Human Y Chromosome Exerts Pleiotropic Effects on Susceptibility to Atherosclerosis
- 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.
Hypertension and renin-angiotensin system blockers are not associated with expression of angiotensin-converting enzyme 2 (ACE2) in the kidney
- Authors: Jiang, Xiao , Eales, James , Scannali, David , Prestes, Priscilla , Charchar, Fadi
- Date: 2020
- Type: Text , Journal article
- Relation: European Heart Journal Vol. 41, no. 48 (2020), p. 4580-4588
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- Description: Aims Angiotensin-converting enzyme 2 (ACE2) is the cellular entry point for severe acute respiratory syndrome coronavirus (SARS-CoV-2) - the cause of coronavirus disease 2019 (COVID-19). However, the effect of renin-angiotensin system (RAS)-inhibition on ACE2 expression in human tissues of key relevance to blood pressure regulation and COVID-19 infection has not previously been reported. Methods and results We examined how hypertension, its major metabolic co-phenotypes, and antihypertensive medications relate to ACE2 renal expression using information from up to 436 patients whose kidney transcriptomes were characterized by RNA-sequencing. We further validated some of the key observations in other human tissues and/or a controlled experimental model. Our data reveal increasing expression of ACE2 with age in both human lungs and the kidney. We show no association between renal expression of ACE2 and either hypertension or common types of RAS inhibiting drugs. We demonstrate that renal abundance of ACE2 is positively associated with a biochemical index of kidney function and show a strong enrichment for genes responsible for kidney health and disease in ACE2 coexpression analysis. Conclusion Our results indicate that neither hypertension nor antihypertensive treatment is likely to alter the expression of the key entry receptor for SARS-CoV-2 in the human kidney. Our data further suggest that in the absence of SARS-CoV-2 infection, kidney ACE2 is most likely nephro-protective but the age-related increase in its expression within lungs and kidneys may be relevant to the risk of SARS-CoV-2 infection. © The Author(s) 2020. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliates “James Eales", "Priscilla Prestes" and "Fadi Charchar” are provided in this record**
Hyperuricemia is independently associated with hypertension in men under 60 years in a general Chinese population
- Authors: Qian, Tingting , Sun, Hui , Xu, Qun , Charchar, Fadi , Wang, Yutang
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Human Hypertension Vol. 35, no. 11 (2021), p. 1020-1028
- Relation: https://purl.org/au-research/grants/nhmrc/1062671
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- Description: Hyperuricemia has been associated with hypertension, however, whether this association exists across all decades of adult life is unknown. This study aimed to assess the association between hyperuricemia and hypertension in relation to age. This retrospective cross-sectional study included a total of 22,556 adult Chinese people who attended Health Physical Examination in a Chinese hospital. Participants were aged between 18 and 95 years (mean [standard deviation], 45.4 [14.0]). Serum uric acid levels and blood pressure were measured. Associations between serum uric acid and blood pressure, and between hyperuricemia and hypertension diagnosis were analyzed using linear or logistic regression, adjusting for confounding risk factors including age, sex, total cholesterol, high-density lipoprotein cholesterol, and fasting blood glucose. Sub-analysis was stratified by age and sex. Before adjustment, high serum uric acid was associated with higher systolic blood pressure (β = 0.214, P < 0.001) and higher diastolic blood pressure (β = 0.271, P < 0.001). Hyperuricemia was associated with hypertension diagnosis (OR, 1.763; 95% CI, 1.635–1.901; P < 0.001) in an unadjusted analysis. These findings remained significant after adjusting for confounding factors. Sub-analysis suggested that the association between uric acid and blood pressure was weaker in older age groups and the association between hyperuricemia and hypertension was limited to people under 60 years. Hyperuricemia was independently associated with hypertension diagnosis in men but not in women, and the independent association between hyperuricemia and hypertension only presented in men under 60 years. This study suggests that hyperuricemia is independently associated with hypertension in Chinese men under 60 years. © 2020, The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar and Yutang Wang” is provided in this record**
Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India : A qualitative inquiry
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 3 (2018), p. 1-11
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- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
Impact of beta-blockers on cardiopulmonary exercise testingin patients with advanced liver disease
- Authors: Wallen, Matthew , Hall, Adrian , Dias, Katrin , Ramos, Joyce , Keating, Shelley , Woodward, Aidan , Skinner, Tina , Macdonald, Graeme , Arena, Ross , Coombes, Jeff
