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Druery M, Das A, Warren J, Newcombe PA, Lipman J, Cameron CM. Early predictors of health-related quality of life outcomes at 12 months post-burn: ABLE study. Injury 2024:111545. [PMID: 38584078 DOI: 10.1016/j.injury.2024.111545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/21/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024]
Abstract
There remains a paucity of evidence on the early predictors of long-term Health-Related Quality of Life (HRQoL) outcomes post-burn in hospitalised adults. The overall aim of this study was to identify the factors (personal, environmental, burn injury and burn treatment factors) that may predict long-term HRQoL outcomes among adult survivors of hospitalised burn injuries at 12 months post-burn. A total of 274 participants, aged 18 years or over, admitted to a single state-wide burn centre with a burn injury were recruited. Injury and burn treatment information were collected from medical records or the hospital database and surveys collected demographic and social data. HRQoL outcome data were collected at 3-, 6- and 12-months using the 12-Item Short Form Survey (SF-12 v1) and Burns Specific Health Scale-Brief (BSHS-B). Personal, environmental, burn injury and burn treatment factors were also recorded at baseline. Analyses were performed using linear and logistic regression. Among 274 participants, 71.5 % (N=196) remained enrolled in the study at 12 months post-burn. The majority of participants reported HRQoL outcomes comparable with population norms and statistically significant improvements in generic (SF-12 v1) and condition-specific (BSHS-B) outcomes over time. However, for participants with poor HRQoL outcomes at 12-months post-burn, Univariable predictors included longer hospital length of stay, unemployment at the time of injury, a diagnosed pre-injury mental health condition, inadequate pre-burn social support, intentional injury, recreational drug use pre-injury and female gender. The early multivariable predictors of insufficient HRQoL outcomes were female gender, a previously diagnosed mental health condition, unemployment, inadequate social support, intentional injury, and prolonged hospital length of stay. These results suggest potential factors that could be used to screen and burns patients for psychosocial intervention and long-term follow up.
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Affiliation(s)
| | - Arpita Das
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia.
| | - Jacelle Warren
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia
| | | | - Jeffrey Lipman
- The University of Queensland, Australia; Jamieson Trauma Institute, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Australia; Queensland University of Technology, Australia
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Borg SJ, Cameron CM, Luetsch K, Rolley A, Geraghty T, McPhail S, McCreanor V. Prevalence of opioid use in adults with spinal cord injury: A systematic review and meta-analysis. J Spinal Cord Med 2024:1-19. [PMID: 38466869 DOI: 10.1080/10790268.2024.2319384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE To determine the prevalence, reported harms and factors associated with opioid use among adults with spinal cord injury (SCI) living in the community. STUDY DESIGN Systematic review and meta-analysis. METHODS Comprehensive literature searches were conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science and Scopus for articles published between 2000 and 2023. Risk of bias was assessed using a prevalence-specific tool. Random-effects meta-analyses were conducted to pool prevalence data for any context of opioids. Sensitivity and subgroup analyses were also performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the study protocol was registered via Prospero (CRD42022350768). RESULTS Of the 4969 potential studies, 38 were included in the review. Fifty-three percent of studies had a low risk of bias, with a high risk of bias in 5% of studies. The pooled prevalence for the 38 studies included in the meta-analysis (total cohort size of 50,473) across any opioid context was 39% (95% confidence interval [CI], 32-47). High heterogeneity was evident, with a prediction interval twice as wide as the 95% CI (prediction interval, 7-84%). Mean or median opioid dose was unreported in 95% of studies. Opioid dose and factors related to opioids were also rarely explored in the SCI populations. CONCLUSIONS Results should be interpreted with caution based on the high heterogeneity and imprecise pooled prevalence of opioids. Contextual details including pain, cohort-specific injury characteristics and opioid dosage were inconsistently reported, indicating a clear need for additional studies in a population at greater risk of experiencing opioid-related adverse effects.
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Affiliation(s)
- Samantha J Borg
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Australia
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Herston, Australia
| | - Cate M Cameron
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Australia
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Herston, Australia
| | - Karen Luetsch
- School of Pharmacy, University of Queensland, Woolloongabba, Australia
| | - Adam Rolley
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Australia
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Herston, Australia
- Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Australia
| | - Timothy Geraghty
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Australia
- Department of Rehabilitation, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Australia
| | - Steven McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Australia
| | - Victoria McCreanor
- Hunter Medical Research Institute, New Lambton Heights, Australia
- University of Newcastle, Newcastle, Australia
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Cameron CM, Shibl R, Cramb S, McCreanor V, Proper M, Warren J, Smyth T, Carter HE, Vallmuur K, Graves N, Bradford N, Loveday B. Community Opioid Dispensing after Injury (CODI): Cohort characteristics and opioid dispensing patterns. Injury 2024; 55:111216. [PMID: 38000939 DOI: 10.1016/j.injury.2023.111216] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/09/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Despite a focus of opioid-related research internationally, there is limited understanding of long-term opioid use in adults following injury. We analysed data from the 'Community Opioid Dispensing after Injury' data linkage study. AIMS This paper aims to describe the baseline characteristics of the injured cohort and report opioid dispensing patterns following injury-related hospitalisations. METHODS Retrospective cohort study of adults hospitalised after injury (ICD-10AM: S00-S99, T00-T75) in Queensland, Australia between 1 January 2014 and 31 December 2015, prior to implementation of opioid stewardship programs. Data were person-linked between hospitalisation, community opioid dispensing and mortality collections. Data were extracted for 90-days prior to the index hospital admission, to establish opiate naivety, to 720 days after discharge. Median daily oral morphine equivalents (i.e., dose) were averaged for each 30-day interval. Cumulative duration of dispensing and dose were compared by demographic and clinical characteristics, stratified by drug dependency status. RESULTS Of the 129,684 injured adults, 61.3 % had no opioids dispensed in the 2-year follow-up period. Adults having any opioids dispensed in the community (38.7 %) were more likely older, female, to have fracture injuries and injuries with a higher severity, compared to those with no opioids dispensed. Longer durations and higher doses of opioids were seen for those with pre-injury opioid use, more hospital readmissions and repeat surgeries, as well as those who died in the 2-year follow-up period. Median dispensing duration was 24-days with a median daily end dose of 13 oral morphine equivalents. If dispensing occurred prior to the injury, duration increased 10-fold and oral morphine equivalents doubled. Adults with a documented dependency prior to, or after, the injury had significantly longer durations of use and higher doses than the rest of the cohort receiving opioids. Approximately 7 % of the total cohort continued to be dispensed opioids at 2-years post injury. CONCLUSION This is a novel population-level profile of opioid dispensing patterns following injury-related hospitalisation, described for the time period prior to the implementation of opioid stewardship programs and regulatory changes in Queensland. Detailed understanding of this pre-implementation period is critical for evaluating the impact of these changes moving forward.
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Affiliation(s)
- C M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
| | - R Shibl
- School of Science Technology and Engineering, University of the Sunshine Coast, Petrie, QLD, Australia
| | - S Cramb
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - V McCreanor
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - M Proper
- Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Australia
| | - J Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - T Smyth
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health
| | - H E Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - K Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - N Graves
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - N Bradford
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - B Loveday
- Q-Script Management Unit, Queensland Health, Brisbane, Australia
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Meloncelli NJ, Barnett AG, Cameron CM, McIntyre D, Callaway LK, d'Emden MC, de Jersey SJ. Gestational diabetes mellitus screening and diagnosis criteria before and during the COVID-19 pandemic: a retrospective pre-post study. Med J Aust 2023; 219:467-474. [PMID: 37846046 DOI: 10.5694/mja2.52129] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/16/2023] [Accepted: 07/10/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE To determine whether perinatal outcomes after excluding gestational diabetes mellitus (GDM) on the basis of fasting venous plasma glucose (FVPG) assessment during the coronavirus disease 2019 (COVID-19) pandemic in 2020 were similar to those during the preceding year after excluding GDM using the standard oral glucose tolerance test (OGTT) procedure. DESIGN Retrospective pre-post study. SETTING, PARTICIPANTS All women who gave birth in Queensland during 1 July - 31 December 2019 and 1 July - 31 December 2020. MAIN OUTCOME MEASURES Perinatal (maternal and neonatal) outcomes for pregnant women assessed for GDM, by assessment method (2019: OGTT/glycated haemoglobin [HbA1c ] assessment; 2020: GDM could be excluded by an FVPG value below 4.7 mmol/L). RESULTS 3968 of 29 113 pregnant women in Queensland during 1 July - 31 December 2019 (13.6%) were diagnosed with GDM, and 4029 of 28 778 during 1 July - 31 December 2020 (14.0%). In 2020, FVPG assessments established GDM in 216 women (1.1%) and excluded it in 1660 (5.8%). The frequencies of most perinatal outcomes were similar for women without GDM in 2019 and those for whom it was excluded in 2020 on the basis of FVPG values; the exception was caesarean delivery, for which the estimated probability increase in 2020 was 3.9 percentage points (95% credibility interval, 2.2-5.6 percentage points), corresponding to an extra 6.5 caesarean deliveries per 1000 births. The probabilities of several outcomes - respiratory distress, neonatal intensive care or special nursery admission, large for gestational age babies - were about one percentage point higher for women without GDM in 2020 (excluding those diagnosed on the basis of FVPG assessment alone) than for women without GDM in 2019. CONCLUSIONS Identifying women at low absolute risk of gestational diabetes-related pregnancy complications on the basis of FVPG assessment as an initial step in GDM screening could reduce the burden for pregnant women and save the health system substantial costs.
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Affiliation(s)
- Nina Jl Meloncelli
- Centre for Health Services Research, the University of Queensland, Brisbane, QLD
| | - Adrian G Barnett
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD
| | - Cate M Cameron
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, QLD
| | - David McIntyre
- Mater Research, the University of Queensland, Brisbane, QLD
| | - Leonie K Callaway
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, QLD
| | - Michael C d'Emden
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, QLD
| | - Susan J de Jersey
- Centre for Health Services Research, the University of Queensland, Brisbane, QLD
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, QLD
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Cameron CM, Vuong K, McWhinney B, Zournazi A, Manzanero S, Warren J, Mitchell G, Vallmuur K, Howell T, Ungerer JPJ. Factors associated with higher alcohol concentrations in emergency department presentations: PACE study. Drug Alcohol Rev 2023; 42:1796-1806. [PMID: 37703216 DOI: 10.1111/dar.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/11/2023] [Revised: 07/10/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION The health impact from alcohol is of recognised concern, from acute intoxication as well as increased risk of chronic health issues over time. Identifying factors associated with higher alcohol consumption when presenting to the emergency department (ED) will inform public health policy and enable more targeted health care and appropriate referrals. METHODS Secondary testing of blood samples collected during routine clinical care of 1160 ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, for 10 days between 22 January and 1 February 2021. Alcohol was measured by blood ethanol (intake in recent hours) and phosphatidylethanol (PEth; intake over 2-4 weeks). Zero-inflated negative binomial regression was used to identify demographic and clinical factors associated with higher alcohol concentrations. RESULTS Males were found to have 83% higher blood ethanol and 32% higher PEth concentrations than females (adjusted rate ratio [ARR] 1.83, 95% confidence interval [CI] 1.37-2.45 and ARR 1.32, 95% CI 1.04-1.68, respectively). Blood ethanol concentrations were 3.4 times higher for those 18-44 years, compared to those aged 65+ (ARR 3.40, 95% CI 2.40-4.82) whereas PEth concentrations were found to be the highest in those aged 45-64 years, being 70% higher than those aged 65+ (ARR 1.70, 95% CI 1.19-2.44). Patients brought in involuntarily had eight-times higher blood ethanol concentrations than those who self-attended. DISCUSSION AND CONCLUSIONS This study used two alcohol markers to identify factors associated with higher alcohol concentrations in emergency presentations. The findings demonstrate how these biomarkers can provide informative data for public health responses and monitoring of alcohol use trends.
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Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kim Vuong
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | | | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Faculty of Biomedical Science, University of Queensland, Brisbane, Australia
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Halim N, Holland AJA, McMaugh A, Cameron CM, Lystad RP, Badgery-Parker T, Mitchell R. Impact of childhood burns on academic performance: a matched population-based cohort study. Arch Dis Child 2023; 108:808-814. [PMID: 37423641 PMCID: PMC10511986 DOI: 10.1136/archdischild-2023-325769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE This study aimed to compare academic performance and high school completion of young people hospitalised for a burn compared with young people not hospitalised for an injury. DESIGN A retrospective population-based matched case-comparison cohort study. PARTICIPANTS Young people aged ≤18 years hospitalised for a burn during 2005-2018 in New South Wales, Australia, with age, sex and residential postcode-matched peers not hospitalised for any injury during 1 July 2001 and 31 December 2018. MAIN OUTCOME MEASURES Performance below the national minimum standard (NMS) on the National Assessment Plan for Literacy and Numeracy assessments and not completing high school. RESULTS Young females hospitalised for a burn had a 72% higher risk of poorer reading compared with their peers (adjusted relative risk (ARR) 1.72; 95% CI 1.33 to 2.23), while young males hospitalised with a burn showed no higher risk (ARR 1.14; 95% CI 0.91 to 1.43). Young males (ARR 1.05; 95% CI 0.81 to 1.35) and females (ARR 1.34; 95% CI 0.93 to 1.94) hospitalised with a burn had no higher risk of not reaching the NMS for numeracy compared with peers. Young people hospitalised with a burn had at least twice the risk of not completing year 10 (ARR 3.86; 95% CI 1.68 to 8.86), year 11 (ARR 2.45; 95% CI 1.89 to 3.18) and year 12 (ARR 2.09; 95% CI 1.63 to 2.67) compared with matched counterparts. CONCLUSIONS Young females hospitalised with a burn displayed poorer academic performance for reading compared with matched peers, while males and females were more likely to leave school earlier. Identifying unmet learning support needs of young burn survivors should be investigated.
