The crux of the matter: did the ABC's Catalyst program change statin use in Australia?

This article argues that the ABC’s Catalyst program criticising statins affected people’s willingness to take these drugs. Abstract Objectives: To examine the impact of a two-part special edition of the Australian Broadcasting Corporation\u27s science journalism program Catalyst (titled Heart of the matter), aired in October 2013, that was critical of HMG-CoA reductase inhibitors (“statins”). Design, setting and participants: Population-based interrupted time-series analysis of a 10% sample of Australian long-term concessional beneficiaries who were dispensed statins under the Pharmaceutical Benefits Scheme (about 51% of all people who were dispensed a statin between 1 July 2009 and 30 June 2014); dispensing of proton pump inhibitors (PPIs) was used as a comparator. Main outcome measures: Change in weekly dispensings and discontinuation of use of statins and PPIs, adjusting for seasonal and long-term trends, overall and (for statins only) stratified by the use of cardiovascular and diabetes medicines. Results: In our sample, 191 833 people were dispensed an average of 26 946 statins weekly. Following the Catalyst program, there was a 2.60% (95% CI, 1.40%–3.77%; P < 0.001) reduction in statin dispensing, equivalent to 14 005 fewer dispensings Australia-wide every week. Dispensing decreased by 6.03% (95% CI, 3.73%–8.28%; P < 0.001) for people not dispensed other cardiovascular and diabetes medicines and 1.94% (0.42%–3.45%; P = 0.01) for those dispensed diabetes medicines. In the week the Catalyst program aired, there was a 28.8% (95% CI, 15.4%–43.7%; P < 0.001) increase in discontinuation of statin use, which decayed by 9% per week. An estimated 28 784 additional Australians ceased statin treatment. Discontinuation occurred regardless of the use of other cardiovascular and diabetes medicines. There were no significant changes in PPI use after the Catalyst program. Conclusions: Following airing of the Catalyst program, there was a temporary increase in discontinuation and a sustained decrease in overall statin dispensing. Up until 30 June 2014, there were 504 180 fewer dispensings of statins, and we estimate this to have affected 60 897 people

The crux of the matter: Did the ABC?s catalyst program change Statin use in Australia?

Objectives: To examine the impact of a two-part special edition of the Australian Broadcasting Corporation’s science journalism program Catalyst (titled Heart of the matter), aired in October 2013, that was critical of HMG-CoA reductase inhibitors (“statins”). Design, setting and participants: Population-based interrupted timeseries analysis of a 10% sample of Australian long-term concessional beneficiaries who were dispensed statins under the Pharmaceutical Benefits Scheme (about 51% of all people who were dispensed a statin between 1. July 2009 and 30. June 2014); dispensing of proton pump inhibitors (PPIs) was used as a comparator. Main outcome measures: Change in weekly dispensings and discontinuation of use of statins and PPIs, adjusting for seasonal and long-term trends, overall and (for statins only) stratified by the use of cardiovascular and diabetes medicines. Results: In our sample, 191 833 people were dispensed an average of 26 946 statins weekly. Following the Catalyst program, there was a 2.60% (95% CI, 1.40%–3.77%; P < 0.001) reduction in statin dispensing, equivalent to 14 005 fewer dispensings Australia-wide every week. Dispensing decreased by 6.03% (95% CI, 3.73%–8.28%; P < 0.001) for people not dispensed other cardiovascular and diabetes medicines and 1.94% (0.42%–3.45%; P = 0.01) for those dispensed diabetes medicines. In the week the Catalyst program aired, there was a 28.8% (95% CI, 15.4%–43.7%; P < 0.001) increase in discontinuation of statin use, which decayed by 9% per week. An estimated 28 784 additional Australians ceased statin treatment. Discontinuation occurred regardless of the use of other cardiovascular and diabetes medicines. There were no significant changes in PPI use after the Catalyst program. Conclusions: Following airing of the Catalyst program, there was a temporary increase in discontinuation and a sustained decrease in overall statin dispensing. Up until 30. June 2014, there were 504 180 fewer dispensings of statins, and we estimate this to have affected 60 897 people

Felekezetiség és múltteremtés. = Denominations and the Creation of their Past. Unknown and/or Unpublished Texts from the Prehistory of Transylvanian historia litteraria

