20 results on '"Turner, D."'
Search Results
2. Energy Conservation in Public Buildings
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Institution of Engineers, Australia. Conference (1979 : Perth, W.A.), Turner, D, and Drummond, G
- Published
- 1979
3. Photoelectric observations of southern Cepheids in 2004.
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Berdnikov, L. N. and Turner, D. G.
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- *
CEPHEIDS , *ASTRONOMICAL photometry , *PHOTOELECTRICITY , *STELLAR magnitudes , *REFLECTING telescopes - Abstract
In March and April 2004, 2808 photoelectric VIC brightness measurements were made for 113 Cepheids using the 0.6 m reflector of the Siding Spring Observatory (Australia). V light curves and V-IC colour curves are presented. [ABSTRACT FROM AUTHOR]
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- 2006
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4. Do tissue spears used to clear ear canal pus improve hearing? A case series study of hearing in remote Australian Aboriginal children with chronic suppurative otitis media before and after dry mopping with tissue spears.
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Sparrow, K, Sanchez, L, Turner, D, MacFarlane, P, and Carney, A S
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OTITIS media treatment ,CEREBROSPINAL fluid otorrhea ,AUDIOLOGISTS ,EAR canal ,HEARING ,INDIGENOUS peoples ,TYMPANIC membrane ,TREATMENT effectiveness ,CHILDREN ,THERAPEUTICS - Abstract
Objective:To determine whether the use of tissue spears to remove otorrhoea from Aboriginal children's ear canals improves hearing in the affected ear.Design:Case series study with controls.Methods:The study comprised 61 Aboriginal children from communities in the remote arid zone of South Australia who had otorrhoea obscuring the tympanic membrane in 1 or both ears. Eighty ears were treated with tissue spears, and hearing was assessed before and after treatment.Results:Forty-two children had unilateral and 19 had bilateral active disease. An additional 13 ears without otorrhoea served as controls. Improvement by 5 dB HL or greater in a four-frequency pure tone average occurred in 41.3 per cent of treated ears. Subsequently, blinded audiologists made qualitative judgements that a functional improvement in hearing had occurred after tissue spear use in 28.4 per cent of ears.Conclusion:Tissue spears can improve hearing thresholds in a significant proportion of children with otorrhoea. However, the duration of the effect is unknown. [ABSTRACT FROM PUBLISHER]
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- 2016
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5. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995-2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data.
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Coleman, M. P., Forman, D., Bryant, H., Butler, J., Rachet, B., Maringe, C., Nur, U., Tracey, E., Coory, M., Hatcher, J., McGahan, C. E., Turner, D., Marrett, L., Gjerstorff, M. L., Johannesen, T. B., Adolfsson, J., Lambe, M., Lawrence, G., Meechan, D., and Morris, E. J.
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CANCER patients - Abstract
The article focuses on a study which analyzed data on cancer survival in Australia, Canada, Denmark, Norway, Sweden and Great Britain between 1995 to 2007. Cancers of the breast, colorectal, lung and ovarian were considered in the study. Data from population-based cancer registries in 12 jurisdictions in the six countries were provided. Results indicate that survival improved in all countries but Australia, Canada and Sweden recorded the highest survival. The largest gains were recorded for colorectal cancer while the smallest were for lung and ovarian.
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- 2011
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6. The burden of diabetes-related foot disease among older adults in Australia.
- Author
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Ahmed MU, Tannous WK, Agho KE, Henshaw F, Turner D, and Simmons D
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- Male, Humans, Aged, Cost of Illness, Australia epidemiology, Diabetes Mellitus, Foot Diseases
- Abstract
Diabetes-related foot disease (DFD) is imposing an enormous burden on the health system and society due to the rapid growth of diabetes worldwide. Given the paucity of robust data on the disease burden of DFD in Australia, this study aimed to estimate the burden of disease due to DFD. The burden of DFD was estimated using the disability-adjusted life-years (DALY) approach. Data of 27 931 individuals aged 45 years and older with diabetes residing in New South Wales (NSW) from the 45 and Up Study survey were used in this study by linking it with the emergency department, hospital admissions and the deaths' registry data. The disease burden of DFD was estimated as 8915 DALY in NSW and 27 164 DALY in Australia in 2011. The burden was prominent among males and people aged 65 years and older. Most of the DALY (87%) was attributed to years of life lost or the fatal burden due to diabetes-related lower limb amputation (DRLEA). The total monetary values of DALY of DFD for NSW and Australia were estimated at approximately AUD 2 billion and AUD 6 billion annually, respectively. Preventative and curative priorities should be given to DRLEA to reduce this burden and target males, especially those aged 65 years and older., (© 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)
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- 2022
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7. Patterns of biopsy-proven renal disease in people living with HIV: 10 years experience in Sydney, Australia.