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Affiliation(s)
- Nicole Halim
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Andrew J A Holland
- Department of Pediatric Surgery, Children's Hospital Westmead, Westmead, New South Wales, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tim Badgery-Parker
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Lystad RP, McMaugh A, Herkes G, Browne G, Badgery-Parker T, Cameron CM, Mitchell RJ. Risk of impaired school performance in children hospitalized with concussion: a population-based matched cohort study. Concussion 2023; 8:CNC105. [PMID: 37691853 PMCID: PMC10488614 DOI: 10.2217/cnc-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/21/2023] [Indexed: 09/12/2023] Open
Abstract
Aim To examine the impact of concussion on objective measures of school performance. Materials & methods Population-based matched cohort study using linked health and education records of young people aged ≤18 years hospitalized with concussion in New South Wales, Australia, during 2005-2018, and matched comparisons not hospitalized with any injury. Results Young people with concussion had higher risk of not achieving the national minimum standards for literacy and numeracy assessments, ranging from 30% for numeracy to 43% for spelling, and not completing high school, ranging from 29% for year 10 to 77% for year 12, compared with matched peers. Conclusion Young people hospitalized with concussion have impaired school performance compared with uninjured matched peers.
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Macquarie Park NSW, 2109, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Macquarie Park NSW, 2109, Australia
| | - Geoffrey Herkes
- Sydney Medical School, University of Sydney, Camperdown NSW, 2006, Australia
- Royal North Shore Hospital, St Leonards NSW, 2065, Australia
| | - Gary Browne
- Sydney Medical School, University of Sydney, Camperdown NSW, 2006, Australia
- The Children's Hospital at Westmead, Westmead NSW, 2145, Australia
| | - Tim Badgery-Parker
- Australian Institute of Health Innovation, Macquarie University, Macquarie Park NSW, 2109, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Herston QLD, 4029, Australia
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane QLD, 4000, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Macquarie Park NSW, 2109, Australia
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Cameron CM, Vuong K, McWhinney B, Zournazi A, Manzanero S, Warren J, Mitchell G, McCreanor V, Vallmuur K, Howell T, Ungerer JPJ. Prevalence of alcohol consumption in emergency presentations: Novel approach using two biomarkers, ethanol and phosphatidylethanol. Drug Alcohol Rev 2023; 42:146-156. [PMID: 36054789 PMCID: PMC10087033 DOI: 10.1111/dar.13534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The aim was to determine the prevalence of alcohol-related presentations to an emergency department (ED) in a major Australian hospital, through a novel surveillance approach using two biomarkers, blood ethanol and phosphatidylethanol (PEth). METHODS Observational study using secondary testing of blood samples collected during routine clinical care of ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, between 22 January and 2 February 2021. Data were collected from 1160 patients during the 10-day study period. The main outcomes were the prevalence of acute alcohol intake, as determined by blood ethanol, and recent use over 2-4 weeks, as determined by PEth concentrations, for all ED presentations and different diagnostic groups. RESULTS The overall prevalence for blood ethanol was 9.3% (95% confidence interval [CI] 7.8%, 11.1%), 5.3% for general medical presentations, increasing four-fold to 22.2% for injury presentations. The overall prevalence of PEth positive samples was 32.5% (95% CI 29.9%, 35.3%) and 41.4% for injury presentations. There were 263 (25.3%) cases that tested negative for acute blood ethanol but positive for PEth concentrations indicative of significant to heavy medium-term alcohol consumption. DISCUSSION AND CONCLUSIONS This novel surveillance approach demonstrates that using blood ethanol tests in isolation significantly underestimates the prevalence of medium-term alcohol consumption in ED presentations. Prevalence of alcohol use was higher for key diagnostic groups such as injury presentations. Performing periodic measurement of both acute and medium-term alcohol consumption accurately and objectively in ED presentations, would be valuable for informing targeted public health prevention and control strategies.
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Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kim Vuong
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Victoria McCreanor
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | | | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Faculty of Biomedical Science, University of Queensland, Brisbane, Australia
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Mitchell RJ, McMaugh A, Schniering C, Cameron CM, Lystad RP, Badgery-Parker T, Nielssen O. Mental disorders and their impact on school performance and high school completion by gender in Australia: A matched population-based cohort study. Aust N Z J Psychiatry 2022; 56:1602-1616. [PMID: 34875885 DOI: 10.1177/00048674211061684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Young people with a mental disorder often perform poorly at school and can fail to complete high school. This study aims to compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder health condition by gender. METHOD A population-based matched case-comparison cohort study of young people aged ⩽18 years hospitalised for a mental disorder during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers. RESULTS Young males with a mental disorder had over a 1.7 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.71; 95% confidence interval: [1.35, 2.15]) and reading (adjusted relative risk: 1.99; 95% confidence interval: [1.80, 2.20]) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.50; 95% confidence interval: [1.14, 1.96]) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a sixfold increased risk and young females with multiple disorders had up to an eightfold increased risk of not completing high school compared to peers. CONCLUSION Early recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Carolyn Schniering
- Centre for Emotional Health, Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Brisbane, QLD, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Tim Badgery-Parker
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Olav Nielssen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Mitchell RJ, McMaugh A, Lystad RP, Cameron CM, Nielssen O. Health service use for young males and females with a mental disorder is higher than their peers in a population-level matched cohort. BMC Health Serv Res 2022; 22:1359. [DOI: 10.1186/s12913-022-08789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
To inform healthcare planning and resourcing, population-level information is required on the use of health services among young people with a mental disorder. This study aims to identify the health service use associated with mental disorders among young people using a population-level matched cohort.
Method
A population-based matched case-comparison retrospective cohort study of young people aged ≤ 18 years hospitalised for a mental disorder during 2005–2018 in New South Wales, Australia was conducted using linked birth, health, and mortality records. The comparison cohort was matched on age, sex and residential postcode. Adjusted rate ratios (ARR) were calculated for key demographics and mental disorder type by sex.
Results
Emergency department visits, hospital admissions and ambulatory mental health service contacts were all higher for males and females with a mental disorder than matched peers. Further hospitalisation risk was over 10-fold higher for males with psychotic (ARR 13.69; 95%CI 8.95–20.94) and anxiety (ARR 11.44; 95%CI 8.70-15.04) disorders, and for both males and females with cognitive and behavioural delays (ARR 10.79; 95%CI 9.30-12.53 and ARR 14.62; 95%CI 11.20-19.08, respectively), intellectual disability (ARR 10.47; 95%CI 8.04–13.64 and ARR 11.35; 95%CI 7.83–16.45, respectively), and mood disorders (ARR 10.23; 95%CI 8.17–12.80 and ARR 10.12; 95%CI 8.58–11.93, respectively) compared to peers.
Conclusion
The high healthcare utilisation of young people with mental disorder supports the need for the development of community and hospital-based services that both prevent unnecessary hospital admissions in childhood and adolescence that can potentially reduce the burden and loss arising from mental disorders in adult life.
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Mitchell RJ, McMaugh A, Herkes G, Homaira N, Hng T, Cameron CM, Lystad RP. Hospital service use for young people with chronic health conditions: A population-based matched retrospective cohort study. J Paediatr Child Health 2022; 58:1439-1446. [PMID: 35638474 PMCID: PMC9545431 DOI: 10.1111/jpc.16028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/11/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
AIM This study aims to identify the hospitalised morbidity associated with three common chronic health conditions among young people using a population-based matched cohort. METHODS A population-level matched case-comparison retrospective cohort study of young people aged ≤18 years hospitalised with asthma, type 1 diabetes (T1D) or epilepsy during 2005-2018 in New South Wales, Australia using linked birth, health and mortality records. The comparison cohort was matched on age, sex and residential postcode. Adjusted rate ratios (ARR) were calculated by sex and age group. RESULTS There were 65 055 young people hospitalised with asthma, 6648 with epilepsy, and 2209 with T1D. Young people with epilepsy (ARR 10.95; 95% confidence interval (CI) 9.98-12.02), T1D (ARR 8.64; 95% CI 7.72-9.67) or asthma (ARR 4.39; 95% CI 4.26-4.53) all had a higher risk of hospitalisation than matched peers. Admission risk was highest for males (ARR 11.00; 95% CI 9.64-12.56) and females with epilepsy (ARR 10.83; 95% CI 9.54-12.29) compared to peers. The highest admission risk by age group was for young people aged 10-14 years (ARR 5.50; 95% CI 4.77-6.34) living with asthma, children aged ≤4 years (ARR 12.68; 95% CI 11.35-14.17) for those living with epilepsy, and children aged 5-9 years (ARR 9.12; 95% CI 7.69-10.81) for those living with T1D compared to peers. CONCLUSIONS The results will guide health service planning and highlight opportunities for better management of chronic health conditions, such as further care integration between acute, primary and community health services for young people.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
| | - Anne McMaugh
- The Macquarie School of EducationMacquarie UniversitySydneyNew South WalesAustralia
| | - Geoffrey Herkes
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,Department of NeurologyRoyal North Shore HospitalSydneyNew South WalesAustralia
| | - Nusrat Homaira
- School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia,Respiratory DepartmentSydney Children's HospitalSydneyNew South WalesAustralia
| | - Tien‐Ming Hng
- Department of Diabetes and EndocrinologyBlacktown and Mount Druitt HospitalSydneyNew South WalesAustralia,School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Cate M Cameron
- Jamieson Trauma InstituteRoyal Brisbane & Women's Hospital, Metro North HealthBrisbaneQueenslandAustralia,Queensland University of Technology (QUT), Centre for Healthcare TransformationAustralian Centre for Health Services Innovation (AusHSI)BrisbaneQueenslandAustralia
| | - Reidar P Lystad
- Australian Institute of Health InnovationMacquarie UniversitySydneyNew South WalesAustralia
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12
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Cameron CM, Lystad RP, McMaugh A, Mitchell RJ. Hospital service use following an injury hospitalisation for young males and females in a population-level matched retrospective cohort study. Injury 2022; 53:2783-2789. [PMID: 35718567 DOI: 10.1016/j.injury.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children and young people who sustain injuries resulting in a hospital admission may experience adverse effects for months or years following the event. Understanding the attributable burden and health service needs is vital for public health planning as well as individual care provision. This study aims to identify the hospitalised morbidity associated with injury among young people by sex using a population-level matched cohort. METHOD A population-level matched case-comparison retrospective cohort study of young people aged ≤18 years hospitalised for an injury during 2005-2018 in New South Wales, Australia using linked birth, health, and mortality records. The comparison cohort was matched on age, gender and residential postcode. Adjusted rate ratios (ARR) were calculated for age group, injury severity and nature of injury by sex. RESULTS There were 122,660 (60.9%) males and 78,712 (39.1%) females aged ≤18 years hospitalised after sustaining an injury. Males (ARR 2.89; 95%CI 2.81-2.97) and females (ARR 2.79; 95%CI 2.68-2.90) who were hospitalised after an injury had a higher risk of subsequent hospital admission than their matched peers. Males (ARR 3.38; 95%CI 2.81-4.05) and females (ARR 3.41; 95%CI 2.72-4.26) with serious injuries had a higher risk of admission compared to peers. Males with dislocations, sprains and strains (ARR 3.40; 95%CI 3.03-3.82), burns (ARR 3.37; 95%CI 2.99-3.80), and fractures (ARR 3.20; 95%CI 3.07-3.33), and females with burns (ARR 3.84; 95%CI 3.40-4.33), dislocations, sprains and strains (ARR 3.54; 95%CI 2.96-4.23), and traumatic brain injury (ARR 3.39; 95%CI 3.01-3.82) had the highest risk of subsequent hospitalisation compared to peers. CONCLUSION Patient management and care extends beyond the injury admission as many young people face high levels of contact with health services in the months and years following injury. These findings will inform health service planning and trauma care management for young people and families affected by injury.
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Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Australia; Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Australia.
