Hamilton S.,University of Western Australia |
Mills B.,University of Western Australia |
McRae S.,National Heart Foundation of Australia |
Thompson S.,University of Western Australia
BMC Cardiovascular Disorders | Year: 2016
Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in Australia. Australian Aboriginal and Torres Strait Islander (Indigenous) people have higher levels of CVD compared with non-Indigenous people. Cardiac Rehabilitation (CR) is an evidence-based intervention that can assist with reducing subsequent cardiovascular events and rehospitalisation. Unfortunately, attendance rates at traditional CR programs, both globally and in Australia, are estimated to be as low as 10-30 % and Indigenous people are known to be particularly under-represented. An in-depth assessment was undertaken to investigate the provision of CR and secondary preveniton services in Western Australia (WA) with a focus on rural, remote and Indigenous populations. This paper reports on the findings for Indigenous people. Methods: Cardiac rehabilitation and Aboriginal Medical Services (n = 38) were identified for interview through the Heart Foundation Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Semi-structured interviews with CR coordinators were conducted and included questions specific to Indigenous people. Results: Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) were conducted. Identification of Indigenous status was reported by 65 % of coordinators; referral and attendance rates of Indigenous patients differed greatly across WA. Efforts to meet the cultural needs of Indigenous patients varied and included case management (32 %), specific educational materials (35 %), use of a buddy or mentoring system (27 %), and access to an Aboriginal Health Worker (71 %). Staff cultural awareness training was available for 97 % and CR guidelines were utilised by 77 % of services. Conclusion: The under-representation of Indigenous Australians participating in CR, as reported in the literature and more specifically in this study, mandates a concerted effort to improve services to better meet the needs of Indigenous patients with CVD as part of closing the gap in life expectancy. Improving access to culturally appropriate CR and secondary prevention in WA must be an important component of this effort given the high rates of premature cardiovascular disease affecting Indigenous people. Our findings also highlight the importance of good systematic data collection across services. Health pathways that ensure continuity of care and alternative methods of CR delivery with dedicated resources are needed. © 2016 The Author(s).
Cleanthous X.,National Heart Foundation of Australia |
Mackintosh A.-M.,National Heart Foundation of Australia |
Anderson S.,National Heart Foundation of Australia
Nutrition and Dietetics | Year: 2011
Aim: To compare the reported content of key nutrients related to cardiovascular health (energy, total fat, saturated fat and sodium) between Private Label and Branded products for various food categories in Australian supermarkets, using Nutrition Information Panel data. Reported serve size was also assessed. Methods: A cross-sectional study using selected Nutrition Information Panel data collected during 2006-2008 for 25 food categories, across 10 Australian supermarkets. Collected data included serve size and nutrients per 100g: energy, total fat, saturated fat and sodium. Differences between Private Label versus Branded products were assessed using independent samples t-test. Results: Data were collected for 3204 products; Private Label products accounted for 26% (n = 824). Serve size was significantly different between Private Label and Branded for seven categories. Total and saturated fat for Private Label products was significantly greater (than Branded) for five and seven categories, respectively. Sodium was significantly different between Private Label and Branded for seven categories, with no consistency in direction. Conclusion: Differences between Branded and Private Label products were food category specific. The present study provides a first-time comparison of a comprehensive sample of Branded versus Private Label products, across multiple food categories, in Australia with respect to nutrients related to cardiovascular health. It also provides insight into serve size differences, and may be used as a baseline for future comparisons of nutritional content and serve sizes between Branded and Private Label products, and to monitor the impact of potential new food product developments and reformulations. © 2011 The Authors. Nutrition & Dietetics © 2011 Dietitians Association of Australia.
Nestel P.,Baker IDI Heart and Diabetes Institute |
Clifton P.,University of South Australia |
Colquhoun D.,University of Queensland |
Noakes M.,CSIRO |
And 3 more authors.
