Gestational Diabetes Mellitus (GDM) increases the risk of type 2 diabetes. A register can be used to follow-up high risk women for early intervention to prevent progression to type 2 diabetes. We ...evaluate the performance of the world's first national gestational diabetes register.
Observational study that used data linkage to merge: (1) pathology data from the Australian states of Victoria (VIC) and South Australia (SA); (2) birth records from the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM, VIC) and the South Australian Perinatal Statistics Collection (SAPSC, SA); (3) GDM and type 2 diabetes register data from the National Gestational Diabetes Register (NGDR). All pregnancies registered on CCOPMM and SAPSC for 2012 and 2013 were included-other data back to 2008 were used to support the analyses. Rates of screening for GDM, rates of registration on the NGDR, and rates of follow-up laboratory screening for type 2 diabetes are reported.
Estimated GDM screening rates were 86% in SA and 97% in VIC. Rates of registration on the NGDR ranged from 73% in SA (2013) to 91% in VIC (2013). During the study period rates of screening at six weeks postpartum ranged from 43% in SA (2012) to 58% in VIC (2013). There was little evidence of recall letters resulting in screening 12 months follow-up.
GDM Screening and NGDR registration was effective in Australia. Recall by mail-out to young mothers and their GP's for type 2 diabetes follow-up testing proved ineffective.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To estimate blood lead levels (BLLs) in the adult Victorian population and compare the distribution of BLLs with the current national reference level to better inform public health prevention and ...management of lead toxicity.
Population‐based cross‐sectional health measurement survey of 50 randomly selected Census Collection Districts (CDs) throughout Victoria. The Victorian Health Monitor (VHM) was conducted over 12 months from May 2009 to April 2010. One eligible person (aged 18–75 years) from each household selected within each CD was randomly selected to participate. Persons with an intellectual disability and pregnant women were excluded from the sampling frame. BLLs were obtained from 3,622 of the 3,653 (99%) VHM participants.
The geometric mean and median BLLs from the adult sample were 0.070 μmol/L (95%CI, 0.068–0.073) and 0.05 μmol/L (range: 0.05 to 1.22 μmol/L), respectively. Elevated BLLs (≥0.483 μmol/L or ≥10 μg/dL) were identified in 19 participants (0.7%; 95%CI, 0.3–1.6). Additionally, 86 participants (1.8%; 95%CI, 1.3–2.4) were identified with BLLs between 0.242 and <0.483 μmol/L (5 to <10 μg/dL). The geometric mean BLL was significantly higher for males, compared with females (0.077 μmol/L vs 0.064 μmol/L; p<0.001). BLLs increased significantly with age for both sexes.
The first population estimates of BLLs in Victorian adults indicate the average adult BLL to be well below the current national reference level. However, some groups of the population have BLLs at which adverse effects may occur.
The results provide baseline estimates for future population health surveillance and comparison with studies of at‐risk groups.
Aim: To examine seasonal variation in hospital use for five paediatric conditions of the Australian Capital Territory residents.
Methods: Hospital admissions (1993–2004) and emergency room (ER) ...presentations (1999–2004) for asthma, croup, bronchiolitis, other respiratory conditions and diarrhoea of children aged <5 years were compared by month and season.
Results: The five conditions comprised 14% of admissions and 24% of ER presentations of children aged <5 years. Bronchiolitis (both admissions and ER presentations) were the highest in the 0–1 year age group (>80%) and the other four conditions peaked at 1–2 years. Children aged 0–2 years contributed 66% of diarrhoea, 62% of croup and 44% of other respiratory admissions whereas ER presentations were higher for other respiratory conditions (57%) and lower for croup (47%). Boys showed higher rates of admissions and ER presentations for all conditions except diarrhoea. Strong seasonal associations were apparent. Incident rate ratios of admissions were significantly higher in autumn compared with summer for asthma and croup whereas bronchiolitis and other respiratory conditions admissions were the highest in winter. Diarrhoea admissions were the highest in spring. ER presentations of the five conditions also showed similar associations with season.
Conclusion: Hospital admissions and ER presentations of these five conditions showed strong seasonal patterns, knowledge of which could contribute to improved resource planning (staffing) to meet expected increases in demand for services and scheduling of elective admissions. These findings could be extended to develop a model for forecasting hospital use and to explore the causes of these diseases to ameliorate seasonal effects.
Vitamin D deficiency can have serious health consequences and may be particularly important for those living with HIV. It is unknown whether HIV infection is a risk factor for vitamin D deficiency. ...The aim of the study was to determine whether vitamin D deficiency is more common in HIV-infected than in HIV-uninfected individuals.
This was a cross-sectional study of HIV-infected and uninfected individuals. A total of 997 HIV-infected participants were from a sexual health clinic in Melbourne with 25(OH)D measurements taken between 2008 and 2012. 3,653 HIV-uninfected individuals were participants in a statewide Victorian survey with 25(OH)D measurements taken between 2009 and 2010. Logistic regression models evaluated the association of HIV status with vitamin D deficiency (25OHD<50 nmol/l).
