Building solutions for prevneting childhood obesity. Overview module

The NSW Centre for Overweight and Obesity, the NSW Centre for Physical Activity & Health and the NSW Centre for Public Health Nutrition are funded by the NSW Department of Health and supported by The University of Sydney

Estimating cancer distant recurrence rates from administrative datasets: comparison of cancer registry and hospital records.

We thank the NSW Central Cancer Registry and the NSW Department of Health for providing data for this study and the Centre for Health Research Linkage for undertaking the record linkage. This study was supported through an Australian National Health and Medical Research Council Project Grant (No 633223) and the NSW Health BiostatisticalOfficer Training Program (for J Patterson)

Heart failure nursing in Australia: Challenges, strengths, and opportunities

Australia has a land mass similar to the United States of America, supporting a population of just over 20 million, which is distributed predominantly across the coastal perimeter. The Australian society is rich in cultural diversity fostered by decades of migration. Both these factors present challenges for health care. First, because resources are scare in rural and remote regions, health outcomes are poorer in these regions, especially among indigenous populations. Second, the cultural diversity of Australians is a challenge to providing evidence-based treatment recommendations. In Australia, in parallel with international trends, there is a strong association between socioeconomic status, chronic conditions, and health outcomes

Update of the evidence base to support the review of the NSW Health Breastfeeding Policy (PD2006_012): A rapid appraisal.

This report provides the findings from a rapid review and appraisal of the evidence base to support a review of the NSW Health Breastfeeding Policy Breastfeeding in NSW: Protection, Promotion and Support (PD2006_012, NSW Department of Health 2006). This Policy is currently being updated, particularly in consideration of the Australian National Breastfeeding Strategy 2010-2015 and the associated, forthcoming Implementation Plan. The development of the NSW Breastfeeding Policy in 2006 was strongly supported by the systematic evidence base that had accumulated at that time. This review therefore includes evidence since the previous evidence summaries, i.e. since 2005. Specifically, it appraises the evidence around the health benefits of breastfeeding, it identifies those sub-groups of the population that are most at risk of poorer breastfeeding practices (not breastfeeding at all, short duration of breastfeeding, low intensity (exclusivity) of breastfeeding), and it examines the evidence, particularly from systematic reviews, of the effectiveness of interventions to promote, encourage and support breastfeeding

Closing the loop: A systems thinking led sustainable sanitation project in Australia

This paper will explain a research project being carried out in Sydney, Australia at the University of Technology Sydney (UTS) highlighting the systems thinking principles and action research methodology being adopted in this project. UTS is set to participate in an Australia-first research project, led by the Institute of Sustainable Futures (ISF), exploring the use of innovative urine diverting toilets in an institutional setting. A UTS Challenge Grant (an internal grant scheme to promote innovative collaborative research) has been awarded to the project which will enable safe nutrient capture and reuse from urine diverting toilets installed on campus for a trial period. The Challenge Grant has some enthusiastic industry partners including the local water utility Sydney Water; the sanitaryware manufacturer CaromaDorf; the Nursery and Garden Industry Association; government partners (NSW Department of Health, and City of Sydney) and the UTS Facilities Management Unit. Researchers from the University of Western Sydney and University of New South Wales in Australia as well as Linkoping University in Sweden are collaborators in this research

Use of cannabis in pregnancy and as a new parent

The most common illicit drug used by women of reproductive age and by pregnant women is cannabis (DrugInfo, 2005). Although there are limited national data available on illicit substance use among parents in Australia, the 2007 National Drug Strategy Household Survey estimated that 12% of parents with children aged 0–14 years used either an illicit substance (such as marijuana or ecstasy) or a licit substance (such as painkillers) for nonmedical purposes in the previous 12 months (Australian Institute of Health and Welfare [AIHW], 2009). \u27Maternal substance abuse is a potent risk condition\u27 (Boris in Zeanah, 2000) as infant development can be affected by interrelated mechanisms that are all clinically important; These can be: direct prenatal effects genetic effects (that influence both parent and infant) cumulative social risks For maternal child and family health nurses, identification and early intervention through active engagement is a priority. It is also essential to have knowledge of alcohol and drug use, its impact on the user and the baby, and what this means for the parents’ capacity to care for their infant. This article addresses these issues and provides an update about cannabis use

Pregnancy, prison and perinatal outcomes in New South Wales, Australia: a retrospective cohort study using linked health data

