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Associate Professor John Hall

Conjoint Professor

School of Medicine and Public Health (Public Health)

Career Summary

Biography

John Hall is Director of the Centre for Clinical Epidemiology and Biostatistics and Associate Professor of Public Health at the University of Newcastle.  A Public Health Physician he has extensive experience in Public Health in Australia as well as globally.  He convenes the Masters of Public Health Program.  He has experience in teaching in Global Health, Health Systems and Policy, Primary Health Care, Environmental Health, and Maternal and Child Health.

His research interests are in Health Systems and Policy in resource poor settings.  He has a particular interest in Tuberculosis and TB DOTS and how Health Policy is transferred to and adapted in resource limited countries.  He continues to serve as a member of the WHO Regional Advisory Panel (RAP) for the Department of Reproductive Health and Research (RHR) for the SEARO and WPRO Regions of WHO. 

Before taking up his current position John Hall was the Director of the Human Resources for Health Knowledge Hub at UNSW.  Established with a $6mill. grant from the Australian Government the HRH Hub@UNSW is a knowledge Hub for gathering, synthesizing and disseminating knowledge to inform policy with regard to the world crisis in human resources for health to achieve the Millennium Development Goals.

John Hall has extensive international experience in Public Health at the National, District and Community levels.  As Principal Medical Officer, Community Health Services in Vanuatu 1990-1992 he was responsible for the day to day technical, financial, human resource and infrastructure needs of the Public Health Programs for the whole country.  This involved responsibility for Communicable Diseases (Malaria/Dengue, HIV/AIDS, TB/Leprosy), Non-Communicable Diseases, Maternal and Child Health (EPI, ARI/CDD, MCH/Family Planning), Health Promotion, and Health Information/Surveillance Systems.  He has worked in Pakistan (1986-1988), South Korea (1981) and the Solomon Islands (1990).

He has undertaken Consultancy work for AusAID, WHO, USAID, ADB and ODA in Papua New Guinea, Solomon Islands, Vanuatu, Kiribati, Marshall Islands, Kenya, Congo, and Zimbabwe.

In Australia John Hall has been the Director of the Western New South Wales Public Health Unit from 1992 - 1994.  This involved the delivery of Public Health Programs to the population of Western NSW.  It included management responsibility for Environmental Health, Immunisation Services, HIV/AIDS, Health Information and Surveillance.  He did a lot of work with Lead Poisoning in children in Broken Hill and the Aboriginal communities in Walgett, Bourke and Wilcannia.

Research Expertise
John Halls research interests are: Global Health Health Policy and Health Systems in Resource Poor Settings Health Policy and Health systems with regard to Disease Control Programs (Communicable & Non communicable Diseases), Maternal and Child Health and Ageing.

Teaching Expertise
John Hall convenes the Masters of Public Health Program at the University of Newcastle. He brings a wealth of experience working in Public Health in Australia and in the Asia Pacific Region to his teaching. He coordinates the MPH Courses PUBH6304 Global health (Semester 1) and PUBH6305 Global Health Systems & Policy (Semester 2).

Administrative Expertise
John Hall is the Director of the Center for Clinical Epidemiology and Biostatistics in the School of Medicine and Public Health and the Hunter Medical Research Institute at the University of Newcastle. He is on the School of Medicine and Public Health Executive Committee and the Post Graduate Education Committee.

Collaborations
His research interests are in Health Systems and Policy in resource poor settings. He has a particular interest in Tuberculosis and TB DOTS and how Health Policy is transferred to and adapted in resource limited countries.

Qualifications

  • PhD, University of Sydney
  • Bachelor of Medicine, Bachelor of Surgery, University of New South Wales
  • Master of Tropical Health, University of Queensland

Keywords

  • Global Health
  • Health Policy
  • International Health
  • Public Health

Professional Experience

Academic appointment

Dates Title Organisation / Department
1/12/2008 - 1/6/2010 Director AusAID Human Resources for Health Knowledge Hub The University of New South Wales
School of Public Health and Community Medicine, Faculty of Medicine
Australia
1/4/2002 - 1/12/2008 Senior Lecturer in International Public Health & MIPH Coordinator University of Sydney
School of Public Health
1/8/1994 - 1/4/2002 Honorary Visiting Fellow & Consultant in International Public Health The University of New South Wales
School of Public Health and Community Medicine, Faculty of Medicine
Australia
1/11/1992 - 1/8/1994 Director New South Wales Department of Health
Western New South Wales Public Health Unit
Australia
1/7/1990 - 1/7/1993 Principal Medical Officer, Community (Public) Health Services Department of Health, Vanuatu
Vanuatu
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (65 outputs)

