ObjectivesTo explore the perceptions of Aboriginal Community Controlled Health Service (ACCHS) staff involved in providing mental healthcare to Aboriginal young people of the current and ideal pathways to mental healthcare for urban Aboriginal young people attending ACCHSs, and to identify what additional supports staff may need to provide optimal mental healthcare to Aboriginal young people.DesignQualitative interview study conducted during May 2016–2017.SettingPrimary care, at two ACCHSs participating in the Study of Environment on Aboriginal Resilience and Child Health in New South Wales.ParticipantsPurposive sampling of staff involved in mental healthcare pathways of Aboriginal young people, including general practitioners (GPs), nurses and Aboriginal Health Workers (AHWs).ResultsAll individuals approached for interview (n=21) participated in the study. Four overarching themes and seven sub-themes were identified: availability and use of tools in practice (valuing training and desire for tools and established pathways), targeting the ideal care pathway (initiating care and guiding young people through care), influencing the care pathway (adversities affecting access to care and adapting the care pathway) and assessing future need (appraising service availability).ConclusionsParticipants desired screening tools, flexible guidelines and training for healthcare providers to support pathways to mental healthcare for Aboriginal young people. Both GPs and AHWs were considered key in identifying children at risk and putting young people onto a pathway to receive appropriate mental healthcare. AHWs were deemed important in keeping young people on the care pathway, and participants felt care pathways could be improved with the addition of dedicated child and adolescent AHWs. The ACCHSs were highlighted as essential to providing culturally appropriate care for Aboriginal young people experiencing mental health problems, and funding for mental health specialists to be based at the ACCHSs was considered a priority.
Background: Findings from previous studies reporting on the associations between chronic obstructive pulmonary disease (COPD) and various dietary patterns have been inconsistent. This review aims to summarise the evidence on the strength of the association between dietary patterns and the prevalence and incidence of COPD. Methods: We conducted a comprehensive search of seven databases between 1 January 1980 and 30 November 2019. Two reviewers independently reviewed each manuscript through the screening, selection, data extraction and quality assessment stages. Data from eight observational studies that met the inclusion criteria were extracted and random-effects meta-analysis was subsequently conducted. Results: Eight observational studies (all eight reporting on healthy dietary patterns and three on unhealthy dietary patterns) met the inclusion criteria and data were extracted to include in the meta-analysis. Consumption of a healthy dietary pattern was associated with a lower risk of COPD ( pooled OR 0.88, 95% CI 0.82-0.94). Consumption of unhealthy dietary patterns was associated with a higher risk of COPD (OR 1.22, 95% CI 0.84-1.76); however, the results were not statistically significant and had high heterogeneity (I 2 =91%). Conclusion: Our results suggests that healthy dietary patterns are associated with a lower prevalence of COPD, while unhealthy dietary patterns are not. More studies, particularly adequately powered longitudinal studies, are needed to further elucidate the effects of healthy and unhealthy dietary patterns on risk of COPD. @ERSpublications This review suggests that individuals with healthy dietary pattern have lower risk of chronic obstructive pulmonary disease http://bit.ly/331PVJ1 Cite this article as: Parvizian MK, Dhaliwal M, Li J, et al. Relationship between dietary patterns and COPD: a systematic review and meta-analysis. ERJ Open Res 2020; 6: 00168-2019 [https://doi.
Background The relationship between ABO non‐identical transfusion and the outcomes of necrotizing enterocolitis (NEC), and all‐cause mortality in very‐low birth weight (VLBW) neonates receiving red blood cell transfusion is unknown. Study design and methods A retrospective multicenter cohort study was conducted in VLBW neonates in neonatal intensive care units between 2004 and 2016. VLBW (≤1500 grams) neonates were followed until discharge or in‐hospital death. The primary exposure was ABO group. Secondary exposures included platelet count, plasma transfusions, and maternal ABO group. Outcome measures were NEC (defined as Bell stage ≥ 2) and all‐cause mortality. Time‐dependent Cox regression models with competing risks were used to investigate factors associated with NEC and mortality. Results Thousand and sixteen neonates were included with 10.8% developing NEC (n = 110) and 14.1% mortality (n = 143). Platelet count (hazard ratio [HR] = 0.995; 95% confidence interval [CI]: 0.922–0.998) and number of plasma transfusions (HR = 2.908; 95% CI:1.265–6.682) were associated with NEC, while ABO group (non‐O vs. O) was not (HR = 0.761; 95% CI: 0.393–1.471). Higher all‐cause mortality occurred in neonates without NEC who were non‐O compared with O (HR = 17.5; 95% CI: 1.784–171.692), but not in neonates with NEC (HR = 1.112; 95% CI: 0.142–8.841). Plasma transfusion was associated with increased mortality in both groups. Discussion ABO non‐identical transfusion was not associated with NEC or mortality in neonates with NEC. It was associated with increased mortality in neonates without NEC. As many neonatal intensive care units transfuse only O group blood as routine practice, future trials are needed to investigate the association between this practice and neonatal mortality.
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