Heart Lung and Circulation | Year: 2015
Background: The National Heart Foundation of Australia (NHFA) 2008 review on omega-3 long-chain polyunsaturated fatty acids (LCPUFA) made recommendations with respect to supplementation for primary and secondary prevention of cardiovascular disease. Since then, new findings have been published regarding the relationship between omega-3 polyunsaturated fatty acids, including supplementation, and cardiovascular health. Methods: A literature search was undertaken in PubMed and Medline, for literature published between January 1, 2007 and August 31, 2013. Results and Conclusions: A total of eight research questions were developed and, using the National Health and Medical Research Council's evidence assessment framework, conclusions were made in relation to dietary intake of fish and omega-3 LCPUFA for cardiovascular health. In the evidence published since 2007, this summary of evidence concludes that dietary intake of fish was found to be mostly consistent with respect to protection from heart disease and stroke. Higher fish intake was associated with lower incident rates of heart failure in addition to lower sudden cardiac death, stroke and myocardial infarction. In relation to omega-3 LCPUFA supplementation, neither a beneficial nor adverse effect was demonstrated in primary or secondary prevention of coronary heart disease (CHD). Although the evidence continues to be positive for the role of omega-3 LCPUFA in the treatment of hypertriglyceridaemia and a modest positive benefit in heart failure. No further evidence was found to support the consumption of 2. g alpha-linolenic acid (ALA)/day over the current Australian guidelines for 1. g/day. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
Banks E.,Australian National University |
Banks E.,The Sax Institute |
Joshy G.,Australian National University |
Weber M.F.,Cancer Council NSW |
And 11 more authors.
BMC Medicine | Year: 2015
Background: The smoking epidemic in Australia is characterised by historic levels of prolonged smoking, heavy smoking, very high levels of long-term cessation, and low current smoking prevalence, with 13% of adults reporting that they smoked daily in 2013. Large-scale quantitative evidence on the relationship of tobacco smoking to mortality in Australia is not available despite the potential to provide independent international evidence about the contemporary risks of smoking. Methods: This is a prospective study of 204,953 individuals aged ≥45years sampled from the general population of New South Wales, Australia, who joined the 45 and Up Study from 2006-2009, with linked questionnaire, hospitalisation, and mortality data to mid-2012 and with no history of cancer (other than melanoma and non-melanoma skin cancer), heart disease, stroke, or thrombosis. Hazard ratios (described here as relative risks, RRs) for all-cause mortality among current and past smokers compared to never-smokers were estimated, adjusting for age, education, income, region of residence, alcohol, and body mass index. Results: Overall, 5,593 deaths accrued during follow-up (874,120 person-years; mean: 4.26years); 7.7% of participants were current smokers and 34.1% past smokers at baseline. Compared to never-smokers, the adjusted RR (95% CI) of mortality was 2.96 (2.69-3.25) in current smokers and was similar in men (2.82 (2.49-3.19)) and women (3.08 (2.63-3.60)) and according to birth cohort. Mortality RRs increased with increasing smoking intensity, with around two- and four-fold increases in mortality in current smokers of ≤14 (mean 10/day) and ≥25 cigarettes/day, respectively, compared to never-smokers. Among past smokers, mortality diminished gradually with increasing time since cessation and did not differ significantly from never-smokers in those quitting prior to age 45. Current smokers are estimated to die an average of 10years earlier than non-smokers. Conclusions: In Australia, up to two-thirds of deaths in current smokers can be attributed to smoking. Cessation reduces mortality compared with continuing to smoke, with cessation earlier in life resulting in greater reductions. © 2015 Banks et al.
Head G.A.,Baker IDI Heart and Diabetes Institute |
McGrath B.P.,Southern Health |
Mihailidou A.S.,University of Sydney |
Nelson M.R.,Menzies Research Institute |
And 7 more authors.
Journal of Hypertension | Year: 2012
Objective: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines. Methods: A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring. Results: ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments. Conclusion: Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Clark R.A.,Flinders University |
Conway A.,Queensland University of Technology |
Poulsen V.,National Heart Foundation of Australia |
Keech W.,National Heart Foundation of Australia |
And 2 more authors.
European Journal of Preventive Cardiology | Year: 2015
The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or homebased, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences. © The European Society of Cardiology 2013.
