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Kallio M, Tornivuori A, Miettinen PJ, Kolho KL, Relas H, Culnane E, Loftus H, Sawyer SM, Kosola S. Health-related quality of life and self-reported health status in adolescents with chronic health conditions before transfer of care to adult health care: an international cohort study. BMC Pediatr 2024; 24:163. [PMID: 38459510 PMCID: PMC10921592 DOI: 10.1186/s12887-024-04629-x] [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: 06/12/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Heath-related quality of life (HRQoL) is lower in adolescents with chronic health conditions compared to healthy peers. While there is evidence of some differences according to the underlying condition and gender, differences by measure and country are poorly understood. In this study we focus on the differences in HRQoL in adolescents with various chronic medical conditions in the year before transfer of care to adult health services. We also study the associations of two different HRQoL measurements to each other and to self-reported health. METHODS We recruited 538 adolescents from New Children`s Hospital, Helsinki, Finland, and the Royal Children`s Hospital, Melbourne, Australia in 2017-2020. We used two validated HRQoL measurement instruments, Pediatric Quality of Life Inventory (PedsQL) and 16D, and a visual analog scale (VAS) for self-reported health status. RESULTS In total, 512 adolescents (50.4% female, mean age 17.8 [SD 1.2] years), completed the survey measures. Higher HRQoL was reported in males than females in both countries (PedsQL 79.4 vs. 74.1; 16D 0.888 vs. 0.846), and in adolescents from Finland than Australia (80.6 vs. 72.2 and 0.905 vs. 0.825, p < 0.001 for all). Adolescents with diabetes, rheumatological, nephrological conditions and/or organ transplants had higher HRQoL than adolescents with neurological conditions or other disease syndromes (p < 0.001). PedsQL and 16D scores showed a strong correlation to each other (Spearman correlation coefficient r = 0.81). Using the 7-point VAS (1-7), 52% (248 of 479) considered their health status to be good (6-7) and 10% (48 of 479) rated it poor (1-2). Better self-reported health was associated with higher HRQoL. CONCLUSIONS The HRQoL of transition aged adolescents varies between genders, diagnostic groups, and countries of residence. The association between self-reported health and HRQoL suggests that brief assessment using the VAS could identify adolescents who may benefit from in-depth HRQoL evaluation. TRIAL REGISTRATION Trial registration name The Bridge and registration number NCT04631965 ( https://clinicaltrials.gov/ct2/show/NCT04631965 ).
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Affiliation(s)
- Mira Kallio
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Anna Tornivuori
- Department of Nursing Science, University of Turku, Turku, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Päivi J Miettinen
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heikki Relas
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
| | - Hayley Loftus
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Silja Kosola
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
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Clough I, Culnane E, Loftus H. Exploring the transition experiences of young adults with cerebral palsy. Child Care Health Dev 2024; 50:e13186. [PMID: 37874030 DOI: 10.1111/cch.13186] [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: 01/08/2023] [Revised: 08/24/2023] [Accepted: 10/02/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND It is important that young adults with a chronic health condition or developmental disability, such as cerebral palsy, receive adequate healthcare transition preparation and support to optimise the transition period and transfer from paediatric to adult health services. Understanding the healthcare experiences of young adults during and after the transition period will provide valuable insights into what enables a positive healthcare experience for young adults in the adult health setting. METHODS Eleven young adults with cerebral palsy who had their last appointment at the Royal Children's Hospital between 2016 and 2018 were purposively recruited for this study. Ten participants completed one-on-one telephone interviews, and one participant provided written responses to interview questions. Five participated via parent proxy. Interviews were recorded, transcribed verbatim, and analysed using the Braun and Clarke six-step thematic analysis to create an interpretive description of participants' transition experiences. RESULTS Three themes were generated: (1) "preparedness of the young adult and parent," which discussed the preparation for adult healthcare, with subthemes (a) expectations of adult care and (b) development of self-management skills during transition; (2) "coordination of transfer process and continuity of care," which illustrated the impact of transfer coordination on continuity of care; and (3) "adjusting to adult services," which highlighted experiences of care in the adult setting, with subthemes (a) differences between paediatric and adult services, (b) availability and accessibility of adult and community services to meet needs, and (c) autonomy and agency. CONCLUSION Dedicated transition support for young adults and their parents during transition from paediatric to adult healthcare plays an important role in ensuring a supportive and well-coordinated transition and transfer of care. Experience of care in the adult setting is influenced by a combination of both transition experience and the capacity of adult services to cater for young adults' needs.
