Journal articles on the topic 'Diabetes Risk factors Australia'
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Nisar, Mehwish, Tracy L. Kolbe-Alexander, Nicola W. Burton, and Asaduzzaman Khan. "A Longitudinal Assessment of Risk Factors and Chronic Diseases among Immigrant and Non-Immigrant Adults in Australia." International Journal of Environmental Research and Public Health 18, no. 16 (August 15, 2021): 8621. http://dx.doi.org/10.3390/ijerph18168621.
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This study aimed to investigate the prevalence and trajectories of chronic diseases and risk behaviors in immigrants from high-income countries (HIC), low–middle-income countries (LMIC), to Australian-born people. Data were used from five waves of the HABITAT (2007–2016) study—11,035 adults living in Brisbane, Australia. Chronic diseases included cancer, diabetes mellitus, coronary heart disease, and chronic obstructive pulmonary disease (COPD). Risk factors assessed were body mass index (BMI), insufficient physical activity, and cigarette smoking. Diabetes mellitus increased in all groups, with the highest increase of 33% in LMIC immigrants. The prevalence of cancers increased 19.6% in the Australian-born, 16.6% in HIC immigrants, and 5.1% in LMIC immigrants. The prevalence of asthma increased in HIC immigrants while decreased in the other two groups. Poisson regression showed that LMIC immigrants had 1.12 times higher rates of insufficient physical activity, 0.75 times lower rates of smoking, and 0.77 times lower rates of being overweight than the Australian-born population. HIC immigrants had 0.96 times lower rates of insufficient physical activity and 0.93 times lower rates of overweight than Australian-born. The findings of this study can inform better strategies to reduce health disparities by targeting high-risk cohorts.
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Coorey, N. J., L. Kensitt, J. Davies, E. Keller, M. Sheel, K. Chani, S. Barry, et al. "Risk factors for TB in Australia and their association with delayed treatment completion." International Journal of Tuberculosis and Lung Disease 26, no. 5 (May 1, 2022): 399–405. http://dx.doi.org/10.5588/ijtld.21.0111.
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BACKGROUND: Australia has a low incidence of TB and has committed to eliminating the disease. Identification of risk factors associated with TB is critical to achieving this goal.METHODS: We undertook a prospective cohort study involving persons receiving TB treatment in four Australian jurisdictions. Risk factors and their association with delayed treatment completion (treatment delayed by at least 1 month) were analysed using univariate analyses and multivariate logistic regression.RESULTS: Baseline surveys were completed for 402 persons with TB. Most (86.1%) were born overseas. Exposure to a person with TB was reported by 19.4%. Diabetes mellitus (10.2%), homelessness (9.2%), cigarette smoking (8.7%), excess alcohol consumption (6.0%) and mental illness (6.2%) were other common risk factors. At follow-up, 24.8% of patients had delayed treatment completion, which was associated with adverse events (34.1%, aOR 6.67, 95% CI 3.36–13.27), excess alcohol consumption (6.0%, aOR 21.94, 95% CI 6.03–79.85) and HIV co-infection (2.7%, aOR 8.10, 95% CI 1.16–56.60).CONCLUSIONS: We identified risk factors for TB and their association with delayed treatment completion, not all of which are routinely collected for surveillance purposes. Recognition of these risk factors should facilitate patient-centred care and assist Australia in reaching TB elimination.
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Simmons, David, Lisa Bourke, Edward Yau, and Mary Hoodless. "Diabetes risk factors, diabetes and diabetes care in a rural Australian community." Australian Journal of Rural Health 15, no. 5 (October 2007): 296–303. http://dx.doi.org/10.1111/j.1440-1584.2007.00903.x.
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Lucero, Adam A., Danielle M. Lambrick, James A. Faulkner, Simon Fryer, Michael A. Tarrant, Melanie Poudevigne, Michelle A. Williams, and Lee Stoner. "Modifiable Cardiovascular Disease Risk Factors among Indigenous Populations." Advances in Preventive Medicine 2014 (2014): 1–13. http://dx.doi.org/10.1155/2014/547018.
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Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (Māori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD).Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized.Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for Māori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour.Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors.
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Hilliard, Marisa E., Virginia Hagger, Christel Hendrieckx, Barbara J. Anderson, Steven Trawley, Michelle M. Jack, Frans Pouwer, Timothy Skinner, and Jane Speight. "Strengths, Risk Factors, and Resilient Outcomes in Adolescents With Type 1 Diabetes: Results From Diabetes MILES Youth–Australia." Diabetes Care 40, no. 7 (April 26, 2017): 849–55. http://dx.doi.org/10.2337/dc16-2688.
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Gupta, Sabrina, Rosalie Aroni, Siobhan Lockwood, Indra Jayasuriya, and Helena Teede. "South Asians and Anglo Australians with heart disease in Australia." Australian Health Review 39, no. 5 (2015): 568. http://dx.doi.org/10.1071/ah14254.
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Objectives The aim of the present study was to determine cardiovascular disease (CVD) risk factors and compare presentation and severity of ischaemic heart disease (IHD) among South Asians (SAs) and Anglo Australians (AAs). Methods A retrospective clinical case audit was conducted at a public tertiary hospital. The study population included SA and AA patients hospitalised for IHD. Baseline characteristics, evidence of diabetes and other CVD risk factors were recorded. Angiography data were also included to determine severity, and these were assessed using a modified Gensini score. Results SAs had lower mean (± s.d.) age of IHD presentation that AAs (52 ± 9 vs 55 ± 9 years, respectively; P = 0.02), as well as a lower average body mass index (BMI; 26 ± 4 vs 29 ± 6 kg/m2, respectively; P = 0.005), but a higher prevalence of type 2 diabetes (57% vs 31%, respectively; P = 0.001). No significant differences were found in coronary angiography parameters. There were no significant differences in the median (interquartile range) Gensini score between SAs and AAs (43.5 (27–75) vs 44 (26.5–68.5), respectively), median vessel score (1 (1–2) vs 2 (1–3), respectively) or multivessel score (37% (33/89) vs 54% (22/41), respectively). Conclusions The findings show that in those with established IHD, cardiovascular risk factors, such as age at onset and BMI, differ between SAs and AAs and these differences should be considered in the prevention and management of IHD. What is known about the topic? There is much evidence on CVD and SAs, it being a leading cause of mortality and morbidity for this population both in their home countries and in countries they have migrated to. Studies conducted in Western nations other than Australia have suggested a difference in the risk profiles and presentations of CVD among SA migrants compared with the host populations in developed countries. Although this pattern of cardiovascular risk factors among SAs has been well documented, there is insufficient knowledge about this population, currently the largest population of incoming migrants, and CVD in the Australian setting. What does this paper add? This paper confirms that a similar pattern of CVD exists in Australia among SAs as does in other Western nations they have migrated to. The CVD pattern found in this population is that of an earlier age of onset at lower BMI compared with the host AA population, as well as a differing cardiovascular risk profile, with higher rates of type 2 diabetes and lower smoking rates. In addition, this study finds similar angiographic results for both the SAs and AAs; however, the SAs exhibit these similar angiographic patterns at younger ages. What are the implications for practitioners? SAs in Australia represent a high cardiovascular risk group and should be targeted for more aggressive screening at younger ages. Appropriate preventative strategies should also be considered bearing in mind the differing risk factors for this population, namely low BMI and high rates of type 2 diabetes. More intensive treatment strategies should also be regarded by practitioners. Importantly, both policy makers and health professionals must consider that all these strategies should be culturally targeted and tailored to this population and not assume a ‘one-size fits all’ approach.
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Cheung, N. W. "058. GESTATIONAL DIABETES AND TYPE 2 DIABETES IN PREGNANCY IN AUSTRALIA." Reproduction, Fertility and Development 22, no. 9 (2010): 18. http://dx.doi.org/10.1071/srb10abs058.
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In the last 30 years, there has been a dramatic increase in the incidence of gestational diabetes (GDM) in Australia. GDM has become a significant population health issue and Australia has been at the forefront of international research into its significance and management. More recently, the tsunami of GDM has been followed by a growing wave of type 2 diabetes in pregnancy. Type 2 diabetes is becoming more prevalent than type 1 diabetes in pregnancy, and adverse pregnancy outcomes are more common. However, diabetes itself is but one factor influencing outcomes in this group of women, with obesity, cultural issues and socioeconomic disadvantage being other significant issues. The research of our group has focused on examining traditional and non-traditional risk factors for GDM, and for the progression from GDM to type 2 diabetes in Australia. Our research has also been directed towards breaking the nexus between GDM and type 2 diabetes. The identification of women with GDM is an opportunity to institute interventions to prevent both GDM and type 2 diabetes. Unfortunately there are numerous barriers to improving lifestyle and reducing diabetes risk in this population. The National Diabetes Services Scheme has provided the opportunity to start translating some of our research into health promotion activities. The NDSS has greatly aided the management of diabetes and GDM by providing subsidised diabetes related products. It has also been established to provide information and services to people with diabetes. As part of this charter, the NDSS has recently started health promotion activities in the area of diabetes in pregnancy. It will underpin a national recall and screening program for diabetes after GDM, and forms the basis for other public health initiatives such as providing information to women with diabetes in pregnancy, facilitating the prevention of diabetes after GDM.