Year Citation Altmetrics Link
2021 Chulasai P, Chinwong D, Chinwong S, Hall JJ, Vientong P, 'Feasibility of a smoking cessation smartphone app (Quit with us) for young adult smokers: A single arm, pre-post study', International Journal of Environmental Research and Public Health, 18 (2021)

While smartphone applications (apps) have been shown to enhance success with smoking cessation, no study has been conducted among young adult smokers aged 18¿24 years in Thailand.... [more]

While smartphone applications (apps) have been shown to enhance success with smoking cessation, no study has been conducted among young adult smokers aged 18¿24 years in Thailand. Quit with US was developed based on the 5 A¿s model and self-efficacy theory. This single arm, prepost study was conducted aiming to assess results after using Quit with US for 4 weeks. The primary outcome was a biochemically verified 7-day point prevalence of smoking abstinence. The secondary outcomes included smoking behaviors, knowledge and attitudes toward smoking and smoking cessation, and satisfaction and confidence in the smartphone app. A total number of 19 young adult smokers were included; most participants were males (68.4%) with the mean (SD) age of 20.42 (1.46) years. After 4 weeks of study, the primary outcome demonstrated a smoking cessation rate of 31.6%. All 19 participants expressed better smoking behaviors and better knowledge and attitudes toward smoking and smoking cessation. Further, they were satisfied with the smartphone app design and content and expressed confidence in using it. These findings provided preliminary evidence that Quit with US was found to be a potentially effective smoking cessation smartphone app for young adult smokers.

DOI 10.3390/ijerph18179376
2021 Thapa P, Jayasuriya R, Hall JJ, Beek K, Mukherjee P, Gudi N, Narasimhan P, 'Role of informal healthcare providers in tuberculosis care in low- And middle-income countries: A systematic scoping review', PLoS ONE, 16 (2021)

Achieving targets set in the End TB Strategy is still a distant goal for many Low- and Middle- Income Countries (LMICs). The importance of strengthening public-private partnership... [more]

Achieving targets set in the End TB Strategy is still a distant goal for many Low- and Middle- Income Countries (LMICs). The importance of strengthening public-private partnership by engaging all identified providers in Tuberculosis (TB) care has long been advocated in global TB policies and strategies. However, Informal Healthcare Providers (IPs) are not yet prioritised and engaged in National Tuberculosis Programs (NTPs) globally. There exists a substantial body of evidence that confirms an important contribution of IPs in TB care. A systematic understanding of their role is necessary to ascertain their potential in improving TB care in LMICs. The purpose of this review is to scope the role of IPs in TB care. The scoping review was guided by a framework developed by the Joanna Briggs Institute. An electronic search of literature was conducted in MEDLINE, EMBASE, SCOPUS, Global Health, CINAHL, and Web of Science. Of a total 5234 records identified and retrieved, 92 full-text articles were screened, of which 13 were included in the final review. An increasing trend was observed in publication over time, with most published between 2010-2019. In 60% of the articles, NTPs were mentioned as a collaborator in the study. For detection and diagnosis, IPs were primarily involved in identifying and referring patients. Administering DOT (Directly Observed Treatment) to the patient was the major task assigned to IPs for treatment and support. There is a paucity of evidence on prevention, as only one study involved IPs to perform this role. Traditional health providers were the most commonly featured, but there was not much variation in the role by provider type. All studies reported a positive role of IPs in improving TB care outcomes. This review demonstrates that IPs can be successfully engaged in various roles in TB care with appropriate support and training. Their contribution can support countries to achieve their national and global targets if prioritized in National TB Programs.

DOI 10.1371/journal.pone.0256795
2021 Peng Z, Hayen A, Hall J, Liu B, 'Microbiology testing and antibiotic treatment for urinary tract infections in general practice: a nationwide observational study', Infection, 49 249-255 (2021)

Purpose: Routine urine testing is recommended prior to antibiotic treatment for urinary tract infections (UTIs) among high-risk groups for complicated UTIs. This study aims to exa... [more]

