School of Population Health Publications - UQ eSpace

A model for predicting the future incidence of coronary heart disease within percentiles of coronary heart disease risk

2007-08-13T00:00:00Z

Background We present a method (The CHD Prevention Model) for modelling the incidence of fatal and nonfatal coronary heart disease (CHD) within various CHD risk percentiles of an adult population. The model provides a relatively simple tool for lifetime risk prediction for subgroups within a population. It allows an estimation of the absolute primary CHD risk in different populations and will help identify subgroups of the adult population where primary CHD prevention is most appropriate and cost-effective. Methods The CHD risk distribution within the Australian population was modelled, based on the prevalence of CHD risk, individual estimates of integrated CHD risk, and current CHD mortality rates. Predicted incidence of first fatal and nonfatal myocardial infarction within CHD risk strata of the Australian population was determined. Results Approximately 25% of CHD deaths were predicted to occur amongst those in the top 10 percentiles of integrated CHD risk, regardless of age group or gender. It was found that while all causes survival did not differ markedly between percentiles of CHD risk before the ages of around 50-60, event-free survival began visibly to differ about 5 years earlier. Conclusions The CHD Prevention Model provides a means of predicting future CHD incidence amongst various strata of integrated CHD risk within an adult population. It has significant application both in individual risk counselling and in the identification of subgroups of the population where drug therapy to reduce CHD risk is most cost-effective. J Cardiovasc Risk 8:31-37 (C) 2001 Lippincott Williams & Wilkins.

A Model for Undertaking Effectiveness and Cost-Effectiveness Analyses of Primary Preventive Strategies in Cardiovascular Disease.

2008-01-02T00:00:00Z

The Cardiovascular Disease Prevention Model is presented, which represents a means of extrapolating the results of clinical trials to a broader, more relevant context. The model is configured as a decision-analysis tree, and underpinned by life-course analysis and Markov processes. Uncertainty and sensitivity analyses are undertaken by Monte Carlo simulation

A model to determine absolute risk for esophageal adenocarcinoma

2013-01-04T14:40:28Z

A Mother's Attitude Towards Her Infant and Child Behaviour Five Years Later

2006-02-17T00:00:00Z

Objective The relationship between maternal attitude to the infant at 6 months of age and behavioural outcomes at 5 years is explored, controlling for numerous demographic, child and psychosocial family factors. Method Data was used from the Mater-University Study of Pregnancy, an Australian longitudinal study of over 7000 mothers and children followed from pregnancy to when the children were 5 years. Measures ranging from the key variables of maternal attitude and child behaviour as well as numerous confounders were dichotomised. Logistic regression analyses were performed to examine the relationship between maternal negative attitude toward the infant and clinically significant levels of child behaviour problems and other infant risks, early social risks, and concurrent social risks. Results The results suggest that maternal negative attitude towards the infant at 6 months is an independent predictor of child behaviour problems at 5 years. This association remained significant for boys' externalizing behaviours and girls' internalizing behaviours. Conclusions The findings lend support to the concept of a sensitive period in early infancy; the need for a broad perspective in the assessment of the mother-infant relationship and the need for early intervention with dysfunctional mother-infant dyads.

Amphetamine availability and admissions for psychosis in New South Wales, 2001-2009

2011-09-06T00:00:00Z

Amphetamine-related harms and treatment preferences of regular amphetamine users in Sydney, Australia

Hando, Julie og Topp, Libby og Hall, Wayne — 2008-08-28T16:41:15Z

Amphetamines remain a popular illicit drug among young adults in Australia and a number of other countries, particularly by injection. A. significant increase in the number of people presenting to drug treatment services with a primary amphetamine problem in Australia and the US has occurred in recent years. A survey of 200 regular amphetamine users was conducted in Sydney to determine the treatment issues and preferences of this population. Substantial harm associated with the use of this drug was found, most notably psychological problems, physical health problems, dependence and financial problems. A perceived need for amphetamine-specific treatment was evident. Popular treatment options requested by users included pharmacotherapies, natural therapies and counselling. While regular amphetamine users can attend existing treatment services, the efficacy of these treatments for amphetamine problems has not been evaluated. There is also a need to develop and evaluate amphetamine-specific interventions in order to attract this population into treatment. (C) 1997 Elsevier Science Ireland Ltd.

