EQ-5D-5L Population Norms and Quality-Adjusted Life Expectancy by Sociodemographic Characteristics and Modifiable Risk Factors for Adults in Queensland, Australia.

OBJECTIVES: Over half of Australia's disease burden is due to morbidity, predominantly chronic conditions. Health-related quality of life instruments provide measures of morbidity and health status across different dimensions with EQ-5D being one of the most widely used. This study reports EQ-5D-5L general population norms for Queensland, Australia using the recently published Australian value set. METHODS: Population survey results from cross-sectional computer-assisted telephone interviews for Queensland adults in 2022 and 2023 were analyzed. EQ-5D-5L, as well as modifiable risk factors and sociodemographic data were collected. Using the recently published final Australian EQ-5D-5L value set, mean utility scores were calculated for Queensland, as well as by sociodemographic characteristics, including remoteness and socioeconomic area-based measures, and modifiable risk factors, such as smoking and body mass index. Results were combined with life tables to estimate quality-adjusted life expectancy (QALE) for subgroups with different lifestyles. RESULTS: The EQ-5D utility score for the Queensland adult population was 0.916. Smoking daily, being obese or older in age, or living in the most disadvantaged socioeconomic area were associated with lower mean scores. QALE was 6.1 and 7.9 years shorter than the life expectancy for Queensland males and females, respectively, but generally, those who reported having healthier lifestyles had higher mean utility scores and thus longer QALE. CONCLUSIONS: In addition to reporting Queensland EQ-5D-5L general population norms, these results demonstrate potential QALE gains in people following healthier lifestyles. The results support investment in prevention and may motivate further studies in this important area.

Dynavision Normative Data for Healthy Adults: Reaction Test Program.

IMPORTANCE: Previous research has calculated normative data for the Dynavision D2 Visuomotor Training (D2) System among healthy athletes to understand concussion management, but to date no studies have identified the norms for healthy adults over a large age range (18-80 yr) for physical response speed. OBJECTIVE: To provide normative data for the D2 for physical response speed in adults ages 18-80 yr. DESIGN: Cross-sectional, descriptive study to obtain normative data on physical response speed using the D2 for adults in age categories 18-40, 41-60, and 61-80 yr. SETTING: Genesis Physical Therapy and Wellness Center, a Midwestern outpatient hospital-based therapy center. PARTICIPANTS: Three hundred adults, stratified into three different age categories. Normal standards with quartiles were identified for each age and sex category. OUTCOMES AND MEASURES: Multiple regression model of the inverse response times. RESULTS: The results showed a significant difference in physical response speed between men and women and between the different age groups. Women in all age categories were slower than men. Physical response speed increased with age in both sexes, but each had significantly different age and sex main effects (p < .0005). CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners can use the normative standards identified in this study in their assessment of clients with visual and cognitive deficits after a brain injury, stroke, or other neurologic pathology. WHAT THIS ARTICLE ADDS: This study's results can be added to the battery of other common evaluation measures that occupational therapists use to evaluate visual and cognitive deficits after neurological impairments.

Psychological distress may affect nutrition indicators in Australian adults.

OBJECTIVE: The purpose of this research was to explore which demographic and health status variables moderated the relationship between psychological distress and three nutrition indicators: the consumption of fruits, vegetables and takeaway. METHOD: We analysed data from the 2009 Self-Reported Health Status Survey Report collected in the state of Queensland, Australia. Adults (N = 6881) reported several demographic and health status variables. Moderated logistic regression models were estimated separately for the three nutrition indicators, testing as moderators demographic (age, gender, educational attainment, household income, remoteness, and area-level socioeconomic status) and health status indicators (body mass index, high cholesterol, high blood pressure, and diabetes status). RESULTS: Several significant interactions emerged between psychological distress, demographic (age, area-level socio-economic status, and income level), and health status variables (body mass index, diabetes status) in predicting the nutrition indicators. Relationships between distress and the nutrition indicators were not significantly different by gender, remoteness, educational attainment, high cholesterol status, and high blood pressure status. CONCLUSIONS: The associations between psychological distress and several nutrition indicators differ amongst population subgroups. These findings suggest that in distressed adults, age, area-level socio-economic status, income level, body mass index, and diabetes status may serve as protective or risk factors through increasing or decreasing the likelihood of meeting nutritional guidelines. Public health interventions for improving dietary behaviours and nutrition may be more effective if they take into account the moderators identified in this study rather than using global interventions.