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Rehan, Farah, Alina Qadeer, Irfan Bashir, and Mohammed Jamshaid. "Risk Factors of Cardiovascular Disease in Developing Countries." International Current Pharmaceutical Journal 5, no. 8 (July 25, 2016): 69–72. http://dx.doi.org/10.3329/icpj.v5i8.28875.
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Cardiovascular diseases (CVDs) have increased the mortality rate both in developing as well as developed countries, however a lower trend in death rates have been seen in developed and high income countries like USA, UK, Australia, Japan and other European countries due to improved life style, better strategic implementation, control of disease both in young and adults and especially reduced smoking habits. In developing countries CVD become an alarming situation due to prevalence of disease in early age that later on become chronic and difficult to control. Various risk factors that can contribute toward CVD in developing countries include smoking, high alcohol and salt intake, dietary factors, diabetes, high blood pressure and psychosocial aspects such as stress, anxiety and depression. Various other factors such as family history and the gender difference also contributing towards the high risk of developing CVD.Rehan et al., International Current Pharmaceutical Journal, July 2016, 5(8): 69-72http://www.icpjonline.com/documents/Vol5Issue8/02.pdf
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O'Callaghan, Cathy, Uday Yadav, Sudha Natarajan, Saroja Srinivasan, and Ritin Fernandez. "Prevalence and predictors of multimorbidity among immigrant Asian Indian women residing in Sydney Australia: A cross-sectional study." F1000Research 10 (July 22, 2021): 634. http://dx.doi.org/10.12688/f1000research.52052.1.
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Abstract Background: There has been a rise in multimorbidity as people age and technology advances which is challenging for health systems. Multimorbidity prevalence varies globally due to various biological and social risk factors which can be accentuated or mitigated for populations in migration. This study investigated the prevalence and predictors of multimorbidity amongst a group of migrant Asian Indian women living in Australia. Methods: A cross-sectional descriptive study design using convenience sampling investigated the multimorbidity risk factors among first generation migrant Asian Indian women in Australia. This study was part of a larger study titled “Measuring Acculturation and Psychological Health of Senior Indian Women Living in Australia” that was conducted in Sydney, Australia. Data were collected using validated instruments as well as investigator developed questions. Women completed questionnaire surveys either by themselves or through the assistance of bilingual coordinators as English was not their first language. Results: 26% of the participants had one chronic condition and 74% had multimorbidities. The prevalence of individual conditions included cardiovascular disease 67.0%, osteoarthritis 57.6%, depression 37.4%, diabetes 31.5%, chronic respiratory conditions 10.8%, cancer 4.9% and nephrological problems 1.47%. In the unadjusted model, factors such as increasing age, education level, employment status, living arrangements, low physical activity, and elements of acculturative stress were significantly associated with multimorbidity. Multi-variable analysis identified the acculturative stress factor of threat to ethnic identity as a predictor of multimorbidity. Conclusion: Identifying the key determinants of multimorbidity in older adults from a migrant community with pre-existing risk factors can assist with the development of culturally appropriate strategies to identify people at risk of health conditions and to mitigate the health effects of acculturative stress.
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Estevez, Jose J., Natasha J. Howard, Jamie E. Craig, and Alex Brown. "Working Towards Eye Health Equity for Indigenous Australians with Diabetes." International Journal of Environmental Research and Public Health 16, no. 24 (December 12, 2019): 5060. http://dx.doi.org/10.3390/ijerph16245060.
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Type 2 diabetes mellitus (T2DM) poses significant challenges to individuals and broader society, much of which is borne by disadvantaged and marginalised population groups including Indigenous people. The increasing prevalence of T2DM among Indigenous people has meant that rates of diabetes-related complications such as blindness from end-stage diabetic retinopathy (DR) continue to be important health concerns. Australia, a high-income and resource-rich country, continues to struggle to adequately respond to the health needs of its Indigenous people living with T2DM. Trends among Indigenous Australians highlight that the prevalence of DR has almost doubled over two decades, and the prevalence of diabetes-related vision impairment is consistently reported to be higher among Indigenous Australians (5.2%–26.5%) compared to non-Indigenous Australians (1.7%). While Australia has collated reliable estimates of the eye health burden owing to T2DM in its Indigenous population, there is fragmentation of existing data and limited knowledge on the underlying risk factors. Taking a systems approach that investigates the social, environmental, clinical, biological and genetic risk factors, and—importantly—integrates these data, may give valuable insights into the most important determinants contributing to the development of diabetes-related blindness. This knowledge is a crucial initial step to reducing the human and societal impacts of blindness on Indigenous Australians, other priority populations and society at large.
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Wall, C. J., R. N. de Steiger, J. S. Mulford, P. L. Lewis, and D. G. Campbell. "PERCEPTION OF PERIOPERATIVE RISK FOR ARTHROPLASTY PATIENTS: A POLL OF AUSTRALIAN ORTHOPAEDIC SURGEONS." Orthopaedic Proceedings 105-B, SUPP_2 (February 2023): 48. http://dx.doi.org/10.1302/1358-992x.2023.2.048.
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There is growing interest in the peri-operative management of patients with indications for hip and knee arthroplasty in the setting of modifiable risk factors such as morbid obesity, type 2 diabetes mellitus, and smoking. A recent survey of the American Association of Hip and Knee Surgeons (AAHKS) found that 95% of respondents address modifiable risk factors prior to surgery. The aim of this study was to poll Australian arthroplasty surgeons regarding their approach to patients with modifiable risk factors.The survey tool used in the AAHKS study was adapted for use in the Australian context and distributed to the membership of the Arthroplasty Society of Australia via Survey Monkey.Seventy-seven survey responses were received, representing a response rate of 64%. The majority of respondents were experienced, high volume arthroplasty surgeons. Overall, 91% of respondents restricted access to arthroplasty for patients with modifiable risk factors. Seventy-two percent of surgeons restricted access for excessive body mass index, 85% for poor diabetic control, and 46% for smoking. Most respondents made decisions based on personal experience or literature review rather than hospital or departmental pressures.Despite differences in healthcare systems, our findings were similar to those of the AAHKS survey, although their responses were more restrictive in all domains. Differences were noted in responses concerning financial considerations for potentially underprivileged populations. The survey is currently being administered by arthroplasty societies in six other countries, allowing comparison of orthopaedic practice across different healthcare systems around the world.In conclusion, over 90% of Australian arthroplasty surgeons who responded to the survey address modifiable risk factors prior to surgery.
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Sajeev, Shelda, Stephanie Champion, Alline Beleigoli, Derek Chew, Richard L. Reed, Dianna J. Magliano, Jonathan E. Shaw, et al. "Predicting Australian Adults at High Risk of Cardiovascular Disease Mortality Using Standard Risk Factors and Machine Learning." International Journal of Environmental Research and Public Health 18, no. 6 (March 19, 2021): 3187. http://dx.doi.org/10.3390/ijerph18063187.
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Effective cardiovascular disease (CVD) prevention relies on timely identification and intervention for individuals at risk. Conventional formula-based techniques have been demonstrated to over- or under-predict the risk of CVD in the Australian population. This study assessed the ability of machine learning models to predict CVD mortality risk in the Australian population and compare performance with the well-established Framingham model. Data is drawn from three Australian cohort studies: the North West Adelaide Health Study (NWAHS), the Australian Diabetes, Obesity, and Lifestyle study, and the Melbourne Collaborative Cohort Study (MCCS). Four machine learning models for predicting 15-year CVD mortality risk were developed and compared to the 2008 Framingham model. Machine learning models performed significantly better compared to the Framingham model when applied to the three Australian cohorts. Machine learning based models improved prediction by 2.7% to 5.2% across three Australian cohorts. In an aggregated cohort, machine learning models improved prediction by up to 5.1% (area-under-curve (AUC) 0.852, 95% CI 0.837–0.867). Net reclassification improvement (NRI) was up to 26% with machine learning models. Machine learning based models also showed improved performance when stratified by sex and diabetes status. Results suggest a potential for improving CVD risk prediction in the Australian population using machine learning models.