- Date: 2017
- Type: Text , Journal article
- Relation: Alimentary Pharmacology and Therapeutics Vol. , no. (2017), p. 1-7
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- Description: Summary Background: Patients with advanced liver disease may develop portal hypertensionthat can result in variceal haemorrhage. Beta-blockers reduce portal pressure andminimise haemorrhage risk. These medications may attenuate measures of car-diopulmonary performance, such as the ventilatory threshold and peak oxygenuptake measured via cardiopulmonary exercise testing. Aim: To determine the effect of beta-blockers on cardiopulmonary exercise testingvariables in patients with advanced liver disease. Methods: This was a cross-sectional analysis of 72 participants who completed acardiopulmonary exercise test before liver transplantation. All participants remainedon their usual beta-blocker dose and timing prior to the test. Variables measuredduring cardiopulmonary exercise testing included the ventilatory threshold, peakoxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and theventilatory equivalents for carbon dioxide slope. Results: Participants taking beta-blockers (n = 28) had a lower ventilatory threshold(P <.01) and peak oxygen uptake (P = .02), compared to participants not takingbeta-blockers. After adjusting for age, the model of end-stage liver-disease score,liver-disease aetiology, presence of refractory ascites and ventilatory thresholdremained significantly lower in the beta-blocker group (P = .04). The oxygen uptakeefficiency slope was not impacted by beta-blocker use. Conclusions: Ventilatory threshold is reduced in patients with advanced liver dis-ease taking beta-blockers compared to those not taking the medication. This mayincorrectly risk stratify patients on beta-blockers and has implications for patientmanagement before and after liver transplantation. The oxygen uptake efficiencyslope was not influenced by beta-blockers and may therefore be a better measureof cardiopulmonary performance in this patient population.
Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study
- Authors: Barker, Anna , Kamar, Jeannette , Tyndall, Tamara , White, Lyn , Hutchinson, Anastasia , Klopfer, Nicole , Weller, Carolina
- Date: 2012
- Type: Text , Journal article
- Relation: International Wound Journal Vol. 10, no. 3 (June 2012), p. 313-320
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- Description: Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12 center dot 6% (2 years preprogramme implementation) to 2 center dot 6% (6 years postprogramme implementation) (P < 0 center dot 001). Audits between 2003 and 2011 of 4368 patient medical records identified compliance with pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital.
Implementing person-environment approaches to prevent falls: A qualitative inquiry in applying the Westmead approach to occupational therapy home visits
- Authors: Clemson, Lindy , Donaldson, Alex , Hill, Keith , Day, Lesley
- Date: 2014
- Type: Text , Journal article
- Relation: Australian Occupational Therapy Journal Vol. 61, no. 5 (2014), p. 325-334
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- Description: Background/aims: Despite evidence of the effectiveness of home safety interventions for preventing falls, there is limited uptake of such interventions within community services. Therefore, as part of a broader translational project, we explored issues underlying the implementation of an evidence-based home safety fall prevention intervention. Method: We conducted in-depth interviews with eight occupational therapists and two programme coordinators engaged to deliver a home safety fall prevention intervention. Six community health centres within two metropolitan regions of Melbourne, Australia participated. The RE-AIM framework and Diffusion of Innovations theory underpinned the interviews which examine the enablers and barriers to implementing a home safety fall prevention intervention and integrating it into routine community preventive practice. Analysis involved thematic and content analysis. Results: Investment in the home safety for fall prevention intervention was supported and valued by coordinators and therapists alike, and a number of themes emerged which influenced implementation of this intervention. These included issues of: compatibility with organisational processes, individual practitioner practices and skills, a prevention approach, and client expectations; relative advantage in terms of flexibility of the process, client engagement and regional capacity building; complexity of implementing the intervention; and observability related to the invisible nature of fall prevention outcomes. Conclusion: Implementation of this home safety fall prevention intervention was influenced by a range of interrelated organisational, practitioner and client related factors. The findings from this project provide insights into, and opportunities to increase the sustainable implementation of the home safety fall prevention intervention into practice.
