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Background: Young people with a mental disorder often perform poorly at school and can fail to complete high school. This study aims to compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder health condition by gender. Method: A population-based matched case-comparison cohort study of young people aged ⩽18 years hospitalised for a mental disorder during 2005–2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers. Results: Young males with a mental disorder had over a 1.7 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.71; 95% confidence interval: [1.35, 2.15]) and reading (adjusted relative risk: 1.99; 95% confidence interval: [1.80, 2.20]) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.50; 95% confidence interval: [1.14, 1.96]) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a sixfold increased risk and young females with multiple disorders had up to an eightfold increased risk of not completing high school compared to peers. Conclusion: Early recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance. [ABSTRACT FROM AUTHOR]

The aim was to investigate the association of cognitive trajectories and overnight surgical hospitalization in older adults, while controlling for and comparing to the association with acute medical hospitalizations. This is a secondary analysis of data from a population-based, longitudinal cohort study of older Australians. Cognition was assessed with 4 biennial waves of prospective neuropsychological data from 1026 Sydney Memory and Aging Study participants age 70 to 90 years at baseline. Hospitalization exposure was obtained from 10 years of electronically linked data from the New South Wales Admitted Patient Data Collection. Latent growth curve modeling estimated global cognition z -score baseline and slope over 6 years, and the effects of contemporaneous surgical and medical hospitalization predictors while controlling for potential demographic and comorbidity confounders. After controlling for confounding variables, this analysis showed that overnight surgical hospitalizations were not associated with worse baseline global cognition or accelerated cognitive decline over 6 years. This was despite this cohort having more surgeries and more complex surgeries compared with Australian data for overnight hospitalizations in over 70-year-olds. Conversely, recent medical hospitalizations were associated with accelerated cognitive decline. This analysis finds that surgery and anesthesia are unlikely to be risk factors for medium to long-term global cognitive decline in healthy older adults, while controlling for contemporaneous medical hospitalizations. These findings are contrary to prior conclusions from several surgical studies that may have been impeded by insufficient comparison groups. They are, however, consistent with recent population-based studies suggesting surgery has minimal association with cognitive decline in the medium to long-term. Future research needs to clarify the association of surgical hospitalization with the full spectrum of cognitive outcomes including subjective cognitive complaints and dementia, and importantly, how these cognitive outcomes correlate with clinically significant functional changes. [ABSTRACT FROM AUTHOR]

Co-administering cannabis with tobacco (i.e. co-administration of the substances mixed together) is a common practice among cannabis users, but the consequences of this practice are not well understood. This study examines the relationship between co-administering cannabis with tobacco and the long-term frequency of cannabis use in a young adult population group with high rates of cannabis and tobacco use. The data are from an Australian prospective population-based study of young adults who recurrently used amphetamine-type stimulants (ATS). The mean age of participants was 20.8 years at baseline, sample size (n = 277), and 47% were female. We examined the frequency and quantity of cannabis consumption over 4 ½ years. Negative binomial regression analysis was conducted to examine the frequency of cannabis use at 12-month follow-up and at 4 ½ years, with co-administering practices as the predictor. At every time interval, participants who always co-administered their cannabis with tobacco used cannabis on more days in the last month than those who only sometimes co-administered, rarely co-administered, or never co-administered these substances (p < 0.001). Sometimes co-administering cannabis with tobacco at baseline predicted more frequent cannabis use at 12-month follow-up (adjusted IRR: 2.25, 95% CI: 1.05, 4.78), independently of the baseline frequency of cannabis use. However, levels of co-administering cannabis with tobacco at 12-month follow-up (rarely, sometimes, and always) did not predict high levels of cannabis use at 4 ½ years follow-up after adjusting for cannabis use at 12-month follow-up. Among people who use ATS and cannabis, frequent cannabis use may be a marker of the practice of co-administering cannabis with tobacco, and can be used to target tobacco cessation interventions in these populations. [ABSTRACT FROM AUTHOR]

