2022 |
Ren S, Hansbro PM, Srikusalanukul W, Horvat JC, Hunter T, Brown AC, et al., 'Generation of cardio-protective antibodies after pneumococcal polysaccharide vaccine: Early results from a randomised controlled trial', Atherosclerosis, 346 68-74 (2022) [C1]
Background and aims: Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may ... [more]
Background and aims: Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may be mediated through IgM antibodies to OxLDL, which have previously been associated with cardioprotective effects. The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is a double-blind, randomised controlled trial (RCT) of PPV in preventing ischaemic events. Participants received PPV or placebo once at baseline and are being followed-up for incident fatal and non-fatal myocardial infarction or stroke over 6 years. Methods: A subgroup of participants at one centre (Canberra; n = 1,001) were evaluated at 1 month and 2 years post immunisation for changes in surrogate markers of atherosclerosis, as pre-specified secondary outcomes: high-sensitive C-reactive protein (CRP), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT). In addition, 100 participants were randomly selected in each of the intervention and control groups for measurement of anti-pneumococcal antibodies (IgG, IgG2, IgM) as well as anti-OxLDL antibodies (IgG and IgM to CuOxLDL, MDA-LDL, and PC-KLH). Results: Concentrations of anti-pneumococcal IgG and IgG2 increased and remained high at 2 years in the PPV group compared to the placebo group, while IgM increased and then declined, but remained detectable, at 2 years. There were statistically significant increases in all anti-OxLDL IgM antibodies at 1 month, which were no longer detectable at 2 years; there was no increase in anti-OxLDL IgG antibodies. There were no significant changes in CRP, PWV or CIMT between the treatment groups at the 2-year follow-up. Conclusions: PPV engenders a long-lasting increase in anti-pneumococcal IgG, and to a lesser extent, IgM titres, as well as a transient increase in anti-OxLDL IgM antibodies. However, there were no detectable changes in surrogate markers of atherosclerosis at the 2-year follow-up. Long-term, prospective follow-up of clinical outcomes is continuing to assess if PPV reduces CVD events.
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Nova |
2021 |
Schadewaldt V, McElduff B, D'Este C, McInnes E, Dale S, Fasugba O, et al., 'Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes', Nursing Outlook, 69 103-115 (2021) [C1]
Background: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose: To identify how context affects the provisi... [more]
Background: Emergency departments (ED) are challenging environments but critical for early management of patients with stroke. Purpose: To identify how context affects the provision of stroke care in 26 Australian EDs. Method: Nurses perceptions of ED context was assessed with the Alberta Context Tool. Medical records were audited for quality of stroke care and patient outcomes. Findings: Collectively, emergency nurses (n = 558) rated context positively with several nurse and hospital characteristics impacting these ratings. Despite these positive ratings, regression analysis showed no significant differences in the quality of stroke care (n = 1591 patients) and death or dependency (n = 1165 patients) for patients in EDs with high or low rated context. Discussion: Future assessments of ED context may need to examine contextual factors beyond the scope of the Alberta Context Tool which may play an important role for the understanding of stroke care and patient outcomes in EDs.
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Nova |
2021 |
Sarma H, D'Este C, Ahmed T, Bossert TJ, Banwell C, 'Developing a conceptual framework for implementation science to evaluate a nutrition intervention scaled-up in a real-world setting', PUBLIC HEALTH NUTRITION, 24 S7-S22 (2021) [C1]
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Nova |
2021 |
Sarma H, Tariqujjaman M, Mbuya MNN, Askari S, Banwell C, Bossert TJ, et al., 'Factors associated with home visits by volunteer community health workers to implement a home-fortification intervention in Bangladesh: a multilevel analysis', PUBLIC HEALTH NUTRITION, 24 S23-S36 (2021) [C1]
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Nova |
2020 |
Hasnain MG, Paul CL, Attia JR, Ryan A, Kerr E, Oldmeadow C, et al., 'Thrombolysis implementation intervention and clinical outcome: A secondary analysis of a cluster randomized trial', BMC Cardiovascular Disorders, 20 432-440 (2020) [C1]
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Nova |
2020 |
Anstey KJ, Cherbuin N, Kim S, McMaster M, D'Este C, Lautenschlager N, et al., 'An internet-based intervention augmented with a diet and physical activity consultation to decrease the risk of dementia in at-risk adults in a primary care setting: Pragmatic randomized controlled trial', Journal of Medical Internet Research, 22 (2020) [C1]
Background: There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life cours... [more]
Background: There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. Objective: This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. Methods: A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of =25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician¿led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). Results: Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means -3.86, 95% CI -6.81 to -0.90, P=.01; week 18: difference in means -4.05, 95% CI -6.81 to -1.28, P<.001; week 36: difference in means -4.99, 95% CI -8.04 to -1.94, P<.001; and week 62: difference in means -4.62, 95% CI -7.62 to -1.62, P<.001). Conclusions: A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results.
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Nova |
2020 |
Stevenson W, Bryant J, Watson R, Sanson-Fisher R, Oldmeadow C, Henskens F, et al., 'A multi-center randomized controlled trial to reduce unmet needs, depression, and anxiety among hematological cancer patients and their support persons', Journal of Psychosocial Oncology, 38 272-292 (2020) [C1]
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Nova |
2020 |
McMaster M, Kim S, Clare L, Torres SJ, Cherbuin N, D'Este C, Anstey KJ, 'Lifestyle Risk Factors and Cognitive Outcomes from the Multidomain Dementia Risk Reduction Randomized Controlled Trial, Body Brain Life for Cognitive Decline (BBL-CD)', JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 68 2629-2637 (2020) [C1]
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Nova |
2020 |
Guillaumier A, Skelton E, Shakeshaft A, Farrell M, Tzelepis F, Walsberger S, et al., 'Effect of increasing the delivery of smoking cessation care in alcohol and other drug treatment centres: a cluster-randomized controlled trial', Addiction, 115 1345-1355 (2020) [C1]
Aim: Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compar... [more]
Aim: Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compared with usual care, on (1) 7-day point prevalence abstinence (PPA) at 8¿weeks follow-up; (2) prolonged abstinence; (3) cigarettes smoked per day; (4) number of quit attempts; and (5) offer and use of nicotine replacement therapy (NRT). All outcomes were assessed at 8¿weeks and 6.5¿months follow-up. Design: Cluster-randomized controlled trial, with AOD service as unit of randomization, conducted January 2015¿March 2016. Setting: Thirty-two eligible services (provided face-to-face client sessions to =¿50 clients/year) in Australia were randomized to control (usual care; n¿=¿15) or intervention (n¿=¿17) groups by an independent blinded biostatistician. Participants: Eligible participants (= 16¿years, current smoker) completed surveys at the service at baseline (n¿=¿896) and telephone follow-up surveys (conducted by blinded assessors) at 8¿weeks (n¿=¿471; 53%) and 6.5¿months (n¿=¿427; 48%). Intervention: Intervention services received an intervention to establish routine screening, assessment and delivery of smoking cessation care. Measurements: Primary outcome was biochemically verified 7-day PPA at 8-week follow-up. Secondary outcomes included verified and self-reported prolonged abstinence, self-reported 7-day PPA, cigarettes/day, quit attempts and offer and use of NRT. Intention-to-treat analyses were performed, assuming missing participants were not abstinent. Findings: At 8¿weeks, the findings in verified 7-day PPA between groups [2.6 versus 1.8%, odds ratio (OR)¿=¿1.72, 95% confidence interval (CI)¿=¿0.5¿5.7, P¿=¿0.373] were inconclusive as to whether a difference was present. Significantly lower mean cigarettes/day were reported in the intervention group compared to the usual care group at 8¿weeks [incidence rate ratio (IRR)¿=¿0.88, 95% CI¿=¿0.8¿0.95, P¿=¿0.001] but were similar at 6.5 months (IRR¿=¿0.96, 95% CI¿=¿0.9¿1.02, P¿=¿0.240) follow-up. At both follow-ups the intervention group reported higher rates of NRT use. Conclusions: Integrating smoking cessation treatment into addiction services did not significantly improve short-term abstinence from smoking.
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Nova |
2020 |
McInnes E, Dale S, Craig L, Phillips R, Fasugba O, Schadewaldt V, et al., 'Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T
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Nova |
2019 |
Miller P, Droste N, Egerton-Warburton D, Caldicott D, Fulde G, Ezard N, et al., 'Driving change: A partnership study protocol using shared emergency department data to reduce alcohol-related harm', EMERGENCY MEDICINE AUSTRALASIA, 31 942-947 (2019)
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2019 |
Williamson A, Barker D, Green S, D'Este C, Davies HTO, Jorm L, et al., 'Increasing the capacity of policy agencies to use research findings: a stepped-wedge trial', HEALTH RESEARCH POLICY AND SYSTEMS, 17 (2019) [C1]
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Nova |
2019 |
Gildner TE, Liebert MA, Capistrant BD, D'Este C, Snodgrass JJ, Kowal P, 'Perceived Income Adequacy and Well-being among Older Adults in Six Low- and Middle-Income Countries', Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 74 516-525 (2019) [C1]
Objectives Perceived income adequacy is positively associated with self-rated health (SRH) and quality of life (QOL) among adults in higher-income countries. Additionally, older i... [more]
Objectives Perceived income adequacy is positively associated with self-rated health (SRH) and quality of life (QOL) among adults in higher-income countries. Additionally, older individuals often report higher levels of income adequacy. However, it is unclear if these associations, documented primarily in high-income countries, are also evident across economically and culturally distinctive low- and middle-income countries. Methods Data were drawn from the World Health Organization's Study on global AGEing and adult health (SAGE), a study of adults aged 50 years or older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. Smaller samples of younger adults (18-49 years) were included for comparison purposes. Participants reported income adequacy, SRH, and QOL. Associations between age and income adequacy and between income adequacy and SRH/QOL were examined using country-specific logistic regression analysis. Results Older adults in China and Russia were more likely to report better income adequacy than their 18- to 49-year-old counterparts; however, the opposite was observed in Ghana and India. SRH and QOL improved as income adequacy increased in all countries. Discussion As expected, income adequacy was correlated with SRH and QOL. However, the relationship between age and income adequacy varied cross-culturally, potentially due to differences in familial and governmental financial support.
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Nova |
2019 |
Brennan-Olsen SL, Bowe SJ, Kowal P, Naidoo N, Quashie NT, Eick G, et al., 'Functional Measures of Sarcopenia: Prevalence, and Associations with Functional Disability in 10,892 Adults Aged 65 Years and Over from Six Lower- and Middle-Income Countries', Calcified Tissue International, 105 609-618 (2019) [C1]
Identification of sarcopenia in lower- and middle-income countries (LMICs) is limited by access to technologies that assess muscle mass. We investigated associations between two f... [more]
Identification of sarcopenia in lower- and middle-income countries (LMICs) is limited by access to technologies that assess muscle mass. We investigated associations between two functional measures of sarcopenia, grip strength and gait speed (GS), with functional disability in adults from six LMICs. Data were extracted from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007¿2010) for adults (= 65¿years) from China, Mexico, Ghana, India, Russia and South Africa (n = 10,892, 52.8% women). We calculated country-specific prevalence of low grip strength, slow GS (= 0.8¿m/s), and both measures combined. Using multivariable negative binomial regression, we separately assessed associations between low grip strength, slow GS, and both measures combined, with the WHO Disability Assessment Schedule 2.0, accounting for selected socioeconomic factors. In women, low grip strength ranged from 7 in South Africa to 51% in India; in men, it ranged from 17 in Russia to 51% in Mexico. Country-specific proportions of slow GS ranged from 77 in Russia, to 33% in China. The concomitant presence of both was the lowest in South Africa and the highest in India (12.3% vs. 33%). Independent of age, those with both low grip strength and slow GS had between 1.2- and 1.5-fold worse functional disability scores, independent of comorbidities, low education, and low wealth (all country-dependent). Low grip strength, slow GS, and the combination of both, were all associated with higher levels of functional disability, thus indicating these objective measures offer a reasonably robust estimate for potential poor health outcomes.
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Nova |
2019 |
Purvis T, Middleton S, Craig LE, Kilkenny MF, Dale S, Hill K, et al., 'Inclusion of a care bundle for fever, hyperglycaemia and swallow management in a National Audit for acute stroke: evidence of upscale and spread', IMPLEMENTATION SCIENCE, 14 (2019) [C1]
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Nova |
2019 |
Schadewaldt V, McElduff B, D'Este C, McInnes E, Dale S, Gunaratne A, et al., 'Validating the Alberta Context Tool in a multi-site Australian Emergency Department nurse population', PLOS ONE, 14 (2019) [C1]
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Nova |
2019 |
Peters R, Booth A, Rockwood K, Peters J, D'Este C, Anstey KJ, 'Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis', BMJ OPEN, 9 (2019) [C1]
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Nova |
2019 |
Middleton S, Gardner G, Gardner A, Considine J, Fitzgerald G, Christofis L, et al., 'Are service and patient indicators different in the presence or absence of nurse practitioners? The EDPRAC cohort study of Australian emergency departments', BMJ OPEN, 9 (2019) [C1]
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Nova |
2019 |
Paul C, D'Este C, Ryan A, Jayakody A, Attia J, Oldmeadow C, et al., 'Staff perspectives from Australian hospitals seeking to improve implementation of thrombolysis care for acute stroke', SAGE OPEN MEDICINE, 7 (2019) [C1]
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Nova |
2019 |
Middleton S, McElduff P, Drury P, D'Este C, Cadilhac DA, Dale S, et al., 'Vital sign monitoring following stroke associated with 90-day independence: A secondary analysis of the QASC cluster randomized trial', International Journal of Nursing Studies, 89 72-79 (2019) [C1]
Background: The Quality in Acute Stroke Care Trial implemented nurse-initiated protocols to manage fever, hyperglycaemia and swallowing (Fever, Sugar, Swallow clinical protocols) ... [more]
Background: The Quality in Acute Stroke Care Trial implemented nurse-initiated protocols to manage fever, hyperglycaemia and swallowing (Fever, Sugar, Swallow clinical protocols) achieving a 16% absolute improvement in death and dependency 90-day post-stroke. Objective: To examine associations between 90-day death and dependency, and monitoring and treatment processes of in-hospital nursing stroke care targeted in the trial. Design: Secondary data analysis from a single-blind cluster randomised control trial. Setting: 19 acute stroke units in New South Wales, Australia. Participants: English-speakers =18 years with ischaemic stroke or intracerebral haemorrhage arriving at participating stroke units <48 h of stroke onset, excluding those for palliation and without a telephone. Method: Data from patients in the 10 intervention hospitals and the nine control hospitals in the QASC trial post-intervention cohort, who had both hospital process of care data and 90-day outcome data were included. Associations between independence at 90-day (modified Rankin Score =1) and processes of care for fever, hyperglycaemia, and dysphagia screening were examined using multiple logistic regression adjusting for treatment group, sex, age group, premorbid modified Rankin scale, marital status, education, stroke severity and correlation within hospitals. Results: Of 1126 patients in the post-intervention cohort (intervention or control), 970 had both in-hospital processes of care data and 90-day outcome data. Patients had significantly lower odds of 90-day independence if, within the first 72 h of stroke unit admission, they had one or more: febrile event (=37.5 °C) (OR 0.47; 95%CI:0.35-0.61; P < 0.0001), higher mean temperature (OR:0.25; 95%CI:0.14-0.45; P < 0.0001), finger-prick blood glucose reading =11 mmol/L (OR:0.61; 95%CI:0.47-0.79; P = 0.0002), higher mean blood glucose (OR 0.89; 95%CI:0.84-0.95; P = 0.0006), or failed the swallowing screen (OR 0.35; 95%CI:0.22-0.56; P < 0.0001). Patients had greater odds of independence when: venous blood glucose was taken on admission to hospital or within 2 h of stroke unit admission (OR 1.4; 95%CI:1.01¿1.83; P = 0.04); finger-prick blood glucose was measured within 72 h of stroke unit admission (OR 1.3; 95%CI:1.02-1.55; P = 0.03); or when swallowing screening or assessment was performed within 24 h of stroke unit admission (OR 1.8; 95%CI:1.29-2.55; P = 0.0006). Conclusion: We have provided robust evidence of the importance of monitoring patients¿ temperature, blood glucose and swallowing status to improve 90-day stroke outcomes. Routine nursing care can result in significant reduction in death and dependency post-stroke.
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Nova |
2019 |
Wright CY, Lucas RM, D'Este C, Kapwata T, Kunene Z, Swaminathan A, et al., 'Effect of A Sun Protection Intervention on the Immune Response to Measles Booster Vaccination in Infants in Rural South Africa', Photochemistry and Photobiology, 95 446-452 (2019) [C1]
The incidence of many serious childhood infections can be reduced by vaccination. High sun exposure at the time of vaccination has been associated with a reduced antigen-specific ... [more]
The incidence of many serious childhood infections can be reduced by vaccination. High sun exposure at the time of vaccination has been associated with a reduced antigen-specific immune response. We hypothesized that providing sun protection advice and equipment to mothers of children who were waiting to be vaccinated would result in a more robust immunization response. We conducted a pilot study in 2015/2016 (data analyzed in 2017¿2018) among 98 Black African children (~18¿months of age) receiving the booster measles vaccination at two clinics in South Africa. Clinics were randomized to receive (or not) sun protection advice and equipment. We recorded demographic information on children and mothers and data on the child's usual sun exposure. At approximately 4¿weeks¿ postmeasles vaccination, we measured measles immunoglobulin G levels in children. All children with blood results (n¿=¿87, 89%) across both groups had antibody titers higher than 200¿mIU¿mL -1 which was considered the protective antibody concentration. There was no statistically significant difference in titers between groups: geometric difference in mean titers 1.13¿mIU¿mL -1 (95% CI 0.85, 1.51; P¿=¿0.39) and 1.38¿mIU¿mL -1 (95% CI 0.90, 2.11, P¿=¿0.14) for unadjusted and adjusted analyses, respectively. This study demonstrated that a sun protection intervention study could be performed in a developing-world pediatric vaccination setting. Although the sun protection intervention around the time of vaccination was not associated with a higher antibody level, given the potential importance of such an effect, a larger study should be considered.
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Nova |
2019 |
Hasnain MG, Paul CL, Attia JR, Ryan A, Kerr E, D'Este C, et al., 'Door-to-needle time for thrombolysis: a secondary analysis of the TIPS cluster randomised controlled trial', BMJ open, 9 (2019) [C1]
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Nova |
2019 |
Middleton S, Dale S, Cheung NW, Cadilhac DA, Grimshaw JM, Levi C, et al., 'Nurse-Initiated Acute Stroke Care in Emergency Departments: The Triage, Treatment, and Transfer Implementation Cluster Randomized Controlled Trial', Stroke, 50 1346-1355 (2019) [C1]
Background and Purpose-We aimed to evaluate the effectiveness of an intervention to improve triage, treatment, and transfer for patients with acute stroke admitted to the emergenc... [more]
Background and Purpose-We aimed to evaluate the effectiveness of an intervention to improve triage, treatment, and transfer for patients with acute stroke admitted to the emergency department (ED). Methods-A pragmatic, blinded, multicenter, parallel group, cluster randomized controlled trial was conducted between July 2013 and September 2016 in 26 Australian EDs with stroke units and tPA (tissue-type plasminogen activator) protocols. Hospitals, stratified by state and tPA volume, were randomized 1:1 to intervention or usual care by an independent statistician. Eligible ED patients had acute stroke <48 hours from symptom onset and were admitted to the stroke unit via ED. Our nurse-initiated T3 intervention targeted (1) Triage to Australasian Triage Scale category 1 or 2; (2) Treatment: tPA eligibility screening and appropriate administration; clinical protocols for managing fever, hyperglycemia, and swallowing; (3) prompt (<4 hours) stroke unit Transfer. It was implemented using (1) workshops to identify barriers and solutions; (2) face-to-face, online, and written education; (3) national and local clinical opinion leaders; and (4) email, telephone, and site visit follow-up. Outcomes were assessed at the patient level. Primary outcome: 90-day death or dependency (modified Rankin Scale score of =2); secondary outcomes: functional dependency (Barthel Index =95), health status (Short Form [36] Health Survey), and ED quality of care (Australasian Triage Scale; monitoring and management of tPA, fever, hyperglycemia, swallowing; prompt transfer). Intention-to-treat analysis adjusted for preintervention outcomes and ED clustering. Patients, outcome assessors, and statisticians were masked to group allocation. Results-Twenty-six EDs (13 intervention and 13 control) recruited 2242 patients (645 preintervention and 1597 postintervention). There were no statistically significant differences at follow-up for 90-day modified Rankin Scale (intervention: n=400 [53.5%]; control n=266 [48.7%]; P=0.24) or secondary outcomes. Conclusions-This evidence-based, theory-informed implementation trial, previously effective in stroke units, did not change patient outcomes or clinician behavior in the complex ED environment. Implementation trials are warranted to evaluate alternative approaches for improving ED stroke care. Clinical Trial Registration-URL: http://www.anzctr.org.au. Unique identifier: ACTRN12614000939695.
