%0 Journal Article
%~ PubMed
%A Nguyen, Ha
%A Ivers, Rebecca
%A Jan, Stephen
%A Martiniuk, Alexandra
%A Pham, Cuong
%T Catastrophic household costs due to injury in Vietnam.
%B Injury
%D 2013
%C United Kingdom
%I Elsevier Ltd
%V 44
%N 5
%P 684-690
%@ 0020-1383
%X OBJECTIVE: Little is known about the costs of injury and their impact on injured persons and their families in Vietnam. This study aimed to examine the cost of injury in hospitalised patients and to identify the most costly injuries and those more likely to result in catastrophic household expenditure. METHOD: A prospective cohort study was conducted, recruiting individuals admitted to Thai Binh General Hospital due to injury in Vietnam from January to August 2010. During the hospitalisation period, data on expenditure including direct medical, direct non-medical and indirect costs were collected. Demographic and injury characteristics were also obtained. The associations between the risk of catastrophic expenditure and injury cause, severity and principal injured region were examined by modified Poisson regression approach. Payment of more than 40% of the household non-subsistence spending was considered a catastrophic expenditure. RESULTS: Of 918 patients approached, 892 (97%) were recruited. Total costs for all participants during the hospitalisation period were US$ 325,812. Patients admitted for road injury accounted for the largest number of injuries (n=477, 53%), and the largest percentage of the total costs (US$ 175,044, 57%). This was followed by individuals hospitalised due to falls, representing 29% of the sample (n=261) and 31% of the total costs (US$ 103,128). In terms of cost per hospital stay, burn injuries were the most costly (US$ 427), followed by falls (US$ 395) and road crashes (US$ 367). Of all sample, 26% experienced catastrophic expenditure due to their injuries. Factors significantly associated with increased risk of catastrophic expenditure were having more severe or higher MAIS injuries (RR=2.02, 95% CI: 1.14-3.57), principal injured region to lower extremities (RR=3.34, 95% CI: 1.41-7.91) or head (RR=3.21, 95% CI: 1.37-7.52), longer hospital stay (RR=1.09, 95% CI: 1.07-1.10), older age, lower income and not having insurance (RR=1.63, 95% CI: 1.21-2.21). CONCLUSION: A high proportion of households experienced catastrophic expenditure following injury, highlighting the important need for programmes to prevent injuries, road traffic and fall-related injuries in particular. Furthermore, expansion of health insurance coverage may help individuals cope with the financial consequences of injury.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Nguyen, Ha
%A Ivers, Rebecca Q
%A Jan, Stephen
%A Martiniuk, Alexandra L C
%A Li, Qiang
%A Pham, Cuong
%T The economic burden of road traffic injuries: evidence from a provincial general hospital in Vietnam.
%B Injury Prevention
%D 2013
%C United Kingdom
%I BMJ Group
%V 19
%N 12
%P 79-84
%@ 1475-5785
%X ObjectiveTo examine the costs of road traffic injuries (RTIs) in Vietnam and factors associated with increased costs.MethodRTI data were collected in a prospective cohort study on the impact of injuries in Vietnam. Participants were persons admitted to the Thai Binh General Hospital because of RTI. All costs incurred by participants and their family members during hospitalisation were collected, including direct medical costs, direct non-medical costs and indirect costs. Generalised linear models were employed to examine predictors of increased costs including demographic and injury context characteristics.ResultsEach RTI hospitalisation costs the patient and family on average US$363 or 6 months of average salary. Income, injury severity, principal region of injury and length of hospital stay were statistically significant predictors of increased costs; age, gender, occupation and road user group were not. After controlling for injury characteristics and income, participants with principal injuries to the lower extremities had a cost 1.28 (95% CI 1.07 to 1.54) times higher than those with principal injuries to the face. Analyses of motorcycle-related RTIs with principal injury to the head also showed increased costs among those without a helmet (1.41 times higher, 95% CI 1.17 to 1.71).ConclusionsRTIs can cause a substantial economic burden to the patient and family. During hospitalisation on average, an RTI would cost approximately 6 months of salary. In addition to interventions to decrease the risk of RTIs, those reducing the severity, such as wearing a motorcycle helmet, should be enforced to minimise the economic and health consequences of injury.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra Lc
%A Manouchehrian, Mitra
%A Negin, Joel A
%A Zwi, Anthony B
%T Brain Gains: a literature review of medical missions to low and middle-income countries.
%B BMC Health Services Research
%D 2012
%C United Kingdom
%I BioMed Central Ltd.
%V 12
%N 
%P 134
%@ 1472-6963
%X ABSTRACT:
%Z FOR Codes: 2201


%0 Journal Article
%~ PubMed
%A Negin, Joel
%A Martiniuk, Alexandra
%A Morgan, Chris
%A Davies, Philip
%A Zwi, Anthony
%T Building health systems capacity in global health graduate programs: reflections from Australian educators.
%B BMC International Health and Human Rights
%D 2012
%C United Kingdom
%I BioMed Central Ltd.
%V 12
%N 1
%P 14
%@ 1472-698X
%X 
%Z FOR Codes: 130209


%0 Journal Article
%~ PubMed
%A Westcott, Mia
%A Martiniuk, Alexandra Lc
%A Fowler, Robert A
%A Adhikari, Neill Kj
%A Dalipanda, Tenneth
%T Critical care resources in the Solomon Islands: a cross-sectional survey.
%B BMC International Health and Human Rights
%D 2012
%C United Kingdom
%I BioMed Central Ltd.
%V 12
%N 
%P 1
%@ 1472-698X
%X ABSTRACT:
%Z FOR Codes: 605


%0 Journal Article
%~ PubMed
%A Puchalski Ritchie, L M
%A van Lettow, M
%A Barnsley, J
%A Chan, A K
%A Joshua, M
%A Martiniuk, A L C
%A Schull, M J
%A Zwarenstein, M
%T Evaluation of lay health workers' needs to effectively support anti-tuberculosis treatment adherence in Malawi.
%B International Journal of Tuberculosis and Lung Disease
%D 2012
%C France
%I International Journal of Tuberculosis and Lung Di
%V 16
%N 11
%P 1492-1497
%@ 1815-7920
%X 
%Z FOR Codes: 110203


%0 Journal Article
%~ PubMed
%A Negin, Joel
%A Martiniuk, Alexandra Lc
%A Farrell, Penny
%A Dalipanda, Tenneth
%T Frequency, cost and impact of inter-island referrals in the Solomon Islands.
%B Rural and Remote Health
%D 2012
%C Australia
%I Australian Rural Health Education Network
%V 12
%N 3
%P 2096
%@ 1445-6354
%X 
%Z FOR Codes: 111799


%0 Journal Article
%~ PubMed
%A Tenthani, Lyson
%A Cataldo, Fabian
%A Chan, Adrienne K
%A Bedell, Richard
%A Martiniuk, Alexandra Lc
%A van Lettow, Monique
%T Involving expert patients in antiretroviral treatment provision in a tertiary referral hospital HIV clinic in Malawi.
%B BMC Health Services Research
%D 2012
%C United Kingdom
%I BioMed Central Ltd.
%V 12
%N 
%P 140
%@ 1472-6963
%X 
%Z FOR Codes: 111708