A comparison of EQ-5D-3L population norms in Queensland, Australia, estimated using utility value sets from Australia, the UK and USA.

PURPOSE: To provide population norms for the EQ-5D-3L by age and gender based on a representative adult sample in Queensland, Australia; to assess differences in health-related quality of life by applying the Australian, UK and USA value sets to these data; and to assess differences in utility scores for key preventive health indicators. METHODS: A cross-sectional computer-assisted telephone interview survey (March-June 2011) with 5,555 adults. Respondents rated their impairment (none, moderate, severe problems) across five domains (mobility, self-care, usual activities, pain and discomfort, anxiety or depression) using the validated EQ-5D-3L health-related quality of life instrument. Utility score indexes were derived using the Australian, UK and USA value sets. RESULTS: Forty per cent of adults reported pain and discomfort while 3% indicated problems with self-care. Approximately one in six had limitations with mobility, usual activities or anxiety or depression. The three value sets performed similarly in discriminating differences based on most characteristics, and clinically meaningful differences were seen for age, body weight, physical activity and daily smoking. There were no differences in utility scores for gender. CONCLUSIONS: This is the first study to report general population findings for the Australian EQ-5D-3L value set. Overall, the Australian value set performed comparably with other value sets commonly used in the Australian population; however, differences were observed. Results will enable further refinement to health and economic studies in an Australian-specific context.

Summer of sorrow: measuring exposure to and impacts of trauma after Queensland's natural disasters of 2010-2011.

OBJECTIVES: To assess the population prevalence of property, income and emotional impacts of the 2010-2011 Queensland floods and cyclones. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional telephone-based survey using a brief trauma exposure and impact screening instrument, conducted between 11 March and 6 June 2011, of 6104 adults who answered natural disaster and mental health questions. MAIN OUTCOME MEASURES: Natural disaster property damage exposure and emotional wellbeing impacts. RESULTS: Two-thirds of respondents (62%) reported being affected by the disasters, with property damage exposure ranging from 37.2% (suburb or local area) to 9.2% (own home, with 2.1% living elsewhere at least temporarily). Income was reduced for 17.0% of respondents and 11.7% of income-producing property owners reported damage to those properties. Trauma impacts ranged from 14.3% of respondents feeling "terrified, helpless or hopeless" to 3.9% thinking they might be "badly injured or die". Up to 5 months after the disasters, 7.1% of respondents were "still distressed" and 8.6% were "worried about how they would manage". Adults of working age and residents of regional and remote areas and of socioeconomically disadvantaged areas were disproportionately likely to report exposure to damage and emotional impacts. CONCLUSIONS: Weather-related disasters exact a large toll on the population through property damage and resultant emotional effects. Vulnerable subpopulations are more severely affected. There is a need for realistic, cost-effective and rapid-deployment mass interventions in the event of weather disasters.

Frequency of sunburn in Queensland adults: still a burning issue.

