Human Y Chromosome Exerts Pleiotropic Effects on Susceptibility to Atherosclerosis
- Eales, James, Maan, Akhlaq, Xu, Xiaoguang, Michoel, Tom, Hallast, Pille, Batini, C, Zadik, Daniel, Prestes, Priscilla, Molina, Elsa, Denniff, Matthew, Schroeder, Juliane, Bjorkegren, Johan, Thompson, John, Maffia, Pasquale, Guzik, Tomasz, Keavney, Bernard, Jobling, Mark, Samani, Nilesh, Charchar, Fadi, Tomaszewski, Maciej
- Authors: Eales, James , Maan, Akhlaq , Xu, Xiaoguang , Michoel, Tom , Hallast, Pille , Batini, C , Zadik, Daniel , Prestes, Priscilla , Molina, Elsa , Denniff, Matthew , Schroeder, Juliane , Bjorkegren, Johan , Thompson, John , Maffia, Pasquale , Guzik, Tomasz , Keavney, Bernard , Jobling, Mark , Samani, Nilesh , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2019
- Type: Text , Journal article
- Relation: Arteriosclerosis, thrombosis, and vascular biology Vol. 39, no. 11 (2019), p. 2386-2401
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- Description: OBJECTIVE: The male-specific region of the Y chromosome (MSY) remains one of the most unexplored regions of the genome. We sought to examine how the genetic variants of the MSY influence male susceptibility to coronary artery disease (CAD) and atherosclerosis. Approach and Results: Analysis of 129 133 men from UK Biobank revealed that only one of 7 common MSY haplogroups (haplogroup I1) was associated with CAD-carriers of haplogroup I1 had ≈11% increase in risk of CAD when compared with all other haplogroups combined (odds ratio, 1.11; 95% CI, 1.04-1.18; P=6.8×10-4). Targeted MSY sequencing uncovered 235 variants exclusive to this haplogroup. The haplogroup I1-specific variants showed 2.45- and 1.56-fold respective enrichment for promoter and enhancer chromatin states, in cells/tissues relevant to atherosclerosis, when compared with other MSY variants. Gene set enrichment analysis in CAD-relevant tissues showed that haplogroup I1 was associated with changes in pathways responsible for early and late stages of atherosclerosis development including defence against pathogens, immunity, oxidative phosphorylation, mitochondrial respiration, lipids, coagulation, and extracellular matrix remodeling. UTY was the only Y chromosome gene whose blood expression was associated with haplogroup I1. Experimental reduction of UTY expression in macrophages led to changes in expression of 59 pathways (28 of which overlapped with those associated with haplogroup I1) and a significant reduction in the immune costimulatory signal. CONCLUSIONS: Haplogroup I1 is enriched for regulatory chromatin variants in numerous cells of relevance to CAD and increases cardiovascular risk through proatherosclerotic reprogramming of the transcriptome, partly through UTY.
- Authors: Eales, James , Maan, Akhlaq , Xu, Xiaoguang , Michoel, Tom , Hallast, Pille , Batini, C , Zadik, Daniel , Prestes, Priscilla , Molina, Elsa , Denniff, Matthew , Schroeder, Juliane , Bjorkegren, Johan , Thompson, John , Maffia, Pasquale , Guzik, Tomasz , Keavney, Bernard , Jobling, Mark , Samani, Nilesh , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2019
- Type: Text , Journal article
- Relation: Arteriosclerosis, thrombosis, and vascular biology Vol. 39, no. 11 (2019), p. 2386-2401
- Full Text:
- Reviewed:
- Description: OBJECTIVE: The male-specific region of the Y chromosome (MSY) remains one of the most unexplored regions of the genome. We sought to examine how the genetic variants of the MSY influence male susceptibility to coronary artery disease (CAD) and atherosclerosis. Approach and Results: Analysis of 129 133 men from UK Biobank revealed that only one of 7 common MSY haplogroups (haplogroup I1) was associated with CAD-carriers of haplogroup I1 had ≈11% increase in risk of CAD when compared with all other haplogroups combined (odds ratio, 1.11; 95% CI, 1.04-1.18; P=6.8×10-4). Targeted MSY sequencing uncovered 235 variants exclusive to this haplogroup. The haplogroup I1-specific variants showed 2.45- and 1.56-fold respective enrichment for promoter and enhancer chromatin states, in cells/tissues relevant to atherosclerosis, when compared with other MSY variants. Gene set enrichment analysis in CAD-relevant tissues showed that haplogroup I1 was associated with changes in pathways responsible for early and late stages of atherosclerosis development including defence against pathogens, immunity, oxidative phosphorylation, mitochondrial respiration, lipids, coagulation, and extracellular matrix remodeling. UTY was the only Y chromosome gene whose blood expression was associated with haplogroup I1. Experimental reduction of UTY expression in macrophages led to changes in expression of 59 pathways (28 of which overlapped with those associated with haplogroup I1) and a significant reduction in the immune costimulatory signal. CONCLUSIONS: Haplogroup I1 is enriched for regulatory chromatin variants in numerous cells of relevance to CAD and increases cardiovascular risk through proatherosclerotic reprogramming of the transcriptome, partly through UTY.
Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019 a systematic analysis for the Global Burden of Disease Study 2019
- Ebrahimi, Hedyeh, Aryan, Zahra, Moghaddam, Sahar, Bisignano, Catherine, Rahman, Muhammad Aziz
- Authors: Ebrahimi, Hedyeh , Aryan, Zahra , Moghaddam, Sahar , Bisignano, Catherine , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: Lancet Respiratory Medicine Vol. 9, no. 9 (SEP 2021), p. 1030-1049
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- Description: Background Prevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)-a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010-19 period. Findings Globally, there were 2.26 million (95% uncertainty interval 2.07 to 2.45) new cases of tracheal, bronchus, and lung cancer, and 2.04 million (1.88 to 2.19) deaths and 45.9 million (42.3 to 49.3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3.26 million (3.03 to 3.51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23.3% (12.9 to 33.6) globally and the number of larynx cancer cases increased by 24.7% (16.0 to 34.1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7.4% (-16.8 to 1.6) and age-standardised incidence rates of larynx cancer decreased by 3.0% (-10.5 to 5.0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0.9% (-8.2 to 10.2) for tracheal, bronchus, and lung cancer and decreased by 0.5% (-8.4 to 8.1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64.2% (61.9-66.4) of all deaths from tracheal, bronchus, and lung cancer and 63.4% (56.3-69.3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019. Interpretation The numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations-namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
- Authors: Ebrahimi, Hedyeh , Aryan, Zahra , Moghaddam, Sahar , Bisignano, Catherine , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: Lancet Respiratory Medicine Vol. 9, no. 9 (SEP 2021), p. 1030-1049
- Full Text:
- Reviewed:
- Description: Background Prevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)-a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010-19 period. Findings Globally, there were 2.26 million (95% uncertainty interval 2.07 to 2.45) new cases of tracheal, bronchus, and lung cancer, and 2.04 million (1.88 to 2.19) deaths and 45.9 million (42.3 to 49.3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3.26 million (3.03 to 3.51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23.3% (12.9 to 33.6) globally and the number of larynx cancer cases increased by 24.7% (16.0 to 34.1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7.4% (-16.8 to 1.6) and age-standardised incidence rates of larynx cancer decreased by 3.0% (-10.5 to 5.0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0.9% (-8.2 to 10.2) for tracheal, bronchus, and lung cancer and decreased by 0.5% (-8.4 to 8.1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64.2% (61.9-66.4) of all deaths from tracheal, bronchus, and lung cancer and 63.4% (56.3-69.3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019. Interpretation The numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations-namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
How healthy is Australian sport?
- Eime, Rochelle, Harvey, Jack
- Authors: Eime, Rochelle , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 9-10
- Full Text: false
- Reviewed:
- Description: Behavioural epidemiology in health promotion has been defined as having five phases: establishing links between behaviours and health; developing measures of the behaviour; identifying influences on the behaviour; evaluating interventions to change the behaviour; and translating the research into practice. This article outlines some recent developments in the application of behavioural epidemiology to the issue of sport participation in Australia and its consequential health benefits.
- Emery, Carolyn, Roos, Ewa, Verhagen, Evert, Finch, Caroline, Bennell, Kim, Spindler, Kurt, Kemp, Joanne, Lohmander, Stefan
- Authors: Emery, Carolyn , Roos, Ewa , Verhagen, Evert , Finch, Caroline , Bennell, Kim , Spindler, Kurt , Kemp, Joanne , Lohmander, Stefan
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 5 (2015), p. 815-825
- Full Text: false
- Reviewed:
- Description: The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period. Recommendations for injury prevention RCTs include context specific considerations regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA. Methodological recommendations for injury prevention RCTs are critical to informing evidence-based practice and policy decisions in health care, public health and the community. Recommendations regarding the interpretation and conduct of injury prevention RCTs will inform the highest level of evidence in the field. These recommendations will facilitate between study comparisons to inform best practice in injury prevention that will have the greatest public health impact.