%0 Journal Article
%~ PubMed
%A Negin, Joel
%A Martiniuk, Alexandra
%A Cumming, Robert G
%A Naidoo, Nirmala
%A Phaswana-Mafuya, Nancy
%A Madurai, Lorna
%A Williams, Sharon
%A Kowal, Paul
%T Prevalence of HIV and chronic comorbidities among older adults.
%B AIDS
%D 2012
%C United States
%I Lippincott Williams & Wilkins
%V 26
%N Suppl 1
%P S55-S63
%@ 1473-5571
%X 
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Adunuri, Nikesh
%A Negin, Joel
%A Tracey, Patti
%A Fontecha, Claudio
%A Caldwell, Paul
%T Primary care provision by volunteer medical brigades in Honduras: a health record review of more than 2,500 patients over three years.
%B International Journal of Health Services
%D 2012
%C United States
%I Baywood Publishing Co., Inc.
%V 42
%N 4
%P 739-753
%@ 0020-7314
%X 
%Z FOR Codes: 111706


%0 Journal Article
%A Martiniuk, Alexandra
%A Adunuri, Nikesh
%A Negin, Joel
%A Tracey, Patti
%A Fontecha, Claudio
%A Caldwell, Paul
%T Primary care provision by volunteer medical brigades in Honduras: a health record review of over 2,500 patients over 3 years
%B International Journal of Health Services
%D 2012
%C United States
%I Baywood Publishing Co., Inc.
%V 42
%N 4
%P 739-753
%@ 1541-4469
%X 
%Z FOR Codes: 111717


%0 Journal Article
%~ PubMed
%A Negin, Joel
%A Martiniuk, Alexandra
%T Sector wide approaches for health in small island states: Lessons learned from the Solomon Islands.
%B Global Public Health
%D 2012
%C United Kingdom
%I Routledge
%V 7
%N 2
%P 137-148
%@ 1744-1706
%X Sector Wide Approaches (SWAps) have increasingly been implemented in countries around the world as a mechanism for effective delivery of health sector funding from various sources. Despite the global focus on aid effectiveness, SWAps have been under-examined. In 2007, the Solomon Islands and development partners began discussing a health SWAp making the Solomon Islands one of the first fragile states globally to adopt a SWAp. This paper explores the establishment and implementation of a health SWAp in the Solomon Islands as a specific case study with lessons learned for the region as well as for aid architecture in fragile states more generally. Tensions between donors and the government impeded agreement and early implementation and country ownership of the SWAp idea was muted. Since mid-2009, however, the Solomon Islands SWAp has made strong progress with greater government ownership and with more focus on partnership and harmonisation rather than on funding mechanisms. The SWAp mechanism has been a challenge for the capacity-constrained Solomon Islands health sector and for development partners familiar with other aid modalities, but current momentum suggests that the SWAp will have a positive impact on adherence to agreed aid effectiveness principles.
%Z FOR Codes: 111799


%0 Journal Article
%~ PubMed
%A van Lettow, Monique
%A ÿkesson, Ann
%A Martiniuk, Alexandra L C
%A Ramsay, Andrew
%A Chan, Adrienne K
%A Anderson, Suzanne T
%A Harries, Anthony D
%A Corbett, Elizabeth
%A Heyderman, Robert S
%A Zachariah, Rony
%A Bedell, Richard A
%T Six-month mortality among HIV-infected adults presenting for antiretroviral therapy with unexplained weight loss, chronic fever or chronic diarrhea in Malawi.
%B PLoS One
%D 2012
%C United States
%I Public Library of Science
%V 7
%N 11
%P e48856
%@ 1932-6203
%X 
%Z FOR Codes: 111708


%0 Journal Article
%~ PubMed
%A Ansari-Moghaddam, Alireza
%A Martiniuk, Alexandra Lc
%A Mohammadi, Mahdi
%A Rad, Mahdieh
%A Sargazi, Fatemeh
%A Sheykhzadeh, Khodadad
%A Jelodarzadeh, Seddighe
%A Karimzadeh, Fatemeh
%T The pattern of injury and poisoning in South East Iran.
%B BMC International Health and Human Rights
%D 2012
%C United Kingdom
%I BioMed Central Ltd.
%V 12
%N 
%P 17
%@ 1472-698X
%X 
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Chen, H Y
%A Jan, S
%A Boufous, S
%A Martiniuk, A L C
%A Ivers, R
%A Senserrick, T
%A Norton, R
%A Muscatello, D
%T Variations in car crash-related hospitalization costs amongst young adults in New South Wales, Australia.
%B Injury
%D 2012
%C United Kingdom
%I Elsevier Ltd
%V 43
%N 9
%P 1593-1599
%@ 0020-1383
%X BACKGROUND: This study aims to examine factors associated with variation in crash-related hospitalization costs for young adults in New South Wales (NSW), Australia with a particular focus on types of vehicle occupant, rurality of residence and socioeconomic status (SES). METHODS: Data on patients aged 17-25 years, admitted to public hospitals due to a crash during July 2000-June 2007 were extracted from the NSW Health Admission Collection database. The hospitalization cost of each admission was calculated based on published charges for specific Australian Refined-Diagnosis Related Groups (AR-DRG). Multivariable analyses using generalized estimating equations were used to estimate costs by vehicle occupant type (driver, passenger and other occupants), rurality of residence (urban, regional and rural areas) and SES (low, moderate and high SES areas). RESULTS: During 2000-2007, there were 11,892 crash-related hospitalizations involving young adults, aged 17-25 years, in NSW. These cost the health sector about A$87.6 million or on average, A$7363 per hospitalization (mean length of stay (LOS) 5.3 days). Compared to drivers, passengers had significantly longer LOS (<0.01) as well as higher hospitalization costs (p=0.04). Regional and rural young adults had significantly longer LOS and higher hospitalization costs compared to urban young adults (p<0.05). Compared with young adults from high SES areas, young adults from moderate SES areas had significantly higher costs (p=0.02), whilst the higher costs for young adults of low SES areas was borderline significant (p=0.06), although differences in LOS by SES were not significant. CONCLUSION: Annually, young adults'' crashes in NSW were estimated to cost the health sector at least A$14.6 million between 2001 and 2007. The higher hospitalization costs and LOS for young adults living in regional and rural vs. urban areas, and those living in moderate and low SES vs. high SES areas partly reflects the severity of these crashes and challenges for treatment. Based on these findings, a strong economic argument can be made for targeting prevention strategies to young people living in rural and low SES areas. The area variations in costs also suggest some scope for policy makers to consider potentially more efficient ways of targeting both treatment and preventative programmes.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Fitzgerald-Husek, Alanna
%A Martiniuk, Alexandra Lc
%A Hinchcliff, Reece
%A Aochamus, Christine E
%A Lee, Richard B
%T "I do what I have to do to survive": An investigation into the perceptions, experiences and economic considerations of women engaged in sex work in Northern Namibia.
%B BMC Women's Health
%D 2011
%C United Kingdom
%I BioMed Central Ltd.
%V 11
%N 
%P 35
%@ 1472-6874
%X ABSTRACT:
%Z FOR Codes: 1117