OBJECTIVE: To assess the current frequency of sunburn, a preventable risk factor for skin cancer, among Queensland adults. DESIGN AND SETTING: Cross-sectional population-based surveys of 16 473 residents aged ≥ 18 2013s across Queensland in 2009 and 2010. MAIN OUTCOME MEASURES: Proportion of the adult population reporting sunburn (skin reddening lasting 12 hours or more) during the previous weekend, by age, sex and other risk factors. RESULTS: One in eight men and one in 12 women in Queensland reported being sunburnt on the previous weekend. Age up to 65 2013s was the strongest predictor of sunburn: eg, people aged 18-24 2013s were seven times more likely (adjusted odds ratio [OR], 7.35; 95% CI, 5.09-10.62) and those aged 35-44 2013s were five times more likely (adjusted OR, 5.22) to report sunburn compared with those aged ≥ 65 2013s. Not having a tertiary education and being in the workforce were also significantly associated with sunburn. Those who had undertaken any physical activity the previous week were more likely to be sunburnt than those who were physically inactive. Sunburn was significantly less likely among people who generally took sun-protective measures in summer. Sunburn was not related to location of residence, socioeconomic disadvantage, skin colour, body weight or current smoking status. CONCLUSIONS: Sunburn remains a public health problem among Queensland residents, especially those under 45 2013s of age. Sun-safe habits reduce sunburn risk, but advice must be integrated with health promotion messages regarding physical activity to reduce the skin cancer burden while maintaining active wellbeing.

New directions in childhood obesity research: how a comprehensive biorepository will allow better prediction of outcomes.

BACKGROUND: Childhood obesity is associated with the early development of diseases such as type 2 diabetes and cardiovascular disease. Unfortunately, to date, traditional methods of research have failed to identify effective prevention and treatment strategies, and large numbers of children and adolescents continue to be at high risk of developing weight-related disease. AIM: To establish a unique 'biorepository' of data and biological samples from overweight and obese children, in order to investigate the complex 'gene × environment' interactions that govern disease risk. METHODS: The 'Childhood Overweight BioRepository of Australia' collects baseline environmental, clinical and anthropometric data, alongside storage of blood samples for genetic, metabolic and hormonal profiles. Opportunities for longitudinal data collection have also been incorporated into the study design. National and international harmonization of data and sample collection will achieve required statistical power. RESULTS: Ethical approval in the parent site has been obtained and early data indicate a high response rate among eligible participants (71%) with a high level of compliance for comprehensive data collection (range 56% to 97% for individual study components). Multi-site ethical approval is now underway. CONCLUSIONS: In time, it is anticipated that this comprehensive approach to data collection will allow early identification of individuals most susceptible to disease, as well as facilitating refinement of prevention and treatment programs.

Trends in Total Physical Activity Time, Walking, and Vigorous Physical Activity Time in Queensland Adults From 2004-2018.

BACKGROUND: Health benefits of physical activity (PA) accrue with small increases in PA, with the greatest benefits for those transitioning from inactivity to any level of PA. This study examined whether self-reported PA time in Queensland adults changed between 2004 and 2018. METHODS: The Queensland government conducts regular cross-sectional telephone surveys. Between 2004 and 2018, adults aged 18-75 years answered identical questions about their weekly minutes of walking, moderate PA, and vigorous PA. Hurdle regression estimated the average annual change in weekly minutes of PA overall and by activity type, focusing on sociodemographic differences in trends. RESULTS: The sample size averaged 1764 (2004-2008) and 10,188 (2009-2018), totaling 107,171 participants aged 18-75 years. Unadjusted PA increased by 10 minutes per week per year (95% confidence interval [CI], 8.8-11.1) overall, with increases for most subgroups. Adjusted PA increased by 10.5 minutes per week per year (95% CI, 9.4-11.7). Trends differed by employment-employed adults and those not in the labor force increased by 14.3 (95% CI, 12.8-15.8) and 2.2 minutes per week per year (95% CI, 0.4-4.0), respectively, with no increase for unemployed adults. The increases were due to both an increased prevalence of doing any activity and an increased average duration among active adults. CONCLUSIONS: Since 2004, PA time has increased for Queensland adults, with substantial variability by employment status.

Income inequality and alcohol attributable harm in Australia.