The frequency of vitamin D deficiency was significantly more common in HIV-infected (39% 95% CI 36%, 42%) compared with HIV-uninfected individuals 23% (95% CI 15%, 31%). In multivariable analysis, males (adjusted odds ratio aOR 0.8; 95% CI 0.6, 0.9; P=0.001), Caucasian country of origin (aOR 0.4; 95% CI 0.3, 0.4; P<0.001), summer/autumn (aOR for autumn 0.2; 95% CI 0.1, 0.3; P<0.001), total cholesterol to high-density lipoprotein ratio >5 (aOR 1.4; 95% CI 1.2, 1.8; P<0.001) and HIV infection (aOR 1.7; 95% CI 1.4, 2.1; P<0.001) were associated with vitamin D deficiency.
Adults living in southern Australia with HIV were more likely to be vitamin D deficient than the general population.
Aim
A major heatwave occurred in Australia in early 2009 with considerable and varied health impacts in South Australia (SA) and Victoria. The aim of this study was to investigate the heat‐adaptive ...behaviours of older people in these states.
Methods
A computer‐assisted telephone survey of 1000 residents of SA and Victoria aged 65 years or older was conducted at the end of summer 2010–2011.
Results
The majority of respondents reported undertaking heat‐adaptive behaviours. In SA, there was a significantly higher proportion of households with air conditioning compared to Victoria, and a higher recall of heat‐health messages. In both states, self‐reported morbidity during heatwaves was higher in women, persons with poorer health and those with cardiovascular conditions.
Conclusion
An increase in global temperatures in conjunction with an ageing population is a concern for public health. Our findings suggest acclimatisation to hot weather may influence behaviours and health outcomes in older people.
•GooD4Mum is a quality improvement study for diabetes prevention after gestational diabetes.•15 general practices in Victoria, Australia participated in GooD4Mum collaborative study.•Diabetes ...screening rates doubled (30%–60%) and 20% increase in BMI monitoring.•Improving screening and monitoring of women with previous gestational diabetes is feasible.
Gestational diabetes (GDM) and Type 2 diabetes pose tremendous health and economic burdens as worldwide incidence increases. Primary care-based systematic diabetes screening and prevention programs could be effective in women with previous GDM. GooD4Mum aimed to determine whether a Quality Improvement Collaborative (QIC) would improve postpartum diabetes screening and prevention planning in women with previous GDM in general practice.
Fifteen general practices within Victoria (Australia) participated in a 12-month QIC, consisting of baseline and four quarterly audits, guideline-led workshops and Plan-Do-Study-Act feedback cycles after each audit. The primary outcome measures were the proportion of women on local GDM registers completing a diabetes screening test and a diabetes prevention planning consultation within the previous 15 months.
Diabetes screening increased with rates more than doubled from 26% to 61% and postpartum screening increased from 43%–60%. Diabetes prevention planning consultations did not show the same level of increase (0%–10%). The recording of body mass index improved overall (51%–69%) but the number of women with normal body mass index did not.
GooD4Mum supported increased diabetes screening and the monitoring of high risk women with previous GDM in general practice.
ORIGINAL ARTICLE Rennie M D'Souza; Hilary J Bambrick; Tord E Kjellstrom ...
Journal of paediatrics and child health,
05/2007, Letnik:
43, Številka:
5
Journal Article
Recenzirano
To examine seasonal variation in hospital use for five paediatric conditions of the Australian Capital Territory residents. Hospital admissions (1993-2004) and emergency room (ER) presentations ...(1999-2004) for asthma, croup, bronchiolitis, other respiratory conditions and diarrhoea of children aged <5 years were compared by month and season. The five conditions comprised 14% of admissions and 24% of ER presentations of children aged <5 years. Bronchiolitis (both admissions and ER presentations) were the highest in the 0-1 year age group (>80%) and the other four conditions peaked at 1-2 years. Children aged 0-2 years contributed 66% of diarrhoea, 62% of croup and 44% of other respiratory admissions whereas ER presentations were higher for other respiratory conditions (57%) and lower for croup (47%). Boys showed higher rates of admissions and ER presentations for all conditions except diarrhoea. Strong seasonal associations were apparent. Incident rate ratios of admissions were significantly higher in autumn compared with summer for asthma and croup whereas bronchiolitis and other respiratory conditions admissions were the highest in winter. Diarrhoea admissions were the highest in spring. ER presentations of the five conditions also showed similar associations with season. Hospital admissions and ER presentations of these five conditions showed strong seasonal patterns, knowledge of which could contribute to improved resource planning (staffing) to meet expected increases in demand for services and scheduling of elective admissions. These findings could be extended to develop a model for forecasting hospital use and to explore the causes of these diseases to ameliorate seasonal effects. PUBLICATION ABSTRACT
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