Purpose: Routine urine testing is recommended prior to antibiotic treatment for urinary tract infections (UTIs) among high-risk groups for complicated UTIs. This study aims to examine whether the proportion of UTI encounters where antibiotics are prescribed that have accompanying urine testing differs by patient groups. Methods: A retrospective analysis was conducted using records of general practice encounters for UTIs occurring between January 2013 and July 2018 in an Australian national database. We calculated the proportion of UTI encounters with antibiotics prescribed that had accompanying urine microbiology testing and the odds ratios for the likelihood of testing by patient groups using generalised estimating equations. Results: Of 132,688 UTI encounters with antibiotics prescribed, 95,800 (72.2%) were accompanied by urine testing. Among high-risk groups for complicated UTIs and expected to have a high likelihood of testing, we found pregnant women [82.6% vs. non-pregnant 72.3%, adjusted odds ratio (aOR) 1.82, 95% confidence intervals (CI) 1.55¿2.12] and children aged 5¿9¿years (77.6% vs. 20¿44¿years 72.0%, aOR 1.33, 95% CI 1.22¿1.45) had relatively high odds of testing. However, children aged < 5¿years (68.7% vs. 20¿44¿years 72.0%, aOR 0.83, 95% CI 0.76¿0.90), patients with recurrent UTIs (69.0% compared to first-onset UTIs 73.6%, aOR 0.81, 95% CI 0.79¿0.83), and patients in residential aged care facilities (67.3% vs. not 72.3%, aOR 0.80, 95% CI 0.72¿0.90) had relatively low odds of testing. Conclusion: Our results suggest inconsistencies and potential underuse of urine testing when antibiotics were prescribed for high-risk groups in UTI management. Further antibiotic stewardship is needed to improve guideline-based antibiotic prescribing for UTIs.

DOI 10.1007/s15010-020-01512-6
2021 He WQ, Kirk MD, Hall J, Liu B, 'Prescribing antimicrobial drugs for acute gastroenteritis, primary care, australia, 2013-2018', Emerging Infectious Diseases, 27 1462-1467 (2021)

During 2013-2018, antimicrobial drugs were prescribed for 6.8% of cases of acute gastroenteritis encountered in general practice in Australia, including 35.7% of Salmonella infect... [more]

During 2013-2018, antimicrobial drugs were prescribed for 6.8% of cases of acute gastroenteritis encountered in general practice in Australia, including 35.7% of Salmonella infections and 54.1% of Campylobacter infections. During that time, prescriptions for acute gastroenteritis decreased by 2.0%. Managing infectious gastroenteritis in general practice will require greater antimicrobial stewardship.

DOI 10.3201/eid2705.203692
2021 Welberry HJ, Jorm LR, Schaffer AL, Barbieri S, Hsu B, Harris MF, et al., 'Psychotropic medicine prescribing and polypharmacy for people with dementia entering residential aged care: the influence of changing general practitioners', Medical Journal of Australia, 215 130-136 (2021)

Objective: To examine relationships between changing general practitioner after entering residential aged care and overall medicines prescribing (including polypharmacy) and that ... [more]

Objective: To examine relationships between changing general practitioner after entering residential aged care and overall medicines prescribing (including polypharmacy) and that of psychotropic medicines in particular. Design: Retrospective data linkage study. Setting, participants: 45 and Up Study participants in New South Wales with dementia who were PBS concession card holders and entered permanent residential aged care during January 2010 ¿ June 2014 and were alive six months after entry. Main outcome measures: Inverse probability of treatment-weighted numbers of medicines dispensed to residents and proportions of residents dispensed antipsychotics, benzodiazepines, and antidepressants in the six months after residential care entry, by most frequent residential care GP category: usual (same as during two years preceding entry), known (another GP, but known to the resident), or new GP. Results: Of 2250 new residents with dementia (mean age, 84.1 years; SD, 7.0 years; 1236 women [55%]), 625 most frequently saw their usual GPs (28%), 645 saw known GPs (29%), and 980 saw new GPs (44%). The increase in mean number of dispensed medicines after residential care entry was larger for residents with new GPs (+1.6 medicines; 95% CI, 1.4¿1.9 medicines) than for those attended by their usual GPs (+0.7 medicines; 95% CI, 0.4¿1.1 medicines; adjusted rate ratio, 2.42; 95% CI, 1.59¿3.70). The odds of being dispensed antipsychotics (adjusted odds ratio [aOR], 1.59; 95% CI, 1.18¿2.12) or benzodiazepines (aOR, 1.69; 95% CI, 1.25¿2.30), but not antidepressants (aOR, 1.32; 95% CI, 0.98¿1.77), were also higher for the new GP group. Differences between the known and usual GP groups were not statistically significant. Conclusions: Increases in medicine use and rates of psychotropic dispensing were higher for people with dementia who changed GP when they entered residential care. Facilitating continuity of GP care for new residents and more structured transfer of GP care may prevent potentially inappropriate initiation of psychotropic medicines.