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Nova |
2019 |
Yiengprugsawan V, D'Este C, Byles J, Kendig H, 'Geographical variations in self-rated health and functional limitations among older Chinese in eight WHO-SAGE provinces', BMC GERIATRICS, 19 (2019) [C1]
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Nova |
2018 |
Roman LS, Menon BK, Blasco J, Hernandez-Perez M, Davalos A, Majoie CBLM, et al., 'Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data', LANCET NEUROLOGY, 17 895-904 (2018)
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2018 |
Haines MM, Brown B, D'Este CA, Yano EM, Craig JC, Middleton S, et al., 'Improving the quality of healthcare: a cross-sectional study of the features of successful clinical networks', Public health research & practice, 28 (2018) [C1]
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Nova |
2018 |
Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, et al., 'What factors are associated with abstinence amongst socioeconomically disadvantaged smokers? A cross-sectional survey of use of cessation aids and quitting approach', Drug and Alcohol Review, 37 170-179 (2018) [C1]
Introduction and Aims: This study aimed to compare current and ex-smokers' sociodemographic and psychosocial characteristics, use of cessation aids and abrupt versus gradual ... [more]
Introduction and Aims: This study aimed to compare current and ex-smokers' sociodemographic and psychosocial characteristics, use of cessation aids and abrupt versus gradual quitting approaches. Design and Methods: A cross-sectional survey of financially disadvantaged adults attending a community service organisation was conducted in New South Wales, Australia, between February 2012 and December 2013. Sociodemographic and psychosocial factors, use of cessation aids and gradual versus abrupt quit approach were assessed. ¿2 tests and logistic regression compared characteristics of current and ex-smokers. Results: Of 905 individuals who completed the survey, 639 (71%) were current smokers and 107 (12%) were ex-smokers. Ex-smokers were older [odds ratio (OR)¿=¿1.03, 95% confidence interval (CI)¿=¿1.01, 1.05], had higher odds of being female (OR¿=¿1.67, 95% CI¿=¿1.06, 2.65), lower odds of being financially stressed (OR¿=¿0.87, 95% CI¿=¿0.76, 0.99), lower odds of anxiety and depression symptoms (OR¿=¿0.91, 95% CI¿=¿0.84, 0.98) and lower odds of having friends and family who were smokers (ORs ranged from 0.30¿0.43). Ex-smokers had lower odds of using cessation aids and higher odds of reporting abrupt quitting during their last quit attempt (OR¿=¿4.48, 95% CI¿=¿2.66, 7.54). Conclusions: Lower levels of disadvantage, less smoking in social networks, less use of cessation aids and abrupt (vs. gradual) quitting approaches were associated with being an ex-smoker. Lower use of evidence based methods to quit by disadvantaged ex-smokers requires further exploration. [Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, D'este C, Oldmeadow C, Palazzi K. What factors are associated with abstinence amongst socioeconomically disadvantaged smokers? A cross-sectional survey of use of cessation aids and quitting approach. Drug Alcohol Rev 2017;00:000-000].
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Nova |
2018 |
Mackenzie L, Carey M, Suzuki E, Yoshimura M, Toi M, D'Este C, Sanson-Fisher R, 'A cross-sectional study of agreement between the Hospital Anxiety and Depression Scale and patient- and radiation oncologist reported single-item assessment of depression and anxiety', Psycho-Oncology, 27 1840-1846 (2018) [C1]
Objective: To describe among radiation oncology patients: (1) the proportion likely to be experiencing symptoms of depression and anxiety as identified by (a) the Hospital Anxiety... [more]
Objective: To describe among radiation oncology patients: (1) the proportion likely to be experiencing symptoms of depression and anxiety as identified by (a) the Hospital Anxiety and Depression Scale (HADS; standardised tool), (b) patient-reported single items (ultrashort tool), and (c) radiation oncologist¿reported single items (clinician judgement); (2) preferences for being offered psychological support; and (3) agreement between single-item measures and the HADS. Methods: Adult cancer patients (n¿=¿152; consent rate 58%) receiving radiotherapy completed a touchscreen tablet survey assessing symptoms of anxiety and depression (HADS and a single-item tool) and support preferences. Each participant's treating radiation oncologist completed a survey assessing his or her perception of whether the patient was anxious or depressed. Results: Prevalence estimates for likely depression (6.9-18%) and anxiety (17-33%) overlapped across the 3 measures. Overall, only 9.9% of patients (95% CI, 5.6%-16%) wanted to be offered psychological support. For depression, agreement between the HADS and ultrashort tool was fair (¿¿=¿0.37, P¿<¿0.0001); agreement between the HADS and clinician judgement was slight (¿¿=¿0.14, P¿<¿0.05). For anxiety, agreement between the HADS and clinician judgement was not significantly greater than chance alone (¿¿=¿0.04, P¿=¿0.33), and agreement between the HADS and ultrashort tool was moderate (¿¿=¿0.49, P¿<¿0.0001). Conclusions: These findings highlight the important role that oncology consultations play in interpreting assessment tool results and responding to individual patient's history and preferences for psychological support.
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Nova |
2018 |
Lokuge K, Wallace P, Subasinghe K, Thurber K, De Silva T, Clarke N, et al., 'Protocol for a cluster-randomised controlled trial evaluating the impact of a preschool-based capacity building intervention on intimate partner violence and substance misuse in Sri Lanka', BMC PUBLIC HEALTH, 18 (2018)
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2018 |
Kim S, McMaster M, Torres S, Cox KL, Lautenschlager N, Rebok GW, et al., 'Protocol for a pragmatic randomised controlled trial of Body Brain Life-General Practice and a Lifestyle Modification Programme to decrease dementia risk exposure in a primary care setting', BMJ OPEN, 8 (2018)
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2018 |
Jones R, Thurber KA, Chapman J, D'Este C, Dunbar T, Wenitong M, et al., 'Study protocol: Our Cultures Count, the Mayi Kuwayu Study, a national longitudinal study of Aboriginal and Torres Strait Islander wellbeing', BMJ Open, 8 (2018)
Introduction Aboriginal and Torres Strait Islander peoples are Australia's first peoples and have been connected to the land for =65 000 years. Their enduring cultures and va... [more]
Introduction Aboriginal and Torres Strait Islander peoples are Australia's first peoples and have been connected to the land for =65 000 years. Their enduring cultures and values are considered critical to health and wellbeing, alongside physical, psychological and social factors. We currently lack large-scale data that adequately represent the experiences of Aboriginal and Torres Strait Islander people; the absence of evidence on cultural practice and expression is particularly striking, given its foundational importance to wellbeing. Method and analysis Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing (Mayi Kuwayu Study) will be a large-scale, national longitudinal study of Aboriginal and Torres Strait Islander adults, with linkage to health-related administrative records. The baseline survey was developed through extensive community consultation, and includes items on: cultural practice and expression, sociodemographic factors, health and wellbeing, health behaviours, experiences and environments, and family support and connection. The baseline survey will be mailed to 200 000 Aboriginal and Torres Strait Islander adults (=16 years), yielding an estimated 16 000-40 000 participants, supplemented through face-to-face recruitment. Follow-up surveys will be conducted every 3-5 years, or as funding allows. The Mayi Kuwayu Study will contribute to filling key evidence gaps, including quantifying the contribution of cultural factors to wellbeing, alongside standard elements of health and risk. Ethics and dissemination This study has received approval from national Human Research Ethics Committees, and from State and Territory committees, including relevant Aboriginal and Torres Strait Islander organisations. The study was developed and is conducted in partnership with Aboriginal and Torres Strait Islander organisations across states and territories. It will provide an enduring and shared infrastructure to underpin programme and policy development, based on measures and values important to Aboriginal and Torres Strait Islander peoples. Approved researchers can access confidentialised data and disseminate findings according to study data access and governance protocols.
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2018 |
Bonevski B, Twyman L, Paul C, D'Este C, West R, Siahpush M, et al., 'Smoking cessation intervention delivered by social service organisations for a diverse population of Australian disadvantaged smokers: A pragmatic randomised controlled trial', Preventive Medicine, 112 38-44 (2018) [C1]
Objectives: There remains a need to identify effective smoking cessation interventions in severely disadvantaged populations. This trial aimed to examine the effectiveness of an i... [more]
Objectives: There remains a need to identify effective smoking cessation interventions in severely disadvantaged populations. This trial aimed to examine the effectiveness of an intervention (Call it Quits) developed to promote smoking cessation and delivered by community social service case-workers. Methods: Call it Quits was a pragmatic, parallel randomised trial of a case-worker delivered smoking cessation intervention conducted in a non-government community social service organisation in New South Wales (NSW), Australia. Adult smokers requiring financial assistance were randomly assigned to the five-session Call it Quits intervention or usual care control group. Of the 618 eligible individuals, 300 were randomised to the intervention group, of whom 187 (62%) consented and 318 were randomised to the control group, of whom 244 (77%) consented, resulting in 431 participants. The primary outcome measure was self-reported continuous abstinence up to 6-month follow-up with biochemical verification. Primary analysis was performed using all the available data from participants under the assumption the data is missing completely at random, followed by sensitivity analyses. Results: No statistically significant differences in the primary outcome were found (1.4% in the control group versus 1.0% in the intervention group, OR = 0.77, p = 0.828). Conclusions: A multi-component smoking cessation intervention delivering motivational interviewing-based counselling and free NRT by a trained case-worker within a community social service setting was not effective at achieving abstinence in a highly disadvantaged sample of smokers but increased attempts to stop and led to a reduction in number of cigarettes smoked daily.
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Nova |
2018 |
Carey M, Sanson-Fisher R, Clinton-McHarg T, Boyes A, Olver I, Oldmeadow C, et al., 'Examining variation across treatment clinics in cancer patients psychological outcomes: results of a cross sectional survey', Supportive Care in Cancer, 26 3201-3208 (2018) [C1]
Purpose: The majority of research on psychological outcomes for cancer patients has focussed on the role of individual characteristics, and disease and treatment factors. There ha... [more]
Purpose: The majority of research on psychological outcomes for cancer patients has focussed on the role of individual characteristics, and disease and treatment factors. There has been very little exploration of the potential contribution of the treatment clinic to these outcomes. This study explored whether there is variation among clinics in cancer patients¿ psychological outcomes. Methods: Cancer outpatients were recruited from 22 medical oncology and haematology clinics in Australia. Participants completed a pen and paper survey including the Hospital Anxiety and Depression Scale (HADS), as well as sociodemographic, disease and treatment characteristics. Results: Of those eligible to participate, 4233 (82%) consented and 2811 (81% of consenters) returned the completed survey. There was no statistically significant variation in HADS depression scores across clinics. Some difference in anxiety scores derived from the HADS questionnaire between clinics (p = 0.03) was found with the percentage of between-clinic variation estimated to be 1.11%. However, once all demographic, disease and treatment predictors were adjusted for there was no statistical differences between clinics (percent of between-clinic variation = 0.53%; p = 0.1415). Conclusions: Psychological outcomes were not found to vary between clinics. Other sources of variation including patient characteristics may over-ride between-clinic variability, if it exists.
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Nova |
2018 |
Dolja-Gore X, Loxton D, D Este C, Blyth F, Byles J, 'Differences in Use of Government Subsidised Mental Health Services by Men and Women with Psychological Distress: A Study of 229,628 Australians Aged 45 Years and Over', Community Mental Health Journal, 54 1008-1018 (2018) [C1]
This study examined factors associated with use of government subsidised mental health services by 229,628 men and women from the Sax Institute¿s 45 and Up Study. Logistical regre... [more]
This study examined factors associated with use of government subsidised mental health services by 229,628 men and women from the Sax Institute¿s 45 and Up Study. Logistical regression models assessed use of mental health services by gender and according to level of psychological distress. Approximately equal proportion of men and women had high psychological distress scores (approximately 7%) but only 7% of these men and 11% of these women used services. Use was associated with predisposing (younger age and higher education), enabling (private health insurance) and need factors (higher psychological distress scores). Associations were similar for men and women except urban area of residence, separated/divorced marital status, and smoking were associated with service use for women but not men. Results suggest some inequity in the use of services by those with higher levels of need and further efforts may be required to reach people with higher need but lower service use.
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Nova |
2018 |
Mackenzie LJ, Carey ML, Suzuki E, Sanson-Fisher RW, Asada H, Ogura M, et al., 'Agreement between patients and radiation oncologists cancer diagnosis and prognosis perceptions: A cross sectional study in Japan', PLoS ONE, 13 (2018) [C1]
This study assessed agreement between radiation oncologist- and cancer patient-reported perceptions about cancer diagnosis, time since diagnosis, treatment purpose, and whether li... [more]
This study assessed agreement between radiation oncologist- and cancer patient-reported perceptions about cancer diagnosis, time since diagnosis, treatment purpose, and whether life expectancy had been discussed; and described preferences for prognosis discussions. Adult cancer patients receiving radiotherapy at a Japanese hospital were invited to complete a touchscreen tablet survey. Patient survey responses were linked and comparisons made with a survey completed by their radiation oncologist. Among 146 cancer patient-oncologist dyads, there was almost perfect agreement on cancer diagnosis (¿ = 0.88, 95% CI: 0.82¿0.94), substantial agreement on time since diagnosis (¿ = 0.70, 95% CI: 0.57¿0.83) and moderate agreement on whether treatment goal was curative or palliative (¿ = 0.44, 95% CI: 0.28¿0.57; all p¿s < 0.0001). Agreement about whether a life expectancy discussion had occurred was less than expected by chance (¿ = -0.06, p = 0.9). Radiation oncologists reported that they had spoken to over two thirds of patients about this, whilst less than one third of patients stated that this discussion had occurred with their radiation oncologist. Over half of the patients who had not discussed life expectancy wanted to. Patients had variable preferences for whether they (80%), their radiation oncologist (78%) or their partner/family (52%) should decide whether they discuss their life expectancy. Although patient self-reported information about diagnosis and time since diagnosis appears to be reasonably accurate (compared with clinician-reported information), limitations of self-reported data about prognostic discussions were highlighted by poor agreement between patient- and clinician-reported information about whether prognostic discussions have occurred. Additional support is needed to improve prognosis communication and understanding in radiation oncology settings.
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Nova |
2017 |
Barker D, D'Este C, Campbell MJ, McElduff P, 'Minimum number of clusters and comparison of analysis methods for cross sectional stepped wedge cluster randomised trials with binary outcomes: A simulation study', TRIALS, 18 (2017) [C1]
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Nova |
2017 |
Moffatt CRM, Glass K, Stafford R, D'Este C, Kirk MD, 'The campylobacteriosis conundrum - Examining the incidence of infection with Campylobacter sp. in Australia, 1998-2013', Epidemiology and Infection, 145 839-847 (2017)
Campylobacter sp. are a globally significant cause of gastroenteritis. Although rates of infection in Australia are among the highest in the industrialized world, studies describi... [more]
Campylobacter sp. are a globally significant cause of gastroenteritis. Although rates of infection in Australia are among the highest in the industrialized world, studies describing campylobacteriosis incidence in Australia are lacking. Using national disease notification data between 1998 and 2013 we examined Campylobacter infections by gender, age group, season and state and territory. Negative binomial regression was used to estimate incidence rate ratios (IRRs), including trends by age group over time, with post-estimation commands used to obtain adjusted incidence rates. The incidence rate for males was significantly higher than for females [IRR 1.20, 95% confidence interval (CI) 1.18-1.21], while a distinct seasonality was demonstrated with higher rates in both spring (IRR 1.18, 95% CI 1.16-1.20) and summer (IRR 1.17, 95% CI 1.16-1.19). Examination of trends in age-specific incidence over time showed declines in incidence in those aged <40 years combined with contemporaneous increases in older age groups, notably those aged 70-79 years (IRR 1998-2013: 1.75, 95% CI 1.63-1.88). While crude rates continue to be highest in children, our findings suggest the age structure for campylobacteriosis in Australia is changing, carrying significant public health implications for older Australians.
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2017 |
Carey M, Sanson-Fisher R, Macrae F, Cameron E, Hill D, D'Este C, Doran C, 'Improving adherence to colorectal cancer surveillance guidelines: results of a randomised controlled trial', BMC CANCER, 17 (2017) [C1]
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Nova |
2017 |
Wright CY, Albers PN, Mathee A, Kunene Z, D'Este C, Swaminathan A, Lucas RM, 'Sun protection to improve vaccine effectiveness in children in a high ambient ultraviolet radiation and rural environment: An intervention study', BMC Public Health, 17 (2017)
Background: Vaccination is a mainstay of preventive healthcare, reducing the incidence of serious childhood infections. Ecological studies have demonstrated an inverse association... [more]
Background: Vaccination is a mainstay of preventive healthcare, reducing the incidence of serious childhood infections. Ecological studies have demonstrated an inverse association between markers of high ambient ultraviolet (UV) radiation exposure (e.g., sunny season, low latitude of residence) and reduction in the vaccination-associated immune response. Higher sun exposure on the day prior to and spanning the day of vaccination has been associated with a reduced antigen-specific immune response independent of skin pigmentation. The South African Department of Health's Expanded Programme on Immunisation provides free vaccinations in government primary health care clinics. In some areas, these clinics may have only a small waiting room and patients wait outside in full sun conditions. In rural areas, patients may walk several kilometres to and from the clinic. We hypothesised that providing sun protection advice and equipment to mothers of children (from 18 months) who were waiting to be vaccinated would result in a more robust immune response for those vaccinated. Methods: We conducted an intervention study among 100 children receiving the booster measles vaccination. We randomised clinics to receive (or not) sun protection advice and equipment. At each clinic we recorded basic demographic data on the child and mother/carer participants, their sun exposure patterns, and the acceptability and uptake of the provided sun protection. At 3-4 weeks post-vaccination, we measured measles IgG levels in all children. Discussion: This is the first intervention study to assess the effect of sun protection measures on vaccine effectiveness in a rural, real-world setting. The novel design and rural setting of the study can contribute much needed evidence to better understand sun exposure and protection, as well as factors determining vaccine effectiveness in rural Africa, and inform the design of immunisation programmes.
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2017 |
Moore G, Redman S, D'Este C, Makkar S, Turner T, 'Does knowledge brokering improve the quality of rapid review proposals? A before and after study', Systematic Reviews, 6 (2017)
Background: Rapid reviews are increasingly being used to help policy makers access research in short time frames. A clear articulation of the review's purpose, questions, sco... [more]
Background: Rapid reviews are increasingly being used to help policy makers access research in short time frames. A clear articulation of the review's purpose, questions, scope, methods and reporting format is thought to improve the quality and generalisability of review findings. The aim of the study is to explore the effectiveness of knowledge brokering in improving the perceived clarity of rapid review proposals from the perspective of potential reviewers. To conduct the study, we drew on the Evidence Check program, where policy makers draft a review proposal (a pre knowledge brokering proposal) and have a 1-hour session with a knowledge broker, who re-drafts the proposal based on the discussion (a post knowledge brokering proposal). Methods: We asked 30 reviewers who had previously undertaken Evidence Check reviews to examine the quality of 60 pre and 60 post knowledge brokering proposals. Reviewers were blind to whether the review proposals they received were pre or post knowledge brokering. Using a six-point Likert scale, reviewers scored six questions examining clarity of information about the review's purpose, questions, scope, method and format and reviewers' confidence that they could meet policy makers' needs. Each reviewer was allocated two pre and two post knowledge brokering proposals, randomly ordered, from the 60 reviews, ensuring no reviewer received a pre and post knowledge brokering proposal from the same review. Results: The results showed that knowledge brokering significantly improved the scores for all six questions addressing the perceived clarity of the review proposal and confidence in meeting policy makers' needs; with average changes of 0.68 to 1.23 from pre to post across the six domains. Conclusions: This study found that knowledge brokering increased the perceived clarity of information provided in Evidence Check rapid review proposals and the confidence of reviewers that they could meet policy makers' needs. Further research is needed to identify how the knowledge brokering process achieves these improvements and to test the applicability of the findings in other rapid review programs.
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2017 |
Paul CL, Ishiguchi P, D Este CA, Shaw JE, Sanson-Fisher RW, Forshaw K, et al., 'Testing for type 2 diabetes in indigenous Australians: Guideline recommendations and current practice', Medical Journal of Australia, 207 206-210 (2017) [C1]
Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to inves... [more]
Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to investigate whether specific patient characteristics were associated with being tested. Design, setting and participants: Cross-sectional study of 20 978 adult Indigenous Australians not diagnosed with diabetes attending 18 ACCHSs across Australia. De-identified electronic whole service data for July 2010 e June 2013 were analysed. Main outcomes measures: Proportions of patients appropriately screened for diabetes according to three national guidelines for Indigenous Australians: National Health and Medical Research Council (at least once every 3 years for those aged 35 years or more); Royal Australian College of General Practitioners and Diabetes Australia (at least once every 3 years for those aged 18 years or more); National Aboriginal Community Controlled Health Organisation (annual testing of those aged 18 years or more at high risk of diabetes). Results: 74% (95% CI, 74¿75%) of Indigenous adults and 77% (95% CI, 76¿78%) of 10 760 patients aged 35 or more had been tested for diabetes at least once in the past 3 years. The proportions of patients tested varied between services (range: all adults, 16¿90%; people aged 35 years or more, 23¿92%). 18% (95% CI, 18¿19%) of patients aged 18 or more were tested for diabetes annually (range, 0.1¿43%). Patients were less likely to be tested if they were under 50 years of age, were transient rather than current patients of the ACCHS, or attended the service less frequently. Conclusions: Some services achieved high rates of 3-yearly testing of Indigenous Australians for diabetes, but recommended rates of annual testing were rarely attained. ACCHSs may need assistance to achieve desirable levels of testing.