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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13
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Mitchell RJ, McMaugh A, Woodhead H, Lystad RP, Zurynski Y, Badgery‐Parker T, Cameron CM, Hng T. The impact of type 1 diabetes mellitus in childhood on academic performance: A matched population-based cohort study. Pediatr Diabetes 2022; 23:411-420. [PMID: 35080102 PMCID: PMC9306722 DOI: 10.1111/pedi.13317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/30/2021] [Accepted: 01/18/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The impact of type 1 diabetes mellitus (T1D) on academic performance is inconclusive. This study aims to compare scholastic performance and high-school completion in young people hospitalized with T1D compared to matched peers not hospitalized with diabetes. RESEARCH DESIGN Retrospective case-comparison cohort study. METHOD A population-level matched case-comparison study of people aged ≤18 hospitalized with T1D during 2005-2018 in New South Wales, Australia using linked health-related and education records. The comparison cohort was matched on age, gender, and residential postcode. Generalized linear mixed modeling examined risk of school performance below the national minimum standard (NMS) and generalized linear regression examined risk of not completing high school for young people hospitalized with T1D compared to peers. Adjusted relative risks (ARR) were calculated. RESULTS Young females and males hospitalized with T1D did not have a higher risk of not achieving the NMS compared to peers for numeracy (ARR: 1.19; 95%CI 0.77-1.84 and ARR: 0.74; 95%CI 0.46-1.19) or reading (ARR: 0.98; 95%CI 0.63-1.50 and ARR: 0.85; 95%CI 0.58-1.24), respectively. Young T1D hospitalized females had a higher risk of not completing year 11 (ARR: 1.73; 95%CI 1.19-2.53) or 12 (ARR: 1.65; 95%CI 1.17-2.33) compared to peers, while hospitalized T1D males did not. CONCLUSIONS There was no difference in academic performance in youth hospitalized with T1D compared to peers. Improved glucose control and T1D management may explain the absence of school performance decrements in students with T1D. However, females hospitalized with T1D had a higher risk of not completing high school. Potential associations of this increased risk, with attention to T1D and psycho-social management, should be investigated.
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Affiliation(s)
- Rebecca J. Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
| | - Anne McMaugh
- The Macquarie School of EducationMacquarie UniversitySydneyNSWAustralia
| | - Helen Woodhead
- School of Women's and Children's Health, Faculty of MedicineUniversity of New South WalesSydneyNSWAustralia,Department of Paediatric Diabetes and EndocrinologyRoyal North Shore HospitalSydneyNSWAustralia,Department of Endocrinology and DiabetesSydney Children's HospitalSydneyNSWAustralia
| | - Reidar P. Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
| | - Yvonne Zurynski
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
| | - Tim Badgery‐Parker
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
| | - Cate M. Cameron
- Jamieson Trauma InstituteRoyal Brisbane & Women's Hospital, Metro North Hospital and Health Services DistrictBrisbaneQLDAustralia,Centre for Healthcare Transformation, Australian Centre for Health Services InnovationQueensland University of TechnologyBrisbaneQLDAustralia
| | - Tien‐Ming Hng
- Department of Diabetes and EndocrinologyBlacktown and Mount Druitt HospitalSydneyNSWAustralia,School of MedicineWestern Sydney UniversitySydneyNSWAustralia
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14
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Cameron CM, McCreanor V, Shibl R, Smyth T, Proper M, Warren J, Vallmuur K, Bradford N, Carter H, Graves N, Loveday B. Community Opioid Dispensing after Injury (CODI): Protocol for a retrospective population-based cohort study (Preprint). JMIR Res Protoc 2022; 11:e36357. [PMID: 35412468 PMCID: PMC9044141 DOI: 10.2196/36357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/04/2022] Open
Abstract
Background There is an urgent need to reduce preventable deaths and hospitalizations from prescription opioid harms and minimize the negative effect opioid misuse can have on injured individuals, families, and the wider community. Data linkage between administrative hospitalization records for injured patients and community opioid dispensing can improve our understanding of the health and surgical trajectories of injured persons and generate insights into corresponding opioid dispensing patterns. Objective The Community Opioid Dispensing after Injury (CODI) study aims to link inpatient hospitalization data with opioid dispensing data to examine the distribution and predictive factors associated with high or prolonged community opioid dispensing among adults, for 2 years following an injury-related hospital admission. Methods This is a retrospective population-based cohort study of adults aged 18 years or older hospitalized with an injury in Queensland, Australia. The study involves the linkage of statewide hospital admissions, opioid prescription dispensing, and mortality data collections. All adults hospitalized for an injury between January 1, 2014, and December 31, 2015, will be included in the cohort. Demographics and injury factors are recorded at the time of the injury admission. Opioid dispensing data will be linked and extracted for 3 months prior to the injury admission date to 2 years after the injury separation date (last date December 31, 2017). Deaths data will be extracted for the 2-year follow-up period. The primary outcome measure will be opioid dispensing (frequency and quantity) in the 2 years following the injury admission. Patterns and factors associated with community opioid dispensing will be examined for different injury types, mechanisms, and population subgroups. Appropriate descriptive statistics will be used to describe the cohort. Regression models will be used to examine factors predictive of levels and duration of opioid use. Nonparametric methods will be applied when the data are not normally distributed. Results The project is funded by the Royal Brisbane and Women’s Hospital Foundation. As of November 2021, all ethics and data custodian approvals have been granted. Data extraction and linkage has been completed. Data management and analysis is underway with results relating to an analysis for blunt chest trauma patients expected to be published in 2022. Conclusions Little is currently known of the true prevalence or patterns of opioid dispensing following injury across Queensland. This study will provide new insights about factors associated with high and long-term opioid dispensing at a population level. This information is essential to inform targeted public policy and interventions to reduce the risk of prolonged opioid use and dependence for those injured. The novel work undertaken for this project will be vital to planning, delivering, monitoring, and evaluating health care services for those injured. The findings of this study will be used to inform key stakeholders as well as clinicians and pain management services. International Registered Report Identifier (IRRID) RR1-10.2196/36357
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Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Victoria McCreanor
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Rania Shibl
- School of Science Technology and Engineering, University of the Sunshine Coast, Petrie, Australia
| | - Tanya Smyth
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Melanie Proper
- Royal Brisbane and Women's Hospital, Metro North Health, Herston, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Natalie Bradford
- Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Hannah Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Australia
| | - Nicholas Graves
- Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Bill Loveday
- QScript Management Unit, Queensland Health, Brisbane, Australia
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15
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Lystad RP, Fajardo Pulido D, Peters L, Johnstone M, Ellis LA, Braithwaite J, Wuthrich V, Amin J, Cameron CM, Mitchell RJ. Feasibility of Monitoring Health and Well-being in Emerging Adults: Pilot Longitudinal Cohort Study. JMIR Form Res 2022; 6:e30027. [PMID: 34989696 PMCID: PMC8778543 DOI: 10.2196/30027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 11/19/2022] Open
Abstract
Background Emerging adulthood is a distinct segment of an individual’s life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a valuable resource for improving the understanding of the multifaceted elements and unique challenges that contribute to the health and well-being of emerging adults. Objective The main aim of this pilot study was to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform the understanding of emerging adulthood. Methods This pilot study was conducted among graduates at a large university. It involved collecting web-based survey data at baseline (ie, graduation) and 12 months post baseline, and linking survey responses to health records from administrative data collections. The feasibility outcome measures of interest included the recruitment rate, response rate, retention rate, data linkage opt-out rate, and availability of linked health records. Descriptive statistics were used to evaluate the representativeness of the sample, completeness of the survey responses, and data linkage characteristics. Results Only 2.8% of invited graduates (238/8532) agreed to participate in this pilot cohort study, of whom 59.7% (142/238) responded to the baseline survey. The retention rate between the baseline and follow-up surveys was 69.7% (99/142). The completeness of the surveys was excellent, with the proportion of answered questions in each survey domain ranging from 87.3% to 100% in both the baseline and follow-up surveys. The data linkage opt-out rate was 32.4% (77/238). Conclusions The overall recruitment rate was poor, while the completeness of survey responses among respondents ranged from good to excellent. There was reasonable acceptability for conducting data linkage of health records from administrative data collections and survey responses. This pilot study offers insights and recommendations for future research aiming to establish a longitudinal cohort study to investigate health and well-being in emerging adults. Trial Registration Australian New Zealand Clinical Trials Registry number ACTRN12618001364268; https://tinyurl.com/teec8wh International Registered Report Identifier (IRRID) RR2-10.2196/16108
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Lorna Peters
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Melissa Johnstone
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Janaki Amin
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia.,Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Vuong KA, Manzanero S, Ungerer JPJ, Mitchell G, McWhinney B, Vallmuur K, Warren J, McCreanor V, Howell T, Pollard C, Schuetz M, Zournazi A, Cameron CM. Prevalence of Alcohol Consumption in Emergency department presentations (PACE) in Queensland, Australia, using alcohol biomarkers ethanol and phosphatidylethanol: an observational study protocol. BMJ Open 2021; 11:e047887. [PMID: 34753753 PMCID: PMC8578965 DOI: 10.1136/bmjopen-2020-047887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/30/2022] Open
Abstract
INTRODUCTION Alcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED. METHODS AND ANALYSIS This is an observational prevalence study involving the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women's Hospital (RBWH) Emergency and Trauma Centre (ETC). Samples will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10-12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study sample. The correlation between acute and medium-term alcohol intake levels will also be examined. ETHICS AND DISSEMINATION This study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.
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Affiliation(s)
- Kim A Vuong
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology, Brisbane, Queensland, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- Faculty of Biomedical Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Kirsten Vallmuur
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Jacelle Warren
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Victoria McCreanor
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | | | - Clifford Pollard
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Michael Schuetz
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Cate M Cameron
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
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Cameron CM, Eley R, Judge C, O'Neill R, Handy M. Did attending P.A.R.T.Y. change youth perceptions? Results from 148 Queensland schools participating in the Prevent Alcohol and Risk-Related Trauma in Youth Program, 2018-2019. Inj Prev 2021; 28:218-224. [PMID: 34667095 DOI: 10.1136/injuryprev-2021-044222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/07/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) is an immersive 1 day in-hospital injury awareness and prevention programme designed to educate high-school students on the consequences of a variety of risk-taking behaviours. This multisite contemporary analysis examined differences in programme effect and temporal changes on participant knowledge and attitudes. METHODS Metropolitan and rural schools were invited to attend the programme at one of the 11 hospital sites throughout Queensland, Australia. Pre-post study design with participant questionnaires provided at three time periods: immediately preprogramme and postprogramme, and 4 months later. The questionnaire used scenarios to determine a participant's opinion on the safety of drugs/alcohol, driving and risk-taking activities, using Likert scales. RESULTS A total of 5999 students participated in the programme between 1 January 2018 and 31 December 2019. Responses to all questions related to safety, harm or risk followed a similar pattern. The immediate postcourse responses demonstrated significant increased awareness of risk or change in action, followed by a decay at 4 months to within 10% of preprogramme levels. Public school students, males and students from Central and North Queensland demonstrated lower risk-aversion (p<0.05). CONCLUSION This study demonstrated across more than 100 school sites, the positive change in knowledge and student participant attitudes towards risk-taking behaviours after attending the P.A.R.T.Y. programme. The need to address the significant decay at the 4-month follow-up was identified. Findings offered potential for tailoring of messaging to target key demographic groups/topics where the decay was greatest.
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Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Metro North Health, Herston, Queensland, Australia .,Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology - QUT, Brisbane, Queensland, Australia
| | - Rob Eley
- Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Chantelle Judge
- Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Roisin O'Neill
- Trauma Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Michael Handy
- Jamieson Trauma Institute, Metro North Health, Herston, Queensland, Australia.,Trauma Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Mitchell RJ, McMaugh A, Homaira N, Lystad RP, Badgery-Parker T, Cameron CM. The impact of childhood asthma on academic performance: A matched population-based cohort study. Clin Exp Allergy 2021; 52:286-296. [PMID: 34564913 DOI: 10.1111/cea.14022] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is inconclusive evidence of the effect of asthma on the academic performance of young people. This study aims to compare scholastic performance and high school completion of young people hospitalized with asthma compared to matched peers not hospitalized with asthma. METHOD A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalized for asthma during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalized linear mixed-modelling examined risk of school performance below the national minimum standard (NMS) and generalized linear regression examined risk of not completing high school for young people hospitalized with asthma compared to matched peers. RESULTS Young males hospitalized with asthma had a 13% and 15% higher risk of not achieving the NMS for numeracy (95%CI 1.04-1.22) and reading (95%CI 1.07-1.23), respectively, compared to peers. Young males hospitalized with asthma had a 51% (95%CI 1.22-1.86) higher risk of not completing year 10, and around a 20% higher risk of not completing year 11 (ARR: 1.25; 95%CI 1.15-1.36) or year 12 (ARR: 1.27; 95%CI 1.17-1.39) compared to peers. Young females hospitalized with asthma showed no difference in achieving numeracy or reading NMSs, but did have a 21% higher risk of not completing year 11 (95%CI 1.09-1.36) and a 33% higher risk of not completing year 12 (95%CI 1.19-1.49) compared to peers. CONCLUSIONS Educational attainment is worse for young people hospitalized with asthma compared to matched peers. Early intervention and strategies for better management of asthma symptoms may enhance academic performance for students.
