Medicine and Health Sciences Commons^™

Effect Of Aspirin On Disability-Free Survival In The Healthy Elderly, John J Mcneil, Robyn L Woods, Mark R Nelson, Christopher M Reid, Brenda Kirpach, Rory Wolfe, Elsdon Storey, Raj C Shah, Jessica E Lockery, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors is unclear.

METHODS: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end …

Effect Of Aspirin On All-Cause Mortality In The Healthy Elderly, John J Mcneil, Mark R Nelson, Robyn L Woods, Jessica E Lockery, Rory Wolfe, Christopher M Reid, Brenda Kirpach, Raj C Shah, Diane G Ives, Elsdon Storey, Joanne Ryan, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Barbara Radziszewska, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: In the primary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, now published in the Journal, we report that the daily use of aspirin did not provide a benefit with regard to the primary end point of disability-free survival among older adults. A numerically higher rate of the secondary end point of death from any cause was observed with aspirin than with placebo.

METHODS: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics …

Effect Of Aspirin On Cardiovascular Events And Bleeding In The Healthy Elderly, John J Mcneil, Rory Wolfe, Robyn L Woods, Andrew M Tonkin, Geoffrey A Donnan, Mark R Nelson, Christopher M Reid, Jessica E Lockery, Brenda Kirpach, Elsdon Storey, Raj C Shah, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Michael Jelinek, Mobin Malik, Charles B Eaton, Donna Brauer, Geoff Cloud, Erica M Wood, Suzanne E Mahady, Suzanne Satterfield, Richard Grimm, Anne M Murray

Journal Articles

BACKGROUND: Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk.

METHODS: From 2010 through 2014, we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability. Participants were randomly assigned to receive 100 mg of enteric-coated aspirin or placebo. The primary end point was a …

Lived Experiences And Insights Into The Advantages Important To Rural Recruitment And Retention Of General Practitioners, Daniel R. Terry, Hoang B. Nguyen, David Schmitz, Ed Baker

Public Health and Population Science Faculty Publications and Presentations

Introduction: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities’ assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach.

Methods: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35–40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ …

Implementation Of Continuous Quality Improvement In Aboriginal And Torres Strait Islander Primary Health Care In Australia: A Scoping Systematic Review, Karen Gardner, Beverly Sibthorpe, Mier Chan, Ginny Sargent, Michelle Dowden, Daniel Mcaullay

Research outputs 2014 to 2021

BACKGROUND: Continuous Quality Improvement (CQI) programs have been taken up widely by Indigenous primary health care (PHC) services in Australia and there has been national policy commitment to support this. However, international evidence shows that implementing CQI is challenging, impacts are variable and little is known about the factors that impede or enhance effectiveness. A scoping review was undertaken to explore uptake and implementation in Indigenous PHC, including barriers and enablers to embedding CQI in routine practice. We provide guidance on how research and evaluation might be intensified to support implementation.

METHODS: Searches were conducted in MEDLINE, CINAHL and the …

Which Type Of Tobacco Product Warning Imagery Is More Effective And Sustainable Over Time?, Dien Anshari, Hua-Hei Yong, Ron Borland, Kamala Swayampakala, Jim Thrasher

Faculty Publications

Objective This study examined smokers’ responses to pictorial health warnings (PHWs) with different types of imagery under natural exposure conditions.

Methods Adult smokers from online panels in Canada (n=2357), Australia (n=1671) and Mexico (n=2537) were surveyed every 4 months from 2012 to 2013. Participants were shown PHWs on packs in their respective countries and asked about: (1) noticing PHWs; (2) negative affects towards PHWs; (3) believability of PHWs; (4) PHW-stimulated discussions; and (5) quit motivation due to PHWs. Country-specific generalised estimating equation models regressed these outcomes on time (ie, survey wave), PHW imagery type (ie, symbolic representations of risk, suffering …

