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Isles S, Kean M, Dipnall JF, Beck B. Temporal trends of transport-related injuries on New Zealand roads. N Z Med J 2024; 137:43-53. [PMID: 38513203 DOI: 10.26635/6965.6342] [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] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM This observational study aimed to investigate temporal trends in transport-related injuries in New Zealand by mode of transport and explore whether specific population groups and localities have a relatively higher incidence of injury. These trends provide insight into changes in injury patterns from road trauma. METHODS A retrospective study of hospitalised road trauma in New Zealand was conducted between 1 July 2017 to 30 June 2021. Data were obtained from the National Minimum Dataset of hospital admissions, and the New Zealand Trauma Registry (NZTR). Road trauma was identified using ICD-10 coding, and major trauma using Abbreviated Injury Scale (AIS) coding. Analysis included road trauma by mode, ethnicity, rurality and population rates. Statistical analysis included Interrupted Time Series (ITS) analysis to account for the impact of COVID-19 on road trauma. RESULTS Over the 4-year period there were 20,607 incidents of transport-related injury that resulted in admission to a New Zealand hospital. Of these, 14.5% (2,992) involved injuries that were classified as major trauma. Car occupants accounted for 62% of hospitalisations, followed by motorcyclists (23%), pedestrians (9%) and pedal cyclists (4%). Temporal trends showed no reduction in injuries from cars, pedal cyclists and pedestrian injuries, but an increase in motorcycling injuries. Māori had an age-standardised incidence rate almost 3.5 times higher than the rate for Asian peoples. CONCLUSION The increases in motorcycling injuries and no changes in pedestrian and cycling injuries, as well as demographic variation, highlight the need to focus on vulnerable road users. Effective and targeted initiatives on vulnerable road users will support objectives to reduce deaths and serious injury on New Zealand roads. Enhanced exposure data is needed for vulnerable road users to account for mobility changes over time. Linked data across population-based datasets is an important asset that enhances our understanding of road traffic injuries and allows evidence-based countermeasures to be developed.
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Affiliation(s)
| | - Michael Kean
- Data Analyst, Te Tāhū Hauora Health Quality & Safety Commission, New Zealand
| | - Joanna F Dipnall
- Senior Research Fellow & Lecturer, Pre-hospital, Emergency and Trauma Research, School of Public Health and Preventive Medicine, Monash University, Melbourne Victoria; Honorary Associate Professor, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Ben Beck
- Head of Sustainable Mobility and Safety Research, School of Public Health and Preventive Medicine, Monash University, Australia
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Gilmartin T, Dipnall JF, Gurvich C, Sharp G. Identifying overcontrol and undercontrol personality types among young people using the five factor model, and the relationship with disordered eating behaviour, anxiety and depression. J Eat Disord 2024; 12:16. [PMID: 38267972 PMCID: PMC10809654 DOI: 10.1186/s40337-024-00967-4] [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: 09/22/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Overcontrol and undercontrol personality types have been associated with an increase in eating pathology, depression and anxiety. The aim of the research was to explore whether latent overcontrol and undercontrol personality types could be identified using cluster analysis of the facets of the five factor model (FFM). We further aimed to understand how these personality types were associated with eating pathology, depressed mood and anxiety. METHODS A total of 561 participants (394 women and 167 men), aged 16-30 years in Australia completed a survey designed to assess disordered eating, FFM personality traits, anxiety, depression and stress. A systematic four-step process using hierarchical, k-means, and random forest cluster analyses were used to identify a meaningful 3-cluster solution. RESULTS The results revealed a cluster solution that represented overcontrol, undercontrol and resilient personality types, and highlighted facets of the FFM that were associated with each type. Both overcontrol and undercontrol personality types were associated with increased clinical symptoms compared to the resilient types. CONCLUSIONS It was concluded that FFM facets may potentially be more meaningful than broad domains in identifying personality types, and that both overcontrol and undercontrol personality types are likely associated with increased clinical symptoms.
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Affiliation(s)
- Tanya Gilmartin
- Department of Neuroscience, Monash University and the Alfred Hospital, Melbourne, Australia.
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, 3220, Australia
| | - Caroline Gurvich
- Department of Psychiatry, HER CENTRE Australia, Central Clinical School, Monash University, Melbourne, Australia
| | - Gemma Sharp
- Department of Neuroscience, Monash University and the Alfred Hospital, Melbourne, Australia
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Teague WJ, Dipnall JF, Palmer CS, Beck B. Trampoline Park Injury Trends. Pediatrics 2024; 153:e2023061659. [PMID: 38058227 DOI: 10.1542/peds.2023-061659] [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] [Accepted: 10/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES Trampolines are an important cause of childhood injury and focus of injury prevention. Understanding and prevention of trampoline park injury is constrained by inadequate exposure data to estimate the at-risk population. This study aimed to measure trampoline park injury incidence and time trends using industry data. METHODS Cross-sectional study to retrospectively analyze reported injuries and exposure in 18 trampoline parks operating in Australia and the Middle East, from 2017 to 2019. Exposure was derived from ticket sales and expressed as jumper hours. Exposure-adjusted incidence was measured using marginalized 0-inflated Poisson modeling and time trends using Joinpoint regression. RESULTS There were 13 256 injured trampoline park users reported from 8 387 178 jumper hours; 11% sustained significant injury. Overall, trampoline park injuries occurred at a rate of 1.14 injuries per 1000 jumper hours (95% confidence intervals 1.00 to 1.28), with rates highest for high-performance (2.11/1000 jumper hours, 1.66 to 2.56) and inflatable bag or foam pit (1.91/1000 jumper hours, 1.35 to 2.50) jumping. Significant injuries occurred at a rate of 0.11 injuries per 1000 jumper hours (0.10 to 0.13), with rates highest for high-performance (0.29/1000 jumper hours, 0.23 to 0.36), and parkour (0.22/1000 jumper hours, 0.15 to 0.28) jumping. Overall, injury rates decreased by 0.72%/month (-1.05 to -0.40) over the study period. CONCLUSIONS Trampoline park injuries occur in important numbers with sometimes serious consequences. However, within these safety standard-compliant parks, exposure-adjusted estimates show injuries to be uncommon and injury rates to be declining. Further reductions are required, especially severe injuries, and this study can enhance injury prevention initiatives.
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Affiliation(s)
- Warwick J Teague
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Surgical Research, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Australia
| | - Cameron S Palmer
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Dipnall JF, Lyons J, Lyons RA, Ameratunga S, Brussoni M, Lecky FE, Beck B, Schneeberg A, Harrison JE, Gabbe BJ. Impact of an injury hospital admission on childhood academic performance: a Welsh population-based data linkage study. Inj Prev 2023:ip-2023-045027. [PMID: 38124009 DOI: 10.1136/ip-2023-045027] [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: 07/04/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND While injuries can impact on children's educational achievements (with threats to their development and employment prospects), these risks are poorly quantified. This population-based longitudinal study investigated the impact of an injury-related hospital admission on Welsh children's academic performance. METHODS The Secure Anonymised Information Linkage databank, 55 587 children residing in Wales from 2006 to 2016 who had an injury hospital admission (58.2% males; 16.8% born in most deprived Wales area; 80.1% one injury hospital admission) were linked to data from the Wales Electronic Cohort for Children. The primary outcome was the Core Subject Indicator reflecting educational achievement at key stages 2 (school years 3-6), 3 (school years 7-9) and 4 (school years 10-11). Covariates in models included demographic, birth, injury and school characteristics. RESULTS Educational achievement of children was negatively associated with: pedestrian injuries (adjusted risk ratio, (95% CIs)) (0.87, (0.83 to 0.92)), cyclist (0.96, (0.94 to 0.99)), high fall (0.96, (0.94 to 0.97)), fire/flames/smoke (0.85, (0.73 to 0.99)), cutting/piercing object (0.96, (0.93 to 0.99)), intentional self-harm (0.86, (0.82 to 0.91)), minor traumatic brain injury (0.92, (0.86 to 0.99)), contusion/open wound (0.93, (0.91 to 0.95)), fracture of vertebral column (0.78, (0.64 to 0.95)), fracture of femur (0.88, (0.84 to 0.93)), internal abdomen/pelvic haemorrhage (0.82, (0.69 to 0.97)), superficial injury (0.94, (0.92 to 0.97)), young maternal age (<18 years: 0.91, (0.88 to 0.94); 19-24 years: 0.94, (0.93 to 0.96)); area based socioeconomic status (0.98, (0.97 to 0.98)); moving to a more deprived area (0.95, (0.93 to 0.97)); requiring special educational needs (0.46, (0.44 to 0.47)). Positive associations were: being female (1.04, (1.03 to 1.06)); larger pupil school sizes and maternal age 30+ years. CONCLUSION This study highlights the importance on a child's education of preventing injuries and implementing intervention programmes that support injured children. Greater attention is needed on equity-focused educational support and social policies addressing needs of children at risk of underachievement, including those from families experiencing poverty. VIBES-JUNIOR STUDY PROTOCOL: http://dx.doi.org/10.1136/bmjopen-2018-024755.