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Turner D, Drak D, Gracey D, and Anderson L
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- Australia epidemiology, Biopsy, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Retrospective Studies, HIV Infections epidemiology, Renal Insufficiency pathology, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic pathology
- Abstract
Background: Acute and chronic kidney diseases are important comorbidities in People Living With HIV (PLWH). Biopsy is often pursued in this cohort with ongoing renal impairment without a clear aetiology, in order to establish the diagnosis and to guide management. Despite the importance of renal disease in PLWH, there is a paucity of biopsy data-especially in the Australian setting. Consequently, who and when to biopsy is mainly based on clinical experience. The aims of this study were to describe biopsy-proven renal disease in PLWH at our institution and to assess for correlation between any demographic or laboratory characteristics with histological diagnosis., Methods: A retrospective review of all PLWH who underwent renal biopsy between January 2010 and December 2020 at Royal Prince Alfred Hospital, Sydney, Australia was performed. All PLWH over 18 years, who were not transplant recipients were included. Demographic, laboratory and biopsy data was extracted from the electronic medical records. Basic descriptive statistics were performed, and correlation was assessed using chi square and Kendall's coefficient of rank test., Results: 19 renal biopsies were included in the study. The majority of PLWH were Australian born (53%), male (84%) and had a mean age of 48 years (SD 13). Comorbid hypertension and diabetes were present in 74% and 21% of people respectively. The mean serum creatinine was 132 µmol/L (SD 55) and the mean estimated glomerular filtration rate (eGFR) was 61 ml/min/1.73m
2 (SD 24). The most common histological diagnosis was tubulointerstial nephritis in 5 people (24%). Hypertensive glomerulosclerosis and IgA nephropathy were present in 4 (19%) and 3 (14%) people respectively. There were no cases of HIV-associated nephropathy. There was no significant correlation between any cohort characteristics and diagnoses., Conclusions: This study represents the first description of biopsy-proven kidney disease in the HIV-infected population of Australia. Our results support the use of renal biopsy in PLWH with ongoing renal impairment for accurate diagnosis and to guide further management. Although a small sample size, our study is larger than other published international biopsy studies., (© 2022. The Author(s).)- Published
- 2022
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8. Social determinants of diabetes-related foot disease among older adults in New South Wales, Australia: evidence from a population-based study.
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Ahmed MU, Tannous WK, Agho KE, Henshaw F, Turner D, and Simmons D
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- Aged, Australia, Humans, Male, New South Wales epidemiology, Social Determinants of Health, Diabetes Mellitus epidemiology, Diabetic Foot epidemiology, Diabetic Foot etiology, Foot Diseases epidemiology, Foot Diseases etiology
- Abstract
Background: Diabetes-related foot is the largest burden to the health sector compared to other diabetes-related complications in Australia, including New South Wales (NSW). Understanding of social determinants of diabetes-related foot disease has not been definitive in Australian studies. This study aimed to investigate the social determinants of diabetes-related foot disease in NSW., Methodology: The first wave of the 45 and Up Study survey data was linked with NSW Admitted Patient Data Collection, Emergency Department Data Collection, and Pharmaceutical Benefits Scheme data resulting in 28,210 individuals with diabetes aged 45 years and older in NSW, Australia. Three outcome variables were used: diabetes-related foot disease (DFD), diabetic foot ulcer (DFU), and diabetic foot infection (DFI). They were classified as binary, and survey logistic regression was used to determine the association between each outcome measure and associated factors after adjusting for sampling weights., Results: The prevalence of DFD, DFU and DFI were 10.8%, 5.4% and 5.2%, respectively, among people with diabetes. Multivariate analyses revealed that the common factors associated with DFD, DFU and DFI were older age (75 years or more), male, single status, background in English speaking countries, and coming from lower-income households (less than AUD 20,000 per year). Furthermore, common lifestyle and health factors associated with DFD, DFU, and DFI were low physical activity (< 150 min of moderate-to-vigorous physical activity per week), history of diabetes for over 15 years, and having cardiovascular disease., Conclusion: Our study showed that about 1 in 10 adults with diabetes aged 45 years and older in NSW reported DFD. Interventions, including the provision of related health services aimed at reducing all forms of DFD in NSW, are recommended to target older individuals with a long history of diabetes, and coming from lower-income households., (© 2021. The Author(s).)