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A. B. Attanayake, H. M. Dumidu, Adrian Barnett, Nicola W. Burton, Wendy J. Brown, and Susanna M. Cramb. "Diabetes and physical activity: A prospective cohort study." PLOS ONE 17, no. 10 (October 26, 2022): e0276761. http://dx.doi.org/10.1371/journal.pone.0276761.
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Diabetes is on the rise as the worldwide population ages. While physical activity can help protect against diabetes, ageing is commonly associated with reduced physical activity. This study aimed to examine if physical activity differs by diabetes status in mid-aged adults, how this association changes over time, and whether physical activity-related sociodemographic factors and health indicators differ in those with and without diabetes. Data came from four waves of the How Areas in Brisbane Influence HealTh and AcTivity (HABITAT), a longitudinal study of mid-age adults living in Brisbane, Australia. Random effects/Expectation-maximisation (RE-EM) regression trees were used to identify factors affecting physical activity among those with and without diabetes, both separately and combined. At study entry, those with diabetes had a higher median age of 58 years (95% CI: 57–60) and a lower median physical activity of 699 MET.min/week (95% CI: 599–799) than people without diabetes (53 years (95% CI: 53–53) and 849 MET.min/week (95% CI: 799–899)). However, the strongest factors influencing physical activity were BMI and gender, not diabetes status. It is vital to promote physical activity among adults, in particular among those with high BMI and women, as well as those with and at high risk of diseases like diabetes.
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Haynes, A., C. Bower, M. K. Bulsara, J. Finn, T. W. Jones, and E. A. Davis. "Perinatal risk factors for childhood Type 1 diabetes in Western Australia-a population-based study (1980-2002)." Diabetic Medicine 24, no. 5 (May 2007): 564–70. http://dx.doi.org/10.1111/j.1464-5491.2007.02149.x.
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Annear, Michael, Peter Lucas, Tim Wilkinson, and Yasuo Shimizu. "Prescribing physical activity as a preventive measure for middle-aged Australians with dementia risk factors." Australian Journal of Primary Health 25, no. 2 (2019): 108. http://dx.doi.org/10.1071/py18171.
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Dementia is increasing in Australia in line with population ageing and is expected to peak by mid-century. The development of common forms of dementia, including Alzheimer’s disease, is associated with lifestyle-related risk factors that are prevalent among middle-aged Australians, including obesity, hypertension, high cholesterol, diabetes and depression. These risk factors can be significantly ameliorated through regular participation in moderate aerobic physical activity (PA). Current national and international guidelines recommend at least 150 min of aerobic PA per week for achieving health protective effects. Lifestyle intervention is a critical area for action as there are currently no medical or pharmaceutical interventions that can halt the progression of common dementias. Physician–patient discussions concerning risk reduction via habitual aerobic PA offers a complementary intervention as part of broader dementia management. Evidence suggests that to achieve the highest rates of adherence to PA, physician advice in primary care should be supported by wider policies, institutions and community services that offer a meaningful referral pathway and patient follow up after initial assessment. International Green Prescription programs provide examples of physician-led interventions in primary care that could inform further action in Australia.
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Yoon, Samuel, Linda M. Fleeman, Bethany J. Wilson, Caroline S. Mansfield, and Paul McGreevy. "Epidemiological study of dogs with diabetes mellitus attending primary care veterinary clinics in Australia." Veterinary Record 187, no. 3 (February 12, 2020): e22-e22. http://dx.doi.org/10.1136/vr.105467.
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BackgroundThe objectives of this study were to establish the prevalence, risk factors and comorbidities/sequelae for diabetes mellitus (DM) in Australian dogs presented to first-opinion veterinary practices.MethodsElectronic patient records of dogs (n=134,329) attending 152 veterinary clinics during 2017 were sourced through VetCompass Australia. They included 418 dogs with DM; a prevalence of 0.36 per cent (95 per cent CI 0.33 per cent to 0.39 per cent) in Australian dogs attending these veterinary clinics. By comparing with the reference group of rarer breeds and unidentified crossbreeds, multivariable modelling was used to reveal breeds (and their crosses) with significantly higher odds of having DM.ResultsThe results revealed that breeds (and their crosses) with significantly higher odds of having DM were Australian terriers (ORs=7.93 (95 per cent CI 2.83 to 22.27)), Siberian huskies (OR=6.24 (95 per cent CI 2.51 to 15.54)), English springer spaniels (OR=5.37 (95 per cent CI 1.48 to 19.53)), West Highland white terriers (OR=4.85 (95 per cent CI 2.55 to 9.25)), miniature schnauzers (OR=3.47 (95 per cent CI 1.16 to 10.35)), all types of poodles (OR=3.41 (95 per cent CI 2.07 to 5.61)), bichon frises (OR=3.41 (95 per cent CI 1.65 to 7.01)), schnauzers (OR=3.18 (95 per cent CI 1.42 to 7.11)) and cavalier King Charles spaniels (CKCS; OR=1.84 (95 per cent CI 1.08 to 3.13)). Breeds with lower risk were German shepherd dogs (OR=0.11 (95 per cent CI 0.01 to 0.84)), golden retrievers (OR=0.09 (95 per cent CI 0.01 to 0.68)) and boxers (no cases identified). Fisher’s exact tests showed that labradoodles were diagnosed significantly more often than purebred Labradors (P=0.04) and did not differ significantly from poodles (P=0.81). Cavoodles did not differ significantly from either CKCS (p~1.00) or poodles (P=0.12). Spoodles were significantly less diagnosed than poodles (P=0.003) but did not differ from cocker spaniels (P=0.66). Desexed male dogs had a higher odds of DM than entire male (OR=0.62 (95 per cent CI 0.39 to 0.98)) and desexed female dogs (OR=0.76 (95 per cent CI 0.61 to 0.96)). Comorbidities/sequelae associated with canine DM included suspected pancreatitis (OR 10.58 (95 per cent CI 5.17 to 22.78)), cataracts (OR 9.80 (95 per cent CI 5.65 to 17.35)), hyperadrenocorticism (OR 6.21 (95 per cent CI 3.29 to 11.88)), urinary tract infection (OR 5.09 (95 per cent CI 1.97 to 13.41)) and hypothyroidism (OR 4.10 (95 per cent CI 1.08 to 15.58)).ConclusionsBreeds at most risk included Australian terriers and Siberian huskies as previously reported, as well as, for the first time, English springer spaniels. In contrast to other populations where there is female predisposition for DM, desexed male dogs in Australia were at increased risk for DM compared with both entire males and desexed females. This predisposition for desexed males to develop DM warrants further investigation.
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Diouf, Ibrahima, Dianna J. Magliano, Melinda J. Carrington, Simon Stewart, and Jonathan E. Shaw. "Prevalence, incidence, risk factors and treatment of atrial fibrillation in Australia: The Australian Diabetes, Obesity and Lifestyle (AusDiab) longitudinal, population cohort study." International Journal of Cardiology 205 (February 2016): 127–32. http://dx.doi.org/10.1016/j.ijcard.2015.12.013.
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William, Jananie, Michael A. Martin, Catherine Chojenta, and Deborah Loxton. "An actuarial investigation into maternal hospital cost risk factors for public patients." Annals of Actuarial Science 12, no. 1 (July 20, 2017): 106–29. http://dx.doi.org/10.1017/s174849951700015x.
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AbstractWe investigate an actuarial approach to identifying the factors impacting government-funded maternal hospital costs in Australia, with a focus on women who experience adverse birth outcomes. We propose a two-phase modelling methodology that adopts actuarial methods from typical insurance claim cost modelling and extends to other statistical techniques to account for the large volume of covariates available for modelling. Specifically, Classification and Regression Trees and generalised linear mixed models are employed to analyse a data set that links longitudinal survey and administrative data from a large sample of women. The results show that adverse births are a statistically significant risk factor affecting maternal hospital costs in the antenatal and delivery periods. Other significant cost risk factors in the delivery period include mode of delivery, private health insurance status, diabetes, smoking status, area of residence and onset of labour. We demonstrate the efficacy of using actuarial techniques in non-traditional areas and highlight how the results can be used to inform public policy.
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Passey, Megan, Mahnaz Fanaian, David Lyle, and Mark F. Harris. "Assessment and management of lifestyle risk factors in rural and urban general practices in Australia." Australian Journal of Primary Health 16, no. 1 (2010): 81. http://dx.doi.org/10.1071/py09061.