A program kiindulópontját az a felismerés jelentette, hogy a 17-18. századi magyar művelődéstörténetével foglalkozó szakemberek nem tettek szervezett erőfeszítéseket az 1990-ben számukra is megnyílt erdélyi gyűjtemények kéziratos forrásainak feltárására. A munkaközösség tagjai arra vállalkoztak, hogy legalább megkezdjék e hiány pótlását. Rendszerességre törekvő feltáró munkát kezdeményeztek tehát olyan jeles gyűjteményekben, mint a kolozsvári akadémiai könyvtár (ez tartalmazza jelenleg a nagy erdélyi felekezetek iskolai könyvtárainak dokumentumait), a marosvásárhelyi Teleki Téka, a gyulafehérvári Batthyáneum és a szebeni Állami Levéltár. A csoport, ahol ez lehetségessé vált, az internet segítségével is hozzáférhetővé teszi e feltáró munka eredményeit, más esetekben a hagyományos formákat alkalmazva tájékoztatja a hazai szakembergárdát a forrásfeltárás elvégzett munkájáról. Másfelől nemzetközi konferenciákon tartott előadásokkal és nemzetközi könyvsorozatokban való szerepléssel is igyekszik bemutatni a nagy erdélyi népcsoportok és felekezetek vetélkedésének egy pozitív oldalát: a vitákban fontos szerepet kapott az egyes közösségek kulturális teljesítménye, s így szükségessé vált annak számbavétele is, hogy a legszélesebb értelemben vett historia litteraria területén milyen produkciót tudnak felmutatni. | Our program started out from the realisation that experts of 17th-18th Hungarian cultural history had made no organised attempt at processing the Transylvanian manuscript sources which became available for us in 1990. Participants of our project intended to make at least the first steps in eliminating this absence. Therefore they initiated exploratory work with a systematising purpose in such significant collections as the Library of the Academy of Kolozsvár (which currently holds the documents from the great Transylvanian denominations' school libraries), the Teleki Téka in Marosvásárhely, the Batthyaneum in Gyulafehérvár and the National Archives in Szeben. Where possible, results of the group were also published through the Internet, while in other instances conventional forms of communication were employed in order to inform Hungarian professionals about the achievements arising from the recovery of the sources. On the other hand, lectures at international conferences and articles published in international collections were utilised to demonstrate a positive facet of the competition among the great Transylvanian ethnicities and confessions: cultural performance played a key role in the debates, and it was inevitable to make an account of the products in the area of historia litteraria in its broadest sense

A Guided Tour of Issues and Trends: The Thirteenth Annual Health Sciences Lively Lunch

In this year\u27s sponsored but no holds barred lunch, the conference theme, Too much is not enough , resonates. Lunch host, Wendy Bahnsen from Rittenhouse offers a brief greeting, and Ramune Kubilius provides the traditional “year in review” synopsis. Moderator Andrea Twiss-Brooks sets the scene and provides a brief introduction to issues of current interest in the health sciences information arena. Topics of this session include: methods of measurement of health sciences journal use (Deborah Blecic); shared collection development and policies (Elizabeth Ketterman); scholarly communication activities in health sciences libraries (Robin Champieux); current challenges, trials, pitfalls and successes of e-books in the health sciences (Anneliese Taylor); provision of information resources for basic scientists (Marysue Schaffer)

Perspectives of practicing school psychologists during COVID-19: A multi-country, mixed methods investigation

COVID-19 presented a range of challenges to the delivery of school psychology services in countries around the world. The current study aimed to investigate the practices of school psychologists from the United States of America, Australia, Germany, Canada, and the United Kingdom, including changes to practice and exploration of the factors that supported the delivery of school psychology services during the pandemic. Quantitative and qualitative data were collected from 1,030 school psychologists and analyzed using a mixed methods, multiple case study design. Differing impacts of the pandemic on the working hours of school psychologists were reported across countries. Participants in all countries reported a shift to online working, with an increased focus on consultation and intervention and a reduction in psychoeducational assessments. School psychologists from all nations emphazised the importance of self-care strategies, social connections and physical activity and the role of support via supervision or professional networks. Access to appropriate technology and responsive workplace policies and procedures were also identified as important. Results have implications for the internationalization of the school psychology profession and can inform international school psychology planning in response to future crises

Passing the acid test? Evaluating the impact of national education initiatives to reduce proton pump inhibitor use in Australia