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- 2021
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9. Prevalence and Burden of Diabetes-Related Foot Disease in New South Wales, Australia: Evidence from the 45 and Up Study Survey Data Linked with Health Services Data.
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Ahmed MU, Tannous WK, Agho KE, Henshaw F, Turner D, and Simmons D
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- Australia, Hospitalization, Humans, New South Wales epidemiology, Prevalence, Surveys and Questionnaires, Diabetes Mellitus epidemiology, Diabetic Foot epidemiology, Foot Diseases
- Abstract
Diabetes-related foot disease (DFD) is a major public health concern due to the higher risks of hospitalisation. However, estimates of the prevalence of DFD in the general population are not available in Australia. This study aims to estimate the prevalence of DFD and diabetes-related lower-extremity amputation (DLEA) among people aged 45 years and over in New South Wales (NSW), Australia. The NSW 45 and Up Study baseline survey data of 267,086 persons aged 45 years and over, linked with health services' administrative data from 2006 to 2012 were used in our study. Of these, 28,210 individuals had been diagnosed with diabetes, and our study identified 3035 individuals with DFD. The prevalence of DFD, diabetic foot ulcer (DFU), diabetic foot infection (DFI), diabetic gangrene (DG), and DLEA were 10.8% (95%CI: 10.3, 11.2), 5.4% (95% CI: 5.1, 5.8), 5.2% (95%CI: 4.9, 5.5), 0.4% (95%CI: 0.3, 0.5), and 0.9% (95%CI: 0.7, 1.0), respectively. DFD, DFU, DFI, DG, and DLEA were the most common among those who were older, born in Australia, from low-income households (
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- 2021
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10. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study.
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Arnold M, Rutherford MJ, Bardot A, Ferlay J, Andersson TM, Myklebust TÅ, Tervonen H, Thursfield V, Ransom D, Shack L, Woods RR, Turner D, Leonfellner S, Ryan S, Saint-Jacques N, De P, McClure C, Ramanakumar AV, Stuart-Panko H, Engholm G, Walsh PM, Jackson C, Vernon S, Morgan E, Gavin A, Morrison DS, Huws DW, Porter G, Butler J, Bryant H, Currow DC, Hiom S, Parkin DM, Sasieni P, Lambert PC, Møller B, Soerjomataram I, and Bray F
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Australia epidemiology, Canada epidemiology, Cancer Survivors, Europe epidemiology, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Neoplasms diagnosis, Neoplasms mortality, New Zealand epidemiology, Registries, Risk Factors, Sex Factors, Time Factors, Treatment Outcome, Young Adult, Developed Countries economics, Healthcare Disparities trends, Income, Neoplasms epidemiology, Neoplasms therapy
- Abstract
Background: Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services and can reflect the prospects of cure. As part of the second phase of the International Cancer Benchmarking Partnership (ICBP), the Cancer Survival in High-Income Countries (SURVMARK-2) project aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends., Methods: In this longitudinal, population-based study, we collected patient-level data on 3·9 million patients with cancer from population-based cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK) for seven sites of cancer (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) diagnosed between 1995 and 2014, and followed up until Dec 31, 2015. We calculated age-standardised net survival at 1 year and 5 years after diagnosis by site, age group, and period of diagnosis. We mapped changes in incidence and mortality to changes in survival to assess progress in cancer control., Findings: In 19 eligible jurisdictions, 3 764 543 cases of cancer were eligible for inclusion in the study. In the 19 included jurisdictions, over 1995-2014, 1-year and 5-year net survival increased in each country across almost all cancer types, with, for example, 5-year rectal cancer survival increasing more than 13 percentage points in Denmark, Ireland, and the UK. For 2010-14, survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK. Over the study period, larger survival improvements were observed for patients younger than 75 years at diagnosis than those aged 75 years and older, and notably for cancers with a poor prognosis (ie, oesophagus, stomach, pancreas, and lung). Progress in cancer control (ie, increased survival, decreased mortality and incidence) over the study period was evident for stomach, colon, lung (in males), and ovarian cancer., Interpretation: The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. While truly valid comparisons require differences in registration practice, classification, and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival., Funding: Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; National Health Service England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; and Wales Cancer Network., (© This is an Open Access article published under the CC BY-NC-ND 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.)
