Brief Report: Out of Sight Out of Mind - Preventable Childhood Kidney Disease in the Far North

APSGN is an immune-mediated kidney disease that occurs after a Streptococcus pyogenes skin or throat infection in children and contributes to chronic kidney disease later in life. It is a disease of poverty and regrettably common in Aboriginal and Torres Strait Islander children. There have been seven documented APSGN outbreaks across Far North Queensland in the last nine years. Despite this disease being notifiable in both Western Australia and the Northern Territory, Queensland is yet to acknowledge the importance of early notification in the management of APSGN. Notification-driven publication of APSGN incidence should help raise its profile and stimulate better public health policy

Apunipima baby basket program: a retrospective cost study

Background: The Baby Basket initiative was developed by Apunipima Cape York Health Council (ACYHC) to address poor maternal and child health (MCH) in Cape York, the northernmost region of Queensland. While positive outcomes for Indigenous MCH programs are reported in the literature, few studies have a strong evidence base or employ a sound methodological approach to evaluation. The aim of the cost study is to identify the resources required to deliver the Baby Basket program in the remote communities of Cape York. It represents an initial step in the economic evaluation of the Apunipima Baby Basket program. The aim of this study was to report whether the current program represents an effective use of scarce resources. Method: The cost study was conducted from the perspective of the health providers and reflects the direct resources required to deliver the Baby Basket program to 170 women across 11 communities represented by ACYHC. A flow diagram informed by interviews with ACYHC staff, administrative documents and survey feedback was used to map the program pathway and measure resource use. Monetary values, in 2013 Australian dollars, were applied to the resources used to deliver the Baby Basket program for one year. Results: The total cost of delivering the Baby Basket progam to 170 participants in Cape York was $148,642 or approximately,$874 per participant. The analysis allowed for the cost of providing the Baby Baskets to remote locations and the time for health workers to engage with women and thereby encourage a relationship with the health service. Routinely collected data showed improved engagement between expectant women and the health service during the life of the program. Conclusion: The Apunipima Baby Basket cost study identifies the resources required to deliver this program in remote communities of Cape York and provides a framework that will support prospective data collection of more specific outcome data, for future cost-effectiveness analyses and cost-benefit analyses. An investment of $874 per Baby Basket participant was associated with improved engagement with the health service, an important factor in maternal and child health

A low burden of severe illness: the COVID-19 Omicron outbreak in the remote Torres and Cape region of Far North Queensland

A coronavirus disease 2019 (COVID-19) outbreak was declared in the remote Torres and Cape region of Far North Queensland soon after the Queensland border opened for quarantine-free domestic travel in December 2021, with a total of 7,784 cases notified during the first ten-month outbreak period. We report a crude attack rate among residents of 25.6% (95% confidence interval [95% CI]: 25.1–26.1%), a hospitalisation rate of 1.6% (95% CI: 1.3–1.9%) and a crude case fatality rate of 0.05% (95% CI: 0.01–0.13%). Hospitalisation and case fatality rates were similar among First Nations and non-Indigenous people, with double dose COVID-19 vaccination rates higher among First Nations than non-Indigenous people by the end of the outbreak period. We attribute the low burden of severe illness to local community leadership, community engagement, vaccination coverage and recency, and community participation in a local culturally considered COVID-19 care-in-the-home program

Psychological dimensions of retirement.

The chapters that follow examine the character of, and issues relating to, western retirement experiences. As our populations age, issues relating to the nature of retirement are of growing importance. Population ageing is a global issue. For instance, Jacobsen, Kent, Lee, & Mather (2011) report that currently one-fifth of the Japanese population is aged over 65 and estimated to increase to one-third of the population by 2040. Based on Bogomolny’s (2004) calculations, by 2025, there will 2 workers in Japan for every person over 65. By 2030 to 2040, 20% of the United States population (i.e., 70 million people), will be aged over 65 (Conrad Glass & Flynn, 2000; Jacobsen, Kent, Lee & Mather, 2011). A drop in the number of workers per government funded beneficiaries from 3.3. to 2.2 has also been predicted (Social Security Board of Trustees, 2008). Many European countries will have similarly high proportions of their population aged over 65 (Heyma, 2004) with concomitant dependency ratios, as will Australia and New Zealand (Kippen, 2002; Statistics New Zealand, 2012). In the 1970s and 1980s there was a trend toward early retirement, however this began to be reversed in many countries in the 1990s. Participation rates in most OECD countries for older workers (50-64 years) have increased to an average of 63% in 2008. Some countries have seen considerable increases in participation rates for these workers (e.g. New Zealand, Netherlands) and in even older workers (65-69 years) (OECD, 2011). Along with the increasing expansion of working lives has come an evolution of the pathways to retirement. Retirement is no longer necessarily a “clean break” from the workforce, with many researchers arguing that the transition from work to retirement is now “blurred”. Retirement is not a single discrete event but can be viewed as an individual process, where for many paid employment still plays a significant role well into the “third age”. The changing nature of retirement over the past few decades highlights the need to continually reassess how we conceptualise it in the literature and how it impacts on the individual, organisations and society. This book seeks to address some of the psychological dimensions of retirement prominent in the literature. The initial chapter of this book outlines a number of definitions pertinent to the topic of retirement. This is followed by an examination of issues that affect retirement decisions. Next, psychological wellbeing and physical health issues are examined in relation to retirement. The final chapters examine the interplay between work and retirement, the role of leisure in retirement, the experiences of women, and the sources and role of social support in retirement

A simulation structure for nursing education in mental health

The aim of the paper is to present a structure for nursing education simulation that incorporates elements of blended and online simulation in a socially constructivist, culturally sensitive environment. To develop the structure for nursing education, a descriptive literature review was conducted in spring 2022 on simulations implemented in mental health nursing education. Nurses require the skills and knowledge to provide mental health care in every area of health care. According to the descriptive literature review, simulation-based learning such as high-fidelity mental health simulation resulted in increased confidence, knowledge gains and improved communication skills. Simulation is a wide concept and allows nurse lecturers to implement the pedagogy as they see it best. The Simulation structure helps especially beginners to follow the simulation as a process. The structure eases the planning phase as well as the debriefing part of the simulation. As it has been shown in the analysis of the literature simulation can be effectively implemented in a blended and / or online environment. It is expected that in the future, simulation games and virtual, online simulations will be more typical ways to conduct a simulation.This research was conducted on a project co-financed by Erasmus+ Programme of the European Union

New genetic loci implicated in fasting glucose homeostasis and their impact on type 2 diabetes risk.