BACKGROUND: There is little research on the relationship between key socioeconomic variables and alcohol related harms in Australia. The aim of this research was to examine the relationship between income inequality and the rates of alcohol-attributable hospitalisation and death at a local-area level in Australia. METHOD: We conducted a cross sectional ecological analysis at a Local Government Area (LGA) level of associations between data on alcohol caused harms and income inequality data after adjusting for socioeconomic disadvantage and remoteness of LGAs.The main outcome measures used were matched rate ratios for four measures of alcohol caused harm; acute (primarily related to the short term consequences of drinking) and chronic (primarily related to the long term consequences of drinking) alcohol-attributable hospitalisation and acute and chronic alcohol-attributable death. Matching was undertaken using control conditions (non-alcohol-attributable) at an LGA level. RESULTS: A total of 885 alcohol-attributable deaths and 19467 alcohol-attributable hospitalisations across all LGAs were available for analysis. After weighting by the total number of cases in each LGA, the matched rate ratios of acute and chronic alcohol-attributable hospitalisation and chronic alcohol-attributable death were associated with the squared centred Gini coefficients of LGAs. This relationship was evident after adjusting for socioeconomic disadvantage and remoteness of LGAs. For both measures of hospitalisation the relationship was curvilinear; increases in income inequality were initially associated with declining rates of hospitalisation followed by large increases as the Gini coefficient increased beyond 0.15. The pattern for chronic alcohol-attributable death was similar, but without the initial decrease. There was no association between income inequality and acute alcohol-attributable death, probably due to the relatively small number of these types of death. CONCLUSION: We found a curvilinear relationship between income inequality and the rates of some types of alcohol-attributable hospitalisation and death at a local area level in Australia. While alcohol-attributable harms generally increased with increasing income inequality, alcohol-attributable hospitalisations actually showed the reverse relationship at low levels of income inequality. The curvilinear patterns we observed are inconsistent with monotonic trends found in previous research making our findings incompatible with previous explanations of the relationship between income inequality and health related harms.

A review of the impacts of health and health behaviors on women's alcohol use.

OBJECTIVES: To summarize longitudinal research regarding physical health and health behaviors on women's subsequent alcohol use. METHODS: Medline/PsycINFO databases were searched; from over 5000 articles, 29 met inclusion criteria. RESULTS: Prior consumption and substance use are strong predictors of later consumption. Prior consumption was also reported to moderate the relationship between other health/health behaviors variables and consumption. Perception of one's health status may be important in modifying consumption patterns among some subgroups. CONCLUSIONS: Routine alcohol screening may help identify women at risk of developing harmful alcohol use. Mechanisms to reduce alcohol access among young women should be supported.

Comparison of a food-frequency questionnaire method and a quantity-frequency method to classify risky alcohol consumption in women.

AIMS: Population surveys use a variety of methods to collect data on alcohol consumption. Comparability of results across methods is a prime consideration. Different methods have been demonstrated to be robust in terms of ranking individuals' alcohol use, while results have been mixed regarding comparability in terms of volume of consumption. In Australia, evidence-based guidelines have been developed that identify critical thresholds of consumption that are associated with increased risk of alcohol-related morbidity. This study investigated whether the identification of individuals consuming alcohol above these thresholds was consistent across two methods used to collect data on consumption. METHODS: The Australian Longitudinal Study of Women's Health (ALSWH) incorporated both a quantity-frequency (QF) method and a food-frequency questionnaire (FFQ) to collect data on alcohol consumption. Comparisons were made between these two methods on the ability to classify women consuming alcohol as risky (between 176 and 350 ml of pure alcohol weekly) and at high risk (greater than 350 ml of pure alcohol weekly) levels. RESULTS: The ranking of individuals was robust across methods. However, concordance in identifying risky/high-risk drinkers varied considerably based on the assumptions underlying the different methods used to calculate drinking volume using the FFQ. Similarly, the sensitivity and specificity of the FFQ methods compared to QF in terms of identifying risky/high-risk consumers were high but variable. CONCLUSIONS: This study indicated that the proportion of respondents exceeding consumption thresholds was sensitive to the instrument used to collect data on alcohol intake. Quantifying such differences is important when making comparisons between surveys that use different methodologies.

Where children play most: physical activity levels of school children across four settings and policy implications.

