Glycated haemoglobin for the diagnosis of diabetes

The development of specific diabetes complications correlates with glycated haemoglobin (HbA1c), the most accepted measure of chronic glycaemia. An HbA1c of 48 mmol/mol (6.5%) or greater has now been recommended in Australia for diagnosis of type 2 diabetes. The HbA1c test should greatly simplify the diagnostic pathway, negating the need for oral glucose tolerance tests in the majority of patients. However, improved performance and precision of the assay with its standardisation across Australia is required. Many clinical situations can impact on the HbA1c assay and the clinician needs to be aware of these if it is to be used appropriately for diagnosis

Factors influencing adoption of conservation tillage in Australian cropping regions

The purpose of this research is to improve understanding of conservation tillage adoption decisions by identifying key biophysical and socio-economic factors influencing no-till adoption by grain growers across four Australian cropping regions. The study is based on interviews with 384 grain growers using a questionnaire aimed at eliciting perceptions relating to a range of possible long- and short-term agronomic interactions associated with the relative economic advantage of shifting to a no-tillage cropping system. Together with other farm and farmer-specific variables, a dichotomous logistic regression analysis was used to identify opportunities for research and extension to facilitate more rapid adoption decisions. The broader systems approach to considering conservation tillage adoption identified important determinants of adoption not associated with soil conservation and erosion prevention benefits. Most growers recognised the erosion-reducing benefits of no-till but it was not an important factor in explaining whether a grower was an adopter or non-adopter. Perceptions associated with shorter-term crop production benefits under no-till, such as the relative effectiveness of pre-emergent herbicides and the ability to sow crops earlier on less rainfall were influential. Employment of a consultant and increased attendance of cropping extension activities were strongly associated with no-till adoption, confirming the information and learning-intensive nature of adopting no-till cropping systems.adoption, conservation tillage, herbicide resistance, no-till, perceptions, weed management, Farm Management,

Choosing a screening tool to assess disordered eating in adolescents with type 1 diabetes mellitus

[Extract] Disturbed eating behaviours and insulin omission in adolescents with type 1 diabetes mellitus have concerned diabetes clinicians for decades, yet screening and management protocols using validated tools for this high risk group are lacking. Clinical eating disorders and milder forms of disordered eating can impact negatively on glycaemic control and are associated with serious health consequences (Rydall et al., 1997). Early detection and treatment of disturbed eating thoughts and behaviours is important (Goebel-Fabbri, 2009)

Letter from M. D'Emden to George Washington Walker

Letter from M. D'Emden to George Washington Walker on 21 November 1836 asking for a loan of sixty pounds

Working collaboratively to highlight the voices of young people in Townsville

Youth crime and crime prevention have been the focus of media attention and policy reforms in Australia. Recent inquiries, reports and reforms have brought about policy changes in the youth justice field, including engaging young people through diversionary services. The Lighthouse operated by the Townsville Aboriginal and Islander Health Service is an afterhours diversionary youth service. In this paper we present and discuss the current youth justice policy and funding context that led to the establishment of The Lighthouse, the service delivery model and practice of The Lighthouse, and report on the research collaboration, establishment, procedure and current status. We then describe a research collaboration between The Lighthouse and social work academics from James Cook University ('JCU'), based on research needs identified by The Lighthouse staff. This research is focused on exploring the voices of young people about service delivery, experiences and needs and mentoring Indigenous leadership. The collaborative research process and endeavours will be described and interim findings of the collaborative research presented

Queensland's high risk foot database: tracking the length and width of Queensland's foot ulcers [Conference Abstract]