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Affiliation(s)
- Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University Faculty of Health, Geelong, Victoria, Australia
| | - Jane Lyons
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea, UK
- Administrative Data Research Wales, Wales, UK
| | - Ronan A Lyons
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea, UK
- Administrative Data Research Wales, Wales, UK
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Shanthi Ameratunga
- School of Population Health, The University of Auckland, Auckland, New Zealand
- Counties Manukau District Health Board, Kidz First Hospital and Population Health Directorate, Auckland, New Zealand
| | - Mariana Brussoni
- Department of Pediatrics, Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Fiona E Lecky
- Centre for Urgent and Emergency Care Research, The University of Sheffield School of Health and Related Research, Sheffield, UK
- Emergency Department, Salford Royal Hospital, Salford, UK
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Amy Schneeberg
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Occupational Science and Occupational Therapy, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - James E Harrison
- Flinders University, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Population Data Science, Faculty of Medicine, Health & Life Science, Swansea University Medical School, Swansea, UK
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Gossage LE, Narayanan A, Dipnall JF, Berk M, Sumich A, Haslbeck JMB, Iusitini L, Wrapson W, Tautolo ES, Siegert R. Understanding suicidality in Pacific adolescents in New Zealand using network analysis. Suicide Life Threat Behav 2023; 53:826-842. [PMID: 37571910 DOI: 10.1111/sltb.12986] [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: 12/19/2022] [Revised: 06/07/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Pacific adolescents in New Zealand (NZ) are three to four times more likely than NZ European adolescents to report suicide attempts and have higher rates of suicidal plans. Suicidal thoughts, plans, and attempts, termed suicidality in this study, result from a complex dynamic interplay of factors, which emerging methodologies like network analysis aim to capture. METHODS This study used cross-sectional network analysis to model the relationships between suicidality, self-harm, and individual depression symptoms, whilst conditioning on a multi-dimensional set of variables relevant to suicidality. A series of network models were fitted to data from a community sample of New Zealand-born Pacific adolescents (n = 550; 51% male; Mean age (SD) = 17 (0.35)). RESULTS Self-harm and the depression symptom measuring pessimism had the strongest associations with suicidality, followed by symptoms related to having a negative self-image about looks and sadness. Nonsymptom risk factors for self-harm and suicidality differed markedly. CONCLUSIONS Depression symptoms varied widely in terms of their contribution to suicidality, highlighting the valuable information gained from analysing depression at the symptom-item level. Reducing the sources of pessimism and building self-esteem presented as potential targets for alleviating suicidality amongst Pacific adolescents in New Zealand. Suicide prevention strategies need to include risk factors for self-harm.
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Affiliation(s)
- Lisa E Gossage
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Ajit Narayanan
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Joanna F Dipnall
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alexander Sumich
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Jonas M B Haslbeck
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
- Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Wendy Wrapson
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - El-Shadan Tautolo
- AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
| | - Richard Siegert
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
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Sarkar R, Dipnall JF, Bassed R, Ozanne-Smith Ao J. Family violence homicide rates: a state-wide comparison of three data sources in Victoria, Australia. HEALTH INF MANAG J 2023; 52:135-143. [PMID: 34875905 DOI: 10.1177/18333583211060464] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Family violence homicide (FVH) is a major public health and social problem in Australia. FVH trend rates are key outcomes that determine the effectiveness of current management practices and policy directions. Data source-related methodological problems affect FVH research and policy and the reliable measurement of homicide trends. OBJECTIVE This study aimed to determine data reliability and temporal trends of Victorian FVH rates and sex and relationship patterns. METHOD FVH rates per 100,000 persons in Victoria were compared between the National Coronial Information System (NCIS), Coroners Court of Victoria (CCoV) Homicide Register, and the National Homicide Monitoring Program (NHMP). Trends for 2001-2017 were analysed using Joinpoint regression. Crude rates were determined by sex and relationship categories using annual frequencies and Australian Bureau of Statistics population estimates. RESULTS NCIS closed FVH cases totalled 360, and an apparent downward trend in the FVH rate was identified. However, CCoV and NHMP rates trended upwards. While NCIS and CCoV were case-based, NHMP was incident-based, contributing to rate variations. The NCIS-derived trend was particularly impacted by unavailable case data, potential coding errors and entry backlog. Neither CCoV nor NHMP provided victim-age in their public domain data to enable age-adjusted rate comparison. CONCLUSION Current datasets have limitations for FVH trend determination; most notably lag times for NCIS data. IMPLICATIONS This study identified an indicative upward trend in FVH rates in Victoria, suggesting insufficiency of current management and policy settings for its prevention and control.
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Affiliation(s)
- Reena Sarkar
- Victorian Institute of Forensic Medicine, Southbank, VIC, Australia
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
| | - Joanna F Dipnall
- Pre-hospital, Emergency and Trauma Research, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Medicine, Deakin University, VIC, Australia
| | - Richard Bassed
- Victorian Institute of Forensic Medicine, Southbank, VIC, Australia
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
| | - Joan Ozanne-Smith Ao
- Victorian Institute of Forensic Medicine, Southbank, VIC, Australia
- Department of Forensic Medicine, Monash University, Southbank, VIC, Australia
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Johnstone-Belford EC, Jacobsen G, Fallon SJ, Dipnall JF, Blau S. The effects of diet and beauty products on the uptake and storage of 14C in hair and nails: ramifications for the application of bomb pulse dating to forensic anthropological casework. Forensic Sci Int 2023; 349:111771. [PMID: 37385158 DOI: 10.1016/j.forsciint.2023.111771] [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: 04/23/2023] [Revised: 06/16/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
Radiocarbon dating is a useful tool in the examination of unknown human remains. Recent studies have shown that the analysis of hair and nail samples can provide a highly accurate estimation of the year of death (YOD). However, little research has examined factors that may influence the uptake and storage of 14C in these tissues, such as diet, or the use of beauty products. This study measured the level of 14C in human hair and nail samples collected from living individuals to determine whether diet, and the use of hair dye or nail polish, has a significant impact on the estimation of YOD. The results of this study showed that diet did not appear to impact the radiocarbon content in human hair and nail, and thus should not be considered a limitation when analysing samples obtained from unidentified human remains. The use of nail polish, and in the majority of cases, hair dye, did not significantly impact the 14C concentration in nails and hair. While the results of this study are preliminary, they suggest that in most cases, both hair and nail can be successfully analysed using radiocarbon dating to estimate an individual's YOD. However, best practice should involve the analysis of multiple tissue types, to minimise any error that may be introduced as a result of the decedent's use of beauty products.
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Affiliation(s)
| | - G Jacobsen
- Australian Nuclear Science and Technology Organisation, Australia
| | - S J Fallon
- Radiocarbon Dating Laboratory, The Australian National University, Australia
| | - J F Dipnall
- School of Public Health and Preventative Medicine, Monash University, Australia
| | - S Blau
- Victorian Institute of Forensic Medicine/ Department of Forensic Medicine, Monash University, Australia
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Gilmartin TL, Gurvich C, Dipnall JF, Sharp G. Dimensional personality pathology and disordered eating in young adults: measuring the DSM-5 alternative model using the PID-5. Front Psychol 2023; 14:1113142. [PMID: 37434891 PMCID: PMC10330766 DOI: 10.3389/fpsyg.2023.1113142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/01/2022] [Accepted: 05/30/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The Personality Inventory for DSM-5 (PID-5) is a self-report measure of personality pathology designed to measure pathological personality traits outlined in the DSM-5 alternative model of personality disorders. Within the extensive literature exploring the relationship between personality and disordered eating, there are few that explore the relationship between the PID-5 and disordered eating behaviours in a non-clinical sample of males and females: restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building. Methods An online survey assessed disordered eating, PID-5 traits and general psychopathology and was completed by 394 female and 167 male participants aged 16-30. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the PID-5 scales, body dissatisfaction and age predicted behaviour. Results The results indicated that each of the six disordered behaviours were associated with a unique pattern of maladaptive personality traits. The statistical models differed between males and females indicating possible differences in how dimensional personality pathology and disordered eating relate. Discussion It was concluded that understanding disordered eating behaviour in the context of personality pathology may assist formulating potentially risky behaviour.
