Prioritising patients for publicly funded bariatric surgery in Queensland, Australia.

Objectives: This study reports the development and pilot application of the Bariatric Surgery Assessment and Prioritisation Tool (BAPT) for use in a public health system. The BAPT was designed as a patient prioritisation instrument to assess patients with excessive weight and type 2 diabetes suitable for bariatric surgery. We assessed whether the instrument successfully identified those who gained the greatest benefits including weight loss, diabetes remission, reduction in comorbidities, and health-related quality of life (HR-QoL).

The Cost-Effectiveness of Germline BReast CAncer Gene Testing in Metastatic Prostate Cancer Followed by Cascade Testing of First-Degree Relatives of Mutation Carriers.

Objectives: Patients with metastatic prostate cancer (mPCa) with BReast CAncer gene (BRCA) mutations benefit from targeted treatments (eg, olaparib). In addition, family members of affected patients have increased risk of hereditary cancers and benefit from early detection and prevention. International guidelines recommend genetic testing in mPCa; however, the value for money of testing patients with mPCa and cascade testing of blood-related family members has not been assessed.

Improving equitable access to publicly funded bariatric surgery in Queensland, Australia.

BackgroundPeople living in regional Queensland, Australia, have less access to health care than their metropolitan neighbours; a gap that is wider if they are also of Aboriginal and Torres Strait Islander ethnicity. The Bariatric Surgery Initiative (BSI) aims to provide metabolic bariatric surgery as a public service accessible to all Queenslanders for patients with morbid obesity according to need, regardless of location or ethnicity.MethodsWe investigated the BSI's progress in closing the metro-regional gap by comparing the distribution of referrals for surgery with the geographic and ethnic spread of obesity across Queensland in 2017-2019.

The cost-effectiveness of germline BRCA testing-guided olaparib treatment in metastatic castration resistant prostate cancer.

Background: Olaparib targets the DNA repair pathways and has revolutionized the management of metastatic castration resistant prostate cancer (mCRPC). Treatment with the drug should be guided by genetic testing; however, published economic evaluations did not consider olaparib and genetic testing as codependent technologies. This study aims to assess the cost-effectiveness of germline testing to inform olaparib treatment in mCRPC.

Health outcomes of patients with type 2 diabetes following bariatric surgery: Results from a publicly funded initiative.

Objective: Bariatric surgery is an effective treatment for type 2 diabetes and morbid obesity. This paper analyses the clinical and patient-reported outcomes of patients treated through the Bariatric Surgery Initiative, a health system collaboration providing bariatric surgery as a state-wide public service in Queensland, Australia.

Research Design And Methods: A longitudinal prospective cohort study was undertaken.

A review of the cost-effectiveness of genetic testing for germline variants in familial cancer.

Background: Targeted germline testing is recommended for those with or at risk of breast, ovarian, or colorectal cancer. The affordability of genetic sequencing has improved over the past decade, therefore the cost-effectiveness of testing for these cancers is worthy of reassessment.

Objective: To systematically review economic evaluations on cost-effectiveness of germline testing in breast, ovarian, or colorectal cancer.

Profiles of vocalization change in children with autism receiving early intervention.

Children with autism spectrum disorder (ASD) commonly present with comorbid language impairment, negatively impacting their learning and participation across settings. Addressing these needs requires a detailed understanding of their communication trajectories. In this study, we used the language environment and analysis (LENA) system to examine possible changes in children's (a) vocalizations and (b) ratio of speech to nonspeech vocalizations over a 10-month period.

Variation in Functional Status After Hip Fracture: Facility and Regional Influence on Mobility and Self-Care.

Background: Recent reports show substantial geographic variation in postacute health care spending. Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. We examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states.

Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.

Objective: To examine geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke.

Design: Retrospective cohort design using Centers for Medicare and Medicaid Services (CMS) claims files. Records from 1209 rehabilitation facilities in 298 hospital referral regions (HRRs) were examined.

Relationship between urinary bisphenol A levels and prediabetes among subjects free of diabetes.

Bisphenol A (BPA) is a high volume production chemical used in the manufacture of polycarbonate plastics and epoxy resins. Recent experimental studies have suggested that BPA affects glucose metabolism through diverse mechanisms including insulin resistance, pancreatic β-cell dysfunction, adipogenesis, inflammation and oxidative stress. Prediabetes is a stage earlier in the hyperglycemia continuum associated with increased future risk of developing diabetes.

Bisphenol A and Metabolic Syndrome: Results from NHANES.