Background: Four decades of population-based tobacco control strategies have contributed to substantial reduction in smoking prevalence in Australia. However, smoking prevalence is still double in socially disadvantaged groups compared to those that are not. But not all tobacco control strategies successfully used in the general population is effective in specific high-risk population groups. Hence, an effective way to reduce smoking in high risk population groups may include targeting them specifically to identify and support smokers to quit. In this backdrop, we examined whether tobacco control interventions at the population-level are more effective in increasing life expectancy among Australians compared to interventions targeting a high risk group or a combination of the two when smoking prevalence is reduced to 10 and 0% respectively.Methods: Using the risk percentiles approach, analyses were performed separately for men and women using data from various sources such as the 2014-15 National Health Survey linked to death registry, simulated data for high risk groups, and the Australian population and deaths data from the census. Indigenous status was simulated by preferentially assigning those who are indigenous to lower SES quintiles. The age-sex distribution of mental disorder status was simulated using its distribution from 2016 National Drug Strategy Household Survey with 25.9% of mentally ill being assigned to current smoking category and the rest to non-smoking category. The age-sex distribution of prisoners was simulated based on 2014 ABS Prisoners Australia survey with 74% of prisoners being assigned to current smoker category and the rest to non-smoker category. Homelessness status was simulated according to age, sex and indigenous status for 2011 census with all homeless being allocated to the lowest SES category. The age-sex distribution of total cholesterol level was simulated based on 2011-13 Australian Health Survey.Results: The results showed that the combined approach for reducing smoking is most effective for improving life expectancy of Australians particularly for the socially disadvantaged and mentally ill groups both of which have high fraction of smokers in the population. For those who were mentally ill the gain in ALE due to reduction of smoking to 10% was 0.53 years for males and 0.36 years for females which were around 51 and 42% respectively of the maximal gains in ALE that could be achieved through complete cessation.Conclusions: Targeting high-risk population groups having substantial fraction of smokers in the population can strongly complement the existing population-based smoking reduction strategies. As population and high risk approaches are both important, the national prevention policies should make judicious use of both to maximize health gain. [ABSTRACT FROM AUTHOR]

The association between psychotic illness and poor physical health is now clearly articulated in the literature. By contrast the impact of depression and/or anxiety on physical health is considerably less understood, despite depression being the leading cause of disability worldwide and is associated with significantly higher prevalence of physical comorbidities than found in the general population. An Australia national cross-sectional population-based survey was conducted to ascertain the prevalence of chronic physical health conditions in persons with, and without depression and/or anxiety, allowing for demographic characteristics and lifestyle factors. The telephone-based survey was conducted using trained interviewers. Survey questions included those eliciting information about demographics, health status, and health behaviours. Independent t-tests and chi square tests showed demographic, health behaviours, and physical illness differed between those with and without depression and/or anxiety. Heart disease, high blood pressure, stroke, cancer, arthritis, chronic neck and/or back pain, and asthma were significantly higher in participants diagnosed with depression and/or anxiety. Binary logistic regression showed the strongest predictor of chronic illness was having a diagnosis of depression and/or anxiety. Depression and anxiety present major health problems impacting a considerable proportion of the population. A greater understanding of the associated physical health issues should provide impetus to broaden the physical health and mental illness research agenda to include these diagnoses. [ABSTRACT FROM AUTHOR]

Background: Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage‐associated morbidities, have been reported in many high‐resource countries. In‐depth analysis of such factors in Victorian births since 2002 was lacking. Aims: Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003–2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009–2013. Materials and methods: In this population‐based cross‐sectional study de‐identified data from the Victorian Perinatal Data Collection were analysed for confinements (excluding terminations) from 2003 to 2013 (n = 764 244). Perinatal information for all births ≥20 weeks (or of at least 400 g birthweight if gestation was unknown) were prospectively collected. Results: One in five women (21.8%) who gave birth between 2009 and 2013 experienced a primary postpartum haemorrhage and one in 71 women (1.4%) experienced a severe primary postpartum haemorrhage. The increasing trends in incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage, blood transfusion, admission to an intensive care or high dependency unit and peripartum hysterectomy were significant (P < 0.001). Women who had an unassisted vaginal birth had the lowest incidence of primary postpartum haemorrhage. The highest incidence was experienced by women who had an unplanned caesarean section birth. Women who had a forceps birth had the highest incidence of severe primary postpartum haemorrhage. Conclusions: The incidence of primary postpartum haemorrhage, severe primary postpartum haemorrhage and associated maternal morbidities have increased significantly over time in Victoria. [ABSTRACT FROM AUTHOR]

Cardiovascular events and mortality have shown a higher incidence within the Christmas holiday period in previous studies and in the northern and southern hemisphere. Our study aimed to assess changes in cardiovascular and stroke mortality variation around the Christmas period in Australia. The study design is a population-based case-control study. Daily mortality data attributed to stroke and cardiovascular was compiled from Australia between 1989 and 2015, amounting to approximately 700,000 and 250,000 deaths, respectively. A locally weighted polynomial regression line was used to estimate expected mortality rates during that period and compared with actual results. There was a non-significant increase of 1.08% (P = 0.35) and 0.20% (P = 0.87) for coronary heart disease and stroke mortality, respectively, in the Christmas holiday period. There is no evidence of an increase in cardiovascular and stroke mortality in the Christmas holiday period in Australia. • There was no increased Christmas risk of cardiovascular (P =.35) or stroke mortality (P =.87). • Winter months had higher mortality. • International differences in Holiday effects may relate to temperature, culture or medical systems. • Understanding mortality spikes are critical to promote safety and health awareness campaigns. [ABSTRACT FROM AUTHOR]

