Diabetes risk reduction behaviours of rural postpartum women with a recent history of gestational diabetes

Introduction: For most women, gestational diabetes is temporary; however, an episode of gestational diabetes mellitus (GDM) confers an approximately seven-fold increased risk of developing type 2 diabetes mellitus. Objective: To examine readiness to adopt diabetes risk reduction behaviours and the prevalence of these behaviours among rural women with GDM during their last pregnancy.Methods: The study design was a self-administered mailed questionnaire seeking information about demographics, stage of change, physical activity level and dietary fat intake. Setting: Regional outpatient context. Participants: Women with a single episode of GDM between 1 July 2001 and 31 December 2005 (n = 210). Main outcome measures: Stage of change for physical activity, weight loss and reducing dietary fat behaviour; meeting activity targets, body mass index (BMI) and dietary fat score.Results: Eighty-four women returned completed questionnaires (40% response rate). Of the 77 women eligible (mean age 35 &plusmn; 3.8 years), 58% met recommended activity targets. Sixty-three percent of women were overweight or obese: mean BMI 29.6 kg/m2 (&plusmn; 7.30). Women reported a high level of preparedness to engage in physical activity, weight loss and reduction of fat intake. Thirty-nine percent of women had not had any postpartum follow-up glucose screening. Women who remembered receiving diabetes prevention information were significantly more likely to meet physical activity targets (p&lt;0.05).Conclusions: Readiness to engage in behaviour change was high among this group of rural women for all three diabetes risk reduction behaviours measured. However, despite a high proportion of women meeting activity targets and reducing fat intake, the majority of women remained overweight or obese. Postpartum follow-up glucose testing needs to be improved and the impact of diabetes prevention information provided during pregnancy warrants further study.<br /

Implementation of the COVID-19 vulnerability index across an international network of health care data sets: collaborative external validation study

Background: SARS-CoV-2 is straining health care systems globally. The burden on hospitals during the pandemic could be reduced by implementing prediction models that can discriminate patients who require hospitalization from those who do not. The COVID-19 vulnerability (C-19) index, a model that predicts which patients will be admitted to hospital for treatment of pneumonia or pneumonia proxies, has been developed and proposed as a valuable tool for decision-making during the pandemic. However, the model is at high risk of bias according to the "prediction model risk of bias assessment" criteria, and it has not been externally validated.Objective: The aim of this study was to externally validate the C-19 index across a range of health care settings to determine how well it broadly predicts hospitalization due to pneumonia in COVID-19 cases.Methods: We followed the Observational Health Data Sciences and Informatics (OHDSI) framework for external validation to assess the reliability of the C-19 index. We evaluated the model on two different target populations, 41,381 patients who presented with SARS-CoV-2 at an outpatient or emergency department visit and 9,429,285 patients who presented with influenza or related symptoms during an outpatient or emergency department visit, to predict their risk of hospitalization with pneumonia during the following 0-30 days. In total, we validated the model across a network of 14 databases spanning the United States, Europe, Australia, and Asia.Results: The internal validation performance of the C-19 index had a C statistic of 0.73, and the calibration was not reported by the authors. When we externally validated it by transporting it to SARS-CoV-2 data, the model obtained C statistics of 0.36, 0.53 (0.473-0.584) and 0.56 (0.488-0.636) on Spanish, US, and South Korean data sets, respectively. The calibration was poor, with the model underestimating risk. When validated on 12 data sets containing influenza patients across the OHDSI network, the C statistics ranged between 0.40 and 0.68.Conclusions: Our results show that the discriminative performance of the C-19 index model is low for influenza cohorts and even worse among patients with COVID-19 in the United States, Spain, and South Korea. These results suggest that C-19 should not be used to aid decision-making during the COVID-19 pandemic. Our findings highlight the importance of performing external validation across a range of settings, especially when a prediction model is being extrapolated to a different population. In the field of prediction, extensive validation is required to create appropriate trust in a model.Development and application of statistical models for medical scientific researc

A computer education and support program for Australian GPs

[Extract] Australian general practitioners (GPs) have been extremely slow to use computer tools in their clinical practice. GPs mostly (40-50%) use computers for front desk functions such as billing, accounting and appointment scheduling. No more than 10% use a computer in the consulting room, despite an acknowledged appreciation of its clinical potential. A computer education course for GPs should therefore be "hands on", be interactive and collaborative in small groups, and encourage individuals to make their own assessments and decisions regarding the uptake of new information.This project was designed and taught by the University of Melbourne General Practice Unit

Collaboration over the internet - The melbourne-singapore way

10.3233/978-1-60750-896-0-764Studies in Health Technology and Informatics52764-76

Petting zoos: leading Australian GPs to computers

[Extract] Clinical use of computers in general practice has not been widespread due to lack of: skilled support, training programs focused on general practitioners (GPs), familiarity with computer systems. The concept of a Computer Petting Zoo is to provide a hands-on computer laboratory where GPs can become familiar with available clinical software in a neutral, non-threatening environment; much like children at a petting zoo. The purpose of the zoo is to increase awareness of and comfort with information technology and thereby assist GPs to make informed choices about computer applications and adopt computer based information management practices

Easing student transition to graduate nurse: A simulated professional learning environment (SIMPLE) for final year student nurses

10.1016/j.nedt.2013.04.026Nurse Education Today343349-35

The asia pacific association for medical informatics (APAMI) and world organisation of family doctors (WONCA) consortium on general and family practice informatics - A statement of intent

10.3233/978-1-60750-896-0-189Studies in Health Technology and Informatics52189-19

Development of sol-gel derived coating for NICALON{sup TM}/SiC composites

Mullite and aluminum titanate precursor polymeric sols were developed for applying as coatings on Nicalon{trademark} fabrics and tows. A Nicalon{trademark}/SiC composite with a mullite interface was fabricated. The mullite precursor interface coatings were applied by a vacuum infiltration method and the SiC matrix was deposited by a forced flow chemical vapor infiltration process. Thin, uniform mullite interface coatings were obtained. However, the Nicalon{trademark}/SiC composite exhibited brittle fracture. Mullite and alumina-titania coatings were applied on Nicalon{trademark} tows and the effect of heat treatment at 1000{degrees}C in air is discussed