PubMed | University of Sydney and National Heart Foundation of Australia
Type: | Journal: Scientific reports | Year: 2016
Considerable evidence has associated increasing portion sizes with elevated obesity prevalence. This study examines typical portion sizes of commonly consumed core and discretionary foods in Australian adults, and compares these data with the Australian Dietary Guidelines standard serves. Typical portion sizes are defined as the median amount of foods consumed per eating occasion. Sex- and age-specific median portion sizes of adults aged 19 years and over (n = 9341) were analysed using one day 24 hour recall data from the 2011-12 National Nutrition and Physical Activity Survey. A total of 152 food categories were examined. There were significant sex and age differences in typical portion sizes among a large proportion of food categories studied. Typical portion sizes of breads and cereals, meat and chicken cuts, and starchy vegetables were 30-160% larger than the standard serves, whereas, the portion sizes of dairy products, some fruits, and non-starchy vegetables were 30-90% smaller. Typical portion sizes for discretionary foods such as cakes, ice-cream, sausages, hamburgers, pizza, and alcoholic drinks exceeded the standard serves by 40-400%. The findings of the present study are particularly relevant for establishing Australian-specific reference portions for dietary assessment tools, refinement of nutrition labelling and public health policies.
PubMed | National Heart Foundation of Australia and University of Western Australia
Type: | Journal: BMC cardiovascular disorders | Year: 2016
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in Australia. Australian Aboriginal and Torres Strait Islander (Indigenous) people have higher levels of CVD compared with non-Indigenous people. Cardiac Rehabilitation (CR) is an evidence-based intervention that can assist with reducing subsequent cardiovascular events and rehospitalisation. Unfortunately, attendance rates at traditional CR programs, both globally and in Australia, are estimated to be as low as 10-30% and Indigenous people are known to be particularly under-represented. An in-depth assessment was undertaken to investigate the provision of CR and secondary preveniton services in Western Australia (WA) with a focus on rural, remote and Indigenous populations. This paper reports on the findings for Indigenous people.Cardiac rehabilitation and Aboriginal Medical Services (n=38) were identified for interview through the Heart Foundation Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Semi-structured interviews with CR coordinators were conducted and included questions specific to Indigenous people.Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) were conducted. Identification of Indigenous status was reported by 65% of coordinators; referral and attendance rates of Indigenous patients differed greatly across WA. Efforts to meet the cultural needs of Indigenous patients varied and included case management (32%), specific educational materials (35%), use of a buddy or mentoring system (27%), and access to an Aboriginal Health Worker (71%). Staff cultural awareness training was available for 97% and CR guidelines were utilised by 77% of services.The under-representation of Indigenous Australians participating in CR, as reported in the literature and more specifically in this study, mandates a concerted effort to improve services to better meet the needs of Indigenous patients with CVD as part of closing the gap in life expectancy. Improving access to culturally appropriate CR and secondary prevention in WA must be an important component of this effort given the high rates of premature cardiovascular disease affecting Indigenous people. Our findings also highlight the importance of good systematic data collection across services. Health pathways that ensure continuity of care and alternative methods of CR delivery with dedicated resources are needed.
News Article | November 22, 2016
PARKVILLE, AUSTRALIA, November 22, 2016-- Dr. James Angus has been included in Marquis Who's Who. As in all Marquis Who's Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.Dr. Angus has been an Honorary Professorial Fellow and Professor Emeritus of the Department of Pharmacology and Therapeutics, Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne since 2014. From 2003 to 2013, Dr. Angus was Dean of the Faculty of Medicine, Dentistry and Health Sciences.Dr. Angus earned a Bachelor of Science in pharmacology with honors and a Ph.D. from the University of Sydney. In 1974, he was a NHMRC Senior Research Officer at Hallstrom Institute of Cardiology, Royal Prince Alfred Hospital & Department of Medicine at the University of Sydney, and the Baker Medical Research Institute in Prahran, Victoria. In 1977 he received the NHMRC CJ Martin Travelling Fellowship to work with Sir James Black who would go on to receive the Nobel Prize for Medicine in 1988. Dr. Angus then continued to work at the Baker Medical Research Institute in a variety of roles over the next 15 years including Senior Research Officer, Research Fellow, Senior Research Fellow, Principal Research Fellow, and Senior Principal Research Fellow of the National Health and Medical Research Council. He was ultimately named Deputy Director of the Baker Medical Research Institute in 1992. In 1993, Dr. Angus