Amphetamine use among young adults in Sydney, Australia

Hando, Julie og Hall, Wayne — 2008-08-28T00:00:00Z

A multigene family of inactivated cysteine proteases in Sarcoptes scabiei

2010-03-31T00:00:00Z

A multilevel model of methicillin-resistant Staphylococcus aureus acquisition within the hierarchy of an Australian tertiary hospital

2012-12-09T00:57:35Z

A multilevel study of the determinants of area-level inequalities in colorectal cancer survival

2010-03-28T00:00:00Z

Amunition from the cancer wars: live and spent bullets

Bain, C. J. — 2008-06-10T00:00:00Z

An accessible method for teaching doctors about death certification

2012-04-16T13:05:11Z

The World Health Organization (WHO) recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD-10. However, investment in health information processes necessary to promote the use of this certifi cate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network’s MOVE-IT strategy (Monitoring of Vital Events– Information Technology) (WHO 2011). Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certifi cates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certifi cate is a requirement to produce standardised statistical information and to the ability to produce cause-specifi c mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the effi cacy and accessibility of the certification module of the WHO’s newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre- and post-research design, the study entailed completion of death certifi cates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specifi city of the ICD-10 coding of the reported causes of death were used to measure the effect of the students’ learning from the training tool. The quality of death certificate completion was assessed using a Quality Index before and after the participants accessed the training tool. In addition, the views of the participants about accessibility and use of the training tool were elicited using a supplementary questionnaire. The results of the study demonstrated improvement in the ability of the participants to complete death certifi cates completely and accurately according to best practice. The training tool was viewed very positively and its implementation in the curriculum for medical students was encouraged. Participants also recommended that interactive discussions to examine the certification exercises would be an advantage.

An advance notification letter increases participation in colorectal cancer screening

2010-01-06T00:00:00Z

Anaemia and vitamin A deficiency in poor urban pregnant women of Bangladesh

2007-08-15T00:00:00Z

This cross-sectional study investigated the prevalence of anaemia and vitamin A deficiency (VAD) among pregnant women in a poor urban population of Bangladesh. It also examined the association of various socio-economic and dietary factors with anaemia and vitamin A status. A maternal and child health clinic in Dhaka city, Bangladesh was used to obtain the sample. Three hundred and eighty three pregnant women, aged 20-30 years, of 20-30 weeks gestation were randomly selected from women on their first presentation for antenatal care. Socio-economic, pregnancy related information, usual dietary pattern, and anthropometric data were collected. Blood haemoglobin and serum retinol (vitamin A) concentrations were determined. About 40% of the pregnant women were anaemic (haemoglobin <11.0 g/dl) and 45% had low serum vitamin A levels (<30 mug/dl); with 8.6% having sub-clinical VAD (serum retinol <20 μg/dl). The women with low serum vitamin A levels had 1.8 times greater risk of being anaemic than did the women with normal vitamin A status. Food frequency data revealed that a large proportion of these women did not consume egg (49%), milk (25%), meat (31%), liver (83%), large fish (32%), small fish (39%) and sweet pumpkin (52%) at all; while about 25% of the women reported consuming dark green leafy vegetables (DGLV) and 64% reported an intake of fruit at least four servings a week. The pregnant women who were either illiterate or received only informal education (up to grade ten) had significantly lower haemoglobin and serum vitamin A levels compared to those who completed at least a secondary school certificate. The women whose husbands were illiterate or received only informal education had significantly (P=0.01) lower serum vitamin A levels than those whose husbands had received at least a secondary school certificate. The women who came from families with a per-capita income below the poverty line had significantly lower haemoglobin and serum vitamin A levels compared to those who came from families with a per-capita income above the poverty line. The women who consumed three servings or less of DGLV and fruit per week had significantly lower haemoglobin and serum vitamin A levels than those who consumed four or more servings a week. The women who never consumed large fish had significantly lower haemoglobin compared to those who reported at least one serving a week. Furthermore, the women who never consumed sweet pumpkin had significantly lower serum vitamin A than the women who ate at least one serving a week. By multiple regression analysis, intake of meat, DGLV and fruit, and serum vitamin A levels were found to have a significant independent relationship with haemoglobin. The overall F-ratio (9.9) was highly significant (P=0.000), the adjusted R-square was 0.086 (multiple R=0.309). Multiple regression analysis for serum vitamin A also revealed a significant independent relationship with per capita income, haemoglobin levels, intakes of DGLV and sweet pumpkin. The overall F-ratio (10.2) was highly significant (P=0.000), the adjusted R-square was 0.10 (multiple R=0.312). In conclusion, anaemia and vitamin A deficiency were highly prevalent among poor urban pregnant women in Bangladesh. Various socio-economic and dietary factors may influence the anaemia and vitamin A status of these women. The present study emphasizes the need for a comprehensive intervention strategy, which include both nutritional and environmental factors, to improve the nutritional status of this population.