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Nova |
2017 |
Papier K, Jordan S, D'Este C, Banwell C, Yiengprugsawan V, Seubsman S-A, Sleigh A, 'Social Demography of Transitional Dietary Patterns in Thailand: Prospective Evidence from the Thai Cohort Study', NUTRIENTS, 9 (2017) [C1]
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Nova |
2017 |
King L, Xiang F, Swaminathan A, Dear K, Harrison SL, van der Mei I, et al., 'Validation of Sun Exposure Reported Annually Against Interim Self-report and Daily Sun Diaries', Photochemistry and Photobiology, 93 1294-1302 (2017)
Data on personal sun exposure over a period exceeding the immediate past days or weeks are typically self-reported in brief questionnaire items. The validity of such self-reportin... [more]
Data on personal sun exposure over a period exceeding the immediate past days or weeks are typically self-reported in brief questionnaire items. The validity of such self-reporting of longer term personal sun exposure, for example over a year, including detail on variation across seasons, has not previously been investigated. In a volunteer sample (n¿=¿331) of Australian adults aged 18¿years and over, we assessed the 12-month reliability of sun exposure reported separately for each season, and its accuracy compared to a daily sun diary in the same season. Seasonal time outdoors displayed fair-to-good reliability between baseline and end of study (12¿months), with responses showing higher agreement at lower levels of time outdoors. There was good agreement for ranking of individuals' time outdoors with the daily sun diary data, although the actual diary time outdoors was typically considerably lower than the self-reported questionnaire data. Place of residence, education, being a smoker, day of the week (i.e. working day vs nonworking day) and working mainly outdoors were significant predictors of agreement. While participants overestimated their actual time outdoors, the self-report questionnaire provided a valid ranking of long-term sun exposure against others in the study that was reliable over time.
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2017 |
Papier K, D'Este C, Bain C, Banwell C, Seubsman SA, Sleigh A, Jordan S, 'Body mass index and type 2 diabetes in Thai adults: Defining risk thresholds and population impacts', BMC Public Health, 17 (2017)
Background: Body mass index (BMI) cut-off values (>25 and >30) that predict diabetes risk have been well validated in Caucasian populations but less so in Asian populations.... [more]
Background: Body mass index (BMI) cut-off values (>25 and >30) that predict diabetes risk have been well validated in Caucasian populations but less so in Asian populations. We aimed to determine the BMI threshold associated with increased type 2 diabetes (T2DM) risk and to calculate the proportion of T2DM cases attributable to overweight and obesity in the Thai population. Methods: Participants were those from the Thai Cohort Study who were diabetes-free in 2005 and were followed-up in 2009 and 2013 (n = 39,021). We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the BMI-T2DM association. We modelled non-linear associations using restricted cubic splines. We estimated population attributable fractions (PAF) and the number of T2DM incident cases attributed to overweight and obesity. We also calculated the impact of reducing the prevalence of overweight and obesity on T2DM incidence in the Thai population. Results: Non-linear modelling indicated that the points of inflection where the BMI-T2DM association became statistically significant compared to a reference of 20.00 kg/m2 were 21.60 (OR = 1.27, 95% CI 1.00-1.61) and 20.03 (OR = 1.02, 95% CI 1.02-1.03) for men and women, respectively. Approximately two-thirds of T2DM cases in Thai adults could be attributed to overweight and obesity. Annually, if prevalent obesity was 5% lower, ~13,000 cases of T2DM might be prevented in the Thai population. Conclusions: A BMI cut-point of 22 kg/m2, one point lower than the current 23 kg/m2, would be justified for defining T2DM risk in Thai adults. Lowering obesity prevalence would greatly reduce T2DM incidence.
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2017 |
Cabello M, Miret M, Caballero FF, Chatterji S, Naidoo N, Kowal P, et al., 'The role of unhealthy lifestyles in the incidence and persistence of depression: A longitudinal general population study in four emerging countries', Globalization and Health, 13 1-8 (2017) [C1]
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Nova |
2017 |
Campbell SJ, Nery SV, D'Este CA, Gray DJ, McCarthy JS, Traub RJ, et al., 'Investigations into the association between soil-transmitted helminth infections, haemoglobin and child development indices in Manufahi District, Timor-Leste', Parasites and Vectors, 10 (2017)
Background: Timor-Leste has a high prevalence of soil-transmitted helminth (STH) infections. High proportions of the population have been reported as being anaemic, and extremely ... [more]
Background: Timor-Leste has a high prevalence of soil-transmitted helminth (STH) infections. High proportions of the population have been reported as being anaemic, and extremely high proportions of children as stunted or wasted. There have been no published analyses of the contributions of STH to these morbidity outcomes in Timor-Leste. Methods: Using baseline cross-sectional data from 24 communities (18 communities enrolled in a cluster randomised controlled trial, and identically-collected data from six additional communities), analyses of the association between STH infections and community haemoglobin and child development indices were undertaken. Stool samples were assessed for STH using qPCR and participant haemoglobin, heights and weights were measured. Questionnaires were administered to collect demographic and socioeconomic data. Intensity of infection was categorised using correlational analysis between qPCR quantification cycle values and eggs per gram of faeces equivalents, with algorithms generated from seeding experiments. Mixed-effects logistic and multinomial regression were used to assess the association between STH infection intensity classes and anaemia, and child stunting, wasting and underweight. Results: Very high stunting (60%), underweight (60%), and wasting (20%) in children, but low anaemia prevalence (15%), were found in the study communities. STH were not significantly associated with morbidity outcomes. Male children and those in the poorest socioeconomic quintile were significantly more likely to be moderately and severely stunted. Male children were significantly more likely than female children to be severely underweight. Increasing age was also a risk factor for being underweight. Few risk factors emerged for wasting in these analyses. Conclusions: According to World Health Organization international reference standards, levels of child morbidity in this population constitute a public health emergency, although the international reference standards need to be critically evaluated for their applicability in Timor-Leste. Strategies to improve child development and morbidity outcomes, for example via nutrition and iron supplementation programmes, are recommended for these communities. Despite the apparent lack of an association from STH in driving anaemia, stunting, wasting and underweight, high endemicity suggests a need for STH control strategies.
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2017 |
Guillaumier A, Bonevski B, Paul C, d'Este C, Durkin S, Doran C, 'Which Type of Antismoking Advertisement Is Perceived as More Effective? An Experimental Study With a Sample of Australian Socially Disadvantaged Welfare Recipients', AMERICAN JOURNAL OF HEALTH PROMOTION, 31 209-216 (2017) [C1]
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Nova |
2017 |
Alam M, D'Este C, Banwell C, Lokuge K, 'The impact of mobile phone based messages on maternal and child healthcare behaviour: A retrospective cross-sectional survey in Bangladesh', BMC Health Services Research, 17 (2017)
Background: Mobile phones are gradually becoming an integral part of healthcare services worldwide. We assessed the association between Aponjon mobile phone based messaging servic... [more]
Background: Mobile phones are gradually becoming an integral part of healthcare services worldwide. We assessed the association between Aponjon mobile phone based messaging services and practices regarding childbirth and care of mother and neonates in selected areas in Bangladesh. Methods: In early 2014, 476 subscriber mothers whose last born child's age was between 3 and 18 months, were recruited to the study by Dnet from selected areas of Bangladesh. One group of mothers received the early warning messages from Aponjon during pregnancy (exposed; n = 210) while the other group of new mothers did not receive the messages during pregnancy as they had enrolled in the service after childbirth (non-exposed; n = 266). We undertook regression analyses to investigate the relationship between timing of exposure to Aponjon messages and socio-economic factors and outcomes of safe delivery, immediate breastfeeding post birth, delayed bathing of the neonate, and number of postnatal care (PNC) visits. Results: Women reported delivering babies at home without a skilled birth attendant (SBA) (n = 58, 12%), at home with SBA (n = 111, 23%) and at health facilities (n = 307, 65%). Most (n = 443, 93%) women breastfed babies immediately post birth. Babies were bathed after 72 h (n = 294, 62%), between 48 and 72 (n = 100, 21%) and between 0 and 47 (n = 80, 17%) hours after birth. PNC frequencies were reported as none (n = 273, 57%), 1 (n = 79, 17%), 2 (n = 54, 11%), 3 (n = 34, 7%) and 4 (n = 36, 8%). There was no significant association between exposure to Aponjon messages during pregnancy and presence of a SBA at birth, breastfeeding practices, and postnatal care visits, although delayed bathing up to 48 h was significant at the 10% but not 5% level (RRR 1.7; 95% CI 0.93-3.0; p = 0.083). Women with higher education, from higher income, older in age, with birth order 1 or 2 were more likely to birth at health facilities. Facility based delivery was an independent factor for delayed bathing and having postnatal care visits. Conclusions: Low cost mobile phone messages may have the potential to positively influence maternal and child healthcare behaviours, such as delayed timing of first bath, in resource-poor settings. Further studies are needed, with adequate sample size to detect significant change.
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2017 |
Makkar SR, Williamson A, D'Este C, Redman S, 'Preliminary testing of the reliability and feasibility of SAGE: A system to measure and score engagement with and use of research in health policies and programs', Implementation Science, 12 (2017)
Background: Few measures of research use in health policymaking are available, and the reliability of such measures has yet to be evaluated. A new measure called the Staff Assessm... [more]
Background: Few measures of research use in health policymaking are available, and the reliability of such measures has yet to be evaluated. A new measure called the Staff Assessment of Engagement with Evidence (SAGE) incorporates an interview that explores policymakers' research use within discrete policy documents and a scoring tool that quantifies the extent of policymakers' research use based on the interview transcript and analysis of the policy document itself. We aimed to conduct a preliminary investigation of the usability, sensitivity, and reliability of the scoring tool in measuring research use by policymakers. Methods: Nine experts in health policy research and two independent coders were recruited. Each expert used the scoring tool to rate a random selection of 20 interview transcripts, and each independent coder rated 60 transcripts. The distribution of scores among experts was examined, and then, interrater reliability was tested within and between the experts and independent coders. Average- and single-measure reliability coefficients were computed for each SAGE subscales. Results: Experts' scores ranged from the limited to extensive scoring bracket for all subscales. Experts as a group also exhibited at least a fair level of interrater agreement across all subscales. Single-measure reliability was at least fair except for three subscales: Relevance Appraisal, Conceptual Use, and Instrumental Use. Average- and single-measure reliability among independent coders was good to excellent for all subscales. Finally, reliability between experts and independent coders was fair to excellent for all subscales. Conclusions: Among experts, the scoring tool was comprehensible, usable, and sensitive to discriminate between documents with varying degrees of research use. Secondly, the scoring tool yielded scores with good reliability among the independent coders. There was greater variability among experts, although as a group, the tool was fairly reliable. The alignment between experts' and independent coders' ratings indicates that the independent coders were scoring in a manner comparable to health policy research experts. If the present findings are replicated in a larger sample, end users (e.g. policy agency staff) could potentially be trained to use SAGE to reliably score research use within their agencies, which would provide a cost-effective and time-efficient approach to utilising this measure in practice.
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2017 |
Regan T, Paul C, Ishiguchi P, D Este C, Koller C, Forshaw K, et al., 'Comparison of two sources of clinical audit data to assess the delivery of diabetes care in aboriginal communities', International Journal of Environmental Research and Public Health, 14 (2017) [C1]
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Nova |
2017 |
Papier K, D este C, Bain C, Banwell C, Seubsman S, Sleigh A, Jordan S, 'Consumption of sugar-sweetened beverages and type 2 diabetes incidence in thai adults: Results from an 8-year prospective study', Nutrition and Diabetes, 7 (2017)
BACKGROUND: The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-... [more]
BACKGROUND: The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, few studies have assessed this association in Asian populations, and the results have been inconsistent. We aimed to assess that association in a prospective study of Thai adults. METHODS: Data were from Thai Cohort Study participants surveyed in 2005, 2009 and 2013. The nation-wide sample included adult cohort members who were free of diabetes in 2005 and who were followed-up in 2013 (n = 39 175). We used multivariable logistic regression to assess associations between SSB intake and eight-year T2DM incidence. We used a counterfactual mediation analysis to explore potential mediation of the SSB intake and T2DM-risk relationship. RESULTS: In women (but not men) consuming SSBs once or more per day (versus rarely) was associated with increased T2DM incidence at the 8-year follow-up (odds ratio (OR) = 2.4, 95% confidence interval (CI) 1.5-3.9). Obesity in 2009 was found to mediate ~ 23% of the total association between SSB intake in 2005 and T2DM risk in 2013 (natural indirect effect 1.15, 95% CI (1.02, 1.31). CONCLUSIONS: Frequent SSB consumption associated with higher T2DM incidence in women but not men. We found that a moderate proportion of the SSB-T2DM relationship was mediated through body mass index (BMI). Our findings suggest that targeting SSB consumption can help prevent a national rise in the incidence of T2DM.
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2017 |
Middleton S, Coughlan K, Mnatzaganian G, Low Choy N, Dale S, Jammali-Blasi A, et al., 'Mortality Reduction for Fever, Hyperglycemia, and Swallowing Nurse-Initiated Stroke Intervention: QASC Trial (Quality in Acute Stroke Care) Follow-Up', Stroke, 48 1331-1336 (2017) [C1]
Background and Purpose - Implementation of nurse-initiated protocols to manage fever, hyperglycemia, and swallowing dysfunction decreased death and disability 90 days poststroke i... [more]
Background and Purpose - Implementation of nurse-initiated protocols to manage fever, hyperglycemia, and swallowing dysfunction decreased death and disability 90 days poststroke in the QASC trial (Quality in Acute Stroke Care) conducted in 19 Australian acute stroke units (2005-2010). We now examine long-term all-cause mortality. Methods - Mortality was ascertained using Australia's National Death Index. Cox proportional hazards regression compared time to death adjusting for correlation within stroke units using the cluster sandwich (Huber-White estimator) method. Primary analyses included treatment group only unadjusted for covariates. Secondary analysis adjusted for age, sex, marital status, education, and stroke severity using multiple imputation for missing covariates. Results - One thousand and seventy-six participants (intervention n=600; control n=476) were followed for a median of 4.1 years (minimum 0.3 to maximum 70 months), of whom 264 (24.5%) had died. Baseline demographic and clinical characteristics were generally well balanced by group. The QASC intervention group had improved long-term survival (>20%), but this was only statistically significant in adjusted analyses (unadjusted hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.58-1.07; P=0.13; adjusted HR, 0.77; 95% CI, 0.59-0.99; P=0.045). Older age (75-84 years; HR, 4.9; 95% CI, 2.8-8.7; P<0.001) and increasing stroke severity (HR, 1.5; 95% CI, 1.3-1.9; P<0.001) were associated with increased mortality, while being married (HR, 0.70; 95% CI, 0.49-0.99; P=0.042) was associated with increased likelihood of survival. Cardiovascular disease (including stroke) was listed either as the primary or secondary cause of death in 80% (211/264) of all deaths. Conclusions - Our results demonstrate the potential long-term and sustained benefit of nurse-initiated multidisciplinary protocols for management of fever, hyperglycemia, and swallowing dysfunction. These protocols should be a routine part of acute stroke care.
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Nova |
2017 |
Duchesne GM, Woo HH, King M, Bowe SJ, Stockler MR, Ames A, et al., 'Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial', The Lancet Oncology, 18 1192-1201 (2017)
Background Androgen-deprivation therapy in patients with prostate cancer who have relapsed with rising prostate-specific antigen concentration only (PSA-only relapse), or with non... [more]
Background Androgen-deprivation therapy in patients with prostate cancer who have relapsed with rising prostate-specific antigen concentration only (PSA-only relapse), or with non-curable but asymptomatic disease at diagnosis, could adversely affect quality of life at a time when the disease itself does not. We aimed to compare the effect of immediate versus delayed androgen-deprivation therapy on health-related quality of life over 5 years in men enrolled in the TOAD (Timing of Androgen Deprivation) trial. Methods This randomised, multicentre, open-label, phase 3 trial done in 29 public and private cancer centres across Australia, New Zealand, and Canada compared immediate with delayed androgen-deprivation therapy in men with PSA-only relapse after definitive treatment, or de-novo non-curable disease. Patients were randomly assigned (1:1) with a database-embedded, dynamically balanced algorithm to immediate androgen-deprivation therapy (immediate therapy group) or to delayed androgen-deprivation therapy (delayed therapy group). Any type of androgen-deprivation therapy was permitted, as were intermittent or continuous schedules. The European Organisation for Research and Treatment of Cancer (EORTC) quality-of-life questionnaires QLQ-C30 and PR25 were completed before randomisation, every 6 months for 2 years, and annually for a further 3 years. The primary outcome of the trial, reported previously, was overall survival, with global health-related quality of life at 2 years as a secondary endpoint. Here we report prespecified secondary objectives of the quality-of-life endpoint. Analysis was by intention to treat. Statistical significance was set at p=0·0036. The trial was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12606000301561, and ClinicalTrials.gov, number NCT00110162. Findings Between Sept 3, 2004, and July 13, 2012, 293 men were recruited and randomly assigned; 151 to the delayed therapy group and 142 to the immediate therapy group. There was no difference between the two groups in global health-related quality of life over 2 years from randomisation. There were no statistically significant differences in global quality of life, physical functioning, role functioning, or emotional functioning, fatigue, dyspnoea, insomnia, or feeling less masculine over the entire 5 years after randomisation. Sexual activity was lower in the immediate therapy group than in the delayed group at 6 and 12 months (at 6 months mean score 29·20 [95% CI 24·59¿33·80] in the delayed group vs 10·40 [6·87¿13·93] in the immediate group, difference 18·80 [95% CI 13·00¿24·59], p<0·0001; at 12 months 28·63 [24·07¿33·18] vs 13·76 [9·94¿17·59], 14·86 [8·95¿20·78], p<0·0001), with the differences exceeding the clinically significant threshold of 10 points until beyond 2 years. The immediate therapy group also had more hormone-treatment-related symptoms at 6 and 12 months (at 6 months mean score 8·48 [95% CI 6·89¿10·07] in the delayed group vs 15·97 [13·92¿18·02] in the immediate group, difference -7·49 [¿10·06 to -4·93], p<0·0001; at 12 months 9·32 [7·59¿11·05] vs 17·07 [14·75¿19·39], -7·75 [¿10·62 to -4·89], p<0·0001), but with differences below the threshold of clinical significance. For the individual symptoms, hot flushes were clinically significantly higher in the immediate group (adjusted proportion 0·31 for delayed therapy vs 0·55 for immediate therapy, adjusted odds ratio 2·87 [1·96¿4·21], p<0·0001) over the 5-year period, as were nipple or breast symptoms (0·06 vs 0·14, 2·64 [1·61¿4·34], p=0·00013). Interpretation Immediate use of androgen-deprivation therapy was associated with early detriments in specific hormone-treatment-related symptoms, but with no other demonstrable effect on overall functioning or health-related quality of life. This evidence can be used to help decision making about treatment initiation for men at this disease stage. Funding Australian National Health and Medical Res...
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2016 |
Barker D, McElduff P, D'Este C, Campbell MJ, 'Stepped wedge cluster randomised trials: a review of the statistical methodology used and available', BMC MEDICAL RESEARCH METHODOLOGY, 16 (2016) [C1]
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Nova |
2016 |
Campbell SJ, Nery SV, D'Este CA, Gray DJ, McCarthy JS, Traub RJ, et al., 'Water, sanitation and hygiene related risk factors for soil-transmitted helminth and Giardia duodenalis infections in rural communities in Timor-Leste', International Journal for Parasitology, 46 771-779 (2016)
There is little evidence on prevalence or risk factors for soil transmitted helminth infections in Timor-Leste. This study describes the epidemiology, water, sanitation and hygien... [more]
There is little evidence on prevalence or risk factors for soil transmitted helminth infections in Timor-Leste. This study describes the epidemiology, water, sanitation and hygiene, and socioeconomic risk factors of STH and intestinal protozoa amongst communities in Manufahi District, Timor-Leste. As part of a cluster randomised controlled trial, a baseline cross-sectional survey was conducted across 18 villages, with data from six additional villages. Stool samples were assessed for soil transmitted helminth and protozoal infections using quantitative PCR (qPCR) and questionnaires administered to collect water, sanitation and hygiene and socioeconomic data. Risk factors for infection were assessed using multivariable mixed-effects logistic regression, stratified by age group (preschool, school-aged and adult). Overall, soil transmitted helminth prevalence was 69% (95% Confidence Interval 67¿71%), with Necator americanus being most common (60%; 95% Confidence Interval 58¿62%) followed by Ascaris spp. (24%; 95% Confidence Interval 23¿26%). Ascaris-N. americanus co-infection was common (17%; 95% Confidence Interval 15%-18%). Giardia duodenalis was the main protozoan identified (13%; 95% Confidence Interval 11¿14%). Baseline water, sanitation and hygiene infrastructure and behaviours were poor. Although risk factors varied by age of participants and parasite species, risk factors for N. americanus infection included, generally, age in years, male sex, and socioeconomic quintile. Risk factors for Ascaris included age in years for children, and piped water to the yard for adults. In this first known assessment of community-based prevalence and associated risk factors in Timor-Leste, soil transmitted helminth infections were highly prevalent, indicating a need for soil transmitted helminth control. Few associations with water, sanitation and hygiene were evident, despite water, sanitation and hygiene being generally poor. In our water, sanitation and hygiene we will investigate implications of improving WASH on soil transmitted helminth infection in impoverished communities.