DOI 10.5694/mja2.51153
2021 Barr ML, Welberry H, Hall J, Comino EJ, Harris E, Harris-Roxas BF, et al., 'General practitioner follow-up after hospitalisation in Central and Eastern Sydney, Australia: Access and impact on health services', Australian Health Review, 45 247-254 (2021)

Objectives: General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP w... [more]

Objectives: General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation. Methods: This data linkage study used a cohort of 10 240 people from the 45 and Up Study who resided in CES and experienced an overnight hospitalisation in the 5 years following recruitment (2007-14). Characteristics of participants who saw a GP within 2 weeks of discharge were compared with those who did not using generalised linear models. Time to subsequent hospitalisation was compared for the two groups using Cox proportional hazards regression models stratified by prior frequency of GP use. Results: Within 2 weeks of discharge, 64.3% participants saw a GP. Seeing a GP within 2 weeks of discharge was associated with lower rates of rehospitalisation for infrequent GP users (i.e. <8 visits in year before the index hospitalisation hazard ratio (HR) 0.83 95% confidence interval (CI) 0.70-0.97) but not frequent GP users (i.e. =8 plus visits HR 1.02 95% CI 0.90-1.17). Conclusion: The effect of seeing a GP on subsequent hospitalisation was protective but differed depending on patient care needs. What is known about the topic?: There is general consensus among healthcare providers that primary care is a significant source of ongoing health care provision. What does this paper add?: This study explored the relationship between GP follow-up after an uncomplicated hospitalisation and its effect on rehospitalisation. What are the implications for practitioners?: Discharge planning and the transfer of care from hospital to GP through discharge arrangements have substantial benefits for both patients and the health system.

DOI 10.1071/AH19285
2021 Xu X, Shi Z, Liu G, Chang D, Inglis SC, Hall JJ, et al., 'The Joint Effects of Diet and Dietary Supplements in Relation to Obesity and Cardiovascular Disease over a 10-Year Follow-Up: A Longitudinal Study of 69,990 Participants in Australia', NUTRIENTS, 13 (2021) [C1]
DOI 10.3390/nu13030944
Co-authors Julie Byles
2020 Craig AT, Heywood AE, Hall J, 'Risk of COVID-19 importation to the Pacific islands through global air travel', Epidemiology and Infection, (2020)

On 30 January 2020, WHO declared coronavirus (COVID-19) a global public health emergency. As of 12 March 2020, 125,048 confirmed COVID-19 cases in 118 countries had been reported.... [more]

On 30 January 2020, WHO declared coronavirus (COVID-19) a global public health emergency. As of 12 March 2020, 125,048 confirmed COVID-19 cases in 118 countries had been reported. On 12 March 2020, the first case in the Pacific islands was reported in French Polynesia; no other Pacific island country or territory has reported cases. The purpose of our analysis is to show how travellers may introduce COVID-19 into the Pacific islands and discuss the role robust health systems play in protecting health and reducing transmission risk. We analyse travel- A nd Global Health Security Index-data using a scoring tool to produce quantitative estimates of COVID-19 importation risk, by departing and arriving country. Our analysis indicates that, as of 12 March 2020, the highest risk air routes by which COVID-19 may be imported into the Pacific islands are from east Asian countries (specifically, China, Korea and Japan) to north Pacific airports (likely Guam, Commonwealth of the Northern Mariana Islands or, to a less extent, Palau); or from China, Japan, Singapore, the United States of America or France to south Pacific ports (likely, Fiji, Papua New Guinea French Polynesia, or New Caledonia). Other importation routes include from other east Asian countries to Guam, and from Australia, New Zealand and other European countries to the south Pacific. The tool provides a useful method for assessing COVID-19 importation risk and may be useful in other settings.

DOI 10.1017/S0950268820000710
Citations Scopus - 22
2020 He WQ, Kirk MD, Sintchenko V, Hall JJ, Liu B, 'Antibiotic Use Associated with Confirmed Influenza, Pertussis, and Nontyphoidal Salmonella Infections', Microbial Drug Resistance, 26 1482-1490 (2020)

Purpose: Antibiotics are not the recommended treatment for uncomplicated influenza or nontyphoidal salmonella infections, whereas they are for current pertussis infection. We inve... [more]

