Rosana Elizabeth Pacella

University of Greenwich · Director of the Institute for Lifecourse Development

In addition to affecting quality of life, diabetic foot ulcers (DFUs) impose an economic burden on both patients and the health system. This study developed a Markov model to analyse the cost-effectiveness of implementing optimal care in comparison with the continuation of usual care for diabetic patients at high risk of DFUs in the Australian sett...

Chronic wounds cost the Australian health system at least US$2·85 billion per year. Wound care services in Australia involve a complex mix of treatment options, health care sectors and funding mechanisms. It is clear that implementation of evidence-based wound care coincides with large health improvements and cost savings, yet the majority of Austr...

Child sexual abuse is widespread and difficult to detect. To enhance case identification, many societies have enacted mandatory reporting laws requiring designated professionals, most often police, teachers, doctors and nurses, to report suspected cases to government child welfare agencies. Little research has explored the effects of introducing a...

Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childh...

This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years (N = 1091) and 20 years (N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories of peer aggression. Invol...

Research suggests that the dimensions of childhood maltreatment (type, age of onset, duration, frequency and perpetrator) play an important role in determining health and wellbeing outcomes, though little information is available on these dimensions for any care experienced cohorts. This study aimed to determine if any variation in maltreatment dim...

This study examined rates of mental health disorders and health risk behaviors in people with diverse gender identities and associations with five types of child maltreatment. We used data from the Australian Child Maltreatment Study (ACMS), a nationally representative survey of Australian residents aged 16 years and more, which was designed to und...

Background Numerous national public inquiries have highlighted the problem of child sexual abuse in religious organizations. Despite this, evidence of population-wide prevalence is scarce. Objective To provide the first nationally representative prevalence estimates of child sexual abuse perpetrated by adults in religious organizations in Australi...

This study aimed to explore key characteristics of the out-of-home care subgroup of a nationally representative Australian sample. To ensure that mental health services are appropriately targeted, it is critical that we understand the differential impacts of childhood experiences for this cohort. Using the Australian Child Maltreatment Study ( N =...

Sexual harassment inflicted by adolescents on their peers is a major public health issue, but its prevalence across childhood is not known. We provide the first nationally representative data on the prevalence of peer sexual harassment across childhood, using cross-sectional data from the Australian Child Maltreatment Study (ACMS). The ACMS surveye...

This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data ( N = 8503), 9.5% of participants identified with a...

Few studies have examined associations between child maltreatment and criminal justice system involvement using large nationally representative samples and comprehensive measures of self‑reported maltreatment. This study analyses nationally representative data from the Australian Child Maltreatment Study, which surveyed 8,500 Australians to obtain...

Background: Little evidence exists about the prevalence of child sexual abuse (CSA) inflicted by different relational classes of perpetrators (e.g., parents; institutional adults; adolescents), and by individual types of perpetrators (e.g., fathers and male relatives; male teachers and male clergy; known and unknown adolescents). Objective: To gene...

Corporal punishment is associated with adverse outcomes; however, little empirical data exists about the state of corporal punishment in Australia. This paper presents the first national prevalence estimates of experiences of corporal punishment during childhood among Australians and its use as adults by Australian parents and caregivers. We also r...

Dementia prevalence is increasing, with no cure at present. Drug therapies have potential side effects and risk of mortality. People with dementia are frequently offered non-pharmacological interventions to improve quality of life and relieve symptoms. Identifying which interventions are cost-effective is important due to finite resources in health...

Objectives To describe the aims, design, methodology, and respondent sample representativeness of the Australian Child Maltreatment Study (ACMS). Design, setting Cross-sectional, retrospective survey; computer-assisted mobile telephone interviewing using random digit dialling (computer-generated), Australia, 9 April – 11 October 2021. ParticipantsP...

Objectives To estimate the prevalence in Australia of each type of child maltreatment; to identify gender- and age group-related differences in prevalence. Design, setting Cross-sectional national survey; mobile telephone interviews using random digit dialling (computer-generated), Australia, 9 April – 11 October 2021. Retrospective self-report dat...

Objectives To examine the associations between experiences of child maltreatment and mental disorders in the Australian population.DesignPopulation-representative survey conducted by computer-assisted telephone interviewing. Setting, participants Australian residents aged 16 years and older. Main outcome measures Mental disorder diagnoses of lifeti...

Objectives To determine the prevalence in Australia of multi-type child maltreatment, defined as two or more maltreatment types (physical abuse, sexual abuse, emotional abuse, neglect, or exposure to domestic violence) and to examine its nature, family risk factors, and gender and age cohort differences. Design Retrospective cross-sectional survey...

Objective: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. Design, setting, participants: Nationally representative survey of Australian residents aged 16 years and older conducted by comput...

Objectives: To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Design, setting: Cross-sectional, retrospective survey using the Juvenile Victimization Questionnaire-R2: Adapted Version (Australian Child Maltreatment Study); computer-assisted mobile...