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Prevention of cardiovascular disease is a major public health challenge. Many chronic health problems are amenable to lifestyle interventions, which can ameliorate progression of disease and contribute to primary prevention. Prior to a large randomised controlled trial we assessed preventive care in trial practices. General practitioners and practice nurses completed a preventive care questionnaire covering frequency of assessing and managing behavioural and physiological risk factors, which was developed from previously validated instruments. Factor analysis confirmed 10 scales. Scores for rural and urban respondents were contrasted using univariate statistics. Sixty-three general practitioners and practice nurses completed the questionnaire (27 urban and 36 rural). The clinicians reported high levels of assessment and advice for cardiovascular risk factors but less frequent referral. There were no differences between urban and rural practitioners in relation to assessment of risk or stage of change, referral or barriers to referral or management of high blood pressure. Rural practitioners had lower scores for frequency of advice, and management of obesity/overweight, pre-diabetes and high lipids. Although clinicians report frequently advising high risk patients to exercise more, there remain significant gaps in provision of dietary advice and referral. Greater attention to addressing these issues is required to maximise the potential benefits for cardiovascular disease prevention in general practice.
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Lee, Simone M., Vincent L. Versace, and Kehinde Obamiro. "Public Awareness of Bowel Cancer Risk Factors, Symptoms and Screening in Tasmania, Australia: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 19, no. 3 (January 28, 2022): 1497. http://dx.doi.org/10.3390/ijerph19031497.
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Tasmania has one of the highest bowel cancer incidence and death rates in the world. Public awareness of risk factors, symptoms, and early detection of bowel cancer is important for minimising the burden of disease. This study measured awareness levels of bowel cancer risk factors, symptoms and screening in Tasmania. An online survey of 3703 participants aged 18 years and older found that alcohol consumption, low physical activity levels, and having diabetes were the least known risk factors for bowel cancer. Over half of all participants were unaware the risk of bowel cancer increased with age, and 53 percent were not confident they would notice a bowel cancer symptom. Over a third of survey respondents did not know that screening commenced at the age of 50. The results indicate that a targeted campaign to increase bowel cancer awareness in Tasmania may help reduce the high rates of morbidity and mortality from the disease.
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Molan, Aus, Kazunori Nosaka, Michael Hunter, Jinxia Zhang, Xiaoni Meng, Manshu Song, and Wei Wang. "First Age- and Gender-Matched Case-Control Study in Australia Examining the Possible Association between Toxoplasma gondii Infection and Type 2 Diabetes Mellitus: The Busselton Health Study." Journal of Parasitology Research 2020 (March 24, 2020): 1–11. http://dx.doi.org/10.1155/2020/3142918.
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An emerging field of research is starting to examine the association of infectious pathogens with type 2 diabetes mellitus (T2DM). An understudied parasite of interest is Toxoplasma gondii. Globally, very few studies have been conducted to investigate this association. Additionally, very little data exists on the prevalence of T. gondii in the general Australian population. Our group sought to determine the prevalence, association, and risk factors between T. gondii infection and T2DM from a representative Australian human population. Through a cross-sectional, age- and gender-matched case-control study, 150 subjects with T2DM together with 150 control subjects from the Busselton Health Study cohort were investigated. Sera samples were tested for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunosorbent assays. Survey-derived data were also analyzed to evaluate associated risk factors. The IgG seroprevalence was found to be 62% and 66% for the T2DM and control groups, respectively (OR:0.84; p=0.471). IgM antibodies were detected in 5% of the T2DM patients and in 10% of the controls (OR=0.51; p=0.135). There were no significant differences between male and female IgG seroprevalence rates for both groups (OR:0.88, 0.80; p=0.723). The IgG seropositivity rate increased significantly in T2DM patients aged 45-84 years in comparison to those aged 18-44 years (p<0.05), but this was not observed in the control subjects. No risk factors were associated with T. gondii seropositivity in both groups. The first Australian study of its kind found T. gondii infection in Western Australia to be highly prevalent. The results also showed that there is no serological evidence of an association between T. gondii infection and T2DM in the studied subjects. Australian health authorities should focus on raising awareness of toxoplasma infection and target T. gondii transmission control. Further studies are needed to clarify the role of T. gondii in T2DM.
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Kothari, Anushka, Karen Hay, and Thanageswaran Rudra. "Risk Factors for Secondary Postpartum Haemorrhage: A Retrospective Study." Journal of Medical Research and Surgery 3, no. 2 (April 3, 2022): 31–35. http://dx.doi.org/10.52916/jmrs224072.
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Background: Secondary Postpartum Haemorrhage (SPPH) refers to any abnormal vaginal bleeding between 24 hours to 6 weeks postpartum. SPPH is a relatively unexplored issue and there is limited evidence, especially regarding risk factors. The aim of this study was to identify risk factors for SPPH.. Method: Patients readmitted with a diagnosis of SPPH between 2014 and 2018 at a tertiary hospital in Queensland, Australia were identified. These patients were compared with randomly selected controls that gave birth via vaginal delivery and caesarean section at the centre during the same time period. Logistic regression analyses were applied for categorical variables and T-test along for continuous variables. Result: 110 cases of SPPH were identified and 225 patients that did not have SPPH were randomly allocated as controls. Incomplete placenta (p=0.005), Antepartum Haemorrhage (APH) (p=<0.00), antepartum (p=0.004) anticoagulation, along with previous obstetric complications (p=0.036) were found to be statistically significant risk factors for SPPH. Previous obstetric complications include conditions such as primary PPH, gestational diabetes and pre-eclampsia. Demographic factors of age and ethnicity did not express any predisposition to SPPH along with other factors such as BMI, parity and plurality. The average estimated blood loss within 24 hours of delivery in the SPPH case group was 350ml and control group was 300ml (p=0.038). Conclusion: This study confirms that incomplete placenta, APH, antepartum anti-coagulation and previous obstetric complications are risk factors for secondary postpartum haemorrhage. Early identification of these risk factors could potentially prevent SPPH, allowing a safer postnatal journey for mothers.
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Nguyen, Binh, Adrian Bauman, and Ding Ding. "Incident Type 2 Diabetes in a Large Australian Cohort Study: Does Physical Activity or Sitting Time Alter the Risk Associated With Body Mass Index?" Journal of Physical Activity and Health 14, no. 1 (January 2017): 13–19. http://dx.doi.org/10.1123/jpah.2016-0184.
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Purpose:To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults.Methods:A sample of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or < 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for individual and combined risk factors, and data stratified by BMI categories.Results:During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese individuals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting.Conclusions:High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.
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Cranney, Leonie, Bronwyn McGill, Philip J. Clare, and Adrian Bauman. "Trends in risk factors and management strategies used by people with type 2 diabetes in New South Wales, Australia." Preventive Medicine 157 (April 2022): 107004. http://dx.doi.org/10.1016/j.ypmed.2022.107004.
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Hodge, A. M., D. R. English, K. O'Dea, and G. G. Giles. "Increased Diabetes Incidence in Greek and Italian Migrants to Australia: How much can be explained by known risk factors?" Diabetes Care 27, no. 10 (September 24, 2004): 2330–34. http://dx.doi.org/10.2337/diacare.27.10.2330.
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Alhazmi, Amani, Elizabeth Stojanovski, Mark McEvoy, and Manohar L. Garg. "Macronutrient intake and type 2 diabetes risk in middle-aged Australian women. Results from the Australian Longitudinal Study on Women's Health." Public Health Nutrition 17, no. 7 (July 18, 2013): 1587–94. http://dx.doi.org/10.1017/s1368980013001870.
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AbstractObjectiveTo investigate the association between macronutrient intake and type 2 diabetes risk in middle-aged Australian women.DesignA prospective cohort study, with 6 years (2002–2007) of follow up. Dietary intake was assessed with a validated FFQ. Relative risks with 95 % confidence intervals were used to examine risk associations.SettingAustralian Longitudinal Study on Women's Health, Australia.SubjectsAustralian women (n 8370) from the Australian Longitudinal Study on Women's Health aged 45–50 years and free of type 2 diabetes at baseline.ResultsAfter 6 years of follow-up, 311 women developed type 2 diabetes. After adjusting for sociodemographic, lifestyle and other dietary risk factors, MUFA, total n-3 PUFA, α-linolenic acid and total n-6 PUFA intakes were positively associated with the incidence of type 2 diabetes. The relative risks for type 2 diabetes for the highest compared with the lowest quintiles were 1·64 (95 % CI 1·06, 2·54), P = 0·04 for MUFA; 1·55 (95 % CI 1·03, 2·32), P = 0·01 for n-3 PUFA; 1·84 (95 % CI 1·25, 2·71), P < 0·01 for α-linolenic acid; and 1·60 (95 % CI 1·03, 2·48), P = 0·04 for n-6 PUFA. Other dietary macronutrients were not significantly associated with diabetes risk.ConclusionsThe data indicate that consumption of MUFA, n-3 PUFA and n-6 PUFA may influence the risk of developing type 2 diabetes in women.