Extracorporeal Cellular Therapy (Elad) In Severe Alcoholic Hepatitis: A Multinational, Prospective, Controlled, Randomized Trial., Julie Thompson, Natasha Jones, Ali Al-Khafaji, Shahid Malik, David Reich, Santiago Munoz, Ross Macnicholas, Tarek Hassanein, Lewis Teperman, Lance Stein, Andrés Duarte-Rojo, Raza Malik, Talal Adhami, Sumeet Asrani, Nikunj Shah, Paul Gaglio, Anupama Duddempudi, Brian Borg, Rajiv Jalan, Robert Brown, Heather Patton, Rohit Satoskar, Simona Rossi, Amay Parikh, Ahmed Elsharkawy, Parvez Mantry, Linda Sher, David Wolf, Marquis Hart, Charles Landis, Alan Wigg, Shahid Habib, Geoffrey Mccaughan, Steven Colquhoun, Alyssa Henry, Patricia Bedard, Lee Landeen, Michael Millis, Robert Ashley, William Frank, Andrew Henry, Jan Stange, Ram Subramanian

Articles, Abstracts, and Reports

Severe alcoholic hepatitis (sAH) is associated with a poor prognosis. There is no proven effective treatment for sAH, which is why early transplantation has been increasingly discussed. Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal cellular therapy (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's discriminant function ≥ 32, and Model for End-Stage Liver Disease (MELD) score ≤ 35 were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC. After a minimum follow-up of …

A Tale Of Two Countries: Progress Towards Unaids 90‐90‐90 Targets In Botswana And Australia, Tafireyi Marukutira, Mark Stoove, Shahin Lockman, Lisa A. Mills, Tendani Gaolathe, Refeletswe Lebelonyane, Joseph N. Jarvis, Sherrie L. Kelly, David P. Wilson, Stanley Luchters

Population Health, East Africa

UNAIDS 90‐90‐90 targets and Fast‐Track commitments are presented as precursors to ending the AIDS epidemic by 2030, through effecting a 90% reduction in new HIV infections and AIDS‐related deaths from 2010 levels (HIV epidemic control). Botswana, a low to middle‐income country with the third‐highest HIV prevalence, and Australia, a low‐prevalence high‐income country with an epidemic concentrated among men who have sex with men (MSM), have made significant strides towards achieving the UNAIDS 90‐90‐90 targets. These two countries provide lessons for different epidemic settings. This paper discusses the lessons that can be drawn from Botswana and Australia with respect to their …

What Are The Characteristics Of Vitamin D Metabolism In Opioid Dependence? An Exploratory Longitudinal Study In Australian Primary Care, Albert Stuart Reece, Gary Hulse

Research outputs 2014 to 2021

OBJECTIVE: Compare vitamin D levels in opioid dependence and control population and adjust for relevant confounding effects. Nuclear hormone receptors (including the vitamin D receptor) have been shown to be key transducers and regulators of intracellular metabolism and comprise an important site of pathophysiological immune and metabolic dysregulation potentially contributing towards pro-ageing changes observed in opioid-dependent patients (ODPs).

DESIGN: Longitudinal prospective comparing ODPs with general medical controls (GMCs).

SETTING: Primary care.

PARTICIPANTS: Prospective review comparing 1168 ODP (72.5% men) and 415 GMC (51.6% men, p

INTERVENTIONS: Nil. Observational study only.

PRIMARY AND SECONDARY OUTCOMES: Serum vitamin D levels and relevant …

The Effect Of Individual Radiographers On Rates Of Attendance To Breast Screening: A 7-Year Retrospective Study, S. Savaridas, J. Brook, J. Codde, M Bulsara, W. Wylie

Health Sciences Papers and Journal Articles

AIM: To establish whether individual radiographers had significantly different rescreening rates whilst controlling for other known confounding factors.

MATERIALS AND METHODS: Women aged 50e69 years were identified from a state-wide screening database at their first screening attendance during the study period (2007e2013). The radiographer performing this index screen and potential confounding factors were recorded and subsequent screening behaviour was assessed. Clients with abnormal screens and those known to have died during the time period were excluded. A univariate analysis of the data from 160,028 women was assessed using the chi-square test to compare those women who attended their next mammography …

Mortality In A Cohort Of Remote-Living Aboriginal Australians And Associated Factors, Zoe Hyde, Kate Smith, Leon Flicker, David Atkinson, Osvaldo P. Almeida, Nicola T. Lautenschlager, Anna Dwyer, Dina Logiudice

Health Sciences Papers and Journal Articles

Objectives: We aimed to describe mortality in a cohort of remote-living Aboriginal Australians using electronic record linkage.

