Declining melatonin levels and older people. How old is old?
- Graham, D., McLachlan, Angus
- Authors: Graham, D. , McLachlan, Angus
- Date: 2004
- Type: Text , Journal article
- Relation: Neuroendocrinology Letters Vol. 25, no. 6 (2004), p. 415-418
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- Description: Objectives: The purpose of this study was to investigate whether melatonin levels in older cohorts within the 'aged' population were significantly lower than in younger 'aged' individuals and hence point to a possible confound in cross-sectional studies which group individuals over 55 in one category. Setting and design: Melatonin levels of 35 North Queensland residents over 55 years of age living in an aged-care facility, a retirement village or the general community were compared across three age groups. Methods: Subjects were ten 56-65 year olds, eighteen 66-75 year olds and seven over-75 year olds. Information was obtained on sleep, awakening, medical conditions and medications, with subsequent exclusion of those with known medical conditions and/or medications. Melatonin was collected by salivary samples at 2200 hours and concentrations were determined by immunoassay. Results: Mean melatonin levels were significantly lower (p=.03) in the 'oldest' (over 75 yrs) group compared to the 'youngest' (56-65 yrs) group. Main findings: The results of this preliminary study indicate that within the older population, melatonin levels appear to decline significantly with age. Conclusions: Future studies of melatonin and ageing may benefit from a longitudinal approach, with older subjects sampled across time. Copyright © Neuroendocrinology Letters.
- Description: C1
- Authors: Graham, D. , McLachlan, Angus
- Date: 2004
- Type: Text , Journal article
- Relation: Neuroendocrinology Letters Vol. 25, no. 6 (2004), p. 415-418
- Full Text:
- Reviewed:
- Description: Objectives: The purpose of this study was to investigate whether melatonin levels in older cohorts within the 'aged' population were significantly lower than in younger 'aged' individuals and hence point to a possible confound in cross-sectional studies which group individuals over 55 in one category. Setting and design: Melatonin levels of 35 North Queensland residents over 55 years of age living in an aged-care facility, a retirement village or the general community were compared across three age groups. Methods: Subjects were ten 56-65 year olds, eighteen 66-75 year olds and seven over-75 year olds. Information was obtained on sleep, awakening, medical conditions and medications, with subsequent exclusion of those with known medical conditions and/or medications. Melatonin was collected by salivary samples at 2200 hours and concentrations were determined by immunoassay. Results: Mean melatonin levels were significantly lower (p=.03) in the 'oldest' (over 75 yrs) group compared to the 'youngest' (56-65 yrs) group. Main findings: The results of this preliminary study indicate that within the older population, melatonin levels appear to decline significantly with age. Conclusions: Future studies of melatonin and ageing may benefit from a longitudinal approach, with older subjects sampled across time. Copyright © Neuroendocrinology Letters.
- Description: C1
Help-seeking by rural residents for mental health problems: The importance of agrarian values
- Judd, Fiona, Jackson, Henry, Komiti, Angela, Murray, Greg, Fraser, Caitlin, Grieve, Aaron, Gomez, Rapson
- Authors: Judd, Fiona , Jackson, Henry , Komiti, Angela , Murray, Greg , Fraser, Caitlin , Grieve, Aaron , Gomez, Rapson
- Date: 2006
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 40, no. 9 (2006), p. 769-776
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- Description: Objective: To examine the role of stoicism, self-efficacy and perceived stigma in predicting help-seeking by rural residents, for mental health problems. Method: A cross-sectional community survey was conducted with a sample of 467 rural residents (58% female), who completed self-report questionnaires assessing current levels of symptomatology, disability, perceived stigma, self-efficacy, stoicism, attitudes towards and experience of seeking help for psychological problems. Results: Overall, 7.6% (n = 129) of respondents had sought help from a general practitioner and/or mental health professional for psychological problems or a mental health issue. More women than men reported having sought such help. Lifetime help-seeking for a psychological problem or mental health issue was positively associated with higher levels of distress and lower levels of stoicism and, to a lesser extent, lower levels of self-efficacy. Conclusions: Efforts to improve help-seeking by rural residents for mental health problems should focus on understanding and addressing attitudes, such as stoicism which act as barriers to help-seeking. © 2006 The Authors; Journal compilation © 2006 The Royal Australian and New Zealand College of Psychiatrists.