%0 Journal Article
%~ PubMed
%A Negin, Joel
%A van Lettow, Monique
%A Semba, Medson
%A Martiniuk, Alexandra
%A Chan, Adrienne
%A Cumming, Robert G
%T Anti-Retroviral Treatment Outcomes among Older Adults in Zomba District, Malawi.
%B PLoS One
%D 2011
%C United States
%I Public Library of Science
%V 6
%N 10
%P e26546
%@ 1932-6203
%X There are approximately 3 million people aged 50 and older in sub-Saharan Africa who are HIV-positive. Despite this, little is known about the characteristics of older adults who are on treatment and their treatment outcomes.
%Z FOR Codes: 111702 110799


%0 Journal Article
%~ PubMed
%A Sodhi, Sumeet
%A Banda, Hastings
%A Kathyola, Damson
%A Burciul, Barry
%A Thompson, Sandy
%A Joshua, Martias
%A Bateman, Eric
%A Fairall, Lara
%A Martiniuk, Alexandra
%A Cornick, Ruth
%A Faris, Gill
%A Draper, Beverley
%A Mondiwa, Martha
%A Katengeza, Egnat
%A Sanudi, Lifah
%A Zwarenstein, Merrick
%A Schull, Michael J
%T Evaluating a streamlined clinical tool and educational outreach intervention for health care workers in Malawi: the PALM PLUS case study.
%B BMC International Health and Human Rights
%D 2011
%C United Kingdom
%I BioMed Central Ltd.
%V 11
%N Suppl 2
%P S11
%@ 1472-698X
%X BACKGROUND: Nearly 3 million people in resource-poor countries receive antiretrovirals for the treatment of HIV/AIDS, yet millions more require treatment. Key barriers to treatment scale up are shortages of trained health care workers, and challenges integrating HIV/AIDS care with primary care. THE RESEARCH: PALM PLUS (Practical Approach to Lung Health and HIV/AIDS in Malawi) is an intervention designed to simplify and integrate existing Malawian national guidelines into a single, simple, user-friendly guideline for mid-level health care workers. Training utilizes a peer-to-peer educational outreach approach. Research is being undertaken to evaluate this intervention to generate evidence that will guide future decision-making for consideration of roll out in Malawi. The research consists of a cluster randomized trial in 30 public health centres in Zomba District that measures the effect of the intervention on staff satisfaction and retention, quality of patient care, and costs through quantitative, qualitative and health economics methods. RESULTS AND OUTCOMES: In the first phase of qualitative inquiry respondents from intervention sites demonstrated in-depth knowledge of PALM PLUS compared to those from control sites. Participants in intervention sites felt that the PALM PLUS tool empowered them to provide better health services to patients. Interim staff retention data shows that there were, on average, 3 to 4 staff departing from the control and intervention sites per month. Additional qualitative, quantitative and economic analyses are planned. THE PARTNERSHIP: Dignitas International and the Knowledge Translation Unit at the University of Cape Town Lung Institute have led the adaptation and development of the PALM PLUS intervention, using experience gained through the implementation of the South African precursor, PALSA PLUS. The Malawian partners, REACH Trust and the Research Unit at the Ministry of Health, have led the qualitative and economic evaluations. Dignitas and Ministry of Health have facilitated interaction with implementers and policy-makers. CHALLENGES AND SUCCESSES: This initiative is an example of South-South knowledge translation between South Africa and Malawi, mediated by a Canadian academic-NGO hybrid. Our success in developing and rolling out PALM PLUS in Malawi suggests that it is possible to adapt and implement this intervention for use in other resource-limited settings.
%Z FOR Codes: 111712


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Lee, Crystal M Y
%A Colagiuri, Stephen
%A Woodward, Mark
%T Higher-than-optimal body mass index and diabetes mortality in the Asia Pacific region.
%B Diabetes research and clinical practice
%D 2011
%C Ireland, Belgium
%I Elsevier Ireland Ltd
%V 94
%N 3
%P 471-6
%@ 0168-8227
%X To estimate the population attributable fraction (PAF) of elevated body mass index (BMI) for diabetes mortality by country, sex and age group, for the Western Pacific and South-East Asia regions.
%Z FOR Codes: 111799 110306 111715


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Secco, Mary
%A Speechley, Kathy N
%T Knowledge Translation Strategies Using the Thinking About Epilepsy Program as a Case Study.
%B Health promotion practice
%D 2011
%C United States
%I Sage Publications, Inc.
%V 12
%N 3
%P 361-9
%@ 1524-8399
%X In many areas of health promotion and health care there is a need to bring new knowledge from research into practice (knowledge translation). Relevant research alone is not usually sufficient to achieve the ultimate outcome(s) of interest. This study aims to address this gap by outlining practices and outcomes involved in moving research findings into action using the example of the Thinking About Epilepsy program. A case study approach is used to discuss evidence-based principles and steps taken to translate evidence about the Thinking About Epilepsy program into action. Data used to inform this process include organizational documents, observations, and stakeholder interviews. Partnerships and techniques used for knowledge translation are discussed. The process of moving research knowledge into action is discussed explicitly in terms of who the policy makers are, what action is desired, the role of partners, and funding. Using a case study approach the authors have illustrated the importance of starting knowledge translation at the beginning, not at the end, of the research project. The principles discussed in this article can be extended past epilepsy and applied to move research findings relevant to other health conditions, health promotion activities, products, and technologies into action.
%Z FOR Codes: 110904


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Wires, Shannon M
%T Reflections on peace-through-health: the first Canadian, Israeli and Palestinian maternal and child health programme for medical students.
%B Medicine, Conflict and Survival
%D 2011
%C United Kingdom
%I Routledge
%V 27
%N 4
%P 197-204
%@ 1362-3699
%X 
%Z FOR Codes: 111717


%0 Journal Article
%~ PubMed
%A Hackett, Maree L
%A Glozier, Nicholas S
%A Martiniuk, Alexandra L
%A Jan, Stephen
%A Anderson, Craig S
%T Sydney Epilepsy Incidence Study to Measure Illness Consequences: the SESIMIC observational epilepsy study protocol.
%B BMC neurology
%D 2011
%C United Kingdom
%I BioMed Central Ltd.
%V 11
%N 1
%P 3
%@ 1471-2377
%X Epilepsy affects an estimated 50 million people and accounts for approximately 1% of days lost to ill health globally, making it one of the most common, serious neurological disorders. While there are abundant global data on epilepsy incidence, prevalence and treatment, there is a paucity of Australian incidence data. There is also a general lack of information on the psychosocial impact and socioeconomic consequences of a new diagnosis of epilepsy on an individual, their family, household, and community which are often specific to the health and social system of each country.
%Z FOR Codes: 110901


