Digital Commons Network^™

Effectiveness Of Quality Incentive Payments In General Practice (Equip-Gp): A Study Protocol For A Cluster-Randomised Trial Of An Outcomes-Based Funding Model In Australian General Practice To Improve Patient Care, Gregory Peterson, Grant Russell, Jan Radford, Nicholas Arnold Zwar, Danielle Mazza, Simon Eckermann, Judy Mullan, Marijka Batterham, Athena Hammond, Andrew D. Bonney

Illawarra Health and Medical Research Institute

Background There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives help achieve this goal. This trial (EQuIP-GP) will investigate whether a funding model based upon targeted, continuous quality incentive payments for Australian general practices increases relational continuity of care, and lessens health-service utilisation, for high-risk patients and children. Methods We will use a mixed methods approach incorporating a two-arm pragmatic cluster randomised control trial with nested qualitative case studies. We aim to recruit 36 general practices from Practice-Based Research …

Geographic Variation In Cardiometabolic Risk Distribution: A Cross-Sectional Study Of 256,525 Adult Residents In The Illawarra-Shoalhaven Region Of The Nsw, Australia, Renin Toms, Darren J. Mayne, Xiaoqi Feng, Andrew D. Bonney

Illawarra Health and Medical Research Institute

Introduction Metabolic risk factors for cardiovascular disease (CVD) warrant significant public health concern globally. This study aims to utilise the regional database of a major laboratory network to describe the geographic distribution pattern of eight different cardiometabolic risk factors (CMRFs), which in turn can potentially generate hypotheses for future research into locality specific preventive approaches. Method A cross-sectional design utilising de-identified laboratory data on eight CMRFs including fasting blood sugar level (FBSL); glycated haemoglobin (HbA1c); total cholesterol (TC); high density lipoprotein (HDL); albumin creatinine ratio (ACR); estimated glomerular filtration rate (eGFR); body mass index (BMI); and diabetes mellitus (DM) status …

Physical Activity And Screen Time In Out Of School Hours Care: An Observational Study, Carol Maher, Rosa Virgara, Anthony D. Okely, Rebecca M. Stanley, Millie Watson, Lucy Lewis

Faculty of Social Sciences - Papers (Archive)

Background

This study aimed to describe, and identify predictors of, physical activity and screen time in children attending out of school hours care (OSHC).

Method

Twenty-three randomly selected OSHC centres (n = 1068 children) participated in this observational, cross-sectional study. Service directors completed interviews regarding policy, training, scheduling and equipment related to physical activity and screen time. Children’s activity behaviours (moderate to vigorous physical activity (MVPA), light physical activity, sedentary time and screen time) were measured using standardised direct observation.

Results

Directors’ interviews revealed a lack of formal policy guiding physical activity and screen time. Time spent in activity …

Cross-Sectional Study Of Area-Level Disadvantage And Glycaemic-Related Risk In Community Health Service Users In The Southern.Iml Research (Simlr) Cohort, Roger Cross, Andrew D. Bonney, Darren J. Mayne, Kathryn M. Weston

Faculty of Science, Medicine and Health - Papers: part A

Objectives. The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia. Methods. HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged 18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categories were defined as HbA1c 5.0-5.99% (lowest risk), 6.0-7.49% (intermediate risk) and 7.5% (highest risk). Logistic regression models were …

Mental Health Presentations To Acute Psychiatric Services: 3-Year Study Of Prevalence And Readmission Risk For Personality Disorders Compared With Psychotic, Affective, Substance Or Other Disorders, Kate L. Lewis, Mahnaz Fanaian, Beth Kotze, Brin F. S Grenyer

Faculty of Social Sciences - Papers (Archive)

Background The relative burden and risk of readmission for people with personality disorders in hospital settings is unknown. Aims To compare hospital use of people with personality disorder with that of people with other mental health diagnoses, such as psychoses and affective disorders. Method Naturalistic study of hospital presentations for mental health in a large community catchment. Mixed-effects Cox regression and survival curves were generated to examine risk of readmission for each group. Results Of 2894 people presenting to hospital, patients with personality disorder represented 20.5% of emergency and 26.6% of in-patients. Patients with personality disorder or psychoses were 2.3 …

Comparability Of The Australian National Cancer Symptom Trials (Cst) Group's Study Populations To National Referrals To Non-Cst Specialist Palliative Care Services Participating In The Palliative Care Outcomes Collaboration, Hiromichi Matsuoka, Samuel F. Allingham, Belinda Fazekas, Linda Brown, Zac Vandersman, Katherine Clark, Meera Agar, David C. Currow

Australian Health Services Research Institute

Using the results of Phase III studies in clinical practice depends on how representative study participants are of the clinical population to whom the results will be applied. The closer the characteristics between the subgroup who participate in a clinical trial and the whole population, the easier it is for clinicians to apply the results directly to the patient that he/she is treating. Trial participation is generally more happenstance than a systematic sampling of a population and is limited by eligibility criteria that do not reflect the entire clinical population. Phase III study populations tend to be younger with fewer …

Comparing Static And Dynamic Flood Models In Estuarine Environments: A Case Study From South-East Australia, Kristian Kumbier, Rafael Cabral Carvalho, Athanasios T. Vafeidis, Colin D. Woodroffe