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Stacey, Anne F., Tiffany K. Gill, Kay Price, and Anne W. Taylor. "Differences in risk factors and chronic conditions between informal (family) carers and non-carers using a population-based cross-sectional survey in South Australia." BMJ Open 8, no. 7 (July 2018): e020173. http://dx.doi.org/10.1136/bmjopen-2017-020173.
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BackgroundThere is growing discussion on the impact of informal caregiving on the health status and morbidity of family carers. Evidence suggests a proportion of carers may be at risk of poor health outcomes. However, there are limited population-based studies that provide representative data on specific risk factors among carers (eg, blood pressure, cholesterol, smoking status, activity and body mass index) and major chronic conditions (eg, asthma, diabetes and arthritis). This study aimed to redress that imbalance.MethodSelf-reported data were from the South Australian Monitoring and Surveillance System (SAMSS), a representative cross-sectional state-wide population-based survey of 600 randomly selected persons per month. SAMSS uses computer-assisted telephone interviewing (CATI) to monitor chronic health-related problems and risk factors and to assess health outcomes. In total, 2247 family carers were identified from 35 195 participants aged 16 years and older for the 5-year period from 2010 to 2015. Logistic regression analyses examined associations of being a carer with self-reported chronic diseases and health risk factors. In addition, the population attributable risk (PAR) of being a carer was examined for selected chronic conditions.ResultsThe prevalence of carers was 6.4%, and peak age group for carers was 50–59 years. Adjusted ORs for chronic conditions in carers were significant for all chronic conditions examined. Although there is a high prevalence of self-reported risk factors and chronic conditions among carers compared with non-carers at the population level, PAR findings suggest that caregiving is associated with a small to moderate increased risk of having these chronic conditions.ConclusionsMonitoring of carer health and morbidity particularly ‘at risk’ individuals such as female carers with asthma or diabetes remains important and provides an ongoing baseline for future surveys. To achieve this, caregiver-based studies need to become part of mainstream biomedical research at both epidemiological and clinical levels.
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Talukder, Mohammad Radwanur, Hai Pham, Richard Woodman, Kim Wilson, Kerry Taylor, John Kaldor, and Lloyd Einsiedel. "The Association between Diabetes and Human T-Cell Leukaemia Virus Type-1 (HTLV-1) with Strongyloides stercoralis: Results of a Community-Based, Cross-Sectional Survey in Central Australia." International Journal of Environmental Research and Public Health 19, no. 4 (February 13, 2022): 2084. http://dx.doi.org/10.3390/ijerph19042084.
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In central Australia, an area that is endemic for the human T-cell leukaemia virus type-1 (HTLV-1), the prevalence of Strongyloides stercoralis and its association with other health conditions are unknown. A cross-sectional community-based survey was conducted in seven remote Aboriginal communities in central Australia, from 2014 to 2018. All residents aged ≥10 years were invited to complete a health survey and to provide blood for Strongyloides serology, HTLV-1 serology and HTLV-1 proviral load (PVL). Risk factors for Strongyloides seropositivity and associations with specific health conditions including diabetes and HTLV-1 were determined using logistic regression. Overall Strongyloides seroprevalence was 27% (156/576) (children, 22% (9/40); adults (≥15 years), 27% (147/536), varied widely between communities (5–42%) and was not associated with an increased risk of gastrointestinal, respiratory or dermatological symptoms. Increasing age, lower HTLV-1 PVL (<1000 copies per 105 peripheral blood leucocytes) compared to the HTLV-1 uninfected group and community of residence were significant risk factors for Strongyloides seropositivity in an adjusted model. A modest reduction in the odds of diabetes among Strongyloides seropositive participants was found (aOR 0.58, 95% CI 0.35, 1.00; p = 0.049); however, this was lost when body mass index was included in the adjusted model (aOR 0.48, 95% CI 0.48, 1.47; p = 0.542). Strongyloides seropositivity had no relationship with anaemia. Exploring social and environmental practices in communities with low Strongyloides seroprevalence may provide useful lessons for similar settings.
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Friedman, N. Deborah, Ann L. Bull, Philip L. Russo, Karin Leder, Christopher Reid, Baki Billah, Silvana Marasco, Emma McBryde, and Michael J. Richards. "An Alternative Scoring System to Predict Risk for Surgical Site Infection Complicating Coronary Artery Bypass Graft Surgery." Infection Control & Hospital Epidemiology 28, no. 10 (October 2007): 1162–68. http://dx.doi.org/10.1086/519534.
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Objective.To analyze the risk factors for surgical site infection (SSI) complicating coronary artery bypass graft (CABG) surgery and to create an alternative SSI risk score based on the results of multivariate analysis.Methods.A prospective cohort study involving inpatient and laboratory-based surveillance of patients who underwent CABG surgery over a 27-month period from January 1, 2003 through March 31, 2005. Data were obtained from 6 acute care hospitals in Victoria, Australia, that contributed surveillance data for SSI complicating CABG surgery to the Victorian Hospital Acquired Infection Surveillance System Coordinating Centre and the Australasian Society of Cardiac and Thoracic Surgeons, also in Victoria.Results.A total of 4,633 (93%) of the 4,987 patients who underwent CABG surgery during this period were matched in the 2 systems databases. There were 286 SSIs and 62 deep or organ space sternal SSIs (deep or organ space sternal SSI rate, 1.33%). Univariate analysis revealed that diabetes mellitus, body mass index (BMI) greater than 35, and receipt of blood transfusion were risk factors for all types of SSI complicating CABG surgery. Six multivariate analysis models were created to examine either preoperative factors alone or preoperative factors combined with operative factors. All models revealed diabetes and BMI of 30 or greater as risk factors for SSI complicating CABG surgery. A new preoperative scoring system was devised to predict sternal SSI, which assigned 1 point for diabetes, 1 point for BMI of 30 or greater but less than 35, and 2 points for BMI of 35 or greater. Each point in the scoring system represented approximately a doubling of risk of SSI. The new scoring system performed better than the National Nosocomial Infections Surveillance System (NNIS) risk index at predicting SSI.Conclusion.A new weighted scoring system based on preoperative risk factors was created to predict sternal SSI risk following CABG surgery. The new scoring system outperformed the NNIS risk index. Future studies are needed to validate this scoring system.
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de Abreu, L., Kara L. Holloway, Mark A. Kotowicz, and Julie A. Pasco. "Dysglycaemia and Other Predictors for Progression or Regression from Impaired Fasting Glucose to Diabetes or Normoglycaemia." Journal of Diabetes Research 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/373762.
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Aims. Diabetes mellitus is a growing health problem worldwide. This study aimed to describe dysglycaemia and determine the impact of body composition and clinical and lifestyle factors on the risk of progression or regression from impaired fasting glucose (IFG) to diabetes or normoglycaemia in Australian women.Methods. This study included 1167 women, aged 20–94 years, enrolled in the Geelong Osteoporosis Study. Multivariable logistic regression was used to identify predictors for progression to diabetes or regression to normoglycaemia (from IFG), over 10 years of follow-up.Results. At baseline the proportion of women with IFG was 33.8% and 6.5% had diabetes. Those with fasting dysglycaemia had higher obesity-related factors, lower serum HDL cholesterol, and lower physical activity. Over a decade, the incidence of progression from IFG to diabetes was 18.1 per 1,000 person-years (95% CI, 10.7–28.2). Fasting plasma glucose and serum triglycerides were important factors in both progression to diabetes and regression to normoglycaemia.Conclusions. Our results show a transitional process; those with IFG had risk factors intermediate to normoglycaemics and those with diabetes. This investigation may help target interventions to those with IFG at high risk of progression to diabetes and thereby prevent cases of diabetes.
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Wan, Ching S., Sally Abell, Rosalie Aroni, Alison Nankervis, Jacqueline Boyle, and Helena Teede. "Ethnic differences in prevalence, risk factors, and perinatal outcomes of gestational diabetes mellitus: A comparison between immigrant ethnic Chinese women and Australian‐born Caucasian women in Australia." Journal of Diabetes 11, no. 10 (March 18, 2019): 809–17. http://dx.doi.org/10.1111/1753-0407.12909.
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Rodrigues, Beverly T., Venkat N. Vangaveti, and Usman H. Malabu. "Prevalence and Risk Factors for Diabetic Lower Limb Amputation: A Clinic-Based Case Control Study." Journal of Diabetes Research 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/5941957.