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Nova |
2016 |
Morris LJ, D'Este C, Sargent-Cox K, Anstey KJ, 'Concurrent lifestyle risk factors: Clusters and determinants in an Australian sample', Preventive Medicine, 84 1-5 (2016)
Objective: To examine clustering among three major lifestyle risk factors for chronic disease (smoking, alcohol, and physical inactivity) and define sociodemographic subgroups wit... [more]
Objective: To examine clustering among three major lifestyle risk factors for chronic disease (smoking, alcohol, and physical inactivity) and define sociodemographic subgroups with elevated risks of multiple lifestyle risk factors. Method: Data on 6052 adults aged 28-32, 48-52, and 68-72 from wave 3 (2007-2010) of the PATH Through Life Cohort Study, Australia, were used to estimate prevalence of individual and combinations of risk factors, and multinomial regression analysis undertaken to examine demographic factors associated with number of risks. Results: Clustering of risks varied by age and gender, with more people than expected having none or all of the risk factors. Smoking clustered with harmful alcohol use, as well as physical inactivity. No relationship was observed between physical inactivity and alcohol use. Several sociodemographic characteristics were associated with the number of lifestyle risk factors including partner status, gender, age, education, and physical and mental health related quality of life. Conclusions: The tendency for lifestyle risk factors to aggregate in different subgroups has meaningful implications for health promotion strategies. Better insight in the more vulnerable subpopulations that are at higher risk of displaying multiple lifestyle risk factors is of importance if we wish to reduce the population propensity for chronic disease.
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Nova |
2016 |
Duchesne GM, Woo HH, Bassett JK, Bowe SJ, D'Este C, Frydenberg M, et al., 'Timing of androgen-deprivation therapy in patients with prostate cancer with a rising PSA (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial', The Lancet Oncology, 17 727-737 (2016)
Background Androgen-deprivation therapy is offered to men with prostate cancer who have a rising prostate-specific antigen after curative therapy (PSA relapse) or who are consider... [more]
Background Androgen-deprivation therapy is offered to men with prostate cancer who have a rising prostate-specific antigen after curative therapy (PSA relapse) or who are considered not suitable for curative treatment; however, the optimal timing for its introduction is uncertain. We aimed to assess whether immediate androgen-deprivation therapy improves overall survival compared with delayed therapy. Methods In this randomised, multicentre, phase 3, non-blinded trial, we recruited men through 29 oncology centres in Australia, New Zealand, and Canada. Men with prostate cancer were eligible if they had a PSA relapse after previous attempted curative therapy (radiotherapy or surgery, with or without postoperative radiotherapy) or if they were not considered suitable for curative treatment (because of age, comorbidity, or locally advanced disease). We used a database-embedded, dynamically balanced, randomisation algorithm, coordinated by the Cancer Council Victoria, to randomly assign participants (1:1) to immediate androgen-deprivation therapy (immediate therapy arm) or to delayed androgen-deprivation therapy (delayed therapy arm) with a recommended interval of at least 2 years unless clinically contraindicated. Randomisation for participants with PSA relapse was stratified by type of previous therapy, relapse-free interval, and PSA doubling time; randomisation for those with non-curative disease was stratified by metastatic status; and randomisation in both groups was stratified by planned treatment schedule (continuous or intermittent) and treatment centre. Clinicians could prescribe any form and schedule of androgen-deprivation therapy and group assignment was not masked. The primary outcome was overall survival in the intention-to-treat population. The trial closed to accrual in 2012 after review by the independent data monitoring committee, but data collection continued for 18 months until Feb 26, 2014. It is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12606000301561) and ClinicalTrials.gov (NCT00110162). Findings Between Sept 3, 2004, and July 13, 2012, we recruited 293 men (261 with PSA relapse and 32 with non-curable disease). We randomly assigned 142 men to the immediate therapy arm and 151 to the delayed therapy arm. Median follow-up was 5 years (IQR 3·3¿6·2) from the date of randomisation. 16 (11%) men died in the immediate therapy arm and 30 (20%) died in the delayed therapy arm. 5-year overall survival was 86·4% (95% CI 78·5¿91·5) in the delayed therapy arm versus 91·2% (84·2¿95·2) in the immediate therapy arm (log-rank p=0·047). After Cox regression, the unadjusted HR for overall survival for immediate versus delayed arm assignment was 0·55 (95% CI 0·30¿1·00; p=0·050). 23 patients had grade 3 treatment-related adverse events. 105 (36%) men had adverse events requiring hospital admission; none of these events were attributable to treatment or differed between treatment-timing groups. The most common serious adverse events were cardiovascular, which occurred in nine (6%) patients in the delayed therapy arm and 13 (9%) in the immediate therapy arm. Interpretation Immediate receipt of androgen-deprivation therapy significantly improved overall survival compared with delayed intervention in men with PSA-relapsed or non-curable prostate cancer. The results provide benchmark evidence of survival rates and morbidity to discuss with men when considering their treatment options. Funding Australian National Health and Medical Research Council and Cancer Councils, The Royal Australian and New Zealand College of Radiologists, Mayne Pharma Australia.
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Nova |
2016 |
Shah T, Greig J, van der Plas LM, Achar J, Caleo G, Squire JS, et al., 'Inpatient signs and symptoms and factors associated with death in children aged 5 years and younger admitted to two Ebola management centres in Sierra Leone, 2014: A retrospective cohort study', The Lancet Global Health, 4 e495-e501 (2016)
Background: Médecins Sans Frontières (MSF) opened Ebola management centres (EMCs) in Sierra Leone in Kailahun in June, 2014, and Bo in September, 2014. Case fatality in the west A... [more]
Background: Médecins Sans Frontières (MSF) opened Ebola management centres (EMCs) in Sierra Leone in Kailahun in June, 2014, and Bo in September, 2014. Case fatality in the west African Ebola virus disease epidemic has been highest in children younger than 5 years. Clinical data on outcomes can provide important evidence to guide future management. However, such data on children are scarce and disaggregated clinical data across all ages in this epidemic have focussed on symptoms reported on arrival at treatment facilities, rather than symptoms and signs observed during admission. We aimed to describe the clinical characteristics of children aged 5 years and younger admitted to the MSF EMCs in Bo and Kailahun, and any associations between these characteristics and mortality. Methods: In a retrospective cohort study, we included data from children aged 5 years and younger with laboratory-confirmed Ebola virus disease admitted to EMCs between June and December, 2014. We described epidemiological, demographic, and clinical characteristics and viral load (measured using Ebola virus cycle thresholds [Ct]), and assessed their association with death using Cox regression modelling. Findings: We included 91 children in analysis; 52 died (57·1%). Case fatality was higher in children aged less than 2 years (76·5% [26/34]) than those aged 2-5 years (45·6% [26/57]; adjusted HR 3·5 [95% CI 1·5-8·5]) and in those with high (Ct<25) versus low (Ct=25) viral load (81·8% [18/22] vs 45·9% [28/61], respectively; adjusted HR 9·2 [95% CI 3·8-22·5]). Symptoms observed during admission included: weakness 74·7% (68); fever 70·8% (63/89); distress 63·7% (58); loss of appetite 60·4% (55); diarrhoea 59·3% (54); and cough 52·7% (48). At admission, 25% (19/76) of children were afebrile. Signs significantly associated with death were fever, vomiting, and diarrhoea. Hiccups, bleeding, and confusion were observed only in children who died. Interpretation: This description of the clinical features of Ebola virus disease over the duration of illness in children aged 5 years and younger shows symptoms associated with death and a high prevalence of distress, with implications for clinical management. Collection and analysis of age-specific data on Ebola is very important to ensure that the specific vulnerabilities of children are addressed. Funding: No specific funding was received for this study. EB is supported by the National Health and Medical Research Council of Australia.
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Nova |
2016 |
Williamson A, D'Este C, Clapham K, Redman S, Manton T, Eades S, et al., 'What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase i findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)', BMJ Open, 6 (2016) [C1]
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Nova |
2016 |
Bryant J, Boyes AW, Hall A, Girgis A, D'Este C, Sitas F, 'Prevalence and factors related to smoking and smoking cessation 6 months following a cancer diagnosis: a population-based study (vol 10, pg 645, 2016 )', JOURNAL OF CANCER SURVIVORSHIP, 10 1112-1112 (2016)
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2016 |
Suzuki E, Mackenzie L, Sanson-Fisher R, Carey M, D Este C, Asada H, Toi M, 'Acceptability of a Touch Screen Tablet Psychosocial Survey Administered to Radiation Therapy Patients in Japan', International Journal of Behavioral Medicine, 23 485-491 (2016) [C1]
Background: Studies in western clinical settings suggest that touch screen computer surveys are an acceptable mode of collecting information about cancer patients¿ wellbeing Purpo... [more]
Background: Studies in western clinical settings suggest that touch screen computer surveys are an acceptable mode of collecting information about cancer patients¿ wellbeing Purpose: We examined the acceptability of a touch screen tablet survey among cancer patients in Japan. Methods: Eligible patients (n = 262) attending a university hospital radiation therapy (RT) department were invited to complete a touch screen tablet survey about psychosocial communication and care. Survey consent and completion rates, the proportion and characteristics of patients who completed the touch screen survey unassisted, and patient-reported acceptability were assessed. Results: Of 158 consenting patients (consent rate 60¿% [95¿% CI 54, 66¿%] of eligible patients), 152 completed the touch screen computer survey (completion rate 58¿% [95¿% CI 52, 64¿%] of eligible patients). The survey was completed without assistance by 74¿% (n = 113; 95¿% CI 67, 81¿%) of respondents. Older age was associated with higher odds of having assistance with survey completion (OR 1.09; 95¿% CI 1.04, 1.14¿%). Ninety-two percent of patients (95¿% CI 86, 96¿%) felt that the touch screen survey was easy to use and 95¿% (95¿% CI 90, 98¿%) agreed or strongly agreed that they were comfortable answering the questions. Overall, 65¿% (95¿% CI 57, 73¿%) of respondents would be willing to complete such a survey more than once while waiting for RT treatment. Conclusions: Although patient self-reported acceptability of the touch screen survey was high, self-administered touch screen tablet surveys may not be entirely appropriate for older cancer patients or possibly for patients with lower educational attainment.
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Nova |
2016 |
Brown BB, Haines M, Middleton S, Paul C, D'Este C, Klineberg E, et al., 'Development and validation of a survey to measure features of clinical networks', BMC Health Services Research, 16 1-11 (2016) [C1]
Background: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Fe... [more]
Background: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Few are ever formally evaluated and, when this is done, not all networks are equally successful in their efforts. There is a need to formatively assess the strategic and operational management and leadership of networks to identify where functioning could be improved to maximise impact. This paper outlines the development and psychometric evaluation of an Internet survey to measure features of clinical networks and provides descriptive results from a sample of members of 19 diverse clinical networks responsible for evidence-based quality improvement across a large geographical region. Methods: Instrument development was based on: a review of published and grey literature; a qualitative study of clinical network members; a program logic framework; and consultation with stakeholders. The resulting domain structure was validated for a sample of 592 clinical network members using confirmatory factor analysis. Scale reliability was assessed using Cronbach's alpha. A summary score was calculated for each domain and aggregate level means and ranges are reported. Results: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficients were equal to or above 0.75. In the survey sample of network members there was strong reported commitment and belief in network-led quality improvement initiatives, which were perceived to have improved quality of care (72.8 %) and patient outcomes (63.2 %). Network managers were perceived to be effective leaders and clinical co-chairs were perceived as champions for change. Perceived external support had the lowest summary score across the seven domains. Conclusions: This survey, which has good construct validity and internal reliability, provides a valid instrument to use in future research related to clinical networks. The survey will be of use to health service managers to identify strengths and areas where networks can be improved to increase effectiveness and impact on quality of care and patient outcomes. Equally, the survey could be adapted for use in the assessment of other types of networks.
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Nova |
2016 |
Middleton S, Lydtin A, Comerford D, Cadilhac DA, McElduff P, Dale S, et al., 'From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/post-test study design', BMJ OPEN, 6 (2016) [C1]
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Nova |
2016 |
Papier K, Jordan S, D'Este C, Bain C, Peungson J, Banwell C, et al., 'Incidence and risk factors for type 2 diabetes mellitus in transitional Thailand: Results from the Thai cohort study', BMJ Open, 6 (2016)
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Nova |
2016 |
Bryant J, Boyes AW, Hall A, Girgis A, D Este C, Sitas F, 'Prevalence and factors related to smoking and smoking cessation 6 months following a cancer diagnosis: a population-based study', Journal of Cancer Survivorship, 10 645-653 (2016) [C1]
Purpose: Limited research has examined smoking amongst recent cancer survivors or the relative contribution of factors on smoking behaviour. This study aimed to describe amongst r... [more]
Purpose: Limited research has examined smoking amongst recent cancer survivors or the relative contribution of factors on smoking behaviour. This study aimed to describe amongst recent Australian cancer survivors (i) prevalence of smoking by cancer type, (ii) characteristics associated with continued smoking following diagnosis, (iii) intention to quit among those who continue to smoke and (iv) characteristics associated with quitting following diagnosis. Method: Cross-sectional data were analysed from 1299 cancer survivors diagnosed with their first primary cancer recruited from two Australian cancer registries in Australia between 2006 and 2008. Results: Of participants, 8.6¿% reported current smoking. Participants who were younger and single or widowed reported higher odds of current smoking. Participants who had a certificate/diploma or tertiary education reported lower odds of smoking. Among current smokers, 53¿% intended to quit in the future. Lung cancer survivors reported more than four times the odds of quitting smoking since diagnosis compared to other cancer types. Conclusion: Of recent Australian cancer survivors, 14¿% report continued smoking. Implications for Cancer Survivors: Smoking following a cancer diagnosis is associated with increased risk of mortality and further morbidity. There is a need to target cessation efforts towards survivors who are younger, without a partner and with a low level of education.
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Nova |
2016 |
Guillaumier A, Bonevski B, Paul C, D Este C, Twyman L, Palazzi K, Oldmeadow C, 'Self-Exempting Beliefs and Intention to Quit Smoking within a Socially Disadvantaged Australian Sample of Smokers', International Journal of Environmental Research and Public Health, 13 118-118 [C1]
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Nova |
2016 |
Carey M, Sanson-Fisher R, Macrae F, Cameron E, Hill D, D'Este C, et al., 'Can a print-based intervention increase screening for first degree relatives of people with colorectal cancer? A randomised controlled trial', Australian and New Zealand Journal of Public Health, 40 582-587 (2016) [C1]
Objective: To test the effectiveness of a targeted print-based intervention to improve screening adherence in first degree relatives of people with colorectal cancer (CRC). Method... [more]
Objective: To test the effectiveness of a targeted print-based intervention to improve screening adherence in first degree relatives of people with colorectal cancer (CRC). Methods: People with CRC and their adult first degree relatives were identified through a population-based cancer registry and randomly allocated as a family unit to the intervention or control condition. The control group received general information about CRC screening. The intervention group received printed advice regarding screening that was targeted to their risk level. Screening adherence was assessed at baseline and at 12 months via self report. Results: 752 (25%) index cases and 574 (34%) eligible first degree relatives consented to take part in the trial and completed baseline interviews. At 12 months, 58% of first degree relatives in the control group and 61% in the intervention group were adherent to screening guidelines (mixed effects logistic regression group by time interaction effect =2.7; 95%CI=1.2¿5.9; P=0.013). Subgroup analysis indicated that the intervention was only effective for those with the lowest risk. Conclusions: Provision of personalised risk information may have a modest effect on adherence to CRC screening recommendations among first degree relatives of people diagnosed with CRC. Implications: Improved strategies for identifying and engaging first degree relatives are needed to maximise the population impact of the intervention.
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Nova |
2016 |
Ren S, Hure A, Peel R, D'Este C, Abhayaratna W, Tonkin A, et al., 'Rationale and design of a randomized controlled trial of pneumococcal polysaccharide vaccine for prevention of cardiovascular events: The Australian Study for the Prevention through Immunization of Cardiovascular Events (AUSPICE)', American Heart Journal, 177 58-65 (2016)
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2016 |
Bonevski B, Guillaumier A, Shakeshaft A, Farrell M, Tzelepis F, Walsberger S, et al., 'An organisational change intervention for increasing the delivery of smoking cessation support in addiction treatment centres: study protocol for a randomized controlled trial', TRIALS, 17 (2016)
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Nova |
2016 |
Paul C, Bonevski B, Twyman L, D'Este C, Siahpush M, Guillaumier A, et al., 'The 'price signal' for health care is loud and clear: A cross-sectional study of self-reported access to health care by disadvantaged Australians', Australian and New Zealand Journal of Public Health, 40 132-137 (2016) [C1]
Objective: To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. Method: A cross-sect... [more]
Objective: To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. Method: A cross-sectional survey with 906 adult clients of a large community welfare agency in New South Wales. Clients attending the service for emergency assistance completed a touchscreen survey. Results: Inability to access health care in the prior year was reported by more than one-third of the sample (38%), compared to the 5% found for the general population. Dentists (47%), specialists (43%) or GPs (29%) were the least accessible types of health care. The main reason for inability to access health care was cost, accounting for 60% of responses. Almost half (47%) the sample reported delayed or non-use of medicines due to cost. Increasing financial stress was associated with increased inability to access GP or specialist care, medicines and imaging. Higher anxiety scores were associated with inability to access health care, and with cost-related inability to access medicines and imaging. Conclusion: For disadvantaged groups, cost-related barriers to accessing care are prominent and are disproportionately high - particularly regarding dentistry, specialist and GP care. Implications: Improvements in health outcomes for disadvantaged groups are likely to require strategies to reduce cost-related barriers to health care.
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Nova |
2016 |
Middleton S, Levi C, Dale S, Cheung NW, McInnes E, Considine J, et al., 'Triage, treatment and transfer of patients with stroke in emergency department trial (the T
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2016 |
Brown BB, Haines M, Middleton S, Paul C, D'Este C, Klineberg E, Elliott E, 'Development and validation of a survey to measure features of clinical networks', BMC health services research, 16 531 (2016)
RESULTS: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficie... [more]
RESULTS: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficients were equal to or above 0.75. In the survey sample of network members there was strong reported commitment and belief in network-led quality improvement initiatives, which were perceived to have improved quality of care (72.8¿%) and patient outcomes (63.2¿%). Network managers were perceived to be effective leaders and clinical co-chairs were perceived as champions for change. Perceived external support had the lowest summary score across the seven domains. CONCLUSIONS: This survey, which has good construct validity and internal reliability, provides a valid instrument to use in future research related to clinical networks. The survey will be of use to health service managers to identify strengths and areas where networks can be improved to increase effectiveness and impact on quality of care and patient outcomes. Equally, the survey could be adapted for use in the assessment of other types of networks. BACKGROUND: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Few are ever formally evaluated and, when this is done, not all networks are equally successful in their efforts. There is a need to formatively assess the strategic and operational management and leadership of networks to identify where functioning could be improved to maximise impact. This paper outlines the development and psychometric evaluation of an Internet survey to measure features of clinical networks and provides descriptive results from a sample of members of 19 diverse clinical networks responsible for evidence-based quality improvement across a large geographical region. METHODS: Instrument development was based on: a review of published and grey literature; a qualitative study of clinical network members; a program logic framework; and consultation with stakeholders. The resulting domain structure was validated for a sample of 592 clinical network members using confirmatory factor analysis. Scale reliability was assessed using Cronbach's alpha. A summary score was calculated for each domain and aggregate level means and ranges are reported.
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2016 |
Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, et al., 'Factors associated with concurrent tobacco smoking and heavy alcohol consumption within a socioeconomically disadvantaged Australian sample', Substance Use and Misuse, 51 459-470 (2016) [C1]
Background: Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial ... [more]
Background: Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users. Objectives: This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers. Methods: A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out. Results: The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers. Conclusion: Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.