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- 2019
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11. Characteristics of recently arrived Asian men who have sex with men diagnosed with HIV through sexual health services in Melbourne and Sydney.
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Blackshaw LCD, Chow EPF, Varma R, Healey L, Templeton DJ, Basu A, Turner D, Medland NA, Rix S, Fairley CK, and Chen MY
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- Adolescent, Adult, Asian People psychology, Australia epidemiology, Cross-Sectional Studies, HIV Infections ethnology, Homosexuality, Male statistics & numerical data, Humans, Male, Mass Screening, Middle Aged, Retrospective Studies, Risk-Taking, Sexual Partners, Young Adult, Asian People statistics & numerical data, Emigrants and Immigrants statistics & numerical data, HIV Infections diagnosis, Homosexuality, Male ethnology, Sexual Behavior ethnology, Sexually Transmitted Diseases ethnology
- Abstract
Objectives: Asian men who have sex with men (MSM) who have recently arrived in Australia are an emergent risk group for HIV; however, little is known about how they compare to Australian MSM diagnosed with HIV. This study compared the characteristics of these two groups., Methods: A retrospective, cross-sectional study of MSM diagnosed with HIV between January 2014 and October 2017 in Melbourne and Sydney public sexual health clinics. Asian MSM were those who had arrived in Australia within 4 years of diagnosis., Results: Among 111 Asian men, 75% spoke a language other than English, 88% did not have Medicare and 61% were international students. Compared with Australian men (n=209), Asian men reported fewer male sexual partners within 12 months (median 4 versus 10, p<0.001), were less likely to have tested for HIV previously (71% versus 89%, p<0.001) and had a lower median CD4 count (326 versus 520, p<0.001). Among Asian men, HIV subtype CRF01-AE was more common (55% versus 16%, p<0.001) and subtype B less common (29% versus 73%, p<0.001)., Conclusions: Asian MSM diagnosed with HIV reported lower risk and had more advanced HIV. Implications for public health: HIV testing and preventative interventions supporting international students are required., (© 2019 The Authors.)
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- 2019
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12. Review article: Let us talk about snakebite management: A discussion on many levels.
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Turner D, Winter S, Winkel K, MacIsaac C, Padula A, and Braitberg G
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- Aged, Animals, Antivenins administration & dosage, Australia, Fatal Outcome, Female, Humans, Practice Guidelines as Topic, Snake Bites diagnosis, Antivenins therapeutic use, Elapidae, Snake Bites therapy, Viper Venoms antagonists & inhibitors
- Abstract
We want to discuss antivenom use in snakebite clinical practice guidelines. Coronial reviews in Victoria of two cases of snakebite envenomation, one described in detail below, prompted us to submit this paper for a wider audience and debate. Venom and antivenom levels were measured in the case detailed below, but not in the other. The coroner received conflicting and varied advice from experts regarding the dose of antivenom. The Victorian Department of Health and Human Services and the Australasian College for Emergency Medicine were instructed to review snakebite management guidelines, particularly with respect to antivenom dosage. The discussion that took place among medical experts led to considerable media attention. We discuss the potential fallout when there is no consensus among medical experts., (© 2019 Australasian College for Emergency Medicine.)