Methods: Between 2004 and 2006, 363 Aboriginal people living in remote Western Australia (WA) completed a questionnaire assessing medical history and behavioural risk factors. We obtained mortality records for the cohort from the WA Data Linkage System and compared them to data for the general population. We used Cox proportional hazards regression to identify predictors of mortality over a 9-year follow-up period.

Results: The leading causes of mortality were diabetes, renal failure, and ischaemic heart disease. Diabetes and renal failure accounted for 28% …

Factors Contributing To Australian Adolescents’ Self-Report Of Their Motor Skill Competence, Amanda Timler, Fleur Mcintyre, Beth Hands

Health Sciences Papers and Journal Articles

An adolescents motor skill competence can affect areas such as sports participation, social activities and future academic or employment decisions. The Adolescent Motor Competence Questionnaire (AMCQ) is a 26-item questionnaire that uses a four point Likert response (never, sometimes, frequently, always) to assess motor-related activities during adolescence. This study aims to provide evidence of the construct validity using Principle Component Analysis (PCA) and to identify factors that contributed to Australian adolescent self-reported motor competence. A final aim was to determine whether individual item responses differed between males and females. The AMCQ was completed by 160 adolescents (M_age = 14.45 …

Finding A Space For Women: The British Medical Association And Women Doctors In Australia, 1880-1939, Louella R. Mccarthy

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

This paper examines the experiences of women in one professional organisation - the British Medical Association in Australia - during a significant period in the development of such bodies. In doing so it offers an opportunity to consider the relationship between professional societies and the construction of a gendered profession. For the medical profession in particular the time-frame of this study, from the 1880s to the 1930s, has been regarded by scholars as especially important. In this period various features of medical professionalism came to prominence: the status and authority of doctors, the processes of formally registering medical credentials, and …

Island-Hopping Study Shows The Most Likely Route The First People Took To Australia, Kasih Norman

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

The First Australians were among the world's earliest great ocean explorers, undertaking a remarkable 2,000km maritime migration through Indonesia which led to the discovery of Australia at least 65,000 years ago. But the voyaging routes taken through Indonesia's islands, and the location of first landfall in Australia, remain a much debated mystery to archaeologists. Our research, published earlier this year in Quaternary Science Reviews, highlights the most likely route by mapping islands in the region over time through changing sea levels.

Tracking The 10be-26al Source-Area Signal In Sediment-Routing Systems Of Arid Central Australia, Martin Struck, John D. Jansen, Toshiyuki Fujioka, Alexandru Tiberiu Codilean, David Fink, Reka H. Fulop, Klaus M. Wilcken, David M. Price, Steven Kotevski, L Keith Fifield, John Chappell

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

Sediment-routing systems continuously transfer information and mass from eroding source areas to depositional sinks. Understanding how these systems alter environmental signals is critical when it comes to inferring source-area properties from the sedimentary record. We measure cosmogenic 10Be and 26Al along three large sediment-routing systems ( ∼  100 000 km2) in central Australia with the aim of tracking downstream variations in 10Be-26Al inventories and identifying the factors responsible for these variations. By comparing 56 new cosmogenic 10Be and 26Al measurements in stream sediments with matching data (n =  55) from source areas, we show that 10Be-26Al inventories in hillslope bedrock …

Adherence To Prescribing Restrictions For Her2-Positive Metastatic Breast Cancer In Australia: A National Population-Based Observational Study (2001-2016), Benjamin Daniels, Federico Girosi, Hanna Tervonen, Belinda E. Kiely, Sarah J. Lord, Nehmat Houssami, Sally-Anne Pearson

Medical Papers and Journal Articles

Background: Targeted cancer therapy is often complex, involving multiple agents and chemotherapeutic partners. In Australia, prescribing restrictions are put in place to reflect existing evidence of cost-effectiveness of these medicines. As therapeutic options continue to expand, these restrictions may not be perceived to align with best practice and it is not known if their use in the real-world clinic adheres to these restrictions. We examined the treatment of women receiving trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) to determine the extent to which treatment adhered to national prescribing restrictions.