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Objective.The aim of the study was to evaluate the prevalence of and risk factors for lower limb amputation in a specialist foot clinic-based setting.Methods.A retrospective quantitative study was conducted, using clinical and biochemical profiles of diabetic foot patients attending the High Risk Foot Clinic at The Townsville Hospital, Australia, between January 1, 2011, and December 31, 2013.Results.The total study sample included 129 subjects, comprising 81 males and 48 females with M : F ratio of 1.7 : 1. Twenty-three subjects were Indigenous Australians, representing 17.8% of the study population. The average age of the cohort was 63.4 years ± 14.1 years [CI 90.98–65.89]. Lower limb amputation was identified as a common and significant outcome (n=44), occurring in 34.1%, more commonly amongst the Indigenous Australians (56.5% versus 29.2%;p=0.94, OR 0.94). Risk factors most closely associated with amputation included diabetic retinopathy (p=0.00, OR 4.4), coronary artery bypass graft (CABG) surgery (p=0.01, OR 4.1), Charcot’s arthropathy (p=0.01, OR 2.9), and Indigenous ethnicity (p=0.01, OR 3.4). Although average serum creatinine, corrected calcium, and glycosylated haemoglobin A1c (Hba1c) levels were higher amongst amputees they were statistically insignificant.Conclusions.Lower limb amputation is a common outcome and linked to ethnicity and neurovascular diabetic complications amongst subjects with diabetic foot ulcer. Further research is needed to identify why risk of lower limb amputation seems to differ according to ethnicity.
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Mengistu, Tesfaye S., Veronika Schreiber, Christopher Flatley, Jane Fox, and Sailesh Kumar. "Factors Associated with Increased Risk of Early Severe Neonatal Morbidity in Late Preterm and Early Term Infants." Journal of Clinical Medicine 10, no. 6 (March 23, 2021): 1319. http://dx.doi.org/10.3390/jcm10061319.
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Although the risk of neonatal mortality is generally low for late preterm and early term infants, they are still significantly predisposed to severe neonatal morbidity (SNM) despite being born at relatively advanced gestations. In this study, we investigated maternal and intrapartum risk factors for early SNM in late preterm and early term infants. This was a retrospective cohort study of non-anomalous, singleton infants (34+0–38+6 gestational weeks) born at the Mater Mother’s Hospital in Brisbane, Australia from January 2015 to May 2020. Early SNM was defined as a composite of any of the following severe neonatal outcome indicators: admission to neonatal intensive care unit (NICU) in conjunction with an Apgar score <4 at 5 min, severe respiratory distress, severe neonatal acidosis (cord pH < 7.0 or base excess <−12 mmol/L). Multivariable binomial logistic regression analyses using generalized estimating equations (GEE) were used to identify risk factors. Of the total infants born at 34+0–38+6 gestational weeks, 5.7% had at least one component of the composite outcome. For late preterm infants, pre-existing diabetes mellitus, instrumental birth and emergency caesarean birth for non-reassuring fetal status were associated with increased odds for early SNM, whilst for early term infants, pre-existing and gestational diabetes mellitus, antepartum hemorrhage, instrumental, emergency caesarean and elective caesarean birth were significant risk factors. In conclusion, we identified several risk factors contributing to early SNM in late preterm and early term cohort. Our results suggest that predicted probability of early SNM decreased as gestation increased.
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Chavada, Ruchir, Deborah Tong, and Michael Maley. "In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections." Diseases 6, no. 3 (August 1, 2018): 71. http://dx.doi.org/10.3390/diseases6030071.
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There has been a progressive rise in the incidence of blood stream infections (BSI) caused by multidrug-resistant Gram-negative organisms (MDR GN), which cause increased morbidity and mortality. For this reason, recent studies have focused on risk factors of acquisition of carbapenemase-producing Enterobacteriaceae and extended-spectrum beta-lactamase producers. However, there is limited data on risk factors for BSI caused by AmpC-producing Enterobacteriaceae (AmpC EC), especially in low prevalence settings such as Australia. This study was performed to identify risk factors for acquisition of AmpC E. coli, using a retrospective matched case control design over a 3-year period. Patients with BSI caused by AmpC E. coli were matched with controls (third generation cephalosporin susceptible E. coli) by age and site of infection (n = 21). There was no significant difference in age, sex, clinical outcome, time to onset of BSI, recent antibiotic use (last 3 months), comorbidities (type 2 diabetes mellitus, renal failure) intensive care unit admission, underlying hematological condition, immunosuppressant use, APACHE II score, or any recent urological procedures (within last 3 months) between the two groups. On univariate analysis, the AmpC E. coli group were more likely to have had a surgical procedure in hospital and lived in a residential aged care facility. On multivariate logistic regression analysis, a recent surgical procedure was associated with the onset of AmpC E. coli BSI (Odd’s Ratio (OR) 4.78, p = 0.034). We concluded that in a relatively low prevalence setting such as Australia, AmpC E. coli BSI is potentially associated with surgery performed in hospital due to previous antibiotic exposure and longer hospitalization.
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Marschner, Simone, Edwina Wing-Lun, Clara Chow, Louise Maple-Brown, Sian Graham, Stephen J. Nicholls, Alex Brown, et al. "Randomised clinical trial using Coronary Artery Calcium Scoring in Australian Women with Novel Cardiovascular Risk Factors (CAC-WOMEN Trial): study protocol." BMJ Open 12, no. 12 (December 2022): e062685. http://dx.doi.org/10.1136/bmjopen-2022-062685.
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IntroductionCardiovascular disease (CVD) is the leading cause of death in women around the world. Aboriginal and Torres Strait Islander women (Australian Indigenous women) have a high burden of CVD, occurring on average 10–20 years earlier than non-Indigenous women. Traditional risk prediction tools (eg, Framingham) underpredict CVD risk in women and Indigenous people and do not consider female-specific ‘risk-enhancers’ such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM) and premature menopause. A CT coronary artery calcium score (‘CT-calcium score’) can detect calcified atherosclerotic plaque well before the onset of symptoms, being the single best predictor for future cardiac events. A CT-calcium score may therefore help physicians intensify medical therapy in women with risk-enhancing factors.Methods and analysisThis multisite, single-blind randomised (1:1) controlled trial of 700 women will assess the effectiveness of a CT-calcium score-guided approach on cardiovascular risk factor control and healthy lifestyle adherence, compared with standard care. Women without CVD aged 40–65 (35–65 for Aboriginal and Torres Strait Islander women) at low-intermediate risk on standard risk calculators and with at least one risk-enhancing factor (eg, HDP, GDM, premature menopause) will be recruited. Aboriginal and Torres Strait Islander women will be actively recruited, aiming for ~10% of the sample size. The 6-month coprimary outcomes will be low-density lipoprotein cholesterol and systolic blood pressure. Barriers and enablers will be assessed, and a health economic analysis performed.Ethics and disseminationWestern Sydney Local Health District Research Ethics Committee (HREC 2021/ETH11250) provided ethics approval. Written informed consent will be obtained before randomisation. Consent will be sought for access to individual participant Medicare Benefits Schedule, Pharmaceutical Benefits Scheme claims usage through Medicare Australia and linked Admitted Patient Data Collection. Study results will be disseminated via peer-reviewed publications and presentations at national and international conferences.Trial registration numberACTRN12621001738819p.
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Phillips, P. "Diabetes complications and risk factors in an Australian population. How well are they managed?" International Journal of Epidemiology 27, no. 5 (October 1, 1998): 853–59. http://dx.doi.org/10.1093/ije/27.5.853.
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Thompson, Samantha J., Sandra M. Gifford, and Lisa Thorpe. "The Social and Cultural Context of Risk and Prevention: Food and Physical Activity in an Urban Aboriginal Community." Health Education & Behavior 27, no. 6 (December 2000): 725–43. http://dx.doi.org/10.1177/109019810002700608.
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One of the key public health challenges facing indigenous and other minority communities is how to develop and implement effective, acceptable, and sustainable strategies for the prevention of noninsulindependent diabetes mellitus (NIDDM). In this article, the authors describe how an ethnographic approach was used to contextualize the behavioral risk factors for NIDDM and applied to the development of a more meaningful and appropriate epidemiological risk factor survey instrument for an urban Aboriginal population in Australia. The overall research design comprised a mixture of qualitative and quantitative methods. The ethnographic study showed that the complex web of meanings that tie people to their family and community can and should be taken into account in any social epidemiology of health and illness if the findings are to have any effective and long-term potential to contribute to successful public health interventions targeting these behavioral risk factors.