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra
%A Negin, Joel
%A Hersch, Fred
%A Dalipanda, Tenneth
%A Jagilli, Rooney
%A Houasia, Patrick
%A Gorringe, Lilijana
%A Christie, Annie
%T Telemedicine in the Solomon Islands: 2006 to 2009.
%B Journal of Telemedicine and Telecare
%D 2011
%C United Kingdom
%I Royal Society of Medicine Press Ltd.
%V 17
%N 5
%P 251-256
%@ 1758-1109
%X Telemedicine has been used in the Solomon Islands since 2000. We used quantitative and qualitative methods to examine telemedicine use in the Solomon Islands from January 2006 to June 2009. During the study period 66 telemedicine cases were submitted to the store and forward telemedicine system being used there. These included orthopaedic, oncology, cardiothoracic, infectious, congenital, gastroenterology and dermatology cases. Most cases (52%) were submitted by doctors at the National Referral Hospital (NRH) in Honiara. The majority of responses came from the NRH (27%). A final, firm recommendation regarding patient diagnosis and/or care was given for 46% of the cases. Interviews were conducted with 23 stakeholders in the Solomon Islands and in Australia to better understand the current and future use of telemedicine. The interviews identified the fragility of the Solomon Islands infrastructure, including the lack of training, as the largest barrier to the future use of telemedicine. The best use of telemedicine appears to be case sharing within the Solomon Islands, with connections to clinicians in other countries as a secondary benefit when particular expertise is required.
%Z FOR Codes: 80614 111715


%0 Journal Article
%~ PubMed
%A Abimbola, Seye
%A Martiniuk, Alexandra L C
%A Hackett, Maree L
%A Anderson, Craig S
%T The Influence of Design and Definition on the Proportion of General Epilepsy Cohorts with Remission and Intractability.
%B Neuroepidemiology
%D 2011
%C Switzerland
%I S. Karger AG
%V 36
%N 3
%P 204-12
%@ 1423-0208
%X Remission while on anti-epileptic drug (AED) therapy and remission off AED are the only prognostic criteria defined by the International League against Epilepsy (ILAE), defining remission as 5 seizure-free years. Prognosis studies in epilepsy have investigated other prognostic categories using different designs and definitions. This systematic review explores factors that explain discrepancies in the proportion of patients reported with commonly studied prognostic categories in general epilepsy cohorts. Thirty publications (reporting 37 studies) were included. The outcome categories were classified as immediate remission (5 studies), remission off medication (7 studies), remission on or off medication (15 studies), intractability (9 studies) and no remission after relapse (1 study). The findings show the importance of qualifying estimates specifically by how they were defined in each study, study design, setting and patient population as these have implications for patient management and counselling. The ILAE should define the outcome measures and terminology to which researchers should be required to adhere in subsequent updates of their guidelines on research related to remission and intractability.
%Z FOR Codes: 111706 111706


%0 Journal Article
%~ PubMed
%A Lam, E K K
%A Batty, G D
%A Huxley, R R
%A Martiniuk, A L C
%A Barzi, F
%A Lam, T H
%A Lawes, C M M
%A Giles, G G
%A Welborn, T
%A Ueshima, H
%A Tamakoshi, A
%A Woo, J
%A Kim, H C
%A Fang, X
%A Czernichow, S
%A Woodward, M
%A , on behalf of the Asia Pacific Cohort Studies Collaboration
%T Associations of diabetes mellitus with site-specific cancer mortality in the Asia-Pacific region.
%B Annals of oncology : official journal of the European Society for Medical Oncology / ESMO
%D 2010
%C United Kingdom
%I Oxford University Press
%V 22
%N 3
%P 730-8
%@ 1569-8041
%X Owing to the increasing prevalence of obesity and diabetes in Asia, and the paucity of studies, we examined the influence of raised blood glucose and diabetes on cancer mortality risk. Materials and methods: Thirty-six cohort Asian and Australasian studies provided 367,???361 participants (74% from Asia); 6% had diabetes at baseline. Associations between diabetes and site-specific cancer mortality were estimated using time-dependent Cox models, stratified by study and sex, and adjusted for age.
%Z FOR Codes: 111299 110306


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra
%A Lee, Crystal My
%A Woodward, Mark
%A Huxley, Rachel
%T Burden of Lung Cancer Deaths due to Smoking for Men and Women in the WHO Western Pacific and South East Asian Regions.
%B Asian Pacific Journal of Cancer Prevention
%D 2010
%C Thailand
%I Asian Pacific Organization for Cancer Prevention
%V 11
%N 1
%P 67-72
%@ 1513-7368
%X Introduction: Eighty percent of all smokers live in low and middle-income countries ofthe Asia Pacific region but actual estimates of the burden of disease due to smoking in the region have yet to be quantified. Methods: The burden of lung cancer due to smoking for all countries in the WHO Western Pacific and South East Asian regions was calculated from the population attributable fractions (PAFs). Nationally representative sex-specific prevalences of smoking were obtained from the World Health Organization, MEDLINE and/or national government documents and hazard ratios (HR) for lung cancer due to smoking in Asian and non-Asian populations were obtained from published data. The HR and prevalence were then used to calculate PAFs for lung cancer deaths due to smoking, by gender and by country. Results: The national prevalence of smoking in the Asia Pacific region ranged from 18-65% in men and from 0-50% in women. The fraction of lung cancer deaths attributable to smoking ranged from 0-40% in Asian women and from 21-49% in Asian men. In ANZ, PAFs were as high as 80% for women and 68% for men. Future estimates of theburden of smoking-related lung cancer in Asia were obtained by assuming a continuation of current smoking habits in these populations. By extrapolating the higher HR from the ANZ region to Asia, resulted in an increase in the PAFs to 4-90% in women and from 62-85% in men. Conclusion: The current burden of lung-cancer due to smoking in the Asia-Pacific region is substantial accounting for up to 50% of deaths from the disease in men and up to 40% in women depending on the country. If current smoking habits in Asia remain unchanged then the number of people dying from smoking-related lung cancer over the next couple of decades is expected to double. It is known that the majority of lung cancer is due to smoking. This is the first paper to systematically compare current burdens of lung cancer deaths due to smoking in countries in the Western Pacific and South East Asia and by gender. Findings from this paper demonstrate the number of lung cancer deaths that could be prevented if the prevalence of smoking was eliminated.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Ivers, Rebecca Q
%A Glozier, Nick
%A Patton, George C
%A Senserrick, Teresa
%A Boufous, Soufiane
%A Lam, Lawrence T
%A Williamson, Ann
%A Stevenson, Mark
%A Woodward, Mark
%A Norton, Robyn
%T Does Psychological Distress Increase the Risk for Motor Vehicle Crashes in Young People? Findings From the DRIVE Study.
%B Journal of Adolescent Health
%D 2010
%C United States
%I Elsevier Inc.
%V 47
%N 5
%P 488-495
%@ 1879-1972
%X PURPOSE: Earlier research demonstrates increased and decreased risk of crash related to psychological distress; however, previous literature has almost entirely used retrospective study designs and has not been able to adequately control for important confounders such as exposure to driving, alcohol and drug use, or having had a previous crash. This study aimed to assess the relationship between psychological distress and risk of motor vehicle crashes. METHODS: The DRIVE study is a prospective cohort study of 20,822 novice drivers aged 17-24 years in Australia. Information on risk factors for motor vehicle crash was collected through online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyze risk of various crash types by low, moderate, high, and very high levels of psychological distress, taking into account other known risk factors for crash. RESULTS: Compared to the referent group with low or no distress, a protective effect against crash was observed for young people who reported a moderate amount of psychological distress in unadjusted (RR = .87; 95% CI = .76-1.00) and multivariable analyses (RR = .85; 95% CI = .74-.97). Severe psychological distress was not significantly associated with an increase or decrease in the risk of crash. Psychological distress was not significantly associated with an increased risk of single vehicle crash. CONCLUSION: Earlier studies may have overestimated risk for motor vehicle crashes associated with psychological distress. This study found little convincing evidence to support a strong risk relationship for higher levels of distress and indeed found a modest protective association for low levels of distress.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Secco, Mary
%A Yake, Laura
%A Speechley, Kathy N
%T Evaluating the effect of a television public service announcement about epilepsy.
%B Health education research
%D 2010
%C United States, Franc
%I Oxford University Press
%V 25
%N 6
%P 1050-60
%@ 1465-3648
%X Public service announcements (PSAs) are non-commercial advertisements aiming to improve knowledge, attitudes and/or behavior. No evaluations of epilepsy PSAs exist. This study sought to evaluate a televised PSA showing first aid for a seizure. A multilevel regression analysis was used to determine the effect of the PSA on epilepsy knowledge and attitudes taking into account school-level clustering as well as individual-level variables, including socioeconomic status, gender, language and familiarity with epilepsy. Of the 803 randomly selected Grade 5 (9-11 years) students, 406 (51%) had seen the epilepsy PSA. Those who saw the PSA scored significantly higher on knowledge (P < 0.001) and had more positive attitudes (P < 0.001) about epilepsy. Those who saw the PSA had even greater knowledge about epilepsy 1 month later, even though the PSA was no longer being televised. Having viewed, the PSA continued to be associated with higher knowledge and more positive attitudes independent of the effects of a school-based epilepsy education program.
%Z FOR Codes: 111712