Background: To establish national prevalence of child maltreatment, reliable, valid and contextually appropriate measurement is needed. This paper outlines the refinement, adaptation and testing of child maltreatment sections of the Juvenile Victimization Questionnaire (JVQ)-R2 for use in the Australian context. Methods: Three phases were undert...

Aims: The provision of guideline-based care for patients with diabetes-related foot ulcers (DFU) in clinical practice is sub-optimal. We estimated the cost-effectiveness of higher rates of guideline-based care, compared with current practice. Methods: The costs and quality-adjusted life-years (QALYs) associated with current practice (30% of pati...

Background. Globally, a growing body of research has shown that ambient air pollution is one of the most critical environmental issues, especially in relation to human health. Exposure to ambient air pollution leads to serious health conditions such as lower respiratory infections, cancers, diabetes mellitus type 2, ischaemic heart disease, stroke...

Background. Household air pollution (HAP) due to the use of solid fuels for cooking is a global problem with significant impacts on human health, especially in low- and middle-income countries. HAP remains problematic in South Africa (SA). While electrification rates have improved over the past two decades, many people still use solid fuels for coo...

Background. Alcohol use was one of the leading contributors to South Africa (SA)’s disease burden in 2000, accounting for 7% of deaths and disability-adjusted life years (DALYs) in the first South African Comparative Risk Assessment Study (SACRA1). Since then, patterns of alcohol use have changed, as has the epidemiological evidence pertaining to t...

Background. Worldwide, higher-than-optimal fasting plasma glucose (FPG) is among the leading modifiable risk factors associated with all- cause mortality and disability-adjusted life years (DALYs) due to the direct sequelae of diabetes and the increased risk for cardiovascular and chronic kidney disease. Objectives. To report deaths and DALYs of h...

The article in context Evidence before the study. The first South African Comparative Risk Assessment (SACRA1) study showed a distinct risk factor profile in 2000 that was dominated by unsafe sex (31.5% of total DALYs) and interpersonal violence (8.4%). The risk factor profile reflected a combination of risks related to poverty and underdevelopment...

Aims: To investigate factors independently associated with time-to-(being)-ulcer-free, time-varying effects and predict adjusted ulcer-free probabilities, in a large prospective cohort with diabetes-related foot ulcers (DFU) followed-up for 24 months. Methods: Patients presenting with DFU(s) to 65 Diabetic Foot Services across Queensland, Austra...

Aim This study examines 3 years of child and adolescent health data from Australian onshore and offshore immigration detention centres from 2014 to 2017, quantifying the health presentation data of children and adolescents in Australian immigration detention and comparing rates between onshore and offshore detention. Methods This study utilised th...

Epidemiological surveys measuring the prevalence of child maltreatment generate essential knowledge that is required to enhance human rights, promote gender equality, and reduce child abuse and neglect and its effects. Yet, evidence suggests Institutional Review Boards (IRBs) may assess the risk of these studies using higher than normal thresholds,...

Background Diabetes-related foot disease (DFD) is a leading cause of global hospitalisation, amputation and disability burdens; yet, the epidemiology of the DFD burden is unclear in Australia. We aimed to systematically review the literature reporting the prevalence and incidence of risk factors for DFD (e.g. neuropathy, peripheral artery disease),...

Background LDL-C is a key contributor to cardiovascular disease (CVD), but the exact attributable disease risk in South Africa is not known. This study aimed to quantify the burden of disease attributable to LDL-C in South Africa for 2000, 2006 and 2012. Methods National mean LDL-C estimates were derived from 14 observational studies using a meta-...

Background Implementation of guideline-based care for diabetes-related foot ulcers (DFU) in clinical practice is typically sub-optimal. We aimed to evaluate the cost-effectiveness of implementing different incremental increases in guideline-based care scenarios, compared with current practice, using discrete event simulation models. Methods The co...

Background Diabetes-related foot ulcers (DFU) take months to heal, reduce patient’s quality-of-life, and induce large healthcare expenditure. Various factors have been identified to influence DFU healing at fixed periods, however, data on factors associated with time-to-healing is scarce. Methods Patients presenting with DFU to Diabetic Foot Servi...

Background There is a shortage of information on the costs and benefits of anti-bullying programs implemented in Australia. Information on the costs and benefits of anti-bullying programs is vital to assist policy making regarding the adoption of these programs. The aim of this study was to estimate the changes to costs and health benefits of imple...

Introduction Child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteri...

Background Diabetes-related foot disease (DFD) is a leading cause of global hospitalisation, amputation and disability burdens; yet, the epidemiology of the DFD burden is unclear in Australia. We aimed to systematically review the literature reporting the prevalence and incidence of risk factors for DFD (e.g. neuropathy, peripheral artery disease),...

Objective To investigate predictors of time-to-healing in a large representative cohort of people with diabetes-related foot ulcers (DFU). Research design and methods Demographic, comorbidity, limb, ulcer and treatment factors were prospectively collected from patients presenting with DFU to one of 65 outpatient Diabetic Foot Services across Queen...

