Publications (9)15.62 Total impact
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Article: Can long-term impairment in general practitioner whiplash patients be predicted using screening and patient-reported outcomes?
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ABSTRACT: The objective of this prospective pilot study was to investigate the predictors of outcome at 6 months for whiplash-associated disorder in a general practitioner primary care population. Psychosocial screening questionnaires, patient-reported outcomes of cervical functional impairment, demographic and accident-specific data have been indicated as predictive of future recovery status and treatment requirements. Participants (n=30, age=37+/-14 years, 77% females) from eight general practitioners were initially screened with a modified Orebro Musculoskeletal Pain Questionnaire, and had recovery status monitored and classified for 6 months using both patient-reported outcomes, quantitatively (Neck Disability Index) and qualitatively (patient status self-classification). Analysis at two separate cutoff levels showed 30% of participants nonrecovered and 17% with moderate/severe impairment. Nonrecovery status and increased treatment was predicted by a 109-point screening score cutoff while moderate/severe impairment was predicted by including the presence of cervical rotation at impact. Initial cervical functional impairment status measured with the Neck Disability Index was sensitive but not specific for prediction. A larger population study investigating these protocols is warranted.International Journal of Rehabilitation Research 04/2008; 31(1):79-80. · 1.08 Impact Factor -
Article: Low levels of ambient air pollution during pregnancy and fetal growth among term neonates in Brisbane, Australia.
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ABSTRACT: There is mounting evidence that maternal exposure to ambient air pollution during pregnancy is associated with adverse birth outcomes. We examined birth weight and small for gestational age (SGA <10th percentile for age and gender) among 26,617 singleton full-term births in Brisbane, Australia (July 2000-June 2003), in relation to ambient pollution during pregnancy. We also examined head circumference (HC) and crown-heel length (CHL) among a sub-sample (n=21,432) of the term neonates. Maternal exposure to PM(10), visibility reducing particles (bsp), O(3) and NO(2) was assessed by calculating average exposure estimates over months and trimesters of pregnancy based on a citywide average of the pollutants. Linear and logistic regression models were employed to examine the effect of these pollutants on the birth outcomes after adjusting for potential confounders and season of birth. The regression coefficients were based on an inter-quartile range (IQR) increase in exposure as well as quartiles of exposure with the lowest used as a reference category. Trimester- and monthly specific exposures to all pollutants were not significantly associated with a reduction in either birth weight or HC, or an increased risk of SGA. An IQR increase in NO(2) during the third trimester was associated with a reduction in CHL (beta=-0.15cm, 95% CI -0.25 to -0.05cm) and this was concentrated around exposure during month nine. No other pollutants were associated with a reduction in CHL. In conclusion, there was no strong evidence suggesting that ambient air pollution during pregnancy is associated with sub-optimal fetal growth in Brisbane.Environmental Research 03/2007; 103(3):383-9. · 3.40 Impact Factor -
Article: The short-term effects of air pollution on daily mortality in four Australian cities.
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ABSTRACT: To examine the short-term health effects of air pollution on daily mortality in four Australian cities (Brisbane, Melbourne, Perth and Sydney), where more than 50% of Australians reside. The study used a similar protocol to APHEA2 (Air Pollution and Health: A European Approach) study and derived single-city and pooled estimates. The results derived from the different approaches for the 1996-99 period showed consistent results for different statistical models used. There were significant effects on total mortality, (RR = 1.0284 per 1 unit increase in nephelometry [10(-4).m(-1)], RR = 1.0011 per 1ppb increase in NO2), and on respiratory mortality (RR = 1.0022 per 1ppb increase in O3). No significant differences between cities were found, but the NO2 and particle effects may refer to the same impacts. Meta-analyses carried out for three cities yielded estimates for the increase in the daily total number of deaths of 0.2% (-0.8% to 1.2%) for a 10 microg/m3 increase in PM10 concentration, and 0.9% (-0.7% to 2.5%) for a 10 microg/m3 increase in PM2.5 concentration. Air pollutants in Australian cities have significant effects on mortality.Australian and New Zealand Journal of Public Health 07/2005; 29(3):205-12. · 1.20 Impact Factor -
Article: Multi-City Studies in Australia and New Zealand: the Impact of Air Pollution on Daily Mortality and Morbidity
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ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.Epidemiology 06/2004; 15(4):S54. · 5.57 Impact Factor -
Article: The short-term effects of air pollution on daily mortality on four Australian cities
ECU Publications. -
Article: Partitioned Regression Analysis Compared to Case-crossover Analysis
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Article: Investigating the time-varying effects of air pollution using distributed lagged models: A comparison of polynomial and window models
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Article: Air pollution and its health impacts: the changing panorama.
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ABSTRACT: Urban air pollution levels are associated with increased mortality and cardiorespiratory morbidity. These health effects occur even at exposure levels below those stipulated in current air-quality guidelines, and it is unclear whether a safe threshold exists. Air pollution in Australia and New Zealand comes primarily from motor vehicle emissions, electricity generation from fossil fuels, heavy industry, and home heating using wood and coal. In individual patients a direct link between symptoms and air pollution exposure may be difficult to establish and may not change their clinical management. However, avoiding exposure during periods of peak pollution may be beneficial. Although there is some evidence that urban air pollution in Australia and New Zealand has been decreasing (through reduced car use, improved emission-control technology and use of more energy-efficient devices in the household and in industry), pollution levels are still unsatisfactory. Further reductions may prevent hundreds of cardiorespiratory hospital admissions and deaths each year.The Medical journal of Australia 177(11-12):604-8. · 2.81 Impact Factor -
Article: The Upper Limb Functional Index: development and determination of reliability, validity, and responsiveness.
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ABSTRACT: Current upper limb regional self-report outcome measures are criticized for poor clinical utility, including length, ease, and time to complete and score, missing responses, and poor psychometric properties. To address these concerns a new measure, the Upper Limb Functional Index (ULFI), was developed with reliability, validity, and responsiveness being determined in a prospective study. Patients from nine Australian outpatient settings completed the ULFI and two established scales, the Disabilities of the Arm, Shoulder, and Hand (DASH) (n=214) and the Upper Extremity Functional Scale (UEFS) (n=64) concurrently to enable construct and criterion validity to be assessed. Two subgroups were used to assess test-retest reliability at 48-hour intervals (n=46) and responsiveness through distribution-based methods (n=29). Internal consistency, change scores, and missing responses were calculated. Practical characteristics of the scale were assessed. The ULFI correlated with the DASH (r=0.85; 95% CI) and UEFS (r=0.78; 95% confidence interval [CI]), demonstrated test-retest reliability (intraclass correlation coefficient=0.96; 95% CI) and internal consistency (Cronbach alpha=0.89). The change scores of the ULFI with standard error of the measurement was 4.5% or 1.13 ULFI-points and minimal detectable change at the 90% CI was 10.4% or 2.6 ULFI-points. Responsiveness indices were standardized response mean at 1.87 and effect size at 1.28. The ULFI demonstrated an impairment range of 0-100%, with no missing responses and a combined patient completion and therapist scoring time of less than 3 minutes. The ULFI demonstrated sound psychometric properties, practical characteristics, and clinical utility thereby making it a viable clinical outcome tool for the determination of upper limb status and impairment. The ULFI is suggested as the preferred upper limb regional tool due to its superior practical characteristics and clinical utility, and comparable psychometric properties without a tendency toward item redundancy.Journal of Hand Therapy 19(3):328-48; quiz 349. · 1.56 Impact Factor
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2005
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University of the Sunshine Coast
Gold Coast, Queensland, Australia
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