Anaemia and vitamin A status among adolescent schoolboys in Dhaka City, Bangladesh

2007-08-15T00:00:00Z

Objectives To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status. Design A cross-sectional study. Setting Government high schools in Dhaka City, Bangladesh. Subjects and methods A total of 381 boys, aged 11–16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined. Results Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 μmol l−1, with only 1.5% having subclinical vitamin A deficiency (<0.70 μmol l−1). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P< 0.000) and the adjusted R2 was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P< 0.000) and the adjusted R2 was 0.186. Conclusion The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.

An alternative approach to projecting health expenditure in Australia

2008-10-03T12:57:51Z

An alternative quality adjustor for the quality effects model for meta-analysis

Doi, Suhail A. R. og Thalib, Lukman — 2010-07-07T00:00:00Z

Analyse met behulp van modellen

Barendregt, J. J. — 2008-03-28T00:00:00Z

Analysing low-risk patient populations allows better discrimination between high-performing and low-performing hospitals: a case study using inhospital mortality from acute myocardial infarction

Coory, Michael og Scott, Ian — 2008-03-28T00:00:00Z

Analysing ordered categorical data from two independent samples

Morton, A. P. og Dobson, A. J. — 2008-08-28T00:00:00Z

Analysing seasonal data

2013-01-07T15:04:23Z

Many common diseases, such as the flu and cardiovascular disease, increase markedly in winter and dip in summer. These seasonal patterns have been part of life for millennia and were first noted in ancient Greece by both Hippocrates and Herodotus. Recent interest has focused on climate change, and the concern that seasons will become more extreme with harsher winter and summer weather. We describe a set of R functions designed to model seasonal patterns in disease. We illustrate some simple descriptive and graphical methods, a more complex method that is able to model non-stationary patterns, and the case-crossover to control for seasonal confounding.

Analysing Seasonal Health Data

Barnett, Adrian G. og Dobson, Annette J. — 2011-03-15T00:00:00Z

Seasonal patterns have been found in a remarkable range of health conditions, including birth defects, respiratory infections and cardiovascular disease. Accurately estimating the size and timing of seasonal peaks in disease incidence is an aid to understanding the causes and possibly to developing interventions. With global warming increasing the intensity of seasonal weather patterns around the world, a review of the methods for estimating seasonal effects on health is timely.

Analysis of Barmah forest virus disease activity in Queensland, Australia, 1993-2003: Identification of a large, isolated outbreak of disease

2010-03-31T00:00:00Z

Barmah Forest virus (BFV) disease is the second most common mosquito-borne disease in Australia. Although the majority of notifications are received from Queensland, little is known about the distribution of the disease within the state, or the important mosquito vectors and nonhuman vertebrate hosts. We conducted a retrospective statistical analysis of the notifications received from Queensland residents from 1993 to 2003 to establish long-term local incidence rates and to identify disease outbreaks. In total, 4,544 notifications were received over the 10-yr period. Disease reporting peaked in autumn, although the peak transmission season encompassed both summer and autumn. Long-term standardized incidence rates for summer/autumn and winter/spring varied across the state, showing positive spatial autocorrelation in both 6-mo periods. Although 15 instances of increased disease activity were identified, only one major disease outbreak affecting eight contiguous local government areas was detected in summer/autumn 2002/2003. This outbreak contained 297 cases, 115 more than would be expected over this period. The factors important to this outbreak are unknown and require further investigation. Although the incidence rates for BFV disease are lower than Ross River virus disease, the most reported mosquito-borne disease in Australia, several factors indicate that this virus should be considered an important public health risk in Queensland. These include consistent endemic transmission, apparent underreporting of the disease, and the potential for outbreaks in major population centers.