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- 2019
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13. Comparison of general and cardiac care-specific indices of spatial access in Australia.
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Versace VL, Coffee NT, Franzon J, Turner D, Lange J, Taylor D, and Clark R
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- Australia, Health Services Accessibility, Health Services Needs and Demand, Humans, Cardiology standards, Rural Health Services standards
- Abstract
Objective: To identity differences between a general access index (Accessibility/ Remoteness Index of Australia; ARIA+) and a specific acute and aftercare cardiac services access index (Cardiac ARIA)., Research Design and Methods: Exploratory descriptive design. ARIA+ (2011) and Cardiac ARIA (2010) were compared using cross-tabulations (chi-square test for independence) and map visualisations. All Australian locations with ARIA+ and Cardiac ARIA values were included in the analysis (n = 20,223). The unit of analysis was Australian locations., Results: Of the 20,223 locations, 2757 (14% of total) had the highest level of acute cardiac access coupled with the highest level of general access. There were 1029 locations with the poorest access (5% of total). Approximately two thirds of locations in Australia were classed as having the highest level of cardiac aftercare. Locations in Major Cities, Inner Regional Australia, and Outer Regional Australia accounted for approximately 98% of this category. There were significant associations between ARIA+ and Cardiac ARIA acute (χ2 = 25250.73, df = 28, p<0.001, Cramer's V = 0.559, p<0.001) and Cardiac ARIA aftercare (χ2 = 17204.38, df = 16, Cramer's V = 0.461, p<0.001)., Conclusions: Although there were significant associations between the indices, ARIA+ and Cardiac ARIA are not interchangeable. Systematic differences were apparent which can be attributed largely to the underlying specificity of the Cardiac ARIA (a time critical index that uses distance to the service of interest) compared to general accessibility quantified by the ARIA+ model (an index that uses distance to population centre). It is where the differences are located geographically that have a tangible impact upon the communities in these locations-i.e. peri-urban areas of the major capital cities, and around the more remote regional centres. There is a strong case for specific access models to be developed and updated to assist with efficient deployment of resources and targeted service provision. The reasoning behind the differences highlighted will be generalisable to any comparison between general and service-specific access models., Competing Interests: The authors have declared that no competing interests exist.
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- 2019
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14. Diagnostic routes and time intervals for patients with colorectal cancer in 10 international jurisdictions; findings from a cross-sectional study from the International Cancer Benchmarking Partnership (ICBP).
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Weller D, Menon U, Zalounina Falborg A, Jensen H, Barisic A, Knudsen AK, Bergin RJ, Brewster DH, Cairnduff V, Gavin AT, Grunfeld E, Harland E, Lambe M, Law RJ, Lin Y, Malmberg M, Turner D, Neal RD, White V, Harrison S, Reguilon I, and Vedsted P
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- Aged, Aged, 80 and over, Australia, Canada, Colorectal Neoplasms pathology, Colorectal Neoplasms therapy, Cross-Sectional Studies, Denmark, Early Detection of Cancer, Female, Humans, Internationality, Male, Middle Aged, Neoplasm Staging, Norway, Referral and Consultation, Registries, Sweden, Time Factors, United Kingdom, Colorectal Neoplasms diagnosis, Delayed Diagnosis statistics & numerical data, Delivery of Health Care, Primary Health Care statistics & numerical data, Secondary Care statistics & numerical data, Time-to-Treatment statistics & numerical data
- Abstract
Objective: International differences in colorectal cancer (CRC) survival and stage at diagnosis have been reported previously. They may be linked to differences in time intervals and routes to diagnosis. The International Cancer Benchmarking Partnership Module 4 (ICBP M4) reports the first international comparison of routes to diagnosis for patients with CRC and the time intervals from symptom onset until the start of treatment. Data came from patients in 10 jurisdictions across six countries (Canada, the UK, Norway, Sweden, Denmark and Australia)., Design: Patients with CRC were identified via cancer registries. Data on symptomatic and screened patients were collected; questionnaire data from patients' primary care physicians and specialists, as well as information from treatment records or databases, supplemented patient data from the questionnaires. Routes to diagnosis and the key time intervals were described, as were between-jurisdiction differences in time intervals, using quantile regression., Participants: A total of 14 664 eligible patients with CRC diagnosed between 2013 and 2015 were identified, of which 2866 were included in the analyses., Primary and Secondary Outcome Measures: Interval lengths in days (primary), reported patient symptoms (secondary)., Results: The main route to diagnosis for patients was symptomatic presentation and the most commonly reported symptom was 'bleeding/blood in stool'. The median intervals between jurisdictions ranged from: 21 to 49 days (patient); 0 to 12 days (primary care); 27 to 76 days (diagnostic); and 77 to 168 days (total, from first symptom to treatment start). Including screen-detected cases did not significantly alter the overall results., Conclusion: ICBP M4 demonstrates important differences in time intervals between 10 jurisdictions internationally. The differences may justify efforts to reduce intervals in some jurisdictions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.)
