Publications by authors named "Bridgette Mcnamara"

Issue Addressed: Little is currently known about the relationships between body composition and the social determinants of health among Aboriginal and Torres Strait Islander youth in Australia, which could help inform policy responses to address health inequities.

Methods: This study aimed to explore the relationship between various social factors and healthy body mass index (BMI) and waist/height ratio (WHtR) among Aboriginal and Torres Strait Islander youth aged 16-24 years. Baseline survey data from 531 participants of the 'Next Generation: Youth Well-being study' were used.

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Objective: To identify additional mental and neurodevelopmental health needs of Aboriginal children born in Western Australia, who are placed in out-of-home care (OOHC), relative to Aboriginal children born in Western Australia who were not placed.

Methods: Data-linkage of hospitalisations, health registries and child protective services data for all Aboriginal children born in WA between 2000 and 2013 was used. Children placed in out-of-home care between 2000 and 2019 were matched to children never placed and prevalence and cumulative incidence estimates of mental and neurodevelopmental health conditions were compared.

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  • The study examines how the Barwon South-West Public Health Unit managed COVID-19 cases during 2020, focusing on their operational model and the impact of community transmission.
  • Between March and October 2020, 575 confirmed cases were reported in the region, with a 4.7% hospitalization rate and a 1.7% fatality rate, particularly during a major outbreak in Wave 2.
  • The local interprofessional model of care was effective in controlling outbreaks, leading to the elimination of the virus within three months and offering valuable insights for future public health strategies in Victoria.
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  • Western Australia has a high rate of Aboriginal children in out-of-home care, with kinship care as the culturally preferred option, yet best-practice standards are not being met.
  • The research involved qualitative interviews with Aboriginal primary healthcare workers, focusing on the challenges and opportunities related to intersectoral collaboration in healthcare.
  • Key challenges included communication issues and government relationships, while opportunities for improvement highlighted the need for Aboriginal-led care, better resources, and aligning services across sectors.
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Increasing testing is key to achieving hepatitis C elimination. This retrospective study aimed to assess the testing cascade of patients at a regional hospital in Victoria, Australia, who inject drugs or are living with hepatitis C, to identify missed opportunities for hepatitis C care. Adult hospital inpatients and emergency department (ED) attendees from 2018 to 2021 with indications for intravenous drug use (IDU) or hepatitis C on their discharge or ED summary were included.

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Background: Rates of dementia for Aboriginal and Torres Strait Islander peoples are three to five times greater compared to non-Indigenous Australians, with earlier age of onset. However, the risk and protective factors that drive these higher rates vary across existing cohort studies, with minimal findings on the role of vascular risk factors beyond stroke. Harmonisation of data across studies may offer greater insights through enhanced diversity and strengthened statistical capabilities.

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Background: Australian Aboriginal and Torres Strait Islander women with diabetes in pregnancy (DIP) are more likely to have glycaemic levels above the target range, and their babies are thus at higher risk of excessive fetal growth. Shoulder dystocia, defined by failure of spontaneous birth of fetal shoulder after birth of the head requiring obstetric maneuvers, is an obstetric emergency that is strongly associated with DIP and fetal size. The aim of this study was to investigate the epidemiology of shoulder dystocia in Aboriginal babies born to mothers with DIP.

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Objectives: Estimates of secondary infections are variedly reported, with few studies done in Australia. We investigated the occurrence and impact of secondary infections complicating COVID-19 and post-COVID-19 admissions in Victoria, Australia, 2020-2023.

Methods: We used linked population-wide data sets and specific International Classification of Disease, 10th Revision codes to identify and estimate the occurrence of secondary infections.

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Objective: The objective of this study was to investigate cardiometabolic health markers among Aboriginal adolescents aged 10-24 years and relationships with age, gender, and body composition.

Methods: Baseline data (2018-2020) from the Next Generation Youth Wellbeing Cohort Study (Western Australia, New South Wales, and Central Australia) on clinically assessed body mass index, waist/height ratio, blood pressure, glycated haemoglobin (HbA1c), total and high-density lipoprotein cholesterol, total/high-density lipoprotein cholesterol ratio, and triglycerides were analysed.

Results: Among 1100 participants, the proportion with individual health markers within the ideal range ranged from 59% for total cholesterol to 91% for HbA1c.

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Article Synopsis
  • The study analyzed 328 SARS-CoV-2 cases during the pre-vaccination period in Barwon South West, Australia, focusing on the differences between symptomatic and asymptomatic infections.
  • It found that asymptomatic cases were overrepresented in ethnic minority groups, especially among those of Asian descent and younger adults, while seniors had a higher likelihood of symptomatic infections.
  • The research suggests that genetic factors may influence the prevalence of asymptomatic infections among different ethnicities and highlights the need for future studies post-vaccination to understand these associations better.
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Background: Discharge against medical advice (DAMA) is a priority issue for the health system. Little is known about the factors associated with DAMA for Aboriginal and/or Torres Strait Islander (Aboriginal) children in Australia.

Objectives: Investigate the associations between DAMA for hospital admissions and emergency department (ED) presentations and: (i) child, family and episode of service characteristics and (ii) 30-day readmission/ re-presentation.

