scholarly journals O016 Exploring the drivers of geographic variation for paediatric tonsillectomy and adenoidectomy

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A7-A8
Author(s):  
A Tran ◽  
D Liew ◽  
R Horne ◽  
J Rimmer ◽  
G Nixon
Keyword(s):  
Geographic Variation ◽  
Language Proficiency ◽  
English Language ◽  
Geographical Area ◽  
Sleep Apnoea ◽  
Factors Associated ◽  
Surgical Access ◽  
Obstructive Sleep ◽  
Surgery Rates ◽  
Wide Population

Abstract Introduction Tonsillectomy and/or adenoidectomy (A/T) is first-line treatment for paediatric obstructive sleep apnoea. Provision of A/T is of critical interest to sleep medicine practitioners. Geographic variation of A/T has been described since the 1930s, but no studies have investigated the reasons behind it. This study aimed to describe the geographical distribution of paediatric A/T and investigate area-level factors associated with this variation. Methods Linked administrative datasets captured a complete state-wide population of paediatric A/T performed between 2010 and 2015. Surgery data were collapsed by patient residence to the level of Local Government Area. Regression models were used to investigate the association between likelihood of surgery and area-level factors. Results There was a 10.2-fold difference in A/T rates across the state, with higher rates more common in regional than metropolitan areas. Area-level factors associated with geographic variation that increased the likelihood of A/T were a higher proportion of children aged 5–9 years (IRR 1.07, 95%CI 1.01–1.14, P=0.03), while a higher proportion with low English-language proficiency (IRR 0.95, 95%CI 0.90–0.99, P=0.03) decreased the likelihood of A/T. In a sub-population of public sector surgeries, low maternal educational attainment increased the likelihood of A/T (IRR 1.09, 95%CI 1.02–1.16, P<0.001) and longer surgical waiting time reduced it (IRR 0.996, 95%CI 0.99273–0.99997, P=0.048). Discussion Significant variation in surgery rates exist by geographical area state-wide, with factors analysed having significant impacts. These findings suggest that improved surgical access and better community understanding of the indications for A/T could decrease geographic variation.

scholarly journals Sociodemographic associations of geographic variation in paediatric tonsillectomy and adenoidectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aimy H. L. Tran ◽  
Danny Liew ◽  
Rosemary S. C. Horne ◽  
Joanne Rimmer ◽  
Gillian M. Nixon
Keyword(s):  
Geographic Variation ◽  
Language Proficiency ◽  
Regression Models ◽  
English Language ◽  
Population Analysis ◽  
English Language Proficiency ◽  
The State ◽  
The Public ◽  
Factors Associated ◽  
Administrative Datasets

AbstractGeographic variation of paediatric tonsillectomy, with or without adenoidectomy, (A/T) has been described since the 1930s until today but no studies have investigated the factors associated with this variation. This study described the geographical distribution of paediatric A/T across the state of Victoria, Australia, and investigated area-level factors associated with this variation. We used linked administrative datasets capturing all paediatric A/T performed between 2010 and 2015 in Victoria. Surgery data were collapsed by patient residence to the level of Local Government Area. Regression models were used to investigate the association between likelihood of surgery and area-level factors. We found a 10.2-fold difference in A/T rates across the state, with areas of higher rates more in regional than metropolitan areas. Area-level factors associated with geographic variation of A/T were percentage of children aged 5–9 years (IRR 1.07, 95%CI 1.01–1.14, P = 0.03) and low English language proficiency (IRR 0.95, 95% CI 0.90–0.99, P = 0.03). In a sub-population analysis of surgeries in the public sector, these factors were low maternal educational attainment (IRR 1.09, 95% CI 1.02–1.16, P < 0.001) and surgical waiting time (IRR 0.99635 95% CI 0.99273–0.99997, P = 0.048). Identifying areas of focus for improvement and factors associated with geographic variation will assist in improving equitable provision of paediatric A/T and decrease variability within regions.

scholarly journals Factors associated with undiagnosed obstructive sleep apnoea in hypertensive primary care patients

2012 ◽  
Vol 30 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Anders Broström ◽  
Ola Sunnergren ◽  
Kristofer Årestedt ◽  
Peter Johansson ◽  
Martin Ulander ◽  
...  
Keyword(s):  
Primary Care ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Factors Associated ◽  
Obstructive Sleep ◽  
Primary Care Patients

Vietnamese–Australian children’s language proficiency and use

2021 ◽  
pp. 136700692110345
Author(s):  
Van H Tran ◽  
Cen Wang ◽  
Sharynne McLeod ◽  
Sarah Verdon
Keyword(s):  
Language Proficiency ◽  
Associated Factors ◽  
English Language ◽  
Language Use ◽  
Language Ideologies ◽  
Negative Impact ◽  
Demographic Factors ◽  
Language Practices ◽  
Language Management ◽  
Factors Associated

