Mary Lam

Mapping quantitative trait loci (QTL) in sheep. I. A new male framework linkage map and QTL for growth rate and body weight.

A male sheep linkage map comprising 191 microsatellites was generated from a single family of 510 Awassi-Merino backcross progeny. Except for ovine chromosomes 1, 2, 10 and 17, all other chromosomes yielded a LOD score difference greater than 3.0 between the best and second-best map order. The map is on average 11% longer than the Sheep Linkage Map v4.7 male-specific map. This map was employed in quantitative trait loci (QTL) analyses on body-weight and growth-rate traits between birth and 98 weeks of age. A custom maximum likelihood program was developed to map QTL in half-sib families for non-inbred strains (QTL-MLE) and is freely available on request. The new analysis package offers the advantage of enabling QTL × fixed effect interactions to be included in the model. Fifty-four putative QTL were identified on nine chromosomes. Significant QTL with sex-specific effects (i.e. QTL × sex interaction) in the range of 0.4 to 0.7 SD were found on ovine chromosomes 1, 3, 6, 11, 21, 23, 24 and 26.

Mapping quantitative trait loci (QTL) in sheep. II. Meta-assembly and identification of novel QTL for milk production traits in sheep

An (Awassi × Merino) × Merino backcross family of 172 ewes was used to map quantitative trait loci (QTL) for different milk production traits on a framework map of 200 loci across all autosomes. From five previously proposed mathematical models describing lactation curves, the Wood model was considered the most appropriate due to its simplicity and its ability to determine ovine lactation curve characteristics. Derived milk traits for milk, fat, protein and lactose yield, as well as percentage composition and somatic cell score were used for single and two-QTL approaches using maximum likelihood estimation and regression analysis. A total of 15 significant (P < 0.01) and additional 25 suggestive (P < 0.05) QTL were detected across both single QTL methods and all traits. In preparation of a meta-analysis, all QTL results were compared with a meta-assembly of QTL for milk production traits in dairy ewes from various public domain sources and can be found on the ReproGen ovine gbrowser http://crcidp.vetsci.usyd.edu.au/cgi-bin/gbrowse/oaries_genome/. Many of the QTL for milk production traits have been reported on chromosomes 1, 3, 6, 16 and 20. Those on chromosomes 3 and 20 are in strong agreement with the results reported here. In addition, novel QTL were found on chromosomes 7, 8, 9, 14, 22 and 24. In a cross-species comparison, we extended the meta-assembly by comparing QTL regions of sheep and cattle, which provided strong evidence for synteny conservation of QTL regions for milk, fat, protein and somatic cell score data between cattle and sheep.

Does Computerised Provider Order Entry Reduce Test Turnaround Times? A Before- and-After Study at Four Hospitals

Few multi-centre studies of the impact of computerised provider order entry (CPOE) systems on health care efficiency and effectiveness exist. Further, demonstrating a link between system use and improvements in patient outcomes is challenging. An often neglected step is to characterise the nature of the problem prior to CPOE introduction to ensure that the problem being addressed has a demonstrated impact on the outcome of interest. We undertook a two-staged project to i) investigate the link between test turnaround time (TAT) and length of stay for emergency department patients prior to CPOE; ii) to measure the impact of CPOE on TAT in four Australian hospitals to examine the consistency of findings. We found TAT is a significant contributor to length of stay. All four hospitals experienced a significant reduction in TAT following CPOE. This study presents evidence that TAT is directly related to length of stay and that CPOE systems are effective at reducing TAT. These results add weight to the hypothesis that the introduction of CPOE may positively impact upon patient outcomes.

Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study.