%0 Journal Article
%~ PubMed
%A Chen, H Y
%A Senserrick, T
%A Martiniuk, A L C
%A Ivers, R Q
%A Boufous, S
%A Chang, H Y
%A Norton, R
%T Fatal crash trends for Australian young drivers 1997-2007: Geographic and socioeconomic differentials.
%B Journal of Safety Research
%D 2010
%C United Kingdom, Unit
%I Pergamon
%V 41
%N 2
%P 123-128
%@ 1879-1247
%X BACKGROUND: Little has been published on changes in young driver fatality rates over time. This paper examines differences in Australian young driver fatality rates over the last decade, examining important risk factors including place of residence and socioeconomic status (SES). METHODS: Young driver (17-25years) police-recorded passenger vehicle crashes were extracted from New South Wales State records from 1997-2007. Rurality of residence and SES were classified into three levels based on drivers'' residential postcode: urban, regional, or rural; and high, moderate, or low SES areas. Geographic and SES disparities in trends of fatality rates were examined by the generalized linear model. Chi-square trend test was used to examine the distributions of posted speed limits, drinking driving, fatigue, seatbelt use, vehicle age, night-time driving, and the time from crash to death across rurality and socioeconomic status. RESULTS: Young driver fatality rate significantly decreased 5% per year (p<0.05); however, stratified analyses (by rurality and by SES) showed that only the reduction among urban drivers was significant (average 5% decrease per year, p<0.01). The higher relative risk of fatality for rural versus urban drivers, and for drivers of low versus high SES remained unchanged over the last decade. High posted speed limits, fatigue, drink driving and seatbelt non-use were significantly associated with rural fatalities, whereas high posted speed limit, fatigue, and driving an older vehicle were significantly related to low SES fatality. CONCLUSION: The constant geographic and SES disparities in young driver fatality rates highlight safety inequities for those living in rural areas and those of low SES. Better targeted interventions are needed, including attention to behavioral risk factors and vehicle age.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Kardamanidis, Katina
%A Martiniuk, Alexandra
%A Ivers, Rebecca Q
%A Stevenson, Mark R
%A Thistlethwaite, Katrina
%T Motorcycle rider training for the prevention of road traffic crashes.
%B Cochrane Database of Systematic Reviews
%D 2010
%C United Kingdom
%I John Wiley & Sons Ltd.
%V 10
%N 
%P CD005240
%@ 1469-493X
%X BACKGROUND: Riding a motorcycle (a two-wheeled vehicle that is powered by a motor and has no pedals) is associated with a high risk of fatal crashes, particularly in new riders. Motorcycle rider training has therefore been suggested as an important means of reducing the number of crashes, and the severity of injuries. OBJECTIVES: To quantify the effectiveness of pre- and post-licence motorcycle rider training on the reduction of traffic offences, traffic crash involvement, injuries and deaths of motorcycle riders. SEARCH STRATEGY: We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library 2008, Issue 3), TRANSPORT, MEDLINE, EMBASE, CINAHL, WHOLIS (World Health Organization Library Information System), PsycInfo, LILACS (Latin American and Caribbean Health Sciences), ISI Web of Science: Social Sciences Citation Index (SSCI), ERIC, ZETOC and SIGLE. Database searches covered all available dates up to October 2008. We also checked reference lists of relevant papers and contacted study authors in an effort to identify published, unpublished and ongoing trials related to motorcycle rider training. SELECTION CRITERIA: We included all relevant intervention studies such as randomised and non-randomised controlled trials, interrupted time-series and observational studies such as cohort and case-control studies. DATA COLLECTION AND ANALYSIS: Two review authors independently analysed data about the study population, study design and methods, interventions and outcome measures as well as data quality from each included study, and compared the findings. We resolved differences by discussion with a third review author. MAIN RESULTS: We reviewed 23 studies: three randomised trials, two non-randomised trials, 14 cohort studies and four case-control studies. Five examined mandatory pre-licence training, 14 assessed non-mandatory training, three of the case-control studies assessed ''any'' type of rider training, and one case-control study assessed mandatory pre-licence training and non-mandatory training. The types of assessed rider training varied in duration and content.Most studies suffered from serious methodological weaknesses. Most studies were non-randomised and controlled poorly for confounders. Most studies also suffered from detection bias due to the poor use of outcome measurement tools such as the sole reliance upon police records or self-reported data. Small sample sizes and short follow-up time after training were also common. AUTHORS'' CONCLUSIONS: Due to the poor quality of studies identified, we were unable to draw any conclusions about the effectiveness of rider training on crash, injury, or offence rates. The findings suggest that mandatory pre-licence training may be an impediment to completing a motorcycle licensing process, possibly indirectly reducing crashes through a reduction in exposure.??It is not clear if training (or what type) reduces the risk of crashes, injuries or offences in motorcyclists, and a best rider training practice can therefore not be recommended. As some type of rider training is likely to be necessary to teach motorcyclists to ride a motorcycle safely, rigorous research is needed.
%Z FOR Codes: 111799


%0 Journal Article
%~ PubMed
%A Samb, Badara
%A Desai, Nina
%A Nishtar, Sania
%A Mendis, Shanti
%A Bekedam, Henk
%A Wright, Anna
%A Hsu, Justine
%A Martiniuk, Alexandra
%A Celletti, Francesca
%A Patel, Kiran
%A Adshead, Fiona
%A McKee, Martin
%A Evans, Tim
%A Alwan, Ala
%A Etienne, Carissa
%T Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.
%B Lancet
%D 2010
%C United Kingdom
%I The Lancet Publishing Group
%V 376
%N 9754
%P 1785-1797
%@ 0140-6736
%X National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries'' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening.
%Z FOR Codes: 111708