- Description: C1
- Description: 2003002045
- Authors: Judd, Fiona , Jackson, Henry , Komiti, Angela , Murray, Greg , Fraser, Caitlin , Grieve, Aaron , Gomez, Rapson
- Date: 2006
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 40, no. 9 (2006), p. 769-776
- Full Text:
- Reviewed:
- Description: Objective: To examine the role of stoicism, self-efficacy and perceived stigma in predicting help-seeking by rural residents, for mental health problems. Method: A cross-sectional community survey was conducted with a sample of 467 rural residents (58% female), who completed self-report questionnaires assessing current levels of symptomatology, disability, perceived stigma, self-efficacy, stoicism, attitudes towards and experience of seeking help for psychological problems. Results: Overall, 7.6% (n = 129) of respondents had sought help from a general practitioner and/or mental health professional for psychological problems or a mental health issue. More women than men reported having sought such help. Lifetime help-seeking for a psychological problem or mental health issue was positively associated with higher levels of distress and lower levels of stoicism and, to a lesser extent, lower levels of self-efficacy. Conclusions: Efforts to improve help-seeking by rural residents for mental health problems should focus on understanding and addressing attitudes, such as stoicism which act as barriers to help-seeking. © 2006 The Authors; Journal compilation © 2006 The Royal Australian and New Zealand College of Psychiatrists.
- Description: C1
- Description: 2003002045
- Authors: Hayes, Louise
- Date: 2007
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Psychiatry Vol. 41, no. 3 (Mar 2007), p. 231-238
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- Description: Objective: This study provides normative and clinical levels of problem behaviours from a large community sample of Australian early primary school children. Method: From a large community sample (n = 1928) of children aged 5 to 10 years (mean = 7.70, SD = 0.89) normative data are provided using the teacher-reported version of the Strengths and Difficulties Questionnaire (SDQ). A response rate of 88% ensures the data are representative. Results: Mean scores on total difficulties between this Australian sample and UK norms were comparable. Some differences in the clinical cut-off scores are evident in the Australian sample, and adjusted clinical cut-offs are provided. Australian teacher reports of problem behaviour revealed lower clinical levels of emotional problems. Boys had significantly greater problems than girls on the Conduct, Hyperactivity, Peer and Prosocial scales. Overall, 5.3% of boys had scores in the clinical range on four of the five subscales. Comparisons of the factor structure revealed that for boys the Peer scale has two interpretations, with two items loading with Conduct problems and associated with greater problem behaviours. For girls, conduct problems are more strongly associated with poorer prosocial skills. Conclusions: Teachers are able provide valuable predictive information on externalizing behaviours. Australian normative comparisons reveal minor variations in teacher interpretation of items. The present data is representative of the Australian community and should be used to assess behaviour difficulties in early primary school children. Future studies on older age children are required to understand the developmental progression of problem behaviours in the community.
- Description: C1
- Description: 2003005423
Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005-2006
- Bean, David, Krahe, Daniel, Wareham, David
- Authors: Bean, David , Krahe, Daniel , Wareham, David
- Date: 2008
- Type: Text , Journal article
- Relation: Annals of Clinical Microbiology and Antimicrobials Vol. 7, no. (June 2008 2008), p.
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- Description: Background: Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI). Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods: Antimicrobial susceptibility to ampicillin, amoxicillin/ clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results: Nitrofurantoin was the most active agent (94% susceptible), followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55%) and trimethoprim (40%), often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum
- Description: C1
- Authors: Bean, David , Krahe, Daniel , Wareham, David
- Date: 2008
- Type: Text , Journal article
- Relation: Annals of Clinical Microbiology and Antimicrobials Vol. 7, no. (June 2008 2008), p.
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- Description: Background: Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI). Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods: Antimicrobial susceptibility to ampicillin, amoxicillin/ clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results: Nitrofurantoin was the most active agent (94% susceptible), followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55%) and trimethoprim (40%), often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum
- Description: C1
- Hindmarsh, Diane, Hayen, Andrew, Finch, Caroline, Close, Jacqueline
- Authors: Hindmarsh, Diane , Hayen, Andrew , Finch, Caroline , Close, Jacqueline
- Date: 2008
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. , no. (2008), p. 1-9
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- Description: Summary: Survival after hospitalisation for hip fracture by age group and sex relative to survival in the general population was assessed in people aged 65+. Men had double the risk of death compared with women to 1 year, but age effects lasted only to 3 months. Clinical outcomes need to be improved. Introduction: We assessed the relative survival of hospitalised fall-related hip fracture patients aged 65+ years leaving hospital in New South Wales, Australia, between July 2000 and December 2003. Method: We carried out a population-based study of all hospital separations for NSW residents with a principal diagnosis of hip fracture (ICD-10-AM S72.0 to S72.2) and first external cause of fall (ICD-10-AM codes W00 to W19), linked to NSW death data. A total of 16,836 cases were included. Relative survival 3 to 36 months post-admission by 10-year age groups and sex was calculated, using NSW life tables for 2002-2004. Relative excess risk was modelled using a generalised linear model with Poisson error structure, using the life table data. Results: One-year cumulative relative survival in 65- to 74-year-olds was 82% (men), 90% (women); in 85+-year-olds 65% (men), 80% (women). Men have a relative excess risk of death of 2.2 (95% CI 2.03-2.38) times that of women. Only 21% of deaths mention the hip fracture as contributing to death. Conclusion: There is a need to reduce the number of hip fractures and improve clinical outcomes for older people hospitalised with hip fractures. © 2008 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Description: C1
- Description: 2003008189
Moving dialysis treatment into people's homes
- Authors: Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: The Renal Society of Australasia Journal Vol. 5, no. 2 (2009), p. 102-104
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- Description: Home based dialysis treatments were among the earliest high technology treatments widely adopted in Australia for home use. Advances in membrane technology together with the development of access devices and delivery systems provided the opportunity of extending dialysis as a treatment to a wider group of patients. The evolution of home dialysis was infl uenced by serendipity. The right people and technology came together at the same time. Dr John Dawborn, supported by Sue Evans, trained with the fi rst home haemodialysis patient Peter Morris in Melbourne, who subsequently transferred to Sydney.