TIMP-2 regulates proliferation, invasion and STAT3-mediated cancer stem cell-dependent chemoresistance in ovarian cancer cells
- Escalona, Ruth, Bilandzic, Maree, Western, Patrick, Kadife, Elif, Kannourakis, George, Findlay, Jock, Ahmed, Nuzhat
- Authors: Escalona, Ruth , Bilandzic, Maree , Western, Patrick , Kadife, Elif , Kannourakis, George , Findlay, Jock , Ahmed, Nuzhat
- Date: 2020
- Type: Text , Journal article
- Relation: BMC Cancer Vol. 20, no. 1 (2020), p.
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- Reviewed:
- Description: Background: The metzincin family of metalloproteinases and the tissue inhibitors of metalloproteinases (TIMPs) are essential proteins required for biological processes during cancer progression. This study aimed to determine the role of TIMP-2 in ovarian cancer progression and chemoresistance by reducing TIMP-2 expression in vitro in Fallopian tube secretory epithelial (FT282) and ovarian cancer (JHOS2 and OVCAR4) cell lines. Methods: FT282, JHOS2 and OVCAR4 cells were transiently transfected with either single or pooled TIMP-2 siRNAs. The expression of different genes after TIMP-2 knock down (T2-KD) or in response to chemotherapy was determined at the mRNA level by quantitative real time PCR (qRT-PCR) and at the protein level by immunofluorescence. Sensitivity of the cell lines in response to chemotherapy after TIMP-2 knock down was investigated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and 5-Ethynyl-2′-deoxyuridine (EdU) assays. Cell invasion in response to TIMP-2 knockdown was determined by xCELLigence. Results: Sixty to 90 % knock down of TIMP-2 expression was confirmed in FT282, OVCAR4 and JHOS2 cell lines at the mRNA and protein levels. TIMP-2 knock down did not change the mRNA expression of TIMP-1 or TIMP-3. However, a significant downregulation of MMP-2 in T2-KD cells occurred at both the protein and activation levels, compared to Control (Cont; scrambled siRNA) and Parental cells (P, transfection reagent only). In contrast, membrane bound MT1-MMP protein levels were significantly upregulated in T2-KD compared to Cont and P cells. T2-KD cells exhibited enhanced proliferation and increased sensitivity to cisplatin and paclitaxel treatments. Enhanced invasion was observed in the T2-KD-JOSH2 and OVCAR4 cells but not in T2-KD-FT282 cells. Treatment with cisplatin or paclitaxel significantly elevated the expression of TIMP-2 in Cont cells but not in T2-KD cells, consistent with significantly elevated expression of chemoresistance and CSC markers and activation of STAT3. Furthermore, a potent inhibitor of STAT3 activation, Momelotinib, suppressed chemotherapy-induced activation of P-STAT3 in OVCAR4 cells with concomitant reductions in the expression of chemoresistance genes and CSC markers. Conclusions: The above results suggest that TIMP-2 may have a novel role in ovarian cancer proliferation, invasion and chemoresistance. © 2020 The Author(s).