Background: Binge eating disorder (BED) is relatively common in young people and is associated with marked impairment in physical and mental health. Aims: We examined perceptions of the severity of BED in a population-based sample of adolescents. Methods: Male (n = 531) and female (n = 1135) adolescents recruited from 12 Australian schools completed a survey that featured a vignette of a fictional female school student suffering from BED followed by a series of questions addressing perceptions of severity. Results: Approximately half of participants agreed or strongly agreed that BED is a serious problem (male: 52.0%; female: 63.2%) requiring professional treatment (male: 48.2%; female: 54.5%). Approximately one-third of boys (30.7%) believed that BED is primarily a problem of "lack of will power/self-control", whereas one in five girls (19.3%) held this view. Less than half of participants (male: 42.7%; female: 44.1%) believed that someone with BED would be deserving of sympathy. Conclusion: The findings suggest that many adolescents, boys in particular, do not consider BED to be a serious mental health problem and believe that individuals with BED lack will-power and/or are undeserving of sympathy. Awareness and understanding of BED may need to be addressed in school-based mental health promotion programs. [ABSTRACT FROM AUTHOR]

Background: One in four Australians is born overseas and 47% are either born overseas or have a parent who was. Obstetric and psychosocial risk factors for these women may differ.Method: Data from one Sydney hospital (2012-2013) of all births recorded in the ObstetriX database were analysed (n = 3,092). Demographics, obstetric and psychosocial risk profile, obstetric interventions and complications and selected maternal and neonatal outcomes were examined for women born in Australia and overseas.Results: Women born in Australia were younger, more likely to be primiparous (28.6 v 27.5%), be obese (32.0% v 21.4%), smoke (19.7 % v 3.0%), have an epidural (26.2% v 20.2%) and were less likely to have gestational diabetes mellitus (GDM) (6.8% v 13.7% when compared to non-Australian born women. The highest rates of GDM, Gestational Hypertension (GH) and maternal anaemia were seen in women born in China, the Philippines and Pakistan respectively. Differences were also seen in psychosocial screening between Australian and non-Australian women with Australian-born women more likely to smoke and report a mental health disorder. There was an association between having an Edinburgh Postnatal Depression Scale (EPDS) ≥ 13 and other psychosocial issues, such as thoughts of self-harm, domestic violence, childhood abuse etc. These women were also less likely to breastfeed. Women with an EPDS ≥ 13 at booking compared to women with EPDS ≤12 had a higher chance of being diagnosed with GDM (AOR 1.85 95% CI 1.14-3.0).Conclusions: There are significant differences in obstetric and psychosocial risk profiles and maternal and neonatal outcomes between Australian-born and non-Australian born women. In particular there appears to be an association between an EPDS of ≥13 and developing GDM, which warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Indigenous people have disproportionally worse health and lower life expectancy than their non-indigenous counterparts in high-income countries. Cancer data for indigenous people are scarce and incidence has not previously been collectively reported in Australia, New Zealand, Canada, and the USA. We aimed to investigate and compare, for the first time, the cancer burden in indigenous populations in these countries.Methods: We derived incidence data from population-based cancer registries in three states of Australia (Queensland, Western Australia, and the Northern Territory), New Zealand, the province of Alberta in Canada, and the Contract Health Service Delivery Areas of the USA. Summary rates for First Nations and Inuit in Alberta, Canada, were provided directly by Alberta Health Services. We compared age-standardised rates by registry, sex, cancer site, and ethnicity for all incident cancer cases, excluding non-melanoma skin cancers, diagnosed between 2002 and 2006. Standardised rate ratios (SRRs) and 95% CIs were computed to compare the indigenous and non-indigenous populations of each jurisdiction, except for the Alaska Native population, which was compared with the white population from the USA.Findings: We included 24 815 cases of cancer in indigenous people and 5 685 264 in non-indigenous people from all jurisdictions, not including Alberta, Canada. The overall cancer burden in indigenous populations was substantially lower in the USA except in Alaska, similar or slightly lower in Australia and Canada, and higher in New Zealand compared with their non-indigenous counterparts. Among the most commonly occurring cancers in indigenous men were lung, prostate, and colorectal cancer. In most jurisdictions, breast cancer was the most common cancer in women followed by lung and colorectal cancer. The incidence of lung cancer was higher in indigenous men in all Australian regions, in Alberta, and in US Alaska Natives than in their non-indigenous counterparts. For breast cancer, rates in women were lower in all indigenous populations except in New Zealand (SRR 1·23, CI 95% 1·16-1·32) and Alaska (1·14, 1·01-1·30). Incidence of cervical cancer was higher in indigenous women than in non-indigenous women in most jurisdictions, although the difference was not always statistically significant.Interpretation: There are clear differences in the scale and profile of cancer in indigenous and non-indigenous populations in Australia, New Zealand, Canada, and the USA. Our findings highlight the need for much-improved, targeted programmes of screening, vaccination, and smoking cessation, among other prevention strategies. Governments and researchers need to work in partnership with indigenous communities to improve cancer surveillance in all jurisdictions and facilitate access to cancer data.Funding: International Agency for Research on Cancer-Australia Fellowship. [ABSTRACT FROM AUTHOR]

