Publications by authors named "Bulsara M"

The rising prevalence of chronic diseases could be mitigated by expanding community programs. This study aimed to evaluate the feasibility of delivering a community wellness program for older adults living with chronic disease. A two-group randomized controlled study, with blinded assessments, enrolling adults (≥50 years) with chronic disease, was conducted at a Western Australian community hub.

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Article Synopsis
  • Informal caregivers providing home care often face stress that can negatively impact their health-related quality of life (HRQOL).
  • The study aimed to assess the impact of the Further Enabling Care at Home (FECH+) program on improving HRQOL for caregivers of older adults after hospital discharge.
  • Conducted as a randomized clinical trial in Australia, caregivers in the intervention group received structured support through phone calls, while the control group only received standard care, with various outcomes tracked over 12 months.
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Background: Despite pain being the most common reason for patients to visit the emergency department (ED), conventional pain management methods are often inadequate. Patient controlled analgesia (PCA), which allows patients to self-administer intravenous analgesia, is widely used across many hospital wards, however, is not routinely used in ED. We aimed to identify clinicians' perceptions of PCA use in the ED setting.

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Introduction: Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis of new conditions.

Methods: Retrospective repeated cross-sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015.

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Introduction: Despite the challenges of providing burn care throughout the 2.5MKm jurisdiction of Western Australia, early intervention after injury remains a key premise of the multidisciplinary model of care applied by the State Adult Burn Unit (SABU) team. In particular, contemporary guidelines support the facilitation of early ambulation after lower limb burn and skin grafting.

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Introduction: Calcium channel blockers (CCB), a commonly prescribed antihypertensive (AHT) medicine, may be associated with increased risk of breast cancer. The proposed study aims to examine whether long-term CCB use is associated with the development of breast cancer and to characterise the dose-response nature of any identified association, to inform future hypertension management.

Methods And Analysis: The study will use data from 2 of Australia's largest cohort studies; the Australian Longitudinal Study on Women's Health, and the 45 and Up Study, combined with the Rotterdam Study.

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  • A study in a hospital looked at how common frailty and pain are in patients admitted for cancer treatment.
  • Researchers found that nearly 20% of these patients were frail and had a higher likelihood of experiencing moderate pain.
  • The results highlight the importance of screening for frailty and assessing pain in cancer patients during their hospital stays.
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Introduction: The study examined whether increased physical activity (PA) in nonmetropolitan cancer survivors was maintained 12 weeks following the PPARCS intervention.

Methods: PA outcomes were assessed using an accelerometer at baseline, end of the intervention, and at 24 weeks. Linear mixed models were used to examine between-group changes in PA outcomes.

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Objective: We examined the impact of long-term mental health outcomes on healthcare services utilisation among childhood cancer survivors in Western Australia using linked hospitalisations and community-based mental healthcare records from 1987 to 2019.

Method: The study cohort included 2977 childhood cancer survivors diagnosed with cancer at age < 18 years in Western Australia from 1982 to 2014 and a matched non-cancer control group of 24,994 individuals. Adjusted hazard ratios of recurrent events were estimated using the Andersen-Gill model.

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Aim: To assess population-level characteristics and post-metastasis survival of people with recurrent metastatic breast cancer (rMBC) during a period when new publicly-subsidised adjuvant and metastatic systemic therapies became available.

Methods: Record linkage study of females in NSW Cancer Registry (NSWCR) diagnosed with non-metastatic breast cancer (BC) in 2001-2002 (C1) and 2006-2007 (C2). We identified first rMBC from NSWCR, administrative hospital records, dispensed medicines and radiotherapy services (2001-2016).

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Background: We investigated differences in cumulative incidence of first distant recurrence (DR) following non-metastatic breast cancer over a time period when new adjuvant therapies became available in Australia.

Methods: We conducted a health record linkage study of females with localized (T1-3N0) or regional (T4 or N+) breast cancer in the New South Wales Cancer Registry in 2001 to 2002 and 2006 to 2007. We linked cancer registry records with administrative records from hospitals, dispensed medicines, radiotherapy services, and death registrations to estimate the 9-year cumulative incidence of DR and describe use of adjuvant treatment.

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Objective: To examine the use of CT, emergency department (ED)-presentation and hospitalisation and in 12 months before and after a diagnosis of cancer.

Design: Population-based retrospective cohort study.

