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Achieving person-centredness with older people in residential aged care

- Wilson, Catherine, Moss, Cheryle, Willetts, Georgina

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

- Abd-Allah, Foad, Adebayo, Oladimeji, Agrawal, Anurag, Alam, Tahiya, Rahman, Muhammad Aziz

  • Authors: Abd-Allah, Foad , Adebayo, Oladimeji , Agrawal, Anurag , Alam, Tahiya , Rahman, Muhammad Aziz
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Lancet Vol. 396, no. 10258 (2020), p. 1160-1203
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  • Description: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Bill & Melinda Gates Foundation. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record**

Testing the NKT cell hypothesis in lenalidomide-treated myelodysplastic syndrome patients

- Chan, Angela, Neeson, Paul, Leeansyah, Edwin, Tainton, K., Quach, Hang, Prince, Henry, Godfrey, Dale, Ritchie, David, Berzins, Stuart

  • Authors: Chan, Angela , Neeson, Paul , Leeansyah, Edwin , Tainton, K. , Quach, Hang , Prince, Henry , Godfrey, Dale , Ritchie, David , Berzins, Stuart
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Leukemia Vol. 24, no. 3 (2010), p. 592-600
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  • Description: Myelodysplastic syndrome (MDS) comprises a group of clonal bone marrow disorders characterized by ineffective hematopoiesis and increased predisposition to acute myeloid leukemia. The causes of MDS remain poorly defined, but several studies have reported the NKT cell compartment of patients with MDS is deficient in number and functionally defective. In support of a central role for NKT cells, a pilot clinical study reported that lenalidomide (an approved treatment for MDS) increased NKT cell numbers in patients with MDS, and several in vitro studies showed lenalidomide specifically promoted NKT cell proliferation and cytokine production. We tested this in a much larger study and confirm a moderate in vitro augmentation of some NKT cell functions by lenalidomide, but find no impact on the NKT cell compartment of patients treated with lenalidomide, despite a consistently positive clinical response. We further show that the frequency and cytokine production of NKT cells is normal in patients with MDS before treatment and remains stable throughout 10 months of lenalidomide therapy. Collectively, our data challenge the concept that NKT cell defects contribute to the development of MDS, and show that a clinical response to lenalidomide is not dependent on modulation of NKT cell frequency or function. © 2010 Macmillan Publishers Limited All rights reserved.

Chiropractic Observation and Analysis Study (COAST): Providing an understanding of current chiropractic practice

- French, Simon, Charity, Melanie, Forsdike, Kirsty, Gunn, Jane, Polus, Barbara, Walker, Bruce, Chondros, Patty, Britt, Helena

  • Authors: French, Simon , Charity, Melanie , Forsdike, Kirsty , Gunn, Jane , Polus, Barbara , Walker, Bruce , Chondros, Patty , Britt, Helena
  • Date: 2013
  • Type: Text , Journal article
  • Relation: Medical Journal of Australia Vol. 199, no. 10 (2013), p. 687-691
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  • Description: Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.

A Novel exercise initiative for seniors to improve balance and physical function

- Sales, Myrla, Polman, Remco, Hill, Keith, Levinger, Pazit

  • Authors: Sales, Myrla , Polman, Remco , Hill, Keith , Levinger, Pazit
  • Date: 2017
  • Type: Text , Journal article
  • Relation: Journal of Aging and Health Vol. 29, no. 8 (2017), p. 1424-1443
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  • Description: Objective: To investigate the feasibility, effectiveness, and short-term effects of an exercise intervention using a novel exercise park in improving seniors’ balance, physical function, and quality of life. Method: Randomized controlled trial with pre- and post-intervention design (baseline and 18-week intervention) was used. Outcome measures included measures of balance, strength, and function, as well as quality of life and fear of falling. MANCOVA was used to assess differences between groups (control and exercise intervention) over time. Results: Intervention group showed significant improvement on single leg stance (p = .02, 95% confidence interval [CI] = [−8.35, −0.549]), knee strength (p < .01, 95% CI = [−29.14, −5.86]), 2-min walk (p = 0.02, 95% CI = [−19.13, −0.859]), and timed sit to stand (p = .03, 95% CI = [−2.26, −0.143]) tests. Discussion: The exercise park program improved physical function and had high adherence and participation rate. Such intervention has been shown to be safe and therefore might enhance participation in exercise programs for older adults.

Multi-session anodal tDCS enhances the effects of postural training on balance and postural stability in older adults with high fall risk: Primary motor cortex versus cerebellar stimulation

