73 research outputs found
sj-docx-1-anp-10.1177_00048674221098942 – Supplemental material for Mental health service utilisation and reoffending in offenders with a diagnosis of psychosis receiving non-custodial sentences: A 14-year follow-up study
No full textSupplemental material, sj-docx-1-anp-10.1177_00048674221098942 for Mental health service utilisation and reoffending in offenders with a diagnosis of psychosis receiving non-custodial sentences: A 14-year follow-up study by Armita Adily, Olayan Albalawi, Grant Sara, Azar Kariminia, Handan Wand, Stephen Allnutt, Peter Schofield, David Greenberg, Luke Grant and Tony Butler in Australian & New Zealand Journal of Psychiatry</p
Death among a cohort of prisoners in New South Wales Australia — a data linkage study
No full textThis thesis examines mortality rates among adults who experienced full-time imprisonment in New
South Wales between January 1988 and December 2002, by record linkage to the Australian National
Death Index.
The cohort included 76383 men and 8820 women. Over a mean follow-up of 7.7 years, 5137 deaths
(4724 men, 423 women) were identified. Three hundred and three deaths (295 men, eight women)
occurred in custody. The median age at death was 36.6 years for men and 32.7 years for women. The
prominent causes of death were drug overdose, suicide, accidental and cardiovascular disease.
The crude mortality rate was 797 per 100000 person-years for men and 685 per 100000 person-years for
women. Risk of mortality was 3.7 times greater in male and 7.8 times greater in female prisoners than
the standard population.
The excess mortality was substantially raised following release from prison in both men (standardised
mortality ratio 4.0 vs 1.7) and women (standardised mortality ratio 8.2 vs 2.1). The period of highest risk
of death was the first two weeks after release. Drug overdose was the main cause of death, responsible
for 68% of the deaths in the first two weeks for men and for 90% of the deaths in this period for women.
In men, there was also a clustering of suicide directly after release.
Prisoners admitted to prison psychiatric hospital, repeat offenders and those in the early stage of followup
were at increased risk of mortality. Violent offenders were overrepresented in suicide figures and
property offenders in death from overdose. Minority groups, in particular men, had a lower risk of death
than white people.
The above findings reinforce how disadvantaged prisoners are, measured by mortality as the most
fundamental scale of human wellbeing. Prison represents a potential opportunity for treatment and
public health intervention to address some of the health problems underlying the high mortality found in
this study. The key challenge is, however, to provide a continuum of care between the prison and
community
Risk factors for strong regret and subsequent IVF request after tubal sterilisation
No full textA case control study was done to examine presterilisation characteristics most consistently associated with strong poststerilisation regret and subsequent request for IVF. The case group was made up of 97 previously sterilised women evaluated for IVF treatment at the Fertility Clinic or Royal North Shore Hospital in Sydney during the period 1980-1992. A Control group of 101 women apparently satisfied with their tuballigation was found from the medical records of one gynaecologist at Royal North Shore Hospital. Of the characteristics that could be objectively determined preoperatively only age, number of living children, timing of sterilisation and marital status were significantly associated with IVF request in the univariate analysis. These characteristics were, then, examined multivariately by means of logistic regression. Age at the time of sterilisation had the most pronounced effect on strong regret. Women who were younger than 30 years old at the time of sterilisation had up to 8.7 times the risk of request for IVF treatment as women 30 to 34 years old. A concurrent caesarean section was associated with a threefold risk relative to an interval procedure, but there was no significant effect associated with sterilisation performed after vaginal delivery or abortion. A strong protective effect (OR=0.07) was found for women with more than 2 children compared to childless women. There was no longer a significant effect of marital status in the multivariate analysis. Other factors not significantly associated with the request for IVF included history of abortion, education, race, the principal method of contraception used before sterilisation, and medical indications for sterilisation. The overwhelming reasons stated by women for requesting IVF were change in marital status, either remarriage or the establishment of a new de facto relationship, and the desire to have a child with the new partner
Age-specific and sex-specific weight gain norms to monitor antiretroviral therapy in children in low-income and middle-income countries.