Analysis of bedside entertainment services' effect on post cardiac surgery physical activity: a prospective, randomised clinical trial

2010-01-07T00:00:00Z

Analysis of Melanoma Onset: Assessing Familial Aggregation by Using Estimating Equations and Fitting Variance Components via Bayesian Random Effects Models

2007-08-15T00:00:00Z

We investigate whether relative contributions of genetic and shared environmental factors are associated with an increased risk in melanoma. Data from the Queensland Familial Melanoma Project comprising 15,907 subjects arising from 1912 families were analyzed to estimate the additive genetic, common and unique environmental contributions to variation in the age at onset of melanoma. Two complementary approaches for analyzing correlated time-to-onset family data were considered: the generalized estimating equations (GEE) method in which one can estimate relationship-specific dependence simultaneously with regression coefficients that describe the average population response to changing covariates; and a subject-specific Bayesian mixed model in which heterogeneity in regression parameters is explicitly modeled and the different components of variation may be estimated directly. The proportional hazards and Weibull models were utilized, as both produce natural frameworks for estimating relative risks while adjusting for simultaneous effects of other covariates. A simple Markov Chain Monte Carlo method for covariate imputation of missing data was used and the actual implementation of the Bayesian model was based on Gibbs sampling using the free ware package BUGS. In addition, we also used a Bayesian model to investigate the relative contribution of genetic and environmental effects on the expression of naevi and freckles, which are known risk factors for melanoma.

Analysis of socio-political and health practices influencing sex ratio at birth in Viet Nam

2009-03-16T00:00:00Z

Viet Nam has experienced rapid social change over the last decade, with a remarkable decline in fertility to just below replacement level. The combination of fertility decline, son preference, antenatal sex determination using ultrasound and sex selective abortion are key factors driving increased sex ratios at birth in favour of boys in some Asian countries. Whether or not this is taking place in Viet Nam as well is the subject of heightened debate. In this paper, we analyse the nature and determinants of sex ratio at birth in Viet Nam, including a small family size norm, recent reinforcement by the Government of the “one-to-two child” family policy, traditional son preference, easy access to antenatal ultrasound screening and legal abortion, and an increase in the proportion of one-child families. In order to prevent an increased sex ratio at birth in Viet Nam, we argue for the relaxation of the one-to-two child family policy and a return to the policy of “small family size” as determined by families, in tandem with a comprehensive approach to promoting the value of women and girls in society, countering traditional gender roles, and raising public awareness of the negative social consequences of a high sex ratio at birth.

Analysis of the causes and effects of delay before diagnosis using surgical mortality data

2013-01-16T13:28:20Z

An analysis of needs for services for alcohol-related problems in Indigenous communities in Far North Queensland

Hunter, E.M. og Brady, M. og Hall, W. D. — 2008-08-28T00:00:00Z

An assessment of interactions between global health initiatives and country health systems

2010-12-07T00:00:00Z

Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.

An assessment of the costs and benefits of interventions aimed at improving rural community water supplies in developed countries

2012-01-24T00:00:00Z

An assessment of the feasibility of a poultry tracing scheme for smallholders in Vietnam

2012-03-20T00:00:00Z

Tracing movements could assist the implementation of bio-containment measures during a disease outbreak. To evaluate the potential for implementing a tracing system for a poultry supply chain in northern Vietnam, a four-month longitudinal study was conducted to identify marketing practices associated with poultry traceability. Poultry sold in batches were traced between farms and markets, and their traceability was assessed upon market arrival. A total of 315 batches were released from the farms; 37% arrived at a market, from which 57.3% were ‘traceable’. The results of the multivariable analysis showed that traceability was associated with farms operating through no more than two traders (Odds ratio [OR] = 5.97, 95% CI 1.15–30.92) and batches brought to the market on the day of purchase (OR = 4.05, 95% CI 1.23–13.27). No specific incentives were provided to farmers or traders. Results suggest that there is potential for implementing a poultry traceability scheme, although the tracing methodology should be refined.