- Yosephi, Mohaddeseh, Ehsani, Fatemeh, Zoghi, Maryam, Jaberzadeh, Shapour

  • Authors: Yosephi, Mohaddeseh , Ehsani, Fatemeh , Zoghi, Maryam , Jaberzadeh, Shapour
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Brain Stimulation Vol. 11, no. 6 (2018), p. 1239-1250
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  • Description: Postural control impairment is a key target for rehabilitation of older adults with high fall risk. To investigate whether anodal transcranial direct current stimulation (a-tDCS) over primary motor cortex (M1) or cerebellum can enhance the positive effects of postural training on balance and postural stability in older adults with high fall risk. In this randomised, double-blinded sham-controlled study, 65 participants were randomly assigned into five groups M1 a-tDCS with postural training, bilateral cerebellar a-tDCS with postural training, sham a-tDCS with postural training, postural training alone and cerebellar a-tDCS alone. Participants in the first two a-tDCS groups received 2 mA stimulation for 20 min concurrently with postural training. Postural training was conducted for three sessions of 20 min per week for two weeks. The Berg Balance Score (BBS) and the stability indices at both static and dynamic levels of the Biodex Balance System were evaluated before and after intervention. A general linear model repeated measure ANOVA was used to assess the effects of variables among groups. Simultaneous postural training with M1 or bilateral cerebellar a-tDCS significantly improved postural stability indices (p < 0.05) and BBS scores (p < 0.05). Besides, the effects of bilateral cerebellar a-tDCS were significantly higher than that of M1 stimulation on these indices (p < 0.05). Moreover, two weeks postural training alone or cerebellar a-tDCS alone is not an adequate intervention to improve the postural stability indices (p > 0.05). Postural training with M1 or bilateral cerebellar a-tDCS, especially bilateral cerebellar a-tDCS, can significantly improve postural control or balance in older adults with high fall risk, while two weeks of postural training alone or two weeks cerebellar a-tDCS alone is not a sufficient intervention. [Display omitted] •Balance did not improve after two weeks of postural training alone in older adults.•Balance did not improve after two weeks of cerebellar a-tDCS alone in older adults.•M1 or cerebellar a-tDCS can enhance the positive effects of postural training on balance in older adults.•Cerebellar more than M1 a-tDCS modulates dynamic balance in older adults with high fall risk.

A feature agnostic approach for glaucoma detection in OCT volumes

- Maetschke, Stefan, Antony, Bhavna, Ishikawa, Hiroshi, Wollstein, Gadi, Schuman, Joel, Garnavi, Rahil

  • Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
  • Date: 2019
  • Type: Text , Journal article
  • Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
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  • Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.

Statistical modelling of falls count data with excess zeros

- Khan, Asaduzzaman, Ullah, Shahid, Nitz, Jenny

  • Authors: Khan, Asaduzzaman , Ullah, Shahid , Nitz, Jenny
  • Date: 2011
  • Type: Text , Journal article
  • Relation: Injury Prevention Vol. 17, no. 4 (2011), p. 266-270
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  • Description: Objective To examine the appropriateness of different statistical models in analysing falls count data. Methods Six count models (Poisson, negative binomial (NB), zero-inflated Poisson (ZIP), zero-inflated NB (ZINB), hurdle Poisson (HP) and hurdle NB (HNB)) were used to analyse falls count data. Empirical evaluation of the competing models was performed using model selection criteria and goodness-of-fit through simulation. Data used were from a prospective cohort study of women aged 40-80 years. Results Of the 465 women analysed, 330 (71%) did not fall at all. The analyses identified strong evidence of overdispersion in the falls data. The NB-based regression models (HNB, ZINB, NB) were better performed than the Poisson-based regression models (Poisson, ZIP, HP). Vuong tests favoured the HNB model over the NB and ZINB models and the NB model over the ZINB model. Model accuracy measures and Monte Carlo simulation of goodness-of-fit confirmed the lack of fit of the Poissonbased regression models and demonstrated the best fit for the HNB model with comparable good fit for the ZINB and NB models. Conclusions Falls count data consisting of a considerable number of zeros can be appropriately modelled by the NBbased regression models, with the HNB model offering he best fit. The evaluation procedure presented in this aper provides a defensible guideline to appropriately odel falls or similar count data with excess zeros.

Sense of belonging as a predictor of reasons for living in older adults

- Kissane, Melissa, McLaren, Suzanne

  • Authors: Kissane, Melissa , McLaren, Suzanne
  • Date: 2006
  • Type: Text , Journal article
  • Relation: Death Studies Vol. 30, no. 3 (2006), p. 243-258
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  • Description: In response to the high rate of suicide among aging people, this study investigated sense of belonging as a predictor of reasons for living in an aged sample. A community sample of 104 Australians aged 61 to 95 years completed The Reasons for Living Inventory and The Sense of Belonging Instrument. Results indicated that a higher sense of belonging predicted more reasons to live overall, and child-related concerns, responsibility to family, and survival and coping beliefs, specifically. Future research should investigate if the enhancement of a sense of belonging among older adults is associated with an increase in reasons for living. Copyright © Taylor & Francis Group, LLC.
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  • Description: 2003002030

Relationship between age, tenure, and disability duration in persons with compensated work-related conditions

- Besen, Elyssa, Young, Amanda, Gaines, Brittany, Pransky, Glenn

  • Authors: Besen, Elyssa , Young, Amanda , Gaines, Brittany , Pransky, Glenn
  • Date: 2016
  • Type: Text , Journal article
  • Relation: Journal of Occupational and Environmental Medicine Vol. 58, no. 2 (2016), p. 140-147
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  • Description: OBJECTIVE:The aim of the study was to examine the relationships among age, tenure, and the length of disability following a work-related injury/illness. METHODS:This study utilized 361,754 administrative workers’ compensation claims. The relationships between age, tenure, and disability duration was estimated with random-effects models. RESULTS:The age-disability duration relationship was stronger than the tenure-disability duration relationship. An interaction was observed between age and tenure. At younger ages, disability duration varied little based on tenure. In midlife, disability duration was greater for workers with lower tenure than for workers with higher tenure. At the oldest ages, disability duration increased as tenure increased. CONCLUSIONS:Findings indicate that age is a more important factor in disability duration than tenure however, the relationship between age and disability duration varies based on tenure, suggesting that both age and tenure are important influences in the work-disability process.
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