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Affiliation(s)
- Tanya Louise Gilmartin
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Joanna F. Dipnall
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Innovation in Mental and Physical Health and Clinical Treatment, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Gemma Sharp
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Zhou JG, Cameron PA, Dipnall JF, Shih K, Cheng I. Using network analyses to characterise Australian and Canadian frequent attenders to the emergency department. Emerg Med Australas 2023; 35:225-233. [PMID: 36216495 DOI: 10.1111/1742-6723.14103] [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: 05/15/2022] [Revised: 08/12/2022] [Accepted: 09/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore and compare the characteristics of frequent attenders to the ED at an Australian and a Canadian tertiary hospitals by utilising a network analysis approach. METHODS We conducted a retrospective population-based study using administrative data over the 2018 and 2019 calendar years. Participants were from a tertiary hospital in Melbourne, Australia, and Toronto, Canada. Frequent attenders were defined as patients with four or more visits in 12 months. Characteristics of younger (18-39 years), middle-aged (40-69 years) and older (70 years and older) frequent attenders were described using descriptive statistics and network analyses. RESULTS Younger frequent attenders were characterised by mental illness and substance use, while older frequent attenders had high rates of physical (including chronic) diseases. Middle-aged frequent attenders were characterised by a combination of mental and physical illnesses. These findings were observed at both hospitals. Across all age groups, the network analyses between the Melbourne and Toronto hospitals were different. Among older frequent attender visits, more diagnoses were associated with high triage acuity at the Toronto hospital than at the Melbourne hospital. Some associations were similar at both sites, for example, the negative correlation between high triage acuity and joint pain. CONCLUSION Younger, middle-aged and older frequent attenders have distinct characteristics, made readily apparent by using network analyses. Future interventions to reduce ED visits should consider the heterogeneity of frequent attenders who have needs specific to their age, presenting problems and jurisdiction.
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Affiliation(s)
- Jonathan G Zhou
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter A Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- The Alfred Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Melbourne, Victoria, Australia
| | - Kingsley Shih
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ivy Cheng
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Gilmartin T, Gurvich C, Dipnall JF, Sharp G. One size does not fit all: Exploring how the five-factor model facets predict disordered eating behaviours among adolescent and young adult males and females. Br J Psychol 2023; 114:132-158. [PMID: 36183174 PMCID: PMC10092835 DOI: 10.1111/bjop.12601] [Citation(s) in RCA: 3] [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: 03/03/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Abstract
There is a wealth of research that has highlighted the relationship between personality and eating disorders. It has been suggested that understanding how subclinical disordered eating behaviours are uniquely associated with personality can help to improve the conceptualization of individuals with eating disorders. This study aimed to explore how the facets of the Five-Factor Model (FFM) predicted restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building among males and females. An online survey assessing disordered eating behaviours, FFM and general psychopathology was completed by 394 females and 167 males aged between 16 and 30 years. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the FFM facets, body dissatisfaction and age predicted behaviour. The results indicated that each of the six disordered behaviours were predicted by a unique pattern of thinking, feeling and behaving. Considerable differences between males and females were found for each path model, suggesting differences between males and females in the personality traits that drive disordered eating behaviours. It was concluded that it is important to take personality into account when treating males and females who engage in disordered eating behaviours.
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Affiliation(s)
- Tanya Gilmartin
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
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11
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Mitra B, Beck B, Dipnall JF, Ponsford J, Gabbe B, Cameron PA. Long-term outcomes of major trauma patients with concussion. Injury 2023; 54:75-81. [PMID: 35965130 DOI: 10.1016/j.injury.2022.07.048] [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: 12/14/2021] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Concussion may be sustained in the setting of injuries to multiple body regions and persistent effects of concussion may impact recovery. This project aimed to evaluate the association between concussion and 6-month and 12-month functional outcomes in survivors after major trauma. METHODS This was a registry-based cohort study that included adult patients with major trauma who presented to hospital between 01 Jan 2008 and 31 Dec 2017 and survived to hospital discharge. We excluded patients presenting with a Glasgow Coma Scale score <13 and those diagnosed with other intracranial injuries. Additionally, from the non-concussed group, patients with fractured skull and/or face were excluded, with the assumption that such patients may have had undiagnosed concussion. A good recovery was considered for Glasgow Outcome Scale-Extended (GOS-E) scores of 7 or 8. In addition, we assessed for patient reported anxiety and/or depression measured using the 3-level EuroQol 5 dimensions questionnaire. A modified mixed effects Poisson models with random intercepts for participant was used to assess the association between concussion and outcome. RESULTS There were 28,161 eligible patients and 12,822 met inclusion criteria. Concussion was diagnosed in 1860 patients (14.5%; 95%CI: 13.9-15.1). There was no association between concussion and good recovery at 12 months (aRR 1.05 (95%CI: 0.99-1.11). There was no association between concussion and anxiety and/or depression at 12 months (aRR 1.03; 95%CI: 0.99-1.07). CONCLUSIONS Concussion was sustained among 14.5% of included patients in the setting of major trauma but not associated with longer-term adverse outcomes using GOS-E. Concussed patients did not report differential rates of anxiety and/or depression.
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Affiliation(s)
- Biswadev Mitra
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Emergency & Trauma Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia; National Trauma Research Institute, The Alfred Hospital, Victoria, Australia.
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Victoria, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Victoria, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Peter A Cameron
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Emergency & Trauma Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia; National Trauma Research Institute, The Alfred Hospital, Victoria, Australia
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12
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Huang S, Dipnall JF, Gabbe BJ, Giummarra MJ. Pain and mental health symptom patterns and treatment trajectories following road trauma: a registry-based cohort study. Disabil Rehabil 2022; 44:8029-8041. [PMID: 34871122 DOI: 10.1080/09638288.2021.2008526] [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] [Indexed: 01/18/2023]
Abstract
PURPOSE This study aimed to characterise recovery from pain and mental health symptoms, and identify whether treatment use facilitates recovery. METHODS Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry participants without neurotrauma who had transport injury claims with the Transport Accident Commission from 2007 to 2014 were included (n = 5908). Latent transition analysis of pain Numeric Rating Scale, SF-12, and EQ-5D-3L pain and mental health items from 6 to 12 months, and 12 to 24 months post-injury were used to identify symptom transitions. RESULTS Four transition groups were identified: transition to low problems by 12-months; transition to low problems at 24-months; stable low problems; and no transition from problems. Group-based trajectory modelling of pain and mental health treatments found three treatment trajectories: low/no treatment, a moderate treatment that declined to low treatment 3-12 months post-injury, and increasing treatment over time. Predictors of pain and mental health recovery transitions, identified using multinomial logistic regression, were primarily found to be non-modifiable socioeconomic and health-related characteristics (e.g., higher education, working pre-injury, and not having comorbidities), and low treatment trajectories. CONCLUSIONS Targeted and collaborative rehabilitation should be considered for people at risk of persistent pain or mental health symptoms to optimise their recovery, particularly patients with socioeconomic disadvantage.IMPLICATIONS FOR REHABILITATIONTwo-thirds of people experience pain and/or mental health within the first 24-months after hospitalization for road trauma, of whom only 6-7% recover by 12-months, and a further 6% recover by 24-months post-injury.There were three main trajectories of administrative records of treatments received in the first two years after injury: 76 and 83% had low treatment, 18 and 12% had moderate then declining treatment levels, and 6 and 5% had stable high treatment for pain or mental health, respectively.People who recovered from pain or mental health symptoms generally had lower treatment and higher socioeconomic position, highlighting that coordinated rehabilitation care should be prioritized for people living with socioeconomic disadvantage.