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- 2018
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15. Investigation of the international comparability of population-based routine hospital data set derived comorbidity scores for patients with lung cancer.
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Lüchtenborg M, Morris EJA, Tataru D, Coupland VH, Smith A, Milne RL, Te Marvelde L, Baker D, Young J, Turner D, Nishri D, Earle C, Shack L, Gavin A, Fitzpatrick D, Donnelly C, Lin Y, Møller B, Brewster DH, Deas A, Huws DW, White C, Warlow J, Rashbass J, and Peake MD
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- Australia epidemiology, Canada epidemiology, Comorbidity, Electronic Health Records, Humans, Lung Neoplasms diagnosis, Lung Neoplasms mortality, Norway epidemiology, Survival Rate, United Kingdom epidemiology, Hospitals statistics & numerical data, Lung Neoplasms epidemiology
- Abstract
Introduction: The International Cancer Benchmarking Partnership (ICBP) identified significant international differences in lung cancer survival. Differing levels of comorbid disease across ICBP countries has been suggested as a potential explanation of this variation but, to date, no studies have quantified its impact. This study investigated whether comparable, robust comorbidity scores can be derived from the different routine population-based cancer data sets available in the ICBP jurisdictions and, if so, use them to quantify international variation in comorbidity and determine its influence on outcome., Methods: Linked population-based lung cancer registry and hospital discharge data sets were acquired from nine ICBP jurisdictions in Australia, Canada, Norway and the UK providing a study population of 233 981 individuals. For each person in this cohort Charlson, Elixhauser and inpatient bed day Comorbidity Scores were derived relating to the 4-36 months prior to their lung cancer diagnosis. The scores were then compared to assess their validity and feasibility of use in international survival comparisons., Results: It was feasible to generate the three comorbidity scores for each jurisdiction, which were found to have good content, face and concurrent validity. Predictive validity was limited and there was evidence that the reliability was questionable., Conclusion: The results presented here indicate that interjurisdictional comparability of recorded comorbidity was limited due to probable differences in coding and hospital admission practices in each area. Before the contribution of comorbidity on international differences in cancer survival can be investigated an internationally harmonised comorbidity index is required., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2018
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16. Sun protection provided by regulation school uniforms in Australian schools: an opportunity to improve personal sun protection during childhood.
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Turner D and Harrison SL
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- Australia, Child, Environmental Exposure, Humans, Clothing, Sunlight
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Childhood sun exposure is linked to excessive pigmented mole development and melanoma risk. Clothing provides a physical barrier, protecting skin from ultraviolet radiation (UVR). Extending sleeves to elbow length and shorts to knee length has been shown to significantly reduce mole acquisition in preschoolers from tropical Queensland. We used publicly available uniform images and guidelines from primary schools in Townsville (latitude 19.25°S, n = 43 schools), Cairns (16.87°S, n = 46) and the Atherton Tablelands (17.26°S, n = 23) in tropical Australia to objectively determine the body surface proportion covered by regulation school uniforms. Uniforms of nongovernment, large (≥800 students), urban, educationally advantaged schools with comprehensive sun protection policies covered more skin than those of government schools (63.2% vs 62.0%; P < 0.001), smaller schools (63.4% vs 62.3%; P = 0.009), rural (62.7% vs 61.9%; P = 0.002) and educationally disadvantaged schools (62.8% vs 62.3%; P < 0.001) with underdeveloped sun protection policies (62.8% vs 62.2%; P = 0.002). Overall, SunSmart and non-SunSmart school uniforms covered identical body surface proportions (62.4%, P = 0.084). Although wearing regulation school uniforms is mandatory at most Australian primary schools, this opportunity to improve children's sun protection is largely overlooked. Recent evidence suggests that even encouraging minor alterations to school uniforms (e.g. slightly longer sleeves/dresses/skirts/shorts) to increase skin coverage may reduce mole acquisition and melanoma risk, especially in high-risk populations., (© 2014 The American Society of Photobiology.)