was appointed to the Chair of Pharmacology at the University of Melbourne.His appointments include Chair of the Melbourne Genomics Health Alliance Phase 1 (2014-2016), Governor and Director of the Florey Institute of Neuroscience and Mental Health, a position he has held since 2012, member of the Program Steering Committee of the Australian Council of Learned Academies (2014-2016), member of the Steering Committee to establish the Australian Academy of Health and Medical Sciences (2013-2014), current President of the National Stroke Foundation, current Chair of the University of Melbourne Sport Board, and current Board Director of the Jack Brockhoff Foundation since 2015.Dr. Angus is a Fellow and former Council Member of the Australian Academy of Science as well as the International Academy of Cardiovascular Sciences, and an Honorary Fellow of the Australian Academy of Health and Medical Sciences. Over the past 25 years, he has received numerous research grants from such learned institutions and organizations as the NHMRC, Australian College of Anaesthetists, National Heart Foundation of Australia, Glaxo Smith Kline Pty Ltd, and Johnson & Johnson Pty Ltd.His scientific society memberships include the Australian Physiological and Pharmacology Society, Australian Society for Clinical and Experimental Pharmacology, British Pharmacological Society, Cardiac Society of Australia and New Zealand, High Blood Pressure Research Council of Australia, International Society for Heart Research, International Society of Autonomic Neuroscience and International Union of Pharmacology, of which he was first Vice President (2002-2006).Dr. Angus is a regular contributor to scientific journals, including the Clinical and Experimental Pharmacology and Physiology Journal, the Journal of Vascular Research, the British Journal of Pharmacology, and Pharmacology and Toxicology. He has attended and lectured at numerous national and international scientific meetings.In recognition of professional excellence, he was the recipient of the Alfred Gottschalk Medal of the Australian Academy of Science in 1984, and the Thomson ISI: Australian Citation Laureate in Pharmacology in 2004. In 2010, Dr. Angus was appointed an Officer to The Order of Australia for distinguished service to biomedical research, particularly in the fields of pharmacology and cardiovascular disease, as a leading academic and medical educator, and as a contributor to a range of advisory boards and professional organizations both nationally and internationally. Further, he received the Centenary Medal in 2003 for services to pharmacology and the community. His many important roles throughout scientific and academic circles have brought distinction to the University of Melbourne and to the Melbourne Medical School. For his professional efforts, Dr. Angus was selected for inclusion in Who's Who in Medicine and Healthcare, Who's Who in Science and Engineering, and Who's Who in the World.About Marquis Who's Who :Since 1899, when A. N. Marquis printed the First Edition of Who's Who in America , Marquis Who's Who has chronicled the lives of the most accomplished individuals and innovators from every significant field of endeavor, including politics, business, medicine, law, education, art, religion and entertainment. Today, Who's Who in America remains an essential biographical source for thousands of researchers, journalists, librarians and executive search firms around the world. Marquis now publishes many Who's Who titles, including Who's Who in America , Who's Who in the World , Who's Who in American Law , Who's Who in Medicine and Healthcare , Who's Who in Science and Engineering , and Who's Who in Asia . Marquis publications may be visited at the official Marquis Who's Who website at www.marquiswhoswho.com
Ilton M.K.,Royal Darwin Hospital |
Walsh W.F.,Prince of Wales Hospital |
Brown A.D.H.,South Australian Health and Medical Research Institute |
Brown A.D.H.,University of South Australia |
And 2 more authors.
Medical Journal of Australia | Year: 2014
Aboriginal and Torres Strait Islander patients with acute coronary syndromes (ACS) experience lower intervention rates and poorer outcomes compared with non-Indigenous patients. A broad range of geographical, cultural and systemic factors contribute to delays and suboptimal treatment for ACS. Every Indigenous ACS patient, regardless of where they live, should be able to expect a coordinated, patientcentred pathway of care provided by designated provider clinical networks and supported by Indigenous cardiac coordinators, Aboriginal liaison offi cers (ALOs) and health workers. These designated provider clinical networks provide: ▶ appropriate prehospital and inhospital treatment ▶ an individualised patient care plan developed jointly with the patient and his or her family ▶ culturally appropriate education initiated within the hospital setting and involving families with support from ALOs ▶ eff ective follow-up care and access to relevant secondary prevention programs. We outline generic pathways to provide policymakers, health planners and health care providers with a framework for ACS diagnosis and management that can be implemented across the diverse settings in which Aboriginal and Torres Strait Islander people reside and their care is delivered, in order to optimise care and assertively address the current disparities in outcomes.