An assessment of the link between water quality and the occurrence of diarrhoea in households in a marginalised urban community

Nala, N. P. og Jagals, P. — 2012-01-24T00:00:00Z

An assessment of the ongoing research support needs of Queensland PHCRED research fellows

2010-03-01T00:00:00Z

Limited time and opportunity exists for primary health care (PHC) workers to undertake research. We wished to conduct a needs analysis of PHCRED research fellows in Queensland to discover whether PHCRED fellowships provide appropriate introductory opportunities for PHC researchers to acquire research skills. A secondary aim was to examine the effectiveness of fellowships in terms of meeting the Research Capacity Building Initiative (RCBI). We developed a series of questions pertinent to research training of PHCRED fellows. After obtaining ethical approval, the questionnaire was administered by telephone interview to all previous PHCRED Queensland research fellows. Quantitative and qualitative data analyses were conducted and feedback was given to all respondents. Thirty-six fellows were interviewed from February to April 2007. We conducted a needs analysis of PHCRED research fellows in Queensland.PHCRED fellowships may be effective in terms of meeting the Research Capacity Building Initiative (RCBI).

A national case-control study of Ewing's sarcoma family of tumours in Australia

2007-08-15T00:00:00Z

Limited population-based epidemiologic information is available on Ewing's sarcoma family of tumours (ESFT), a rare group of neoplasms. Several associations have been noted on a few studies but results were not consistent, except for exposure to farming among cases and their parents. Here we present the non-farm findings of a nationwide case-control study of ESFT in children and young adults in Australia. The analysis included 106 persons with confirmed ESFT and 344 population-based controls selected randomly via telephone. Information was collected by interview (84% face to face). We found a strong and significant association of ESFT with hernias, in particular hernia repaired in hospital (OR = 5.6, 95% Cl 1.3-6.4). Among other factors, there was a near doubling of risk for males, and male cases had their pubertal signs earlier (started shaving earlier) than male controls. There was also an increased risk of ESFT at higher levels of self-assessed exercise, but no other factor really stood out. For pregnancy-related factors, there was a tripling of risk for glandular fever, a doubling of risk for urinary tract infection and a near doubling of risk for X-rays during or just before pregnancy, but these estimates were not significant. In addition, there was a large number of inverse associations with medical conditions (specifically bone disorders), case exposure to medications, vaccinations and X-rays, with ultrasound during the pregnancy having the most certain effects. We conclude that, although the aetiology of ESFT remains obscure, overall there is strong evidence of an association with inguinal hernia; this can now be added to the farm-associated risk reported by others and us. The other associations reported here await replication and refinement in future studies. (C) 2003 Wiley-Liss, Inc.

A national food and nutrition monitoring and surveillance system: a framework and a business case: final report

2009-03-09T00:00:00Z

An adequate and varied diet is important for normal growth and development, maintenance of good health and the prevention of chronic disease; as is the need for up-to-date, reliable and timely data to provide a basis for informed decision making and regulation by government. Despite this, and clear evidence for the contribution of nutrition to the considerable burden of preventable ill health, Australia’s policy makers do not have adequate information to develop cost-effective food and nutrition policy and regulation. The need for a national food and nutrition monitoring and surveillance system has long been recognised and it has been identified as a priority in several public health nutrition, obesity, physical activity and chronic disease-related policy documents. This report provides a framework and cost estimates for establishing a national food and nutrition monitoring surveillance system (FNMS). The development of the framework follows extensive consultation with a diverse range of stakeholders: Australian, State and Territory Governments, non-government organisations, professional associations and industry bodies. The framework was also informed by a review of selected international approaches to food and nutrition monitoring. Overwhelming support for an ongoing, sustainable FNMS emerged from these consultations. Government agencies, policy makers, regulators and industry representatives state that they do not have adequate information on the following: • the nutritional adequacy of the food supply; • equity of food access; • effects on health of changes in the composition of foods in the food supply; • use of nutritional supplements and their effect on nutrient intake, nutritional status and health; final report: national food and nutrition monitoring and surveillance system April 2006 5 www.nexusmc.com.au • differences in nutritional status between different population sub-groups; • alignment of food and nutrient intakes in the population with dietary targets and guidelines and nutrient reference values developed for Australia and New Zealand; • trends in eating patterns and their effect on food industry growth and innovation; • implications of technological and regulatory changes on the composition of the food supply; and • risks associated with exposure to bioactive compounds in foods at current levels of consumption. The consultation process also identified a range of significant costs and risks associated with not having an ongoing system, including: • reduced ability to appropriately develop, target and monitor the outcomes of public health nutrition interventions; • late detection of new, or accelerating, nutrition problems in the community, and the lack of trend information about the possible causes; • increasing reliance on outdated data to undertake effective risk assessment for food additives, fortification with vitamins and minerals, chemical residues etc; and • an inability to monitor the objectives of public health nutrition policies and programs. For the majority of stakeholders the costs and risks of not having a system far outweighed the costs of establishing an ongoing monitoring system. THE FRAMEWORK The framework presented in this report provides a basis for providing the information identified by stakeholders as necessary for making informed decisions about food and nutrition policy in Australia.