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Sanchez, Luis, Tracey Johnson, Suzanne Williams, Geoffrey Spurling, and Joanne Durham. "Identifying inequities in an urban Latin American population: a cross-sectional study in Australian primary health care." Australian Journal of Primary Health 26, no. 2 (2020): 140. http://dx.doi.org/10.1071/py19049.
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In Australia, people from culturally and linguistically diverse backgrounds often face inequitable health outcomes and access to health care. An important, but under-researched, population is people of Latin American descent. A cross-sectional study obtained clinical data on Latin American Spanish-speaking patients from Brisbane’s south-west. Extracted data included demographic characteristics, risk factors, chronic disease and service use. A total of 382 people (60.5% female, 39.5% male), mainly from El Salvador and Chile and predominantly older people (70% over 50 years), were identified. Compared with the general Australian population, the proportion of people with dyslipidaemia, diabetes, arthritis and musculoskeletal, mental health disorders and being obese or overweight was high. There was also a higher use of the 20–40min general medicine consultation than in the general population. The proportion of patients receiving health promotion and chronic disease management activities was higher than in other reports. However, there were gaps in the provision of these services. The study shows an ageing population group with significant risk factors and an important burden of chronic disease and comorbidity. Addressing inequalities in health for culturally and linguistically diverse populations demands improvements in healthcare delivery and targeted actions based on a solid understanding of their complex health needs and their health, social and cultural circumstances.
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Hodgetts, Kay, Mariana Kleinecke, Celeste Woerle, Mirjam Kaestli, Richard Budd, Jessica R. Webb, Linda Ward, Mark Mayo, Bart J. Currie, and Ella M. Meumann. "Melioidosis in the remote Katherine region of northern Australia." PLOS Neglected Tropical Diseases 16, no. 6 (June 13, 2022): e0010486. http://dx.doi.org/10.1371/journal.pntd.0010486.
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Melioidosis is endemic in the remote Katherine region of northern Australia. In a population with high rates of chronic disease, social inequities, and extreme remoteness, the impact of melioidosis is exacerbated by severe weather events and disproportionately affects First Nations Australians. All culture-confirmed melioidosis cases in the Katherine region of the Australian Top End between 1989–2021 were included in the study, and the clinical features and epidemiology were described. The diversity of Burkholderia pseudomallei strains in the region was investigated using genomic sequencing. From 1989–2021 there were 128 patients with melioidosis in the Katherine region. 96/128 (75%) patients were First Nations Australians, 72/128 (56%) were from a very remote region, 68/128 (53%) had diabetes, 57/128 (44%) had a history of hazardous alcohol consumption, and 11/128 (9%) died from melioidosis. There were 9 melioidosis cases attributable to the flooding of the Katherine River in January 1998; 7/9 flood-associated cases had cutaneous melioidosis, five of whom recalled an inoculating event injury sustained wading through flood waters or cleaning up after the flood. The 126 first-episode clinical B. pseudomallei isolates that underwent genomic sequencing belonged to 107 different sequence types and were highly diverse, reflecting the vast geographic area of the study region. In conclusion, melioidosis in the Katherine region disproportionately affects First Nations Australians with risk factors and is exacerbated by severe weather events. Diabetes management, public health intervention for hazardous alcohol consumption, provision of housing to address homelessness, and patient education on melioidosis prevention in First Nations languages should be prioritised.
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McDONALD, Stephen, Graeme MAGUIRE, Natalia DUARTE, Xing Li WANG, and Wendy HOY. "C-reactive protein, cardiovascular risk, and renal disease in a remote Australian Aboriginal community." Clinical Science 106, no. 2 (February 1, 2004): 121–28. http://dx.doi.org/10.1042/cs20030186.
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Rates of cardiovascular and renal disease in Australian Aboriginal communities are high, but we do not know the contribution of inflammation to these diseases in this setting. In the present study, we sought to examine the distribution of C-reactive protein (CRP) and other markers of inflammation and their relationships with cardiovascular risk markers and renal disease in a remote Australian Aboriginal community. The study included 237 adults (58% of the adult population) in a remote Aboriginal community in the Northern Territory of Australia. Main outcome measures were CRP, fibrinogen and IgG concentrations, blood pressure (BP), presence of diabetes, lipids, albuminuria, seropositivity to three common micro-organisms, as well as carotid intima-media thickness (IMT). Serum concentrations of CRP [7 (5–13) mg/l; median (inter-quartile range)] were markedly increased and were significantly correlated with fibrinogen and IgG concentrations and inversely correlated with serum albumin concentration. Higher CRP concentrations were associated with IgG seropositivity to Helicobacter pylori and Chlamydia pneumoniae and higher IgG titre for cytomegalovirus. Higher CRP concentrations were associated with the following: the 45–54-year age group, female subjects, the presence of skin sores, higher body mass index, waist circumference, BP, glycated haemoglobin and greater albuminuria. CRP concentrations increased with the number of cardiovascular risk factors, carotid IMT and albuminuria independently of other risk factors. These CRP concentrations were markedly higher than described in other community settings and are probably related, in a large part, to chronic and repeated infections. Their association with markers of cardiovascular risk and renal disease are compatible with the high rates of cardiovascular and renal disease in this community, and provide more evidence of strong links between these conditions, through a shared background of infection/inflammation. This suggests that a strong focus on prevention and management of infections will be important in reducing these conditions, in addition to interventions directed at more traditional risk factors.
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Alhazmi, Amani, Elizabeth Stojanovski, Mark McEvoy, Wendy Brown, and Manohar L. Garg. "Diet quality score is a predictor of type 2 diabetes risk in women: The Australian Longitudinal Study on Women's Health." British Journal of Nutrition 112, no. 6 (July 24, 2014): 945–51. http://dx.doi.org/10.1017/s0007114514001688.
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The present study aimed to determine the ability of two diet quality scores to predict the incidence of type 2 diabetes in women. The study population comprised a nationally representative sample of 8370 Australian middle-aged (45–50 years) women participating in the ALSWH (Australian Longitudinal Study on Women's Health), who were free of diabetes and completed FFQ at baseline. The associations between the Australian Recommended Food Score (ARFS) and Dietary Guideline Index (DGI) with type 2 diabetes risk were assessed using multiple logistic regression models, adjusting for sociodemographic characteristics, lifestyle factors and energy intake. During 6 years of follow-up, 311 incident cases of type 2 diabetes were reported. The DGI score was inversely associated with type 2 diabetes risk (OR comparing the highest with the lowest quintile of DGI was 0·51; 95 % CI 0·35, 0·76; P for trend = 0·01). There was no statistically significant association between the ARFS and type 2 diabetes risk (OR comparing the highest with the lowest quintile of ARFS was 0·99; 95 % CI 0·68, 1·43; P for trend = 0·42). The results of the present prospective study indicate that the DGI score, which assesses compliance with established dietary guidelines, is predictive of type 2 diabetes risk in Australian women. The risk of type 2 diabetes among women in the highest quintile of DGI was approximately 50 % lower than that in women in the lowest quintile. The ARFS was not significantly predictive of type 2 diabetes.
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Post, Dannielle Kay, Mark Daniel, Gary Misan, and Matthew T. Haren. "A workplace health promotion application of the Precede-Proceed model in a regional and remote mining company in Whyalla, South Australia." International Journal of Workplace Health Management 8, no. 3 (September 14, 2015): 154–74. http://dx.doi.org/10.1108/ijwhm-08-2014-0028.
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Purpose – Workplace health promotion enables the dissemination of health-related information to a large portion of society and provides a vehicle for translating results of efficacy studies to effective lifestyle interventions under less controlled real-world conditions. To achieve effectiveness there needs to be a systematic approach to the design, implementation, and evaluation of workplace health promotion interventions. The purpose of this paper is to describe the development of a workplace programme in a mining and steel making town in regional South Australia. Design/methodology/approach – The Precede-Proceed model (PPM) was used as a framework to design the development, implementation, and evaluation of the programme. Findings – Quality of life issues and antecedents of modifiable behavioural and environmental factors to be targeted by interventions were identified. Relevant socio-behavioural theories were used to guide intervention development and evaluation. An intervention programme was planned to enable the delivery of educational and skills-development strategies by peers within structured organisational work units. Originality/value – This research utilises the PPM to develop, implement, and evaluate intervention strategies targeting the development of diabetes and cardiometabolic risk in a remotely located workplace population. Novel to this approach is the utilisation of the entire PPM in the research; the multiple baseline, interrupted time series design of the study; and its application in a workplace environment noted for increased health risk factors, within a community at high risk of development of type 2 diabetes.