- Authors: Escalona, Ruth , Bilandzic, Maree , Western, Patrick , Kadife, Elif , Kannourakis, George , Findlay, Jock , Ahmed, Nuzhat
- Date: 2020
- Type: Text , Journal article
- Relation: BMC Cancer Vol. 20, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Background: The metzincin family of metalloproteinases and the tissue inhibitors of metalloproteinases (TIMPs) are essential proteins required for biological processes during cancer progression. This study aimed to determine the role of TIMP-2 in ovarian cancer progression and chemoresistance by reducing TIMP-2 expression in vitro in Fallopian tube secretory epithelial (FT282) and ovarian cancer (JHOS2 and OVCAR4) cell lines. Methods: FT282, JHOS2 and OVCAR4 cells were transiently transfected with either single or pooled TIMP-2 siRNAs. The expression of different genes after TIMP-2 knock down (T2-KD) or in response to chemotherapy was determined at the mRNA level by quantitative real time PCR (qRT-PCR) and at the protein level by immunofluorescence. Sensitivity of the cell lines in response to chemotherapy after TIMP-2 knock down was investigated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and 5-Ethynyl-2′-deoxyuridine (EdU) assays. Cell invasion in response to TIMP-2 knockdown was determined by xCELLigence. Results: Sixty to 90 % knock down of TIMP-2 expression was confirmed in FT282, OVCAR4 and JHOS2 cell lines at the mRNA and protein levels. TIMP-2 knock down did not change the mRNA expression of TIMP-1 or TIMP-3. However, a significant downregulation of MMP-2 in T2-KD cells occurred at both the protein and activation levels, compared to Control (Cont; scrambled siRNA) and Parental cells (P, transfection reagent only). In contrast, membrane bound MT1-MMP protein levels were significantly upregulated in T2-KD compared to Cont and P cells. T2-KD cells exhibited enhanced proliferation and increased sensitivity to cisplatin and paclitaxel treatments. Enhanced invasion was observed in the T2-KD-JOSH2 and OVCAR4 cells but not in T2-KD-FT282 cells. Treatment with cisplatin or paclitaxel significantly elevated the expression of TIMP-2 in Cont cells but not in T2-KD cells, consistent with significantly elevated expression of chemoresistance and CSC markers and activation of STAT3. Furthermore, a potent inhibitor of STAT3 activation, Momelotinib, suppressed chemotherapy-induced activation of P-STAT3 in OVCAR4 cells with concomitant reductions in the expression of chemoresistance genes and CSC markers. Conclusions: The above results suggest that TIMP-2 may have a novel role in ovarian cancer proliferation, invasion and chemoresistance. © 2020 The Author(s).
Review of the clinical effectiveness of the neuraminidase inhibitors against influenza B viruses
- Farrukee, Rubaiyea, Mosse, Jennifer, Hurt, Aeron
- Authors: Farrukee, Rubaiyea , Mosse, Jennifer , Hurt, Aeron
- Date: 2013
- Type: Text , Journal article
- Relation: Expert Review of Anti-Infective Therapy Vol. 11, no. 11 (2013), p. 1135-1145
- Full Text: false
- Reviewed:
- Description: Influenza A and B viruses cause significant morbidity and mortality worldwide each year. The neuraminidase inhibitors (NAIs) are the most commonly used class of influenza antiviral drugs for the treatment of infected patients. In vitro studies have shown that influenza B viruses are significantly less susceptible to oseltamivir and other neuraminidase inhibitors compared with influenza A viruses. Following analysis of published clinical studies, we show that oseltamivir does appear to have lower effectiveness in patients infected with influenza B virus compared with influenza A infected patients, but due to insufficient studies on zanamivir, laninamivir or peramivir, it was not possible to conclude the relative effectiveness of these drugs against influenza A virus compared with B virus.
Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- Feigin, Valery, Stark, Benjamin, Johnson, Catherine, Roth, Gregory, Rahman, Muhammad Aziz
- Authors: Feigin, Valery , Stark, Benjamin , Johnson, Catherine , Roth, Gregory , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: The Lancet Neurology Vol. 20, no. 10 (2021), p. 1-26
- Full Text:
- Reviewed:
- Description: Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
- Authors: Feigin, Valery , Stark, Benjamin , Johnson, Catherine , Roth, Gregory , Rahman, Muhammad Aziz
- Date: 2021
- Type: Text , Journal article
- Relation: The Lancet Neurology Vol. 20, no. 10 (2021), p. 1-26
- Full Text:
- Reviewed:
- Description: Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**
Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia
- Finch, Caroline, Clapperton, Angela, McCrory, Paul
- Authors: Finch, Caroline , Clapperton, Angela , McCrory, Paul
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 198, no. 8 (2013), p. 427-430
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Objective: To describe trends in hospitalisation for sport-related concussion. Design, setting and patients: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002-03 to 2010-11 financial years for patients aged ≥15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. Main outcome measures: Number and cost of hospitalisations; rate of hospitalisation per 100000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100000 participants over 9 years. Results: There were 4745 hospitalisations of people aged ≥15 years for sport-related concussion, with a total hospital treatment cost of $17944799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%-77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100000 participants also increased significantly, by 38.9% (95% CI, 17.5%-61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling. Conclusions: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 years. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.
- Description: 2003011025
Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury : Population-based study
- Finch, Caroline, Shee, Anna Wong, Clapperton, Angela
- Authors: Finch, Caroline , Shee, Anna Wong , Clapperton, Angela
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 7. e005043
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
- Authors: Finch, Caroline , Shee, Anna Wong , Clapperton, Angela
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 7. e005043
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004-2010 : A future epidemic of osteoarthritis?