BACKGROUND Studies from the United States and the United Kingdom have found that imprisoned women are less likely to experience poorer maternal and perinatal outcomes than other disadvantaged women. This population-based study used both community controls and women with a history of incarceration as a control group, to investigate whether imprisoned pregnant women in New South Wales, Australia, have improved maternal and perinatal outcomes. METHODS Retrospective cohort study using probabilistic record linkage of routinely collected data from health and corrective services in New South Wales, Australia. Comparison of the maternal and perinatal outcomes of imprisoned pregnant women aged 18-44 years who gave birth between 2000-2006 with women who were (i) imprisoned at a time other than pregnancy, and (ii) community controls. OUTCOMES OF INTEREST onset of labour, method of birth, pre-term birth, low birthweight, Apgar score, resuscitation, neonatal hospital admission, perinatal death. RESULTS Babies born to women who were imprisoned during pregnancy were significantly more likely to be born pre-term, have low birthweight, and be admitted to hospital, compared with community controls. Pregnant prisoners did not have significantly better outcomes than other similarly disadvantaged women (those with a history of imprisonment who were not imprisoned during pregnancy). CONCLUSIONS In contrast to the published literature, we found no evidence that contact with prison health services during pregnancy was a "therapunitive" intervention. We found no association between imprisonment during pregnancy and improved perinatal outcomes for imprisoned women or their neonates. A history of imprisonment remained the strongest predictor of poor perinatal outcomes, reflecting the relative health disadvantage experienced by this population of women.This work was undertaken with funding from the National Health and Medical Research Council of Australia. Project Grant ID 457515

Patient preferences for adjuvant radiotherapy in early breast cancer are strongly influenced by treatment received through random assignment

Objective: TARGIT‐A randomised women with early breast cancer to receive external beam radiotherapy (EBRT) or intraoperative radiotherapy (TARGIT‐IORT). This study aimed to identify what extra risk of recurrence patients would accept for per‐ ceived benefits and risks of different radiotherapy treatments. Methods: Patient preferences were determined by self‐rated trade‐off question‐ naires in two studies: Stage (1) 209 TARGIT‐A participants (TARGIT‐IORT n = 108, EBRT n = 101); Stage (2) 123 non‐trial patients yet to receive radiotherapy (pre‐treat‐ ment group), with 85 also surveyed post‐radiotherapy. Patients traded‐off risks of local recurrence in preference selection between TARGIT‐IORT and EBRT. Results: TARGIT‐IORT patients were more accepting of IORT than EBRT patients with 60% accepting the highest increased risk presented (4%–6%) compared to 12% of EBRT patients, and 2% not accepting IORT at all compared to 43% of EBRT pa‐ tients. Pre‐treatment patients were more accepting of IORT than post‐treatment pa‐ tients with 23% accepting the highest increased risk presented compared to 15% of post‐treatment patients, and 15% not accepting IORT at all compared to 41% of pre‐ treatment patients. Conclusions: Breast cancer patients yet to receive radiotherapy accept a higher recurrence risk than the actual risk found in TARGIT‐A. Measured patient preferences are highly influenced by experience of treatment received. This finding challenges the validity of post‐treatment preference studies

Alcohol and other drug withdrawal: practice guidelines.

Clinical guidelines seek to direct clinical practice by outlining recognised, evidence-based treatment interventions. They draw on current literature and clinical practice expertise. These Guidelines provide guidance for clinical decision-making in the context of individual client requirements, withdrawal setting, treatment availability and individual service protocols. These Guidelines are consistent with the World Health Organisation’s (WHO) United Nations Principles of Drug Dependence Treatment (United Nations Office on Drugs and Crime and World Health Organization, 2008). They outline current best practice for the management of AOD-dependent clients accessing withdrawal care. 1 Introduction - page 1 2 Definitions of dependence and withdrawal - page 5 3 Principles of AOD withdrawal care - page 9 4 Continuity of Care - page 11 5 Features of AOD withdrawal - page 13 6 Special needs groups - page 19 7 Presentation to AOD withdrawal - page 29 8 AOD withdrawal settings - page 31 9 Assessment - page 37 10 Alcohol withdrawal - page 45 11 Opioid withdrawal - page 65 12 Benzodiazepines - page 87 13 Amphetamine-type substances (ATS) - page 99 14 Cannabis - page 111 15 Nicotine - page 121 16 AOD withdrawal for clients with a dual diagnosis - page 133 17 References - page 16