Publications by authors named "Caroline Gao"

Background And Objective: The 2014 Hazelwood coal mine fire exposed residents in nearby Morwell to high concentrations of particulate matter <2.5 µm (PM) for approximately 6 weeks. This analysis aimed to evaluate the long-term impact on respiratory health.

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  • The text explores the concept of the 'missing middle' in mental health care in Australia, where certain subgroups are not having their needs adequately met by existing services.
  • Using the Delphi method, experts from various groups collaborated to define the term and identify key issues, resulting in ten subthemes, of which four core ones were widely acknowledged: service gap, inflexibility, inadequate service quality and duration, and social disadvantage.
  • Ultimately, a consensus definition was formed that frames the 'missing middle' as a systemic service gap in mental health care, emphasizing the need for more effective solutions to support affected individuals.
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  • The study analyzed the relationship between social determinants and increased mental health issues among young Australians (ages 15-25) from 2007 to 2021, noting a significant rise in psychological distress during this period, especially post-COVID-19.
  • Key social factors examined included loneliness, lack of social support, family relationships, education/employment participation, and socio-economic status, with loneliness being identified as the most impactful on mental health.
  • The findings call for urgent, coordinated action to address the mental health crisis, emphasizing the need for holistic community initiatives and policy changes to improve the psychosocial well-being of young people.
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  • The study highlights the challenges faced by youth-specific integrated mental healthcare services in Australia, particularly in accommodating young people with severe and complex needs despite being designed for early intervention.
  • A significant number of young people (about 20%) were identified as having 'high complexity' due to factors like severe disorders and trauma history, while two other moderate complexity subgroups were distinguished based on their specific issues.
  • Findings emphasized the need for better understanding and consensus regarding complexity in clinical settings to improve service planning and resource allocation.
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The concept of ultra-high risk for psychosis (UHR) has been at the forefront of psychiatric research for several decades, with the ultimate goal of preventing the onset of psychotic disorder in high-risk individuals. Orygen (Melbourne, Australia) has led a range of observational and intervention studies in this clinical population. These datasets have now been integrated into the UHR 1000+ cohort, consisting of a sample of 1,245 UHR individuals with a follow-up period ranging from 1 to 16.

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Using population-level cancer diagnosis data, we compared cancer incidence in locations affected by smoke from a six week-long open cut coal mine fire in regional Victoria, Australia, up to seven years following the event. There was no detectable effect on cancer incidence overall. While several subgroups exhibited changes, these were more likely due to statistical chance rather than real effects.

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Background: In Australia, the first nationwide COVID-19 lockdown occurred in March 2020 bringing challenges for early intervention psychosis (EIP) services. Limited evidence exists on the impacts of the pandemic on treatment outcomes among EIP clients.

Methods: This prospective cohort study analysed routine data from 15 headspace Early Psychosis centres in Australia.

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  • The Hazelwood Health Study looked at how smoke from a mine fire in 2014 affected the lung health of residents over time.
  • The study involved comparing people who were exposed to the smoke with those who were not and used special tests to see how well their lungs were working.
  • Results showed that the more smoke people were exposed to, the more problems they had with a part of their lungs, which was similar to the effects of getting older.
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  • The COVID-19 pandemic has led to a notable rise in mental health issues among final-year secondary school students, disrupting their social and educational milestones as they transition to higher education.
  • A study analyzed application data from before and during the pandemic to assess the increase in requests for mental health-related special consideration, revealing a 38% rise in applications during the pandemic.
  • Findings highlighted that the most significant increases were in regions affected by lockdowns and natural disasters, particularly among Year 12 students and those with other special needs, emphasizing the need for a robust mental health support system in higher education.
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Aims: Young people with first-episode psychosis (FEP) or at ultra-high risk (UHR) of psychosis often have lower vocational engagement than their peers. This study examines the effect of treatment in early intervention for psychosis services in Australia on engagement in education and employment.

Methods: This is a naturalistic sample of young people aged 12-25 with FEP ( = 1574) and UHR ( = 1515), accessing treatment in the Early Psychosis (hEP) programme.

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Background: In 2014, the Hazelwood coalmine fire in regional Victoria, Australia shrouded nearby communities in smoke for six weeks. Prior investigations identified substantial adverse effects, including increases in the use of health services. In this study, we examined the effects on hospital and ambulance use in the eight years following the fire.

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Background: In randomized clinical trials, treatment effects may vary, and this possibility is referred to as heterogeneity of treatment effect (HTE). One way to quantify HTE is to partition participants into subgroups based on individual's risk of experiencing an outcome, then measuring treatment effect by subgroup. Given the limited availability of externally validated outcome risk prediction models, internal models (created using the same dataset in which heterogeneity of treatment analyses also will be performed) are commonly developed for subgroup identification.