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- 2014
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17. Access to cardiac rehabilitation does not equate to attendance.
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Clark RA, Coffee N, Turner D, Eckert KA, van Gaans D, Wilkinson D, Stewart S, and Tonkin AM
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- Aftercare organization & administration, Australia epidemiology, Censuses, Critical Pathways organization & administration, Critical Pathways statistics & numerical data, Female, Geographic Information Systems, Health Services Accessibility organization & administration, Humans, Male, Middle Aged, Native Hawaiian or Other Pacific Islander statistics & numerical data, Rehabilitation Centers organization & administration, Secondary Prevention organization & administration, Secondary Prevention statistics & numerical data, Software, Health Services Accessibility statistics & numerical data, Heart Diseases epidemiology, Heart Diseases prevention & control, Heart Diseases rehabilitation, Patient Participation statistics & numerical data, Rehabilitation Centers statistics & numerical data
- Abstract
Background/aims: Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%-30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia., Methods: An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h)., Results: Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event., Conclusion: Results demonstrated that the majority of Australians had excellent 'geographic' access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our 'geographic' lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.
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- 2014
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18. Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007.
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Walters S, Maringe C, Coleman MP, Peake MD, Butler J, Young N, Bergström S, Hanna L, Jakobsen E, Kölbeck K, Sundstrøm S, Engholm G, Gavin A, Gjerstorff ML, Hatcher J, Johannesen TB, Linklater KM, McGahan CE, Steward J, Tracey E, Turner D, Richards MA, and Rachet B
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Australia epidemiology, Canada epidemiology, Denmark epidemiology, Female, Humans, Lung Neoplasms pathology, Male, Middle Aged, Norway epidemiology, Retrospective Studies, Survival Rate trends, Sweden epidemiology, Young Adult, Lung Neoplasms mortality, Neoplasm Staging, Population Surveillance
- Abstract
Background: The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007., Methods: Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis., Results: Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer., Conclusions: There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved.
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- 2013
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19. Application of geographic modeling techniques to quantify spatial access to health services before and after an acute cardiac event: the Cardiac Accessibility and Remoteness Index for Australia (ARIA) project.
- Author
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Clark RA, Coffee N, Turner D, Eckert KA, van Gaans D, Wilkinson D, Stewart S, and Tonkin AM
- Subjects
- Acute Disease, Aged, Australia, Female, Humans, Male, Geographic Information Systems, Health Services Accessibility, Heart Diseases therapy
- Abstract
Background: Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services., Methods and Results: An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), the team developed a numeric/alphabetic index at 2 points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alphabetic) measured access to 4 basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to his or her community. The numeric index ranged from 1 (access to principal referral center with cardiac catheterization service ≤1 hour) to 8 (no ambulance service, >3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within a 1-hour drive-time) to E (no services available within 1 hour). The panel found that 13.9 million Australians (71%) resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were overrepresented by people >65 years of age (32%) and indigenous people (60%)., Conclusions: The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and could be applied to other common disease states within other regions of the world.
- Published
- 2012
- Full Text
- View/download PDF
20. A survey of sleeping difficulties in an Australian population.
- Author
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Lack L, Miller W, and Turner D
- Subjects
- Adult, Australia, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Sleep Stages, Wakefulness, Sleep Initiation and Maintenance Disorders epidemiology
- Published
- 1988
- Full Text
- View/download PDF
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