- Description: 2003007106
- Authors: Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: The Renal Society of Australasia Journal Vol. 5, no. 2 (2009), p. 102-104
- Full Text:
- Reviewed:
- Description: Home based dialysis treatments were among the earliest high technology treatments widely adopted in Australia for home use. Advances in membrane technology together with the development of access devices and delivery systems provided the opportunity of extending dialysis as a treatment to a wider group of patients. The evolution of home dialysis was infl uenced by serendipity. The right people and technology came together at the same time. Dr John Dawborn, supported by Sue Evans, trained with the fi rst home haemodialysis patient Peter Morris in Melbourne, who subsequently transferred to Sydney.
- Description: 2003007106
Content and functionality of alcohol and other drug websites: Results of an online survey
- Klein, Britt, White, Angela, Kavanagh, David, Shandley, Kerrie, Kay-Lambkin, Frances, Proudfoot, Judith, Drennan, Judy, Connor, Jason, Baker, Amanda, Young, Ross
- Authors: Klein, Britt , White, Angela , Kavanagh, David , Shandley, Kerrie , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Young, Ross
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p.
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- Description: Background: There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood. Objective: To investigate content and functionality preferences for AOD and other health websites. Methods: An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences. Results: Surveys were obtained from 1214 drug (n = 766) and alcohol website users (n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (
- Authors: Klein, Britt , White, Angela , Kavanagh, David , Shandley, Kerrie , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Young, Ross
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p.
- Full Text:
- Reviewed:
- Description: Background: There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood. Objective: To investigate content and functionality preferences for AOD and other health websites. Methods: An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences. Results: Surveys were obtained from 1214 drug (n = 766) and alcohol website users (n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (
Functional data modelling approach for analysing and predicting trends in incidence rates-an application to falls injury
- Ullah, Shahid, Finch, Caroline
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
Measuring non-technical skills in medical emergency care: a review of assessment measures.
- Cooper, Simon J., Endacott, Ruth, Cant, Robyn
- Authors: Cooper, Simon J. , Endacott, Ruth , Cant, Robyn
- Date: 2010
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 2, no. (2010), p. 7-16
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- Description: Aim: To review the literature on non-technical skills and assessment methods relevant to emergency care. Background: Non-technical skills (NTS) include leadership, teamwork, decision making and situation awareness, all of which have an impact on healthcare outcomes. Significant concerns have been raised about the rates of adverse medical events, many of which are attributed to NTS failures. Methods: Ovid, Medline, ProQUEST, PsycINFO and specialty websites were searched for NTS measures using applicable access strategies, inclusion and exclusion criteria. Publications identified were assessed for relevance. Results: A range of non-technical skill measures relevant to emergency care was identified: leadership (n = 5), teamwork (n = 7), personality/behavior (n = 3) and situation awareness tools (n = 1). Of these, 9 have been used with emergency care populations/clinicians. All had varying degrees of reliability and validity. In the last decade there has been some development of teamwork measures specific to emergency care with a predominantly global and collective rating of broad skills. Conclusion: A variety of non-technical skill measures are available; only a few have been used in the emergency care arena. There is a need for an increase in the focused assessment of teamwork skills for a greater understanding of team performance to enhance patient safety in medical emergency care.
- Authors: Cooper, Simon J. , Endacott, Ruth , Cant, Robyn
- Date: 2010
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 2, no. (2010), p. 7-16
- Full Text:
- Reviewed:
- Description: Aim: To review the literature on non-technical skills and assessment methods relevant to emergency care. Background: Non-technical skills (NTS) include leadership, teamwork, decision making and situation awareness, all of which have an impact on healthcare outcomes. Significant concerns have been raised about the rates of adverse medical events, many of which are attributed to NTS failures. Methods: Ovid, Medline, ProQUEST, PsycINFO and specialty websites were searched for NTS measures using applicable access strategies, inclusion and exclusion criteria. Publications identified were assessed for relevance. Results: A range of non-technical skill measures relevant to emergency care was identified: leadership (n = 5), teamwork (n = 7), personality/behavior (n = 3) and situation awareness tools (n = 1). Of these, 9 have been used with emergency care populations/clinicians. All had varying degrees of reliability and validity. In the last decade there has been some development of teamwork measures specific to emergency care with a predominantly global and collective rating of broad skills. Conclusion: A variety of non-technical skill measures are available; only a few have been used in the emergency care arena. There is a need for an increase in the focused assessment of teamwork skills for a greater understanding of team performance to enhance patient safety in medical emergency care.