- Finch, Caroline, Kemp, Joanne, Clapperton, Angela
- Authors: Finch, Caroline , Kemp, Joanne , Clapperton, Angela
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 7 (2015), p. 1138-1143
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. Methods: Health sector data relating to adults aged 15+ years, for 2004-2010 inclusive, was extracted from the Victorian Admitted Episodes Dataset (VAED) and Victorian Emergency Minimum Dataset (VEMD). Data relating to sports injuries were identified using activity codes in each dataset Trends in injury frequency and rates were determined, and economic burden was calculated. Results: The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. Conclusions: The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA. © 2015 Osteoarthritis Research Society International.
- Authors: Finch, Caroline , Kemp, Joanne , Clapperton, Angela
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 7 (2015), p. 1138-1143
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. Methods: Health sector data relating to adults aged 15+ years, for 2004-2010 inclusive, was extracted from the Victorian Admitted Episodes Dataset (VAED) and Victorian Emergency Minimum Dataset (VEMD). Data relating to sports injuries were identified using activity codes in each dataset Trends in injury frequency and rates were determined, and economic burden was calculated. Results: The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. Conclusions: The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA. © 2015 Osteoarthritis Research Society International.
- Finch, Caroline, Cook, Jill, Gabbe, Belinda, Orchard, John
- Authors: Finch, Caroline , Cook, Jill , Gabbe, Belinda , Orchard, John
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 22-25
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: Injuries are a major contributor to healthcare costs and individuals' health and disability status. In response to the overall public health burden, injuries were one of the first medical conditions identified as an Australian National Health Priority Area. Our previous epidemiological research has shown that sports injuries, especially those sustained through formal and highly competitive sport, are often associated with considerable pain and dysfunction. They have significant ongoing impact on quality of life and need for medical treatment, including in the hospital setting.They are also a major barrier towards both the uptake and continuance of health-generating physical activity guidance.
Behind every active and sporting population, there is an Epidemiologist
- Authors: Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 3-4
- Full Text: false
- Reviewed:
- Description: This Round Table on The Epidemiology of Fitness, Sport and Physical Recreation makes for compelling reading. Australia has long been regarded as a sports-mad nation and one that has achieved major international sporting achievements because of its long-term investment in sports medicine and sports science research. Sports spectatorship is also a major pastime in Australia, underpinning the value of using sport to promote a range of health promotion messages (e.g. in relation to tobacco, alcohol, social tolerance and most recently violence prevention). People of all ages now enjoy participating in a wide range of activities from general physical activity to fitness training to cycling to team ball sports such as Australian football to combat sports. All of these feature in papers in this issue.
Short and long term mortality rates after a lower limb amputation
- Fortington, Lauren, Geertzen, Jan, Van Netten, Jaap, Postema, Klaas, Rommers, Gerardus, Dijkstra, Pieter
- Authors: Fortington, Lauren , Geertzen, Jan , Van Netten, Jaap , Postema, Klaas , Rommers, Gerardus , Dijkstra, Pieter
- Date: 2013
- Type: Text , Journal article
- Relation: European Journal of Vascular and Endovascular Surgery Vol. 46, no. 1 (July 2013), p. 124-131
- Full Text: false
- Reviewed:
- Description: Objective: To determine mortality rates after a first lower limb amputation and explore the rates for different subpopulations. Methods: Retrospective cohort study of all people who underwent a first amputation at or proximal to transtibial level, in an area of 1.7 million people. Analysis with Kaplan-Meier curves and Log Rank tests for univariate associations of psycho-social and health variables. Logistic regression for odds of death at 30-days, 1-year and 5-years. Results: 299 people were included. Median time to death was 20.3 months (95%CI: 13.1; 27.5). 30-day mortality = 22%; odds of death 2.3 times higher in people with history of cerebrovascular disease (95%CI: 1.2; 4.7, P = 0.016). 1 year mortality = 44%; odds of death 3.5 times higher for people with renal disease (95%CI: 1.8; 7.0, P < 0.001). 5-years mortality = 77%; odds of death 5.4 times higher for people with renal disease (95%CI: 1.8; 16.0,P = 0.003). Variation in mortality rates was most apparent in different age groups; people 75-84 years having better short term outcomes than those younger and older. Conclusions: Mortality rates demonstrated the frailty of this population, with almost one quarter of people dying within 30-days, and almost half at 1 year. People with cerebrovascular had higher odds of death at 30 days, and those with renal disease and 1 and 5 years, respectively.