Improving the non-technical skills of hospital medical emergency teams : The Team Emergency Assessment Measure (TEAM™)
- Authors: Cant, Robyn , Porter, Joanne , Cooper, Simon J. , Roberts, Kate , Wilson, Ian , Gartside, Christopher
- Date: 2016
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 28, no. 6 (2016), p. 641-646
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- Description: Objectives: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Methods: Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. Results: In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Conclusion: Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
In search of the optimum structural model for internet gaming disorder
- Authors: Stavropoulos, Vasileios , Gomez, Rapson , Griffiths, Mark
- Date: 2021
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 21, no. 1 (2021), p.
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- Description: Background: Internet gaming Disorder (IGD) constitutes a recently proposed clinical disorder (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2013). The present study examined if IGD is best conceptualized as categorical (present/absent), or dimensional (severity ranging from low to high), or both (i.e., hybrid of categorical/dimensional). Methods: Ratings of the nine DSM-5 IGD symptoms, as presented in the Internet Gaming Disorder Scale 9-Short Form (Pontes & Griffiths, Comput Hum Behav 45:137-143, 2015), from 738 gamers, aged 17 to 72 years, were collected. Confirmatory factor analysis (CFA), latent class analysis (LCA), and factor mixture modelling analysis (FMMA) procedures were applied to determine the optimum IGD model. Results: Although the findings showed most support for a FFMA model with two classes and one factor, there was also good statistical and substantive support for the one-factor CFA model, and the LCA model with three classes. Conclusion: It was concluded that while the optimum structure of IGD is most likely to be a hybrid model (i.e., concurrently categorical and dimensional), a uni-dimensional model and/or a three-class categorical model are also plausible. © 2021, The Author(s).
Inattention and disordered gaming : does culture matter?
- Authors: Stavropoulos, Vasileios , Baynes, Kyi , O’Farrel, Dominic , Gomez, Rapson , Mueller, Astrid , Yucel, Murat , Griffiths, Mark
- Date: 2020
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 91, no. 2 (2020), p. 333-348
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- Description: Problematic gaming has emerged as a contemporary concern, leading to the introduction of the diagnostic term ‘Internet Gaming Disorder’ (IGD; American Psychiatric Association). The present study aims to empirically assess the association between inattention and IGD, in the light of variable levels of vertical-individualism that reflects cultural inclinations towards independence, competitiveness, and hierarchy. The participants (N = 1032) comprised a normative cohort of Massively Multiplayer Online (MMO) gamers (Mage = 24 years; 48.7% male). IGD was measured with the nine-item short-form IGD Scale (IGD9-SF), inattention with the Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale, and vertical individualism with the Individualism-Collectivism Questionnaire. Complex hierarchical and moderated regressions were employed. Findings demonstrated an association between IGD and inattention, and additionally showed that this association was exacerbated by a more vertically-individualistic cultural orientation without significant gender differences. The need of differentially addressing IGD risk among inattentive gamers of diverse cultural orientation is highlighted. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia
- 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
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- 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
Influence of core competence on voice behavior of clinical nurses : a multicenter cross-sectional study
- Authors: Guo, Yufang , Wang, Xinxin , Plummer, Virginia , Cross, Wendy , Lam, Louisa , Wang, Shuangshuang
- Date: 2021
- Type: Text , Journal article
- Relation: Psychology Research and Behavior Management Vol. 14, no. (2021), p. 501-510
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- Description: Background: Voice behavior, referred to as a positive guarantee for organizational development, is influenced by several kinds of individual, collective and organizational features. However, the impact of individual competence on voice behavior is unclear. The aim of the present study was to investigate the status quo of core competence and voice behavior of clinical nurses and explore the impact of core competence on nurses’ voice behavior. Methods: A multicenter cross-sectional survey. A total of 1717 nurses were recruited from nine tertiary and secondary hospitals between March and June 2019. An online questionnaire, including socio-demographic variables, employee voice behavior scale and competence inventory for registered nurses, was used to investigate prohibitive and promotive voice behavior and core competence of clinical nurses. Pearson correlation and hierarchical multiple regression were performed in the data analysis. Results: The mean score for prohibitive and promotive voice behavior of nurses were 3.46 (SD 0.77) and 3.46 (SD 0.88), respectively. The mean score for core competence was 2.46 (SD 0.77). Critical thinking/research aptitude was the most important predictor for both prohibitive and promotive voice behavior (each p < 0.05), but its influence on promotive voice behavior was greater (p < 0.05). Leadership was another significant predictor for prohibitive voice behavior (p < 0.05). Legal/ethical practice, teaching-coaching, professional development and shift work were other predictors for promotive voice behavior (each p < 0.05). Conclusion: Clinical nurses experience modest levels of prohibitive and promotive voice behavior and their core competence is moderate. Core competence, especially critical thinking/research aptitude, impacts significantly on voice behavior of clinical nurses. Cultivating nurses’ core competence could positively increase their voice behavior for organizational development. © 2021 Guo et al.