Air temperature and the incidence of fall-related hip fracture hospitalisations in older people
- Turner, R. M., Hayen, Andrew, Dunsmuir, William, Finch, Caroline
- Authors: Turner, R. M. , Hayen, Andrew , Dunsmuir, William , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 22, no. 4 (2011), p. 1183-1189
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
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- Description: Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
- Authors: Turner, R. M. , Hayen, Andrew , Dunsmuir, William , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 22, no. 4 (2011), p. 1183-1189
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
Clonal origins of Vibrio cholerae O1 El Tor strains, Papua New Guinea, 2009-2011
- Horwood, Paul, Collins, Deirdre, Jonduo, Marinjho, Rosewell, Alexander, Dutta, Samir, Dagina, Rosheila, Ropa, Berry, Siba, Peter, Greenhill, Andrew
- Authors: Horwood, Paul , Collins, Deirdre , Jonduo, Marinjho , Rosewell, Alexander , Dutta, Samir , Dagina, Rosheila , Ropa, Berry , Siba, Peter , Greenhill, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 17, no. 11 (2011), p. 2063-2065
- Full Text:
- Reviewed:
- Description: We used multilocus sequence typing and variable number tandem repeat analysis to determine the clonal origins of Vibrio cholerae O1 El Tor strains from an outbreak of cholera that began in 2009 in Papua New Guinea. The epidemic is ongoing, and transmission risk is elevated within the Pacific region.
- Authors: Horwood, Paul , Collins, Deirdre , Jonduo, Marinjho , Rosewell, Alexander , Dutta, Samir , Dagina, Rosheila , Ropa, Berry , Siba, Peter , Greenhill, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 17, no. 11 (2011), p. 2063-2065
- Full Text:
- Reviewed:
- Description: We used multilocus sequence typing and variable number tandem repeat analysis to determine the clonal origins of Vibrio cholerae O1 El Tor strains from an outbreak of cholera that began in 2009 in Papua New Guinea. The epidemic is ongoing, and transmission risk is elevated within the Pacific region.
Managing deteriorating patients: Registered nurses' performance in a simulated setting
- Cooper, Simon J., McConnell-Henry, Tracy, Cant, Robyn, Porter, Joanne, Missen, Karen, Kinsman, Leigh, Endacott, Ruth, Scholes, Julie
- Authors: Cooper, Simon J. , McConnell-Henry, Tracy , Cant, Robyn , Porter, Joanne , Missen, Karen , Kinsman, Leigh , Endacott, Ruth , Scholes, Julie
- Date: 2011
- Type: Text , Journal article
- Relation: The Open Nursing Journal Vol. 5, no. (2011), p. 120-126
- Full Text:
- Reviewed:
- Description: Aim: To examine, in a simulated environment, rural nurses’ ability to assess and manage patient deterioration using measures of knowledge, situation awareness and skill performance. Background: Nurses’ ability to manage deterioration and ‘failure to rescue’ are of significant concern with questions over knowledge and clinical skills. Simulated emergencies may help to identify and develop core skills. Methods: An exploratory quantitative performance review. Thirty five nurses from a single ward completed a knowledge questionnaire and two video recorded simulated scenarios in a rural hospital setting. Patient actors simulated deteriorating patients with an Acute Myocardial Infarction (AMI) and Chronic Obstructive Pulmonary Disease (COPD) as the primary diagnosis. How aware individuals were of the situation (levels of situation awareness) were measured at the end of each scenario. Results: Knowledge of deterioration management varied considerably (range: 27%-91%) with a mean score of 67%. Average situation awareness scores and skill scores across the two scenarios (AMI and COPD) were low (50%) with many important observations and actions missed. Participants did identify that ‘patients’ were deteriorating but as each patient deteriorated staff performance declined with a reduction in all observational records and actions. In many cases, performance decrements appeared to be related to high anxiety levels. Participants tended to focus on single signs and symptoms and failed to use a systematic approach to patient assessment. Conclusion: Knowledge and skills were generally low in this rural hospital sample with notable performance decrements as patients acutely declined. Educational models that incorporate high fidelity simulation and feedback techniques are likely to have a significant positive impact on performance.
