Medicine and Health Sciences Commons^™

Is The Australian Smoking Population Hardening?, Tanya Buchanan, Christopher A. Magee, Ezinne Oyidia Igwe, Peter James Kelly

Illawarra Health and Medical Research Institute

Background The hardening hypothesis proposes that as smoking rates decline, the remaining smokers will become hardcore and resistant to quitting. This group of highly resistant quitters will potentially require more individualistic approaches to cessation and harm reduction. The harm reduction approach (specifically e-cigarettes) has been proposed as an option to address hardened Australian smokers. We tested the hardening hypothesis by analysing the rates of hardcore smoking in the Australian smoking population between 2010-2016. Methods Data were drawn from three waves of the National Drug Strategy Household Survey (NDSHS) in 2010, 2013 and 2016. Two different definitions were used to assess …

Australian And New Zealand Medical Students' Attitudes And Confidence Towards Providing Nutrition Care In Practice, Breanna Marie Lepre, Jennifer Crowley, Dineo Mpe, Harsh Bhoopatkar, Kylie J. Mansfield, Clare Wall, Eleanor J. Beck

Illawarra Health and Medical Research Institute

The prevalence of lifestyle-related chronic disease is increasing. Doctors in primary care are ideally placed to support patient nutrition care, but recent reviews show education is still lacking. This study aimed to identify medical students’ attitudes towards the role of nutrition in health, nutrition knowledge, and perceptions of nutrition education, in postgraduate (Australia) and undergraduate (New Zealand) programs in order to identify gaps in nutrition knowledge and skills to better inform future education. Second-year graduate and third-year undergraduate students participated in semi-structured focus groups and interviews. A general inductive approach was used to investigate students’ 1) attitudes toward the role …

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 …

Whole Grain Intake Of Australians Estimated From A Cross-Sectional Analysis Of Dietary Intake Data From The 2011-13 Australian Health Survey, Leanne M. Galea, Eleanor J. Beck, Yasmine Probst, Chris Cashman

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

Objective: The Australian Dietary Guidelines recommend Australians choose mostly whole-grain and/or high-fibre varieties within the grains (cereal) foods category, with other groups specifying a whole grain Daily Target Intake of 48 g for Australians aged 9 years or above. The USA and UK report estimates of whole grain intake that are low and declining, and no comprehensive studies on whole grain intake in the Australian population are available. The present study aimed to determine national estimates of whole grain intake, compared with current recommendations. Design: A recently updated whole grain database was applied to the most current population dietary intake …

The Major Types Of Added Sugars And Non-Nutritive Sweeteners In A Sample Of Australian Packaged Foods, Yasmine Probst, Alexis Dengate, Jennifer Jacobs, Jimmy Chun Yu Louie, Elizabeth K. Dunford

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

Limiting the intake of added sugars in the diet remains a key focus of global dietary recommendations. To date there has been no systematic monitoring of the major types of added sugars used in the Australian food supply. The present study aimed to identify the most common added sugars and non-nutritive sweeteners in the Australian packaged food supply. Secondary analysis of data from the Australian FoodSwitch database was undertaken. Forty-six added sugars and eight non-nutritive sweetener types were extracted from the ingredient lists of 5744 foods across seventeen food categories. Australia. Not applicable. Added sugar ingredients were found in 61 …

The Development Of Professional Practice Standards For Australian General Practice Nurses, Elizabeth J. Halcomb, Moira Stephens, Julianne Bryce, Elizabeth Foley, Christine Ashley

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

Aims The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses.

Background Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting.

Design …

Dietary Iodine Intake Of The Australian Population After Introduction Of A Mandatory Iodine Fortification Programme, Karen E. Charlton, Yasmine Probst, Gabriella Kiene

Illawarra Health and Medical Research Institute

To address mild iodine deficiency in Australia, a mandatory fortification program of iodised salt in bread was implemented in 2009. This study aimed to determine factors associated with achieving an adequate dietary iodine intake in the Australian population post-fortification, and to assess whether bread consumption patterns affect iodine intake in high-risk groups. Using nationally representative data of repeated 24-h dietary recalls from the 2011-2012 Australian National Nutrition and Physical Activity Survey, dietary iodine intakes and food group contributions were compared by age, socioeconomic status (SES), and geographical remoteness (N = 7735). The association between fortified bread intake and adequacy …