- Description: C1
Change in health-related quality of life in the first 18 months after lower limb amputation: A prospective, longitudinal study
- Fortington, Lauren, Dijkstra, Pieter, Bosmans, Joline, Post, Wendy, Geertzen, Jan
- Authors: Fortington, Lauren , Dijkstra, Pieter , Bosmans, Joline , Post, Wendy , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 6 (2013), p. 587-594
- Full Text:
- Reviewed:
- Description: Objective: To describe changes in health-related quality of life in people with lower limb amputation, from time of amputation to 18 months, taking into consideration the influence of age and walking distance. In addition, quality of life for people with amputation is compared with the Dutch population norm values. Design: Multicentre, longitudinal study. Subjects: All people undergoing first amputation: 106 were referred, of whom 82 were included, mean age 67.8 years (standard deviation; SD 13.0), 67% men. A total of 35 remained in the study at 18 months. Methods: Dutch language RAND-36 questionnaire (Research and Development Corporation measure of Quality of Life) was completed at time of amputation, 6 and 18 months after amputation. Results: Over time, a significant improvement was seen in physical function, social function, pain, vitality, and perceived change in health (all p < 0.001). Subjects over 65 years of age had a poorer outcome compared with people < 65 years for physical function only (p < 0.001). Walking distance was associated with improved scores in social function (p = 0.047). Conclusion: Quality of life improved significantly in 5 of 7 domains investigated; most change occurred in the first 6 months. Physical function remained well below population norm values. Different domains may be affected in different ways for older and younger age groups, but this requires further research. © 2013 Foundation of Rehabilitation Information.
- Description: C1
- Authors: Fortington, Lauren , Dijkstra, Pieter , Bosmans, Joline , Post, Wendy , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 6 (2013), p. 587-594
- Full Text:
- Reviewed:
- Description: Objective: To describe changes in health-related quality of life in people with lower limb amputation, from time of amputation to 18 months, taking into consideration the influence of age and walking distance. In addition, quality of life for people with amputation is compared with the Dutch population norm values. Design: Multicentre, longitudinal study. Subjects: All people undergoing first amputation: 106 were referred, of whom 82 were included, mean age 67.8 years (standard deviation; SD 13.0), 67% men. A total of 35 remained in the study at 18 months. Methods: Dutch language RAND-36 questionnaire (Research and Development Corporation measure of Quality of Life) was completed at time of amputation, 6 and 18 months after amputation. Results: Over time, a significant improvement was seen in physical function, social function, pain, vitality, and perceived change in health (all p < 0.001). Subjects over 65 years of age had a poorer outcome compared with people < 65 years for physical function only (p < 0.001). Walking distance was associated with improved scores in social function (p = 0.047). Conclusion: Quality of life improved significantly in 5 of 7 domains investigated; most change occurred in the first 6 months. Physical function remained well below population norm values. Different domains may be affected in different ways for older and younger age groups, but this requires further research. © 2013 Foundation of Rehabilitation Information.
- Description: C1
The Importance of Foot Care in Older People With Diabetes
- Fortington, Lauren, Geertzen, Jeertzen, Van Netten, Jaap, Van Baal, Jeff, Bus, Sicco, Schaper, Nicolaas
- Authors: Fortington, Lauren , Geertzen, Jeertzen , Van Netten, Jaap , Van Baal, Jeff , Bus, Sicco , Schaper, Nicolaas
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 14, no. 2 (February 2013 2013), p. 136
- Full Text: false
- Reviewed:
- Description: C1
Rehabilitation in skilled nursing centres for elderly people with lower limb amputations: A mixed-methods, descriptive study
- Fortington, Lauren, Rommers, Gerardus, Wind-Kral, Anne, Dijkstra, Pieter, Geertzen, Jan
- Authors: Fortington, Lauren , Rommers, Gerardus , Wind-Kral, Anne , Dijkstra, Pieter , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 10 (2013), p. 1065-1070
- Full Text:
- Reviewed:
- Description: Objectives: To describe the current set-up, barriers and potential for providing rehabilitation to people with lower limb amputation in skilled nursing centres. Design: Survey and interviews. Subjects/participants: Elderly care physicians, physiotherapists. Methods: In 2011, clinicians from 34 skilled nursing centres participated in a semi-structured interview covering rehabilitation and daily care, personal skills and training, team work and communication, and discharge processes. Results: Each centre sees only a small proportion of people with amputation (a maximum of 3.6% of all admissions). This limited number of patients appears to be the main barrier in providing care, as it is difficult for clinicians to maintain knowledge, and resources are spread widely. Two main areas of improvement were suggested by participants: (i) use of guidelines in care; and (ii) collaboration with specialized team members. Conclusion: The spread of patients across many centres makes it difficult for professionals working in skilled nursing centres to obtain the necessary skills and knowledge for care of people with amputation. A designated skilled nursing centre for amputation rehabilitation is presented as a solution, but smaller clinical changes are also suggested, including improvements in communication and training.