Faculty of Science, Medicine and Health - Papers: Part B

Static and dynamic flood models differ substantially in their complexity and their ability to represent environmental processes such as storm tide or riverine flooding. This study analysed spatial differences in flood extent between static (bathtub) and dynamic flood models (Delft3D) in estuarine environments with different morphology and hydrodynamics in order to investigate which approach is most suitable to map flooding due to storm surges and river discharge in estuarine environments. Time series of observed water levels and river discharge measurements were used to force model boundaries. Observational data, such as tidal gauge and water level logger measurements, satellite imagery and …

Study On Performance Evaluation Of Co2 Heat Pump System Integrated With Thermal Energy Storage For Space Heating, Zhihua Wang, Yuxin Zheng, Fenghao Wang, Mengjie Song, Zhenjun Ma

Faculty of Engineering and Information Sciences - Papers: Part B

CO2 heat pumps have drawn a great deal of attention owing to their advantages of high efficiency and environmental friendly for heating water under low ambient temperature. However, the system performance is not desirable and shows a lower COP for space heating, especially for a radiator as heating terminal, due to the higher inlet water temperature at the gas cooler, which causes a large throttle loss when the refrigerant flow through the throttling device. To tackle this issue, a transcritical CO2 heat pump system integrated with thermal energy storage (TES) systems was developed in this paper. The heating performance of …

Improving Blood Pressure Control In Primary Care: The Impress Study, Catherine Stephen, Elizabeth J. Halcomb, Susan Mcinnes, Marijka Batterham, Nicholas Arnold Zwar

Faculty of Science, Medicine and Health - Papers: Part B

Background Hypertension is a preventable risk factor for cardiovascular disease, the leading cause of death globally. When hypertension is present with tobacco smoking, poor nutrition, physical inactivity or excessive alcohol consumption, risk of cardiovascular disease is increased. Given the prolonged engagement and ongoing relationship with patients, general practice nurses are ideally situated to actively engage with patients about optimal blood pressure control and lifestyle risk reduction. Objectives This study will test the effectiveness of a nurse-led intervention to reduce blood pressure in adults with hypertension and high cardiovascular risk. Design A multi-site, cluster randomised control trial where the general practice …

The Effectiveness Of A Dementia And Driving Education Module On Practitioner Knowledge, Confidence And Competence: A Pilot Study, H.C. Chang, Victoria Traynor, Nadine S. Veerhuis, Mu-Hsing Ho, Li-Yu Tang, Megan F. Liu, Hui-Wen Chien, Yung-Jen Yang

Faculty of Science, Medicine and Health - Papers: Part B

Abstract presented at the 11th International Association of Gerontology and Geriatrics Asia/Oceania Regional Congress, 23-27 October 2019, Taipei, Taiwan

Demographic And Clinical Predictors Of Health-Related Quality Of Life Among People With Type 2 Diabetes Mellitus Living In Northern Thailand: A Cross-Sectional Study, Saneh Khunkaew, Ritin S. Fernandez, Jenny Sim

Faculty of Science, Medicine and Health - Papers: Part B

Background Type 2 Diabetes Mellitus (T2DM) is a chronic disease which is growing global health problems. However, research on such prediction of health-related quality of life (HRQOL) in Thailand is limited, in particular on the demographic and clinical characteristic in each HRQOL domains. Therefore, the aim of the present study was to determine the demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus (T2DM) in Northern Thailand. Methods A cross-sectional study of people with T2DM at a large teaching hospital in Northern Thailand was conducted. The HRQOL was evaluated using the Thai version …

Understanding Spatial Variability Of Air Quality In Sydney: Part 2-A Roadside Case Study, Imogen Wadlow, Clare Paton-Walsh, Hugh I. Forehead, Pascal Perez, Mehrdad Amirghasemi, Elise-Andree Guerette, Owen Gendek, Prashant Kumar

Faculty of Science, Medicine and Health - Papers: Part B

Motivated by public interest, the Clean Air and Urban Landscapes (CAUL) hub deployed instrumentation to measure air quality at a roadside location in Sydney. The main aim was to compare concentrations of fine particulate matter (PM2.5) measured along a busy road section with ambient regional urban background levels, as measured at nearby regulatory air quality stations. The study also explored spatial and temporal variations in the observed PM2.5 concentrations. The chosen area was Randwick in Sydney, because it was also the subject area for an agent-based traffic model. Over a four-day campaign in February 2017, continuous measurements of PM2.5 were …

Why Health Care Professionals Belong To An Intensive Care Virtual Community: Qualitative Study, Kaye D. Rolls, Margaret Hansen, Debra Jackson, Doug Elliott

Faculty of Science, Medicine and Health - Papers: Part B

Background: Clinical practice variation that results in poor patient outcomes remains a pressing problem for health care organizations. Some evidence suggests that a key factor may be ineffective internal and professional networks that limit knowledge exchange among health care professionals. Virtual communities have the potential to overcome professional and organizational barriers and facilitate knowledge flow. Objective: This study aimed to explore why health care professionals belong to an exemplar virtual community, ICUConnect. The specific research objectives were to (1) understand why members join a virtual community and remain a member, (2) identify what purpose the virtual community serves in their …