Levels of circulating glucose are tightly regulated. To identify new loci influencing glycemic traits, we performed meta-analyses of 21 genome-wide association studies informative for fasting glucose, fasting insulin and indices of beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) in up to 46,186 nondiabetic participants. Follow-up of 25 loci in up to 76,558 additional subjects identified 16 loci associated with fasting glucose and HOMA-B and two loci associated with fasting insulin and HOMA-IR. These include nine loci newly associated with fasting glucose (in or near ADCY5, MADD, ADRA2A, CRY2, FADS1, GLIS3, SLC2A2, PROX1 and C2CD4B) and one influencing fasting insulin and HOMA-IR (near IGF1). We also demonstrated association of ADCY5, PROX1, GCK, GCKR and DGKB-TMEM195 with type 2 diabetes. Within these loci, likely biological candidate genes influence signal transduction, cell proliferation, development, glucose-sensing and circadian regulation. Our results demonstrate that genetic studies of glycemic traits can identify type 2 diabetes risk loci, as well as loci containing gene variants that are associated with a modest elevation in glucose levels but are not associated with overt diabetes

Analysis of Xq27-28 linkage in the international consortium for prostate cancer genetics (ICPCG) families.

BACKGROUND: Genetic variants are likely to contribute to a portion of prostate cancer risk. Full elucidation of the genetic etiology of prostate cancer is difficult because of incomplete penetrance and genetic and phenotypic heterogeneity. Current evidence suggests that genetic linkage to prostate cancer has been found on several chromosomes including the X; however, identification of causative genes has been elusive. METHODS: Parametric and non-parametric linkage analyses were performed using 26 microsatellite markers in each of 11 groups of multiple-case prostate cancer families from the International Consortium for Prostate Cancer Genetics (ICPCG). Meta-analyses of the resultant family-specific linkage statistics across the entire 1,323 families and in several predefined subsets were then performed. RESULTS: Meta-analyses of linkage statistics resulted in a maximum parametric heterogeneity lod score (HLOD) of 1.28, and an allele-sharing lod score (LOD) of 2.0 in favor of linkage to Xq27-q28 at 138 cM. In subset analyses, families with average age at onset less than 65 years exhibited a maximum HLOD of 1.8 (at 138 cM) versus a maximum regional HLOD of only 0.32 in families with average age at onset of 65 years or older. Surprisingly, the subset of families with only 2-3 affected men and some evidence of male-to-male transmission of prostate cancer gave the strongest evidence of linkage to the region (HLOD = 3.24, 134 cM). For this subset, the HLOD was slightly increased (HLOD = 3.47 at 134 cM) when families used in the original published report of linkage to Xq27-28 were excluded. CONCLUSIONS: Although there was not strong support for linkage to the Xq27-28 region in the complete set of families, the subset of families with earlier age at onset exhibited more evidence of linkage than families with later onset of disease. A subset of families with 2-3 affected individuals and with some evidence of male to male disease transmission showed stronger linkage signals. Our results suggest that the genetic basis for prostate cancer in our families is much more complex than a single susceptibility locus on the X chromosome, and that future explorations of the Xq27-28 region should focus on the subset of families identified here with the strongest evidence of linkage to this region.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Identification and functional characterization of G6PC2 coding variants influencing glycemic traits define an effector transcript at the G6PC2-ABCB11 locus.

Genome wide association studies (GWAS) for fasting glucose (FG) and insulin (FI) have identified common variant signals which explain 4.8% and 1.2% of trait variance, respectively. It is hypothesized that low-frequency and rare variants could contribute substantially to unexplained genetic variance. To test this, we analyzed exome-array data from up to 33,231 non-diabetic individuals of European ancestry. We found exome-wide significant (P<5×10-7) evidence for two loci not previously highlighted by common variant GWAS: GLP1R (p.Ala316Thr, minor allele frequency (MAF)=1.5%) influencing FG levels, and URB2 (p.Glu594Val, MAF = 0.1%) influencing FI levels. Coding variant associations can highlight potential effector genes at (non-coding) GWAS signals. At the G6PC2/ABCB11 locus, we identified multiple coding variants in G6PC2 (p.Val219Leu, p.His177Tyr, and p.Tyr207Ser) influencing FG levels, conditionally independent of each other and the non-coding GWAS signal. In vitro assays demonstrate that these associated coding alleles result in reduced protein abundance via proteasomal degradation, establishing G6PC2 as an effector gene at this locus. Reconciliation of single-variant associations and functional effects was only possible when haplotype phase was considered. In contrast to earlier reports suggesting that, paradoxically, glucose-raising alleles at this locus are protective against type 2 diabetes (T2D), the p.Val219Leu G6PC2 variant displayed a modest but directionally consistent association with T2D risk. Coding variant associations for glycemic traits in GWAS signals highlight PCSK1, RREB1, and ZHX3 as likely effector transcripts. These coding variant association signals do not have a major impact on the trait variance explained, but they do provide valuable biological insights