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Nova |
2015 |
Ojagbemi A, D'Este C, Verdes E, Chatterji S, Gureje O, 'Gait speed and cognitive decline over 2 years in the Ibadan study of aging', Gait and Posture, 41 736-740 (2015) [C1]
Background: The evidence suggesting that gait speed may represent a sensitive marker for cognitive decline in the elderly requires support from diverse racial groups. Objective: W... [more]
Background: The evidence suggesting that gait speed may represent a sensitive marker for cognitive decline in the elderly requires support from diverse racial groups. Objective: We investigated the relationship between gait speed and cognitive decline over 2 years in a community dwelling sample of elderly Africans. Methods: Data are from the Ibadan study of aging (ISA) conducted among a household multi-stage probability sample of 2149 Yoruba Nigerians aged 65 years or older. Gait speed was measured as the time taken to complete a 3 or 4. m distance at normal walking speed. We assessed cognitive functions with a modified version of the 10-word learning list and delay recall test, and examined the relationship between baseline gait speed, as well as gait speed changes, and follow-up cognition using multiple linear regression and longitudinal analyses using random effects. Results: Approximately 71% of 1461 participants who were dementia free and who had their gait speed measured at baseline (2007) were successfully followed up in two waves (2008 and 2009). Along with increasing age, poor health and economic status, a slower baseline gait speed was independently associated with poorer follow-up cognition in both linear regression (1.2 words, 95% CI. =. 0.48-2.0) and longitudinal analyses (0.8 words, 95% CI. =. 0.44-1.2). Also, a greater change in gait speed between 2007 and 2009 was associated with the worst follow-up cognition (0.3 words, 95% CI. =. 0.09-0.51). Conclusion: The finding that a substantial change in gait speed was associated with reduced cognitive performance is of potential importance to efforts aimed at early identification of cognitive disorders in this population.
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2015 |
Boyes AW, Clinton-Mcharg T, Waller AE, Steele A, D'Este CA, Sanson-Fisher RW, 'Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy', Acta Oncologica, 54 507-514 (2015) [C1]
Background. Information about the unmet supportive care needs of haematological cancer patients is needed for service planning and to inform clinical practice. This study describe... [more]
Background. Information about the unmet supportive care needs of haematological cancer patients is needed for service planning and to inform clinical practice. This study described the prevalence of, and factors associated with, unmet supportive care needs among haematological cancer patients. Material and methods. A total of 380 adults diagnosed with haematological cancer were recruited from the outpatient department at three comprehensive cancer treatment centres in Australia. Of these, 311 completed a self-report questionnaire. Unmet needs were assessed using the 34-item Supportive Care Needs Survey (SCNS-SF34). The data were examined using descriptive statistics and logistic regression. Results. Overall, 51% (95% CI 45-57%) of participants reported having at least one 'moderate to high' level unmet need, while 25% (95% CI 20-30%) reported 'no need' for help with any items. Unmet needs were most commonly reported in the psychological (35%; 95% CI 30-41%) and physical aspects of daily living (35%; 95% CI 30-41%) domains. The three most frequently endorsed items of 'moderate to high' unmet need were: lack of energy/tiredness (24%; 95% CI 20-30%), not being able to do the things you used to do (21%; 95% CI 17-26%), and uncertainty about the future (21%; 95% CI 16-25%). Patients' sociodemographic characteristics influenced unmet needs more than disease characteristics. Patients who were female, aged less than 55 years or not in the labour force had higher odds of reporting 'moderate to high' level unmet supportive care needs. Conclusion. Unmet supportive care needs are prevalent among haematological cancer patients, particularly in the psychological and physical aspects of daily living domains. These findings provide valuable insight about the range of resources, multidisciplinary linkages and referral pathways needed to address haematological cancer patients' unmet needs.
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Nova |
2015 |
Plotnikoff RC, Costigan SA, Short C, Grunseit A, James E, Johnson N, et al., 'Factors associated with higher sitting time in general, chronic disease, and psychologically-distressed, adult populations: Findings from the 45 & up Study', PLoS ONE, 10 (2015) [C1]
This study examined factors associated with higher sitting time in general, chronic disease, and psychologically-distressed, adult populations (aged =45 years). A series of logist... [more]
This study examined factors associated with higher sitting time in general, chronic disease, and psychologically-distressed, adult populations (aged =45 years). A series of logistic regression models examined potential socio-demographic and health factors associated with higher sitting (=6hrs/day) in adults from the 45 and Up Study (n = 227,187), including four separate subsamples for analysis comprising those who had ever had heart disease (n = 26,599), cancer (n = 36,381), diabetes (n = 19,550) or psychological distress (n = 48,334). Odds of higher sitting were significantly (p<.01) associated with a number of factors across these groups, with an effect size of ORs=1.5 observed for the high-income =$70,000AUD, employed full-time and severe physical limitations demographics. Identification of key factors associated with higher sitting time in this population-based sample will assist development of broad-based, public health and targeted strategies to reduce sitting-time. In particular, those categorized as being high-income earners, full-time workers, as well as those with severe physical limitations need to be of priority, as higher sitting appears to be substantial across these groups.
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Nova |
2015 |
Mackenzie LJ, Carey M, Sanson-Fisher R, D'Este C, Yoong SL, 'A cross-sectional study of radiation oncology outpatients' concern about, preferences for, and perceived barriers to discussing anxiety and depression.', Psycho-oncology, 24 1392-1397 (2015) [C1]
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Nova |
2015 |
Paul CL, Carey ML, Russell G, D'Este C, Sanson-Fisher RW, Zwar N, 'Prevalence of FOB testing in eastern-Australian general practice patients: What has a national bowel cancer screening program delivered?', Health Promotion Journal of Australia, 26 39-44 (2015) [C1]
Issues addressed The National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006, offering free immunochemical Faecal Occult Blood Test (FOBT) to persons a... [more]
Issues addressed The National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006, offering free immunochemical Faecal Occult Blood Test (FOBT) to persons aged 50, 55 or 65. The study aimed to examine the prevalence of self-reported screening for colorectal cancer (CRC) using the FOBT and factors associated with not having an FOBT. Methods A cross-sectional study of Australian general practice patients aged 50 and over with no personal history of CRC completed a health risk survey while waiting for scheduled appointments between November 2010 and November 2011. Results A total of 5671 patients from 12 practices were approached to participate. Of the 4707 eligible patients (adults attending for care who understood English and were capable of providing informed consent), 4062 (86%) consented to participate, with 2269 eligible to complete the FOBT items. Approximately half (52%) of participants reported ever having an FOBT. More than one-third (39.7%) of the sample reported having an FOBT in the prior three years. Those who recalled receiving a mailed kit as part of the NBCSP were five times more likely to report being screened. Those less likely to report screening were aged 50-59 years, were female and had been diagnosed with a form of cancer other than CRC. Conclusions There is justification for the extension of the NBCSP to ensure a majority of the age-appropriate population is screened for CRC. So what? Further work is needed to identify whether high rates of screening are achievable using the mailed-kit approach, and how to increase participation by females, those aged 50-69 years and those diagnosed with other cancers.
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Nova |
2015 |
Bonevski B, Twyman L, Paul C, D'Este C, West R, Siahpush M, et al., 'Comparing socially disadvantaged smokers who agree and decline to participate in a randomised smoking cessation trial', BMJ OPEN, 5 (2015) [C1]
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Nova |
2015 |
Bryant J, Sanson-Fisher R, Stevenson W, Smits R, Henskens F, Wei A, et al., 'Protocol of a multi-centre randomised controlled trial of a web-based information intervention with nurse-delivered telephone support for haematological cancer patients and their support persons', BMC Cancer, 15 (2015) [C3]
Background: High rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distr... [more]
Background: High rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distress may be minimised by ensuring that patients are sufficiently involved in decision making, provided with tailored information and adequate preparation for potentially threatening procedures. To date, there are no published studies evaluating interventions designed to reduce psychosocial distress and unmet needs specifically in patients with haematological cancers and their Support Persons. This study will examine whether access to a web-based information tool and nurse-delivered telephone support reduces depression, anxiety and unmet information needs for haematological cancer patients and their Support Persons. Methods/Design: A non-blinded, parallel-group, multi-centre randomised controlled trial will be conducted to compare the effectiveness of a web-based information tool and nurse-delivered telephone support with usual care. Participants will be recruited from the haematology inpatient wards of five hospitals in New South Wales, Australia. Patients diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, Burkitt's lymphoma, Lymphoblastic lymphoma (B or T cell), or Diffuse Large B-Cell lymphoma and their Support Persons will be eligible to participate. Patients and their Support Persons will be randomised as dyads. Participants allocated to the intervention will receive access to a tailored web-based tool that provides accurate, up-to-date and personalised information about: cancer and its causes; treatment options including treatment procedures information; complementary and alternative medicine; and available support. Patients and Support Persons will complete self-report measures of anxiety, depression and unmet needs at 2, 4, 8 and 12 weeks post-recruitment. Patient and Support Person outcomes will be assessed independently. Discussion: This study will assess whether providing information and support using web-based and telephone support address the major psychosocial challenges faced by haematological patients and their Support Persons. The approach, if found to be effective, has potential to improve psychosocial outcomes for haematological and other cancer patients, reduce the complexity and burden of meeting patients' psychosocial needs for health care providers with high potential for translation into clinical practice.
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Nova |
2015 |
Hall AE, Sanson-Fisher RW, Lynagh MC, Tzelepis F, D'Este C, 'What do haematological cancer survivors want help with? A cross-sectional investigation of unmet supportive care needs', BMC research notes, 8 221 (2015) [C1]
BACKGROUND: This study aimed to identify the most prevalent unmet needs of haematological cancer survivors. METHODS: Haematological cancer survivors aged 18-80 years at time of re... [more]
BACKGROUND: This study aimed to identify the most prevalent unmet needs of haematological cancer survivors. METHODS: Haematological cancer survivors aged 18-80 years at time of recruitment were selected from four Australian state cancer registries. Survivors completed the Survivor Unmet Needs Survey. The most frequently reported "high/very high" unmet needs items were identified, as well as characteristics associated with the three most prevalent "high/very high" unmet needs reported by haematological cancer survivors. RESULTS: A total of 715 eligible survivors returned a completed survey. "Dealing with feeling tired" (17%), was the most frequently endorsed "high/very high" unmet need. Seven out of the ten most frequently endorsed unmet needs related to emotional health. Higher levels of psychological distress (e.g., anxiety, depression and stress) and indicators of financial burden as a result of cancer (e.g., having used up savings and trouble meeting day-to-day expenses due to cancer) were consistently identified as characteristics associated with the three most prevalent "high/very high" unmet needs. CONCLUSIONS: A minority of haematological cancer survivors endorsed a "high/very high" unmet need on individual items. Additional emotional support may be needed by a minority of survivors. Survivors reporting high levels of psychological distress or those who experience increased financial burden as a result of their cancer diagnosis may be at risk of experiencing the most prevalent "high/very high" unmet needs identified by this study.
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Nova |
2015 |
Dale S, Levi C, Ward J, Grimshaw JM, Jammali-Blasi A, D'Este C, et al., 'Barriers and enablers to implementing clinical treatment protocols for fever, hyperglycaemia, and swallowing dysfunction in the quality in acute stroke care (QASC) project-a mixed methods study', Worldviews on Evidence-Based Nursing, 12 41-50 (2015) [C1]
Background: The Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) ... [more]
Background: The Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) in acute stroke care. This cluster-randomised controlled trial was conducted in 19 stroke units in Australia. Aim: To describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocols and, postimplementation, to determine which of these barriers eventuated as actual barriers. Methods: Preimplementation: Workshops were held at the intervention stroke units (n = 10). The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocols, the second workshop involved bedside clinicians. Postimplementation, an online survey with stroke champions from intervention sites was conducted. Results: A total of 111 clinicians attended the preimplementation workshops, identifying 22 barriers covering four main themes: (a) need for new policies, (b) limited workforce (capacity), (c) lack of equipment, and (d) education and logistics of training staff. Preimplementation enablers identified were: support by clinical champions, medical staff, nursing management and allied health staff; easy adaptation of current protocols, care-plans, and local policies; and presence of specialist stroke unit staff. Postimplementation, only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption of the FeSS protocols, namely, no previous use of insulin infusions; hyperglycaemic protocols could not be commenced without written orders; medical staff reluctance to use the ASSIST swallowing screening tool; poor level of engagement of medical staff; and doctors' unawareness of the trial. Linking Evidence to Action: The process of identifying barriers and enablers preimplementation allowed staff to take ownership and to address barriers and plan for change. As only five of the 22 barriers identified preimplementation were reported to be actual barriers at completion of the trial, this suggests that barriers are often overcome whilst some are only ever perceived rather than actual barriers.
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Nova |
2015 |
Schofield PW, Malacova E, Preen DB, D'Este C, Tate R, Reekie J, et al., 'Does Traumatic Brain Injury Lead to Criminality? A Whole-Population Retrospective Cohort Study Using Linked Data', PLOS ONE, 10 (2015) [C1]
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Nova |
2014 |
Butcher NE, D'Este C, Balogh ZJ, 'The quest for a universal definition of polytrauma: a trauma registry-based validation study.', J Trauma Acute Care Surg, 77 620-623 (2014) [C1]
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Nova |
2014 |
Paul CL, Levi CR, D'Este CA, Parsons MW, Bladin CF, Lindley RI, et al., 'Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care', Implementation Science, 9 (2014) [C3]
Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy w... [more]
Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy with tissue plasminogen activator (tPA), if given within 4.5 hours of onset to appropriate cases of ischaemic stroke.Objectives: To test the effectiveness of a multi-component multidisciplinary collaborative approach compared to usual care as a strategy for increasing thrombolysis rates for all stroke patients at intervention hospitals, while maintaining accepted benchmarks for low rates of intracranial haemorrhage and high rates of functional outcomes for both groups at three months.Methods and design: A cluster randomised controlled trial of 20 hospitals across 3 Australian states with 2 groups: multi- component multidisciplinary collaborative intervention as the experimental group and usual care as the control group. The intervention is based on behavioural theory and analysis of the steps, roles and barriers relating to rapid assessment for thrombolysis eligibility; it involves a comprehensive range of strategies addressing individual-level and system-level change at each site. The primary outcome is the difference in tPA rates between the two groups post-intervention. The secondary outcome is the proportion of tPA treated patients in both groups with good functional outcomes (modified Rankin Score (mRS <2) and the proportion with intracranial haemorrhage (mRS =2), compared to international benchmarks.Discussion: TIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796. © 2014 Paul et al.; licensee BioMed Central Ltd.
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Nova |
2014 |
Shakeshaft A, Doran C, Petrie D, Breen C, Havard A, Abudeen A, et al., 'The effectiveness of community action in reducing risky alcohol consumption and harm: a cluster randomised controlled trial.', PLoS Med, 11 e1001617 (2014) [C1]
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Nova |
2014 |
Williamson A, Redman S, Mcelduff P, D' Este C, Dadds M, Raphael B, et al., 'The Construct Validity of the Strengths and Difficulties Questionnaire for Aboriginal Children Living in Urban New South Wales, Australia', Australian Psychologist, (2014) [C1]
The current study explores the construct validity of the standard Strengths and Difficulties Questionnaire (SDQ) for Aboriginal children living in urban communities in New South W... [more]
The current study explores the construct validity of the standard Strengths and Difficulties Questionnaire (SDQ) for Aboriginal children living in urban communities in New South Wales, Australia. Parent report SDQ data from the first 717 Aboriginal children aged 4-17 years who participated in the baseline survey of the Study of Environment on Aboriginal Resilience and Child Health were analysed. The overall construct validity of the SDQ in our sample was acceptable but not "good." The internal consistency reliability was excellent overall and good for all subscales with the exception of peer problems, a concept that may have a different significance for urban Aboriginal parents. Removing the peer relationships subscale, however, did not improve the fit of the model. The convergent validity of the SDQ was good. The prosocial behaviours scale and both the peer and conduct problems scales were highly correlated suggesting Aboriginal parents conceptualise these differently and that prosocial behaviours may be considered a key indicator of well-being for Aboriginal children. Overall, the SDQ is a promising tool for urban Aboriginal children in New South Wales. Those working with Aboriginal young people should focus on the SDQ total difficulties score and limit their reliance on the peer relationships subscale. © 2014 The Australian Psychological Society.
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Nova |
2014 |
Sanson-Fisher RW, D'Este CA, Carey ML, Noble N, Paul CL, 'Evaluation of Systems-Oriented Public Health Interventions: Alternative Research Designs', ANNUAL REVIEW OF PUBLIC HEALTH, VOL 35, 35 9-27 (2014) [C1]
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Nova |
2014 |
Passey ME, Sanson-Fisher RW, D'Este CA, Stirling JM, 'Tobacco, alcohol and cannabis use during pregnancy: Clustering of risks', Drug and Alcohol Dependence, 134 44-50 (2014) [C1]
Background: Antenatal substance use poses significant risks to the unborn child. We examined use of tobacco, alcohol and cannabis among pregnant Aboriginal and Torres Strait Islan... [more]
Background: Antenatal substance use poses significant risks to the unborn child. We examined use of tobacco, alcohol and cannabis among pregnant Aboriginal and Torres Strait Islander women; and compared characteristics of women by the number of substances reported. Methods: A cross-sectional survey with 257 pregnant Indigenous women attending antenatal services in two states of Australia. Women self-reported tobacco, alcohol and cannabis use (current use, ever use, changes during pregnancy); age of initiation of each substance; demographic and obstetric characteristics. Results: Nearly half the women (120; 47% (95%CI:40%, 53%) reported no current substance use; 119 reported current tobacco (46%; 95%CI:40%, 53%), 53 (21%; 95%CI:16%, 26%) current alcohol and 38 (15%; 95%CI:11%, 20%) current cannabis use. Among 148 women smoking tobacco at the beginning of pregnancy, 29 (20%; 95%CI:14%, 27%) reported quitting; with 80 of 133 (60%; 95%CI:51%, 69%) women quitting alcohol and 25 of 63 (40%; 95%CI:28%, 53%) women quitting cannabis. Among 137 women reporting current substance use, 77 (56%; 95%CI:47%, 65%) reported one and 60 (44%; 95%CI:35%, 53%) reported two or three. Women using any one substance were significantly more likely to also use others. Factors independently associated with current use of multiple substances were years of schooling and age of initiating tobacco. Conclusions: While many women discontinue substance use when becoming pregnant, there is clustering of risk among a small group of disadvantaged women. Programmes should address risks holistically within the social realities of women's lives rather than focusing on individual tobacco smoking. Preventing uptake of substance use is critical. © 2013 The Authors.
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Nova |
2014 |
Yoong SL, Carey ML, Sanson-Fisher RW, D'Este CA, Mackenzie L, Boyes A, 'A cross-sectional study examining Australian general practitioners' identification of overweight and obese patients', Journal of General Internal Medicine, 29 328-334 (2014) [C1]
BACKGROUND: Overweight and obese patients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such a... [more]
BACKGROUND: Overweight and obese patients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such advice. One reason may be that physicians do not identify their overweight and obese patients. OBJECTIVES: We aimed to determine the extent that Australian general practitioners (GP) recognise overweight or obesity in their patients, and to explore patient and GP characteristics associated with non-detection of overweight and obesity. METHODS: Consenting adult patients (n = 1,111) reported weight, height, demographics and health conditions using a touchscreen computer. GPs (n = 51) completed hard-copy questionnaires indicating whether their patients were overweight or obese. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GP detection, using patient self-reported weight and height as the criterion measure for overweight and obesity. For a subsample of patients (n = 107), we did a sensitivity analysis with patient-measured weight and height. We conducted an adjusted, multivariable logistic regression to explore characteristics associated with non-detection, using random effects to adjust for correlation within GPs. RESULTS: Sensitivity for GP assessment was 63 % [95 % CI 57-69 %], specificity 89 % [95 % CI 85-92 %], PPV 87 % [95 % CI 83-90 %] and NPV 69 % [95 % CI 65-72 %]. Sensitivity increased by 3 % and specificity was unchanged in the sensitivity analysis. Men (OR: 1.7 [95 % CI 1.1-2.7]), patients without high blood pressure (OR: 1.8 [95 % CI 1.2-2.8]) and without type 2 diabetes (OR: 2.4 [95 % CI 1.2-8.0]) had higher odds of non-detection. Individuals with obesity (OR: 0.1 [95 % CI 0.07-0.2]) or diploma-level education (OR: 0.3 [95%CI 0.1-0.6]) had lower odds of not being identified. No GP characteristics were associated with non-detection of overweight or obesity. CONCLUSIONS: GPs missed identifying a substantial proportion of overweight and obese patients. Strategies to support GPs in identifying their overweight or obese patients need to be implemented. © 2013 Society of General Internal Medicine.