OBJECTIVE: This study examined physical activity levels among 2,296 Queensland school children in the school, club sport, active transport and free time settings. Childhood physical activity contributes to musculoskeletal strength, psychosocial benefits and cardiovascular health. METHODS: Data were collected from parents by computer-assisted telephone interview on an annual preventive health monitoring survey conducted by the Queensland Government. RESULTS: Parents reported that children achieved the largest proportions of their physical activity in school (33%) or their free time (42%). Moderate participation levels were reported for active transport and organised sport and these activities contributed lower proportions to total physical activity (10% and 15%, respectively). After adjusting for age and sex, living in a family with higher levels of activity and with a parent that knows physical activity guidelines was associated with higher activity levels. Implications for public health: Increasing physical activity in settings where less active children are already participating, specifically in school settings and during free time, may have more immediate benefits than encouraging children to be active in new settings. Many children achieve seven or more hours of physical activity weekly but do not meet the physical activity guideline criterion of 60 minutes of physical activity daily; consequently, quantifying physical activity solely against the guidelines may underestimate children's physical activity.

Alcohol consumption of Australian women: results from the Australian Longitudinal Study on Women's Health.

INTRODUCTION AND AIMS: Alcohol misuse is responsible for extensive personal harm and high societal costs. Research related specifically to women's alcohol consumption is important due to gender differences in clinical outcomes and disease progression. DESIGN AND METHODS: This study examines longitudinal changes in the patterns of alcohol consumption associated with harm in the long term (chronic) and short term (acute) as defined by the Australian National Health and Medical Research Council. Results are presented for three age cohorts (18 - 23 years, 45 - 50 years and 70 - 75 years) using data from the Australian Longitudinal Study on Women's Health 1996 - 2003. Initial response rates for the study were 41%, 54% and 36% for the Younger, Mid-aged and Older cohort, respectively. RESULTS: The percentages of women that initiated usual weekly consumption in excess of 140 g of alcohol, designated as long-term risky or high risk consumption, between surveys 1 and 2 were 2.7%, 2.1% and 1.7% (Younger, Mid-aged and Older cohorts, respectively). Similarly, between surveys 1 and 2, 7.8% of younger women and 2.5% of mid-aged women initiated consumption of 50 g of alcohol on one occasion at least weekly, placing them at risk of alcohol-related harm in the short-term weekly. Examining data across the three time-points in the Younger cohort, 0.3% of women were at risk of alcohol-related harm in the long term across all three time-points, and 9.2% were at risk at one or two time-points. The percentage of younger women at risk of alcohol-related harm in the short term at least weekly was 3.4% at risk at all three time-points and 24% at risk at one or two time-points. DISCUSSION AND CONCLUSIONS: This study indicates that there is a small percentage of women who maintain levels of alcohol consumption associated with increased risk of morbidity and mortality over time, but a much larger proportion of women that drink at hazardous levels sporadically during the life course. Prevention efforts may need to target transient high-risk alcohol consumers differently than consistently heavy alcohol consumers. Non-response bias and attrition may have caused the prevalence of both entrenched and episodic heavy consumption to be underestimated.

Including mobile-only telephone users in a statewide preventive health survey-Differences in the prevalence of health risk factors and impact on trends.

The Queensland preventive health survey is conducted annually to monitor the prevalence of behavioural risk factors in the north-east Australian state. Prompted by domestic and international trends in mobile telephone usage, the 2015 survey incorporated both mobile and landline telephone numbers from a list-based sampling frame. Estimates for landline-accessible and mobile-only respondents are compared to assess potential bias in landline-only surveys in the context of public health surveillance. Significant differences were found in subcategories of all health prevalence estimates considered (alcohol consumption, body mass index, smoking, and physical activity) from 2015 survey results. Results from Australian and international studies that have considered mobile telephone non-coverage bias are also summarised and discussed. We find that adjusting for sampling biases of telephone surveys by weighting does not fully compensate for the differences in prevalence estimates. However, predicted trends from previous years' surveys only differ significantly for the 2015 prevalence estimates of alcohol consumption. We conclude that the inclusion of mobile telephones into standard telephones surveys is important for obtaining valid, reliable and representative data to reduce bias in health prevalence estimates. Importantly, unlike some international experiences, the addition of mobiles telephones into the Queensland preventive health survey occurred before population trends were significantly affected.