Per and poly-fluoroalkyl substances (PFASs) have been widely used and detected in human matrices. Evidence that PFAS exposure may be associated with adverse human reproductive health effects exists, however, data is limited. The use of a human matrix such as follicular fluid to determine chemical exposure, along with reproductive data will be used...

Objective This study conducted a systematic review and meta-analysis and estimated the economic costs attributable to child and adolescent bullying victimization in Australia. Method The costs of bullying victimization were measured from a societal perspective which accounts for costs associated with healthcare, education resources and productivit...

OBJECTIVE No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (GBD) study presents a robust opportunity to address this gap. RESEARCH DESIGN AND METHODS GBD 2016 data, including prevalence and years lived with disability (YLDs), for the DRLECs...

Objectives Child maltreatment through physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, causes substantial adverse health, educational and behavioural consequences through the lifespan. The generation of reliable data on the prevalence and characteristics of child maltreatment in nationwide populations is es...

Aim There is now a strong body of literature showing that bullying victimisation during childhood and adolescence precedes the later development of anxiety and depressive disorders. This study aimed to quantify the burden of anxiety and depressive disorders attributable to experiences of bullying victimisation for the Australian population. Method...

Purpose Given the importance of measuring health-related quality of life (HRQoL) for cost–utility studies, this study aimed to determine the validity and responsiveness of two preference-based HRQoL instruments, the EuroQol-five dimensions-five levels questionnaire (EQ-5D-5L) and the Sheffield Preference-based Venous Ulcer questionnaire (SPVU-5D) i...

Background: Despite increased awareness of the adverse impact of bullying on mental health, the prevalence of bullying in Australia is uncertain. The aim of the current study was to conduct a systematic review and meta-analysis to estimate the prevalence of bullying (traditional and cyber) among Australian children and adolescents. This study synt...

Current provision of services for the care of chronic wounds in Australia is disjointed and costly. There is large variability in the way that services are provided, and little evidence regarding the cost-effectiveness of a specialist model of care for treatment and management. A decision-analytic model to evaluate the cost-effectiveness of a speci...

CHEERS checklist—Items to include when reporting economic evaluations of health interventions. (DOCX)

Breakdown of costs included in the economic model. (DOCX)

Background Valuation of the economic cost of antimicrobial resistance (AMR) is important for decision making and should be estimated accurately. Highly variable or erroneous estimates may alarm policy makers and hospital administrators to act, but they also create confusion as to what the most reliable estimates are and how these should be assessed...

Background: Emerging scientific evidence suggests that exposure to environmental pollutants is associated with negative effects on fecundity as measured by time to pregnancy (TTP). Objectives: To conduct a systematic review of the literature on the association between selected endocrine disrupting chemicals (EDCs), and fecundity as measured by T...

Wound management in Australia suffers from a lack of adequate coordination and communication between sectors that impacts patient outcomes and costs. Wound Innovations is a specialist service comprising of a transdisciplinary team that aims to streamline and improve patient care and outcomes. We compared patient experiences and outcomes prior to ac...

Venous leg ulcers (VLUs) result in substantial economic costs and reduced quality of life (QoL); however, there are few Australian cost estimates, especially using patient‐level data. We measured community‐setting VLU management costs and the impact on the QoL of affected individuals. VLU patients were recruited from a specialist wound clinic, an o...

Chronic wounds are a significant problem in Australia. The health care‐related costs of chronic wounds in Australia are considerable, equivalent to more than AUD $3.5 billion, approximately 2% of national health care expenditure. Chronic wounds can also have a significant negative impact on the health‐related quality of life of affected individuals...

Objectives The aim of this study was to review all published economic evaluations of guideline-based care for chronic wounds and to assess how useful these studies are for decision making in health services. Methods Embase, PubMed, Scopus, Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database (NHS EED) were sea...

Background: Venous leg ulcers (VLUs) are expensive to treat and impair quality of life of affected individuals. Although improved healing and reduced recurrence rates have been observed following the introduction of evidence-based guidelines, a significant evidence-practice gap exists. Compression is the recommended first-line therapy for treatmen...

Background: Chronic wounds are a silent epidemic in Australia. They are an under-recognised public health issue, and their significant health and economic impact is underestimated. Evidence-based practice in wound care has significant health and economic benefits, yet there are still considerable evidence–practice gaps. Methods: Stakeholders attend...

Globally ~435 million people have diabetes [1], and an estimated 19–34% (~83–148 million people) of those will be expected to develop foot ulcers in their lifetime [2]. Foot ulcers are typically precipitated by other diabetes‐related lower‐extremity complications, (DRLECs) including peripheral neuropathy and peripheral vascular disease [2,3]. Colle...

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the impo...

This is a duplicate entry for DOI: 10.1016/S0140-6736(17)31833-0 (ResearchGate staff: Please remove this entry.)

Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluat...

Background: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years l...

Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study...