Australian Women's Experiences Of The Subdermal Contraceptive Implant: A Qualitative Perspective, Kumiyo Inoue, Marguerite Kelly, Alexandra Barratt, Deborah Bateson, Alison Rutherford, Kirsten I. Black, Mary Stewart, Juliet Richters

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

Background The number of prescriptions for contraceptive implants has steadily increased in Australia, but implant use is still low. Objectives The objectives of the study were to describe women's nuanced responses, and characterise their multidimensional and complex reasons for (dis)continuing use of the contraceptive implant. Method A descriptive qualitative approach was used for this study. A larger qualitative study using in-depth, open-ended interviews, conducted in New South Wales between 2012 and 2013 with 94 women aged 16-49 years who had used contraception, included 10 interviews containing accounts of implant use. The 10 interviews were analysed thematically in the present study. …

Evaluating Women's Knowledge Of The Combined Oral Contraceptive Pill In An Australian Rural General Practice Setting, Sharna Kulhavy, Teresa M. Treweek

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

Background: In addition to the contraceptive action of the combined oral contraceptive pill (COCP), there are a number of other benefits to its use such as menstrual cycle regulation. However, COCP use is also associated with a higher risk of thromboembolism. Despite the prevalence of COCP use, studies have indicated that overall women have poor knowledge of the COCP.

Aim: To evaluate women's knowledge of the COCP in a rural general practice setting. The extent of knowledge was assessed in several domains including: COCP use and effectiveness, mechanism of action, and the risks and benefits of COCP use. …

Identification Of Dietary Patterns Associated With Blood Pressure In A Sample Of Overweight Australian Adults, Shirin Anil, Karen E. Charlton, Linda C. Tapsell, Yasmine Probst, Rhoda Ndanuko, Marijka Batterham

Illawarra Health and Medical Research Institute

The dietary approaches to stop hypertension (DASH) diet provides strong evidence for an optimal dietary pattern for blood pressure (BP) control; however, investigation at the level of key foods in a dietary pattern is sparse. This study aimed to assess the relationship between dietary patterns driven by key foods with BP in a sample of obese Australian adults. Secondary analysis was conducted on baseline data of 118 participants (45.1±8.4 years, mean BP=124.1±15.8/72.6±9.2 mm Hg) recruited in a weight reduction randomized controlled trial (ACTRN12608000425392). Dietary assessment was by a validated diet history interview. The average of three office BP measurements was …

Food Patterns Of Australian Children Ages 9 To 13 Y In Relation To Ω-3 Long Chain Polyunsaturated Intake, Setyaningrum Rahmawaty, Philippa Lyons-Wall, Marijka Batterham, Karen Charlton, Barbara J. Meyer

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

Objective: The aim of this study was to examine food patterns of Australian children ages 9 to 13 y in relation to ω-3 long-chain polyunsaturated fatty acid (ω-3 LCPUFA) intake.

Methods: Secondary analysis was conducted on nationally representative food data of 1110 Australian children ages 9 to 13 y (525 boys and 585 girls) that was obtained using two 24-h recalls. Principle component factor analysis was used to identify food patterns. Discriminant function analysis was used to identify the relationship between the food patterns and total ω-3 LCPUFA intake.

Results: Four major food patterns emerged for each sex. For boys …

Patterns Of Genotypic Diversity Suggest A Long History Of Clonality And Population Isolation In The Australian Arid Zone Shrub Acacia Carneorum, Eleanor K. O'Brien, Andrew J. Denham, David J. Ayre

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

For plants capable of both sexual and clonal reproduction, the relative frequency of these reproductive modes is influenced by genetic and ecological factors. Acacia carneorum is a threatened shrub from the Australian arid zone that occurs as a set of small, spatially isolated populations. Sexual reproduction appears to be very rare: despite regular flowering, only two populations set seed. It is not known whether this reflects an ancient pattern, or results from rapid land use changes following arrival of Europeans in the region 150 years ago. We assessed genotypic variation throughout the range of A. carneorum using AFLP markers, to …

Analysis Of The Psychological Impact Of A Vascular Risk Factor Intervention: Results From A Cluster Randomized Controlled Trial In Australian General Practice, Suzanne Helen Mckenzie, Upali W. Jayasinghe, Mahnaz Fanaian, Megan Passey, Mark Fort Harris