Estimating the prevalence of individuals likely to use publicly funded alcohol treatment services: an indirect estimation technique.

INTRODUCTION AND AIMS: Determining prevalence estimates of illicit or stigmatized behaviours is problematic, due to under-reporting and difficulties in sampling adequately populations most at risk of engaging in such behaviours. This has led to the development of indirect prevalence estimation techniques such as multiplier methods, capture-recapture, multivariate indicator methods and back-calculation. This study reports on the development of a treatment multiplier to estimate the number of clients estimated to seek treatment through publicly funded services annually. DESIGN AND METHODS: This study uses a multiplier method of indirect prevalence estimation, using the number of clients receiving publicly funded treatment as the benchmark population. Data for the multiplier were collected through a drug and alcohol telephone information and referral helpline. Participants are callers seeking assistance for their own alcohol use. RESULTS: Results indicate that up to 40 200 individuals (95% confidence interval: 34 900, 47 000) may seek treatment at these agencies annually. This estimate represents a 300% increase in current publicly funded treatment provision. DISCUSSION AND CONCLUSION: This method was cost-effective and resulted in estimates similar to those obtained through a population-based survey. This method can be adapted easily to areas with a complete registry of clients receiving publicly funded alcohol or drug treatment services and a helpline service with adequate geographic coverage.

Patterns and incidence of gamma-hydroxybutyrate (GHB)-related ambulance attendances in Melbourne, Victoria.

OBJECTIVE: To examine the nature and extent of ambulance attendances involving gamma-hydroxybutyrate (GHB) and to compare these with heroin-related attendances in Melbourne, Victoria. DESIGN: Retrospective analysis of a database of ambulance service records on attendances at non-fatal drug overdoses, March 2001-October 2005. PARTICIPANTS AND SETTING: Patients who took GHB and were attended to by an ambulance, as recorded by Metropolitan Ambulance Service (Melbourne) paramedics. MAIN OUTCOME MEASURES: Transportation to hospital by ambulance; other outcomes included number, age, sex and Glasgow Coma Score (GCS) of patients, characteristics of attendances (in public or private space, others present, police co-attendance). RESULTS: There were 618 GHB-related ambulance attendances across the 46 months of data collection; 362 involving GHB only and 256 involving the concurrent use of GHB and other drugs. These figures compare to 3723 heroin overdoses observed during the same period. The number of GHB-related attendances increased by around 4% per month, which was a higher rate of increase than that found for heroin overdose attendances. Most patients were younger than 25 years, were attended in public spaces, and had a GCS <10. Around 90% of patients were transported to hospital, compared with 21% of heroin overdose attendances. CONCLUSIONS: Ambulance attendance data can be used to index GHB-associated harms. The clear increases in GHB-related ambulance attendances over time highlights the need for further research on how best to respond to this emergent drug-related harm.

Respiratory syncytial virus detection by Remel Xpect, Binax Now RSV, direct immunofluorescent staining, and tissue culture.

The performance characteristics of Xpect RSV (XP) and Binax Now RSV (BN) were compared to those of direct fluorescent-antibody staining and/or tissue culture for detection of respiratory syncytial virus (RSV) in nasopharyngeal aspirate and wash samples from children (n = 110) and adults (n = 66). The sensitivity, specificity, positive predictive value, and negative predictive value of XP were 75%, 98%, 95%, and 90%, respectively; and those of BN were 74%, 100%, 100%, and 90%, respectively. The performances of the assays were similar within a given age group and specimen type (nasopharyngeal aspirate or wash specimen). XP and BN are useful for screening for RSV in respiratory specimens when large volumes are tested or low levels of staffing occur.