Medicine (Northern Health) - Research Publications
Permanent URI for this collection
Search Results
1 - 5 of 5
-
ItemImpact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study(BMJ PUBLISHING GROUP, 2021-12)OBJECTIVES: The COVID-19 pandemic has changed the way people are accessing healthcare. The aim of this study was to examine the impact of COVID-19 on emergency department (ED) attendance for frequent attenders and to explore potential reasons for changes in attendance. DESIGN: This convergent parallel mixed methods study comprised two parts. SETTING: An interrupted time-series analysis evaluated changes in ED presentation rates; interviews investigated reasons for changes for frequent ED users in a culturally and linguistically diverse setting. PARTICIPANTS: A total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23-99). RESULTS: Interrupted time-series analysis from 4868 eligible participants showed an instantaneous decrease in weekly ED presentations by 36% (p<0.001), with reduction between 45% and 67% across emergency triage categories. 32% did not know they could leave home to seek care with differences seen in English versus non-English speakers (p<0.001). 35% reported postponing medical care. There was a high fear about the health system becoming overloaded (mean 4.2 (±2) on 6-point scale). Four key themes emerged influencing health-seeking behaviour: fear and/or avoidance of hospital care; use of telehealth for remote assessment; no fear or avoidance of hospital care; not leaving the house for any reason. CONCLUSIONS: This study demonstrated reduced ED use by a vulnerable population of previously frequent attenders. COVID-19 has resulted in some fear and avoidance of hospitals, but has also offered new opportunity for alternative care through telehealth.
-
ItemIs two days of intermittent energy restriction per week a feasible weight loss approach in obese males? A randomised pilot study(WILEY, 2018-02)AIM: The 5:2 diet (two non-consecutive days of 2460 KJ (600 calories) and 5 days of ad libitum eating per week) is becoming increasingly popular. This pilot study aimed to determine whether the 5:2 diet can achieve ≥5% weight loss and greater improvements in weight and biochemical markers than a standard energy-restricted diet (SERD) in obese male war veterans. METHODS: A total of 24 participants were randomised to consume either the 5:2 diet or a SERD (2050 KJ (500 calorie) reduction per day) for 6 months. Weight, waist circumference (WC), fasting blood glucose, blood lipids, blood pressure and dietary intake were measured at baseline, 3 and 6 months by a blinded investigator. RESULTS: After 6 months, participants in both groups significantly reduced body weight (P = <0.001), WC (P = <0.001) and systolic blood pressure (P = 0.001). Mean weight loss was 5.3 ± 3.0 kg (5.5 ± 3.2%) for the 5:2 group and 5.5 ± 4.3 kg (5.4 ± 4.2%) for the SERD group. Mean WC reduction for the 5:2 group was 8.0 ± 4.5 and 6.4 ± 5.8 cm for the SERD group. There was no significant difference in the amount of weight loss or WC reduction between diet groups. There was no significant change in diastolic blood pressure, fasting blood glucose or blood lipids in either dietary group. CONCLUSIONS: Results suggest that the 5:2 diet is a successful but not superior weight loss approach in male war veterans when compared to a SERD. Future research is needed to determine the long-term effectiveness of the 5:2 diet and its effectiveness in other population groups.
-
ItemBody image in older, inpatient women and the relationship to BMI, anxiety, depression, and other sociodemographic factors(WILEY, 2020-02)OBJECTIVES: To determine the prevalence of body image dysfunction in a cohort of older, inpatient women, and to examine any associated health or sociodemographic factors. METHODS: In this cross-sectional, observational study, 50 older women admitted to a subacute hospital completed the Body Shape Questionnaire (BSQ-34), Geriatric Depression Screen (GDS), and Geriatric Anxiety Index (GAI). Additional sociodemographic and health-related data including body mass index (BMI) were collected on all participants. Data were first analysed to determine the prevalence of body image dysfunction. To examine factors significantly associated with body image impairment, partial correlation analyses were initially performed between BSQ-34 score and included variables, followed by stepwise regression analysis undertaken to determine significantly contributing independent variables. RESULTS: Only three out of 50 women displayed body image dysfunction using suggested cut-off scores from the BSQ-34, giving a prevalence rate of only 6%. After controlling for multiple variables however, both higher GDS score and higher BMI were found to be significantly and independently associated with poorer body image, with the strongest association being between higher BSQ-34 score and higher BMI (Spearman rank r = 0.455, P < 0.001). Furthermore, when high BMI and depression occurred together, this association was even greater, accounting for over 50% of the impact on body image scores (P = 0.0001). CONCLUSION: For this small cohort of older, inpatient women, rates of body image dysfunction were low. There did however appear to be an association between poorer body image and higher BMI and depression rates in the group, which may be worth exploring further in less frail, community-dwelling cohorts.
-
ItemLetter to the Editor: Treatment of obesity in older persons, reply(WILEY, 2019-08)
-
ItemTreatment of obesity in older persons-A systematic review(WILEY, 2019-04)The study aims to systematically review the available evidence regarding weight loss interventions (lifestyle, surgical, and pharmacological) for obesity in adults aged over 60 years. A search of prospective, randomized studies took place in January 2018, on Medline (Web of Science) and PubMed databases. Search terms included the following: elderly, obese, hypocaloric, pharmacotherapy, and bariatric surgery. Abstracts were screened for eligibility. A total of 256 publications regarding lifestyle interventions were identified; of these, 69 studies were eligible. As no eligible studies were identified for pharmacotherapy or bariatric surgery, the search was broadened to include non- randomized studies. Four pharmacotherapy and 66 surgery studies were included. Lifestyle intervention had similar weight loss efficacy in older compared with younger people, with positive effects on a number of relevant outcomes, including physical function and cardiovascular parameters. There was little data regarding obesity pharmacotherapy in older persons. The available data for bariatric surgery indicate comparable weight loss and resolution of type 2 diabetes, with similar or slightly higher complication rates in older compared with younger people. Older age alone should not be considered a contraindication to intensive lifestyle or surgical intervention for obesity. There are insufficient data to guide clinical decisions regarding obesity pharmacotherapy in older people.