Illawarra Health and Medical Research Institute

Background Screening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention on behavioural and physiological risk factors in 30 Australian practices. The primary aim of this analysis is to investigate the psychological impact of participating in the intervention arm of the trial. The secondary aim is to identify the mediating effects of changes in behavioural risk factors or BMI. Methods This study is an analysis of a secondary outcome …

Soil Formation Rates Determined From Uranium-Series Isotope Disequilibria In Soil Profiles From The Southeastern Australian Highlands, P O. Suresh, A Dosseto, P P. Hesse, H K. Handley

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

The sustainability of soil resources is determined by the balance between the rates of production and removal of soils. Samples from four weathering profiles at Frogs Hollow in the upper catchment area of the Murrumbidgee River (southeastern Australia) were analyzed for their uranium-series (U-series) isotopic composition to estimate soil production rates. Sequential leaching was conducted on sample aliquots to assess how U-series nuclides are distributed between primary and secondary minerals. Soil is increasingly weathered from bottom to top which is evident from the decrease in (234U/238U) ratios and increase in relative quartz content with decreasing soil depth. One soil profile …

Sedimentation, Elevation And Marsh Evolution In A Southeastern Australian Estuary During Changing Climatic Conditions, Kerrylee Rogers, Neil Saintilan, Alice J. Howe, José F. Rodríguez

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

Mangrove and salt marsh vertical accretion and surface elevation change was measured at Kooragang Island within the Ramsar-listed Lower Hunter estuarine wetlands in New South Wales, Australia, using surface elevation tables and marker horizons over a ten-year period. We surveyed mangrove, salt marsh and a zone of mangrove encroachment into salt marsh. The period of analysis was dominated by El Niño (drought) climatic conditions, though included a series of east coast low pressure systems and associated storms over the central coast of NSW in June 2007. The storms may have initially caused scouring of sediments in the mangrove zone, followed …

The Significance And Vulnerability Of Australian Saltmarshes: Implications For Management In A Changing Climate, Neil Saintilan, Kerrylee Rogers

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

We review the distribution, status and ecology of Australian saltmarshes and the mechanisms whereby enhanced atmospheric carbon dioxide and associated climate change have influenced and will influence the provision of ecosystem goods and services. Research in temperate and subtropical saltmarsh has demonstrated important trophic contributions to estuarine fisheries, mediated by the synchronised mass-spawning of crabs, which feed predominantly on the C-4 saltmarsh grass Sporobolus virginicus and microphytobenthos. Saltmarshes also provide unique feeding and habitat opportunities for several species of threatened microbats and birds, including migratory shorebirds. Saltmarshes increased in extent relative to mangrove in Australia in both tide- and wave-dominated …

Allochthonous And Autochthonous Contributions To Carbon Accumulation And Carbon Store In Southeastern Australian Coastal Wetlands, N Saintilan, K Rogers, D Mazumder, C Woodroffe

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

Estimates of carbon store and carbon accumulation rate in mangrove and saltmarsh are beset by issues of scale and provenance. Estimates at a site do not allow scaling to regional estimates if the drivers of variability are not known. Also, carbon accumulation within soils provides a net offset only if carbon is derived in-situ, or would not otherwise be sequestered. We use a network of observation sites extending across 2000 km of southeastern Australian coastline to determine the influence of geomorphic setting and coastal wetland vegetation type on rates of carbon accumulation, carbon store and probable sources. Carbon accumulation above …

Post-Glacial Sea-Level Changes Around The Australian Margin: A Review, Stephen E. Lewis, Craig R. Sloss, Colin V. Murray-Wallace, Colin D. Woodroffe, Scott G. Smithers

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

It has been known since Rhodes Fairbridge's first attempt to establish a global pattern of Holocene sea-level change by combining evidence from Western Australia and from sites in the northern hemisphere that the details of sea-level history since the Last Glacial Maximum vary considerably across the globe. The Australian region is relatively stable tectonically and is situated in the 'far-field' of former ice sheets. It therefore preserves important records of post-glacial sea levels that are less complicated by neotectonics or glacio-isostatic adjustments. Accordingly, the relative sea-level record of this region is dominantly one of glacio-eustatic (ice equivalent) sea-level changes. The …