Patients and methods: Our population-based, retrospective cohort study used dispensing records …

How Are Junior Doctors Managing Patients With Self-Limiting Illnesses At Their First Presentation? A Video Vignette Study, Eugene D'Souza, Catherine Krejany, Rosie Meng, Moyez Jiwa

Medical Papers and Journal Articles

Purpose: To conduct a video vignette survey of medical students and doctors investigating test ordering for patients presenting with self-limiting or minor illness.

Methods: Participants were shown six video vignettes of common self-limiting illnesses and invited to devise investigation and management plans for the patients’ current presentation. The number of tests ordered was compared with those recommended by an expert panel. A Theory of Planned Behaviour Questionnaire explored participants’ beliefs and attitudes about ordering tests in the context of self-limiting illness.

Results: Participants (n=61) were recruited from across Australia. All participants ordered at least one test that was not recommended …

Low-Level Cadmium Exposure And Cardiovascular Outcomes In Elderly Australian Women: A Cohort Study, Kane Deering, Anna C. Callan, Richard Prince, Wai Lim, Peter Thompson, Joshua Lewis, Andrea Hinwood, Amanda Devine

Research outputs 2014 to 2021

Background

Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women.

Objectives

This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women.

Methods

UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2.7 years and 14.5 years of atherosclerotic vascular disease (ASVD) hospitalisations and deaths, including both the principle cause of death and all associated causes of death. Health outcome data were retrieved from the Western Australian Data …

The 12-Year Prevalence And Trends Of Childhood Disabilities In Australia: Findings From The Survey Of Disability, Aging And Carers, Diana Arabiat, Lisa Whitehead, Mohammad Al Jabery

Research outputs 2014 to 2021

Aim:

This paper contributes to knowledge on the prevalence and nature of disabilities in Australian children over a 12‐year period (2003–2015). Understanding the current state of childhood disability is imperative for predicting future needs for long‐term care and early intervention services for this population.

Methods:

We used data on children 0–14 years from the 2003, 2009, 2012, and 2015 survey of Disability, Aging and Carers, which is an ongoing national survey covering both rural and urban areas of all States and Territories of Australia.

Results:

Using the test for trends in population, no significant increases were noted in the prevalence …

Geographic Disparities In Previously Diagnosed Health Conditions In Colorectal Cancer Patients Are Largely Explained By Age And Area Level Disadvantage, Belinda C Goodwin, Sonja March, Michael J Ireland, Fiona Crawford-Williams, Shu-Kay Ng, Peter D Baade, Suzanne K. Chambers, Joanne F Aitken, Jeff Dunn

Research outputs 2014 to 2021

Background: Geographical disparity in colorectal cancer (CRC) survival rates may be partly due to aging populations and disadvantage in more remote locations; factors that also impact the incidence and outcomes of other chronic health conditions. The current study investigates whether geographic disparity exists amongst previously diagnosed health conditions in CRC patients above and beyond age and area-level disadvantage and whether this disparity is linked to geographic disparity in CRC survival.

Methods: Data regarding previously diagnosed health conditions were collected via computer-assisted telephone interviews with a cross-sectional sample of n = 1,966 Australian CRC patients between 2003 and 2004. Ten-year survival …

Carers' Preferences For The Delivery Of Therapy Services For People With Disability In Rural Australia: Evidence From A Discrete Choice Experiment, G Gallego, A Dew, M Lincoln, K Bulkeley, J Brentnall, C Vietch

Medical Papers and Journal Articles

Background: The implementation of the Australian National Disability Insurance Scheme (NDIS) is expected to generate a responsive, person-centred system that will empower people with disability to choose the services and support they receive. However little attention has been paid to examine how users of the NDIS will choose and spend their individual budgets. This study aimed to determine quantitatively the relative importance that carers of people with a disability living in rural Australia place on different therapy service delivery characteristics.

Methods: A stated preference discrete choice experiment (DCE) was incorporated into a survey of carers of people with disability living …

Vitamin D Deficiency And Segregation Status In Prisoners, Zelda Doyle, John Dearin, Joe Mcgirr

Medical Papers and Journal Articles

Purpose: The purpose of this paper is to investigate if any exposure to segregation minimal association in a single male prison population had any association with an increased risk of vitamin D deficiency.