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This study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10-24 years and examined associations with health behaviours and self-rated health. Data were cross-sectional from the 'Next Generation: Youth Well-being study' baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR).

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  • The Barwon South West Public Health Unit launched a targeted SMS messaging program in winter 2022 to promote oral antiviral treatments for COVID-19 in the Barwon South West region of Victoria, Australia.
  • A study conducted among COVID-19 cases aged 50 and older revealed that 36.7% reported receiving antiviral prescriptions, with most being prescribed by their regular GPs.
  • Key barriers to accessing antivirals included delays in medical appointments and testing, while having trusted sources of information, like family or doctors, acted as facilitators; the SMS messages influenced nearly 12.5% of those who obtained the treatment.
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Introduction: Dementia is an emergent health priority for Indigenous peoples worldwide, yet little is known about disease drivers and protective factors.

Methods: Database searches were conducted in March 2022 to identify original publications on risk, protective, genetic, neuroradiological, and biological factors related to dementia and cognitive impairment involving Indigenous peoples.

Results: Modifiable risk factors featured across multiple studies include childhood adversity, hearing loss, low education attainment, unskilled work history, stroke, head injury, epilepsy, diabetes, hypertension, hyperlipidemia, depression, low BMI, poor mobility, and continence issues.

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To examine protective and risk factors for Buruli ulcer (BU), we conducted a case-control study of 245 adult BU cases and 481 postcode-matched controls across BU-endemic areas of Victoria, Australia. We calculated age- and sex-adjusted odds ratios for socio-environmental, host, and behavioral factors associated with BU by using conditional logistic regression. Odds of BU were >2-fold for persons with diabetes mellitus and persons working outdoors who had soil contact in BU-endemic areas (compared with indoor work) but were lower among persons who had bacillus Calmette-Guérin vaccinations.

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Background: Aboriginal and Torres Strait Islander (hereafter Aboriginal) women have a high prevalence of diabetes in pregnancy (DIP), which includes pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). We aimed to characterize the impact of DIP in babies born to Aboriginal mothers.

Methods: A retrospective cohort study, using routinely collected linked health data that included all singleton births (N = 510 761) in Western Australia between 1998 and 2015.

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  • The study investigates COVID-19 severity (hospitalization and death rates) among residents of residential aged care facilities (RACFs) in Victoria, Australia, during Delta and Omicron epidemic periods.
  • Results show that the hospitalization risk (HR) and case fatality risk (CFR) were significantly lower during the Omicron period compared to Delta, with vaccination status playing a crucial role in reducing these risks.
  • The findings emphasize the importance of staying up-to-date with vaccinations to mitigate COVID-19 severity among elderly residents, as males and those with longer intervals since last vaccination faced higher risks.
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  • Cases of Buruli ulcer, linked to Mycobacterium ulcerans, have notably increased in Victoria, Australia, prompting research into environmental transmission.
  • Analysis of samples from properties with Buruli ulcer cases revealed links to specific environmental features, including certain native plants, soil alkalinity, and common ringtail possums.
  • While ringtail possums may be key hosts for the bacteria, differences in environmental risk factors between positive properties and actual cases suggest that human behavior and other factors also play a role in how the disease spreads.
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Prevention initiatives during childhood and adolescence have great potential to address the health inequities experienced by Aboriginal and Torres Strait Islander (Indigenous) populations in Australia by targeting modifiable risk factors for cardio-metabolic diseases. We aimed to synthesize existing evidence about potential determinants of cardio-metabolic risk markers-obesity, elevated blood pressure, elevated blood glucose, abnormal lipids, or a clustering of these factors known as the metabolic syndrome (MetS)-for Indigenous children and adolescents. We systematically searched six databases for journal articles and three websites for relevant grey literature.

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Objective: To assess the association between maternal asthma and adverse perinatal outcomes in an Australian Indigenous population.

Methods: This prospective cohort study included all Indigenous mother and baby dyads for births from 2001 to 2013 in Western Australia (n = 25 484). Data were linked from Western Australia Births, Deaths, Midwives, Hospital, and Emergency Department collections.

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Objective: To examine associations between area-level socio-economic factors and the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Victoria during 2020.

Design, Setting: Population-level ecological study of the incidence of SARS-CoV-2 infections in Victoria, by postcode, 1 March - 13 August 2020.

Main Outcome Measures: Relationships between the incidence of SARS-CoV-2 infections by postcode (Department of Health and Human Services data published on The Age website), and demographic, education level, ethnic background, economic and employment-related factors, housing-related factors, and social disadvantage (Australian Bureau of Statistics data for 2014-19), expressed as incidence rate ratios (IRRs).

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Introduction: Perinatal outcomes for singleton pregnancies are poorer, on average, for Aboriginal people than non-Aboriginal people, but little is known about Aboriginal multifetal pregnancies. Yet multifetal pregnancies and births are often more complicated and have poorer outcomes than singleton pregnancies. We describe the pregnancies, births and perinatal outcomes for Aboriginal twins born in Western Australia (WA) and New South Wales (NSW) with comparisons to Aboriginal singletons in both states and to non-Aboriginal births in NSW.

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Background: Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children.

Methods: A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020.

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Background: Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population.

Aim: To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1-4 years of age).

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