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Affiliation(s)
- Rebecca J Mitchell
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Nusrat Homaira
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Respiratory Department, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Reidar P Lystad
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tim Badgery-Parker
- Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Services District, Brisbane, Queensland, Australia.,Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
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19
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Mitchell RJ, Cameron CM, McMaugh A, Lystad RP, Badgery-Parker T, Ryder T. The impact of childhood injury and injury severity on school performance and high school completion in Australia: a matched population-based retrospective cohort study. BMC Pediatr 2021; 21:426. [PMID: 34563157 PMCID: PMC8464154 DOI: 10.1186/s12887-021-02891-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/25/2021] [Indexed: 12/02/2022] Open
Abstract
Background Exploring the impact of injury and injury severity on academic outcomes could assist to identify characteristics of young people likely to require learning support services. This study aims to compare scholastic performance and high school completion of young people hospitalised for an injury compared to young people not hospitalised for an injury by injury severity; and to examine factors influencing scholastic performance and school completion. Method A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised for an injury during 2005–2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of performance below the national minimum standard (NMS) on the National Assessment Plan for Literacy and Numeracy (NAPLAN) and generalised linear regression examined risk of not completing high school for injured young people compared to matched peers. Results Injured young people had a higher risk of not achieving the NMS compared to their matched peers for numeracy (ARR: 1.12; 95%CI 1.06–1.17), reading (ARR: 1.09; 95%CI 1.04–1.13), spelling (ARR: 1.13; 95%CI 1.09–1.18), grammar (ARR: 1.11; 95%CI 1.06–1.15), and writing (ARR: 1.07; 95%CI 1.04–1.11). As injury severity increased from minor to serious, the risk of not achieving the NMS generally increased for injured young people compared to matched peers. Injured young people had almost twice the risk of not completing high school at year 10 (ARR: 2.17; 95%CI 1.73–2.72), year 11 (ARR: 1.95; 95%CI 1.78–2.14) or year 12 (ARR: 1.93; 95%CI 1.78–2.08) compared to matched peers. Conclusions The identification of characteristics of young people most likely to encounter problems in the academic environment after sustaining an injury is important to facilitate the potential need for learning support. Assessing learning needs and monitoring return-to-school progress post-injury may aid identification of any ongoing learning support requirements. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02891-x.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Services District, Brisbane, Australia.,Queensland University of Technology (QUT), Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Brisbane, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Tim Badgery-Parker
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Tayhla Ryder
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
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Vallmuur K, Cameron CM, Watson A, Warren J. Comparing the accuracy of ICD-based severity estimates to trauma registry-based injury severity estimates for predicting mortality outcomes. Injury 2021; 52:1732-1739. [PMID: 34039471 DOI: 10.1016/j.injury.2021.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 05/08/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Trauma registries have been used internationally for several decades to measure the quality of trauma care between hospitals. Given the significant costs involved in establishing and maintaining trauma registries, and increasing availability of routinely collected, linked health data describing a patient's journey (and inherent cost savings in data re-use), there is significant interest in development of integrated, comprehensive trauma data repositories. However, approaches to estimating injury severity using routinely collected data would need to be developed if routinely collected hospital data were to be used as an alternative/supplement to registries. OBJECTIVES This study aimed to compare the accuracy of registry-based injury severity estimates with ICD-based injury severity estimates in predicting mortality outcomes in a cohort of minor and major trauma patients in Queensland, using retrospectively linked trauma registry and hospital admissions data. METHODS Queensland Trauma Registry (QTR) data with an admission date between 1 January 2005 and 31 December 2011 was linked with all acute care patients included in the Queensland Hospital Admitted Patient Data Collection (QHAPDC) with a Principal Diagnosis coded with an ICD-10-AM code within Chapter 19 (S00-T98). Abbreviated Injury Scale coding was undertaken manually by QTR trauma data nurses for the registry data. ICD-based injury severity scores (ICISS) were calculated automatically using all injury-related diagnoses captured in the QHAPDC data using the ICISS multiplicative and worst injury method. RESULTS There were 92,140 QTR patients admitted between January 2005 and December 2011 with a valid ISS with a matching QHAPDC record (98.4% survived, 1.6% died). ICISS (multiplicative and worst injury approach) showed marginally better predictive accuracy than ISS when predicting mortality across minor and major injury and ICISS showed marginally better predictive accuracy to ISS when restricted to major trauma/high threat to life cases. Both ICISS and ISS restricted to major trauma/high threat to life showed poorer accuracy compared to the predictive performance when both minor and major cases were included. CONCLUSION ICD-based predictions were as accurate as ISS-based predictions for this cohort and this study provides evidence to support the potential for using routinely coded hospital data for risk adjustment within State-based trauma data repositories.
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Affiliation(s)
- Kirsten Vallmuur
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Queensland, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia.
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia; Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Queensland, Australia
| | - Angela Watson
- Centre for Accident Research and Road Safety Queensland, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Jacelle Warren
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Queensland University of Technology, Brisbane, Queensland, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia
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Lystad RP, Fajardo Pulido D, Peters L, Johnstone M, Ellis LA, Braithwaite J, Wuthrich V, Amin J, Cameron CM, Mitchell RJ. Monitoring Health and Well-Being in Emerging Adults: Protocol for a Pilot Longitudinal Cohort Study. JMIR Res Protoc 2020; 9:e16108. [PMID: 32324142 PMCID: PMC7206521 DOI: 10.2196/16108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/02/2019] [Accepted: 03/17/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Emerging adulthood is a unique segment of an individual's life course. The defining features of this transitional period include identity exploration, instability, future possibilities, self-focus, and feeling in-between adolescence and adulthood, all of which are thought to affect quality of life, health, and well-being. A longitudinal cohort study with a comprehensive set of measures would be a unique and valuable resource for improving the understanding of the multi-faceted elements and unique challenges that contribute to the health and well-being of emerging adults. OBJECTIVE The main aim of this pilot study is to evaluate the feasibility and acceptability of recruiting university graduates to establish a longitudinal cohort study to inform our understanding of emerging adulthood. METHODS This is a pilot longitudinal cohort study of Australian university graduates. It will involve collecting information via online surveys (baseline and 12-month follow-up) and data linkage with health records. Recruitment, response, and retention rates will be calculated. Descriptive analysis of the representativeness of recruited participants and completeness of survey responses will be conducted. RESULTS Participant recruitment was completed in October 2018, and data collection for the baseline and follow-up surveys was completed in November 2019. As of April 2020, the process of acquiring health records from administrative data collections has commenced. CONCLUSIONS The findings from this pilot study will identify areas for improvement and inform the development of a future longitudinal cohort study of emerging adults. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001364268; https://tinyurl.com/teec8wh. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16108.
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Lorna Peters
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Melissa Johnstone
- Department of Educational Studies, Macquarie University, Sydney, Australia
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Janaki Amin
- Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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22
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Mitchell R, Cameron CM, Lystad RP, Nielssen O, McMaugh A, Herkes G, Schniering C, Hng TM. Impact of chronic health conditions and injury on school performance and health outcomes in New South Wales, Australia: a retrospective record linkage study protocol. BMJ Paediatr Open 2019; 3:e000530. [PMID: 31548999 PMCID: PMC6733328 DOI: 10.1136/bmjpo-2019-000530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/24/2019] [Accepted: 08/21/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Children who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to be affected and the use of objective measures of education performance. This may highlight educational disparities that could be addressed with learning support. This study aims to examine education performance, school completion and health outcomes of children in New South Wales (NSW), Australia, who were hospitalised with an injury or a chronic health condition compared with children who have not been hospitalised for these conditions. METHOD AND ANALYSIS This research will be a retrospective population-level case-comparison study of hospitalised injured or chronically ill children (ie, diabetes, epilepsy, asthma or mental health conditions) aged ≤18 years in NSW, Australia, using linked health and education administrative data collections. It will examine the education performance, school completion and health outcomes of children who have been hospitalised in NSW with an injury or a chronic health condition compared with children randomly drawn from the NSW population (matched on gender, age and residential postcode) who have not been hospitalised for these conditions. ETHICS AND DISSEMINATION The study received ethics approval from the NSW Population Health Services Research Ethics Committee (2018HRE0904). Findings from the research will be published in peer-reviewed journals and presented at scientific conferences.
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Affiliation(s)
- Rebecca Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Olav Nielssen
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Anne McMaugh
- Department of Educational Studies, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Geoffrey Herkes
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Carolyn Schniering
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Tien-Ming Hng
- Department of Diabetes and Endocrinology, Blacktown and Mount Druitt Hospital, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
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23
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Cameron CM, Cumsille Nazar J, Ehrlich C, Kendall E, Crompton D, Liddy AM, Kisely S. General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial. AUST HEALTH REV 2019; 41:665-671. [PMID: 27977388 DOI: 10.1071/ah16151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/11/2016] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to assess the effects of a community intervention aimed at general practitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to the intervention and controls that were not. Methods A comparison was made of primary care consultation and pathology data of people with SMI from intervention and control areas. Negative binomial regression models were used to compare the frequency and length of GP consultations, as well as the number and type of pathology examinations. Results Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areas were not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting for gender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rate ratio 1.56; 95% confidence interval 1.28-1.91). They also had more pathology screening for chronic diseases, in accordance with implemented guideline recommendations. These benefits persisted after the end of the intervention. Conclusion These findings suggest that the ACTIVATE program aimed at training GPs to screen and better manage chronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changes in medical management practices by GPs in the intervention area during that time. What is known about the topic? People with an SMI have higher mortality and poorer physical health than the general population. What does this paper add? The community intervention had a significant and sustained effect, with demonstrated desired changes in screening and medical management by GPs for adults with SMI in the intervention area. What are the implications for practitioners? GPs are ideally placed to assist in the prevention and better management of health conditions, thereby reducing avoidable illness and deaths in vulnerable populations, such as adults with SMI. Ongoing professional training and dissemination of clinical guidelines are critical for raising awareness about the physical and oral health care needs of people with SMI.
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Affiliation(s)
- Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - Jose Cumsille Nazar
- School of Health Services and Social Work, Griffith University, Meadowbrook, Qld 4131, Australia. Email
| | - Carolyn Ehrlich
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - Elizabeth Kendall
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - David Crompton
- School of Health Services and Social Work, Griffith University, Meadowbrook, Qld 4131, Australia. Email
| | - Ann Maree Liddy
- General Practice Queensland t/a CheckUP Australia, PO Box 3205, South Brisbane, Qld 4101, Australia. Email
| | - Steve Kisely
- School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia. Email
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24
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Keijzers G, Sweeny A, Crilly J, Good N, Cameron CM, Mihala G, Thone J, Scuffham PA. Immunisation status of children presenting to the emergency department: Linkage of a longitudinal birth cohort with national immunisation data. J Paediatr Child Health 2019; 55:772-780. [PMID: 30381855 DOI: 10.1111/jpc.14288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/16/2018] [Accepted: 09/29/2018] [Indexed: 11/24/2022]
Abstract
AIM To describe the relationship between emergency department (ED) diagnosis of infectious disease and immunisation status in children ≤5 years. We also aimed to demonstrate feasibility of proof-of-concept linkage between disparate databases. METHODS Data from a cohort of 3404 children born in Southeast Queensland/Far North New South Wales between 2006 and 2011 were linked to Australian Childhood Immunisation Registry data and Emergency Department Information System data for presentations between 2006 and 2014. Immunisation status was assigned using the 2009 National Immunisation Program schedule. RESULTS Of 1490 children (79% of those consented) with data on immunisation status, 87.2 and 84.6% were fully immunised by 12 and 24 months, respectively. Adding partially immunised children increased this to 93.2 and 91.4% at 12 and 24 months, respectively. Nearly two-thirds of all children made at least one ED presentation. Children presenting to ED with an infectious disease did not differ in immunisation status compared to children with other (non-infectious disease type) presentations but were younger, more likely to live with other children and had a longer ED stay and higher admission rate. Respiratory syncytial virus (RSV) was more frequently diagnosed in unimmunised children. CONCLUSIONS In an existing birth cohort, immunisation rates were lower than the national average. RSV was more prevalent in unimmunised children presenting to ED, but immunisation status was not significantly associated with other infectious disease presentations. Linkage between national immunisation data and Australian ED data is feasible and has the potential to identify previously unrecognised factors related to child immunisation status and health-care utilisation.