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Nova |
2014 |
Hall A, D Este C, Tzelepis F, Lynagh M, Sanson-Fisher R, 'Factors associated with haematological cancer survivors experiencing a high level of unmet need across multiple items of supportive care: a cross-sectional survey study', Supportive Care in Cancer, 22 2899-2909 (2014) [C1]
Purpose: This study aimed to identify subgroups of haematological cancer survivors who report a ¿high/very high¿ level of unmet need on multiple (=7) items of supportive care.... [more]
Purpose: This study aimed to identify subgroups of haematological cancer survivors who report a ¿high/very high¿ level of unmet need on multiple (=7) items of supportive care.
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Nova |
2014 |
Guillaumier A, Bonevski B, Doran C, Paul C, D'Este C, Siahpush M, 'Paying the price: A cross-sectional survey of Australian socioeconomically disadvantaged smokers' responses to hypothetical cigarette price rises', Drug and Alcohol Review, 33 177-185 (2014) [C1]
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Nova |
2014 |
Dolja-Gore X, Loxton DJ, D'Este CA, Byles JE, 'Mental health service use: Is there a difference between rural and non-rural women in service uptake?', Australian Journal of Rural Health, 22 92-100 (2014) [C1]
This study examines differences in uptake of the Medicare items rolled out in 2006 under the 'Better Access Scheme' (BAS) between rural and non-rural Australian women. I... [more]
This study examines differences in uptake of the Medicare items rolled out in 2006 under the 'Better Access Scheme' (BAS) between rural and non-rural Australian women. It compares differences in women's uptake of the BAS services by area of residence (ARIA+) across time using the Australian Longitudinal Study of Women's Health (ALSWH) survey data linked to Medicare data. Women aged 28-33 years at the time the BAS was introduced that responded to the self-reported question on depression/anxiety and consented to linkage of their survey data with Medicare data (n=4316). Participants were grouped by ARIA+according to BAS use, diagnoses of anxiety/depression but no BAS use and other eligible women. Across all areas, women born 1973-1978 with a self-reported diagnosis of depression/anxiety or having treatment under the BAS had a significantly lower mean mental health score compared to other women. Significantly more women living in non-rural areas had used at least one service provided under the BAS initiative compared to women in outer regional, inner regional or remotes areas (21% versus 18% versus 13% versus 7%, respectively), and across all areas, 12% of women reported having a diagnosis of depression/anxiety but not been treated under the BAS. While there is a gradual uptake of the new BAS services, a large percentage of women who have a diagnosis of depression/anxiety have not been treated under the BAS. The data suggest that women in urban areas have been better able to take up the services compared to non-urban women. © 2014 National Rural Health Alliance Inc.
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Nova |
2014 |
Breen C, Shakeshaft A, Sanson-Fisher R, D'Este C, Mattick RP, Gilmour S, 'Identifying individual- and population-level characteristics that influence rates of risky alcohol consumption in regional communities', Australian and New Zealand Journal of Public Health, 38 60-65 (2014) [C1]
Objective: To examine the extent to which individual- and community- level characteristics account for differences in risky alcohol consumption. Method: A cross-sectional postal s... [more]
Objective: To examine the extent to which individual- and community- level characteristics account for differences in risky alcohol consumption. Method: A cross-sectional postal survey of 2,977 randomly selected individuals from 20 regional communities in NSW, Australia. Individuals drinking at harmful levels on the AUDIT and for risk of harm in the short term and long-term were identified. Multi-level modelling of the correlates of risky alcohol consumption at the individual and community level was conducted. Results: There were differences between communities in alcohol consumption patterns. Being male, unmarried and reporting worse health were significant individual-level correlates for drinking at levels for risk of harm in the long term. The number of GPs (+) and police (-) were significant community characteristics. Being younger (=25), unmarried, Australian born and with a larger income was associated with drinking at levels for risk of harm in the short term and harmful drinking on the AUDIT. The number of hotels and clubs was positively associated with drinking at levels for risk of harm in the short term. Conclusions: Rates of risky drinking vary significantly between communities and both individual and community characteristics are significantly associated with risky alcohol consumption. Implications: A combination of individual- and population-level interventions, tailored to the risk profile of individual communities, is most likely to be optimally effective. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.
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Nova |
2014 |
Stewart JM, Sanson-Fisher R, Eades S, D'Este C, 'Aboriginal health: agreement between general practitioners and patients on their health risk status and screening history.', Australian and New Zealand journal of public health, 38 563-566 (2014) [C1]
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Nova |
2014 |
Williamson A, Andersen M, Redman S, Dadds M, D'Este C, Daniels J, et al., 'Measuring mental health in Indigenous young people: A review of the literature from 1998-2008', Clinical Child Psychology and Psychiatry, 19 260-272 (2014) [C1]
Background: Indigenous young people are disproportionately exposed to risk factors for poor mental health. Methodologically rigorous research will be critical in the development a... [more]
Background: Indigenous young people are disproportionately exposed to risk factors for poor mental health. Methodologically rigorous research will be critical in the development and evaluation of prevention and treatment programs. Research examining the mental health of Indigenous young people may have been undermined by poor measurement. The extent to which research has used measures with adequate psychometrics is unknown. Methods: MEDLINE, PsychINFO and PUBMED databases, were systematically searched to identify papers published between 1998-2008 measuring the mental health of Indigenous young people from Australia, Canada, New Zealand or the US. Data extracted included type of mental health instrument, psychometric analyses reported and results. Results: Fifty-four relevant studies were identified. Seventy-nine mental health instruments were used, and 18% were bespoke. Only 14% of instruments had been validated for the relevant Indigenous population. Few studies reported assessment of the reliability or validity of instruments. Data about both the reliability and validity of 10 measures were reported. None of the measures met the standards set by the review. Evidence of at least one type of reliability and validity was demonstrated for six measures. Conclusions: From 1998-2008 few studies of mental health in Indigenous young people used measurement instruments with previously determined reliability and validity. © The Author(s) 2013.
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Nova |
2014 |
Denham JW, Nowitz M, Joseph D, Duchesne G, Spry NA, Lamb DS, et al., 'Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans-Tasman Radiation Oncology Group (TROG) 03.04 Randomised Androgen Deprivation and Radiotherapy (RADAR) randomized controlled trial for locally advanced prostate cancer', BJU International, 114 344-353 (2014) [C1]
Objective To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non-spinal fracture rates and bone mineral density (BMD) in men wit... [more]
Objective To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non-spinal fracture rates and bone mineral density (BMD) in men with locally advanced prostate cancer. Patients and Methods Between 2003 and 2007, 1071 men with locally advanced prostate cancer were randomly allocated, using a 2 × 2 trial design, to 6 months i.m. leuprorelin (androgen suppression [AS]) before radiotherapy alone ± 12 months additional leuprorelin ± 18 months zoledronic acid (ZdA), commencing at randomization. The main endpoint was incident thoraco-lumbar vertebral fractures, which were assessed radiographically at randomization and at 3 years, then reassessed by centralized review. Subsidiary endpoints included incident non-spinal fractures, which were documented throughout follow-up, and BMD, which was measured in 222 subjects at baseline, 2 years and 4 years. Results Incident vertebral fractures at 3 years were observed in 132 subjects. Their occurrence was not increased by 18 months' AS, nor reduced by ZdA. Incident non-spinal fractures occurred in 72 subjects and were significantly related to AS duration but not to ZdA. Osteopenia and osteoporosis prevalence rates at baseline were 23.4 and 1.4%, respectively, at the hip. Treatment for 6 and 18 months with AS caused significant reductions in hip BMD at 2 and 4 years (P < 0.01) and ZdA prevented these losses at both time points. Conclusion In an AS-naïve population, 18 months of ZdA treatment prevented the sustained BMD losses caused by 18 months of AS treatment; however, the study power was insufficient to show that AS duration or ZdA influenced vertebral fracture rates. © 2013 The Authors. BJU International © 2013 BJU International.
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2014 |
Middleton S, Comerford D, Lydtin A, Dale S, Hill K, Dunne J, et al., 'The QASC Implementation Project: Implementing evidence based care in stroke services throughout NSW, Australia', CEREBROVASCULAR DISEASES, 37 325-325 (2014)
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2014 |
Yego F, D'Este C, Byles J, Williams JS, Nyongesa P, 'Risk factors for maternal mortality in a Tertiary Hospital in Kenya: a case control study', BMC PREGNANCY AND CHILDBIRTH, 14 (2014) [C1]
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Nova |
2014 |
Yego F, D'Este C, Byles J, Nyongesa P, Williams JS, 'A case-control study of risk factors for fetal and early neonatal deaths in a tertiary hospital in Kenya', BMC PREGNANCY AND CHILDBIRTH, 14 (2014) [C1]
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Nova |
2014 |
Hall A, D'Este C, Tzelepis F, Sanson-Fisher R, Lynagh M, 'The Survivor Unmet Needs Survey (SUNS) for haematological cancer survivors: a cross-sectional study assessing the relevance and psychometric properties', BMC HEALTH SERVICES RESEARCH, 14 (2014) [C1]
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Nova |
2014 |
Islam MR, Attia J, Alauddin M, McEvoy M, McElduff P, Slater C, et al., 'Availability of arsenic in human milk in women and its correlation with arsenic in urine of breastfed children living in arsenic contaminated areas in Bangladesh.', Environmental Health: A Global Access Science Source, 13 1-10 (2014) [C1]
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Nova |
2014 |
Hall A, Sanson-Fisher R, Lynagh M, Tzelepis F, D'Este C, 'A COMPARISON OF THE UNMET NEEDS OF YOUNGER AND OLDER ADULT HAEMATOLOGICAL CANCER SURVIVORS', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 10 162-163 (2014) [E3]
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2014 |
Drury P, Levi C, McInnes E, Hardy J, Ward J, Grimshaw JM, et al., 'Management of fever, hyperglycemia, and swallowing dysfunction following hospital admission for acute stroke in New South Wales, Australia', INTERNATIONAL JOURNAL OF STROKE, 9 23-31 (2014) [C1]
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Nova |
2014 |
Drury P, Levi C, D'Este C, Mcelduff P, Mcinnes E, Hardy J, et al., 'Quality in Acute Stroke Care (QASC): Process evaluation of an intervention to improve the management of fever, hyperglycemia, and swallowing dysfunction following acute stroke', International Journal of Stroke, 9 766-776 (2014) [C1]
Background: Our randomized controlled trial of a multifaceted evidence-based intervention for improving the inpatient management of fever, hyperglycemia, and swallowing dysfunctio... [more]
Background: Our randomized controlled trial of a multifaceted evidence-based intervention for improving the inpatient management of fever, hyperglycemia, and swallowing dysfunction in the first three-days following stroke improved outcomes at 90 days by 15%. We designed a quantitative process evaluation to further explain and illuminate this finding. Methods: Blinded retrospective medical record audits were undertaken for patients from 19 stroke units prior to and following the implementation of three multidisciplinary evidence-based protocols (supported by team-building workshops, and site-based education and support) for the management of fever (temperature =37·5°C), hyperglycemia (glucose >11mmol/l), and swallowing dysfunction in intervention stroke units. Results: Data from 1804 patients (718 preintervention; 1086 postintervention) showed that significantly more patients admitted to hospitals allocated to the intervention group received care according to the fever (n=186 of 603, 31% vs. n=74 of 483, 15%, P<0·001), hyperglycemia (n=22 of 603, 3·7% vs. n=3 of 483, 0·6%, P=0·01), and swallowing dysfunction protocols (n=241 of 603, 40% vs. n=19 of 483, 4·0%, P=0·001). Significantly more patients in these intervention stroke units received four-hourly temperature monitoring (n=222 of 603, 37% vs. n=90 of 483, 19%, P<0·001) and six-hourly glucose monitoring (194 of 603, 32% vs. 46 of 483, 9·5%, P<0·001) within 72 hours of admission to a stroke unit, and a swallowing screen (242 of 522, 46% vs. 24 of 350, 6·8%, P=0·0001) within the first 24 hours of admission to hospital. There was no difference between the groups in the treatment of patients with fever with paracetamol (22 of 105, 21% vs. 38 of 131, 29%, P=0·78) or their hyperglycemia with insulin (40 of 100, 40% vs. 17 of 57, 30%, P=0·49). Interpretation: Our intervention resulted in better protocol adherence in intervention stroke units, which explains our main trial findings of improved patient 90-day outcomes. Although monitoring practices significantly improved, there was no difference between the groups in the treatment of fever and hyperglycemia following acute stroke. A significant link between improved treatment practices and improved outcomes would have explained further the success of our intervention, and we are still unable to explain definitively the large improvements in death and dependency found in the main trial results. One potential explanation is that improved monitoring may have led to better overall surveillance of deteriorating patients and faster initiation of treatments not measured as part of the main trial. © 2013 World Stroke Organization.
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Nova |
2014 |
Carey M, Jones KA, Yoong SL, D'Este C, Boyes AW, Paul C, et al., 'Comparison of a single self-assessment item with the PHQ-9 for detecting depression in general practice', Family Practice, 31 (2014) [C1]
Background: Several factors need to be considered when selecting a screening tool for depression including accuracy, level of burden for patients and for staff to administer and f... [more]
Background: Several factors need to be considered when selecting a screening tool for depression including accuracy, level of burden for patients and for staff to administer and follow-up. Objective: This study aimed to explore the utility of a single self-assessment item in identifying possible cases of depression in primary care by examining sensitivity and specificity with the nine-item Patient Health Questionnaire (PHQ-9) at different thresholds. Design: Cross-sectional survey presented on a touchscreen computer. Participants. Adult patients attending 12 urban general practices in Australia completed a health status questionnaire (n = 1004). Main measures. Depression was assessed by the PHQ-9 and a single self-assessment item. Sensitivity, specificity, and positive and negative predictive values were calculated for the single item using a PHQ-9 score of 10 or more as the criterion value. Key results. A total of 1004 participants (61% female, 48% aged 55 years or older) completed both the PHQ-9 and a single self-assessment item. When using a threshold of mild depression or greater, the single item had adequate specificity (76%, 95% CI: 71-80%), with 76 out of every 100 people defined as non-depressed by the PHQ-9 also identified as not depressed by the single item. Sensitivity was high (91%, 95% CI: 84-95%), with the single item identifying 91 out of every 100 true cases (as defined by the PHQ-9). Conclusions: The single self-assessment item has high sensitivity and moderate specificity to identify possible cases of depression when used at a threshold of mild depression or greater. © The Author 2014.
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Nova |
2014 |
Guillaumier A, Bonevski B, Paul C, Durkin S, D'Este C, 'Socioeconomically disadvantaged smokers' ratings of plain and branded cigarette packaging: an experimental study', BMJ OPEN, 4 (2014) [C1]
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Nova |
2014 |
The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects), D'Este C, Attia J, 'Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: A pooled analysis of 97 prospective cohorts with 1·8 million participants', The Lancet, 383 970-983 (2014) [C1]
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Nova |
2014 |
Mackenzie LJ, Carey ML, Sanson-Fisher RW, D'Este CA, Paul CL, Yoong SL, 'Agreement between HADS classifications and single-item screening questions for anxiety and depression: a cross-sectional survey of cancer patients.', Ann Oncol, 25 889-895 (2014) [C1]
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Nova |
2014 |
Carey M, Jones K, Meadows G, Sanson-Fisher R, D'Este C, Inder K, et al., 'Accuracy of general practitioner unassisted detection of depression.', Aust N Z J Psychiatry, 48 571-578 (2014) [C1]
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Nova |
2014 |
Williamson A, Redman S, Haynes A, Barker D, Jorm L, Green S, et al., 'Supporting Policy In health with Research: an Intervention Trial (SPIRIT) protocol for a stepped wedge trial', BMJ Open, 4 (2014)
Introduction: Governments in different countries have committed to better use of evidence from research in policy. Although many programmes are directed at assisting agencies to b... [more]
Introduction: Governments in different countries have committed to better use of evidence from research in policy. Although many programmes are directed at assisting agencies to better use research, there have been few tests of the effectiveness of such programmes. This paper describes the protocol for SPIRIT (Supporting Policy In health with Research: an Intervention Trial), a trial designed to test the effectiveness of a multifaceted programme to build organisational capacity for the use of research evidence in policy and programme development. The primary aim is to determine whether SPIRIT results in an increase in the extent to which research and research expertise is sought, appraised, generated and used in the development of specific policy products produced by health policy agencies. Methods and analysis: A stepped wedge cluster randomised trial involving six health policy agencies located in Sydney, Australia. Policy agencies are the unit of randomisation and intervention. Agencies were randomly allocated to one of three start dates (steps) to receive the 1-year intervention programme, underpinned by an action framework. The SPIRIT intervention is tailored to suit the interests and needs of each agency and includes audit, feedback and goal setting; a leadership programme; staff training; the opportunity to test systems to assist in the use of research in policies; and exchange with researchers. Outcome measures will be collected at each agency every 6 months for 30 months (starting at the beginning of step 1). Ethics and dissemination: Ethics approval was granted by the University of Western Sydney Human Research and Ethics Committee HREC Approval H8855. The findings of this study will be disseminated broadly through peer-reviewed publications and presentations at conferences and used to inform future strategies.
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2013 |
Stenson BJ, Tarnow-Mordi WO, Darlow BA, Simes J, Juszczak E, Askie L, et al., 'Oxygen Saturation and Outcomes in Preterm Infants', NEW ENGLAND JOURNAL OF MEDICINE, 368 2094-2104 (2013)
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2013 |
Boyes AW, Girgis A, D'Este CA, Zucca AC, Lecathelinais C, Carey ML, 'Prevalence and predictors of the short-term trajectory of anxiety and depression in the first year after a cancer diagnosis: a population-based longitudinal study.', J Clin Oncol, 31 2724-2729 (2013) [C1]
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Nova |
2013 |
Carter GL, Clover K, Whyte IM, Dawson AH, D'Este C, 'Postcards from the EDge: 5-year outcomes of a randomised controlled trial for hospital-treated self-poisoning', BRITISH JOURNAL OF PSYCHIATRY, 202 372-380 (2013) [C1]
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Nova |
2013 |
Yoong SL, Carey ML, Sanson-Fisher R, D'Este C, 'Recruitment in general practice', Australian Family Physician, 42 9 (2013) [C3]
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Nova |
2013 |
Luque-Fernandez MA, Franco M, Gelaye B, Schomaker M, Gutierrez Garitano I, D'Este C, Williams MA, 'Unemployment and stillbirth risk among foreign-born and Spanish pregnant women in Spain, 2007-2010: a multilevel analysis study', EUROPEAN JOURNAL OF EPIDEMIOLOGY, 28 991-999 (2013) [C1]
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Nova |
2013 |
Hall AE, Sanson-Fisher RW, Lynagh MC, Threlfall T, D'Este CA, 'Format and readability of an enhanced invitation letter did not affect participation rates in a cancer registry-based study: a randomized controlled trial', JOURNAL OF CLINICAL EPIDEMIOLOGY, 66 85-94 (2013) [C1]
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Nova |
2013 |
Mackenzie LJ, Carey ML, Sanson-Fisher RW, D'Este CA, 'Psychological distress in cancer patients undergoing radiation therapy treatment', SUPPORTIVE CARE IN CANCER, 21 1043-1051 (2013) [C1]
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Nova |
2013 |
Boyes AW, D'Este CA, Carey ML, Lecathelinais C, Girgis A, 'How does the Distress Thermometer compare to the Hospital Anxiety and Depression Scale for detecting possible cases of psychological morbidity among cancer survivors?', Supportive Care in Cancer, 21 119-127 (2013) [C1]
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Nova |
2013 |
Yoong SLI, Carey ML, Sanson-Fisher R, D'Este C, 'Recruitment in general practice', Australian family physician, 42 9 (2013)
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2013 |
Paul CL, Carey M, Yoong SL, D'Este C, Makeham M, Henskens F, 'Access to chronic disease care in general practice: The acceptability of implementing systematic waiting-room screening using computer-based patient-reported risk status', British Journal of General Practice, 63 (2013) [C1]
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Nova |
2013 |
Hall A, Campbell HS, Sanson-Fisher R, Lynagh M, D'Este C, Burkhalter R, Carey M, 'Unmet needs of Australian and Canadian haematological cancer survivors: a cross-sectional international comparative study', PSYCHO-ONCOLOGY, 22 2032-2038 (2013) [C1]
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Nova |
2013 |
MacKenzie LJ, Carey ML, Paul CL, Sanson-Fisher RW, D'Este CA, 'Do we get it right? Radiation oncology outpatients' perceptions of the patient centredness of life expectancy disclosure', Psycho-Oncology, 22 2720-2728 (2013) [C1]
Objective A patient-centred approach to discussing life expectancy with cancer patients is recommended in Western countries. However, this approach to eliciting and meeting patien... [more]
Objective A patient-centred approach to discussing life expectancy with cancer patients is recommended in Western countries. However, this approach to eliciting and meeting patient preferences can be challenging for clinicians. The aims of this study were the following: (i) to examine cancer patients' preferences for life expectancy disclosure; and (ii) to explore agreement between cancer patients' preferences for, and perceived experiences of, life expectancy disclosure. Methods Cancer patients undergoing radiotherapy treatment in metropolitan Australia completed a cross-sectional touchscreen computer survey including optional questions about their life expectancy disclosure preferences and experiences. Results Of the 208 respondents, 178 (86%) indicated that they would prefer their clinician to ask them before discussing life expectancy, and 30 (14%) indicated that they would prefer others (i.e. clinicians, family) to decide whether they were given life expectancy information. Of the 175 respondents who were classified as having a self- determined or other-determined disclosure experience, 105 (60%) reported an experience of life expectancy disclosure that was in accordance with their preferences. Cohen's ¿ was -0.04 (95% CI, -0.17, 0.08), indicating very poor agreement between patients' preferences for and perceived experiences of life expectancy disclosure (p = 0.74). Conclusions In light of patient-centred prognosis disclosure guidelines, our findings of a majority preference for, and experience of, a self-determined approach to life expectancy disclosure amongst radiation oncology patients are encouraging. However, poor agreement between preferences and experiences highlights that additional effort from clinicians is required in order to achieve a truly patient-centred approach to life expectancy disclosure. Copyright © 2013 John Wiley & Sons, Ltd.