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Affiliation(s)
- Isabelle Clough
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Evelyn Culnane
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
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Hall T, Constable L, Loveday S, Honisett S, Schreurs N, Goldfeld S, Loftus H, Jones R, Reupert A, Yap MBH, Woolfenden S, Montgomery A, Dalziel K, Bailey C, Pringle G, Fisher J, Forell S, Eapen V, Haslam R, Sanci L, Eastwood J, Hiscock H. Identifying and responding to family adversity in Australian community and primary health settings: a multi-site cross sectional study. Front Public Health 2023; 11:1147721. [PMID: 37771827 PMCID: PMC10525396 DOI: 10.3389/fpubh.2023.1147721] [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: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Background Unaddressed family adversity has potentially modifiable, negative biopsychosocial impacts across the life course. Little is known about how Australian health and social practitioners identify and respond to family adversity in community and primary health settings. Objective To describe, in two Australian community health services: (1) the number of adversities experienced by caregivers, (2) practitioner identification of caregivers experiencing adversity, (3) practitioner response to caregivers experiencing adversity, and (4) caregiver uptake of referrals. Methods Survey of caregivers of children aged 0-8 years attending community health services in Victoria and New South Wales (NSW). Analysis described frequencies of caregiver self-reported: (1) experiences of adversity, (2) practitioner identification of adversity, (3) practitioner response to adversity, and (4) referral uptake. Analyses were sub-grouped by three adversity domains and site. Results 349 caregivers (Victoria: n = 234; NSW: n = 115) completed the survey of whom 88% reported experiencing one or more family adversities. The median number of adversities was 4 (2-6). Only 43% of participants were directly asked about or discussed an adversity with a practitioner in the previous 6 months (Victoria: 30%; NSW: 68%). Among caregivers experiencing adversity, 30% received direct support (Victoria: 23%; NSW: 43%), and 14% received a referral (Victoria: 10%; NSW: 22%) for at least one adversity. Overall, 74% of caregivers accepted referrals when extended. Conclusion The needs of Australian families experiencing high rates of adversity are not systematically identified nor responded to in community health services. This leaves significant scope for reform and enhancement of service responses to families experiencing adversity.
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Affiliation(s)
- Teresa Hall
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Leanne Constable
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sarah Loveday
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Suzy Honisett
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Natalie Schreurs
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Hayley Loftus
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Renee Jones
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC, Australia
| | - Marie B. H. Yap
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sue Woolfenden
- Sydney Institute Women, Children and their Families, Sydney Local Health District, Croydon, NSW, Australia
- Discipline of Paediatrics, University of New South Wales, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Alicia Montgomery
- Sydney Institute Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Kim Dalziel
- Health Economics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Cate Bailey
- Health Economics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Glenn Pringle
- Innovation and Community Care, IPC Health, Wyndham Vale, VIC, Australia
| | - Jane Fisher
- Global and Women's Health, Monash University, Clayton, VIC, Australia
| | - Suzie Forell
- Health Justice Australia, Darlinghurst, Sydney, NSW, Australia
- School of Law, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Infant Child and Adolescent Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Ric Haslam
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Lena Sanci
- Department of General Practice, The University of Melbourne, Parkville, VIC, Australia
| | - John Eastwood
- Sydney Institute Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Harriet Hiscock
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Health Services and Economics, Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
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Hall T, Loveday S, Pullen S, Loftus H, Constable L, Paton K, Hiscock H. Co-designing an Integrated Health and Social Care Hub With and for Families Experiencing Adversity. Int J Integr Care 2023; 23:3. [PMID: 37033364 PMCID: PMC10077991 DOI: 10.5334/ijic.6975] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/29/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Integrated care research often fails to adequately describe co-design methods. This article outlines the process, principles and tools to co-design an integrated health and social care Hub for families experiencing adversity. Research methods The Child and Family Hub was co-designed in four stages: (1) partnership building and stakeholder engagement, (2) formative research, (3) persona development and (4) co-design workshops and consultations. Local families, community members and intersectoral practitioners were engaged at each stage. The co-design workshops employed a human-centred design process and were evaluated using the Public and Patient Engagement Evaluation Tool (PEET). Results 121 family participants and 80 practitioners were engaged in the Hub's co-design. The PEET highlighted the co-design team's satisfaction achieved by community members working alongside practitioners to generate mutual learning. Resourcing was a key challenge. Discussion Human-centred design offered a systematic process and tools for integrating formative evidence with lived and professional experience in the Hub's co-design. Applying community engagement principles meant that a diverse range of stakeholders were engaged across all stages of the project which built trust in and local ownership of the Hub model. Conclusion Co-design research with families experiencing adversity should attend to language, engagement methods, team composition and resourcing decisions.