- Authors: Cooper, Simon J. , McConnell-Henry, Tracy , Cant, Robyn , Porter, Joanne , Missen, Karen , Kinsman, Leigh , Endacott, Ruth , Scholes, Julie
- Date: 2011
- Type: Text , Journal article
- Relation: The Open Nursing Journal Vol. 5, no. (2011), p. 120-126
- Full Text:
- Reviewed:
- Description: Aim: To examine, in a simulated environment, rural nurses’ ability to assess and manage patient deterioration using measures of knowledge, situation awareness and skill performance. Background: Nurses’ ability to manage deterioration and ‘failure to rescue’ are of significant concern with questions over knowledge and clinical skills. Simulated emergencies may help to identify and develop core skills. Methods: An exploratory quantitative performance review. Thirty five nurses from a single ward completed a knowledge questionnaire and two video recorded simulated scenarios in a rural hospital setting. Patient actors simulated deteriorating patients with an Acute Myocardial Infarction (AMI) and Chronic Obstructive Pulmonary Disease (COPD) as the primary diagnosis. How aware individuals were of the situation (levels of situation awareness) were measured at the end of each scenario. Results: Knowledge of deterioration management varied considerably (range: 27%-91%) with a mean score of 67%. Average situation awareness scores and skill scores across the two scenarios (AMI and COPD) were low (50%) with many important observations and actions missed. Participants did identify that ‘patients’ were deteriorating but as each patient deteriorated staff performance declined with a reduction in all observational records and actions. In many cases, performance decrements appeared to be related to high anxiety levels. Participants tended to focus on single signs and symptoms and failed to use a systematic approach to patient assessment. Conclusion: Knowledge and skills were generally low in this rural hospital sample with notable performance decrements as patients acutely declined. Educational models that incorporate high fidelity simulation and feedback techniques are likely to have a significant positive impact on performance.
Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis
- Vu, Trang, Finch, Caroline, Day, Lesley
- Authors: Vu, Trang , Finch, Caroline , Day, Lesley
- Date: 2011
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 11, no. 45 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods: We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results: More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions: The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by future studies. Our findings have particular relevance for falls prevention strategies, clinical practice and planning of follow-up services for these patients.
- Authors: Vu, Trang , Finch, Caroline , Day, Lesley
- Date: 2011
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 11, no. 45 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods: We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results: More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions: The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by future studies. Our findings have particular relevance for falls prevention strategies, clinical practice and planning of follow-up services for these patients.
Respiratory viral pathogens associated with lower respiratory tract disease among young children in the highlands of Papua New Guinea
- Chidlow, Glenys, Laing, Ingrid, Harnett, Gerald, Greenhill, Andrew, Phuanukoonnon, Suparat, Siba, Peter, Pomat, William, Shellam, Geoffrey, Smith, David, Lehmann, Deborah
- Authors: Chidlow, Glenys , Laing, Ingrid , Harnett, Gerald , Greenhill, Andrew , Phuanukoonnon, Suparat , Siba, Peter , Pomat, William , Shellam, Geoffrey , Smith, David , Lehmann, Deborah
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Clinical Virology Vol. 54, no. 3 (2012), p. 235-239
- Full Text:
- Reviewed:
- Description: Background: Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). However, comprehensive studies of the viral aetiology of ALRI have not been conducted in PNG for almost 30 years. Objectives: To determine the viruses associated with ALRI among children living in the PNG highlands using sensitive molecular detection techniques. Study design: Pernasal swabs were collected routinely between 1 week and 18 months of age and also during episodes of ALRI, as part of a neonatal pneumococcal conjugate vaccine trial. A tandem multiplex real-time PCR assay was used to test for a comprehensive range of respiratory viruses in samples collected from 221 young children. Picornavirus typing was supported by DNA sequence analysis. Results: Recognized pathogenic respiratory viruses were detected in 198/273 (73%) samples collected from children with no evidence of ALRI and 69/80 (86%) samples collected during ALRI episodes. Human rhinoviruses (HRV) species A, B and C were detected in 152 (56%) samples from non-ALRI children and 50 (63%) samples collected during ALRI episodes. Partial structural region sequences for two new species C rhinoviruses were added to the GenBank database. ALRI was associated with detection of adenovirus species B (p< 0.01) or C (p< 0.05), influenza A (p< 0.0001) or respiratory syncytial virus (p< 0.0001). Multiple viruses were detected more often during ALRI episodes (49%) than when children displayed no symptoms of ALRI (18%) (p< 0.0001). Conclusions: The burden of infection with respiratory viruses remains significant in young children living in the PNG highlands.
