scholarly journals The recording of Aboriginal and Torres Strait Islander status in general practice clinical records: a cross-sectional study

2015 ◽  
Vol 40 (S1) ◽  
pp. S70-S74 ◽  
Author(s):  
Allison Thomson ◽  
Simon Morgan ◽  
Peter O'Mara ◽  
Amanda Tapley ◽  
Kim Henderson ◽  
...  
2020 ◽  
Vol 26 (4) ◽  
pp. 287
Author(s):  
Prabha Lakhan ◽  
Uchechukwu L. Osuagwu ◽  
Deborah Askew ◽  
Noel Hayman ◽  
Geoffrey Spurling

This cross-sectional study aimed to identify the period prevalence of visual impairment (VI) and blindness among Aboriginal and Torres Strait Islander people attending an Indigenous urban primary healthcare service, eye care practitioner referrals for those with VI and any opportunities to improve care delivery. Visual acuity (VA) examinations, using a Snellen chart, are performed as part of routine annual health assessments offered to children and adults. This study included patients aged ≥5 years (n=1442) who had a health assessment conducted between 1 January 2015 and 31 December 2016 and provided consent for the use of their health assessment information for research. Of patients with available data, 2.4% (33/1374) experienced VI, defined as presenting VA worse than 6/12 to 6/60 in the better-seeing eye. VI was more common in those aged ≥60 years (14/136; 10.3%) and was significantly associated with increasing age (P<0.001). No patients experienced blindness, defined as presenting VA worse than 6/60 in the better-seeing eye. All patients with VI were aged ≥16 years. Nine (27%) of the 33 patients with VI in the better-seeing eye were referred to an optometrist or an ophthalmologist. The low period prevalence of VI and no blindness in this study are positive findings. The findings also indicate that routine VA testing of older adults, especially those aged ≥60 years, should be conducted to avoid missing those not having an annual health assessment.


2016 ◽  
Vol 62 (1) ◽  
pp. 84-94 ◽  
Author(s):  
PJ Schluter ◽  
DA Askew ◽  
GK Spurling ◽  
M Lee ◽  
N Hayman

2019 ◽  
Vol 25 (5) ◽  
pp. 449 ◽  
Author(s):  
Deborah A. Askew ◽  
Warren J. Jennings ◽  
Noel E. Hayman ◽  
Philip J. Schluter ◽  
Geoffrey K. Spurling

Many Aboriginal and Torres Strait Islander people live in urban areas, but epidemiological data about their health status and health needs are lacking. This knowledge is critical to informing and evaluating initiatives to improve service delivery and health outcomes. One potential data source is de-identified routinely collected clinical data. This cross-sectional study, conducted in an urban Aboriginal and Torres Strait Islander primary healthcare service, involved randomly selecting a sample of 400 patients aged ≥15 years, and manually extracting electronic health record data. In the sample, 49% of patients were aged <35 years, 56% were female and 38% were employed. Overall, 56% of females and 47% of males aged 35–54 years had depression, 26% had experienced a bereavement within the last 12 months, and while 44% were alcohol abstainers, 35% were drinking at high-risk levels. The present study cannot demonstrate causal relationships between the observed high rates of chronic disease in older people and frequent experiences of bereavement and high levels of mental ill health in young- and middle-aged adults. However, a life course approach provides a framework to understand the interconnectedness of these results, and suggests that strategies to blunt the intergenerational burden of chronic disease need to address the social and emotional wellbeing of youth.


2013 ◽  
Vol 199 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Deborah A Askew ◽  
Philip J Schluter ◽  
Geoffrey K P Spurling ◽  
Chelsea J R Bond ◽  
Alex D H Brown

2017 ◽  
Vol 23 (4) ◽  
pp. 335 ◽  
Author(s):  
Prabha Lakhan ◽  
Deborah Askew ◽  
Mark F. Harris ◽  
Corey Kirk ◽  
Noel Hayman

Health literacy is an important determinant of health status. This cross-sectional study aimed to describe the prevalence of adequate health literacy among Aboriginal and Torres Strait Islander patients or their carers including parents of sick children attending an urban primary healthcare clinic in Australia, and their experiences of communication with General Practitioners (GPs). A questionnaire, including questions from the Brief Health Literacy Screen (BHLS) and questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS): Communication with Provider, was administered to 427 participants. Descriptive statistics, Pearson’s Chi-Square test and logistic regression analysis were used to describe the prevalence and risk factors associated with health literacy and any associations between the CAHPS questions and health literacy. In total, 72% of participants had adequate health literacy. An age of ≥50 years was independently associated with inadequate health literacy, and completion of secondary or post-secondary schooling was protective. Communication questions that identified areas for improvement included less use of incomprehensible medical words and more frequent use of visual aids. The study provides useful information on health literacy among Aboriginal and Torres Strait Islander patients, or their carers, and their experiences of communication with GPs. Further population-based research is required to investigate the effect of health literacy on health outcomes of Aboriginal and Torres Strait Islander patients.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paola Solis-Pazmino ◽  
Jorge Salazar-Vega ◽  
Eddy Lincango-Naranjo ◽  
Cristhian Garcia ◽  
Gabriela Jaramillo Koupermann ◽  
...  

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.


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