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Affiliation(s)
- Teresa Hall
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Sarah Loveday
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Sandie Pullen
- Innovation, Design & Communications, Manager, IPC Health, AU
| | - Hayley Loftus
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Leanne Constable
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Kate Paton
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
| | - Harriet Hiscock
- Centre for Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children’s Research Institute, AU
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Hinwood GL, Loftus H, Shepherd DA, Guzys A, Reddihough DS, Reid SM. Survival of individuals with cerebral palsy in Victoria, Australia: A longitudinal cohort study spanning four decades. Dev Med Child Neurol 2023; 65:580-587. [PMID: 36161450 DOI: 10.1111/dmcn.15420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/27/2022]
Abstract
AIM To provide an updated description of the rates, trends, and predictors of mortality of individuals with cerebral palsy (CP), born in the Australian state of Victoria between 1970 and 2012. METHOD Data were extracted for 4807 individuals (2091 females; 2716 males). The probability of survival to 30th June 2017 was calculated using the Kaplan-Meier method. Mortality rates were calculated per 1000 person-years using age strata and compared with population mortality rates to produce mortality ratios. Cox proportional hazards regression was used to calculate hazard ratios for selected demographic and clinical characteristics and to estimate the effect of birth epoch on 15-year survival. RESULTS There were 666 recorded deaths. Compared to the general population, mortality was higher for all persons with CP and highest for children aged 1 to 15 years (45-62 times). We observed 35% improvement in the probability of survival to 15 years for births in the 2000s relative to the 1970s (hazard ratio 0.65, 95% confidence interval [CI] 0.49, 0.86), but only 4% improvement for the subgroup with complex CP (hazard ratio 0.96, 95% CI 0.69, 1.33). INTERPRETATION The observed improvements in survival for those born in the 2000s is likely related predominantly to a proportional reduction in complex CP within the cohort. WHAT THIS PAPER ADDS Length of survival improved for Australians with cerebral palsy (CP) born this millennium. Improved survival was mainly because of a proportional reduction in complex CP. A small improvement in length of survival was seen for children with complex CP.
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Affiliation(s)
- Gina L Hinwood
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Clayton, Victoria, Australia
| | - Hayley Loftus
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Daisy A Shepherd
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Angela Guzys
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Dinah S Reddihough
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Reid
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, Victoria, Australia
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Culnane E, Efron D, Williams K, Marraffa C, Antolovich G, Prakash C, Loftus H. Carer perspectives of a transition to adult care model for adolescents with an intellectual disability and/or autism spectrum disorder with mental health comorbidities. Child Care Health Dev 2023; 49:281-291. [PMID: 35947107 DOI: 10.1111/cch.13040] [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: 11/12/2021] [Revised: 03/23/2022] [Accepted: 08/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transition to adult care for adolescents with an intellectual disability and/or autism spectrum disorder with coexisting mental health disorders, often termed 'dual disability', is complex. It requires a family-centred approach, with collaboration among health, disability and social services and early planning. AIM To describe carer perspectives of transition to adult care and the outcomes of a transition support intervention, Fearless, Tearless Transition, for adolescents with dual disabilities piloted at a tertiary children's hospital. METHODS Carers of adolescents with a dual disability were invited to complete a survey at the commencement of their participation in the Fearless, Tearless Transition model, and again at the conclusion of the project. Within this intervention, carers and adolescents were encouraged to attend dedicated transition clinics and participate in a shared care general practitioner (GP) and paediatrician process. RESULTS One hundred and fifty-one carers of adolescents with dual disabilities were included in Fearless, Tearless Transition. Of this cohort, 138 adolescents and their carers received support in a dedicated transition clinic with 99 carers completing the initial survey at the commencement of the model. Eighty-two per cent of carers reported moderate to high levels of anxiety about transitioning from paediatric to adult care with 39% feeling 'unprepared' about transition. Eighty-one per cent reported having inadequate access to respite care with 47% reporting a lack of access to services in the community and 56% expressing dissatisfaction with their GPs. One hundred and two families participated in the shared care process with 80 GPs and 33 paediatricians. Twenty-two carers completed the second survey reporting a modest but significant improvement in preparedness for transition to adult care. CONCLUSION This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early, centralized transition planning, consistent methods of assessing adolescent and carer needs and shared care.