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Affiliation(s)
- Sherry Huang
- Institute for Social Neuroscience, ISN Psychology, Ivanhoe, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, UK
| | - Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Australia
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13
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Gossage L, Narayanan A, Dipnall JF, Iusitini L, Sumich A, Berk M, Wrapson W, Tautolo ES, Siegert R. Risk factors for depression in Pacific adolescents in New Zealand: A network analysis. J Affect Disord 2022; 311:373-382. [PMID: 35598743 DOI: 10.1016/j.jad.2022.05.076] [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: 09/07/2021] [Revised: 04/28/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Network analysis provides opportunities to gain a greater understanding of the complex interplay of risk factors for depression and heterogeneous symptom presentations. This study used network analysis to discover risk factors associated with both depression severity and depression symptoms amongst Pacific adolescents in New Zealand. METHODS Mixed graphical models with regularization were fitted to data from a community sample of New Zealand born, Pacific adolescents, (n = 561; 51% male; Mean age (SD) = 17 (0.35)) and associations between a wide range of potentially explanatory variables and depression severity and depression symptoms investigated. The associations identified were then tested for reliability, using resampling techniques and sensitivity analysis. RESULTS In the networks, the explanatory variables associated with both depression severity and depression symptoms were those related to quality of the relationships with mother or friends, school connectedness, and self-assessed weight, but the symptoms they were associated with varied substantially. In the depression severity networks, impulsivity appeared to be a bridging node connecting depression severity with delinquency and negative peer influence. LIMITATIONS The data were analysed cross-sectionally, so causal inferences about the directions of relationships could not be inferred and most of the data were self-reported. CONCLUSIONS The results illustrate the varied way that adolescent depression can manifest itself in terms of symptoms and suggest specific items on the depression inventory that might be suitable targets for prevention strategies and interventions, based on the risk factor - depression symptom profiles of individuals or groups.
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Affiliation(s)
- Lisa Gossage
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand.
| | - Ajit Narayanan
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Joanna F Dipnall
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Leon Iusitini
- AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
| | - Alexander Sumich
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Michael Berk
- Deakin University, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Wendy Wrapson
- AUT Public Health and Mental Health Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - El-Shadan Tautolo
- AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
| | - Richard Siegert
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
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14
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Giummarra MJ, Dipnall JF, Gabbe BJ. A registry-based observational cohort study examining patterns of pain and mental health symptoms and their impact on work or other activities after injury. Rehabil Psychol 2022; 67:405-420. [PMID: 35708919 DOI: 10.1037/rep0000453] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Purpose/Objective Research: This study aimed to examine patterns of pain and mental health after injury, and the patient characteristics associated with reductions in those symptoms. RESEARCH METHOD/DESIGN This registry-based observational cohort study included all people ≥ 16 years old hospitalized for unintentional injuries from 2007 to 2014 who were included in the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry, survived to 12-months postinjury and did not have severe brain injury or spinal cord injury (N = 31,073). Symptoms and related impacts were measured with pain Numerical Rating Scale, EuroQol Five Dimensions Three Level questionnaire (EQ-5D-3L), and 12-item Short Form Health Survey (SF-12) pain and mental health items at 6-, 12-, and 24-months postinjury. Symptom patterns over time, and their predictors, were examined using Latent Class and Transition Analyses and multinomial logistic regression. RESULTS Four classes were identified: (1) Low pain and mental health problems (49-54%); (2) mental health problems only (11-12%); (3) pain problems only (18-23%); and (4) pain and mental health problems (16-17%). Most people stayed within the same class over time, or transitioned to fewer problems. People who transitioned to lower problems had higher socioeconomic status (e.g., higher education level, higher neighborhood-level advantage, and employment), better preinjury health (e.g., no disability or substance use condition) and noncompensable injuries. CONCLUSION/IMPLICATIONS Reduced pain and mental health symptoms and related impairments were primarily associated with nonmodifiable biological, social, or economic characteristics. People with persistent symptoms were often already living with social disadvantage preinjury, and may have benefited from risk screening and proactive interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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15
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Dipnall JF, Lu J, Gabbe BJ, Cosic F, Edwards E, Page R, Du L. Comparison of state-of-the-art machine and deep learning algorithms to classify proximal humeral fractures using radiology text. Eur J Radiol 2022; 153:110366. [DOI: 10.1016/j.ejrad.2022.110366] [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] [Received: 02/02/2022] [Revised: 04/08/2022] [Accepted: 05/16/2022] [Indexed: 12/01/2022]
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16
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Dipnall JF, Rivara FP, Lyons RA, Ameratunga S, Brussoni M, Lecky FE, Bradley C, Beck B, Lyons J, Schneeberg A, Harrison JE, Gabbe BJ. Predictors of health-related quality of life following injury in childhood and adolescence: a pooled analysis. Inj Prev 2021; 28:301-310. [PMID: 34937765 DOI: 10.1136/injuryprev-2021-044309] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/12/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Injury is a leading contributor to the global disease burden in children and places children at risk for adverse and lasting impacts on their health-related quality of life (HRQoL) and development. This study aimed to identify key predictors of HRQoL following injury in childhood and adolescence. METHODS Data from 2259 injury survivors (<18 years when injured) were pooled from four longitudinal cohort studies (Australia, Canada, UK, USA) from the paediatric Validating Injury Burden Estimates Study (VIBES-Junior). Outcomes were the Paediatric Quality of Life Inventory (PedsQL) total, physical, psychosocial functioning scores at 1, 3-4, 6, 12, 24 months postinjury. RESULTS Mean PedsQL total score increased with higher socioeconomic status and decreased with increasing age. It was lower for transport-related incidents, ≥1 comorbidities, intentional injuries, spinal cord injury, vertebral column fracture, moderate/severe traumatic brain injury and fracture of patella/tibia/fibula/ankle. Mean PedsQL physical score was lower for females, fracture of femur, fracture of pelvis and burns. Mean PedsQL psychosocial score was lower for asphyxiation/non-fatal submersion and muscle/tendon/dislocation injuries. CONCLUSIONS Postinjury HRQoL was associated with survivors' socioeconomic status, intent, mechanism of injury and comorbidity status. Patterns of physical and psychosocial functioning postinjury differed according to sex and nature of injury sustained. The findings improve understanding of the long-term individual and societal impacts of injury in the early part of life and guide the prioritisation of prevention efforts, inform health and social service planning to help reduce injury burden, and help guide future Global Burden of Disease estimates.
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Affiliation(s)
- Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia .,Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Frederick P Rivara
- Departments of Pediatrics and Epidemiology, and the Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
| | - Ronan A Lyons
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Health Data Research UK, Swansea University, Swansea, UK.,National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Shanthi Ameratunga
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Population Health, University of Auckland, Auckland, New Zealand.,Kidz First Hospital and Population Health Directorate, Counties Manukau District Health Board, Auckland, New Zealand
| | - Mariana Brussoni
- Department of Pediatrics, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Fiona E Lecky
- Centre for Urgent and Emergency Care Research, School of Health and Related Research, University of Sheffield, Sheffield, UK.,Emergency Department, Salford Royal Hospital, Salford, UK
| | - Clare Bradley
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jane Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Amy Schneeberg
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - James E Harrison
- Flinders Institute for Health and Medical Research, Flinders University, Adelaide, South Australia, Australia
| | - Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Health Data Research UK, Swansea University, Swansea, UK
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17
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Abstract
Child family violence homicide (FVH) is a significant public health problem in Australia and globally. Population-wide studies of orofacial injuries in child FVH are uncommon despite their recognized importance. This whole population descriptive study of orofacial injuries in child FVH in Victoria, Australia aims to implement a novel methodological approach to provide an overview of child FVH and describe frequency and patterns of abusive orofacial injuries. Closed cases of child FVH aged 0-17 years, January 2000-December 2018, were identified from screening all Victorian assault deaths for eligible offender relationships. Significant associations of clinical/demographic characteristics were explored using two-step clustering and the Spearman correlation coefficient. Of 895 closed homicide cases, 358 were FV-related. Of the 53 child FVH, 40 were eligible for injury analysis with 36 of these cases (90%) having orofacial injuries. Among these 36 cases, 72% were aged 0-4 years, males predominated (64%) and the injury mechanism was blunt force for 56%. The discrete orofacial injury frequency was associated with the non-orofacial injury frequency (rho: 0.362, 2-tailed p < 0.03). A three-cluster statistical solution was identified, each represented by an injury mechanism. The largest cluster identified a pattern of blunt force trauma in 0-4 years with drug presence, high average non-orofacial injury numbers and parent-offenders. A novel methodological approach was implemented to comprehensively describe the frequency, nature, patterns and risk indicators of orofacial injuries in child FVH. It explored associations between a wide range of clinical and demographic characteristics, which might have otherwise been missed in summary description. These methods will potentially underpin future comparative studies of intentional-unintentional child injuries and fatal-nonfatal child abuse. The study narrows a significant research gap regarding patterns of inflicted injuries, and demographic and clinical indicators in child FVH potentially informing future systematic classification processes, risk assessment tools and pathways to FV intervention.