No full textBACKGROUND
Viral load and CD4% are often not available in resource-limited settings for monitoring children's responses to antiretroviral therapy (ART). We aimed to construct normative curves for weight gain at 6, 12, 18, and 24 months following initiation of ART in children, and to assess the association between poor weight gain and subsequent responses to ART.
DESIGN
Analysis of data from HIV-infected children younger than 10 years old from African and Asian clinics participating in the International epidemiologic Databases to Evaluate AIDS.
METHODS
The generalized additive model for location, scale, and shape was used to construct normative percentile curves for weight gain at 6, 12, 18, and 24 months following ART initiation. Cox proportional models were used to assess the association between lower percentiles (< 50th) of weight gain distribution at the different time points and subsequent death, virological suppression, and virological failure.
RESULTS
Among 7173 children from five regions of the world, 45% were underweight at baseline. Weight gain below the 50th percentile at 6, 12, 18, and 24 months of ART was associated with increased risk of death, independent of baseline characteristics. Poor weight gain was not associated with increased hazards of virological suppression or virological failure.
CONCLUSION
Monitoring weight gain on ART using age-specific and sex-specific normative curves specifically developed for HIV-infected children on ART is a simple, rapid, sustainable tool that can aid in the identification of children who are at increased risk of death in the first year of ART
IeDEA-WHO Research-Policy Collaboration: contributing real-world evidence to HIV progress reporting and guideline development.
No full textPartnerships between researchers and policymakers can improve uptake and integration of scientific evidence. This article describes the research-policy partnership between the International epidemiology Databases to Evaluate AIDS (IeDEA) ( www.iedea.org) and the World Health Organization (WHO), which was established in 2014. IeDEA is an international research consortium, which analyses data on almost 2 million people living with HIV under care in routine settings in 46 countries in Asia-Pacific, the Caribbean, Central and South America, North America and sub-Saharan Africa. Five multiregional analyses were identified to inform the WHO on progress towards the second and third 90s of the 90-90-90 targets in adults and children: (i) trends in CD4 cell counts at the start of antiretroviral therapy (ART); (ii) delays from enrolment in HIV care to ART initiation; (iii) the impact of ART guideline changes; (iv) retention in care, mortality and loss to follow-up; and (v) viral suppression within the first 3 years after initiating ART. Results from these analyses were contributed to the 2015 and 2016 WHO global HIV progress reports, will contribute to the 2018 report, and were published in academic journals. The partnership has been mutually beneficial: discussion of WHO policy agendas led to more policy-framed, relevant and timely IeDEA research, and the collaboration provided the WHO with timely access to the latest data from IeDEA, as it was shared prior to peer-review publication
The Sexual Health and Attitudes of Australian Prisoners
No full textThe second Sexual Health and Attitudes of Australian Prisoners study will be the largest population-based survey of prisoners’ sexual health, attitudes and behaviour undertaken in Australia. it has been nearly 10 years since the first survey. The 2nd survey will expand survey coverage and examine vulnerable prisoner subgroup, and provide up-to-date evidence essential to sexual and reproductive health policy and practice for this growing and disadvantaged population.$AUD 1,649,586.13Project GrantsStandard Project Gran
The IeDEA Harmonist Data Toolkit: A Data Quality and Data Sharing Solution for a Global HIV Research Consortium.
No full textWe describe the design, implementation, and impact of a data harmonization, data quality checking, and dynamic report generation application in an international observational HIV research network. The IeDEA Harmonist Data Toolkit is a web-based application written in the open source programming language R, employs the R/Shiny and RMarkdown packages, and leverages the REDCap data collection platform for data model definition and user authentication. The Toolkit performs data quality checks on uploaded datasets, checks for conformance with the network's common data model, displays the results both interactively and in downloadable reports, and stores approved datasets in secure cloud storage for retrieval by the requesting investigator. Including stakeholders and users in the design process was key to the successful adoption of the application. A survey of regional data managers as well as initial usage metrics indicate that the Toolkit saves time and results in improved data quality, with a 61% mean reduction in number of error records in a dataset. The generalized application design allows the Toolkit to be easily adapted to other research networks
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