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PEASE, ANTHONY J., ARUL EARNEST, NATALIE NANAYAKKARA, SANJEEVA RANASINHA, JEFF R. FLACK, WENDY A. DAVIS, GLORIA M. KILMARTIN, NATALIE WISCHER, and SOPHIA ZOUNGAS. "Burden of Cardiovascular Risk Factors and Disease in Type 1 Diabetes—Results of the Australian National Diabetes Audit (ANDA)." Diabetes 67, Supplement 1 (May 2018): 1697—P. http://dx.doi.org/10.2337/db18-1697-p.
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Buss, Vera Helen, Marlien Varnfield, Mark Harris, and Margo Barr. "Remotely Conducted App-Based Intervention for Cardiovascular Disease and Diabetes Risk Awareness and Prevention: Single-Group Feasibility Trial." JMIR Human Factors 9, no. 3 (July 1, 2022): e38469. http://dx.doi.org/10.2196/38469.
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Background Cardiovascular disease and type 2 diabetes mellitus are two of the most prevalent chronic conditions worldwide. An unhealthy lifestyle greatly contributes to someone’s risk of developing these conditions. Mobile health is an emerging technology that can help deliver health promotion interventions to the population, for example, in the form of health apps. Objective The aim of this study was to test the feasibility of an app-based intervention for cardiovascular and diabetes risk awareness and prevention by measuring nonusage, dropout, adherence to app use, and usability of the app over 3 months. Methods Participants were eligible if they were aged 45 years or older, resided in Australia, were free of cardiovascular disease and diabetes, were fluent in English, and owned a smartphone. In the beginning, participants received an email with instructions on how to install the app and a user guide. After 3 months, they received an email with an invitation to an end-of-study survey. The survey included questions about general smartphone use and the user version of the Mobile Application Rating Scale. We analyzed app-generated and survey data by using descriptive and inferential statistics as well as thematic analysis for open-text comments. Results Recruitment took place between September and October 2021. Of the 46 participants who consented to the study, 20 (44%) never used the app and 15 (33%) dropped out. The median age of the app users at baseline was 62 (IQR 56-67) years. Adherence to app use, that is, using the app at least once a week over 3 months, was 17% (8/46) of the total sample and 31% (8/26) of all app users. The mean app quality rating on the user version of the Mobile Application Rating Scale was 3.5 (SD 0.6) of 5 points. The app scored the highest for the information section and the lowest for the engagement section of the scale. Conclusions Nonusage and dropouts were too high, and the adherence was too low to consider the intervention in its current form feasible. Potential barriers that we identified include the research team not actively engaging with participants early in the study to verify that all participants could install the app, the intervention did not involve direct contact with health care professionals, and the app did not have enough interactive features.
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Gault, A., K. O'Dea, K. G. Rowley, T. McLeay, and K. Traianedes. "Abnormal Glucose Tolerance and Other Coronary Heart Disease Risk Factors in an Isolated Aboriginal Community in Central Australia." Diabetes Care 19, no. 11 (November 1, 1996): 1269–73. http://dx.doi.org/10.2337/diacare.19.11.1269.
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Lim, Rebecca Sin Mei, Sam Flatman, and Markus C. Dahm. "Sinonasal Melioidosis in a Returned Traveller Presenting with Nasal Cellulitis and Sinusitis." Case Reports in Otolaryngology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/920352.
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We illustrate a case involving a 51-year-old man who presented to a tertiary hospital with sepsis secondary to an abscess of the nasal vestibule and pustular eruptions of the nasal mucosa. Associated cellulitis extended across the face to the eye, and mucosal thickening of the sinuses was seen on computed tomography. The patient underwent incision and drainage and endoscopic sinus surgery. Blood cultures and swabs were positive for a gram-negative bacillus,Burkholderia pseudomallei. He had multiple risk factors including travel to an endemic area. The patient received extended antibiotic therapy in keeping with published national guidelines. Melioidosis is caused byBurkholderia pseudomallei, found in the soil in Northern Australia and Asia. It is transmitted via cutaneous or inhaled routes, leading to pneumonia, skin or soft tissue abscesses, and genitourinary infections. Risk factors include diabetes, chronic lung disease, and alcohol abuse. It can exist as a latent, active, or reactivated infection. A high mortality rate has been identified in patients with sepsis. Melioidosis is endemic in tropical Northern Australia and northeastern Thailand where it is the most common cause of severe community-acquired sepsis. There is one other report of melioidosis in the literature involving orbital cellulitis and sinusitis.
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Nanayakkara, Natalie, Sanjeeva Ranasinha, Adelle M. Gadowski, Wendy A. Davis, Jeffrey Ronald Flack, Natalie Wischer, Sof Andrikopoulos, and Sophia Zoungas. "Age-related differences in glycaemic control, cardiovascular disease risk factors and treatment in patients with type 2 diabetes: a cross-sectional study from the Australian National Diabetes Audit." BMJ Open 8, no. 8 (August 2018): e020677. http://dx.doi.org/10.1136/bmjopen-2017-020677.
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ObjectiveTo compare the glycaemic control and cardiovascular risk factor profiles of younger and older patients with type 2 diabetes. Cross-sectional analysis of data from the 2015 Australian National Diabetes Audit was undertaken.MethodsData were obtained from adults with type 2 diabetes presenting to Australian secondary/tertiary diabetes centres. Logistic regression examined associations with glycated haemoglobin A1c (HbA1c) >7% (53 mmol/mol) and cardiovascular risk factors.ResultsData from 3492 patients were analysed. Mean (±SD) age was 62.9±12.5 years, mean diabetes duration 13.5±9.4 years and mean HbA1c 8.2%±1.8%. Mean HbA1c was 8.6%±2.1% and 8.0%±1.6% for the younger (<60 years) and older subgroups (≥60 years), respectively (p<0.001). The adjusted OR (aOR) of HbA1c above >7.0% was 1.5 times higher (95% CI 1.22 to 1.84) for younger patients compared with older patients after adjustment for gender, smoking, diabetes duration, renal function and body mass index. Younger patients were also more likely to have dyslipidaemia (aOR 2.02, 95% CI 1.53 to 2.68; p<0.001), be obese (aOR 1.25, 95% CI 1.05 to 1.49; p<0.001) and be current smokers (aOR 2.13 95% CI 1.64 to 2.77; p<0.001) than older patients.ConclusionsYounger age was associated with poorer glycaemic control and adverse cardiovascular risk factor profiles. It is imperative to optimise and monitor treatment in order to improve long-term outcomes.
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Orchard, Suzanne, Jonathan Broder, Jessica Lockery, Peter Gibbs, Sara Espinoza, Michael Ernst, Robyn Woods, and and John McNeil. "Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults." Innovation in Aging 5, Supplement_1 (December 1, 2021): 611. http://dx.doi.org/10.1093/geroni/igab046.2339.
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Abstract Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk.
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Hotu, Cheri, Marc Rémond, Graeme Maguire, Elif Ekinci, and Neale Cohen. "Impact of an integrated diabetes service involving specialist outreach and primary health care on risk factors for micro‐ and macrovascular diabetes complications in remote Indigenous communities in Australia." Australian Journal of Rural Health 26, no. 6 (June 4, 2018): 394–99. http://dx.doi.org/10.1111/ajr.12426.
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Goldberg, Lynette, and Dianne Baldock. "The Preventing Dementia MOOC: Contribution to First Nations’ Health and Well-Being." Innovation in Aging 4, Supplement_1 (December 1, 2020): 11. http://dx.doi.org/10.1093/geroni/igaa057.036.
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Abstract Dementia is a global public health issue. First Nations people are at increased risk due to complex intergenerational factors grounded in inequalities in health services and economic and educational opportunities. While there is yet no drug-related cure for this progressive and terminal neurological condition, evidence confirms that increased understanding of dementia and modification of lifestyle factors can reduce risk. The primary potentially modifiable risk factors are not completing secondary school, midlife hypertension, obesity, type II diabetes, depression, physical inactivity, smoking, hearing loss acquired after the age of 55 years, and social isolation. Inherent in these factors is stress, affecting mental health. Addressing these factors globally could prevent or delay over 40 million cases of dementia. The free Preventing Dementia Massive Open Online Course (PD MOOC) is a globally recognized 4-week course that aims to build self-efficacy in knowledge and management of modifiable risk factors. The course has reached over 68,000 people world-wide and is rated highly; however, its contribution to First Nations communities has not yet been investigated. We describe the content of the PD MOOC, report on its impact in a cohort of older Aboriginal people (≥ 50 years of age) in Circular Head, Tasmania, Australia six months after course completion, and emphasize the importance of including traditional approaches to healing. We describe a protocol in which cultural determinants of health can be infused into the PD MOOC and evaluated to promote health and well-being globally for older First Nations people.