- Authors: Chidlow, Glenys , Laing, Ingrid , Harnett, Gerald , Greenhill, Andrew , Phuanukoonnon, Suparat , Siba, Peter , Pomat, William , Shellam, Geoffrey , Smith, David , Lehmann, Deborah
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Clinical Virology Vol. 54, no. 3 (2012), p. 235-239
- Full Text:
- Reviewed:
- Description: Background: Acute lower respiratory tract infections (ALRI) commonly result in fatal outcomes in the young children of Papua New Guinea (PNG). However, comprehensive studies of the viral aetiology of ALRI have not been conducted in PNG for almost 30 years. Objectives: To determine the viruses associated with ALRI among children living in the PNG highlands using sensitive molecular detection techniques. Study design: Pernasal swabs were collected routinely between 1 week and 18 months of age and also during episodes of ALRI, as part of a neonatal pneumococcal conjugate vaccine trial. A tandem multiplex real-time PCR assay was used to test for a comprehensive range of respiratory viruses in samples collected from 221 young children. Picornavirus typing was supported by DNA sequence analysis. Results: Recognized pathogenic respiratory viruses were detected in 198/273 (73%) samples collected from children with no evidence of ALRI and 69/80 (86%) samples collected during ALRI episodes. Human rhinoviruses (HRV) species A, B and C were detected in 152 (56%) samples from non-ALRI children and 50 (63%) samples collected during ALRI episodes. Partial structural region sequences for two new species C rhinoviruses were added to the GenBank database. ALRI was associated with detection of adenovirus species B (p< 0.01) or C (p< 0.05), influenza A (p< 0.0001) or respiratory syncytial virus (p< 0.0001). Multiple viruses were detected more often during ALRI episodes (49%) than when children displayed no symptoms of ALRI (18%) (p< 0.0001). Conclusions: The burden of infection with respiratory viruses remains significant in young children living in the PNG highlands.
Stuttering, disability and the higher education sector in Australia
- Meredith, Grant, Packman, Ann, Marks, Genee
- Authors: Meredith, Grant , Packman, Ann , Marks, Genee
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Speech-Language Pathology Vol. 14, no. 4 (2012), p. 370-376
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- Description: The aim of this study was to ascertain the extent to which Australian public universities and their associated disability liaison services offer web-based information for current or prospective students who stutter. The disability pages of the websites of all 39 public universities in Australia were visited and the information about disability services assessed according to 12 criteria developed by the authors. Results indicate that there is a dearth of information on Australian university websites available for students or prospective students who stutter. Only 13% of the sites reported any form of alternative teaching and assessment procedures for speech-impaired students and only 51% of 39 disability liaison officers responded when contacted by email. Such a student could not make an informed choice to enrol in a university based upon the information on disability services available on public Australian university websites. © 2012 The Speech Pathology Association of Australia Limited.
- Authors: Meredith, Grant , Packman, Ann , Marks, Genee
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Speech-Language Pathology Vol. 14, no. 4 (2012), p. 370-376
- Full Text:
- Reviewed:
- Description: The aim of this study was to ascertain the extent to which Australian public universities and their associated disability liaison services offer web-based information for current or prospective students who stutter. The disability pages of the websites of all 39 public universities in Australia were visited and the information about disability services assessed according to 12 criteria developed by the authors. Results indicate that there is a dearth of information on Australian university websites available for students or prospective students who stutter. Only 13% of the sites reported any form of alternative teaching and assessment procedures for speech-impaired students and only 51% of 39 disability liaison officers responded when contacted by email. Such a student could not make an informed choice to enrol in a university based upon the information on disability services available on public Australian university websites. © 2012 The Speech Pathology Association of Australia Limited.
Can eye-tracking technology improve situational awareness in paramedic clinical education?
- Williams, Brett, Quested, Andrew, Cooper, Simon J.
- Authors: Williams, Brett , Quested, Andrew , Cooper, Simon J.
- Date: 2013
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 5, no. (2013), p. 23-28
- Full Text:
- Reviewed:
- Description: Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing medical error: eye-tracking technology can be used to provide an objective and qualitative measure of the initial perception component of SA. Feedback from eye-tracking technology can be used to improve the understanding and teaching of SA in clinical contexts, and consequently, has potential for reducing clinician error and the concomitant adverse events.
- Authors: Williams, Brett , Quested, Andrew , Cooper, Simon J.
- Date: 2013
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 5, no. (2013), p. 23-28
- Full Text:
- Reviewed:
- Description: Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing medical error: eye-tracking technology can be used to provide an objective and qualitative measure of the initial perception component of SA. Feedback from eye-tracking technology can be used to improve the understanding and teaching of SA in clinical contexts, and consequently, has potential for reducing clinician error and the concomitant adverse events.