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Affiliation(s)
- Evelyn Culnane
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
| | - Daryl Efron
- University of Melbourne, Melbourne, Victoria, Australia.,Department of General Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,Centre for Community Child Health, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine Marraffa
- University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Neurodevelopment and Disability, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Giuliana Antolovich
- University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Neurodevelopment and Disability, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Chidambaram Prakash
- Department of Mental Health, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Honisett S, Loftus H, Liu H, Montgomery A, De Souza D, Hall T, Eastwood J, Hiscock H, Goldfeld S. Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families-A scoping study. Health Promot J Austr 2023; 34:211-221. [PMID: 36448724 PMCID: PMC10947353 DOI: 10.1002/hpja.684] [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] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
ISSUE ADDRESSED To determine if Australian policies support a primary health care system to identify family adversity and subsequently support these families. METHODS Two methodological approaches were used: (i) a scoping review of Australian federal and two states (Victoria and New South Wales) policies related to family adversity (e.g., childhood maltreatment or household dysfunction, such as parental mental illness); (ii) thirteen semi-structured interviews with Victorian Community Health Service (CHS) staff and government policy makers, recruited via snowball sampling to understand the context of policy making and service implementation. Data collected were subsequently discussed in relation to the Stages Model of policy analysis. RESULTS One hundred and eighty-eight policies referenced family adversity. Of these, 37 policies met all eligibility criteria including a focus on early intervention within primary care and were included in the review. Most policies were developed within health departments (78%) and included a wide range of adversities, with the majority based within maternal and child health and CHS platforms. Most policy development included consultation with stakeholders. Although most policies received some level of funding, few included funding details and only a third included evaluation. CONCLUSIONS There are many policies related to family adversity in Australia, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity. SO WHAT More work needs to be done to ensure policies are adequately implemented, evaluated and transparently and appropriately funded. The co-occurrence of adversity should focus policy action; and potentially lead to more effective and efficient outcomes.
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Affiliation(s)
- Suzy Honisett
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Hayley Loftus
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - HueiMing Liu
- Health Systems Science, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Alicia Montgomery
- Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia
| | | | - Teresa Hall
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Eastwood
- Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia
- Centre for Research Excellence for Integrated Health and Social Care, University of Sydney Menzies Centre for Health Policy and Economics, Sydney, New South Wales, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Hall T, Goldfeld S, Loftus H, Honisett S, Liu H, De Souza D, Bailey C, Reupert A, Yap MBH, Eapen V, Haslam R, Sanci L, Fisher J, Eastwood J, Mukumbang FC, Loveday S, Jones R, Constable L, Forell S, Morris Z, Montgomery A, Pringle G, Dalziel K, Hiscock H. Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites. BMJ Open 2022; 12:e055431. [PMID: 35613800 PMCID: PMC9125738 DOI: 10.1136/bmjopen-2021-055431] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Integrated community healthcare Hubs may offer a 'one stop shop' for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales. METHODS AND ANALYSIS This multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100-200 per site) and Hub practitioners (n=20-30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data. ETHICS AND DISSEMINATION Royal Children's Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications. TRIAL REGISTRATION NUMBER ISRCTN55495932.