BackgroundTraumatic injury and mental health disorders are co-associated. Early identification of depression, anxiety and stress following injury, and subsequent preventive intervention, may reduce the long-term symptoms and negative impacts associated with depression and anxiety. The purpose of the study was to determine the incidence, severity and predictors of depression, anxiety and stress in injured patients in the acute phase of care, and at six months following injury, as well as the effectiveness of an in-hospital screening tool.MethodsThis descriptive longitudinal study of trauma patients was conducted at a Level 1 Metropolitan Trauma Centre in Australia over 14xa0months. Participants were interviewed using the Depression Anxiety Stress Scale short-form version (DASS-21) during hospital admission then at 3 and 6xa0months after injury. Descriptive statistics were performed to evaluate participant characteristics and incidence of depression, anxiety and stress. Correlations and logistic regression were conducted to investigate the ability of the DASS-21 to predict symptoms of depression, anxiety and stress and to investigate factors associated with depression, anxiety and stress 6xa0months after injury.Results201 participants ranging in age (18–94 years) and injury severity participated in the baseline interview and 109 completed all 3 interviews over 6xa0months. Over half (54%) reported above normal scores for depression, anxiety and/or stress in at least one of the 3 time points. Intensive care unit admission and high levels of depression, anxiety and stress at 3xa0months post injury were predictors for high levels of depression, anxiety and stress at 6xa0months. Low scores for depression, anxiety and stress during admission were correlated with low scores for depression, anxiety and stress at 3 and 6xa0months.ConclusionDepression, anxiety and stress in patients hospitalised following injury is common and should be anticipated in patients who have had an intensive care admission. Screening at 3xa0months following injury identifies patients at risk of long-term symptoms of depression, anxiety and stress.

Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia

BACKGROUNDnAccurate economic data are fundamental for improving current funding models and ultimately in promoting the efficient delivery of services. The financial burden of a high trauma casemix to designated trauma centres in Australia has not been previously determined, and there is some evidence that the episode funding model used in Australia results in the underfunding of trauma.nnnAIMnTo describe the costs of acute trauma admissions in trauma centres, identify predictors of higher treatment costs and cost variance in New South Wales (NSW), Australia.nnnMATERIALS AND METHODSnData linkage of admitted trauma patient and financial data provided by 12 Level 1 NSW trauma centres for the 08/09 financial year was performed. Demographic, injury details and injury scores were obtained from trauma registries. Individual patient general ledger costs (actual trauma patient costs), Australian Refined Diagnostic Related Groups (AR-DRG) and state-wide average costs (which form the basis of funding) were obtained. The actual costs incurred by the hospital were then compared with the state-wide AR-DRG average costs. Multivariable multiple linear regression was used for identifying predictors of costs.nnnRESULTSnThere were 17,522 patients, the average per patient cost was

The use of information technology and mental health among older care-givers in Australia.

10,603 and the median was

Do AR-DRGs Adequately Describe the Trauma Patient Episode in New South Wales, Australia?

4628 (interquartile range:

Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis.

2179-10,148). The actual costs incurred by trauma centres were on average

The study design and methodology for the ARCHER study - adolescent rural cohort study of hormones, health, education, environments and relationships

134 per bed day above AR-DRG costs-determined costs. Falls, road trauma and violence were the highest causes of total cost. Motor cyclists and pedestrians had higher median costs than motor vehicle occupants. As a result of greater numbers, patients with minor injury had comparable total costs with those generated by patients with severe injury. However the median cost of severely injured patients was nearly four times greater. The count of body regions injured, sex, length of stay, serious traumatic brain injury and admission to the Intensive Care Unit were significantly associated with increased costs (p<0.001).nnnCONCLUSIONnThis multicentre trauma costing study demonstrated the feasibility of trauma registry and financial data linkage. Discrepancies between the observed costs of care in these 12 trauma centres and the NSW average AR-DRG costs suggest that trauma care is currently underfunded in NSW.

Mapping quantitative trait loci (QTL) in sheep. IV. Analysis of lactation persistency and extended lactation traits in sheep

Objective: This study examined the relationship between the use of the Internet and the mental health status of older care-givers in Australia. Methods: It utilized data obtained from a national health survey of a stratified random sample from the total population of people with disability, aged 60 years or older and carers of people with chronic health problems or disabilities who lived in a household. Internet usage was assessed by responses to a direct question during a personal structured interview. General mental health of caregivers was assessed using the SF-12v2 Health Survey to obtain the mental health summary scores. Data were analysed using logistic regression analyses with bootstrapping resampling and estimation statistical technique. Results: After adjusting for potential confounders there was a significant association between use of the Internet and better mental health among older care-givers. There was an approximately 60% increase in the odds of better mental health (OR = 1.56, 95% CI = 1.04–2.35) for care-givers who used the Internet in the past 12 months when compared with those who did not. Conclusions: The use of Internet has a beneficial effect on the mental health of care-giver aged 60 years or above. The results have direct implications on the provision of support and care of care-givers.