The selection of population groups by age for a National Population Health Survey using objective measures

© Commonwealth of AustraliaThis paper identifies a range of age groups in the population that might be included in a proposed Australian Health Measurement Survey (AHMS) program

Early intervention – from evidence to implementation: The policymaker’s tale. A case study

© Commonwealth of AustraliaImplementing evidence from research, into policy, and then practice, is a challenging task, glistening with opportunities and fraught with practical difficulties and political realities. This case study describes a process of taking research evidence, embedding it into policy and then implementing and making it happen 'on the ground', as a 'live' early intervention program in South Australia. Evidence on the level of disadvantage of people living in particular geographic locations in metropolitan Adelaide, and research on effective early intervention programs for disadvantaged families with infants were used to support policy directions and to gain funding to establish a pilot program. A community development approach was adopted, and strategies used to ensure the participation of those communities in the design and establishment of the program are also discussed. A number of key criteria were identified to support the successful transition from research, to policy, to planning and practice, and these are reviewed in the light of experience. This is a sobering tale, with exciting outcomes but a number of important lessons, which may be helpful to others seeking to ensure the successful implementation of early intervention programs for children and their families in Australia

Ethical considerations arising from National Health Measurement Surveys: with particular reference to the Australian Health Measurement Survey (AHMS) program

© Commonwealth of AustraliaThe purpose of this paper is to identify a range of ethical considerations that may arise during the design and implementation of national health surveys that incorporate physical and biochemical measures. These surveys are able to provide important information on the prevalence of various health conditions and distributions of physical, mental and biochemical characteristics of the population, as well as providing data on the relationship between risk factors and selected conditions, and social and environmental determinants of health. In Australia, a program of national health measurement surveys that will collect a range of measures (physical and biochemical characteristics) has been proposed, the Australian Health Measurement Survey (AHMS) program. The ethical, legal and social issues that arise are numerous. A number of broad policy issues emerge that require further discussion. In order to ensure that survey programs are conducted within an ethical framework, these issues must be identified and discussed with communities and others, and broad agreement reached about the most appropriate ways to proceed

Ethical considerations for a proposed program of National Population Health Surveys using objective measures for Australia

Copyright © 2003 Commonwealth of AustraliaThe purpose of this paper is to identify a range of ethical considerations that arise as part of the design of a proposed program of national population health surveys using objective measures, the Australian Health Measurement Survey (AHMS) program. A number of broad issues emerge that require discussion and resolution

A National Biomedical Risk Factor Survey for Australia: issues for consideration

National population health surveys containing a component of physical measurement have been used both in Australia and overseas to add to the information about the state of health of a population and to complement research into particular issues, diseases or directions in health policy. This short paper outlines some of the issues that require consideration as part of the initial scoping of these types of surveys in general, and will report briefly on some of the models that have been used overseas

Interview with Miss Althea Graves

Interview with Miss Althea Graves at Smith Hill Libraryhttps://digitalcommons.providence.edu/psp470_2023/1003/thumbnail.jp

Is it working ... together? Linking research, policy and practice in relation to children and health inequalities in South Australia

Despite an increasing interest in the extent of child health inequalities in Australia and effective strategies to address them, there remains a significant gap between existing research evidence and its incorporation into planning, policy and practice in Australia. Researchers, policy-makers and practitioners face difficulties in bringing research into practice effectively, and local communities are often neglected in the processes. This paper presents a brief summary of data on child health inequalities in South Australia over the last decade. It then reviews the extent to which research findings have been incorporated into human services' policy and practice. Particular barriers for researchers, policy-makers, planners, practitioners and communities are discussed, drawing on local and overseas experience, and possible strategies for addressing some of the barriers are outlined

Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction

<p><b>Background:</b> The purpose of this study was to examine the prevalence of abnormalities in cardiac structure and function present in patients with heart failure and a preserved ejection fraction (HFPEF) and to determine whether these alterations in structure and function were associated with cardiovascular morbidity and mortality.</p> <p><b>Methods and Results:</b> The Irbesartan in HFPEF trial (I-PRESERVE) enrolled 4128 patients; echocardiographic determination of left ventricular (LV) volume, mass, left atrial (LA) size, systolic function, and diastolic function were made at baseline in 745 patients. The primary end point was death or protocol-specific cardiovascular hospitalization. A secondary end point was the composite of heart failure death or heart failure hospitalization. Associations between baseline structure and function and patient outcomes were examined using univariate and multivariable Cox proportional hazard analyses. In this substudy, LV hypertrophy or concentric remodeling was present in 59%, LA enlargement was present in 66%, and diastolic dysfunction was present in 69% of the patients. Multivariable analyses controlling for 7 clinical variables (including log N-terminal pro-B–type natriuretic peptide) indicated that increased LV mass, mass/volume ratio, and LA size were independently associated with an increased risk of both primary and heart failure events (all P<0.05).</p> <p><b>Conclusions:</b> Left ventricular hypertrophy or concentric remodeling, LA enlargement, and diastolic dysfunction were present in the majority of patients with HFPEF. Left ventricular mass and LA size were independently associated with an increased risk of morbidity and mortality. The presence of structural remodeling and diastolic dysfunction may be useful additions to diagnostic criteria and provide important prognostic insights in patients with HFPEF.</p&gt

Use of 3-D navigation to target the site of autologous blood installation for lung volume reduction in bullous emphysema

Bronchoscopic lung volume reduction (BLVR) using intrabullous autologous blood instillation has been reported in single cases where other techniques are not possible. We present the use of three-dimensional navigation to instill autologous blood into emphysematous bullae for BLVR. A 62-year-old man presented with increasing dyspnea, due to emphysema with a conglomerate of giant bullae with two particularly large bullae. Surgical treatment was refused, so bronchoscopic autologous blood instillation into the bronchial segment leading to the large bullae was attempted, but was unsuccessful; blood failed to penetrate into the bullous cavity. Dyspnea worsened over the following year. We therefore performed another bronchoscopy and punctured a large bulla with a needle and created a tunnel from the central airways. Puncture position and direction were determined using a prototype of an electromagnetic navigation system. Under fluoroscopic guidance, a catheter was placed via the tunnel into the bulla and blood was instilled. This resulted in an almost complete shrinkage of the bullae, reduction of residual volume, and marked improvement in dyspnea within 4 months. To our knowledge, this is the first reported case of successful BLVR by navigated bronchoscopy with transbronchial puncture, dilatation, and autologous blood instillation into a giant bulla

Definitions of severity in treatment seeking studies of febrile illness in children in low and middle income countries: a scoping review

Objectives: Understanding treatment seeking for severe febrile illness (SFI) is methodologically challenging. In this scoping review, we investigate definitions of severe febrile illness in treatment seeking studies on children under 5 years of age in low and middle income countries. We analyze the association of SFI definitions with different concepts of treatment seeking and identify related research gaps. Methods: We searched Pubmed, Scopus and WHOLIS, and screened references of included publications for eligibility. Results: Definitions of SFI had either a biomedical perspective (predominantly in quantitative studies) or a caregiver perspective (predominantly in qualitative studies). In quantitative analyses of treatment seeking, severity was more often conceptualized as a determinant rather than an outcome of a treatment seeking process. The majority of quantitative analyses only included surviving children or did not explicitly mention dead children. Conclusion: Different research questions lead to diverse definitions and concepts of severity and treatment seeking outcomes, which limits the comparability of the available evidence. Systematic exclusion of dead children is likely to bias inferences on the association of treatment seeking and health outcomes of children with SFI in low and middle income countries