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Affiliation(s)
- Teresa Hall
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Hayley Loftus
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Suzy Honisett
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Hueiming Liu
- Centre of Health Systems Science, The George Institute for Global Health, Camperdown, New South Wales, Australia
| | - Denise De Souza
- Centre for Research in Education and Sustainability, Torrens University Australia - Fitzroy Campus, Melbourne, Victoria, Australia
| | - Cate Bailey
- Health Economics Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Andrea Reupert
- Department of Education, Monash University, Melbourne, Victoria, Australia
| | | | - Valsamma Eapen
- ICAMHS, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Ric Haslam
- Mental Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Eastwood
- Paediatrics and Child Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Sarah Loveday
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Renee Jones
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Leanne Constable
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Suzie Forell
- Health Justice Australia, Melbourne, Victoria, Australia
| | - Zoe Morris
- Department of Education, Monash University, Melbourne, Victoria, Australia
| | - Alicia Montgomery
- Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Kim Dalziel
- School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
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9
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Culnane E, Loftus H, Peters R, Haydar M, Hodgson A, Herd L, Hardikar W. Enabling successful transition-Evaluation of a transition to adult care program for pediatric liver transplant recipients. Pediatr Transplant 2022; 26:e14213. [PMID: 34967989 DOI: 10.1111/petr.14213] [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: 08/06/2021] [Revised: 10/18/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study aimed to evaluate the transition to adult care program instituted for liver transplant recipients (LTRs) at a large tertiary pediatric hospital in Melbourne, Australia. Evaluation included the change in a Global Assessment Measure (GAM) before and after the transition program, satisfaction with the program, and measures of transition success including rejection rates and attendance at appointments post-transfer. We hypothesized that the introduction of our structured transition program would improve disease understanding, health system understanding, and self-care. We also hypothesized that those who had undergone the transition program would have lower failure to attend rates and lower rates of rejection than historical controls. METHODS A LTR transition program was instituted at our service from 2013 to 2015. The program involved initial assessment of competencies with a Global Assessment Measure (GAM), followed by the introduction of a personalized goal setting program addressing issues identified in dedicated transition clinics. Assessment of competencies was compared between the commencement of the program and immediately prior to transfer. Patient satisfaction with the transition process was assessed at an interview 6-12 months after transfer to the adult service. Rejection rates and failure to attend rates were compared between the intervention group and a group of LTRs who did not receive the intervention. RESULTS Twenty-eight LTRs participated in the study; 20 received the transition intervention and 8 served as controls. Within the intervention group, all domains of transition competency and reported anxiety regarding transferring had significantly improved at the conclusion of the intervention and all reported satisfaction with the transition program with most (81%) reporting readiness to transfer. There were no significant differences in rejection rates or failure to attend rates between those who did and did not receive the transition intervention. CONCLUSION A longitudinal holistic transition program has the potential to positively impact the competencies and readiness of LTRs to successful transition and transfer to adult care.
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Affiliation(s)
- Evelyn Culnane
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia.,Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Rebecca Peters
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Madeleine Haydar
- Transition Support Service, Department of Adolescent Medicine, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Alexandra Hodgson
- Department of Gastroenterology and Hepatology, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Lauren Herd
- Department of Gastroenterology and Hepatology, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia
| | - Winita Hardikar
- Department of Gastroenterology and Hepatology, The Royal Children's Hospital (RCH) Melbourne, Parkville, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia.,Population Allergy, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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10
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Hall T, Honisett S, Paton K, Loftus H, Constable L, Hiscock H. Prioritising interventions for preventing mental health problems for children experiencing adversity: a modified nominal group technique Australian consensus study. BMC Psychol 2021; 9:165. [PMID: 34689828 PMCID: PMC8542357 DOI: 10.1186/s40359-021-00652-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite the well-established link between childhood adversity and mental health problems, there is a dearth of evidence to inform decision making about the most acceptable and feasible interventions for preventing mental health problems for children experiencing adversity. Expert consensus is an important input into evidence-informed policy and practice but is often employed at the national level which misses important local contextual factors shaping decision making. This study aimed to: (1) reach consensus on local priority interventions for preventing mental health problems for children living with adversity in Wyndham, Victoria; and (2) understand the enabling factors and barriers to implementing these interventions. METHODS This study employed six online modified nominal group technique (NGT) workshops with 19 stakeholders; intersectoral service providers from health, social and education sectors and caregivers of children aged 0-8 years. RESULTS Three interventions reached consensus among the mixed stakeholder groups as being a high or very high priority for implementation in Wyndham: nurse home visiting, parenting programs and community-wide programs. Key rationales were the ability for these interventions to act as a gateway for families to increase their knowledge about topics immediately relevant to them (i.e. parenting), increase their knowledge about available supports and build relationships with service providers. CONCLUSIONS Local priorities for preventing mental health problems for children living with adversity emphasized relational approaches to service provision and were shaped by the availability of existing interventions and supports in the locality. The NGT was found to be an effective method for prioritising evidence-based practice interventions in health settings, engaging local stakeholders, and identifying enablers and barriers to implementation.