%0 Journal Article
%~ PubMed
%A Chen, H Y
%A Senserrick, T
%A Chang, H Y
%A Ivers, R Q
%A Martiniuk, A L C
%A Boufous, S
%A Norton, R
%T Road crash trends for young drivers in New South Wales, Australia, from 1997 to 2007.
%B Traffic Injury Prevention
%D 2010
%C United States
%I Taylor & Francis Inc.
%V 11
%N 1
%P 8-15
%@ 1538-957X
%X OBJECTIVES: The objective of this article was to explore overall crash and injury trends over the past decade for young drivers residing in New South Wales (NSW), Australia, including gender and age disparities. METHODS: Passenger vehicle crashes for drivers aged 17-25 occurring during 1997-2007 were extracted from the state crash database to calculate crash rates (per licensed driver). Generalized linear models were used to examine crash trends over time by severity of driver injury, adjusting for age, gender, rurality of residence, and socioeconomic status. Yearly adjusted relative risks of crash by gender and by age group were also examined over the study period. RESULTS: Young driver noninjury and fatality rates significantly decreased by an average of 4 percent (95% CI: 4-5) and 5 percent (95% CI: 0-9) respectively each year from 1997 to 2007. Young driver injury rates significantly increased by about 12 percent (95% CI: 9-14) to the year 2001 and then significantly decreased. The relative risk of crash (regardless of driver injury) for males compared to females significantly decreased over time. Compared to drivers aged 21-25, drivers aged 17 and particularly 18- to 20-year-olds had significantly and consistently higher crash risks across the study period. CONCLUSIONS: Overall, there has been a significant decline in young driver crashes in NSW over the last decade. Regardless of injury severity, males'' risk of crash has reduced more than female young drivers, but drivers aged 17 continue to be at higher risk. These findings provide feedback on potential road safety successes and areas needing specific interventions for future improvements.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Glozier, Nicholas
%A Martiniuk, Alexandra
%A Patton, George
%A Ivers, Rebecca
%A Li, Qiang
%A Hickie, Ian
%A Senserrick, Teresa
%A Woodward, Mark
%A Norton, Robyn
%A Stevenson, Mark
%T Short sleep duration in prevalent and persistent psychological distress in young adults: the DRIVE study.
%B Sleep
%D 2010
%C United States
%I The American Academy of Sleep Medicine
%V 33
%N 9
%P 1139-1145
%@ 0161-8105
%X OBJECTIVES: Young people are sleeping less. Short sleep duration has a range of negative consequences including a hypothesized link with psychological distress, which has yet to be studied DESIGN: Prospective cohort study SETTING: Community-based sample from Australia PARTICIPANTS: Twenty thousand (20,822) young adults (aged 17-24) identified through the state vehicle licensing authority. A random sample (n = 5000) was approached for follow-up 12-18 months later, with 2837 providing full data. MAIN OUTCOME MEASURE: Psychological distress, determined by a Kessler 10 score > 21, at baseline; and as both onset and persistence of distress at follow-up. RESULTS: Shorter sleep duration was linearly associated with prevalent psychological distress: relative risk (RR) 1.14 (95% CI 1.12 to 1.15). Only the very short (< 5 h) sleepers among those not distressed at baseline had an increased risk for onset of psychological distress (RR 3.25 [95% CI 1.84, 5.75]). Of 945 cohort participants reporting psychological distress at baseline, 419 (44%) were distressed at follow-up. Each hour less of sleep increased the risk of psychological distress persisting after adjustment for potential confounding variables: RR 1.05 (95% CI 1.01 to 1.10). Long sleep duration showed no association with distress at any time point. CONCLUSIONS: Self-reported shorter sleep duration is linearly associated with prevalent and persistent psychological distress in young adults. In contrast, only the very short sleepers had a raised risk of new onset of distress. Different approaches to sleep duration measurement yield different results and should guide any interventions to improve subjective sleep duration in young adults.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Chen, H Y
%A Ivers, R Q
%A Martiniuk, A L C
%A Boufous, S
%A Senserrick, T
%A Woodward, M
%A Stevenson, M
%A Norton, R
%T Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.
%B Journal of epidemiology and community health
%D 2010
%C United Kingdom, Spai
%I BMJ Group
%V 64
%N 11
%P 998-1003
%@ 1470-2738
%X Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Schull, Michael J
%A Banda, Hastings
%A Kathyola, Damson
%A Fairall, Lara
%A Martiniuk, Alexandra
%A Burciul, Barry
%A Zwarenstein, Merrick
%A Sodhi, Sumeet
%A Thompson, Sandy
%A Joshua, Martias
%A Mondiwa, Martha
%A Bateman, Eric
%T Strengthening health human resources and improving clinical outcomes through an integrated guideline and educational outreach in resource-poor settings: a cluster-randomized trial.
%B Trials
%D 2010
%C United Kingdom
%I BioMed Central Ltd.
%V 11
%N 
%P 118
%@ 1745-6215
%X In low-income countries, only about a third of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) patients eligible for anti-retroviral treatment currently receive it. Providing decentralized treatment close to where patients live is crucial to a faster scale up, however, a key obstacle is limited health system capacity due to a shortage of trained health-care workers and challenges of integrating HIV/AIDS care with other primary care services (e.g. tuberculosis, malaria, respiratory conditions). This study will test an adapted primary care health care worker training and guideline intervention, Practical Approach to Lung Health and HIV/AIDS Malawi (PALM PLUS), on staff retention and satisfaction, and quality of patient care.
%Z FOR Codes: 110309 111712


%0 Journal Article
%~ PubMed
%A Chen, H Y
%A Ivers, R Q
%A Martiniuk, A L C
%A Boufous, S
%A Senserrick, T
%A Woodward, M
%A Stevenson, M
%A Williamson, A
%A Norton, R
%T Risk and type of crash among young drivers by rurality of residence: findings from the DRIVE Study.
%B Accident Analysis & Prevention
%D 2009
%C United Kingdom
%I Elsevier Ltd
%V 41
%N 4
%P 676-682
%@ 0001-4575
%X BACKGROUND: Most previous literature on urban/rural differences in road crashes has a primary focus on severe injuries or deaths, which may be largely explained by variations of medical resources. Little has been reported on police-reported crashes by geographical location, or crash type and severity, especially among young drivers. METHODS: DRIVE is a prospective cohort study of 20,822 drivers aged 17-24 in NSW, Australia. Information on risk factors was collected via online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyse risk of various crash types by three levels of rurality of residence: urban, regional (country towns and surrounds) and rural. RESULTS: Compared to urban drivers, risk of crash decreased with increasing rurality (regional adjusted RR: 0.7, 95% CI 0.6-0.9; rural adjusted RR: 0.5, 95% CI 0.3-0.7). Among those who crashed, risk of injurious crash did not differ by geographic location; however, regional and rural drivers had significantly higher risk of a single versus multiple vehicle crash (regional adjusted RR 1.8, 95% CI 1.3-2.5; rural adjusted RR: 2.0, 95% CI 1.1-3.6), which was explained by speeding involvement and road alignment at the time or site of crash. CONCLUSIONS: Although young urban drivers have a higher crash risk overall, rural and regional residents have increased risk of a single vehicle crash. Interventions to reduce single vehicle crashes should aim to address key issues affecting such crashes, including speeding and specific aspects of road geometry.
%Z FOR Codes: 111706