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
Extending ICPC-2 PLUS terminology to develop a classification system specific for the study of chiropractic encounters
- Charity, Melanie, French, Simon, Forsdike, Kirsty, Britt, Helena, Polus, Bolus, Gunn, Jane
- Authors: Charity, Melanie , French, Simon , Forsdike, Kirsty , Britt, Helena , Polus, Bolus , Gunn, Jane
- Date: 2013
- Type: Text , Journal article
- Relation: Chiropractic and Manual Therapies Vol. 21, no. 1 (2013), p.1-10
- Full Text:
- Reviewed:
- Description: Background: Typically a large amount of information is collected during healthcare research and this information needs to be organised in a way that will make it manageable and to facilitate clear reporting. The Chiropractic Observation and Analysis STudy (COAST) was a cross sectional observational study that described the clinical practices of chiropractors in Victoria, Australia. To code chiropractic encounters COAST used the International Classification of Primary Care (ICPC-2) with the PLUS general practice clinical terminology to code chiropractic encounters. This paper describes the process by which a chiropractic-profession specific terminology was developed for use in research by expanding the current ICPC-2 PLUS system.Methods: The coder referred to the ICPC-2 PLUS system when coding chiropractor recorded encounter details (reasons for encounter, diagnoses/problems and processes of care). The coder used rules and conventions supplied by the Family Medicine Research Unit at the University of Sydney, the developers of the PLUS system. New chiropractic specific terms and codes were created when a relevant term was not available in ICPC-2 PLUS.Results: Information was collected from 52 chiropractors who documented 4,464 chiropractor-patient encounters. During the study, 6,225 reasons for encounter and 6,491 diagnoses/problems were documented, coded and analysed; 169 new chiropractic specific terms were added to the ICPC-2 PLUS terminology list. Most new terms were allocated to diagnoses/problems, with reasons for encounter generally well covered in the original ICPC 2 PLUS terminology: 3,074 of the 6,491 (47%) diagnoses/problems and 274 of the 6,225 (4%) reasons for encounter recorded during encounters were coded to a new term. Twenty nine new terms (17%) represented chiropractic processes of care.Conclusion: While existing ICPC-2 PLUS terminology could not fully represent chiropractic practice, adding terms specific to chiropractic enabled coding of a large number of chiropractic encounters at the desired level. Further, the new system attempted to record the diversity among chiropractic encounters while enabling generalisation for reporting where required. COAST is ongoing, and as such, any further encounters received from chiropractors will enable addition and refinement of ICPC-2 PLUS (Chiro). More research is needed into the diagnosis/problem descriptions used by chiropractors. © 2013 Charity et al.; licensee BioMed Central Ltd.
- Authors: Charity, Melanie , French, Simon , Forsdike, Kirsty , Britt, Helena , Polus, Bolus , Gunn, Jane
- Date: 2013
- Type: Text , Journal article
- Relation: Chiropractic and Manual Therapies Vol. 21, no. 1 (2013), p.1-10
- Full Text:
- Reviewed:
- Description: Background: Typically a large amount of information is collected during healthcare research and this information needs to be organised in a way that will make it manageable and to facilitate clear reporting. The Chiropractic Observation and Analysis STudy (COAST) was a cross sectional observational study that described the clinical practices of chiropractors in Victoria, Australia. To code chiropractic encounters COAST used the International Classification of Primary Care (ICPC-2) with the PLUS general practice clinical terminology to code chiropractic encounters. This paper describes the process by which a chiropractic-profession specific terminology was developed for use in research by expanding the current ICPC-2 PLUS system.Methods: The coder referred to the ICPC-2 PLUS system when coding chiropractor recorded encounter details (reasons for encounter, diagnoses/problems and processes of care). The coder used rules and conventions supplied by the Family Medicine Research Unit at the University of Sydney, the developers of the PLUS system. New chiropractic specific terms and codes were created when a relevant term was not available in ICPC-2 PLUS.Results: Information was collected from 52 chiropractors who documented 4,464 chiropractor-patient encounters. During the study, 6,225 reasons for encounter and 6,491 diagnoses/problems were documented, coded and analysed; 169 new chiropractic specific terms were added to the ICPC-2 PLUS terminology list. Most new terms were allocated to diagnoses/problems, with reasons for encounter generally well covered in the original ICPC 2 PLUS terminology: 3,074 of the 6,491 (47%) diagnoses/problems and 274 of the 6,225 (4%) reasons for encounter recorded during encounters were coded to a new term. Twenty nine new terms (17%) represented chiropractic processes of care.Conclusion: While existing ICPC-2 PLUS terminology could not fully represent chiropractic practice, adding terms specific to chiropractic enabled coding of a large number of chiropractic encounters at the desired level. Further, the new system attempted to record the diversity among chiropractic encounters while enabling generalisation for reporting where required. COAST is ongoing, and as such, any further encounters received from chiropractors will enable addition and refinement of ICPC-2 PLUS (Chiro). More research is needed into the diagnosis/problem descriptions used by chiropractors. © 2013 Charity et al.; licensee BioMed Central Ltd.