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Affiliation(s)
- Teresa Hall
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
| | - Suzy Honisett
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Kate Paton
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Hayley Loftus
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Leanne Constable
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Harriet Hiscock
- Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, The Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia
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11
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Kosola S, Culnane E, Loftus H, Tornivuori A, Kallio M, Telfer M, Miettinen PJ, Kolho KL, Aalto K, Raivio T, Sawyer S. Bridge study protocol: an international, observational cohort study on the transition of healthcare for adolescents with chronic conditions. BMJ Open 2021; 11:e048340. [PMID: 34155079 PMCID: PMC8217914 DOI: 10.1136/bmjopen-2020-048340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION More than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients' health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients' growing independence and educational and employment pathways during the transition process. METHODS AND ANALYSIS Bridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children's Hospital in Helsinki, Finland, or the Royal Children's Hospital (RCH) in Melbourne, Australia. Baseline assessment took place approximately 6 months prior to the transfer of care and follow-up data will be collected 1 year and 2 years after the transfer of care. Data will be collected from patients' hospital records and from questionnaires completed by the patient and their parent/guardian at each time point. The primary outcomes of this study are adherence to medical appointments, clinical health status and HRQoL and costs of care. Secondary outcome measures are educational and employment outcomes. ETHICS AND DISSEMINATION The Ethics Committee for Women's and Children's Health and Psychiatry at the Helsinki University Hospital (HUS/1547/2017) and the RCH Human Research Ethics Committee (38035) have approved the Bridge study protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study as well as patients and their parents/guardians. TRIAL REGISTRATION NUMBER NCT04631965.
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Affiliation(s)
- Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Transition Support Service, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Royal Children's Hospital, Parkville, Victoria, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - Mira Kallio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Clinical Research, University of Helsinki, Helsinki, Finland
| | - Michelle Telfer
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Päivi J Miettinen
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Medical Technology, Tampere University, Tampere, Finland
| | - Kristiina Aalto
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Taneli Raivio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Susan Sawyer
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute and the Royal Children's Hospital, Parkville, Victoria, Australia
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12
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Culnane E, Loftus H, Efron D, Williams K, Di Iorio N, Shepherd R, Marraffa C, Lubitz L, Antolovich G, Prakash C. Development of the Fearless, Tearless Transition model of care for adolescents with an intellectual disability and/or autism spectrum disorder with mental health comorbidities. Dev Med Child Neurol 2021; 63:560-565. [PMID: 33332592 PMCID: PMC8247054 DOI: 10.1111/dmcn.14766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 12/04/2022]
Abstract
AIM First, to understand the barriers to achieving effective transition and the supports required from the perspective of parents and carers, adolescents with intellectual disability and/or autism spectrum disorder and co-existing mental health disorders (often termed 'dual disability'), and those who provide services to this group. Second, to develop an informed model of shared care to improve the transition of adolescents with dual disabilities. METHOD Carers and a young adult with a dual disability were surveyed about their experience of transition care. Other key stakeholders including paediatricians, general practitioners, and policy makers were also interviewed. These data informed the model of care. RESULTS Paediatricians and general practitioners reported difficulties establishing working relationships to foster smooth transitions, and carers reported lacking a regular general practitioner with adequate expertise to care for people with dual disabilities. A process of shared care between paediatricians and general practitioners was developed and initiated by a dedicated transition manager, who assisted with care coordination and service linkages. Standardized clinical assessment tools were also introduced to determine patient and carer support needs. INTERPRETATION This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early transition planning, consistent methods of assessing patient and carer needs, and shared care. WHAT THIS PAPER ADDS Adolescents with co-occurring disabilities require a collaborative health and disability service interface. Fearless, Tearless Transition is a new approach to transitioning adolescents with dual disabilities from paediatric to adult care. Carers of adolescents with dual disabilities require support navigating and negotiating services. Engaging general practitioners and paediatricians in shared care early during the transition process is essential.