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Affiliation(s)
- Gerben Keijzers
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.,School of Medicine, Bond University, Gold Coast, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Logan, Queensland, Australia
| | - Norm Good
- CSIRO Digitial Productivity/Australian e-Health Research Centre, Royal Women's and Children's Hospital, Brisbane, Queensland, Australia
| | - Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Logan, Queensland, Australia
| | - Gabor Mihala
- Menzies Health Institute Queensland, Griffith University, Logan, Queensland, Australia
| | - Jae Thone
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Logan, Queensland, Australia
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Burgess J, Watt K, Kimble RM, Cameron CM. Combining Technology and Research to Prevent Scald Injuries (the Cool Runnings Intervention): Randomized Controlled Trial. J Med Internet Res 2018; 20:e10361. [PMID: 30305263 PMCID: PMC6234332 DOI: 10.2196/10361] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/28/2018] [Accepted: 08/21/2018] [Indexed: 02/02/2023] Open
Abstract
Background New technologies, internet accessibility, social media, and increased smartphone ownership provide new opportunities for health researchers to communicate and engage target audiences. An innovative burn prevention intervention was developed using these channels. Objective The aim of this study was to evaluate the efficacy of Cool Runnings, an app-based intervention to increase knowledge of childhood burn risk (specifically hot beverage scalds) and correct burn first aid among mothers of young children. Methods This was a 2-group, parallel, single-blinded randomized controlled trial (RCT). Participants were women aged 18 years and above, living in Queensland, Australia, with at least 1 child aged 5-12 months at time of enrollment. The primary outcome measures were change in knowledge about risk of burns and correct burn first aid assessed via 2 methods: (1) overall score and (2) categorized as adequate (score=4) versus inadequate (score<4). Efficacy of gamification techniques was also assessed. Results In total, 498 participants were recruited via social media and enrolled. At the 6-month follow-up, 244 participants completed the posttest questionnaire. Attrition rates in both groups were similar. Participants who remained in the study did not differ from those lost to follow-up on any characteristics except education level. Although similar at baseline, intervention group participants achieved significantly greater improvement in overall knowledge posttest than control group participants on both primary outcome measures (overall knowledge intervention: mean [SD] of overall knowledge 2.68 [SD 1.00] for intervention vs 2.13 [SD 1.03] for control; 20.7% [25/121] adequate in intervention vs 7.3% [2/123] in control). Consequently, the number needed to treat was 7.46. Logistic regression showed participants exposed to the highest level of disadvantage had 7.3 times higher odds of improved overall knowledge scores than participants in other levels of disadvantage. There were also significant correlations between gamification techniques and knowledge change (P<.001). In addition, odds of knowledge improvement between baseline and 6-month follow-up was higher in participants with low-moderate app activity compared with no app activity (odds ratio [OR] 8.59, 95% CI 2.9-25.02) and much higher in participants with high app activity (OR 18.26, 95% CI 7.1-46.8). Conclusions Despite substantial loss to follow-up, this RCT demonstrates the Cool Runnings app was an effective intervention for improving knowledge about risks of hot beverage scalds and burn first aid in mothers of young children. The benefits of combining gamification elements in the intervention were also highlighted. Given the low cost and large reach of smartphone apps to deliver content to and engage with targeted populations, the results from this RCT provide important information on how smartphone apps can be used for widespread injury prevention campaigns and public health campaigns generally. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616000019404; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369745&showOriginal=true&isReview=true (Archived by WebCite at http://www.webcitation.org/72b1E8gTW)
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Affiliation(s)
- Jacqueline Burgess
- Centre for Children's Burns and Trauma Research, University of Queensland, Brisbane, Australia.,Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia.,Wound Management Innovation Cooperative Research Centre, Brisbane, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Roy M Kimble
- Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia.,Department of Paediatric Surgery, Urology Burns & Trauma Unit, Lady Cilento Children's Hospital, Brisbane, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Services District, Brisbane, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Kenardy J, Edmed SL, Shourie S, Warren J, Crothers A, Brown EA, Cameron CM, Heron-Delaney M. Changing patterns in the prevalence of posttraumatic stress disorder, major depressive episode and generalized anxiety disorder over 24 months following a road traffic crash: Results from the UQ SuPPORT study. J Affect Disord 2018; 236:172-179. [PMID: 29738952 DOI: 10.1016/j.jad.2018.04.090] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the prevalence and changing patterns of PTSD, major depressive episode (MDE), and generalized anxiety disorder (GAD) in adult claimants who sustained a non-catastrophic injury in a road traffic crash (RTC) in Queensland, Australia. METHOD Participants (N = 284) were assessed at approximately 6, 12, and 24 months post-RTC using the composite international diagnostic interview (CIDI) modules for PTSD, and CIDI-short form for MDE, and GAD. RESULTS The prevalence of at least one of these disorders was 48.2%, 52.5%, and 49.3%, at 6, 12, and 24 months, respectively. Comorbidity was common (20.8% at 6 months, 27.1% at 12 months, and 21.1% at 24 months) and only 33.1% of participants never met PTSD, GAD, or MDE criteria. A substantial proportion of participants (42.3%) had an unstable diagnostic pattern over time. Participants with multiple diagnoses at 6 months were more likely to continue to meet diagnostic criteria for any disorder at 12 and 24 months than participants with a single diagnosis. Participants with PTSD (with or without MDE/GAD) were more likely to meet criteria for any disorder at 24 months than participants with another diagnosis. Preinjury psychiatric history increased the likelihood of any disorder at 24 months post-injury, but did not significantly increase the likelihood of PTSD. CONCLUSIONS People injured in a RTC are at risk of having complex psychological presentations over time. Interventions to prevent mental disorders, especially PTSD, in the early post-injury period are needed to prevent chronic psychological injury, including consideration of comorbidity and dynamic course.
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Affiliation(s)
- Justin Kenardy
- Recover Injury Research Center, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Shannon L Edmed
- Recover Injury Research Center, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Swati Shourie
- Recover Injury Research Center, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jacelle Warren
- Recover Injury Research Center, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Anna Crothers
- Centre for Applied Health Economics (CAHE), School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Erin A Brown
- Recover Injury Research Center, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Queensland, Australia
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Keijzers G, Sweeny A, Crilly J, Good N, Cameron CM, Mihala G, Scott R, Scuffham PA. Parental-reported allergic disorders and emergency department presentations for allergy in the first five years of life; a longitudinal birth cohort. BMC Pediatr 2018; 18:169. [PMID: 29788917 PMCID: PMC5964731 DOI: 10.1186/s12887-018-1148-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/08/2018] [Indexed: 01/16/2023] Open
Abstract
Background To measure rates of parental-report of allergic disorders and ED presentations for allergic disorders in children, and to describe factors associated with either. Methods An existing cohort of 3404 children born between 2006 and 2011 (Environments for Healthy Living) with prospectively collected pre-natal, perinatal and follow-up data were linked to i) nationwide Medicare and pharmaceutical data and ii) Emergency Department (ED) data from four hospitals in Australia. Parental-reported allergy was assessed in those who returned follow-up questionnaires. ED presentation was defined as any presentation for a suite of allergic disorders, excluding asthma. Univariate analysis and multivariate logistic regression were used to descibe risk factors for both parental-reported allergy and ED presentation for an allergic disorder. Results The incidence of parental-reported child allergy at 1, 3 and 5 years of age was 7.8, 7.8 and 12.6%, respectively. Independent predictors of parental-report of allergy in multivariate analysis were parental-report of asthma (OR 2.2, 95% CI 1.4–3.4) or eczema (OR 4.3, 95% CI 3.1–6.1) and age > 6 months at introduction of solids (OR 1.3, 95% CI 1.0–1.7). Factors associated with ED presentations for allergy, which occurred in 3.6% of the cohort, were presence of maternal asthma (OR 2.3 95% CI:1.1, 4.9) and child born in spring (OR 1.7, 95% CI 1.1, 2.7). Conclusions More than 10% of children up to 5 years have a parental-reported allergic disorder, and 3.6% presented to ED. Parental-report of eczema and/or asthma and late introduction of solids were predictors of parental-report of allergy. Spring birth and maternal asthma were predictors for ED presentation for allergy. Electronic supplementary material The online version of this article (10.1186/s12887-018-1148-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gerben Keijzers
- Department of Emergency Medicine, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia. .,School of Medicine, Bond University, Gold Coast, QLD, Australia. .,School of Medicine, Griffith University, Gold Coast, QLD, Australia.
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Julia Crilly
- Department of Emergency Medicine, Gold Coast Health, Gold Coast, QLD, Australia.,Menzies Health Institute, Gold Coast, QLD, Australia
| | - Norm Good
- CSIRO Digitial Productivity/ Australian e-Health Research Centre, Royal Women's and Children's Hospital, Brisbane, QLD, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Meadowbrook, QLD, Australia
| | - Gabor Mihala
- Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - Rani Scott
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, QLD, Australia
| | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
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Abstract
OBJECTIVE Prior and repeated self-harm hospitalisations are common risk factors for suicide. However, few studies have accounted for pre-existing comorbidities and prior hospital use when quantifying the burden of self-harm. The aim is to quantify hospitalisation in the 12 months preceding and re-hospitalisation and mortality risk in the 12 months post a self-harm hospitalisation. METHOD A population-based matched cohort using linked hospital and mortality data for individuals ⩾18 years from four Australian jurisdictions. A non-injured comparison cohort was matched on age, gender and residential postcode. Twelve-month pre- and post-index self-harm hospitalisations and mortality were examined. RESULTS The 11,597 individuals who were hospitalised following self-harm in 2009 experienced 21% higher health service use in the 12 months pre and post the index admission and a higher mortality rate (2.9% vs 0.3%) than their matched counterparts. There were 133 (39.0%) deaths within 2 weeks of hospital discharge and 342 deaths within 12 months of the index hospitalisation in the self-harm cohort. Adjusted rate ratios for hospital readmission were highest for females (2.86; 95% confidence interval: [2.33, 2.52]) and individuals aged 55-64 years (3.96; 95% confidence interval: [2.79, 5.64]). CONCLUSION Improved quantification of the burden of self-harm-related hospital use can inform resource allocation for intervention and after-care services for individuals at risk of repeated self-harm. Better assessment of at-risk self-harm behaviour, appropriate referrals and improved post-discharge care, focusing on care continuity, are needed.
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Affiliation(s)
- Rebecca J Mitchell
- 1 Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Cate M Cameron
- 2 Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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O'Leary P, Cameron CM, Lakhani A, Osborne JM, de Souza L, Hope K, Naimi MS, Khan H, Jawad QS, Majidi S. Violence against children in Afghanistan: Concerns and opportunities for positive change. Child Abuse Negl 2018; 76:95-105. [PMID: 29096162 DOI: 10.1016/j.chiabu.2017.10.010] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 09/18/2017] [Accepted: 10/14/2017] [Indexed: 06/07/2023]
Abstract
Violence against children (VAC) in Afghanistan is a serious issue in the context of many decades of conflict and poverty. To date, limited studies have explored the extent of VAC in Afghanistan and the settings where VAC takes place. To understand (i) the extent of VAC, (ii) settings where VAC takes place, (iii) parental forms of VAC and (iv) regional differences, an interview administered cross-sectional survey was employed among a community sample of 145 children and 104 parents living within Kabul, Torkham, and Jalalabad. Demographic information was collected as well as items from the International Child Abuse Screening Tool (ICAST-CH). In this study, 71% of children reported experiencing physical violence is some form in the past year. Home was the most likely location of violence. The overwhelming majority of parents reported using physical violence as a discipline method. Parents who attained higher levels of education and had more skilled occupations used violence less as a discipline method. However, consistent with international research, children cited their parents as their preferred source of support in situations of violence. Interestingly, parents did not see violent forms of discipline as more effective than non-violent strategies. The results offer a disturbing yet 'on the ground' insight into VAC in Afghanistan from the experience of children and parents. The results have important implications for programming design and provide a focus for stopping and preventing VAC in Afghanistan and similar contexts.
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Affiliation(s)
- Patrick O'Leary
- Menzies Health Institute Queensland, School of Human Services and Social Work, Griffith University, Meadowbrook, QLD 4131, Australia.
| | - Cate M Cameron
- Menzies Health Institute Queensland, School of Human Services and Social Work, Griffith University, Meadowbrook, QLD 4131, Australia.
| | - Ali Lakhani
- Menzies Health Institute Queensland, School of Human Services and Social Work, Griffith University, Meadowbrook, QLD 4131, Australia.
| | - Jodie M Osborne
- Menzies Health Institute Queensland, School of Human Services and Social Work, Griffith University, Meadowbrook, QLD 4131, Australia.
| | - Luana de Souza
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland; Terre des Hommes Foundation, Afghanistan Country Office, House No. 103, Quali-Fatullah, Kabul, Afghanistan.
| | - Kristen Hope
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland.
| | - Mohammad S Naimi
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland; Terre des Hommes Foundation, Afghanistan Country Office, House No. 103, Quali-Fatullah, Kabul, Afghanistan.
| | - Hassan Khan
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland; Terre des Hommes Foundation, Afghanistan Country Office, House No. 103, Quali-Fatullah, Kabul, Afghanistan.
| | - Qazi S Jawad
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland; Terre des Hommes Foundation, Afghanistan Country Office, House No. 103, Quali-Fatullah, Kabul, Afghanistan.
| | - Sabir Majidi
- Terre des Hommes Foundation, Avenue de Montchoisi, 15-CH-1006 Lausanne, Switzerland.