Injuries in Australian rules football : An overview of injury rates, patterns, and mechanisms across all levels of play
- Authors: Saw, Richard , Finch, Caroline , Samra, David , Baquie, Peter , Cardoso, Tanusha , Hope, Danielle , Orchard, John
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Health Vol. 10, no. 3 (2018), p. 208-216
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- Description: Context: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). Objective: To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. Study Design: A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. Results: The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. Clinical Relevance: An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game. © 2017,
Integrating renal and palliative care project : A nurse-led initiative
- Authors: Smith, Vicky , Potts, Carita , Wellard, Sally , Penney, Wendy
- Date: 2015
- Type: Text , Journal article
- Relation: Renal Society of Australasia Journal Vol. 11, no. 1 (2015), p. 35-40
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- Description: Renal nurses working in dialysis settings in Australian regional and rural locations face challenges in facilitating advance care planning (ACP) and providing quality physical and psychological symptom care at the end of life (EOL) for a growing population of older and sicker people with end-stage kidney disease (ESKD). Following concerns raised by patients, families, renal and palliative care nurses early in 2009 in one regional setting, gaps in service delivery were identified. These identified gaps were supported by an emerging literature that identified the need for integrated, palliative, supportive care earlier in the disease trajectory. This care, provided on a needs basis, incorporates ACP, and identifies and addresses complex symptom and psychological issues to improve quality of life (QOL) and planning EOL care for patients and their families/carers. This approach to care, now called renal supportive care, is in varying stages of implementation across Australia for all renal patients, predominantly in metropolitan centres. With limited financial resources, a successful multi-professional collaboration and coordinated approach was established in January 2009 in Ballarat, a large regional setting in Victoria. An implementation framework was developed, addressing the continuum of care from pre-dialysis to withdrawal/cessation from renal replacement therapy (RRT), with an integrated palliative supportive approach during active treatment or EOL care. This project has provided a step forward in improving confidence and responsibility for palliative care by renal nurses working in dialysis settings, helping them to address the challenges faced in evaluating symptom burden, facilitating ACP and delivery of quality EOL care for patients, their families and carers with ESKD.
Is being an immigrant a risk factor for CVD in Australia?