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Affiliation(s)
- Reena Sarkar
- Department of Forensic Medicine, Monash University, Victoria, 3006, Australia.
| | - Richard Bassed
- Department of Forensic Medicine, Monash University, Victoria, 3006, Australia
- Victorian Institute of Forensic Medicine, Victoria, 3006, Australia
| | - Joanna F Dipnall
- Pre-Hospital, Emergency and Trauma Research, School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia
- School of Medicine, Deakin University, Victoria, 3216, Australia
| | - Joan Ozanne-Smith
- Department of Forensic Medicine, Monash University, Victoria, 3006, Australia
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18
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Giummarra MJ, Xu R, Guo Y, Dipnall JF, Ponsford J, Cameron PA, Ameratunga S, Gabbe BJ. Driver, Collision and Meteorological Characteristics of Motor Vehicle Collisions among Road Trauma Survivors. Int J Environ Res Public Health 2021; 18:ijerph182111380. [PMID: 34769922 PMCID: PMC8583338 DOI: 10.3390/ijerph182111380] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022]
Abstract
Road trauma remains a significant public health problem. We aimed to identify sub-groups of motor vehicle collisions in Victoria, Australia, and the association between collision characteristics and outcomes up to 24 months post-injury. Data were extracted from the Victorian State Trauma Registry for injured drivers aged ≥16 years, from 2010 to 2016, with a compensation claim who survived ≥12 months post-injury. People with intentional or severe head injury were excluded, resulting in 2735 cases. Latent class analysis was used to identify collision classes for driver fault and blood alcohol concentration (BAC), day and time of collision, weather conditions, single vs. multi-vehicle and regional vs. metropolitan injury location. Five classes were identified: (1) daytime multi-vehicle collisions, no other at fault; (2) daytime single-vehicle predominantly weekday collisions; (3) evening single-vehicle collisions, no other at fault, 36% with BAC ≥ 0.05; (4) sunrise or sunset weekday collisions; and (5) dusk and evening multi-vehicle in metropolitan areas with BAC < 0.05. Mixed linear and logistic regression analyses examined associations between collision class and return to work, health (EQ-5D-3L summary score) and independent function Glasgow Outcome Scale - Extended at 6, 12 and 24 months. After adjusting for demographic, health and injury characteristics, collision class was not associated with outcomes. Rather, risk of poor outcomes was associated with age, sex and socioeconomic disadvantage, education, pre-injury health and injury severity. People at risk of poor recovery may be identified from factors available during the hospital admission and may benefit from clinical assessment and targeted referrals and treatments.
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Affiliation(s)
- Melita J. Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC 3162, Australia
- Correspondence: ; Tel.: +61-4-3964-1211
| | - Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
| | - Joanna F. Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
- Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia;
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC 3121, Australia
| | - Peter A. Cameron
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland 1010, New Zealand;
- Population Health Directorate, Counties Manukau District Health Board, South Auckland 2104, New Zealand
| | - Belinda J. Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia; (R.X.); (Y.G.); (J.F.D.); (P.A.C.); (B.J.G.)
- Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea University, Swansea SA2 8PP, UK
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19
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Dipnall JF, Page R, Du L, Costa M, Lyons RA, Cameron P, de Steiger R, Hau R, Bucknill A, Oppy A, Edwards E, Varma D, Jung MC, Gabbe BJ. Predicting fracture outcomes from clinical registry data using artificial intelligence supplemented models for evidence-informed treatment (PRAISE) study protocol. PLoS One 2021; 16:e0257361. [PMID: 34555069 PMCID: PMC8460020 DOI: 10.1371/journal.pone.0257361] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background Distal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive modelling, which considers both the characteristics of the fracture and patient, provides the best opportunity to reduce variation in care and improve patient outcomes. This type of data is housed in unstructured data sources with no particular format or schema. The “Predicting fracture outcomes from clinical Registry data using Artificial Intelligence (AI) Supplemented models for Evidence-informed treatment (PRAISE)” study aims to use AI methods on unstructured data to describe the fracture characteristics and test if using this information improves identification of key fracture characteristics and prediction of patient-reported outcome measures and clinical outcomes following wrist fractures compared to prediction models based on standard registry data. Methods and design Adult (16+ years) patients presenting to the emergency department, treated in a short stay unit, or admitted to hospital for >24h for management of a wrist fracture in four Victorian hospitals will be included in this study. The study will use routine registry data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), and electronic medical record (EMR) information (e.g. X-rays, surgical reports, radiology reports, images). A multimodal deep learning fracture reasoning system (DLFRS) will be developed that reasons on EMR information. Machine learning prediction models will test the performance with/without output from the DLFRS. Discussion The PRAISE study will establish the use of AI techniques to provide enhanced information about fracture characteristics in people with wrist fractures. Prediction models using AI derived characteristics are expected to provide better prediction of clinical and patient-reported outcomes following distal radius fracture.
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Affiliation(s)
- Joanna F. Dipnall
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- * E-mail:
| | - Richard Page
- School of Medicine, Deakin University, St. John of God Hospital, University Hospital Geelong, Geelong, Victoria, Australia
| | - Lan Du
- Department of Data Science & AI, Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Matthew Costa
- Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Ronan A. Lyons
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University, Swansea, United Kingdom
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, United Kingdom
| | - Peter Cameron
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- The Alfred Hospital, Prahran, Victoria, Australia
| | - Richard de Steiger
- Department of Surgery, University of Melbourne, Epworth HealthCare, Epworth, Richmond, Victoria, Australia
| | - Raphael Hau
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Andrew Bucknill
- Department of Orthopaedic Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Oppy
- Department of Orthopaedic Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
| | - Elton Edwards
- Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- The Alfred Hospital, Prahran, Victoria, Australia
| | - Dinesh Varma
- Department of Surgery, Monash University, Melbourne, Australia
- National Trauma Research Institute, Melbourne, Australia
- Department of Radiology, Alfred Hospital, Melbourne, Australia
| | - Myong Chol Jung
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Data Science & AI, Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Belinda J. Gabbe
- Clinical Registries, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, United Kingdom
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20
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Giummarra MJ, Dipnall JF, Gibson G, Beck B, Gabbe BJ. Health status after penetrating major trauma in Victoria, Australia: a registry-based cohort study. Qual Life Res 2021; 30:3511-3521. [PMID: 34032955 DOI: 10.1007/s11136-021-02876-4] [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] [Accepted: 05/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE As few studies have examined long-term health after penetrating injury, this population-based registry study sought to assess health outcomes up to 24 months post-injury. METHODS Major trauma patients with penetrating trauma (2009-2017) were included from the Victorian State Trauma Registry (N = 1,067; 102 died, 208 were lost to follow-up). The EQ-5D-3L was used to measure health status at 6, 12 and 24-months. Mixed linear and logistic regressions were used to examine predictors of summary scores, and problems versus no problems on each health dimension. RESULTS Average health status summary scores were 0.70 (sd = 0.26) at 6 and 12 months, and 0.72 (sd = 0.26) at 24 months post-injury. Prevalence of problems was consistent over time: mobility (24-26%), self-care (17-20%), usual activities (47-50%), pain/discomfort (44-49%), and anxiety/depression (54-56%). Lower health status and reporting problems was associated with middle-older age, female sex, unemployment; pre-injury disability, comorbid conditions; and assault and firearm injury versus cutting/piercing. CONCLUSION Problems with usual activities, pain/discomfort and anxiety or depression are common after penetrating major trauma. Risk factor screening in hospital could be used to identify people at risk of poor health outcomes, and to link people at risk with services in hospital or early post-discharge to improve their longer-term health outcomes.