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Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Inj Prev 2018; 25:301-306. [PMID: 29386371 DOI: 10.1136/injuryprev-2017-042650] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/25/2017] [Accepted: 12/27/2017] [Indexed: 11/03/2022]
Abstract
AIM The high incidence of hot beverage scalds among young children has not changed in the past 15 years, but preventive campaigns have been scarce. A novel approach was used to engage mothers of young children in an app-based hot beverage scald prevention campaign 'Cool Runnings'. This paper provides baseline data for this randomised controlled trial (RCT). METHOD Queensland-based mothers aged 18+ years with at least one child aged 5-12 months were recruited via social media to Cool Runnings, which is a two-group, parallel, single-blinded RCT. RESULTS In total, 498 participants from across Queensland completed the baseline questionnaire. The most common source of burn first aid information was the internet (79%). One-third (33%) correctly identified hot beverage scalds as the leading cause of childhood burns, 43% knew the age group most at risk. While 94% reported they would cool a burn with water, only 10% reported the recommended 20min duration. After adjusting for all relevant variables, there were two independent predictors of adequate burn first aid knowledge: first aid training in the past year (OR=3.32; 95% CI 1.8 to 6.1) and smoking status (OR=0.17; 95% CI 0.04 to 0.7). CONCLUSION In this study, mothers of young children were largely unaware how frequently hot beverage scalds occur and the age group most susceptible to them. Inadequate burn first aid knowledge is prevalent across mothers of young children; there is an urgent and compelling need to improve burn first aid knowledge in this group. Given the high incidence of hot beverages scalds in children aged 6-24 months, it is important to target future burn prevention/first aid campaigns at parents of young children. TRIAL REGISTRATION NUMBER ACTRN12616000019404; Pre-results.
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Affiliation(s)
- Jacqueline D Burgess
- Centre for Children's Burns and Trauma Research, University of Queensland, Children's Health Research Centre, Brisbane, Australia.,Wound Management Innovation Cooperative Research Centre, Brisbane, Australia.,Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia
| | - Kerrianne A Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, University of Queensland, Children's Health Research Centre, Brisbane, Australia.,Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia.,Department of Paediatric Surgery, Urology Burns and Trauma Unit, Lady Cilento Children's Hospital, Brisbane, Australia
| | - Cate M Cameron
- The Jamieson Trauma Institute, Metro North Hospital and Health Service District, Herston, Australia.,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
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Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study. Arch Osteoporos 2017; 12:67. [PMID: 28726112 DOI: 10.1007/s11657-017-0359-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 05/28/2017] [Accepted: 07/04/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED With an ageing population, the burden of hip fractures is expected to increase in the coming decades. Older individuals with hip fracture are more than 3.5 times more likely to die within 12 months compared to non-injured individuals. The main priority for reducing mortality should be prevention of hip fracture. PURPOSE The aim of this study is to quantify and describe the 12-month mortality of older persons presenting to hospitals in Australia with a hip fracture. METHODS Population-based matched cohort study using linked hospital and mortality data from four Australian states (New South Wales, Queensland, South Australia, and Tasmania). Individuals aged 65 years and older who had a hospital admission with a primary diagnosis of hip fracture in 2009 (n = 9748) and a matched comparison cohort of non-injured individual were selected from the electoral roll (n = 9748). The comparison group was matched 1:1 on age, sex, and postcode of residence. Adjusted mortality rate ratios (MRR) and attributable risk percent were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. RESULTS The hip fracture cohort experienced significantly worse survival at the 12-month post-fracture hospitalisation (P < 0.0001). Individuals with hip fracture were more than 3.5 times more likely to die within 12 months compared to their non-injured counterparts (MRR 3.62 [95%CI 3.23-4.05]). Hip fracture was likely to be a contributory factor in 72% of mortality within 12 months after the index hospital admission. Excess mortality risk at 12 months was higher in males than that in females and in the 65-74-year age group. CONCLUSIONS With an ageing population in Australia, the burden of hip fractures is expected to increase in the coming decades. Because incident hip fracture is the main predictor of subsequent mortality, the main priority for reducing excess mortality after hip fracture is primary and secondary prevention of hip fracture.
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Affiliation(s)
- Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW, 2109, Australia.
| | - Cate M Cameron
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW, 2109, Australia
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Burgess JD, Kimble RM, Watt K, Cameron CM. The Adoption of Social Media to Recruit Participants for the Cool Runnings Randomized Controlled Trial in Australia. JMIR Res Protoc 2017; 6:e200. [PMID: 29066427 PMCID: PMC5676032 DOI: 10.2196/resprot.8189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Using social media to recruit specific populations for research studies is gaining popularity. Given that mothers of young children are the most active on social media, and young children are the most at risk of preventable burn injuries, social media was used to recruit mothers of young children to a burn prevention intervention. OBJECTIVE The aim of this paper was to describe the social media recruitment methods used to enroll mothers of young children to the app-based burn prevention intervention Cool Runnings. METHODS Participants were recruited via paid Facebook and Instagram advertisements to a 2-group, parallel, single-blinded, randomized controlled trial (RCT). The advertisements were targeted at women 18 years and older, living in Queensland, Australia, with at least 1 child aged 5 to 12 months at the time of recruitment. RESULTS Over the 30-day recruitment period from January to February 2016, Facebook and Instagram advertisements reached 65,268 people, generating 2573 link clicks, 1161 app downloads, and 498 enrolled participants to the Cool Runnings RCT. The cost per enrolled participant was Aus $13.08. Saturdays were the most effective day of the week for advertising results. The most popular time of day for enrolments was between 5 to 11 PM. This recruitment strategy campaign resulted in a broad reach of participants from regional, rural, and remote Queensland. Participants were representative of the population in regard to age and education levels. CONCLUSIONS To our knowledge, this is the first use of social media recruitment for an injury prevention campaign. This recruitment method resulted in the rapid and cost-effective recruitment of participants with social, geographic, and economic diversity that were largely representative of the population.
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Affiliation(s)
- Jacqueline D Burgess
- Centre for Children's Burns and Trauma Research, University of Queensland, South Brisbane, Australia.,Wound Management Innovation Cooperative Research Centre, Brisbane, Australia.,Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, University of Queensland, South Brisbane, Australia.,Pegg Leditschke Children's Burns Centre, Lady Cilento Childen's Hospital, Brisbane, Australia.,Urology Burns & Trauma Unit, Department of Paediatric Surgery, Lady Cilento Children's Hospital, Brisbane, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Cate M Cameron
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
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Crilly J, Cameron CM, Scuffham PA, Good N, Scott R, Mihala G, Sweeny A, Keijzers G. Emergency department presentations in infants: Predictors from an Australian birth cohort. J Paediatr Child Health 2017; 53:981-987. [PMID: 28744935 DOI: 10.1111/jpc.13617] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/10/2017] [Accepted: 04/10/2017] [Indexed: 12/01/2022]
Abstract
AIM Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants. METHODS A prospective birth cohort from Queensland and New South Wales (Environments for Healthy Living) was used to understand infant health service use. Baseline and 12-month questionnaire data pertaining to children born between 2006 and 2011 were used to identify predictors of ED presentation, using multiple regression analysis. RESULTS Of the 2184 children in the cohort with available baseline and 12-month data, 579 (27%) presented at least once to an ED during their first 12 months of life. Statistically significant predictors of ED presentation in the multivariate analysis included the mother having asthma (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.15-2.39) and a higher Kessler-6 score (a measure of psychological distress) of the primary carer at baseline (OR 1.04, 95% CI 1.01-1.08). Maternal education level was not associated with ED presentations of infants. CONCLUSIONS This study describes maternal and child factors of children who present to the ED in the first year of life. Factors related to an infant's support system were found to be predictors for an ED presentation in the first year of life. This study emphasises the need to review the maternal medical history and psychosocial situation. There may be benefits for health-care practitioners to take the opportunity (such as during routine childhood immunisation) to perform a brief screening tool (such as the Kessler-6) to understand psychological distress experienced by mothers. This may influence the likelihood of a child presenting to an ED within the first 12 months of life.
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Affiliation(s)
- Julia Crilly
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Cate M Cameron
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Paul A Scuffham
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Norm Good
- Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Rani Scott
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Gabor Mihala
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Gerben Keijzers
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
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Abstract
BACKGROUND Longitudinal research is subject to participant attrition. Systemic differences between retained participants and those lost to attrition potentially bias prevalence of outcomes, as well as exposure-outcome associations. This study examines the impact of attrition on the prevalence of child injury outcomes and the association between sociodemographic factors and child injury. METHODS Participants were recruited as part of the Environments for Healthy Living (EFHL) birth cohort study. Baseline data were drawn from maternal surveys. Child injury outcome data were extracted from hospital records, 2006-2013. Participant attrition status was assessed up to 2014. Rates of injury-related episodes of care were calculated, taking into account exposure time and Poisson regression was performed to estimate exposure-outcome associations. RESULTS Of the 2222 participating families, 799 families (36.0%) had complete follow-up data. Those with incomplete data included 137 (6.2%) who withdrew, 308 (13.8%) were lost to follow-up and 978 families (44.0%) who were partial/non-responders. Families of lower socioeconomic status were less likely to have complete follow-up data (p<0.05). Systematic differences in attrition did not result in differential child injury outcomes or significant differences between the attrition and non-attrition groups in risk factor effect estimates. Participants who withdrew were the only group to demonstrate differences in child injury outcomes. CONCLUSION This research suggests that even with considerable attrition, if the proportion of participants who withdraw is minimal, overall attrition is unlikely to affect the population prevalence estimate of child injury or measures of association between sociodemographic factors and child injury.
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Affiliation(s)
- Cate M Cameron
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - Jodie M Osborne
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - Anneliese B Spinks
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Dutton Park, Brisbane, Queensland, Australia
| | - Tamzyn M Davey
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Neil Sipe
- School of Geography, Planning and Environmental Management, The University of Queensland, Brisbane, Queensland, Australia
| | - Roderick J McClure
- Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts, USA
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Abstract
INTRODUCTION The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. METHODS AND ANALYSIS In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. ETHICS AND DISSEMINATION Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. TRIAL REGISTRATION NUMBER Australia New Zealand Clinical Trials Registry (ACTRN12616000828426). Retrospectively registered on 23 June 2016; pre-results.
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Affiliation(s)
- Martha Druery
- Burns Trauma and Critical Care Research Centre, University of Queensland, Herston, Australia
| | - Peter A Newcombe
- School of Psychology, University of Queensland, St Lucia, Australia
| | - Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Australia
| | - Jeffrey Lipman
- Burns Trauma and Critical Care Research Centre, University of Queensland, Herston, Australia
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Werner AK, Cameron CM, Watt K, Vink S, Jagals P, Page A. Is Increasing Coal Seam Gas Well Development Activity Associated with Increasing Hospitalisation Rates in Queensland, Australia? An Exploratory Analysis 1995-2011. Int J Environ Res Public Health 2017; 14:E540. [PMID: 28524113 PMCID: PMC5451990 DOI: 10.3390/ijerph14050540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/06/2017] [Accepted: 05/06/2017] [Indexed: 11/17/2022]
Abstract
The majority of Australia's coal seam gas (CSG) reserves are in Queensland, where the industry has expanded rapidly in recent years. Despite concerns, health data have not been examined alongside CSG development. This study examined hospitalisation rates as a function of CSG development activity in Queensland, during the period 1995-2011. Admissions data were examined with CSG well numbers, which served as a proxy for CSG development activity. Time series models were used to assess changes in hospitalisation rates for periods of "low", "medium", "high", and "intense" activity compared to a period of "very low" activity, adjusting for covariates. "All-cause" hospitalisation rates increased monotonically with increasing gas well development activity in females (324.0 to 390.3 per 1000 persons) and males (294.2 to 335.4 per 1000 persons). Hospitalisation rates for "Blood/immune" conditions generally increased for both sexes. Female and male hospitalisation rates for "Circulatory" conditions decreased with increasing CSG activity. Hospitalisation rates were generally low for reproductive and birth outcomes; no clear associations were observed. This study showed some outcomes were associated with increasing CSG development activity. However, as a condition of data access, the population and outcomes were aggregated to a broad geographic study area rather than using higher geographic resolution data. Higher resolution data, as well as other data sources, should be explored. Further research should be conducted with an expanded time period to determine if these trends continue as the industry grows.
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Affiliation(s)
- Angela K Werner
- Sustainable Minerals Institute, The University of Queensland, St. Lucia, QLD 4072, Australia.
| | - Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Logan, QLD 4131, Australia.
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia.
| | - Sue Vink
- Sustainable Minerals Institute, The University of Queensland, St. Lucia, QLD 4072, Australia.
| | - Paul Jagals
- Children's Health and Environment Programme, University of Queensland, Centre for Children's Health Research, Brisbane, QLD 4101, Australia.
| | - Andrew Page
- Centre for Health Research, Western Sydney University, Penrith, NSW 2150, Australia.