Background Foot ulcers are a leading cause of avoidable hospital admissions and lower extremity amputations. However, large clinical studies describing foot ulcer presentations in the ambulatory setting are limited. The aim of this descriptive observational paper is to report the characteristics of ambulatory foot ulcer patients managed across 13 of 17 Queensland Health & Hospital Services. Methods Data on all foot ulcer patients registered with a Queensland High Risk Foot Form (QHRFF) was collected at their first consult in 2012. Data is automatically extracted from each QHRFF into a Queensland high risk foot database. Descriptive statistics display age, sex, ulcer types and co-morbidities. Statewide clinical indicators of foot ulcer management are also reported. Results Overall, 2,034 people presented with a foot ulcer in 2012. Mean age was 63(±14) years and 67.8% were male. Co-morbidities included 85% had diabetes, 49.7% hypertension, 39.2% dyslipidaemia, 25.6% cardiovascular disease, 13.7% kidney disease and 12.2% smoking. Foot ulcer types included 51.6% neuropathic, 17.8% neuro-ischaemic, 7.2% ischaemic, 6.6% post-surgical and 16.8% other; whilst 31% were infected. Clinical indicator results revealed 98% had their wound categorised, 51% received non-removable offloading, median ulcer healing time was 6-weeks and 37% had ulcer recurrence. Conclusion This paper details the largest foot ulcer database reported in Australia. People presenting with foot ulcers appear predominantly older, male with several co-morbidities. Encouragingly it appears most patients are receiving best practice care. These results may be a factor in the significant reduction of Queensland diabetes foot-related hospitalisations and amputations recently reported

Using photography to voice young people's views about community and local service delivery

Youth offending has received significant attention in recent years in Queensland and across Australia. While the voices of young people who are offending or at risk of offending are evident in some studies, other reports do not identify them as key stakeholders. A recent university-industry research collaboration sought to prioritise the voices of young people engaging with The Lighthouse, a diversionary service within Townsville Aboriginal and Islander Heath Services (TAIHS), through use of qualitative, Photovoice methods. The primary aim of this photovoice project was to capture the perceptions and needs of young people currently at risk of offending, and to document those views to help shape local service delivery. A thematic analysis enabled the identification of four key themes. These themes identified that participants felt unsafe and under surveillance in public spaces; they wanted more amenities where they could enjoy being in the community with their peers; they reported that peers and family were very important to them; and they appreciated services on offer at The Lighthouse and acknowledged these services supported behavioural change. The findings provide a unique contribution to the use of creative research methodologies, and to policy and service delivery focused on young people at risk of offending

The voices of “at risk” young people about services they received: a systematic literature review

In Australia young people who are at risk of offending have attracted much media and policy attention. In recent times, policy reform has seen increased funding for social services delivery to support young people at risk of entering, or are currently in, the juvenile justice system. However, there is limited literature that explores how young people experience services delivered to them. This article reports on a systematic literature review exploring the voices of children and youth on social service delivery for young people who have offended or are at risk of offending. The review aimed to identify English language publications in the fifteen-year period from 2004 to 2018, critique their methodological quality, and analyse and describe the findings of identified studies. Through a search of electronic social sciences databases twelve (n = 12) eligible publications were identified, including six qualitative studies, one quantitative study and five reports. The review highlighted a scarcity of research on this topic but provided evidence about how young people who are at risk of offending experienced social services, and their recommendations for effective service delivery. Implication Statement •Practitioners need to create supportive, caring and respectful environments that facilitate young people’s agency and self-determination; •Young people need information and clarification but may not ask for it; •Experiences of racism need to be acknowledged and racist attitudes actively addressed. An easy read poster has been developed on the recommendation of practice-based research partners to highlight the implications for practice

The Lighthouse Guide to Working with Young People

This Easy Read poster reports results of a systematic literature review exploring the voices of children and youth on social service delivery for young people who have offended or are at risk of offending. Through a search of electronic social sciences databases twelve (n=12) eligible publications were identified, including six qualitative studies, one quantitative study and five reports. The review highlighted a scarcity of research on this topic but provided evidence about how young people who are at risk of offending experienced social services, and their recommendations for effective service delivery. The data anaylis identified six themes:Supportive & Caring Relationships; Importance of Peers; Respectful Engagement; Dealing with Racism; Information & Clarification and Agency & Empathy. This easy read post was developed on the recommendation of practice-based research partners to highlight the implications for practice