apolipoprotein B-48 (apoB-48) kinetics in statin-treated patients with type 2 diabetes (T2DM). METHODS A total of 12 men with T2DM were randomized to rosuvastatin or rosuvastatin plus ER niacin for 12 weeks and then crossed to the alternate therapy. Postprandial metabolic studies were performed at the end of each treatment period. D3-leucine tracer was administered as subjects consumed a high-fat liquid meal. ApoB-48 kinetics were determined using stable isotope tracer kinetics with fractional catabolic rates (FCRs) and secretion rates derived using a non-steady-state compartmental model. Area-under-the-curve (AUC) and incremental AUC (iAUC) for plasma triglyceride and apoB-48 were also calculated over the 10-h period after ingestion of the fat meal. RESULTS In statin-treated patients with T2DM, apoB-48 concentration was lower with ER niacin (8.24 ± 1.98 vs 5.48 ± 1.14 mg/l, p = 0.03) compared with statin alone. Postprandial triglyceride and apoB-48 AUC were also significantly lower on ER niacin treatment (-15 and -26%, respectively; p < 0.05), without any change to triglyceride and apoB-48 iAUC. ApoB-48 secretion rate in the basal state (3.21 ± 0.34 vs 2.50 ± 0.31 mg/kg/day; p = 0.04) and number of apoB-48-containing particles secreted in response to the fat load (1.35 ± 0.19 vs 0.84 ± 0.12 mg/kg; p = 0.02) were lower on ER niacin. ApoB-48 FCR was not altered with ER niacin (8.78 ± 1.04 vs 9.17 ± 1.26 pools/day; p = 0.79). CONCLUSIONS ER niacin reduces apoB-48 concentration by lowering fasting and postprandial apoB-48 secretion rate. This effect may be beneficial for lowering atherogenic postprandial lipoproteins and may provide cardiovascular disease risk benefit in patients with T2DM.
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Affiliation(s)
- J Pang
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - D C Chan
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - S J Hamilton
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Combined Universities Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - V S Tenneti
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - G F Watts
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - P H R Barrett
- Metabolic Research Centre, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Engineering, Computing and Mathematics, University of Western Australia, Perth, Western Australia, Australia
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