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Mitchell RJ, Cameron CM, McClure R. Higher mortality risk among injured individuals in a population-based matched cohort study. BMC Public Health 2017; 17:150. [PMID: 28148259 PMCID: PMC5288995 DOI: 10.1186/s12889-017-4087-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/30/2017] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Improved understanding of long-term mortality attributable to injury is needed to accurately inform injury burden studies. This study aims to quantify and describe mortality attributable to injury 12 months after an injury-related hospitalisation in Australia. METHOD A population-based matched cohort study using linked hospital and mortality data from three Australian states during 2008-2010 was conducted. The injured cohort included individuals ≥18 years who had an injury-related hospital admission in 2009. A comparison cohort of non-injured people was obtain by randomly selecting from the electoral roll. This comparison group was matched 1:1 on age, gender and postcode of residence. Pre-index injury health service use and 12-month mortality were examined. Adjusted mortality rate ratios (MRR) and attributable risk were calculated. Cox proportional hazard regression was used to examine the effect of risk factors on survival. RESULTS Injured individuals were almost 3 times more likely to die within 12 months following an injury (MRR 2.90; 95% CI: 2.76-3.04). Individuals with a traumatic brain injury (MRR 7.58; 95% CI: 5.92-9.70) or injury to internal organs (MRR 7.38; 95% CI: 5.90-9.22) were 7 times more likely to die than the non-injured group. Injury was likely to be a contributory factor in 92% of mortality within 30 days and 66% of mortality at 12 months following the index injury hospital admission. Adjusted mortality rate ratios varied by type of cause-specific death, with MRR highest for injury-related deaths. CONCLUSIONS There are likely chronic consequences of sustaining a traumatic injury. Longer follow-up post-discharge is needed to consider deaths likely to be attributable to the injury. Better enumeration of long-term injury-related mortality will have the potential to improve estimates of injury burden.
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Affiliation(s)
- Rebecca J. Mitchell
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW 2109 Australia
| | - Cate M. Cameron
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Rod McClure
- Harvard Injury Control Research Center, Harvard School of Public Health, Harvard University, Boston, USA
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Cameron CM, Spinks AB, Osborne JM, Davey TM, Sipe N, McClure RJ. Recurrent episodes of injury in children: an Australian cohort study. AUST HEALTH REV 2017; 41:485-491. [DOI: 10.1071/ah15193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 07/12/2016] [Indexed: 11/23/2022]
Abstract
Objective
The aim of the present study was to compare sociodemographic characteristics of children with single versus recurrent episodes of injury and provide contemporary evidence for Australian injury prevention policy development.
Methods
Participants were identified from the Environments for Healthy Living: Griffith Birth Cohort Study 2006–11 (n = 2692). Demographic data were linked to the child’s hospital emergency and admissions data from birth to December 2013. Data were dichotomised in two ways: (1) injured or non-injured; and (2) single or recurrent episodes of injury. Multivariate logistic regression was used for analysis.
Results
The adjusted model identified two factors significantly associated with recurrent episodes of injury in children aged <3 years. Children born to mothers <25 years were almost fourfold more likely to have recurrent episodes of injury compared with children of mothers aged ≥35 years (adjusted odds ratio (aOR) = 3.68; 95% confidence interval (CI) 1.44–9.39) and, as a child’s age at first injury increased, odds of experiencing recurrent episodes of injury decreased (aOR = 0.97; 95% CI 0.94–0.99). No differences were found in sociodemographic characteristics of children aged 3–7 years with single versus recurrent episodes of injury (P > 0.1).
Conclusion
National priorities should include targeted programs addressing the higher odds of recurrent episodes of injury experienced by children aged <3 years with younger mothers or those injured in the first 18 months of life.
What is known about the topic?
Children who experience recurrent episodes of injury are at greater risk of serious or irrecoverable harm, particularly when repeat trauma occurs in the early years of life.
What does the paper add?
The present study identifies key factors associated with recurrent episodes of injury in young Australian children. This is imperative to inform evidence-based national injury prevention policy development in line with the recent expiry of the National Injury Prevention and Safety Promotion Plan: 2004–2014.
What are the implications for practitioners?
Injury prevention efforts need to target the increased injury risk experienced by families from lower socioeconomic backgrounds and, as a priority, children under 3 years of age with younger mothers and children who are injured in the first 18 months of life. These families require access to education programs, resources, equipment and support, particularly in the child’s early years. These programs could be provided as part of the routine paediatric and child health visits available to families after their child’s birth or incorporated into hospital and general practitioner injury treatment plans.
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Mitchell RJ, Cameron CM, McClure R. Quantifying the hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. BMJ Open 2016; 6:e013266. [PMID: 27927664 PMCID: PMC5168691 DOI: 10.1136/bmjopen-2016-013266] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/06/2016] [Accepted: 11/08/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To quantify the 12-month hospitalised morbidity and mortality attributable to traumatic injury using a population-based matched cohort in Australia. SETTING New South Wales, Queensland and South Australia, Australia. PARTICIPANTS Individuals ≥18 years who had an injury-related hospital admission in 2009 formed the injured cohort. The non-injured comparison cohort was randomly selected from the electoral roll and was matched 1:1 on age, gender and postcode of residence at the date of the index injury admission of their matched counterpart. PRIMARY OUTCOME MEASURES Using linked emergency department presentation, hospital admission and mortality records from 1 January 2008 to 31 December 2010 for both the injured and non-injured cohorts, 12-month mortality and pre-index and post-index injury hospital service use was examined. Adjusted rate ratios and attributable risk were calculated. RESULTS There were 167 600 individuals injured in 2009 and admitted to hospital in New South Wales, South Australia or Queensland with a matched comparison. The injured cohort had 3 times higher proportion of having ≥1 comorbidity preinjury, higher preinjury hospital service use, and a higher 12-month mortality compared with a non-injured comparison group. The injured cohort had 2.20 (95% CI 2.12 to 2.28) times higher rate of hospital admissions in the 12 months post the index injury admission compared with the non-injured comparison cohort. Injury was a likely contributory factor in at least 55% of hospitalisations within 12 months of the index injury hospitalisation. CONCLUSIONS Individuals who had an injury-related hospitalisation had higher mortality and are hospitalised at increased rates for many months postinjury. While comorbid conditions are significant, they do not account for the differences in outcomes. This study contributes to informing research efforts on better quantifying the attributable burden of hospitalised injury-related disability and mortality in Australia.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Australia
| | - Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Rod McClure
- Harvard Injury Control Research Center, Harvard School of Public Health, Harvard University, Cambridge, Massachusetts, USA
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Burgess JD, Cameron CM, Watt K, Kimble RM. Cool Runnings - an app-based intervention for reducing hot drink scalds: study protocol for a randomised controlled trial. Trials 2016; 17:388. [PMID: 27488411 PMCID: PMC4973069 DOI: 10.1186/s13063-016-1521-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/22/2016] [Indexed: 11/15/2022] Open
Abstract
Background Globally, burns are the fifth leading cause of non-fatal children’s injuries, and the leading cause of childhood burns is hot beverage scalds. Although there have been a number of programmes aimed at preventing scalds in children, very few have specifically addressed hot beverage scalds, and fewer have reported a reduction in injury rates. In Australia, hot beverage scalds account for 18 % of all childhood burns – a figure that has remained constant for the past decade. Innovative new technologies, such as Smartphone applications (apps), present a novel way for delivering individual-level injury prevention messages. The low cost, scalability and broad reach make this technology an ideal channel for health interventions. One of the latest methods being used in health-related apps aimed at behaviour change is gamification. Gamification uses the gaming principles of rewards, competition and personalisation to engage participants and motivate them towards preferred behaviours. This intervention will use a Smartphone app-based platform that combines gamification and behaviour-change strategies to increase knowledge and awareness of hot beverage scald risks and burn first aid among mothers of young children. Methods/design This is a two-group, parallel, single-blinded randomised control trial (RCT) to evaluate the efficacy of a Smartphone app-based injury prevention intervention. The primary outcome measure is change in knowledge. Change in knowledge is measured in three components: knowledge of correct burns first aid; knowledge of the main cause of burns/scalds in children aged 0–15yrs; knowledge of the main age group at risk for burns/scalds. The secondary outcome measures relate to the gamification methods, measuring participants frequency of engagement with the Cool Runnings app. Queensland-based mothers aged 18+ years who own a Smartphone and have at least one child aged 5–12 months are eligible to participate. Discussion To our knowledge, this is the first study to evaluate an app-based delivery of injury prevention messages, and the first study to test the efficacy of gamification techniques in an injury prevention intervention. If this intervention is found to be effective, this RCT will provide a platform for targeting other childhood injury prevention campaigns. Trial registration This trial was registered on 14 January 2016 with the Australian New Zealand Clinical Trials Registry (ACTRN12616000019404).
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Affiliation(s)
- J D Burgess
- Centre for Children's Burns and Trauma Research, University of Queensland, Level 7, 62 Graham Street, Brisbane, Queensland, 4101, Australia. .,Wound Management Innovation Cooperative Research Centre, Brisbane, Queensland, 4101, Australia.
| | - C M Cameron
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, 4031, Australia
| | - K Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - R M Kimble
- Centre for Children's Burns and Trauma Research, University of Queensland, Level 7, 62 Graham Street, Brisbane, Queensland, 4101, Australia
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Werner AK, Watt K, Cameron CM, Vink S, Page A, Jagals P. All-age hospitalization rates in coal seam gas areas in Queensland, Australia, 1995-2011. BMC Public Health 2016; 16:125. [PMID: 26852381 PMCID: PMC4744625 DOI: 10.1186/s12889-016-2787-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/27/2016] [Indexed: 02/04/2023] Open
Abstract
Background Unconventional natural gas development (UNGD) is expanding globally, with Australia expanding development in the form of coal seam gas (CSG). Residents and other interest groups have voiced concerns about the potential environmental and health impacts related to CSG. This paper compares objective health outcomes from three study areas in Queensland, Australia to examine potential environmentally-related health impacts. Methods Three study areas were selected in an ecologic study design: a CSG area, a coal mining area, and a rural/agricultural area. Admitted patient data, as well as population data and additional factors, were obtained for each calendar year from 1995 through 2011 to calculate all-age hospitalization rates and age-standardized rates in each of these areas. The three areas were compared using negative binomial regression analyses (unadjusted and adjusted models) to examine increases over time of hospitalization rates grouped by primary diagnosis (19 ICD chapters), with rate ratios serving to compare the within-area regression slopes between the areas. Results The CSG area did not have significant increases in all-cause hospitalization rates over time for all-ages compared to the coal and rural study areas in adjusted models (RR: 1.02, 95 % CI: 1.00–1.04 as compared to the coal mining area; RR: 1.01, 95 % CI: 0.99–1.04 as compared to the rural area). While the CSG area did not show significant increases in specific hospitalization rates compared to both the coal mining and rural areas for any ICD chapters in the adjusted models, the CSG area showed increases in hospitalization rates compared only to the rural area for neoplasms (RR: 1.09, 95 % CI: 1.02–1.16) and blood/immune diseases (RR: 1.14, 95 % CI: 1.02–1.27). Conclusions This exploratory study of all-age hospitalization rates for three study areas in Queensland suggests that certain hospital admissions rates increased more quickly in the CSG study area than in other study areas, particularly the rural area, after adjusting for key sociodemographic factors. These findings are an important first step in identifying potential health impacts of CSG in the Australian context and serve to generate hypotheses for future studies. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2787-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Angela K Werner
- Sustainable Minerals Institute, The University of Queensland, Sir James Foots Bldg (47a), Level 6, CWiMI, Corner Staffhouse and College Roads, St. Lucia, QLD, 4072, Australia.
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia. .,School of Public Health, The University of Queensland, Herston, QLD, Australia.
| | - Cate M Cameron
- CONROD Injury Research Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, QLD, Australia.
| | - Sue Vink
- Sustainable Minerals Institute, The University of Queensland, Sir James Foots Bldg (47a), Level 6, CWiMI, Corner Staffhouse and College Roads, St. Lucia, QLD, 4072, Australia.
| | - Andrew Page
- Centre for Health Research, Western Sydney University, Penrith, NSW, Australia.
| | - Paul Jagals
- School of Public Health, The University of Queensland, Herston, QLD, Australia.
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Osborne JM, Shibl R, Cameron CM, Kendrick D, Lyons RA, Spinks AB, Sipe N, McClure RJ. Validity of parent's self-reported responses to home safety questions. Int J Inj Contr Saf Promot 2015; 23:229-39. [PMID: 25715735 DOI: 10.1080/17457300.2014.992348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of the study was to describe the validity of parent's self-reported responses to questions on home safety practices for children of 2-4 years. A cross-sectional validation study compared parent's self-administered responses to items in the Home Injury Prevention Survey with home observations undertaken by trained researchers. The relationship between the questionnaire and observation results was assessed using percentage agreement, sensitivity, specificity, positive predictive value, negative predictive value and intraclass correlation coefficients. Percentage agreements ranged from 44% to 100% with 40 of the total 45 items scoring higher than 70%. Sensitivities ranged from 0% to 100%, with 27 items scoring at least 70%. Specificities also ranged from 0% to 100%, with 33 items scoring at least 70%. As such, the study identified a series of self-administered home safety questions that have sensitivities, specificities and predictive values sufficiently high to allow the information to be useful in research and injury prevention practice.