- Description: C1
- Authors: Fortington, Lauren , Rommers, Gerardus , Wind-Kral, Anne , Dijkstra, Pieter , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 10 (2013), p. 1065-1070
- Full Text:
- Reviewed:
- Description: Objectives: To describe the current set-up, barriers and potential for providing rehabilitation to people with lower limb amputation in skilled nursing centres. Design: Survey and interviews. Subjects/participants: Elderly care physicians, physiotherapists. Methods: In 2011, clinicians from 34 skilled nursing centres participated in a semi-structured interview covering rehabilitation and daily care, personal skills and training, team work and communication, and discharge processes. Results: Each centre sees only a small proportion of people with amputation (a maximum of 3.6% of all admissions). This limited number of patients appears to be the main barrier in providing care, as it is difficult for clinicians to maintain knowledge, and resources are spread widely. Two main areas of improvement were suggested by participants: (i) use of guidelines in care; and (ii) collaboration with specialized team members. Conclusion: The spread of patients across many centres makes it difficult for professionals working in skilled nursing centres to obtain the necessary skills and knowledge for care of people with amputation. A designated skilled nursing centre for amputation rehabilitation is presented as a solution, but smaller clinical changes are also suggested, including improvements in communication and training.
- Description: C1
Mobility in Elderly People With a Lower Limb Amputation: A Systematic Review
- Fortington, Lauren, Rommers, Gerardus, Geertzen, Jan, Postema, Klaas, Dijkstra, Pieter
- Authors: Fortington, Lauren , Rommers, Gerardus , Geertzen, Jan , Postema, Klaas , Dijkstra, Pieter
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 13, no. 4 (May 2012 2012), p. 319-325
- Full Text: false
- Reviewed:
- Description: Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring extensive rehabilitation and long term care. Mobility is key to regaining independence; however, the impact of multiple comorbidities in this patient group can make regaining mobility a particularly challenging task. An evidence-based prognosis for mobility is needed for rehabilitation and long term care planning. This systematic review summarizes the prosthetic and nonprosthetic mobility outcomes achieved by elderly people with a lower limb amputation, to determine whether an accurate prognosis for mobility can be made. MEDLINE, EMBASE, and CINAHL were searched for studies published before May 2010 in English, German, Dutch, or French, using keywords and synonyms for elderly, mobility, rehabilitation, and amputation. Mobility focused on actual movement (moving from one place to another) and was limited to long-term measurements, 6 months after amputation or 3 months after discharge from rehabilitation. The 15 included studies featured a diversity of objective outcome measures and mobility grades that proved difficult to compare meaningfully. In general, studies that included selected populations of prosthetic walkers showed that advanced prosthetic mobility skills can be achieved by the elderly person with a lower limb amputation, including outdoor/community walking. Studies that included all subjects undergoing a lower limb amputation reported that less than half of the elderly population achieved a household level of prosthetic mobility. The predominant findings from the included studies were incomplete reporting of study populations and poor reporting of the reliability of the mobility measures used. The strength of conclusions from this review was therefore limited and the prognosis for mobility in elderly people after lower limb amputation remains unclear. Further research into mobility outcomes of this population is needed to provide evidence that enables more informed choices in rehabilitation and long term care.
