26 research outputs found
Novel measures of cardiovascular health and its association with prevalence and progression of age-related macular degeneration: the CHARM study
<p>Abstract</p> <p>Background</p> <p>To determine if novel measures of cardiovascular health are associated with prevalence or progression of age-related macular degeneration (AMD).</p> <p>Methods</p> <p>Measures of the cardiovascular system: included intima media thickness (IMT), pulse wave velocity (PWV), systemic arterial compliance (SAC), carotid augmentation index (AI). For the prevalence study, hospital-based AMD cases and population-based age- and gender-matched controls with no signs of AMD in either eye were enrolled. For the progression component, participants with early AMD were recruited from two previous studies; cases were defined as progression in one or both eyes and controls were defined as no progression in either eye.</p> <p>Results</p> <p>160 cases and 160 controls were included in the prevalence component. The upper two quartiles of SAC, implying good cardiovascular health, were significantly associated with increased risk of AMD (OR = 2.54, 95% CL = 1.29, 4.99). High PWV was associated with increased prevalent AMD. Progression was observed in 82 (32.3%) of the 254 subjects recruited for the progression component. Higher AI (worse cardiovascular function) was protective for AMD progression (OR = 0.30, 95%CL = 0.13, 0.69). Higher aortic PWV was associated with increased risk of AMD progression; the highest risk was seen with the second lowest velocity (OR = 6.22, 95% CL = 2.35, 16.46).</p> <p>Conclusion</p> <p>The results were unexpected in that better cardiovascular health was associated with increased risk of prevalent AMD and progression. Inconsistent findings between the prevalence and progression components could be due to truly different disease etiologies or to spurious findings, as can occur with inherent biases in case control studies of prevalence. Further investigation of these non-invasive methods of characterizing the cardiovascular system should be undertaken as they may help to further elucidate the role of the cardiovascular system in the etiology of prevalent AMD and progression.</p
Developing a self-management package for pulmonary fibrosis: an international Delphi study
Rationale
Self-management is considered as an important part of disease management for people with pulmonary fibrosis (PF), but there is a lack of consensus regarding what components should be included. This study aimed to attain consensus from experts in PF and people living with the disease on the essential components and format of a PF self-management package.
Methods
A two-round Delphi process was conducted. In each round, a panel of experts completed an online survey to rate a range of components, formats and delivery methods, followed by an online patient focus group to integrate patient perspectives. Consensus was defined a priori.
Results
45 experts participated in Round 1 and 51 in Round 2. Both focus groups included six people with PF. 12 components were considered essential for self-management in PF: 1) understanding treatment options; 2) understanding and accessing clinical trials; 3) managing medications; 4) role of oxygen therapy; 5) role and importance of pulmonary rehabilitation and regular physical activity; 6) managing shortness of breath; 7) managing fatigue; 8) managing mood; 9) managing comorbidities; 10) smoking cessation advice and support; 11) accessing community support; and 12) how to communicate with others when living with PF. Both groups agreed that self-management in PF required individualisation, goal setting and feedback.
Conclusion
This study identified 12 essential components and highlighted individualisation, goal setting and feedback in self-management of PF. The findings provide a basis for the development of PF self-management interventions
Gene-environment interaction in progression of AMD: The CFH gene, smoking and exposure to chronic infection
Lower urinary tract symptoms in relation to region of birth in 95,393 men living in Australia: the 45 and Up Study
Purpose Lower urinary tract symptoms (LUTS) are very
common among older men globally, but evidence regarding
the relationship between LUTS and country of origin is
limited. This study aimed to investigate the relationship
between the prevalence of LUTS and region of birth in a
large, ethnically diverse population of older men resident
in New South Wales, Australia.
Methods Data on LUTS, demographic and behavioural
factors were collected by postal questionnaire from 2006 to
2009 and analysed for 95,393 men aged 45 and over from
the 45 and Up Study, who had not had previous prostate
surgery. Logistic regression was used to investigate the
association between region of birth and moderate/severe
LUTS, ascertained using a modified International Prostate
Symptom Score, adjusting for age, income, education,
alcohol consumption and smoking.
Results Overall, 18,530 (19.4 %) men had moderate or
severe LUTS. Compared to Australian-born men, prevalence
of moderate/severe LUTS was significantly higher in men
born in the Middle East & North Africa, Southeast Asia and
North America regions (adjusted odds ratios (OR) = 1.43;
95 % CI = 1.23–1.66, OR = 1.25; 1.10–1.42, OR = 1.26;
1.05–1.52, respectively), whereas men from the UK & Ireland
had significantly lower prevalence (OR = 0.85;
0.80–0.90). Patterns of association were generally similar for
storage- and voiding-related types of LUTS. However, participants
born in Sub-Saharan Africa showed a significantly
elevated prevalence of moderate/severe voiding symptoms
(1.22; 1.03–1.45) but not storage symptoms, compared to
Australian-born respondents.
Conclusion The prevalence of LUTS and of specific
subtypes of LUTS varies according to region of birth
Exposure to Chlamydia pneumoniae Infection and Progression of Age-related Macular Degeneration
Residential proximity to agriculture and risk of childhood leukemia and central nervous system tumors in the Danish national birth cohort
Understanding the telehealth experience of care by people with ILD during the COVID-19 pandemic: What have we learnt?
Introduction: The COVID-19 pandemic resulted in a rapid transformation of health services. This study aimed to understand the experiences of healthcare by people with interstitial lung disease (ILD), to inform future service delivery.
Methods: Four specialist clinics in tertiary centres in Australia (Victoria:2 sites; New South Wales: 1 site; Western Australia: 1 site) recruited patients with ILD during an 8-week period from March 2021. Participants completed a COVID-specific questionnaire focused on health-related experiences during 2020.
Results: Ninety nine (65% of 153) participants completed the questionnaire. 47% had idiopathic pulmonary fibrosis or connective tissue disease-associated ILD, 62% were female and the average age was 66 years. Whilst 56% rated their overall health in 2020 as the same as months prior, 38% indicated a worsening in health attributed to reduced physical activity and fear of contracting the virus. Access to healthcare professionals was ‘good’ in 61%, and ‘fair-to-poor’ for 37% due to missed respiratory assessments, with telehealth (mainly telephone) being perceived as less effective. 89% had contact with respiratory physicians, 68% with general practitioners, predominantly via telephone, with few video consultations. High satisfaction with care was reported by 78%, with lower satisfaction attributed to delays in assessments, disruption to usual services such as pulmonary rehabilitation, and dissatisfaction with telehealth.
Conclusion: People with ILD were generally satisfied with their care during 2020, however reduced access to healthcare professionals was challenging for those experiencing a deterioration in health. Telehealth was largely well received but did not always meet the needs of people with ILD particularly when unwell