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Background And Aim: There are few long-term studies of respiratory health effects of landscape fires, despite increasing frequency and intensity due to climate change. We investigated the association between exposure to coal mine fire PM and fractional exhaled nitric oxide (FeNO) concentration 7.5 years later.

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Background: Chronic, low-intensity air pollution exposure has been consistently associated with increased atherosclerosis in adults. However, there was limited research regarding the implications of acute, high-intensity air pollution exposure during childhood. We aimed to determine whether there were any associations between early-life exposure to such an episode and early-life vascular function changes.

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Aim: Cognitive impairments are a core feature of first-episode psychosis (FEP) and one of the strongest predictors of long-term psychosocial functioning. Cognition should be assessed and treated as part of routine clinical care for FEP. Cognitive screening offers the opportunity to rapidly identify and triage those in most need of cognitive support.

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We are developing an economic model to explore multiple topics in Australian youth mental health policy. To help make that model more readily transferable to other jurisdictions, we developed a software framework for authoring modular computational health economic models (CHEMs) (the software files that implement health economic models). We specified framework user requirements for: a simple programming syntax; a template CHEM module; tools for authoring new CHEM modules; search tools for finding existing CHEM modules; tools for supplying CHEM modules with data; reproducible analysis and reporting tools; and tools to help maintain a CHEM project website.

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In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM). We investigated whether the long-term effects of PM on respiratory health were moderated by diet quality.

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Bacteria and fungi are ubiquitous throughout built environments and are suspended in the air, potentially affecting human health. However, the impacts of climate zones on the diversity, structure, and stochastic assembly of indoor airborne microbes remain unknown. This study comprehensively analyzed indoor airborne microbes across five climate zones in China during the summer and winter using high-throughput sequencing.

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Randomized controlled trials can be used to generate evidence on the efficacy and safety of new treatments in eating disorders research. Many of the trials previously conducted in this area have been deemed to be of low quality, in part due to a number of practical constraints. This article provides an overview of established and more innovative clinical trial designs, accompanied by pertinent examples, to highlight how design choices can enhance flexibility and improve efficiency of both resource allocation and participant involvement.

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This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community.

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Background And Objective: Chronic, low-intensity air pollution exposure has been consistently associated with reduced lung function throughout childhood. However, there is limited research regarding the implications of acute, high-intensity air pollution exposure. We aimed to determine whether there were any associations between early life exposure to such an episode and lung growth trajectories.

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Background: Evidence on the relationship between air pollution and allergic sensitisation in childhood is inconsistent, and this relationship has not been investigated in the context of smoke events that are predicted to increase with climate change. Thus, we aimed to evaluate associations between exposure in two early life periods to severe levels of particulate matter with an aerodynamic diameter < 2.5 μm (PM) from a mine fire, background PM, and allergic sensitisation later in childhood.

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Background: Multimodal modeling that combines biological and clinical data shows promise in predicting transition to psychosis in individuals who are at ultra-high risk. Individuals who transition to psychosis are known to have deficits at baseline in cognitive function and reductions in gray matter volume in multiple brain regions identified by magnetic resonance imaging.

Methods: In this study, we used Cox proportional hazards regression models to assess the additive predictive value of each modality-cognition, cortical structure information, and the neuroanatomical measure of brain age gap-to a previously developed clinical model using functioning and duration of symptoms prior to service entry as predictors in the Personal Assessment and Crisis Evaluation (PACE) 400 cohort.

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Despite increasing vaccination rates, the incidence of breakthrough infections with COVID-19 has increased due to the continued emergence of new variants of the SARS-CoV-2 coronavirus. Therefore, Non-pharmaceutical interventions remain the most effective measures for coping with the ever-changing pandemic. The lifting of compulsory interventions has made individuals primary responsibility for their own health, which highlights the importance of increasing awareness of the infection risk from the environment in which they live and their individual behaviors.

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Background: Episodic spikes in air pollution due to landscape fires are increasing, and their potential for longer term health impacts is uncertain.

Objective: Our objective is to evaluate associations between exposure and in infancy to severe pollution from a mine fire, background ambient air pollution, and subsequent hospital care.

Methods: We linked health records of births, emergency department (ED) visits, and hospitalizations of children born in the Latrobe Valley, Australia, 2012-2015, which included a severe pollution episode from a mine fire (9 February 2014 to 25 March 2014).

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