Objective: To describe trends in age-specific incidence rates of female sterilization (FS) procedures in Western Australia and to evaluate the effects of the introduction of government-subsidized contraceptive methods and the implementation of the Australian government's baby bonus policy on FS rates.Design: Population-based retrospective descriptive study.Setting: Not applicable.Patient(s): All women ages 15-49 undergoing an FS procedure during the period January 1, 1990, to December 31, 2008 (n = 47,360 procedures).Intervention(s): Records from statutory statewide data collections of hospitals separations and births were extracted and linked.Main Outcome Measure(s): Trends in FS procedures and the influence on these trends of the introduction of government policies: subsidization of long-acting reversible contraceptives (Implanon and Mirena) and the Australian baby bonus initiative.Result(s): The annual incidence rate of FS procedures declined from 756.9 per 100,000 women in 1990 to 155.2 per 100,000 women in 2008. Compared with the period 1990-1994, women ages 30-39 years were 47% less likely (rate ratio [RR] = 0.53; 95% confidence interval [CI], 0.39-0.72) to undergo sterilization during the period 2005-2008. Adjusting for overall trend, there were significant decreases in FS rates after government subsidization of Implanon (RR = 0.89; 95% CI, 0.82-0.97) and Mirena (RR = 0.81; 95% CI, 0.73-0.91) and the introduction of the baby bonus (RR = 0.70; 95% CI, 0.61-0.81).Conclusion(s): Rates of female sterilization procedures in Western Australia have declined substantially across all age groups in the last two decades. Women's decisions to undergo sterilization procedures may be influenced by government interventions that increase access to long-term reversible contraceptives or encourage childbirth. [ABSTRACT FROM AUTHOR]

Background The Barwon area in Australia has one of the highest incidence rates of inflammatory bowel disease ( IBD) and therefore is an ideal location to study the impact of environmental exposures on the disease's development. Aim To study these exposures prior to the development of IBD in a population-based cohort. Method One hundred and thirty-two incident cases (81 Crohn disease ( CD) and 51 ulcerative colitis ( UC)) from an IBD registry and 104 controls replied to the International Organization of Inflammatory Bowel Diseases environmental questionnaire. This included 87 questions about pre-illness exposures that included childhood illnesses, vaccinations, breastfeeding, house amenities, pets and swimming, diet and smoking. Results The factors associated with CD included smoking (odds ratio ( OR): 1.42, confidence interval ( CI): 1-2.02, P = 0.029); childhood events, including tonsillectomy ( OR: 1.74, CI: 1.15-2.6, P = 0.003) and chicken pox infection ( OR: 3.89, CI: 1.61-9.4, P = 0.005) and pre-diagnosis intake of frequent fast food ( OR: 2.26, CI: 1.76-4.33, P = 0.003). In UC, the risk factors included smoking ( OR: 1.39, CI: 1.1-1.92, P = 0.026) and pre-diagnosis intake of frequent fast food ( OR: 2.91, CI: 1.54-5.58, P < 0.001), and high caffeine intake was protective ( OR: 0.51, 95% CI: 0.3-0.87, P = 0.002). Other protective exposures for UC included high fruit intake ( OR: 0.59, CI: 0.4-0.88, P = 0.003) and having pets as a child ( OR: 0.36, CI: 0.2-0.79, P = 0.001). Conclusion This first Australian population-based study of environmental risk factors confirms that smoking, childhood immunological events and dietary factors play a role in IBD development; while high caffeine intake and pet ownership offer a protective effect. [ABSTRACT FROM AUTHOR]