Aim: To explore Vietnamese–Australian children’s proficiency and use of Vietnamese and English and identify associated factors that are related to demographics, language practices, language ideologies, and language management. Methodology: Vietnamese–Australian parents ( n = 151) completed a questionnaire (in English or Vietnamese) regarding their child’s language proficiency and use, demographic details and a range of factors as conceptualized by Spolsky’s language policy theory: language practices; language ideologies; and language management. Data and analysis: Bivariate analyses (Pearson’s correlation and analysis of variance) and multiple regression models were conducted to explore associations between language proficiency and use and associated factors and identify the most significant factors. Findings/conclusions: Factors associated with children’s Vietnamese language proficiency (oral/written) included: demographic factors; language practices; language ideologies; and language management. In contrast, children’s English language proficiency (oral/written) was linked to demographic factors and language practices. Children’s Vietnamese language use was not significantly correlated with demographics but rather with language practices, language ideologies, and language management. Children’s home language use and proficiency did not have a negative impact upon their English proficiency. Originality: This study is the first to consider factors associated with Vietnamese–Australian children’s language proficiency and use. Significance/implications: Demographic factors, language practices, language ideologies, and language management were associated with children’s language proficiency and use. The results can be used by parents, educators, policy-makers, speech–language pathologists and other professionals to support Vietnamese–Australian and multilingual children around the world to develop and maintain their home and majority languages.

scholarly journals Hepatitis B Screening Compliance and Non-compliance among Chinese, Koreans, Vietnamese and Cambodians

2010 ◽  
Vol 3 ◽  
pp. CGast.S3732 ◽  
Author(s):  
Grace X. Ma ◽  
Yin Tan ◽  
Min Qi Wang ◽  
Ying Yuan ◽  
Wang Gyu Chae
Keyword(s):  
Hepatitis B ◽  
Language Proficiency ◽  
English Language ◽  
Cross Sectional ◽  
Factors Associated ◽  
Educational Effort ◽  
Younger Age ◽  
Lower Education ◽  
Hepatitis B Screening ◽  
Never Screened

Objective The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency. Methods A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and women. Results Overall, 71.4% of the sample reported having never been screened and 28.6% reported being screened for HBV Demographic, acculturation, and barrier factors were differentially associated with screening rates among the subgroups. Demographic factors associated with never-screened were: lower education, younger age, being male, and no insurance for Chinese; lower education, lower income and no insurance for Cambodians; younger age and unmarried for Koreans; and no health insurance for Vietnamese; Acculturation factors associated with never-screened were: not speaking English for Chinese; not speaking English, not reading newspapers in English, and watching TV in one's native language for Cambodians; not speaking English for Koreans; while no significant factors were found for Vietnamese. All barriers were associated with never-screened for Cambodians and Chinese. Those who lacked knowledge about HBV and had language and transportation barrier were more likely to be never-screened for Koreans. There were no significant relationships between the barriers and the screening status for Vietnamese. Conclusions High incidence of HBV and liver cancer in Asian Americans mandates a more vigorous and more culturally and linguistically appropriate educational effort to increase screening and vaccination for HBV in these underserved and mostly uninsured populations.

scholarly journals Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024086 ◽  
Author(s):  
Kapil Gupta ◽  
Mahesh Nagappa ◽  
Arun Prasad ◽  
Lusine Abrahamyan ◽  
Jean Wong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Respiratory Depression ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Factors Associated ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Daily Dose ◽  
Morphine Equivalent

ObjectiveThis systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).DesignSystematic review and meta-analysis.Data sourcesPubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials.gov (January 1946 to November 2017).Eligibility criteriaThe inclusion criteria were: (1) adult patients 18 years or older who were administered opioids after surgery and developed postoperative OIRD (OIRD group); (2) all studies which reported both OIRD events and associated risk factors; (3) all studies with reported data for each risk factor on patients with no OIRD (control group) and (4) published articles in English language.Data analysisWe used a random effects inverse variance analysis to evaluate the existing evidence of risk factors associated with OIRD. Newcastle-Ottawa scale scoring system was used to assess quality of study.ResultsTwelve observational studies were included from 8690 citations. The incidence of postoperative OIRD was 5.0 cases per 1000 anaesthetics administered (95% CI: 4.8 to 5.1; total patients: 841 424; OIRD: 4194). Eighty-five per cent of OIRD occurred within the first 24 hours postoperatively. Increased risk for OIRD was associated with pre-existing cardiac disease (OIRD vs control: 42.8% vs 29.6%; OR: 1.7; 95% CI: 1.2 to 2.5; I2: 0%; p<0.002), pulmonary disease (OIRD vs control: 17.8% vs 10.3%; OR: 2.2; 95% CI: 1.3 to 3.6; I2: 0%; p<0.001) and obstructive sleep apnoea (OIRD vs control: 17.9% vs 16.5%; OR: 1.4; 95% CI: 1.2 to 1.7; I2: 31%; p=0.0003). The morphine equivalent daily dose of the postoperative opioids was higher in the OIRD group than in the control; (24.7±14 mg vs 18.9±13.0 mg; mean difference: 2.8; 95% CI: 0.4 to 5.3; I2: 98%; p=0.02). There was no significant association between OIRD and age, gender, body mass index or American Society of Anesthesiologists physical status.ConclusionPatients with cardiac, respiratory disease and/or obstructive sleep apnoea were at increased risk for OIRD. Patients with postoperative OIRD received higher doses of morphine equivalent daily dose.