Food Groups And Fatty Acids Associated With Self-Reported Depression: An Analysis From The Australian National Nutrition And Health Surveys, Barbara J. Meyer, Nithin Kolanu, David A. Griffiths, Ben Grounds, Peter R. C Howe, Irene A. Kreis

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

Objective The aim of this study was to explore the associations between incidence of depression and dietary intakes of foods and fatty acids in adult Australians. Methods Data from the 1995 Australian National Nutrition Survey (NNS), the 1995 Australian National Health Survey (NHS) and an updated fatty acid database were merged and the 24-h fatty acid intakes were calculated for the 10 986 adult participants ages 18 to 79 y in the 1995 NNS. The merged data set was used to run a logistic regression with depression as the response variable and the food groups and calculated fatty acid values, …

Chaperones For Pap Smears: Do Australian Gps Offer Or Use Them?, Lucie Stanford, Andrew Bonney, Rowena Ivers

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

No abstract provided.

Longitudinal Nasopharyngeal Carriage And Antibiotic Resistance Of Respiratory Bacteria In Indigenous Australian And Alaska Native Children With Bronchiectasis, Kim M. Hare, Rosalyn J. Singleton, Keith Grimwood, Patricia C. Valery, Allen C. Cheng, Peter S. Morris, Amanda J. Leach, Heidi Smith-Vaughan, Mark Chatfield, Greg Redding, Alisa L. Reasonover, Gabrielle B. Mccallum, Lori Chikoyak, Malcolm I. Mcdonald, Ngiare Brown, Paul J. Torzillo, Anne B. Chang

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

Background Indigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD)/bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated populations. Methods Indigenous children aged 0.5-8.9 years with CSLD/bronchiectasis from remote Australia (n = 79) and Alaska (n = 41) were enrolled in a prospective cohort study during 2004-8. At scheduled study visits until 2010 antibiotic use in …

Dietary Intake And Food Sources Of Epa, Dpa And Dha In Australian Children, Setyaningrum Rahmawaty, Karen Charlton, Philippa Lyons-Wall, Barbara J. Meyer

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

Secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity survey was undertaken to assess the intake and food sources of EPA, DPA and DHA (excluding supplements) in 4,487 children aged 2-16 years. An average of two 24-h dietary recalls was analysed for each child and food sources of EPA, DPA and DHA were assessed using the Australian nutrient composition database called AUSNUT 2007. Median (inter quartile range, IQR) for EPA, DPA and DHA intakes (mg/day) for 2-3, 4-8, 9-13, 14-16 year were: EPA 5.3 (1.5-14), 6.7 (1.8-18), 8.7 (2.6-23), 9.8 (2.7-28) respectively; DPA 6.2 (2.2-14), 8.2 (3.3-18), …

Improvement In Iodine Status Of Pregnant Australian Women 3 Years After Introduction Of A Mandatory Iodine Fortification Programme, Karen E. Charlton, Heather Yeatman, Erin Brock, Catherine Lucas, Luke Gemming, Alison Goodfellow, Gary Ma

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

Introduction In order to address population-level mild iodine deficiency in Australia, a mandatory iodine fortification programme of salt used in bread was introduced in late 2009.

Methods A before–after study was conducted to assess changes in median urinary iodine concentration (MUIC) measurements, according to supplement use, in convenience samples of pregnant women attending a public antenatal clinic in a regional area of New South Wales, Australia in 2008 (n = 139), 2011 (n = 147) and 2012 (n = 114). Knowledge and practices related to iodine nutrition were investigated in 2012, using self-administered questionnaires.

Results The mild iodine deficiency confirmed …

Energy In-Equivalence In Australian Marsupials: Evidence For Disruption Of The Continent's Mammal Assemblage, Or Are Rules Meant To Be Broken?, Adam J. Munn, Craig Dunne, Dennis W.H Muller, Marcus Clauss

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

The energy equivalence rule (EER) is a macroecological hypothesis that posits that total population energy use (PEU) should be independent of species body mass, because population densities and energy metabolisms scale with body mass in a directly inverse manner. However, evidence supporting the EER is equivocal, and the use of basal metabolic rate (BMR) in such studies has been questioned; ecologically-relevant indices like field metabolic rate (FMR) are probably more appropriate. In this regard, Australian marsupials present a novel test for the EER because, unlike eutherians, marsupial BMRs and FMRs scale differently with body mass. Based on either FMR or …