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Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine , Deakin University, Geelong, VIC, Australia
| | - Georgia Gibson
- Institute for Social Neuroscience, Ivanhoe, VIC, Australia
| | - Ben Beck
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Health Data Research UK, Swansea University Medical School, Singleton Park, Swansea University, Swansea, UK, SA2 8PP, Wales
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21
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Gao CX, Dimitriadis C, Ikin J, Dipnall JF, Wolfe R, Sim MR, Smith K, Cope M, Abramson MJ, Guo Y. Impact of exposure to mine fire emitted PM 2.5 on ambulance attendances: A time series analysis from the Hazelwood Health Study. Environ Res 2021; 196:110402. [PMID: 33137314 DOI: 10.1016/j.envres.2020.110402] [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] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/06/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND For six weeks from February 9, 2014, smoke and ash from a fire in the Morwell open cut brown coal mine adjacent to the Hazelwood power station covered parts of the Latrobe Valley, in south eastern Australia. AIMS To evaluate the health impact of the mine fire, daily counts of ambulance attendances from July 2010 to March 2015 were analysed. METHODS Time series models were used to evaluate the relative risk of ambulance attendances during the mine fire, in comparison with the remainder of the analysis period, and to also assess the risk of ambulance attendances associated with lagged effects of exposure to mine fire-related PM2.5 levels. The models controlled for factors likely to influence ambulance attendances including seasonality, long-term temporal trends, day of the week, daily maximum temperature and public holidays. RESULTS A 10 μg/m3 increase in fire-related PM2.5 was found to be associated with a 42% (95%CI: 14-76%) increase in ambulance attendances for respiratory conditions and a 7% (0-14%) increase in all ambulance attendances over a 20-day lag period. A smaller effect associated with exposure to fire-related PM2.5 was identified when assuming shorter lag effects. Similar results were identified when assessing whether ambulance attendances increased during the 30-day mine fire period. There was a 15% (8-21%) increased risk of ambulance attendances for all conditions and a 47% (19-81%) increased risk for respiratory conditions during the mine fire period. CONCLUSIONS Exposure to smoke and ash from a fire in an open cut brown coal mine was associated with increased ambulance attendances, particularly for respiratory conditions. These findings guide the development and implementation of effective and timely strategies and health service planning to respond and mitigate health risks that arise in affected communities during future major air pollution episodes.
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Affiliation(s)
- Caroline X Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Centre for Youth Mental Health (Orygen), University of Melbourne, Australia
| | - Christina Dimitriadis
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jillian Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Martin Cope
- CSIRO Oceans and Atmosphere, Aspendale, Victoria, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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22
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Medvedev ON, Berk M, Dean OM, Brown E, Sandham MH, Dipnall JF, McNamara RK, Sumich A, Krägeloh CU, Narayanan A, Siegert RJ. A novel way to quantify schizophrenia symptoms in clinical trials. Eur J Clin Invest 2021; 51:e13398. [PMID: 32894576 PMCID: PMC7988538 DOI: 10.1111/eci.13398] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND A major problem in quantifying symptoms of schizophrenia is establishing a reliable distinction between enduring and dynamic aspects of psychopathology. This is critical for accurate diagnosis, monitoring and evaluating treatment effects in both clinical practice and trials. MATERIALS AND METHODS We applied Generalizability Theory, a robust novel method to distinguish between dynamic and stable aspects of schizophrenia symptoms in the widely used Positive and Negative Symptom Scale (PANSS) using a longitudinal measurement design. The sample included 107 patients with chronic schizophrenia assessed using the PANSS at five time points over a 24-week period during a multi-site clinical trial of N-Acetylcysteine as an add-on to maintenance medication for the treatment of chronic schizophrenia. RESULTS The original PANSS and its three subscales demonstrated good reliability and generalizability of scores (G = 0.77-0.93) across sample population and occasions making them suitable for assessment of psychosis risks and long-lasting change following a treatment, while subscales of the five-factor models appeared less reliable. The most enduring symptoms represented by the PANSS were poor attention, delusions, blunted affect and poor rapport. More dynamic symptoms with 40%-50% of variance explained by patient transient state including grandiosity, preoccupation, somatic concerns, guilt feeling and hallucinatory behaviour. CONCLUSIONS Identified dynamic symptoms are more amendable to change and should be the primary target of interventions aiming at effectively treating schizophrenia. Separating out the dynamic symptoms would increase assay sensitivity in trials, reduce the signal to noise ratio and increase the potential to detect the effects of novel therapies in clinical trials.
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Affiliation(s)
- Oleg N Medvedev
- University of Waikato, Hamilton, New Zealand.,Auckland University of Technology, Auckland, New Zealand
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia
| | - Olivia M Dean
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia
| | - Ellie Brown
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia
| | | | - Joanna F Dipnall
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia.,Emergency and Trauma Unit, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Pre-hospital, Monash University, Melbourne, Vic., Australia
| | - Robert K McNamara
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alexander Sumich
- Auckland University of Technology, Auckland, New Zealand.,Division of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | | | - Ajit Narayanan
- Auckland University of Technology, Auckland, New Zealand
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23
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Sarkar R, Ozanne-Smith J, Dipnall JF, Bassed R. Population study of orofacial injuries in adult family violence homicides in Victoria, Australia. Forensic Sci Int 2020; 316:110467. [PMID: 32891827 DOI: 10.1016/j.forsciint.2020.110467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/01/2020] [Revised: 07/16/2020] [Accepted: 08/18/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study describes the prevalence and orofacial injury patterns associated with adult family violence (FV) homicides in Victoria, Australia. It follows a methods study for case selection of all FV homicides and injury measurement. Comprehensive analysis of orofacial injuries in FV homicides and their clinico-demographic context will inform future research on clinical FV indicators and sentinel injuries, and potentially lead to premorbid intervention in health services. METHODS All closed cases of FV homicides aged ≥18 years, January 2006 to December 2018, were identified by screening Victorian fatal assaults, based on victim-offender relationship. Primary data such as post-mortem computed tomography scans and photographs were assessed. Socio-demographic, clinical, interpersonal and incident parameters were descriptively analysed and statistically compared across FV homicides with and without facial injuries using cluster analysis and nonparametric tests. RESULTS Of 170 adult homicides screened for eligibility, 151 were included for final analysis. Over the 12-year period, 78.1% of all Victorian adult FV homicides had orofacial injuries. Significant cluster patterns of injury mechanism, victim-offender relationship and drug/alcohol impairment were identified in all homicides. Non-facial injuries were significantly higher in facial vs. non-facial injury homicides. Facial abrasion and incised wounds were the most common injury types. CONCLUSIONS This is the first forensic-epidemiologic study evaluating the empirical evidence concerning orofacial injuries associated with population-wide adult Victorian FV homicides. The high level of orofacial injuries in this population during the study period may inform clinical practice and policy in FV intervention in Victoria and globally.
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Affiliation(s)
- Reena Sarkar
- Department of Forensic Medicine, Monash University, Australia.
| | | | - Joanna F Dipnall
- Pre-hospital, Emergency and Trauma Research, School of Public Health and Preventive Medicine, Monash University, Australia; School of Medicine, Deakin University, Australia
| | - Richard Bassed
- Department of Forensic Medicine, Monash University, Australia; Victorian Institute of Forensic Medicine, Victoria, Australia
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24
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Maybery D, Jones R, Dipnall JF, Berger E, Campbell T, McFarlane A, Carroll M. A mixed-methods study of psychological distress following an environmental catastrophe: the case of the Hazelwood open-cut coalmine fire in Australia. Anxiety, Stress, & Coping 2019; 33:216-230. [DOI: 10.1080/10615806.2019.1695523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Darryl Maybery
- Monash Rural Health Warragul, Monash University, Warragul, Australia
| | - Rebecca Jones
- Monash Rural Health Warragul, Monash University, Warragul, Australia
| | - Joanna F. Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne Australia
- IMPACT SRC, School of Medicine, Deakin University, Geelong, Australia
| | - Emily Berger
- Faculty of Education, Monash University, Clayton, Australia
| | - Timothy Campbell
- Monash Rural Health Warragul, Monash University, Warragul, Australia
- Monash Rural Health Churchill, Monash University, Churchill, Australia
| | - Alexander McFarlane
- The Centre for Traumatic Stress Studies, The University of Adelaide, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Churchill, Australia
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25
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Johnson AL, Gao CX, Dennekamp M, Williamson GJ, Carroll MTC, Dimitriadis C, Dipnall JF, Ikin JF, Johnston FH, McFarlane AC, Sim MR, Stub DA, Abramson MJ, Guo Y. Coal-mine fire-related fine particulate matter and medical-service utilization in Australia: a time-series analysis from the Hazelwood Health Study. Int J Epidemiol 2019; 49:80-93. [DOI: 10.1093/ije/dyz219] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Accepted: 10/02/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study assessed the association between coal-mine-fire-related fine particulate matter (PM2.5) and medical-service utilization, following a 6-week coal-mine fire in Australia, in 2014. Areas in the immediate vicinity of the mine experienced hourly mine-fire-related PM2.5 concentrations of up to 3700 μg/m3.