Publisher's version (útgefin grein)Background Proton pump inhibitor (PPI) use is widespread. There have been increasing concerns about overuse of high-dose PPIs for durations longer than clinically necessary. Objective To evaluate the impact of national education initiatives on reducing PPI use in Australia. Design Population-based, controlled interrupted time series analysis of PPI dispensing claims data for Australian adults from July 2012 to June 2018; we used statin dispensing as a control. Interventions A year-long educational initiative led by NPS MedicineWise (previously the National Prescribing Service) from April 2015. Simultaneously, Choosing Wisely released recommendations in April 2015 and May 2016. Both promoted review of prolonged PPI use and encouraged stepping down or ceasing treatment, where appropriate. Measurements We examined monthly changes in PPI (and statin) dispensing (stratified by high, standard and low tablet strength), rates of switching from higher to lower strength PPIs and rates of PPI (and statin) discontinuation. Results We observed 12 040 021 PPI dispensings to 579 594 people. We observed a sustained -1.7% (95% CI: -2.7 to -0.7%) decline in monthly dispensing of standard strength PPIs following the initiatives until the end of the study period. There were no significant changes in high or low strength PPI (or statin) dispensings, switching to lower strength PPIs, or PPI (and statin) treatment discontinuation. Conclusion Our findings suggest that these educational initiatives alone were insufficient in curbing overuse of PPIs on a national level. Concerted efforts with policy levers such as imposing tighter restrictions on subsidised use of PPIs may be more effective. Noting low strength esomeprazole is not publicly subsidised in Australia, availability of these preparations may also facilitate more appropriate practiceThis research is supported by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines and Ageing (ID: 1060407) and a Cooperative Research Centre Project (CRC-P) Grant from the Australian Government Department of Industry, Innovation and Science (ID: CRC-P-439). Dr Zoega was supported by a Scientia Fellowship from UNSW Sydney. Dr Schaffer was supported by a NHMRC Early Career Fellowship (#1158763).Peer Reviewe

Endogenous Retrovirus Insertion in the KIT Oncogene Determines White and White spotting in Domestic Cats

The Dominant White locus (W) in the domestic cat demonstrates pleiotropic effects exhibiting complete penetrance for absence of coat pigmentation and incomplete penetrance for deafness and iris hypopigmentation. We performed linkage analysis using a pedigree segregating White to identify KIT (Chr. B1) as the feline W locus. Segregation and sequence analysis of the KIT gene in two pedigrees (P1 and P2) revealed the remarkable retrotransposition and evolution of a feline endogenous retrovirus (FERV1) as responsible for two distinct phenotypes of the W locus, Dominant White, and white spotting. A full-length (7125 bp) FERV1 element is associated with white spotting, whereas a FERV1 long terminal repeat (LTR) is associated with all Dominant White individuals. For purposes of statistical analysis, the alternatives of wild-type sequence, FERV1 element, and LTR-only define a triallelic marker. Taking into account pedigree relationships, deafness is genetically linked and associated with this marker; estimated P values for association are in the range of 0.007 to 0.10. The retrotransposition interrupts a DNAase I hypersensitive site in KIT intron 1 that is highly conserved across mammals and was previously demonstrated to regulate temporal and tissue-specific expression of KIT in murine hematopoietic and melanocytic cells. A large-population genetic survey of cats (n = 270), representing 30 cat breeds, supports our findings and demonstrates statistical significance of the FERV1 LTR and full-length element with Dominant White/blue iris (P \u3c 0.0001) and white spotting (P \u3c 0.0001), respectively

Using Australia’s National Data Linkage Demonstration Project (NDLDP) to improve cardiac care: Towards a national, whole-of-population linked data resource for evidence-informed health policy