scholarly journals Factors Associated With Accuracy of Self-Assessment Compared With Tested Non–English Language Proficiency Among Primary Care Providers

Medical Care ◽  
2019 ◽  
Vol 57 (5) ◽  
pp. 385-390 ◽  
Author(s):  
Lisa Diamond ◽  
Marcela Toro Bejarano ◽  
Sukyung Chung ◽  
Warren Ferguson ◽  
Javier Gonzalez ◽  
...  
Keyword(s):  
Primary Care ◽  
Language Proficiency ◽  
English Language ◽  
Primary Care Providers ◽  
English Language Proficiency ◽  
Care Providers ◽  
Self Assessment ◽  
Factors Associated

scholarly journals Taiwanese Migrants in Australia: An Investigation of Their Acculturation and Wellbeing

2016 ◽  
Vol 10 ◽  
Author(s):  
Nigar G. Khawaja ◽  
Sabrina Yang ◽  
Wendell Cockshaw
Keyword(s):  
Social Support ◽  
Environmental Factors ◽  
Language Proficiency ◽  
English Language ◽  
English Language Proficiency ◽  
Psychological Wellbeing ◽  
Hierarchical Regression ◽  
Personal Factors ◽  
Regression Analyses ◽  
Factors Associated

Taiwanese migrants who have settled in Brisbane, Australia (N= 271) completed a questionnaire battery available in both Mandarin and English. A series of multiple and hierarchical regression analyses were used to investigate the factors associated with these migrants’ acculturation and indicators of psychological wellbeing. Results indicated that various personal factors (age, English language proficiency, and duration of stay) were associated with acculturation and indicators of psychological wellbeing. Acculturation was not associated with wellbeing. Social support was associated with the indicators of the participants’ wellbeing. The outcome indicated that although associated with similar personal and environmental factors, acculturation and psychological wellbeing occurred separately. The study highlights the significance of certain personal resources and social support.

scholarly journals A Fully Remote Diagnostic and Treatment Pathway in Patients with Obstructive Sleep Apnoea during the COVID-19 Pandemic: A Single Centre Experience

2021 ◽  
Vol 10 (19) ◽  
pp. 4310
Author(s):  
Andras Bikov ◽  
Safia Khalil ◽  
Meg Gibbons ◽  
Andrew Bentley ◽  
David Jones ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Published Data ◽  
Treatment Pathway ◽  
Factors Associated ◽  
Obstructive Sleep ◽  
Single Centre Experience ◽  
Set Up ◽  
Index Disease

The COVID-19 pandemic led to significant delays in the diagnostic and management pathway of patients with obstructive sleep apnoea (OSA). During the first wave of COVID-19, our department adopted a fully remote diagnostic (home cardiorespiratory polygraphy) and treatment (autoset continuous positive airway pressure, CPAP) approach. As a novel mode of service delivery, our aim was to evaluate our pathway and analyse factors associated with adherence to CPAP. We analysed the first 300 patients (51 ± 13 years, 48% men) who were set up on remote CPAP between 20 May 2020 and 11 September 2020. The associations between CPAP usage at 90 days and age, gender, body mass index, disease severity, Epworth Sleepiness Scale and comorbidities were investigated with linear and logistic regression analyses. A total of 124 patients (41.3%) were fully-adherent to CPAP therapy, defined as CPAP usage ≥ 4 h on ≥ 70% of the days. Only driving status was associated with adherence to CPAP. Patients who were adherent at 28 days were more likely to stay adherent at 90 days (3.77 odd ratio /3.10–4.45/ 95% confidence interval). We have shown that a fully remote diagnostic and treatment pathway for patients with OSA can be successfully delivered, and our preliminary outcomes of adherence to CPAP are comparable with published data.

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