Design/methodology/approach: A retrospective case study was undertaken with all inmates who had a 25-hyrdoxy-vitamin D test taken during the study period deemed eligible. Hand searching of the medical records by an independent party identified eligible participants whose data were recorded for analysis.

Findings: In total, 124 prisoners were deemed eligible for inclusion; 67 were vitamin D sufficient and 57 were vitamin D deficient by Australian standards. Time …

A Framework For Development Of Android Mobile Electronic Prescription Transfer Applications In Compliance With Security Requirements Mandated By The Australian Healthcare Industry, Kyaw Kyaw Htat

Theses: Doctorates and Masters

This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance.

The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of …

The Delivery Of Primary Health Care In Remote Australian Communities: A Grounded Theory Study Of The Perspective Of Nurses, Kylie Mccullough

Theses: Doctorates and Masters

Around 85% of Australia’s landmass is remote and sparsely populated. Across these vast areas of desert, wilderness and tropical islands, nurses provide the majority of health care services. The residents of Australia’s remote communities have poorer health status than their metropolitan counterparts. The proportion of Indigenous people is high and health and social disadvantage is widespread. The characteristics of each remote community are unique and often reflect challenges associated with distance to tertiary health services and limited health resources. As a result, nursing practice within this context is very different to other nursing contexts. Despite recognition of Primary Health Care …

Nurse-Led Primary Health Care For Homeless Men: A Multimethods Descriptive Study, Michael A. Roche, Christine M. Duffield, Judith Smith, Dana A. Kelly, Robyn Cook, Jen M. Bichel-Findlay, Carla Saunders, David J. Carter

Research outputs 2014 to 2021

Aim: To explore the primary healthcare needs and health service use of homeless men in inner Sydney. Background: People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. Methods: A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless …

Vulnerable, Single And Living In Poverty: Women’S Challenges To Accessing Food In The Australian Capital Territory, Tanya Lawlis, Amanda Devine, Penney Upton

Research outputs 2014 to 2021

Objective: To explore challenges to food access faced by vulnerable women living in the Australian Capital Territory and surrounds.

Method: Qualitative study comprising semi‐structured interviews supplemented with quantitative demographic data.

Results:Forty‐one women, mean age of 43 years, living in government and community housing who had an income of

Conclusion: Access to safe, nutritious and healthy food is difficult for women living in poverty. Acknowledgement of challenges that contribute to women’s food insecurity by all stakeholders is essential to address the problem and build sustainable actions and solutions.

Implications for public health: Collaboration from all stakeholders within our food system …

Exploring The Preparedness Of Novice (Student) Paramedics For The Mental Health Challenges Of The Paramedic Profession: Using The Wisdom Of The Elders, Lisa Holmes

Theses: Doctorates and Masters

This study investigates the preparedness of novice (student) paramedics for the mental health challenges of the paramedic profession and identifies the coping strategies used by veteran paramedics to successfully meet these challenges. The lived experience of veteran paramedics is utilised to provide this important assistance.

Initially, two surveys were developed and administered to 16 course coordinators and 302 students of the 16 accredited undergraduate degree paramedicine courses across Australia and New Zealand, to identify the perceived need (for preparation) within the curriculum. In addition, the anticipations, confidence and fears of novice (student) paramedics, course coordinators and veteran paramedics were also …

A Profile Of Game Style, Physical, Technical And Tactical Skills, And The Pathways That Underpin Expertise In Australian Youth Soccer Players, Bradley Scott Keller

Theses: Doctorates and Masters

The attainment of expertise has been the focus of research in many domains including music, chess and sport. This research has progressed with many theories detailing the best way to develop expertise and nurture talent in sport. Soccer is a multifaceted sport which requires a number of physical, technical and tactical skills to be successful, making it difficult to achieve expertise. Although Australia’s performance on the international stage is improving, there is a lack of evidence to inform the most effective development pathways to support the next wave of talented youth soccer players. Therefore, the aim of the thesis was …