- Description: C1
- Fortington, Lauren, Bekker, Sheree, Morgan, Damian, Finch, Caroline
- Authors: Fortington, Lauren , Bekker, Sheree , Morgan, Damian , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 29, no. 4 (2019), p. 324-328
- Full Text: false
- Reviewed:
- Description: Objective: Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training. Design: Face-to-face interviews. Setting: Community sports organizations in Victoria, Australia. Participants: Representatives from 14 organizations who participated in a government-funded AED program. Main Outcome Measures: Motivations to participate in the AED program were explored using a qualitative descriptive approach. Results: Two overarching themes emerged: awareness of the program and decision to apply. Awareness was gained indirectly through grant advertising in newsletters/emails/web sites and directly through their sporting associations. For most organizations, there was no decision process per se, rather, the opportunity to apply was the key determinant for participating in the program. A duty of care also emerged as a key driving factor, with recognition of AEDs as a valuable asset to communities broadly, not just the participants' immediate sports setting. Reflecting on participation in the program, these participants identified that it was important to increase awareness about AED ownership and use. The program benefits were clearly summed up as being best prepared for a worst-case scenario. Discussion: This study provides new understanding of why community sports organizations apply for an AED and training. The strongest reason was simply the opportunity to acquire this at no cost. Therefore, for wider implementation of AEDs, additional funding opportunities, targeted awareness of these opportunities, and continued promotion of AED importance are recommended.
Sprinting and hamstring strain injury : beliefs and practices of professional physical performance coaches in Australian football
- Freeman, Brock, Talpey, Scott, James, Lachlan, Young, Warren
- Authors: Freeman, Brock , Talpey, Scott , James, Lachlan , Young, Warren
- Date: 2021
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 48, no. (2021), p. 12-19
- Full Text:
- Reviewed:
- Description: Objectives: The purpose of this study was to establish beliefs and practices of physical performance coaches regarding sprinting and Hamstring Strain Injury (HSI) in Australian Rules football. Designs: Delphi-validated questionnaire. Setting: Online. Participants: Eighteen high-performance managers of the Australian Football League. Main outcome measures: Descriptive statistics were collected to establish experience; central themes were established for the analyses of the beliefs and practices. Results: Nine (50%) physical performance coaches responded to an invitation to complete the questionnaire. Participants held an undergraduate degree and had 9.2 ± 4.3 years of experience. Accelerations (n = 9), maximum speed sprints (n = 9) and running with hip flexion (n = 7) were the most common activities associated with HSI. Coaches believed sprinting, eccentric strength training and proper periodisation were effective strategies to reduce HSI risk. There's a disparity between beliefs and practices when using GPS to monitor sprinting, however, all coaches reported regular exposure to sprint training across both pre and in-season. Overstriding (n = 9) and pelvic instability (n = 6) were identified as key flaws in running mechanics. Conclusions: This information can be used to improve training strategies, whilst these findings indicate further investigations into sprint training and running mechanics for HSI risk reduction. © 2020 Elsevier Ltd
- Authors: Freeman, Brock , Talpey, Scott , James, Lachlan , Young, Warren
- Date: 2021
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 48, no. (2021), p. 12-19
- Full Text:
- Reviewed:
- Description: Objectives: The purpose of this study was to establish beliefs and practices of physical performance coaches regarding sprinting and Hamstring Strain Injury (HSI) in Australian Rules football. Designs: Delphi-validated questionnaire. Setting: Online. Participants: Eighteen high-performance managers of the Australian Football League. Main outcome measures: Descriptive statistics were collected to establish experience; central themes were established for the analyses of the beliefs and practices. Results: Nine (50%) physical performance coaches responded to an invitation to complete the questionnaire. Participants held an undergraduate degree and had 9.2 ± 4.3 years of experience. Accelerations (n = 9), maximum speed sprints (n = 9) and running with hip flexion (n = 7) were the most common activities associated with HSI. Coaches believed sprinting, eccentric strength training and proper periodisation were effective strategies to reduce HSI risk. There's a disparity between beliefs and practices when using GPS to monitor sprinting, however, all coaches reported regular exposure to sprint training across both pre and in-season. Overstriding (n = 9) and pelvic instability (n = 6) were identified as key flaws in running mechanics. Conclusions: This information can be used to improve training strategies, whilst these findings indicate further investigations into sprint training and running mechanics for HSI risk reduction. © 2020 Elsevier Ltd
- French, Simon, Charity, Melanie, Forsdike, Kirsty, Gunn, Jane, Polus, Barbara, Walker, Bruce, Chondros, Patty, Britt, Helena
- Authors: French, Simon , Charity, Melanie , Forsdike, Kirsty , Gunn, Jane , Polus, Barbara , Walker, Bruce , Chondros, Patty , Britt, Helena
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 199, no. 10 (2013), p. 687-691
- Full Text: false
- Reviewed:
- Description: Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.