Introduction In Australia, the Commonwealth, State and Territory governments are each responsible for specific aspects of health care. Historically, cross-jurisdictional health data have not been linked routinely, resulting in significant blind spots in our understanding of the interplay between hospital and primary care, a major impediment to evidence-informed health policy. Objectives and Approach In December 2016, the Australian Health Ministers’ Advisory Council approved the NDLDP, to establish the value of national linked data to inform health planning and policy. The Australian Institute of Health and Welfare (AIHW) linked five years of hospital, emergency department, pharmaceutical dispensing, medical services claims and mortality data for Australia’s two most populous states (New South Wales and Victoria). The Victorian Agency for Health Innovation (VAHI) is leading the ‘Delivering better cardiac outcomes: Primary, specialist and hospital care’ project to demonstrate the value of the collection in identifying evidence-practice gaps and driving change in cardiac care. Results The NDLDP combined data for over 10 million individuals with over 7 billion records of health transactions, utilising a new strategy for confidentialising dates to protect patient privacy. The NDLDP is governed by a Steering Committee; the AIHW is the data custodian approving outputs from analyses within a secure host environment. VAHI established a Project Steering Committee to oversee roll-out, governance and capacity building of the approved cardiac project. The VAHI project was instigated by evidence that best-practice pharmacological treatments for cardiac care are underutilised in Australia, but with no quantification of the population-level extent of this gap. The project quantified significant variations and underuse of post-discharge pharmacological care for patients admitted to hospital with key cardiac conditions, including atrial fibrillation and acute myocardial infarction. Conclusion/Implications This collaboration between government, clinical networks and academic researchers demonstrated this novel data linkage can enable evaluation of patient care pathways across both hospital and community-based services. These linked data resources provide essential information to investigate variation in care in Australia and improve care integration in cardiac care and beyond

Prescribed medicine use and extent of off-label use according to age in a nationwide sample of Australian children

Funding Information: This research is supported by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines Intelligence (ID: 1196900). AS is supported by an NHMRC Early Career Fellowship (ID: 1158763). RC is supported by an NHMRC Emerging Leadership Investigator Grant (ID: 1196516). HZ is supported by a UNSW Scientia Fellowship. NN is supported by the Financial Markets Foundation for Children. CB is supported by an Australian Government Research Training Program Scholarship We thank the Australian Government Services Australia, for providing the data. Open access publishing facilitated by University of New South Wales, as part of the Wiley - University of New South Wales agreement via the Council of Australian University Librarians. Funding Information: This research is supported by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines Intelligence (ID: 1196900). AS is supported by an NHMRC Early Career Fellowship (ID: 1158763). RC is supported by an NHMRC Emerging Leadership Investigator Grant (ID: 1196516). HZ is supported by a UNSW Scientia Fellowship. NN is supported by the Financial Markets Foundation for Children. CB is supported by an Australian Government Research Training Program Scholarship Publisher Copyright: © 2022 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.BACKGROUND: Medicine prescribing for children is impacted by a lack of paediatric-specific dosing, efficacy and safety data for many medicines. OBJECTIVES: To estimate the prevalence of medicine use among children and the rate of 'off-label' prescribing according to age at dispensing. METHODS: We used population-wide primarily outpatient dispensing claims data for 15% of Australian children (0-17 years), 2013-2017 (n = 840,190). We estimated prescribed medicine use and 'off-label' medicine use according to the child's age (<1 year, 1-5 years, 6-11 years, 12-17 years) defined as medicines without age-appropriate dose recommendations in regulator-approved product information. Within off-label medicines, we also identified medicines with and without age-specific dose recommendations in a national prescribing guide, the Australian Medicines Handbook Children's Dosing Companion (AMH CDC). RESULTS: The overall dispensing rate was 2.0 dispensings per child per year. The medicines with the highest average yearly prevalence were systemic antibiotics (435.3 per 1000 children), greatest in children 1-5 years (546.9 per 1000). Other common medicine classes were systemic corticosteroids (92.7 per 1000), respiratory medicines (91.2 per 1000), acid-suppressing medicines in children <1 year (47.2 per 1000), antidepressants in children 12-17 years (40.3 per 1000) and psychostimulants in children 6-11 years (27.0 per 1000). We identified 12.2% of dispensings as off-label based on age, but 66.3% of these had age-specific dosing recommendations in the AMH CDC. Among children <1 year, off-label dispensings were commonly acid-suppressing medicines (35.5%) and topical hydrocortisone (33.1%); in children 6-11 years, off-label prescribing of clonidine (16.0%) and risperidone (13.1%) was common. Off-label dispensings were more likely to be prescribed by a specialist (21.7%) than on-label dispensings (7.5%). CONCLUSIONS: Prescribed medicine use is common in children, with off-label dispensings for medicines without paediatric-specific dosing guidelines concentrated in classes such as acid-suppressing medicines and psychotropics. Our findings highlight a need for better evidence to support best-practice prescribing.Peer reviewe