Methods
Data on medical-service utilization were collected from the Medicare Benefits Schedule—a national database of payment for medical services. PM2.5 concentrations were modelled using atmospheric chemical transport modelling. Quasi-Poisson interrupted distributed lag time-series analysis examined the association between daily mine-fire-related PM2.5 concentrations and medical-service utilization, including General Practitioner (GP) consultations and respiratory, cardiovascular and mental health services. Confounders included seasonality, long-term trend, day of the week, maximum daily temperature and public holidays. Gender and age stratification were conducted.
Results
A 10-μg/m3 increase in PM2.5 was associated with an increased relative risk of service usage for all long and short GP consultations [11% (95% confidence interval: 7 to 15%)] and respiratory services [22% (4 to 43%)] in both men and women. Sex stratification found an increased relative risk in mental health consultations in men [32% (2 to 72%)] but not women. No associations were found for cardiovascular services in men or women.
Conclusions
Coal-mine-fire-related PM2.5 exposure was associated with increased use of medical services for GP consultations and respiratory services in men and women and mental health consultations in men. These findings can inform the development of future public-health-policy responses in the event of major air-pollution episodes.
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Affiliation(s)
- Amanda L Johnson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Caroline X Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Martine Dennekamp
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Sandy Bay, Tasmania, Australia
| | | | - Christina Dimitriadis
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- IMPACT SRC, School of Medicine, Faculty of Health, Deakin University, Australia
| | - Jillian F Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Fay H Johnston
- Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Alexander C McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, South Australia, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dion A Stub
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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26
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Andrews SM, Dipnall JF, Tichawangana R, Hayes KJ, Fitzgerald JA, Siddall P, Poulos C, Cunningham C. An Exploration of Pain Documentation for People Living with Dementia in Aged Care Services. Pain Manag Nurs 2019; 20:475-481. [DOI: 10.1016/j.pmn.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/09/2018] [Accepted: 01/22/2019] [Indexed: 10/26/2022]
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27
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Johnson AL, Dipnall JF, Dennekamp M, Williamson GJ, Gao CX, Carroll MTC, Dimitriadis C, Ikin JF, Johnston FH, McFarlane AC, Sim MR, Stub DA, Abramson MJ, Guo Y. Fine particulate matter exposure and medication dispensing during and after a coal mine fire: A time series analysis from the Hazelwood Health Study. Environ Pollut 2019; 246:1027-1035. [PMID: 31159135 DOI: 10.1016/j.envpol.2018.12.085] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 08/01/2018] [Revised: 11/15/2018] [Accepted: 12/27/2018] [Indexed: 06/09/2023]
Abstract
Limited research has examined the impacts of coal mine fire smoke on human health. The aim of this study was to assess the association between prolonged smoke PM2.5 exposure from a brown coal mine fire that burned over a seven week period in 2014 and medications dispensed across five localities in South-eastern Victoria, Australia. Spatially resolved PM2.5 concentrations were retrospectively estimated using a dispersion model coupled with a chemical transport model. Data on medications dispensed were collected from the national Pharmaceutical Benefits Schedule database for 2013-2016. Poisson distributed lag time series analysis was used to examine associations between daily mine fire-related PM2.5 concentrations and daily counts of medications dispensed for respiratory, cardiovascular or psychiatric conditions. Factors controlled for included: seasonality, long-term trend, day of the week, maximum ambient temperature and public holidays. Positive associations were found between mine fire-related PM2.5 and increased risks of medications dispensed for respiratory, cardiovascular and psychiatric conditions, over a lag range of 3-7 days. A 10 μg/m3 increase in coal mine fire-related PM2.5 was associated with a 25% (95%CI 19-32%) increase in respiratory medications, a 10% (95%CI 7-13%) increase in cardiovascular medications and a 12% (95%CI 8-16%) increase in psychiatric medications dispensed. These findings have the potential to better prepare for and develop more appropriate public health responses in the event of future coal mine fires.
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Affiliation(s)
- Amanda L Johnson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Joanna F Dipnall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia; IMPACT SRC, School of Medicine, Faculty of Health, Deakin University, 1 Gheringhap Street Geelong, Victoria, 3220, Australia
| | - Martine Dennekamp
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Sandy Bay Campus, Churchill Ave, Hobart, Tasmania, 7001, Australia
| | - Caroline X Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Matthew T C Carroll
- Monash Rural Health - Churchill, Monash University, Northways Rd, Churchill, Victoria, 3842, Australia
| | - Christina Dimitriadis
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Jillian F Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Fay H Johnston
- Menzies Institute of Medical Research, University of Tasmania, Medical Science Precinct, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia
| | - Alexander C McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, Level 1, Helen Mayo North, 30 Frome Road, South Australia, 5005, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Dion A Stub
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia; Ambulance Victoria, 375 Manningham Road, Doncaster, Victoria, 3108, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
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28
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Gabbe BJ, Dipnall JF, Lynch JW, Rivara FP, Lyons RA, Ameratunga S, Brussoni M, Lecky FE, Bradley C, Simpson PM, Beck B, Demmler JC, Lyons J, Schneeberg A, Harrison JE. Validating injury burden estimates using population birth cohorts and longitudinal cohort studies of injury outcomes: the VIBES-Junior study protocol. BMJ Open 2018; 8:e024755. [PMID: 30082368 PMCID: PMC6078268 DOI: 10.1136/bmjopen-2018-024755] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Traumatic injury is a leading contributor to the global disease burden in children and adolescents, but methods used to estimate burden do not account for differences in patterns of injury and recovery between children and adults. A lack of empirical data on postinjury disability in children has limited capacity to derive valid disability weights and describe the long-term individual and societal impacts of injury in the early part of life. The aim of this study is to establish valid estimates of the burden of non-fatal injury in children and adolescents. METHODS AND ANALYSIS Five longitudinal studies of paediatric injury survivors <18 years at the time of injury (Australia, Canada, UK and USA) and two whole-of-population linked administrative data paediatric studies (Australia and Wales) will be analysed over a 3-year period commencing 2018. Meta-analysis of deidentified patient-level data (n≈2,600) from five injury-specific longitudinal studies (Victorian State Trauma Registry; Victorian Orthopaedic Trauma Outcomes Registry; UK Burden of Injury; British Columbia Children's Hospital Longitudinal Injury Outcomes; Children's Health After Injury) and >1 million children from two whole-of-population cohorts (South Australian Early Childhood Data Project and Wales Electronic Cohort for Children). Systematic analysis of pooled injury-specific cohort data using a variety of statistical techniques, and parallel analysis of whole-of-population cohorts, will be used to develop estimated disability weights for years lost due to disability, establish appropriate injury classifications and explore factors influencing recovery. ETHICS AND DISSEMINATION The project was approved by the Monash University Human Research Ethics Committee project number 12 311. Results of this study will be submitted for publication in internationally peer-reviewed journals. The findings from this project have the capacity to improve the validity of paediatric injury burden measurements in future local and global burden of disease studies.