- Authors: Dassanayake, Jayantha , Gurrin, Lyle , Payne, Warren , Sundararajan, Vijaya , Dharmage, Shyamali
- Date: 2008
- Type: Text , Conference paper
- Relation: Circulation Vol. 118, no. 12 (Sep 2008), p. E166-E166
- Full Text: false
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- Description: Objective: To investigate whether being an immigrant is increase risk for AMI and stroke. Design and setting: A retrospective analysis of Victorian hospital admissions in 1996/97 and 2001/02 was conducted. Participants: AMI and stroke were defined using primary cases of admission of ICD-9-CM:‘P410’,ICD-10-AM:‘121’,‘122’and stroke ICD-9-CM‘P433’,’P436’,ICD- 10-AM ‘163’,‘164’diagnostic codes. Main outcome measured: Rate ratio (RR) of AMI and stroke were calculated using 1996 and 2001 Australian census data. Results: Male immigrants from three ethnic groups: USSR/Baltic (RR 3.91 95%CI 3.22,4.71), Southern Asia (RR 1.56 95%CI 1.31,1.85) and Middle East (RR 1.34 95%CI 1.10,1.63), consistently displayed higher risk for AMI (both years) than the Australian born cohort; while Southeast Asians (RR 0.51 95%CI 0.42,0.62) and Northeast Asians (RR 0.35 95%CI 0.24,0.50) were at lower risk. The findings for females were less consistent. North East Asian male and female immigrants (RR 0.57 95% CI 0.41, 0.76, RR 0.56 95%CI 0.41, 0.74), were consistently at lower risk for stroke than Australian born counterparts. Female immigrants from the Pacific Islands were consistently at higher risk (RR 1.52 95%CI 1.25, 1.84, RR 1.22 95%CI 0.98, 1.51) of stroke than Australian born women. Conclusion: A number of Non-Australian born adult males currently residing in Victoria are identified at increased risk of AMI, whereas few groups are at decreased risk, compared to Australian born males. North East Asian males and females were consistently at a lower risk for AMI and stroke than their Australian-born counterparts. However, Asia male and female immigrants are generally at a lower risk of stroke.
- Description: C1
Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?
- Authors: Kiropoulos, Litza , Klein, Britt , Austin, David , Gilson, Kathryn , Pier, Ciaran , Mitchell, Joanna , Ciechomski, Lisa
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 22, no. 8 (2008), p. 1273-1284
- Full Text: false
- Reviewed:
- Description: This study compared Panic Online (PO), an internet-based CBT intervention, to best-practice face-to-face CBT for people with panic disorder with or without agoraphobia. Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria, Australia. Participants were randomly assigned to either PO (n=46) or best practice face-to-face CBT (n=40). Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT. Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings, self reported panic disorder severity and panic attack frequency, measures of depression, anxiety, stress and panic related cognitions, and displayed improvements in quality of life. Participants rated both treatment conditions as equally credible and satisfying. Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist. Consistent with this, therapists' ratings for compliance to treatment and understanding of the CBT material was higher in the face-to-face CBT treatment group. PO required significantly less therapist time than the face-to-face CBT condition.
Is isolated systolic hypertension an indication for renal denervation?
- Authors: Wang, Yutang
- Date: 2014
- Type: Text , Commentary
- Relation: Frontiers in Physiology Vol. 5, no. 505 (2014), p. 1-2
- Relation: http://purl.org/au-research/grants/nhmrc/1062671
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- Description: Ewen et al. recently reported in the journal Hypertension that they investigated, for the first time, the effect of renal denerva tion on blood pressure in 63 patients with isolated systolic hypertension (Ewen et al., 2014). The authors concluded that renal denervation reduced office and ambula- tory blood pressure in patients with iso- lated systolic hypertension (Ewen et al., 2014). However, this conclusion may not be drawn, as renal denervation may not decrease ambulatory blood pressure in these patients. The potential risk of renal denervation may overweigh its benefit in patients with isolated systolic hypertension. Therefore, adjusted drug treatment may be recommended to these patients before renal denervation.
Is quality of life following hip arthroscopy in patients with chondrolabral pathology associated with impairments in hip strength or range of motion?