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Affiliation(s)
- Evelyn Culnane
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia
| | - Hayley Loftus
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia
| | - Daryl Efron
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Department of General MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Centre for Community Child HealthThe Royal Children’s HospitalMelbourneVICAustralia
| | - Katrina Williams
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of PaediatricsMonash UniversityMelbourneVICAustralia
| | - Nikki Di Iorio
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of Mental HealthThe Royal Children’s HospitalMelbourneVICAustralia
| | - Rebecca Shepherd
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia
| | - Catherine Marraffa
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of Neurodevelopment and DisabilityThe Royal Children’s HospitalMelbourneVICAustralia
| | - Lionel Lubitz
- Transition Support ServiceDepartment of Adolescent MedicineThe Royal Children’s HospitalMelbourneVICAustralia,Department of General MedicineThe Royal Children’s HospitalMelbourneVICAustralia
| | - Giuliana Antolovich
- Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Health ServicesMurdoch Children’s Research InstituteMelbourneVICAustralia,Department of Neurodevelopment and DisabilityThe Royal Children’s HospitalMelbourneVICAustralia
| | - Chidambaram Prakash
- Centre for Community Child HealthThe Royal Children’s HospitalMelbourneVICAustralia
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13
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Shi M, Loftus H, McAinch AJ, Su XQ. Blueberry as a source of bioactive compounds for the treatment of obesity, type 2 diabetes and chronic inflammation. J Funct Foods 2017. [DOI: 10.1016/j.jff.2016.12.036] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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14
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Zulli A, Smith RM, Kubatka P, Novak J, Uehara Y, Loftus H, Qaradakhi T, Pohanka M, Kobyliak N, Zagatina A, Klimas J, Hayes A, La Rocca G, Soucek M, Kruzliak P. Caffeine and cardiovascular diseases: critical review of current research. Eur J Nutr 2016; 55:1331-43. [PMID: 26932503 DOI: 10.1007/s00394-016-1179-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [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: 08/29/2015] [Accepted: 02/06/2016] [Indexed: 12/21/2022]
Abstract
Caffeine is a most widely consumed physiological stimulant worldwide, which is consumed via natural sources, such as coffee and tea, and now marketed sources such as energy drinks and other dietary supplements. This wide use has led to concerns regarding the safety of caffeine and its proposed beneficial role in alertness, performance and energy expenditure and side effects in the cardiovascular system. The question remains "Which dose is safe?", as the population does not appear to adhere to the strict guidelines listed on caffeine consumption. Studies in humans and animal models yield controversial results, which can be explained by population, type and dose of caffeine and low statistical power. This review will focus on comprehensive and critical review of the current literature and provide an avenue for further study.
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Affiliation(s)
- Anthony Zulli
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Renee M Smith
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Jan Novak
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic.,Department of Physiology, Masaryk University, Brno, Czech Republic
| | - Yoshio Uehara
- Division of Clinical Nutrition, Faculty of Home Economics, Kyoritsu Women's University, Tokyo, Japan
| | - Hayley Loftus
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Tawar Qaradakhi
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | | | | | - Jan Klimas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Odborarov 10, 832 32, Bratislava, Slovak Republic
| | - Alan Hayes
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Giampiero La Rocca
- Human Anatomy Section, Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy
| | - Miroslav Soucek
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Peter Kruzliak
- Laboratory of Structural Biology and Proteomics, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho tr 1/1946, Brno, 612 42, Czech Republic.
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15
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Loftus H, Powles E. P188 Do genitourinary medicine physicians need to know about tropical diseases? Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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