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Affiliation(s)
- Jodie M Osborne
- a School of Medicine , Griffith University , Meadowbrook , Australia
| | - Rania Shibl
- b School of Accountancy, Faculty of Business , Queensland University of Technology , Brisbane , Australia
| | - Cate M Cameron
- c Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute , Griffith University , Meadowbrook , Australia
| | - Denise Kendrick
- d School of Medicine, Division of Primary Care , University of Nottingham , Nottingham , United Kingdom
| | - Ronan A Lyons
- e Farr Institute of Health Informatics Research , Swansea University , Swansea , United Kingdom
| | - Anneliese B Spinks
- a School of Medicine , Griffith University , Meadowbrook , Australia.,f Ecosystem Sciences , Commonwealth Scientific and Industrial Research Organisation (CSIRO) , Dutton Park , Australia
| | - Neil Sipe
- g School of Geography, Planning and Environmental Management , The University of Queensland , St Lucia , Australia
| | - Roderick J McClure
- h Harvard Injury Control Research Center , Harvard School of Public Health , Boston , USA
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Mitchell RJ, Cameron CM, McClure RJ, Williamson AM. Data linkage capabilities in Australia: practical issues identified by a Population Health Research Network 'Proof of Concept project'. Aust N Z J Public Health 2015; 39:319-25. [PMID: 25716143 DOI: 10.1111/1753-6405.12310] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 08/01/2014] [Accepted: 09/01/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To describe the practical issues that need to be overcome to conduct national data linkage projects in Australia and propose recommendations to improve efficiency. METHODS Review of the processes, documentation and applications required to conduct national data linkage in Australia. RESULTS The establishment of state and national data linkage centres in Australia has placed Australia at the forefront of research linking health-related administrative data collections. However, improvements are needed to reduce the clerical burden on researchers, simplify the process of obtaining ethics approval, improve data accessibility, and thus improve the efficiency of data linkage research. CONCLUSIONS While a sound state and national data linkage infrastructure is in place, the current complexity, duplication and lack of cohesion undermines any attempts to conduct research involving national record linkage in a timely manner. IMPLICATIONS Data linkage applications and Human Research Ethics Committee approval processes need to be streamlined and duplication removed, in order to reduce the administrative and financial burden on researchers if national data linkage research is to be viable.
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Affiliation(s)
| | - Cate M Cameron
- Centre of National Research on Disability and Rehabilitation Medicine, School of Human Services and Social Work, Griffith University, Queensland.,Griffith Health Institute, Griffith University, Queensland
| | - Rod J McClure
- Harvard Injury Control Research Center, Harvard School of Public Health, United States
| | - Ann M Williamson
- Transport and Road Safety Research, University of New South Wales
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Golenko XA, Shibl R, Scuffham PA, Cameron CM. Relationship between socioeconomic status and general practitioner visits for children in the first 12 months of life: an Australian study. AUST HEALTH REV 2015; 39:136-145. [DOI: 10.1071/ah14108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 10/29/2014] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to examine the relationship between socioeconomic status (SES) and child general practitioner (GP) visits in the first 12 months of life. Methods A longitudinal analysis of 1202 mother and child dyads was conducted as part of the Environments for Healthy Living study from south-east Queensland, Australia, for participants enrolled between 2006 and 2009. Maternally reported survey data (sociodemographic and child health information) were linked with individual Medical Benefits Scheme data from birth to 12 months, identifying GP service use. Results On average, children visited the GP 10.2 times in the first 12 months of life. An inverse relationship was found for SES and child GP visits, with maternal education and child gender the strongest predictors of the total number of GP visits. Almost 70% of participants had all GP consultations bulk billed and only 3.5% paid more than A$100 in total. Conclusions Children from lower SES families may have a greater need for health services due to higher rates of illness and injury. Bulk billing and low-cost access to GP services, regardless of length of consultation, improve equity of access; however, indirect costs may prevent low-income mothers from accessing care for their child when needed. What is known about the topic? The relationship between health and SES, and the influence that health service use can have on this relationship, are well recognised. Previous studies on adult populations in Australia suggest that people of lower SES have more frequent GP consultations due to greater exposure to health risk. However, consultation times are often shorter because short consultations are more likely to be bulk billed, which is resulting in ongoing unmet need. Early childhood visits to the GP can strongly influence long-term health outcomes; however, relatively few studies have examined GP service use among children in Australia. What does this paper add? This paper builds on current knowledge by providing valuable insights into GP service use in the first 12 months of life. It provides evidence to suggest that the relationship between SES and health risk already exists in the first 12 months of life and that bulk billing and low-cost access to GP services improves equity of access. It also highlights the importance of health policy and practice that enables GP service utilisation based on need rather than ability to pay. What are the implications for practitioners? Policies and practice that promote equity of access, such as bulk billing for lower SES families, can assist in improving long-term health outcomes for disadvantaged populations. Greater equity with regard to length of consultation and bulk billing for adults may assist in reducing the disparities in health outcomes between the higher and lower SES populations. Furthermore, indirect costs and the availability of appropriate services for specific groups, such as low income, rural and remote and linguistically and culturally diverse populations, may also be important barriers to access.
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Scheltinga F, Shibl R, Green AC, Ng SK, Scuffham PA, Cameron CM. Varying sun protection of young children by migrant and Australian-born mothers. Aust N Z J Public Health 2014; 38:513-7. [PMID: 25307255 DOI: 10.1111/1753-6405.12272] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 03/01/2014] [Accepted: 05/01/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To compare sun protection by Australian-born and migrant mothers of three-year-old children. METHODS Australian-born and migrant mothers taking part in the Environments for Healthy Living prospective birth-cohort study were asked standard questions about their child's sun protection. Children were given a skin cancer susceptibility score based on grandparents' ethnic origin. Logistic regression was used to estimate odds ratios (ORs) to measure the association of sun protection of children according to mothers' migrant status adjusted for socio-demographic characteristics. RESULTS A total of 613 Australian-born and 224 migrant mothers of three-year-old children were studied. Mothers who had migrated less than four years ago were more likely to allow their three-year-old to spend more than two hours outdoors between 10 am and 3 pm compared to Australian-born mothers (OR=2.80, 95%CI 1.20-6.57). Mothers from high latitude countries (>45 degrees) were more likely to apply sunscreen to their child than those from lower latitude countries (OR=3.15, 95%CI 1.03-9.61). CONCLUSIONS AND IMPLICATIONS Strategies should aim to increase general awareness about the need for sun protection of young children, and recent migrants should be alerted to the harms of excessive sun exposure.
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Affiliation(s)
- Fay Scheltinga
- Athena Institute, Free University of Amsterdam, The Netherlands
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Ng SK, Cameron CM, Hills AP, McClure RJ, Scuffham PA. Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: the EFHL longitudinal birth cohort study. BMC Pregnancy Childbirth 2014; 14:314. [PMID: 25201481 PMCID: PMC4165994 DOI: 10.1186/1471-2393-14-314] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 08/11/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Long-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. This study aims to identify socioeconomic differences in prepregnancy body mass index, quantify the impact of prepregnancy obesity on birth outcomes, and identify determinants of postpartum weight retention. METHODS A total of 2231 pregnant women, recruited from three public hospitals in Southeast Queensland in Australia during antenatal clinic visits, completed a questionnaire to elicit information on demographics, socioeconomic and behavioural characteristics. Perinatal information was extracted from hospital records. A follow-up questionnaire was completed by each participant at 12 months after the birth to obtain the mother's postpartum weight, breastfeeding pattern, dietary and physical activity characteristics, and the child's health and development information. Multivariate logistic regression method was used to model the association between prepregnancy obesity and outcomes. RESULTS Being overweight or obese prepregnancy was strongly associated with socioeconomic status and adverse behavioural factors. Obese women (18% of the cohort) were more likely to experience gestational diabetes, preeclampsia, cesarean delivery, and their children were more likely to experience intensive- or special-care nursery admission, fetal distress, resuscitation, and macrosomia. Women were more likely to retain weight postpartum if they consumed three or fewer serves of fruit/vegetables per day, did not engage in recreational activity with their baby, spent less than once a week on walking for 30 minutes or more or spent time with friends less than once per week. Mothers who breastfed for more than 3 months had reduced likelihood of high postpartum weight retention. CONCLUSIONS Findings provide additional specificity to the increasing evidence of the predisposition of obesity prepregnancy on adverse maternal and perinatal outcomes. They may be used to target effective behavioural change interventions to address obesity in women.
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Affiliation(s)
- Shu-Kay Ng
- />School of Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
| | - Cate M Cameron
- />Centre of National Research on Disability and Rehabilitation, School of Human Services and Social Work, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
| | - Andrew P Hills
- />Mater Mothers’ Hospital, Mater Research Institute – University of Queensland and Centre for Musculoskeletal Research, Griffith University, Brisbane, QLD Australia
| | - Roderick J McClure
- />Injury Research Institute, Monash University, Monash, VIC 3800 Australia
| | - Paul A Scuffham
- />School of Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
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Cameron CM, Shibl R, McClure RJ, Ng SK, Hills AP. Maternal pregravid body mass index and child hospital admissions in the first 5 years of life: results from an Australian birth cohort. Int J Obes (Lond) 2014; 38:1268-74. [PMID: 25059115 DOI: 10.1038/ijo.2014.148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/27/2014] [Accepted: 07/18/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the association of maternal pregravid body mass index (BMI) and child offspring, all-cause hospitalisations in the first 5 years of life. METHODS Prospective birth cohort study. From 2006 to 2011, 2779 pregnant women (2807 children) were enrolled in the Environments for Healthy Living: Griffith birth cohort study in South-East Queensland, Australia. Hospital delivery record and self-report baseline survey of maternal, household and demographic factors during pregnancy were linked to the Queensland Hospital Admitted Patients Data Collection from 1 November 2006 to 30 June 2012, for child admissions. Maternal pregravid BMI was classified as underweight (<18.5 kg m(-)(2)), normal weight (18.5-24.9 kg m(-)(2)), overweight (25.0-29.9 kg m(-)(2)) or obese (⩾30 kg m(-)(2)). Main outcomes were the total number of child hospital admissions and ICD-10-AM diagnostic groupings in the first 5 years of life. Negative binomial regression models were calculated, adjusting for follow-up duration, demographic and health factors. The cohort comprised 8397.9 person years (PYs) follow-up. RESULTS Children of mothers who were classified as obese had an increased risk of all-cause hospital admissions in the first 5 years of life than the children of mothers with a normal BMI (adjusted rate ratio (RR) =1.48, 95% confidence interval 1.10-1.98). Conditions of the nervous system, infections, metabolic conditions, perinatal conditions, injuries and respiratory conditions were excessive, in both absolute and relative terms, for children of obese mothers, with RRs ranging from 1.3-4.0 (PYs adjusted). Children of mothers who were underweight were 1.8 times more likely to sustain an injury or poisoning than children of normal-weight mothers (PYs adjusted). CONCLUSION RESULTS suggest that if the intergenerational impact of maternal obesity (and similarly issues related to underweight) could be addressed, a significant reduction in child health care use, costs and public health burden would be likely.
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Affiliation(s)
- C M Cameron
- 1] Centre of National Research on Disability and Rehabilitation, School of Human Services and Social Work, Griffith University, Griffith, Queensland, Australia [2] Griffith Health Institute, Griffith University, Griffith, Queensland, Australia
| | - R Shibl
- Faculty of Business, Queensland University of Technology, Brisbane, Queensland, Australia
| | - R J McClure
- Monash Injury Research Institute, Monash University, Monash, Victoria, Australia
| | - S-K Ng
- 1] Griffith Health Institute, Griffith University, Griffith, Queensland, Australia [2] School of Medicine, Griffith University, Griffith, Queensland, Australia
| | - A P Hills
- 1] Griffith Health Institute, Griffith University, Griffith, Queensland, Australia [2] Mater Mothers' Hospital, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia
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Mitchell RJ, Cameron CM, Bambach MR. Data linkage for injury surveillance and research in Australia: perils, pitfalls and potential. Aust N Z J Public Health 2014; 38:275-80. [DOI: 10.1111/1753-6405.12234] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 02/01/2014] [Accepted: 02/01/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Rebecca J. Mitchell
- Transport and Road Safety Research, University of New South Wales
- Falls and Injury Prevention, Neuroscience Research Australia, University of New South Wales
| | - Cate M. Cameron
- Centre of National Research on Disability and Rehabilitation Medicine, School of Human Services and Social Work, Griffith University, Queensland
- Griffith Health Institute, Griffith University, Queensland
| | - Mike R. Bambach
- Transport and Road Safety Research, University of New South Wales
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Mallan KM, Daniels LA, Nothard M, Nicholson JM, Wilson A, Cameron CM, Scuffham PA, Thorpe K. Dads at the dinner table. A cross-sectional study of Australian fathers’ child feeding perceptions and practices. Appetite 2014; 73:40-4. [DOI: 10.1016/j.appet.2013.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Cameron CM, Davey TM, Kendall E, Wilson A, McClure RJ. Changes in alcohol consumption in pregnant Australian women between 2007 and 2011. Med J Aust 2013; 199:355-7. [DOI: 10.5694/mja12.11723] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 05/30/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Cate M Cameron
- Griffith Health Institute, Griffith University, Logan, QLD
- Population and Social Health Research Program, Griffith University, Logan, QLD
| | - Tamzyn M Davey
- Griffith Health Institute, Griffith University, Logan, QLD
| | - Elizabeth Kendall
- Griffith Health Institute, Griffith University, Logan, QLD
- Population and Social Health Research Program, Griffith University, Logan, QLD
- Centre of National Research on Disability and Rehabilitation Medicine, Brisbane, QLD
| | - Andrew Wilson
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW
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