Male-specific region of the y chromosome and cardiovascular risk phylogenetic analysis and gene expression studies
- Bloomer, Lisa, Nelson, Christopher, Eales, James, Denniff, Matthew, Christofidou, Paraskevi, Debiec, Radoslaw, Moore, Jasbir, Consortium, Cardiogenics, Zukowska-Szczechowska, Ewa, Goodall, Alison, Thompson, John, Samani, Nilesh, Charchar, Fadi, Tomaszewski, Maciej
- Authors: Bloomer, Lisa , Nelson, Christopher , Eales, James , Denniff, Matthew , Christofidou, Paraskevi , Debiec, Radoslaw , Moore, Jasbir , Consortium, Cardiogenics , Zukowska-Szczechowska, Ewa , Goodall, Alison , Thompson, John , Samani, Nilesh , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2013
- Type: Text , Journal article
- Relation: Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 33, no. 7 (2013), p. 1722-1727
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: Objective-Haplogroup I of male-specific region of the human Y chromosome is associated with 50% increased risk of coronary artery disease. It is not clear to what extent conventional cardiovascular risk factors and genes of the malespecific region may explain this association. Approach and Results-A total of 1988 biologically unrelated men from 4 white European populations were genotyped using 11 Y chromosome single nucleotide polymorphisms and classified into 13 most common European haplogroups. Approximately 75% to 93% of the haplotypic variation of the Y chromosome in all cohorts was attributable to I, R1a, and R1b1b2 lineages. None of traditional cardiovascular risk factors, including body mass index, blood pressures, lipids, glucose, C-reactive protein, creatinine, and insulin resistance, was associated with haplogroup I of the Y chromosome in the joint inverse variance meta-analysis. Fourteen of 15 ubiquitous single-copy genes of the male-specific region were expressed in human macrophages. When compared with men with other haplogroups, carriers of haplogroup I had 0.61- and 0.64-fold lower expression of ubiquitously transcribed tetratricopeptide repeat, Y-linked gene (UTY) and protein kinase, Y-linked, pseudogene (PRKY) in macrophages (P=0.0001 and P=0.002, respectively). Conclusions-Coronary artery disease predisposing haplogroup I of the Y chromosome is associated with downregulation of UTY and PRKY genes in macrophages but not with conventional cardiovascular risk factors. © 2013 American Heart Association, Inc.
- Description: 2003011132
- Authors: Bloomer, Lisa , Nelson, Christopher , Eales, James , Denniff, Matthew , Christofidou, Paraskevi , Debiec, Radoslaw , Moore, Jasbir , Consortium, Cardiogenics , Zukowska-Szczechowska, Ewa , Goodall, Alison , Thompson, John , Samani, Nilesh , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2013
- Type: Text , Journal article
- Relation: Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 33, no. 7 (2013), p. 1722-1727
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: Objective-Haplogroup I of male-specific region of the human Y chromosome is associated with 50% increased risk of coronary artery disease. It is not clear to what extent conventional cardiovascular risk factors and genes of the malespecific region may explain this association. Approach and Results-A total of 1988 biologically unrelated men from 4 white European populations were genotyped using 11 Y chromosome single nucleotide polymorphisms and classified into 13 most common European haplogroups. Approximately 75% to 93% of the haplotypic variation of the Y chromosome in all cohorts was attributable to I, R1a, and R1b1b2 lineages. None of traditional cardiovascular risk factors, including body mass index, blood pressures, lipids, glucose, C-reactive protein, creatinine, and insulin resistance, was associated with haplogroup I of the Y chromosome in the joint inverse variance meta-analysis. Fourteen of 15 ubiquitous single-copy genes of the male-specific region were expressed in human macrophages. When compared with men with other haplogroups, carriers of haplogroup I had 0.61- and 0.64-fold lower expression of ubiquitously transcribed tetratricopeptide repeat, Y-linked gene (UTY) and protein kinase, Y-linked, pseudogene (PRKY) in macrophages (P=0.0001 and P=0.002, respectively). Conclusions-Coronary artery disease predisposing haplogroup I of the Y chromosome is associated with downregulation of UTY and PRKY genes in macrophages but not with conventional cardiovascular risk factors. © 2013 American Heart Association, Inc.
- Description: 2003011132
Measuring situation awareness in emergency settings: a systematic review of tools and outcomes
- Cooper, Simon J., Porter, Joanne, Peach, Linda
- Authors: Cooper, Simon J. , Porter, Joanne , Peach, Linda
- Date: 2013
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 6, no. (2013), p. 1-7
- Full Text:
- Reviewed:
- Description: Background: Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings. Methods: Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor. Results: One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness) and four incorporated the Situation Awareness Global Assessment Technique. Conclusion: A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and improve decision-making.
- Authors: Cooper, Simon J. , Porter, Joanne , Peach, Linda
- Date: 2013
- Type: Text , Journal article
- Relation: Open Access Emergency Medicine Vol. 6, no. (2013), p. 1-7
- Full Text:
- Reviewed:
- Description: Background: Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings. Methods: Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor. Results: One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness) and four incorporated the Situation Awareness Global Assessment Technique. Conclusion: A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and improve decision-making.