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Affiliation(s)
- Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - John W Lynch
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Frederick P Rivara
- Departments of Pediatrics and Epidemiology, and the Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Mariana Brussoni
- Department of Pediatrics, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- British Columbia Injury Research and Prevention Unit, Children's Hospital Research Institute, Vancouver, Canada
| | - Fiona E Lecky
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Clare Bradley
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Pam M Simpson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Jane Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Amy Schneeberg
- British Columbia Injury Research and Prevention Unit, Children's Hospital Research Institute, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - James E Harrison
- Research Centre for Injury Studies, Flinders University, Adelaide, South Australia, Australia
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29
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Response to 'Pitfalls of big data'. Aust N Z J Psychiatry 2018; 52:604-605. [PMID: 29589468 DOI: 10.1177/0004867418765364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Joanna F Dipnall
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Julie A Pasco
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,3 Western Clinical School, The University of Melbourne, St Albans, VIC, Australia.,4 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,7 Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lana J Williams
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Seetal Dodd
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Felice N Jacka
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,9 Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,10 Black Dog Institute, Sydney, NSW, Australia
| | - Denny Meyer
- 2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Getting RID of the blues: Formulating a Risk Index for Depression (RID) using structural equation modeling. Aust N Z J Psychiatry 2017; 51:1121-1133. [PMID: 28856902 DOI: 10.1177/0004867417726860] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/16/2022]
Abstract
OBJECTIVE While risk factors for depression are increasingly known, there is no widely utilised depression risk index. Our objective was to develop a method for a flexible, modular, Risk Index for Depression using structural equation models of key determinants identified from previous published research that blended machine-learning with traditional statistical techniques. METHODS Demographic, clinical and laboratory variables from the National Health and Nutrition Examination Study (2009-2010, N = 5546) were utilised. Data were split 50:50 into training:validation datasets. Generalised structural equation models, using logistic regression, were developed with a binary outcome depression measure (Patient Health Questionnaire-9 score ⩾ 10) and previously identified determinants of depression: demographics, lifestyle-environs, diet, biomarkers and somatic symptoms. Indicative goodness-of-fit statistics and Areas Under the Receiver Operator Characteristic Curves were calculated and probit regression checked model consistency. RESULTS The generalised structural equation model was built from a systematic process. Relative importance of the depression determinants were diet (odds ratio: 4.09; 95% confidence interval: [2.01, 8.35]), lifestyle-environs (odds ratio: 2.15; 95% CI: [1.57, 2.94]), somatic symptoms (odds ratio: 2.10; 95% CI: [1.58, 2.80]), demographics (odds ratio:1.46; 95% CI: [0.72, 2.95]) and biomarkers (odds ratio:1.39; 95% CI: [1.00, 1.93]). The relationships between demographics and lifestyle-environs and depression indicated a potential indirect path via somatic symptoms and biomarkers. The path from diet was direct to depression. The Areas under the Receiver Operator Characteristic Curves were good (logistic:training = 0.850, validation = 0.813; probit:training = 0.849, validation = 0.809). CONCLUSION The novel Risk Index for Depression modular methodology developed has the flexibility to add/remove direct/indirect risk determinants paths to depression using a structural equation model on datasets that take account of a wide range of known risks. Risk Index for Depression shows promise for future clinical use by providing indications of main determinant(s) associated with a patient's predisposition to depression and has the ability to be translated for the development of risk indices for other affective disorders.
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Affiliation(s)
- Joanna F Dipnall
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Julie A Pasco
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,3 Western Clinical School, The University of Melbourne, St Albans, VIC, Australia.,4 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,7 The Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lana J Williams
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Seetal Dodd
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Felice N Jacka
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,9 The Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,10 Black Dog Institute, Sydney, NSW, Australia
| | - Denny Meyer
- 2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Why so GLUMM? Detecting depression clusters through graphing lifestyle-environs using machine-learning methods (GLUMM). Eur Psychiatry 2016; 39:40-50. [PMID: 27810617 DOI: 10.1016/j.eurpsy.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/31/2016] [Accepted: 06/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Key lifestyle-environ risk factors are operative for depression, but it is unclear how risk factors cluster. Machine-learning (ML) algorithms exist that learn, extract, identify and map underlying patterns to identify groupings of depressed individuals without constraints. The aim of this research was to use a large epidemiological study to identify and characterise depression clusters through "Graphing lifestyle-environs using machine-learning methods" (GLUMM). METHODS Two ML algorithms were implemented: unsupervised Self-organised mapping (SOM) to create GLUMM clusters and a supervised boosted regression algorithm to describe clusters. Ninety-six "lifestyle-environ" variables were used from the National health and nutrition examination study (2009-2010). Multivariate logistic regression validated clusters and controlled for possible sociodemographic confounders. RESULTS The SOM identified two GLUMM cluster solutions. These solutions contained one dominant depressed cluster (GLUMM5-1, GLUMM7-1). Equal proportions of members in each cluster rated as highly depressed (17%). Alcohol consumption and demographics validated clusters. Boosted regression identified GLUMM5-1 as more informative than GLUMM7-1. Members were more likely to: have problems sleeping; unhealthy eating; ≤2 years in their home; an old home; perceive themselves underweight; exposed to work fumes; experienced sex at ≤14 years; not perform moderate recreational activities. A positive relationship between GLUMM5-1 (OR: 7.50, P<0.001) and GLUMM7-1 (OR: 7.88, P<0.001) with depression was found, with significant interactions with those married/living with partner (P=0.001). CONCLUSION Using ML based GLUMM to form ordered depressive clusters from multitudinous lifestyle-environ variables enabled a deeper exploration of the heterogeneous data to uncover better understandings into relationships between the complex mental health factors.
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Affiliation(s)
- J F Dipnall
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Department of statistics, data science and epidemiology, Swinburne university of technology, Swinburne, Australia.
| | - J A Pasco
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Melbourne clinical school-western campus, the university of Melbourne, Saint-Albans, VIC, Australia; Department of epidemiology and preventive medicine, Monash university, Melbourne, VIC, Australia; University hospital of Geelong, Geelong, VIC, Australia
| | - M Berk
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; University hospital of Geelong, Geelong, VIC, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia; Florey institute of neuroscience and mental health, Parkville, VIC, Australia; Orygen, the National centre of excellence in youth mental health, Parkville, VIC, Australia
| | - L J Williams
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia
| | - S Dodd
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; University hospital of Geelong, Geelong, VIC, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia
| | - F N Jacka
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia; Centre for adolescent health, Murdoch children's research institute, Melbourne, Australia; Black Dog institute, Sydney, Australia
| | - D Meyer
- Department of statistics, data science and epidemiology, Swinburne university of technology, Swinburne, Australia
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression. PLoS One 2016; 11:e0148195. [PMID: 26848571 PMCID: PMC4744063 DOI: 10.1371/journal.pone.0148195] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/14/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study. METHODS The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009-2010). Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators. RESULTS After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30), serum glucose (OR 1.01; 95% CI 1.00, 1.01) and total bilirubin (OR 0.12; 95% CI 0.05, 0.28). Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016), and current smokers (p<0.001). CONCLUSION The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling methodology and was demonstrated to be a useful tool for detecting three biomarkers associated with depression for future hypothesis generation: red cell distribution width, serum glucose and total bilirubin.
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Affiliation(s)
- Joanna F. Dipnall
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Julie A. Pasco
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- Department of Medicine, The University of Melbourne, St Albans, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lana J. Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Seetal Dodd
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Felice N. Jacka
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- Black Dog Institute, Sydney, Australia
| | - Denny Meyer
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
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Dipnall JF, Pasco JA, Meyer D, Berk M, Williams LJ, Dodd S, Jacka FN. The association between dietary patterns, diabetes and depression. J Affect Disord 2015; 174:215-24. [PMID: 25527991 DOI: 10.1016/j.jad.2014.11.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 09/26/2014] [Revised: 11/16/2014] [Accepted: 11/17/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Type 2 diabetes and depression are commonly comorbid high-prevalence chronic disorders. Diet is a key diabetes risk factor and recent research has highlighted the relevance of diet as a possible risk for factor common mental disorders. This study aimed to investigate the interrelationship among dietary patterns, diabetes and depression. METHODS Data were integrated from the National Health and Nutrition Examination Study (2009-2010) for adults aged 18+ (n=4588, Mean age=43yr). Depressive symptoms were measured by the Patient Health Questionnaire-9 and diabetes status determined via self-report, usage of diabetic medication and/or fasting glucose levels ≥126mg/dL and a glycated hemoglobin level ≥6.5% (48mmol/mol). A 24-h dietary recall interview was given to determine intakes. Multiple logistic regression was employed, with depression the outcome, and dietary patterns and diabetes the predictors. Covariates included gender, age, marital status, education, race, adult food insecurity level, ratio of family income to poverty, and serum C-reactive protein. RESULTS Exploratory factor analysis revealed five dietary patterns (healthy; unhealthy; sweets; 'Mexican' style; breakfast) explaining 39.8% of the total variance. The healthy dietary pattern was associated with reduced odds of depression for those with diabetes (OR 0.68, 95% CI [0.52, 0.88], p=0.006) and those without diabetes (OR 0.79, 95% CI [0.64, 0.97], p=0.029) (interaction p=0.048). The relationship between the sweets dietary pattern and depression was fully explained by diabetes status. CONCLUSION In this study, a healthy dietary pattern was associated with a reduced likelihood of depressive symptoms, especially for those with Type 2 diabetes.
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Affiliation(s)
- Joanna F Dipnall
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Julie A Pasco
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
| | - Denny Meyer
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
| | - Lana J Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.
| | - Seetal Dodd
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
| | - Felice N Jacka
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Centre for Adolescent Health, Murdoch Children׳s Research Institute, Melbourne, VIC, Australia; Black Dog Institute, Sydney, NSW, Australia.
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