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Nova |
2013 |
Yoong SL, Carey M, Sanson-Fisher R, D'Este C, 'Prevalence and correlates of overweight and obesity in adult Australian general practice patients', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 37 586-586 (2013) [C3]
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Nova |
2013 |
Yoong SL, Carey ML, D'Este C, Sanson-Fisher RW, 'Agreement between self-reported and measured weight and height collected in general practice patients: a prospective study', BMC MEDICAL RESEARCH METHODOLOGY, 13 (2013) [C1]
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Nova |
2013 |
Yoong SL, Carey ML, Sanson-Fisher RW, D'Este CA, 'A cross-sectional study assessing Australian general practice patients' intention, reasons and preferences for assistance with losing weight', BMC FAMILY PRACTICE, 14 (2013) [C1]
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Nova |
2013 |
Courtney RJ, Paul CL, Carey ML, Sanson-Fisher RW, Macrae FA, D'Este C, et al., 'A population-based cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients', BMC CANCER, 13 (2013) [C1]
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Nova |
2013 |
Yego F, Williams JS, Byles J, Nyongesa P, Aruasa W, D'Este C, 'A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya', REPRODUCTIVE HEALTH, 10 (2013) [C1]
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Nova |
2013 |
Paterson BJ, Kirk MD, Cameron AS, D'Este C, Durrheim DN, 'Historical data and modern methods reveal insights in measles epidemiology: a retrospective closed cohort study', BMJ OPEN, 3 (2013) [C1]
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Nova |
2013 |
Mackenzie LJ, Sanson-Fisher RW, Carey ML, D'Este CA, 'Radiation oncology outpatient perceptions of patient-centred care: a cross-sectional survey', BMJ OPEN, 3 (2013) [C1]
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Nova |
2012 |
Dibley MJ, Titaley CR, D'Este CA, Agho K, 'Iron and folic acid supplements in pregnancy improve child survival in Indonesia', American Journal of Clinical Nutrition, 95 220-230 (2012) [C1]
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Nova |
2012 |
Eades SJ, Sanson-Fisher RW, Wenitong M, Panaretto K, D'Este CA, Gilligan C, Stewart JM, 'An intensive smoking intervention for pregnant Aboriginal and Torres Strait Islander women: A randomised controlled trial', Medical Journal of Australia, 197 42-46 (2012) [C1]
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Nova |
2012 |
Middleton S, D'Este C, Grimshaw J, Ward JE, Levi C, 'Team-building intervention to improve acute stroke care Reply', LANCET, 379 1390-1390 (2012) [C3]
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2012 |
Middleton S, D'Este CA, Grimshaw J, Ward JE, Levi CR, 'Reply: Team-building intervention to improve acute stroke care', Lancet, 379 1390 (2012) [C3]
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2012 |
Kowal PR, Chatterji S, Naidoo N, Biritwum R, Fan W, Ridaura RL, et al., 'Data resource profile: The World Health Organization Study on global AGEing and adult health (SAGE)', International Journal of Epidemiology, 41 1639-1649 (2012) [C2]
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2012 |
Guest M, Boggess MM, Attia JR, 'Relative risk of elevated hearing threshold compared to ISO1999 normative populations for Royal Australian Air Force male personnel', Hearing Research, 285 65-76 (2012) [C1]
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Nova |
2012 |
Reid MG, Parkinson L, Gibson RE, Schofield PW, D'Este CA, Attia JR, et al., 'Memory Complaint Questionnaire performed poorly as screening tool: Validation against psychometric tests and affective measures', Journal of Clinical Epidemiology, 65 199-205 (2012) [C1]
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Nova |
2012 |
Mackenzie LJ, Carey ML, Sanson-Fisher RW, D'Este CA, Hall AE, 'Cancer patients' willingness to answer survey questions about life expectancy', Supportive Care in Cancer, 20 3335-3341 (2012) [C1]
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Nova |
2012 |
Passey ME, D'Este CA, Stirling JM, Sanson-Fisher RW, 'Factors associated with antenatal smoking among Aboriginal and Torres Strait Islander women in two jurisdictions', Drug and Alcohol Review, 31 608-616 (2012) [C1]
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Nova |
2012 |
White VM, Macvean ML, Grogan S, D'Este CA, Akkerman D, Ieropoli S, Sanson-Fisher RW, 'Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial', Psycho-Oncology, 21 1053-1062 (2012) [C1]
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Nova |
2012 |
Yoong SL, Carey ML, Sanson-Fisher RW, D'Este CA, 'A cross-sectional study assessing the self-reported weight loss strategies used by adult Australian general practice patients', BMC Family Practice, 13 (2012) [C1]
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Nova |
2012 |
Carey ML, Sanson-Fisher RW, Macrae F, Hill D, D'Este CA, Paul CL, Doran CM, 'Improving adherence to surveillance and screening recommendations for people with colorectal cancer and their first degree relatives: a randomized controlled trial', BMC Cancer, 12 62 (2012) [C3]
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Nova |
2012 |
Boyes AW, Girgis A, D'Este CA, Zucca AC, 'Prevalence and correlates of cancer survivors' supportive care needs 6months after diagnosis: A population-based cross-sectional study', BMC Cancer, 12 150-150 (2012) [C1]
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Nova |
2012 |
Gwynn JD, Flood VM, D'Este CA, Attia JR, Turner N, Cochrane J, et al., 'Poor food and nutrient intake among Indigenous and non-Indigenous rural Australian children', BMC Pediatrics, 12 1-14 (2012) [C1]
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Nova |
2012 |
Passey ME, D'Este CA, Sanson-Fisher RW, 'Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: A cross-sectional survey', BMC Public Health, 12 1-10 (2012) [C1]
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Nova |
2012 |
Islam MR, Khan I, Hassan SMN, McEvoy MA, D'Este CA, Attia JR, et al., 'Association between type 2 diabetes and chronic arsenic exposure in drinking water: A cross sectional study in Bangladesh', Environmental Health, 11 1-8 (2012) [C1]
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Nova |
2012 |
Clinton-Mcharg TL, Carey ML, Sanson-Fisher RW, D'Este CA, Shakeshaft A, 'Preliminary development and psychometric evaluation of an unmet needs measure for adolescents and young adults with cancer: The Cancer Needs Questionnaire - Young People (CNQ-YP)', Health and Quality of Life Outcomes, 10 (2012) [C1]
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Nova |
2012 |
Abir T, Rahman B, D'Este CA, Farooq A, Hasnat MA, 'The association between chronic arsenic exposure and hypertension: A meta-analysis', Journal of Toxicology, 2012 1-13 (2012) [C1]
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Nova |
2012 |
Islam MR, Khan I, Attia JR, Hassan SMN, McEvoy MA, D'Este CA, et al., 'Association between hypertension and chronic arsenic exposure in drinking water: A cross-sectional study in Bangladesh', International Journal of Environmental Research and Public Health, 9 4522-4536 (2012) [C1]
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Nova |
2012 |
Haines M, Brown B, Craig J, D'Este CA, Elliott E, Klineberg E, et al., 'Determinants of successful clinical networks: The conceptual framework and study protocol', Implementation Science, 7 1-10 (2012) [C3]
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Nova |
2012 |
Yoong SL, Carey ML, Sanson-Fisher RW, Russell G, Mazza D, Makeham M, et al., 'Touch screen computer health assessment in Australian general practice patients: A cross-sectional study protocol', BMJ Open, 2 1-7 (2012) [C3]
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2012 |
Middleton S, McElduff P, Ward J, Grimshaw JM, Dale S, D'Este C, et al., 'Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): A cluster randomised controlled trial', Dysphagia, 27 441 (2012)
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2011 |
Bonevski B, Paul CL, D'Este CA, Sanson-Fisher RW, West R, Girgis A, et al., 'RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population', BMC Public Health, 11 70 (2011) [C1]
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Nova |
2011 |
McNamara BJ, Sanson-Fisher RW, D'Este CA, Eades S, 'Type 2 diabetes in Indigenous populations: Quality of intervention research over 20 years', Preventive Medicine, 52 3-9 (2011) [C1]
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Nova |
2011 |
Middleton S, McElduff P, Ward J, Grimshaw JM, Dale S, D'Este CA, et al., 'Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): A cluster randomised controlled trial', The Lancet, 378 1699-1706 (2011) [C1]
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Nova |
2011 |
Boyes AW, Girgis A, D'Este CA, Zucca AC, 'Flourishing or floundering? Prevalence and correlates of anxiety and depression among a population-based sample of adult cancer survivors 6 months after diagnosis', Journal of Affective Disorders, 135 184-192 (2011) [C1]
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Nova |
2011 |
Denham J, Lamb DS, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'Another form of subgroup to beware', Radiotherapy and Oncology, 101 525-526 (2011) [C3]
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2011 |
Schofield PW, Butler T, Hollis S, D'Este CA, 'Are prisoners reliable survey respondents? A validation of self-reported traumatic brain injury (TBI) against hospital medical records', Brain Injury, 25 74-82 (2011) [C1]
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Nova |
2011 |
Guest M, D'Este CA, Attia JR, Boggess M, Brown A, Tavener M, et al., 'Impairment of color vision in aircraft maintenance workers', International Archives of Occupational and Environmental Health, 84 723-733 (2011) [C1]
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Nova |
2011 |
Lamb DS, Denham J, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'A comparison of the prognostic value of early PSA test-based variables following external beam radiotherapy, with or without preceding androgen deprivation: Analysis of data from the TROG 96.01 randomized trial', International Journal of Radiation Oncology Biology Physics, 79 385-391 (2011) [C1]
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Nova |
2011 |
Breen C, Shakeshaft A, Slade T, D'Este CA, Mattick RP, 'Assessing reliability of measures using routinely collected data', Alcohol and Alcoholism, 46 501-502 (2011) [C3]
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2011 |
Breen C, Shakeshaft A, Slade T, Love S, D'Este CA, Mattick RP, 'Do community characteristics predict alcohol-related crime?', Alcohol and Alcoholism, 46 464-470 (2011) [C1]
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Nova |
2011 |
De Morgan SE, Redman S, D'Este CA, Rogers K, 'Knowledge, satisfaction with information, decisional conflict and psychological morbidity amongst women diagnosed with ductal carcinoma in situ (DCIS)', Patient Education and Counseling, 84 62-68 (2011) [C1]
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Nova |
2011 |
Gilligan C, Sanson-Fisher RW, Anderson AE, D'Este CA, 'Strategies to increase community-based intervention research aimed at reducing excessive alcohol consumption and alcohol-related harm', Drug and Alcohol Review, 30 659-663 (2011) [C1]
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Nova |
2011 |
Guest M, Boggess MM, D'Este CA, Attia JR, Brown A, 'An observed relationship between vestibular function and auditory thresholds in aircraft-maintenance workers', Journal of Occupational and Environmental Medicine, 53 146-152 (2011) [C1]
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Nova |
2011 |
Guest M, Attia JR, D'Este CA, Boggess MM, Brown AM, Gibson RE, et al., 'Peripheral neuropathy in military aircraft maintenance workers in Australia', Journal of Occupational and Environmental Medicine, 53 381-387 (2011) [C1]
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Nova |
2011 |
Gwynn JD, Flood VM, D'Este CA, Attia JR, Turner N, Cochrane J, Wiggers JH, 'The reliability and validity of a short FFQ among Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children', Public Health Nutrition, 14 388-401 (2011) [C1]
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Nova |
2011 |
Nair BR, Heim C, Krishnan C, D'Este CA, Marley J, Attia JR, 'The effect of Baroque music on behavioural disturbances in patients with dementia', Australasian Journal on Ageing, 30 11-15 (2011) [C1]
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Nova |
2011 |
Middleton S, Levi CR, Ward J, Grimshaw J, Griffiths R, D'Este CA, et al., 'Death, dependency and health status 90 days following hospital admission for acute stroke in NSW', Internal Medicine Journal, 41 736-743 (2011) [C1]
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Nova |
2011 |
Denham J, Steigler A, Lamb DS, Joseph D, Turner S, Matthews J, et al., 'Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial', The Lancet Oncology, 12 451-459 (2011) [C1]
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Nova |
2010 |
Evensen AE, Sanson-Fisher RW, D'Este CA, Fitzgerald MN, 'Trends in publications regarding evidence-practice gaps: A literature review', Implementation Science, 5 1-5 (2010) [C1]
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Nova |
2010 |
Rahman R, Faiz MA, Selim S, Rahman B, Basher A, Jones AL, et al., 'Annual incidence of snake bite in rural Bangladesh', Plos Neglected Tropical Diseases, 4 e860 (2010) [C1]
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Nova |
2010 |
Williamson A, Redman S, Dadds M, Daniels J, D'Este CA, Raphael B, et al., 'Acceptability of an emotional and behavioural screening tool for children in Aboriginal Community Controlled Health Services in urban NSW', Australian and New Zealand Journal of Psychiatry, 44 894-900 (2010) [C1]
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Nova |
2010 |
Butler T, Schofield PW, Greenberg D, Allnutt SH, Indig D, Carr V, et al., 'Reducing impulsivity in repeat violent offenders: An open label trial of a selective serotonin reuptake inhibitor', Australian and New Zealand Journal of Psychiatry, 44 1137-1143 (2010) [C1]
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Nova |
2010 |
Barton CA, McGuire A, Waller M, Treloar SA, McClintock C, McFarlane AC, D'Este CA, 'Smoking prevalence, its determinants and short-term health implications in the Australian Defence Force', Military Medicine, 175 267-272 (2010) [C1]
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Nova |
2010 |
Guest M, Boggess M, Attia JR, D'Este CA, Brown A, Gibson RE, et al., 'Hearing impairment in F-111 maintenance workers: The study of health outcomes in aircraft maintenance personnel (SHOAMP) general health and medical study', American Journal of Industrial Medicine, 53 1159-1169 (2010) [C1]
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Nova |
2010 |
McEvoy MA, Smith WT, D'Este CA, Duke JM, Peel R, Schofield PW, et al., 'Cohort Profile: The Hunter Community Study', International Journal of Epidemiology, 39 1452-1463 (2010) [C1]
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Nova |
2010 |
Gilligan C, Sanson-Fisher RW, Eades S, Wenitong M, Panaretto K, D'Este CA, 'Assessing the accuracy of self-reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation', Drug and Alcohol Review, 29 35-40 (2010) [C1]
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Nova |
2010 |
Clinton-Mcharg TL, Paul CL, Sanson-Fisher RW, D'Este CA, Williamson A, 'Determining research priorities for young people with haematological cancer: A value-weighting approach', European Journal of Cancer, 46 3263-3270 (2010) [C1]
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Nova |
2010 |
Bailey LJ, Sanson-Fisher RW, Aranda S, D'Este CA, Sharkey K, Schofield P, 'Quality of life research: Types of publication output over time for cancer patients, a systematic review', European Journal of Cancer Care, 19 581-588 (2010) [C1]
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Nova |
2010 |
Sanson-Fisher RW, Bailey LJ, Aranda S, D'Este CA, Stojanovski E, Sharkey K, Schofield P, 'Quality of life research: is there a difference in output between the major cancer types?', European Journal of Cancer Care, 19 714-720 (2010) [C1]
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Nova |
2010 |
Hope K, Durrheim DN, Barnett D, D'Este CA, Kewley CD, Dalton CB, et al., 'Willingness of frontline health care workers to work during a public health emergency', Australian Journal of Emergency Management, 25 39-47 (2010) [C1]
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Nova |
2010 |
Gwynn JD, Hardy LL, Wiggers JH, Smith WT, D'Este CA, Turner N, et al., 'The validation of a self-report measure and physical activity of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children', Australian and New Zealand Journal of Public Health, 34 S57-S65 (2010) [C1]
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Nova |
2010 |
Hope KG, Merritt TD, Durrheim DN, Massey PD, Kohlhagen JK, Todd KW, D'Este CA, 'Evaluating the utility of emergency department syndromic surveillance for a regional public health service', Communicable Diseases Intelligence Quarterly Report, 34 310-318 (2010) [C1]
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Nova |
2009 |
Brown A, Gibson RE, Tavener MA, Guest M, D'Este CA, Byles JE, et al., 'Sexual function in F-111 maintenance workers: The study of health outcomes in aircraft maintenance personnel', Journal of Sexual Medicine, 6 1569-1578 (2009) [C1]
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Nova |
2009 |
Middleton S, Levi CR, Ward J, Grimshaw J, Griffiths R, D'Este CA, et al., 'Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer', Implementation Science, 4 1-11 (2009) [C1]
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Nova |
2009 |
Buchan H, Lourey E, D'Este CA, Sanson-Fisher RW, 'Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: A randomised controlled trial', Implementation Science, 4 1-8 (2009) [C1]
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Nova |
2009 |
Denham J, Steigler A, Wilcox C, Lamb DS, Joseph D, Atkinson C, et al., 'Why are pretreatment prostate-specific antigen levels and biochemical recurrence poor predictors of prostate cancer survival?', Cancer, 115 4477-4487 (2009) [C1]
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Nova |
2009 |
Miles S, Rogers KM, Thomas P, Soans B, Attia JR, Abel C, et al., 'A comparison of single-photon emission CT lung scintigraphy and CT pulmonary angiography for the diagnosis of pulmonary embolism', Chest, 136 1546-1553 (2009) [C1]
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Nova |
2009 |
Gilligan C, Sanson-Fisher RW, D'Este CA, Eades S, Wenitong M, 'Knowledge and attitudes regarding smoking during pregnancy among Aboriginal and Torres Strait Islander women', Medical Journal of Australia, 190 557-561 (2009) [C1]
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Nova |
2009 |
McGuire A, Waller M, Loos C, McClintock C, McFarlane AC, Nielsen L, et al., 'Self-reported indicators of psychological health', Psychiatric Annals, 39 48-55 (2009) [C1]
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Nova |
2009 |
Gilligan C, Sanson-Fisher RW, Eades S, D'Este CA, Kay-Lambkin FJ, Scheman S, 'Identifying pregnant women at risk of poor birth outcomes', Journal of Obstetrics and Gynaecology, 29 181-187 (2009) [C1]
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Nova |
2009 |
Denham J, Lamb DS, Joseph D, Matthews J, Atkinson C, Spry NA, et al., 'PSA response signatures: A powerful new prognostic indicator after radiation for prostate cancer?', Radiotherapy and Oncology, 90 382-388 (2009) [C1]
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Nova |
2009 |
Denham J, Kumar M, Gleeson PS, Lamb DS, Joseph D, Atkinson C, et al., 'Recognizing false biochemical failure calls after radiation with or without neo-adjuvant androgen deprivation for prostate cancer', International Journal of Radiation Oncology Biology Physics, 74 404-411 (2009) [C1]
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Nova |
2009 |
Denham J, Steigler A, Kumar M, Lamb DS, Joseph D, Spry NA, et al., 'Measuring time to biochemical failure in the Trog 96.01 trial: When should the clock start ticking?', International Journal of Radiation Oncology Biology Physics, 75 1008-1012 (2009) [C1]
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Nova |
2009 |
Girgis A, Cockburn JD, Butow P, Bowman D, Schofield P, Stojanovski E, et al., 'Improving patient emotional functioning and psychological morbidity: Evaluation of a consultation skills training program for oncologists', Patient Education and Counseling, 77 456-462 (2009) [C1]
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Nova |
2009 |
Xu L, Dibley M, D'Este CA, Phillips M, Porteous JE, Attia JR, 'Food groups and risk of forearm fractures in postmenopausal women in Chengdu, China', Climacteric, 12 222-229 (2009) [C1]
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Nova |
2009 |
Mackenzie L, Byles JE, D'Este CA, 'Longitudinal study of the Home Falls and Accidents Screening Tool in identifying older people at increased risk of falls', Australasian Journal on Ageing, 28 64-69 (2009) [C1]
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Nova |
2008 |
Butow P, Cockburn JD, Girgis A, Bowman DA, Schofield P, D'Este CA, et al., 'Increasing oncologists' skills in eliciting and responding to emotional cues: evaluation of a communication skills training program', Psycho-Oncology, 17 209-218 (2008) [C1]
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2008 |
Denham J, Steigler A, Wilcox C, Lamb DS, Joseph D, Atkinson C, et al., 'Time to biochemical failure and prostate-specific antigen doubling time as surrogates for prostate cancer-specific mortality: evidence from the TROG 96.01 randomised controlled trial', Lancet Oncology, 9 1058-1068 (2008) [C1]
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Nova |
2008 |
Agho KE, Dibley MJ, D'Este CA, Gibberd RW, 'Factors associated with haemoglobin concentration among Timor-Leste children aged 6-59 months', Journal of Health Population and Nutrition, 26 200-209 (2008) [C1]
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Nova |
2008 |