A national survey of training and smoking cessation services provided in community pharmacies in Thailand

2010-10-31T00:00:00Z

A nationwide web-based automated system for outbreak early detection and rapid response in China

2012-03-06T00:00:00Z

Anatomic site, sun exposure, and risk of cutaneous melanoma

2011-10-25T00:00:00Z

An attempt to identify the likely sources of Escherichia coli harboring toxin genes in rainwater tanks

Ahmed, W. og Sidhu, J. P. S. og Toze, S. — 2012-05-28T23:27:32Z

An audit of suicides completed by people with a history of psychiatric service use, Victoria, 1989-1994

2008-08-28T00:00:00Z

An Australian Longitudinal Study on Factors Leading to Childhood Agression and Subsequent Delinquency

2008-08-28T00:00:00Z

An Australian twin study of the genetic basis of preeclampsia and eclampsia

2007-08-14T00:00:00Z

OBJECTIVE: We investigated maternal versus fetal genetic causes of preeclampsia and eclampsia by assessing concordance between monozygotic and dizygotic female co-twins, between female partners of male monozygotic and dizygotic twin pairs, and between female twins and partners of their male co-twins in dizygotic opposite-sex pairs. STUDY DESIGN: Two large birth cohorts of volunteer Australian female twin pairs (N = 1504 pairs and N = 858 pairs) were screened and interviewed, and available medical and hospital records were obtained and reviewed where indicated, with diagnoses assigned according to predetermined criteria. RESULTS: With strict diagnostic criteria used for preeclampsia and eclampsia, no concordant female twin pairs were found. Collapsing diagnoses of definite, probable, or possible preeclampsia or eclampsia resulted in very low genetic recurrence risk estimates. CONCLUSION: Results from these two cohorts of female twin pairs do not support clear, solely maternal genetic influences on preeclampsia and eclampsia. Numbers of parous female partners of male twins were too low for conclusions to be drawn regarding paternal transmission.

An Australian version of the neighborhood environment walkability scale: Validity evidence

2009-03-28T13:57:56Z

This study examined validity evidence for the Australian version of the Neighborhood Environment Walkability Scale (NEWS-AU). A stratified two-stage cluster sampling design was used to recruit 2,650 adults from Adelaide (Australia). The sample was drawn from residential addresses within eight high-walkable and eight low-walkable suburbs matched for socio-economic status (SES). Neighborhood walkability was measured using Geographic Information Systems data on dwelling density, intersection density, net retail area, and land-use mix. Participants completed the NEWS-AU and reported weekly minutes of walking for transport and recreation (International Physical Activity Questionnaire [IPAQ]). Multilevel confirmatory factor analysis (MCFA) was used to define the individual- and Census Collection District (CCD)-level measurement model of the NEWS-AU. Seven individual-level and five CCD-level factors were identified. These measurement models were somewhat similar to those of the original Neighborhood Environment Walkability Scale (NEWS). Patterns of associations between the NEWS-AU factors/scales and the walking measures provided some validity evidence for the instrument.