A Physiological Evaluation Of Shelters That Might Sustain Life During An Australian Bushfire, Benjamin J. Haberley, David J. R Hoyle, Nigel A.S Taylor

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

South-Eastern Australia experiences the most frequent and severe bushfires in the world. In 2009, bushfires in Victoria claimed 173 lives and cost more than $4 billion in structural damage. As a consequence, the establishment of building standards that might govern the construction of bushfire shelters was recommended. Since no relevant standards existed, it was suggested that if these shelters could keep the internal conditions to a maximal mean Modified Discomfort Index (MDI) of 39o for 60 min, then they could restrain the rise in core temperature to no more than 2oC. The current investigators were invited to test this hypothesis …

Hydration Status Of Underground Miners In A Temperate Australian Region, Benjamin G. Polkinghorne, Vinodkumar Gopaldasani, Susan Furber, Brian Davies, Victoria M. Flood

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

Background Dehydration is a health risk for miners in tropical regions of Australia. However, it is not known whether dehydration poses a health risk to miners working in temperate regions of Australia. Methods A cross-sectional study of 88 miners from two underground mines was undertaken in south-eastern New South Wales, Australia. Participants had their height, weight, waist circumference and hydration status measured and completed a self-administered questionnaire on fluid intake, access to water, and socio-demographic characteristics. Health and Safety managers were surveyed about guidelines relating to healthy work and lifestyle behaviours which impact/influence hydration. Results Hydration tests indicated that more …

Australian General Practitioner Perceptions Of The Detection And Screening Of At-Risk Drinking, And The Role Of The Audit-C: A Qualitative Study, Chun Wah Michael Tam, Nicholas Arnold Zwar, Roslyn Markham

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

Background: At-risk drinking is common in Australia. Validated screening tools such as the AUDIT-C have been promoted to general practitioners (GPs), but appear rarely used and detection of at-risk drinking in primary care remains low. We sought to describe Australian GP perceptions of the detection and screening of at-risk drinking; to understand their low uptake of alcohol screening questionnaires, and in particular, their attitude to the adoption of the AUDIT-C. Methods. Semi-structured focus group interviews of four groups of GPs and GP trainees were conducted in metropolitan Sydney between August and October 2011. Audio recordings were transcribed and analysed using …

Gendered Dimensions Of Aboriginal Australian And California Indian Fire Knowledge Retention And Revival, Christine Eriksen

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

Fire has played a key role in the land management practices of Aboriginal Australians and Native Americans for millennia. However, colonial interests have disrupted indigenous use of fire in multiple ways. This article summarises how gender is entwined—spatially and temporally— in the adaptive knowledge trajectories through which some Aboriginal Australian and California Indian fire knowledge is retained and revived. The article draws on oral narratives shared by indigenous elders, cultural practitioners, and land stewards during prescribed burns, fire knowledge workshops, field trips with students, informal conversations and audio-recorded interviews.

Has The Iodine Status, Knowledge And Practices Of Pregnant Australian Women Improved Since Mandatory Bread Fortification?, K Charlton, H Yeatman, E Brock, C Lucas, L Gemming, G Ma

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

Abstract of poster that presented at the 20th International Congress of Nutrition: Granada, Spain, September 15-20, 2013.

How Well Do Australian Shoppers Understand Energy Terms On Food Labels?, Wendy L. Watson, Kathy Chapman, Lesley King, Bridget Kelly, Clare Hughes, Jimmy Chun Yu Louie, Jennifer Crawford, Timothy P. Gill

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

Objective To investigate nutrition literacy among adult grocery buyers regarding energy-related labelling terms on food packaging. Design Qualitative interviews and quantitative surveys to determine shoppers' understanding of energy terms ('energy', 'calories' and 'kilojoules') and how energy terms affect perceptions of healthiness and intentions to purchase breakfast cereals, muesli bars and frozen meals. Setting Individual in-depth interviews and surveys in two metropolitan supermarkets, Sydney, Australia. Subjects Australian adults (interview n 40, survey n 405) aged 18-79 years. Results The relationship between energy and perceived healthiness of food varied by product type: higher energy breakfast cereals were perceived to be healthier, while …