Background. Bisphenol A (BPA) is detected in the urine of >95% of US adults. Recent evidence from population-based studies suggests that BPA is associated with individual components for metabolic syndrome (MetS).

Urinary bisphenol a levels and measures of obesity: results from the national health and nutrition examination survey 2003-2008.

Bisphenol A (BPA) is a widely used chemical. We examined the association between urinary BPA levels and obesity in the National Health and Nutritional Examination Survey (NHANES) 2003-2008. The main outcome of interest was obesity defined as (1) body mass index (BMI) ≥ 30 Kg/m(2) and (2) waist circumference (WC) ≥ 102 cm in men and ≥ 88 cm in women.

Markers of Sleep-Disordered Breathing and Prediabetes in US Adults.

Background. Prediabetes is a preclinical stage in the hyperglycemia continuum where subjects are at increased risk of developing diabetes. Several studies reported a positive association between markers of sleep-disordered breathing (SDB) and diabetes.

Bisphenol A and peripheral arterial disease: results from the NHANES.

Background: Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, and > 93% of U.S. adults have detectable levels of urinary BPA.

Markers of Sleep Disordered Breathing and Diabetes Mellitus in a Multiethnic Sample of US Adults: Results from the National Health and Nutrition Examination Survey (2005-2008).

We examined gender and ethnic differences in the association between sleep disordered breathing (SDB) and diabetes among 6,522 participants aged ≥20 years from the National Health and Nutrition Examination Survey 2005-08. SDB severity was defined based on an additive summary score including sleep duration, snoring, snorting, and daytime sleepiness. We found that the summary SDB score was significantly associated with diabetes after adjusting for potential confounders in the whole population.

Urinary bisphenol A and hypertension in a multiethnic sample of US adults.

Background: Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, with >93% of US adults having detectable BPA levels in urine. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of hypertension, including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, no previous human study has examined the association between markers of BPA exposure and hypertension.

Relationship between body mass index and high cystatin levels among US adults.

High cystatin C levels among patients without clinically recognized chronic kidney disease (CKD) may identify patients who are at preclinical stages of CKD. Higher body mass index (BMI) has been found to be associated with increased risk of CKD. However, the association between BMI and high cystatin C levels is not clear.

Relationship between urinary bisphenol A levels and diabetes mellitus.

Background: Bisphenol A (BPA) is a widely used chemical in the manufacture of polycarbonate plastics and epoxy resins. Recent animal studies have suggested that BPA exposure may have a role in the development of weight gain, insulin resistance, pancreatic endocrine dysfunction, thyroid hormone disruption, and several other mechanisms involved in the development of diabetes. However, few human studies have examined the association between markers of BPA exposure and diabetes mellitus.

Relationship between serum cystatin C and hypertension among US adults without clinically recognized chronic kidney disease.

Previous animal studies have suggested that mild reductions in renal function, even before the development of clinically recognized chronic kidney disease (CKD), are associated with hypertension. However, few studies have examined this hypothesis in humans. We therefore examined the association between serum cystatin C levels and hypertension among subjects without clinically recognized CKD in a large multiethnic sample of US adults.

The association between acculturation and hypertension in a multiethnic sample of US adults.

Previous studies analyzing acculturation and cardiovascular risk were restricted to individual race/ethnic groups and did not fully account for potential confounders. We examined the independent association between acculturation and hypertension in a contemporary multiethnic sample that included white, black, Latino, and Asian individuals. We examined 51,048 participants in the 2007 California Health Interview Survey who were >18 years, 59.

Association between serum IGF-1 and diabetes among U.S. adults.

Objective: Serum insulin-like growth factor (IGF)-1 may have a role in the maintenance of glucose homeostasis. We examined the association between serum IGF-1 and diabetes in a representative sample of U.S.

Association between IGF-1 and chronic kidney disease among US adults.

Background: Insulin-like growth factor (IGF-1) has been associated with cardiovascular disease, hypertension and diabetes in previous studies. However, the association between IGF-1 and chronic kidney disease (CKD) has not been previously studied. Therefore, we examined the association between serum IGF-1 and CKD in a representative sample of US adults.

Association between serum gamma-glutamyltransferase and chronic kidney disease among US adults.

Background/aim: Serum gamma-glutamyltransferase (GGT), a biomarker of oxidative stress, is associated with an increased risk of diabetes and hypertension. However, it is not known whether higher serum GGT is independently associated with chronic kidney disease (CKD). Therefore, we examined the association between serum GGT levels and CKD in a representative sample of US adults.