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Ivers, Rebecca Q
%A Glozier, Nick
%A Patton, George C
%A Lam, Lawrence T
%A Boufous, Soufiane
%A Senserrick, Teresa
%A Williamson, Ann
%A Stevenson, Mark
%A Norton, Robyn
%T Self-harm and risk of motor vehicle crashes among young drivers: findings from the DRIVE Study.
%B CMAJ
%D 2009
%C Canada
%I Canadian Medical Association
%V 181
%N 11
%P 807-812
%@ 1488-2329
%X BACKGROUND: Some motor vehicle crashes, particularly single-vehicle crashes, may result from intentional self-harm. We conducted a prospective cohort study to assess the risk that intentional self-harm poses for motor vehicle crashes among young drivers. METHODS: We prospectively linked survey data from newly licensed drivers aged 17-24 years to data on licensing attempts and police-reported motor vehicle crashes during the follow-up period. We investigated the role of recent engagement in self-harm on the risk of a crash. We took into account potential confounders, including number of hours of driving per week, psychological symptoms and substance abuse. RESULTS: We included 18 871 drivers who participated in the DRIVE Study for whom data on self-harm and motor vehicle crashes were available. The mean follow-up was 2 years. Overall, 1495 drivers had 1 or more crashes during the follow-up period. A total of 871 drivers (4.6%) reported that they had engaged in self-harm in the year before the survey. These drivers were at significantly increased risk of a motor vehicle crash compared with drivers who reported no self-harm (relative risk [RR] 1.42, 95% confidence interval [CI] 1.15-1.76). The risk remained significant, even after adjustment for age, sex, average hours of driving per week, previous crash, psychological distress, duration of sleep, risky driving behaviour, substance use, remoteness of residence and socio-economic status (RR 1.37, 95% CI 1.09-1.72). Most of the drivers who reported self-harm and had a subsequent crash were involved in a multiple-vehicle crash (84.1% [74/88]). INTERPRETATION: Engagement in self-harm behaviour was an independent risk factor for subsequent motor vehicle crash among young drivers, with most crashes involving multiple vehicles.
%Z FOR Codes: 111799


%0 Journal Article
%~ PubMed
%A Ansary-Moghaddam, Alireza
%A Martiniuk, Alexandra
%A Lam, Tai-Hing
%A Jamrozik, Konrad
%A Tamakoshi, Akiko
%A Fang, Xianghua
%A Suh, Il
%A Barzi, Federica
%A Huxley, Rachel
%A Woodward, Mark
%T Smoking and the risk of upper aero digestive tract cancers for men and women in the Asia-Pacific region.
%B International Journal of Environmental Research and Public Health
%D 2009
%C Switzerland
%I Molecular Diversity Preservation International (M
%V 6
%N 4
%P 1358-1370
%@ 1660-4601
%X Although smoking is an established causal factor for upper aero digestive tract cancer (UADTC), most of the evidence originates from the West. Thus, we analysed data from 455,409 subjects in the Asia Pacific Cohort Studies Collaboration. Over a median of around six years follow-up, 371 deaths from UADTC were observed. The hazard ratio (95% confidence interval) for current smokers, compared with those who had never smoked, was 2.36 (1.76 - 3.16), adjusted for age and alcohol drinking. Tobacco control policies are urgently required in Asia to prevent millions of deaths from UADTC that smoking will otherwise cause.
%Z FOR Codes: 111299 111705


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Millar, Heather C
%A Malefoasi, George
%A Vergeer, Petra
%A Garland, Trevor
%A Knight, Simon
%T Cooperation, Integration, and Long-term Commitment: What Solomon Islanders and Development Workers Say About Health Sector Aid.
%B Asia-Pacific Journal of Public Health
%D 2008
%C United States
%I Sage Science Press
%V 20
%N 4
%P 287-297
%@ 1010-5395
%X INTRODUCTION: The Solomon Islands is experiencing instability and insecurity and also a concomitant increase in aid. This article aims to address the need for theoretical coordination frameworks to be further informed by the actual experiences, requirements, and views of the recipients of aid. METHODS: Qualitative research techniques were used to better understand governmental and nongovernmental leaders'' views of health sector aid in the Solomon Islands. Data were collected using previously published literature, government and nongovernmental documents, and in-person interviews. RESULTS: Two key themes emerged from the interviews: the need for coordination and integration of aid and the need for this integration to occur over the long-term. These themes are presented using quotations from key informants. CONCLUSION: Themes and quotations arising from the analyses may assist in understanding theoretical frameworks for coordination, particularly in postconflict states. Future needs regarding mechanisms of collaboration in the Solomons are also discussed.
%Z FOR Codes: 1117


%0 Journal Article
%~ PubMed
%A Woodward, Mark
%A Martiniuk, Alexandra
%A Ying Lee, Crystal
%A Lam, Tai
%A Vanderhoorn, Stephen
%A Ueshima, Hirotsugu
%A Fang, Xianghua
%A Kim, Hyeon
%A Rodgers, Anthony
%A Patel, Anushka
%A Jamrozik, Konrad
%A Huxley, Rachel
%A , for the Asia Pacific Cohort Studies Collaboration
%T Elevated total cholesterol: its prevalence and population attributable fraction for mortality from coronary heart disease and ischaemic stroke in the Asia-Pacific region.
%B European Journal of Cardiovascular Prevention and Rehabilitation
%D 2008
%C France
%I Lippincott Williams and Wilkins
%V 15
%N 4
%P 397-401
%@ 1741-8267
%X BACKGROUND: About half of the world''s cases of cardiovascular disease occur in the Asia-Pacific region. The contribution of serum total cholesterol (TC) to this burden is poorly quantified. DESIGN: The most recent nationally representative data on TC distributions for countries in the region were sought. Individual participant data from 380 483 adults in the Asia Pacific Cohort Studies Collaboration were used to estimate associations between TC and cardiovascular disease. METHODS: High TC was defined as >/=6.2 mmol/l, and nonoptimal TC as >/=3.8 mmol/l. Hazard ratios for fatal coronary heart disease (CHD) and ischaemic stroke (IS) were found from Cox models. Sex-specific population attributable fractions for high TC and nonoptimal TC were estimated for each country. The former used conventional methods, based on single measures of TC and a fixed dichotomy of risk strata; the latter took account of the continuous positive association between TC and both CHD and IS and regression dilution. RESULTS: Data were available from 16 countries. Where reported, the prevalence of high TC ranged from 4 to 27%. The fraction of fatal CHD and IS attributable to high TC ranged from 0 to 14% and 0 to 15%, respectively. Although leaving the relative ranking of countries much the same, the fractions estimated for nonoptimal TC were typically at least twice as big, ranging from 0 to 47% and 0 to 35%, respectively. CONCLUSION: Conventional methods for estimating disease burden severely underestimate the effect of TC. Cholesterol-lowering strategies could have a tremendous effect in reducing cardiovascular deaths in this populous region.
%Z FOR Codes: 111716