D'Este CA, Attia JR, Brown AM, Gibson RE, Gibberd RW, Tavener MA, et al., 'Cancer incidence and mortality in aircraft maintenance workers', American Journal of Industrial Medicine, 51 16-23 (2008) [C1]
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Nova |
2007 |
Sanson-Fisher RW, Bonevski B, Green LW, D'Este CA, 'Limitations of the Randomized Controlled Trial in Evaluating Population-Based Health Interventions', American Journal of Preventive Medicine, 33 155-161 (2007) [C1]
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2007 |
Hawkins NG, Sanson-Fisher RW, Shakeshaft A, D'Este CA, Green LW, 'The Multiple Baseline Design for Evaluating Population-Based Research', American Journal of Preventive Medicine, 33 162-168 (2007) [C1]
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2007 |
Nair BR, Browne WL, Chua L-E, D'Este C, O'Dea I, Agho K, 'Validating an Australian version of the Time and Change Test: A screening test for cognitive impairment', AUSTRALASIAN JOURNAL ON AGEING, 26 87-90 (2007)
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2007 |
Carter GL, Clover K, Whyte IM, Dawson AH, D'Este CA, 'Postcards from the EDge: 24-Month outcomes of a randomised controlled trial for hospital-treated self-poisoning', British Journal of Psychiatry, 191 548-553 (2007) [C1]
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Nova |
2007 |
Watson J, Graves SR, Ferguson JK, D'Este CA, Batey RG, 'Hepatitis C virus RNA quantitation and degradation studies in whole blood samples in vitro', Gut, 56 306-307 (2007) [C3]
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2007 |
Gilligan C, Sanson-Fisher RW, Eades S, D'Este CA, 'Antenatal smoking in vulnerable population groups: An area of need', Journal of Obstetrics and Gynaecology, 27 664-671 (2007) [C1]
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2006 |
Schofield PW, Gibson RE, Tavener MA, Attia JR, D'Este CA, Guest M, et al., 'Neuropsychological health in F-111 aircraft maintenance workers', NeuroToxicology, 27 852-860 (2006) [C1]
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Nova |
2006 |
Callister R, Clancy R, Gleeson M, Cox A, Dorrington M, D'Este C, et al., 'Effect of Lactobacillus acidophilus Probiotic Treatment in Fatigued Athletes with an Interferon- Defect', MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 38 S30-S30 (2006)
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2006 |
Mackenzie LA, Byles JE, D'Este CA, 'Validation of self-reported fall events in intervention studies', Clinical Rehabilitation, 20 331-339 (2006) [C1]
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2006 |
Clancy RL, Gleeson M, Cox A, Callister R, Dorrington M, D'Este CA, et al., 'Reversal in fatigued athletes of a defect in interferon gamma secretion after administration of Lactobacillus acidophilus', British Journal of Sports Medicine, 40 351-354 (2006) [C1]
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2006 |
Zhang X, Attia JR, D'Este CA, Ma X-Y, 'The relationship between higher blood pressure and ischaemic, haemorrhagic stroke among Chinese and Caucasians: meta-analysis', European Journal of Cardiovascular Prevention and Rehabilitation, 13 429-437 (2006) [C1]
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2006 |
Xu L, Phillips M, D'Este CA, Dibley MJ, Porteous JE, Attia JR, 'Diet, activity, and other lifestyle risk factors for forearm fracture in postmenopausal women in China: a case-control study', Menopause - The Journal of the North American Menopause Society, 13 102-110 (2006) [C1]
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2006 |
Attia JR, D'Este CA, Schofield PW, Brown AM, Gibson RE, Tavener MA, et al., 'Mental health in F-111 maintenance workers: the study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study', Journal of Occupational and Environmental Medicine, 48 682-691 (2006) [C1]
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Nova |
2006 |
Clancy RL, Ren Z, Pang GT, Fletcher PJ, D'Este CA, 'Chronic Chlamydia pneumoniae infection may promote coronary artery disease in humans through enhancing secretion of interleukin-4', Clinical and Experimental Immunology, 146 197-202 (2006) [C1]
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Nova |
2005 |
Christie D, Denham J, Steigler A, Lamb D, Turner S, Mameghan H, et al., 'Delayed rectal and urinary symptomatology in patients treated for prostate cancer by radiotherapy with or without short term neo-adjuvant androgen deprivation', Radiotherapy and oncology, 77 117-125 (2005) [C1]
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2005 |
Byles JE, D'Este CA, Parkinson L, O'Connell R, Treloar C, 'Single index of multimorbidity did not predict multiple outcomes', Journal of Clinical Epidemiology, 58 997-1005 (2005) [C1]
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Nova |
2005 |
Zhang X, Attia JR, D'Este CA, Yu XH, Wu XG, 'A risk score predicted coronary heart disease and stroke in a Chinese cohort', Journal of Clinical Epidemiology, 58 951-958 (2005) [C1]
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2005 |
Carter GL, Clover K, Whyte IM, Dawson AH, D'Este CA, 'Postcards from the EDge project: randomised controlled trial of an intervention using postcards to reduce repetition of hospital treated deliberate self poisoning', British Medical Journal, 331 805-810 (2005) [C1]
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Nova |
2005 |
Thakkinstian A, McElduff P, D'Este CA, Duffy D, Attia JR, 'A method for meta-analysis of molecular association studies', Statistics in Medicine, 24 1291-1306 (2005) [C1]
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Nova |
2005 |
Mackenzie S, Swan JR, D'Este CA, Spigelman AD, 'Elective open abdominal aortic aneurysm repair: a seven-year experience', Therapeutics and Clinical Risk Management, 1 27-31 (2005) [C1] |
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2005 |
Denham J, Steigler A, Lamb D, Joseph D, Mameghan H, Turner S, et al., 'Short-term androgen deprivation and radiotherapy for locally advanced prostate cancer : results from the Trans-Tasman Radiation Oncology Group 96.01 randomised controlled trial', The Lancet, 6 841-850 (2005) [C1]
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2004 |
Xu L, McElduff P, D'Este CA, Attia JR, 'Does dietary calcium have a protective effect on bone fractures in women? A meta-analysis of observational studies', The British Journal of Nutrition, 91 625-634 (2004) [C1]
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2004 |
Zhang X, Attia JR, D'Este CA, Yu X, 'Prevalence and Magnitude of Classical Risk Factors for Stroke in a Cohort of 5092 Chinese Steelworkers Over 13.5 Years of Follow-up', Stroke, 35 1052-1056 (2004) [C1]
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2004 |
Rodsutti J, Hensley M, Thakkinstian A, D'Este C, Attia J, 'A clinical decision rule to prioritize polysomnography in patients with suspected sleep apnea', SLEEP, 27 694-699 (2004) [C1]
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2004 |
Rodsutti J, Thakkinstian A, Hensley MJ, D'Este CA, Attia JR, 'A clinical decision rule to prioritise polysomnography in patients with suspected sleep apnoea', Sleep, 27 694-699 (2004) [C2]
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2004 |
Ward JE, Proude EM, D'Este CA, 'Randomized trial in family practice of a brief intervention to reduce STI risk in young adults', Family Practice, 21 537-544 (2004) [C1]
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2004 |
Thakkinstian A, D'Este CA, Eisman J, Nguyen T, Attia JR, 'Meta-Analysis of Molecular Association Studies: Vitamin D Receptor Gene Polymorphisms and BMD as a Case Study', Journal of Bone & Mineral Research, 19 419 (2004) [C1]
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2004 |
Thakkinstian A, D'Este CA, Attia JR, 'Haplotype analysis of VDR gene polymorphisms: a meta-analysis', Osteoporosis International: with other metabolic bone diseases, 15 729-734 (2004) [C1]
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2004 |
Do TT, Dibley MJ, D'Este CA, 'Receiver operating characteristic analysis of body mass index to detect increased risk of functional morbidity in Vietnamese rural adults', European Journal of Clinical Nutrition, 58 1594-1603 (2004) [C1]
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2004 |
Attia JR, D'Este CA, Levi CR, 'The progress trial three years later. HOPE trial may shed some light', BMJ, 329 1403-1404 (2004) [C1]
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2004 |
Xu L, Dibley MJ, D'Este CA, 'Reliability and validity of a food-frequency questionnaire for Chinese postmenopausal women', Public Health Nutrition, 7 91-98 (2004) [C1]
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2004 |
Horowitz G, Byles JE, Lee J, D'Este CA, 'Comparison of the Tono-Pen and Goldmann tonometer for measuring intraocular pressure in patients with glaucoma', Clinical and Experimental Ophthalmology, 32 584-589 (2004) [C1]
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2004 |
Palmer CM, McNulty AM, D'Este CA, Donovan B, 'Genital injuries in women reporting sexual assault', Sexual Health, 1 55-59 (2004) [C1]
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2004 |
Xf Z, Attia JR, D'Este CA, Yu X, Wu X, 'Prevalence and magnitude of classical risk factors for coronary heart disease in a cohort of 4400 Chinese steelworkers over 13.5 years' follow-up', European Journal of Cardiovascular Prevention & Rehabilitation, 11 113-120 (2004) [C1]
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2003 |
Wang Y, Levi CR, Attia JR, D'Este CA, Spratt N, Fisher JD, 'Seasonal Variation in Stroke in the Hunter Region, Australia: A 5-Year Hospital-Based Study, 1995-2000', Stroke: a journal of cerebral circulation, 34 1144-1150 (2003) [C1]
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2003 |
Attia JR, Thakkinstian A, D'Este CA, 'Meta-analyses of molecular association studies: Methodologic lessons for genetic epidemiology', The Journal of Clinical Epidemiology, 297-303 (2003) [C1]
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Nova |
2003 |
Wang Y, Levi CR, D'Este CA, Attia JR, Fisher JD, 'Variation of Stroke Attack Rates in Rural, Urban, and Coalfields Areas of the Hunter Region, Australia 1995-2000', Journal of Stroke & Cerebrovascular Diseases, 12 103-110 (2003) [C1]
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2002 |
Young JM, D'Este CA, Ward JE, 'Improving family physicians' use of evidence-based smoking cessation strategies : a cluster randomization trial', Preventive Medicine, 35 572-583 (2002) [C1]
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2002 |
Hanrahan P, D'Este CA, Menzies S, Plummer T, Hersey P, 'A randomised trial of skin photography as an aid to screening skin lesions in older males', Journal of Medical Screening, 9(3) 128-132 (2002) [C1]
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2001 |
Edmond K, Attia JR, D'Este CA, Condon J, 'Drowning and near-drowning in Northern Territory children', Medical Journal of Australia, 175 605-608 (2001) [C1]
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2001 |
Heller RF, D'Este CA, Lim L, O'Connell RL, Powell H, 'Randomised controlled trial to change the hospital management of unstable angina', Medical Journal of Australia, 174 217-221 (2001) [C1]
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Nova |
2001 |
Heller RF, D'Este C, Lim LL, O'Connell RL, Powell H, 'Randomised controlled trial to change the hospital management of unstable angina.', The Medical journal of Australia, 174 217-221 (2001)
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2001 |
Naing N, D'Este CA, Isa A, Salleh R, Mahmod M, 'Factors contributing to poor compliance with anti-TB treatment among tuberculosis patients', Southeast Asian Journal of Tropical Medicine and Public Health, 32 369382 (2001) [C1] |
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2001 |
Heller RF, Powell H, O'Connell RL, D'Este CA, Lim L, 'Trends in the hospital management of unstable angina', Journal of Epidemiology and Community Health, 55 483-486 (2001) [C2]
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2001 |
Naing NN, D'Este C, Isa AR, Salleh R, Bakar N, Mahmod MR, 'Factors contributing to poor compliance with anti-TB treatment among tuberculosis patients', Southeast Asian Journal of Tropical Medicine and Public Health, 32 369-382 (2001)
Tuberculosis (TB) has made a comeback. It has become a resurgent public health problem in developing countries in the tropics and is the leading cause of death from any single inf... [more]
Tuberculosis (TB) has made a comeback. It has become a resurgent public health problem in developing countries in the tropics and is the leading cause of death from any single infectious agent. Non-compliance to anti-tuberculosis treatment is the most serious problem in TB control. A cross-sectional study was conducted to investigate the determinants of poor compliance with anti-tuberculosis treatment among tuberculosis patients in Kota Bharu, Kelantan, Malaysia in 1999. A total of 390 patients were included in the study of which 130 were tuberculosis patients who defaulted treatment and 260 were those compliant to treatment. Data collection was done by interviewing the patients and collecting clinical and laboratory data from their medical records. Using multiple logistic regression analysis, patients who were not on direct observed therapy (DOT) lived distant to the health facility, were non-intravenous drug users (IVDU) and were HIV positive had statistically significant higher odds of being non-compliant. Patients should be given treatment under direct supervision with special attention to IVDU and HIV positive groups. Anti-TB treatment should be accessible to patients at the nearest health center from their residence. Interventions with health education programs emphasizing the benefits of treatment compliance should be implemented by further large-scale multi-centered studies.
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2000 |
Lim L, Heller RF, O'Connell RL, D'Este CA, 'Stated and actual management of acute myocardial infarction among different specialties', Medical Journal of Australia, 172 208-212 (2000) [C1]
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2000 |
Heller RF, Fisher J, D'Este CA, Lim L, Dobson AJ, Porter R, 'Death and readmission in the year after hospital admission with cardiovascular disease: the Hunter Area Heart and Stroke Register', The Medical Journal of Australia, 172 261-265 (2000) [C1]
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2000 |
Mukti A, Treloar CJ, Suprawimbarti, Asdie A, D'Este CA, Higginbotham HN, Heller RF, 'A Universal Precautions Education Intervention for Health Workers in Sradjito and PKU Hospital Indonesia', Southeast Asian Journal of Tropical Medicine and Public Health, 31 1-7 (2000) [C1]
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2000 |
Vu H, Heller RF, Lim L, D'Este CA, O'Connell RL, 'Mortality after acute myocardial infarction is lower in metropolitan regions than in non-metropolitan regions', Journal of Epidemiology & Community Health, 54 590-595 (2000) [C1]
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2000 |
Heller RF, O'Connell RL, D'Este CA, Lim L, Fletcher P, 'Differences in cardiac procedures among patients in metropolitan and non-metropolitan hospitals after acute myocardial infarction and angina', Australian Journal of Rural Health, 8 310-317 (2000) [C1]
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2000 |
Hanrahan P, Menzies S, D'Este C, Plummer T, Hersey P, 'Participation of older males in a study on photography as an aid to early detection of melanoma', Australian and New Zealand Journal of Public Health, 24/6 615-618 (2000) [C1]
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2000 |
Harris MA, Byles JE, Cockburn J, D'Este CA, 'A general practice-based recruitment strategy for colorectal cancer screening', Australian and New Zealand Journal of Public Health, 24 441-443 (2000) [C1]
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2000 |
Mukti AG, Treloar C, Suprawimbarti, Asdie AH, D'Este K, Higginbotham N, Heller R, 'A universal precautions education intervention for health workers in Sardjito and PKU Hospital Indonesia', Southeast Asian Journal of Tropical Medicine and Public Health, 31 405-411 (2000)
A non-randomized control trial was conducted to develop and evaluate a culturally appropriate academic detailing intervention on the universal precautions knowledge, attitude and ... [more]
A non-randomized control trial was conducted to develop and evaluate a culturally appropriate academic detailing intervention on the universal precautions knowledge, attitude and behavior of health care workers in hospitals. Fivety-five health care workers (44 nurses and 11 doctors) participated in the study. They were visited individually to discuss principles of universal precautions as well as the effect of automatic pilot on their work practices. Self-reported measures of knowledge and attitudes were collected from each participant before and after the intervention. A nurse observer collected measures of participants' compliance with the universal precautions guidelines according to a pre-determined protocol before and after the intervention. There was a significantly different level of knowledge, attitudes and compliance on universal precautions between the control and intervention hospital with p=0.0007, p=0.038 and p=0.03 respectively following the intervention. It is concluded that an academic detailing approach of education used in this study has significantly improved knowledge, attitudes and compliance scores.
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1999 |
Hanrahan PF, Hersey P, D'Este C, 'Failure to identify changes of melanoma is associated with the patient's age and the histological type and thickness of melanoma', JOURNAL OF INVESTIGATIVE DERMATOLOGY, 112 538-538 (1999)
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1999 |
Dobson AJ, McElduff P, Heller R, Alexander H, Colley P, D'Este K, 'Changing patterns of coronary heart disease in the Hunter Region of New South Wales, Australia', Journal of Clinical Epidemiology, 52 761-771 (1999) [C1]
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1999 |
Hong Y, Dibley MJ, D'Este CA, Hou R, 'The national survey on the constitution and health of Chinese students in 1995: Nutritional status of school students aged 10-17 in Shaanxi, China', Asia Pacific Journal of Clinical Nutrition, 8 121-128 (1999) [C1]
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1999 |
Nair B, Dobson A, O'Dea I, Hogben K, D'Este K, Page J, 'Further validation of "timed up and go" in stroke patients', AUSTRALASIAN JOURNAL ON AGEING, 18 98-99 (1999)
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1998 |
Harrison G, Byth P, D'Este CA, 'The third five-year survey of Fellows (by examination) of the Faculty of Intensive Care, Australia and New Zealand College of Anaesthetists', Anaesthic Intensive Care, 26 401-410 (1998) [C1]
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1998 |
Ward J, Bruce T, Holt P, D'Este CA, Sladden M, 'Labour saving strategies to maintain response rates: a randomised trial', Australian and New Zealand Journal of Public Health, 22 394-396 (1998) [C1]
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1998 |
Hanrahan P, Hersey P, D'Este CA, 'Factors involved in presentation of older people with thick melanoma', Medical Journal Australia, 169 410-414 (1998) [C1]
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1998 |
Hobbs M, Ward J, D'Este CA, Donnelly N, 'Consultations for cervical smears in general practice: a missed opportunity for smoking cessation advice?', Tobacco Control, 7 193-194 (1998) [C1]
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1997 |
Gupta L, Ward J, DEste C, 'Differential effectiveness of telephone prompts by medical and nonmedical staff in increasing survey response rates: A randomised trial', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 21 98-99 (1997)
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1997 |
Beaglehole R, Stewart AW, Jackson R, Dobson AJ, McElduff P, DEste K, et al., 'Declining rates of coronary heart disease in New Zealand and Australia, 1983-1993', AMERICAN JOURNAL OF EPIDEMIOLOGY, 145 707-713 (1997)
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1997 |
Hanrahan PF, Hersey P, Menzies SW, Watson AB, DEste CA, 'Examination of the ability of people to identify early changes of melanoma in computer-altered pigmented skin lesions', ARCHIVES OF DERMATOLOGY, 133 301-311 (1997)
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1995 |
BOYLE CA, DOBSON AJ, 'THE ACCURACY OF HOSPITAL RECORDS AND DEATH CERTIFICATES FOR ACUTE MYOCARDIAL-INFARCTION', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 25 316-323 (1995)
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1993 |
Ward J, D'Este C, Sanson-Fisher R, 'Beyond opportunistic Pap smears in general practice. Women's views of strategies to promote regular screening.', Australian family physician, 22 2032-2034 (1993)
BACKGROUND: An opportunistic reminder for a Pap smear is effective and acceptable in general practice. Women's views of strategies to promote ongoing attendance for Pap smear... [more]
BACKGROUND: An opportunistic reminder for a Pap smear is effective and acceptable in general practice. Women's views of strategies to promote ongoing attendance for Pap smears were unknown at the time of this study. OBJECTIVE: To determine women's perceptions of strategies to help them attend for their next Pap smear. SETTING AND PATIENTS: Randomly selected male general practitioners in urban Sydney and 174 of their female patients. RESULTS: Seventy-eight per cent response rate to a questionnaire sent after a consultation in which opportunistic screening was offered. A reminder letter from the GP was nominated as likely to help 'a lot' by at least 50 per cent of respondents. Free Pap smears and child-minding were nominated by at least 50 per cent of respondents as making 'no difference'. CONCLUSION: This survey has explored women's perceptions of potential strategies to promote continuing Pap smear screening. Given the disappointing results when these strategies have been implemented in individual general practices, however, the authors recommend prospective controlled evaluation before widespread adoption.
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