Setting: West Australian linked administrative records at individual level.

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Background: Our previous strain-specific systematic review (SR) showed that Lactobacillus reuteri (LR) DSM 17938 reduces necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and time to full feeds (TFF) in preterm infants. Considering progress in the field over the past 6 years, we aimed to update our SR.

Methods: SR of randomized controlled trials (RCTs) and non-RCTs was conducted.

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Background: The long-term effects of childhood cancer are unclear in the Australian context. We examined hospitalization trends for physical diseases and estimated the associated inpatient care costs in all 5-year childhood cancer survivors (CCS) diagnosed in Western Australia (WA) from 1982 to 2014.

Methods: Hospitalization records for 2,938 CCS and 24,792 comparisons were extracted from 1987 to 2019 (median follow-up = 12 years, min = 1, max = 32).

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Objective: Dementia affects individuals older than 65 years. Currently, residential aged care facilities (RACF) use psychotropic medications to manage behavioural and neuropsychiatric symptoms of dementia (BPSD), which are recommended for short-term use and have substantial side effects, including increased mortality. Cannabinoid-based medicines (CBM) have some benefits that inhibit BPSD and cause minimal adverse effects (AEs), yet limited research has been considered with this population.

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Purpose: Whilst computed tomography (CT) imaging has been a vital component of injury management, its increasing use has raised concern regarding ionising radiation exposure. This study aims to identify latent classes (underlying patterns) of CT use over a 3-year period following the incidence of injury and factors predicting the observed patterns.

Method: A retrospective observational cohort study was conducted in 21,544 individuals aged 18 + years presenting to emergency departments (ED) of four tertiary public hospitals with new injury in Western Australia.

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Objectives: We investigated shear wave elastography (SWE), B mode US and power Doppler (PDUS) as imaging biomarkers for longitudinal follow-up in idiopathic inflammatory myopathy (IIM), with a particular focus on immune-mediated necrotizing myopathy (IMNM) and DM.

Methods: Participants had serial SWE, PDUS on the deltoid (D) and vastus lateralis (VL) muscles on four occasions at intervals of 3-6 months. Clinical assessments included manual muscle testing, and patient- and physician-reported outcome scales.

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Infant and Young Child Feeding (IYCF) breastfeeding guidelines of the World Health Organization (WHO) have been promoted in Nepal since the early 1990s. This study investigated whether antenatal and perinatal service delivery in Nepal are associated with early initiation of breastfeeding and age-appropriate feeding practice (exclusive breastfeeding to six months; introduction of complementary foods at six months with continued breastfeeding to two years). Data from the 2016 Nepal Demographic and Health Survey (NDHS) were analysed using multivariable logistic regression.

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Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assist health care professionals to target interventions and develop resources to improve patient outcomes.

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Background: Physical activity (PA) is important for cancer survivors. Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors. The objective of this study was to ascertain whether wearable technology, coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia.

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Background: Western Australia (WA) public health measures to eradicate SARS-CoV-2 resulted in a secondary reduction in paediatric respiratory syncytial virus (RSV) admissions. Following an absent expected 2020 winter peak, RSV-positive admissions surged during the summer of 2020.

Aim: This report examines the number of RSV-positive admissions and severities across 36 months to better understand this out-of-season epidemic.

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Importance: The Ages and Stages Questionnaire (ASQ) is a commonly used developmental screening tool, but its utility is debated.

Objectives: To conduct a a systematic review and meta-analysis to evaluate ASQ's utility as a screening or diagnostic tool to identify developmental delay in children aged 12-60 months.

Data Sources: Medline, EMBASE, CINAHL, PsycINFO, and Mednar were searched from inception until December 2021.

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Micro Abstract: Targeted intraoperative radiotherapy (TARGIT-IORT) is delivered immediately after lumpectomy for breast cancer. We estimated its impact. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres in 35 countries, saving >20 million miles of travel and preventing ~2,000 non-breast cancer deaths.

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Annual influenza vaccination of health care students and workers helps protect themselves and patients from influenza, which has a high disease burden during seasonal peaks in Australia. Health care students are an important cohort whose early attitudes and habits towards influenza vaccination may influence future behaviours. We explored the knowledge, attitudes, and behaviours towards influenza vaccination of health care students in two universities from 2018 to 2020 using convergent mixed methodology.

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