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Speechley, Kathy N
%A Secco, Mary
%A Karen Campbell, M
%T Development and psychometric properties of the Thinking about Epilepsy questionnaire assessing children's knowledge and attitudes about epilepsy.
%B Epilepsy & Behavior
%D 2007
%C United States
%I Academic Press
%V 10
%N 4
%P 595-603
%@ 1525-5050
%X OBJECTIVE: Epilepsy is the most common neurological disorder in the world, yet it is still widely misunderstood. A lack of knowledge and negative attitudes about epilepsy are largely blamed for the stigma felt by people with epilepsy and their families. Recent calls for research into stigma have been made by the World Health Organization and international epilepsy organizations. Our objective is to describe the development, structure, and psychometric properties of the Thinking about Epilepsy questionnaire. METHODS: A 36-item questionnaire was designed to assess Grade 5 (ages 9-11) students'' knowledge of and attitudes about epilepsy and to evaluate changes in knowledge and attitudes following an epilepsy education program. The questionnaire contains 18 knowledge, 10 attitude, and 8 demographic questions. RESULTS: Psychometric properties of the Thinking about Epilepsy questionnaire were ascertained using data from 783 Grade 5 students. Three items (one knowledge item and two attitude items) were removed prior to the factor analysis due to their low extraction communalities. Factor analysis revealed a bidimensional structure (knowledge and attitudes) with five knowledge factors and two attitude factors. The questionnaire was found to have good internal consistency reliability (Cronbach''s alpha=0.74 for knowledge and 0.82 for attitudes). Both the knowledge and attitude measures were deemed to have acceptable face, content, and construct validity. CONCLUSION: The final 33-item Thinking about Epilepsy questionnaire demonstrates adequate reliability for the knowledge measure, good reliability for the attitude measure, and excellent validity for both measures. The Thinking about Epilepsy questionnaire offers a viable option for assessing elementary school students'' knowledge and attitudes regarding epilepsy in general or in conjunction with its affiliated Thinking about Epilepsy education program.
%Z FOR Codes: 1701


%0 Journal Article
%~ PubMed
%A Martiniuk, A L C
%A Speechley, K N
%A Secco, M
%A Campbell, M K
%A Donner, A
%T Evaluation of an epilepsy education program for Grade 5 students: a cluster randomized trial.
%B Epilepsy & Behavior
%D 2007
%C United States
%I Academic Press
%V 10
%N 4
%P 604-610
%@ 1525-5050
%X OBJECTIVE: Epilepsy is a common and often highly stigmatized disorder. Several international organizations indicate a need to assess the stigma that exists and to develop and evaluate interventions to dispel myths about epilepsy. METHODS: A stratified cluster randomized controlled trial evaluated whether an epilepsy education program (intervention) increases knowledge of and positive attitudes about epilepsy in Grade 5 students (ages 9-11). The study also investigated characteristics of the individuals (gender, language spoken at home, familiarity with epilepsy) and schools (Catholic vs public, size of school, and school level socioeconomic status) that affect epilepsy knowledge and attitudes. We assessed epilepsy knowledge and attitudes at baseline and 1 month following the program using a 33-item questionnaire. RESULTS: In total, 24 schools (783 individuals) were cluster randomized. Those in the intervention group had an average 11.8-point increase (95% confidence interval (CI)=11.4-12.5) in knowledge 1 month following the program, compared with the control group increase of 2.2 points (95% CI=1.8-2.6) out of a total of 57 points. For attitudes, the intervention group had a mean increase of 8.15 points (95% CI=4.70-11.60), compared with the control group increase of 1.64 points (95% CI=-0.84-4.42) out of a total of 50 points. The intervention was responsible for 63% of the variation in postprogram epilepsy knowledge and 28% of the variation in postprogram attitudes about epilepsy. CONCLUSIONS: The epilepsy education program was associated with a significant increase in epilepsy knowledge and positive attitudes in the intervention group 1 month later compared with the control group.
%Z FOR Codes: 1701


%0 Journal Article
%~ PubMed
%A Martiniuk, Alexandra L C
%A Lee, Crystal M Y
%A Lawes, Carlene M M
%A Ueshima, Hirotsugu
%A Suh, Il
%A Lam, Tai Hing
%A Gu, Dongfeng
%A Feigin, Valery
%A Jamrozik, Konrad
%A Ohkubo, Takayoshi
%A Woodward, Mark
%A , Asia-Pacific Cohort Studies Collaboration
%T Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region.
%B Journal of Hypertension
%D 2007
%C United Kingdom
%I Lippincott Williams & Wilkins
%V 25
%N 1
%P 73-79
%@ 0263-6352
%X OBJECTIVE: About half of the world''s burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. METHODS: The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600,000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. RESULTS: In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. CONCLUSIONS: In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.
%Z FOR Codes: 111799 110201


%0 Journal Article
%~ PubMed
%A Lee, Crystal Man Ying
%A Huxley, Rachel R
%A Lam, Tai Hing
%A Martiniuk, Alexandra Lynda Conboy
%A Ueshema, Hirotsugu
%A Pan, Wen-Harn
%A Welborn, Tim
%A Woodward, Mark
%A , Asia Pacific Cohort Studies Collaboration
%T Prevalence of diabetes mellitus and population attributable fractions for coronary heart disease and stroke mortality in the WHO South-East Asia and Western Pacific regions.
%B Asia Pacific Journal of Clinical Nutrition
%D 2007
%C 54 University St,P O
%I Blackwell Publishing Asia
%V 16
%N 1
%P 187-192
%@ 0964-7058
%X The aims of this study were to obtain the most recent representative data for the prevalence of diabetes in adult populations in the World Health Organisation''s South-East Asia and Western Pacific regions and to quantify the contribution of diabetes to the burden of mortality from cardiovascular diseases in these regions. Previous reports indicate that there are 83 million individuals with diabetes in the Asia-Pacific region, but since many of the country-specific estimates were not from nationally representative studies, this figure may not accurately reflect the current burden of diabetes. Information on the prevalence of diabetes was obtained by searching Medline and government health websites. Data were available from 12 countries representing 78% of the total population of the Asia-Pacific region. Six of 10 countries with complete data reported a prevalence of diabetes exceeding those estimates currently cited by the World Health Organization; three of which have also already exceeded the World Health Organization projections for 2030. In the 12 countries in the region with nationally representative data, the prevalence of diabetes ranged from 2.6% to 15.1%. Hazard ratios from the Asia Pacific Cohort Studies Collaboration were used to calculate population attributable fractions for diabetes for fatal cardiovascular diseases in the region. Population attributable fractions ranged from 2% to 12% for coronary heart disease, 1% to 6% for haemorrhagic stroke, and 2% to 11% for ischaemic stroke. Accurate estimates of the prevalence of diabetes are of great importance and standard methods are needed for periodic surveillance across the Asia-Pacific region and elsewhere.
%Z FOR Codes: 111715