Ancylostoma caninum MTP-1, an astacin-like metalloprotease secreted by infective hookworm larvae, is involved in tissue migration

2011-10-27T00:00:00Z

An ecological approach to public health intervention: Ross River virus in Australia

Weinstein, P. — 2008-08-28T00:00:00Z

An econometric approach to estimating support prices and measures of productivity change in public hospitals

O'Donnell, C. J. og Nguyen, K. — 2013-01-11T15:35:35Z

In industry sectors where market prices for goods and services are unavailable, it is common to use estimated output and input distance functions to estimate rates of productivity change. It is also possible, but less common, to use estimated distance functions to estimate the normalised support (or efficient) prices of individual inputs and outputs. A problem that arises in the econometric estimation of these functions is that more than one variable in the estimating equation may be endogenous. In such cases, maximum likelihood estimation can lead to biased and inconsistent parameter estimates. To solve the problem, we use linear programming to construct a quantity index. The distance function is then written in the form of a conventional stochastic frontier model where the explanatory variables are unambiguously exogenous. We use this approach to estimate productivity indexes, measures of environmental change, levels of efficiency, and support prices for a sample of Australian public hospitals.

An Ecosystems Approach

Parkes, Margot og Weinstein, Philip — 2008-08-28T00:00:00Z

A Needs Survey of Immunisation for Aboriginal and Torres Strait Islander People in Queensland

2007-12-20T00:00:00Z

An endogenous circadian rhythm in sleep inertia results in greatest cognitive impairment upon awakening during the biological night

2009-03-20T00:00:00Z

Sleep inertia is the impaired cognitive performance immediately upon awakening, which decays over tens of minutes. This phenomenon has relevance to people who need to make important decisions soon after awakening, such as on-call emergency workers. Such awakenings can occur at varied times of day or night, so the objective of the study was to determine whether or not the magnitude of sleep inertia varies according to the phase of the endogenous circadian cycle. Twelve adults (mean, 24 years; 7 men) with no medical disorders other than mild asthma were studied. Following 2 baseline days and nights, subjects underwent a forced desynchrony protocol composed of seven 28-h sleep/wake cycles, while maintaining a sleep/wakefulness ratio of 1:2 throughout. Subjects were awakened by a standardized auditory stimulus 3 times each sleep period for sleep inertia assessments. The magnitude of sleep inertia was quantified as the change in cognitive performance (number of correct additions in a 2-min serial addition test) across the first 20 min of wakefulness. Circadian phase was estimated from core body temperature (fitted temperature minimum assigned 0°). Data were segregated according to: (1) circadian phase (60° bins); (2) sleep stage; and (3) 3rd of the night after which awakenings occurred (i.e., tertiary 1, 2, or 3). To control for any effect of sleep stage, the circadian rhythm of sleep inertia was initially assessed following awakenings from Stage 2 (62% of awakening occurred from this stage; n = 110). This revealed a significant circadian rhythm in the sleep inertia of cognitive performance (p = 0.007), which was 3.6 times larger during the biological night (circadian bin 300°, ~2300–0300 h in these subjects) than during the biological day (bin 180°, ~1500–1900 h). The circadian rhythm in sleep inertia was still present when awakenings from all sleep stages were included (p = 0.004), and this rhythm could not be explained by changes in underlying sleep drive prior to awakening (changes in sleep efficiency across circadian phase or across the tertiaries), or by the proportion of the varied sleep stages prior to awakenings. This robust endogenous circadian rhythm in sleep inertia may have important implications for people who need to be alert soon after awakening.

An ethical framework for drug epidemiology: identifying the issues

Fry, C. og Hall, W. D. — 2008-08-28T00:00:00Z

The Global Workshop on Drug Information Systems: Activities, Methods and Future Opportunities, held in Vienna from 3 to 5 December 2001, highlighted the need for an ethical framework for drug epidemiology. The present article suggests some first steps that could be taken towards developing such a framework by identifying some of the key issues for consideration. The scope of drug epidemiology is defined and attention is drawn to the current dearth of scholarship and lack of specific guidelines on the ethical issues raised by such research. The importance of ethics in drug epidemiology is explained and it is argued that a guiding framework would be helpful in promoting an understanding of some of the prominent ethical challenges in this field (for example, obtaining free and informed consent to participation, the use of inducements to recruit subjects, the protection of interviewees from violations of privacy and the risk of prosecution, and the safety of field research staff). The traditional principles of biomedical ethics are outlined and their limitations in enabling an understanding of ethical issues in drug epidemiology are considered. The utility of practical case-based approaches to ethical analysis is also discussed. The article concludes with broad recommendations for an ethical framework for drug epidemiology that can be refined in further discussion on those important issues.