- Authors: Kemp, Joanne , Makdissi, Michael , Schache, Anthony , Finch, Caroline , Pritchard, Michael , Crossley, Kay
- Date: 2016
- Type: Text , Journal article
- Relation: Knee Surgery Sports Traumatology Arthroscopy Vol. 24, no. 12 (2016), p. 3955-3961
- Full Text: false
- Reviewed:
- Description: If physical impairments that are associated with poorer outcomes can be identified in people with chondrolabral hip pathology, then rehabilitation programmes that target such modifiable impairments could potentially be established to improve quality of life. The aim of this study was to examine the relationship between quality-of-life PROs and physical impairment measurements in people with chondrolabral pathology post-hip arthroscopic surgery. This was a cross-sectional study where multiple stepwise linear regression analyses were conducted to determine which physical impairment measurements were most associated with poorer quality-of-life patient-reported outcomes (PROs). Eighty-four patients (42 women; all aged 36 +/- 10 years) with hip chondrolabral pathology 12- to 24-month post-hip arthroscopy were included. The Hip disability and Osteoarthritis Outcome Score Quality-of-life (HOOS-Q) subscale and International Hip Outcome Tool (IHOT-33) PROs were collected. Measurements of active hip ROM and strength were assessed. Modifiable post-surgical physical impairments were associated with PRO in patients with chondrolabral pathology. Greater hip flexion ROM was independently associated with better scores in both HOOS-Q and IHOT-33 (adjusted r (2) values ranged from 0.249 to 0.341). Greater hip adduction strength was independently associated with better HOOS-Q and IHOT-33 (adjusted r (2) 0.227-0.317). Receiver Operator Curve analyses determined that the limit value for hip flexion ROM was 100A degrees (sensitivity 92 %, specificity 75 %), and hip adduction strength was 0.86 Nm/kg (sensitivity 96 %, specificity 70 %). Hip flexion ROM and adduction strength were associated with better quality-of-life PRO scores in patients with chondrolabral pathology 12- to 24-month post-hip arthroscopy. These impairments could be targeted by clinicians designing rehabilitation programmes to this patient group.
Is the revised trauma score still useful?
- Authors: Gabbe, Belinda , Cameron, Peter , Finch, Caroline
- Date: 2003
- Type: Text , Journal article
- Relation: ANZ Journal of Surgery Vol. 73, no. 11 (2003), p. 944-948
- Full Text: false
- Reviewed:
- Description: The revised trauma score (RTS) has been embraced by the trauma community worldwide. Although originally developed as a triage tool, the use of the RTS has since been expanded to include the prediction of outcome following traumatic injury. Through a critical review of the literature, evidence for use of the RTS is discussed along with the limitations of this commonly used tool. In summary, the RTS is a well-established predictor of mortality in trauma populations, but there is a lack of definitive evidence supporting its use as a primary triage tool and as a predictor of outcomes other than mortality. Difficulty in collecting the components of the RTS creates issues for data validity and the use of the RTS as a research tool. Although the weighted RTS has been developed to improve the prediction capacity of the RTS, studies reporting its use are few and there is debate regarding the applicability of the published coefficients for broad use. Overall, further studies are warranted to clearly establish the usefulness of the RTS as a triage tool in the field, to further evaluate the weighted version of the RTS, and to determine the ability of the RTS to predict functional outcome and quality of life. In particular, future research is needed to address these issues in Australian trauma populations.
- Description: 2003005273
Knee flexion strength is significantly reduced following competition in semi-professional Australian Rules football athletes : Implications for injury prevention programs
- Authors: Charlton, Paula , Raysmith, Benjamin , Wollin, Martin , Rice, Simon , Purdam, Craig , Clark, Ross , Drew, Michael
- Date: 2018
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 31, no. (2018), p. 9-14
- Full Text:
- Reviewed:
- Description: Objectives: To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. Design: Cohort study. Setting: Semi-professional AF club. Participants: Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). Main Outcome Measures: Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion. All outcome measures were evaluated pre-match to determine baseline measurements and repeated acutely post-match and at 26, 50 and 74 h following. Comparisons were made between baseline measures and all other time points. Results: Knee flexion strength was significantly reduced at a group level acutely (−122.8N, 95%CI −156.2 to −89.4, p = 0.000) and at 26 h (−89.6N, 95%CI −122.9 to −56.2, p = 0.000) following competition. Hamstring flexibility was significantly reduced at all time periods following competition (all p < 0.05), however these values were not clinically meaningful. Conclusions: Knowledge that unilateral isometric knee flexion strength returns to pre-competition levels by 50 h following match-play in AF athletes is valuable for planning recovery time frames and may inform implementation of secondary prevention strategies. © 2018 Elsevier Ltd