Purpose: Antibiotics are not the recommended treatment for uncomplicated influenza or nontyphoidal salmonella infections, whereas they are for current pertussis infection. We investigated adherence to these recommendations in a population of older community-dwelling adults. Methods: Population-based prospective cohort study of Australian adults 45 years of age and older followed by record-linkage to laboratory-confirmed influenza, pertussis, and nontyphoidal salmonella notifications, hospitalization records, and antibiotic dispensing data from January 1, 2009 to December 31, 2015. Proportions of those with infections who were prescribed antibiotics were estimated, and characteristics associated with antibiotic prescribing were examined. Results: There were 1,056 influenza, 151 pertussis, and 334 nontyphoidal salmonella cases in the cohort eligible for analysis. Antibiotics were dispensed in 56.2% (594/1,056) of influenza, 78.8% (119/151) of pertussis, and 39.5% (132/334) of nontyphoidal salmonella cases within the ±10-day window around the infection onset date. The likelihood of antibiotic dispensing did not differ according to most participant characteristics examined, including whether cases had an associated hospitalization, their age, and recorded comorbidities. Macrolides were the predominant class of antibiotics dispensed for pertussis (79%), whereas both beta-lactams (36.3%) and macrolides (35.4%) were used for cases of influenza. There was no dominant antibiotic class dispensed among those with nontyphoidal salmonella. Conclusions: Given concerns regarding increasing antibiotic resistance, the high proportion of adults with influenza and nontyphoidal salmonella cases dispensed antibiotics indicate the need for further strengthening of antimicrobial stewardship by raising education and awareness of guidelines for managing these infections.

DOI 10.1089/mdr.2020.0017
Citations Scopus - 1
2020 Li J, Li X, Jiang J, Xu X, Wu J, Xu Y, et al., 'The Effect of Cognitive Behavioral Therapy on Depression, Anxiety, and Stress in Patients With COVID-19: A Randomized Controlled Trial', Frontiers in Psychiatry, 11 (2020)

Background: As a public health emergency of international concern, the COVID-19 outbreak has had a tremendous impact on patients&apos; psychological health. However, studies on ps... [more]

Background: As a public health emergency of international concern, the COVID-19 outbreak has had a tremendous impact on patients' psychological health. However, studies on psychological interventions in patients with COVID-19 are relatively rare. Objectives: This study examined the effectiveness of Cognitive Behavioral Therapy (CBT) in relieving patients' psychological distress during the COVID-19 epidemic. Methods: Ninety-three eligible participants selected by cluster sampling were randomized to an intervention group (N = 47) and a control group (N = 46). Participants in the control group received routine treatment according to the Chinese Management Guidelines for COVID-19, while participants in the intervention group received routine treatment with additional CBT. The Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) was used to evaluate depression, anxiety, and stress for all participants at baseline and post-intervention. Two-sided t-test, and proportion tests were used to examine the differences between the intervention and control group for each DASS-21 indicator. Univariate linear regression was used to examine the association between chronic disease status and change in each DASS-21 indicator after intervention. Two-way scatter plots were generated to show the association of the length of hospital stay and the changes of each DASS-21 indicator by intervention and control groups. Results: Significant decreases in means were found for scales of depression, anxiety, stress and total DASS-21 in both intervention (p < 0.001) and control group (p = 0.001), with participants in the intervention group having a bigger reduction in means. After the intervention, more participants in the intervention group had no depression or anxiety symptoms than in the control group, but no statistical differences were found (p > 0.05). Compared with participants with chronic disease, participants with no chronic disease had a significantly larger reduction of total DASS-21 scale (coefficient = -4.74, 95% CI: -9.31; -0.17).The length of hospital stay was significantly associated with a greater increase in anxiety scale in the intervention group (p = 0.005), whilst no significant association was found in the control group (p = 0.29). Conclusions: The patients with COVID-19 experienced high levels of anxiety, depression and stress. Our study result highlights the effectiveness of CBT in improving the psychological health among patients with COVID-19, also suggests that CBT should be focused on patients with chronic disease and those who have longer hospital stays. These results have important implications in clinical practice in improving psychological health in the context of COVID-19 pandemic. Trial Registration: ISRCTN68675756. Available at: http://www.isrctn.com/ISRCTN68675756.

DOI 10.3389/fpsyt.2020.580827
Citations Scopus - 13
2019 Barr ML, Welberry H, Comino EJ, Harris-Roxas BF, Harris E, Lloyd J, et al., 'Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis', Primary health care research &amp; development, 20 e141 (2019)

AIM: To describe the characteristics of people in Central and Eastern Sydney (CES), NSW, who had a General Practice Management Plan (GPMP) and claimed for at least one private all... [more]

AIM: To describe the characteristics of people in Central and Eastern Sydney (CES), NSW, who had a General Practice Management Plan (GPMP) and claimed for at least one private allied health service item; and to examine if allied health service use results in less hospitalisations over a five-year period. BACKGROUND: The number of people living with chronic health conditions is increasing in Australia. The Chronic Disease Management programme was introduced to the Medicare Benefits Schedule (MBS) to provide a more structured approach to managing patients with chronic conditions and complex care needs. The programme supports general practitioners claiming up to one GPMP and one Team Care Arrangement every year, and the patient additionally claiming for up to five private allied health services visits. METHODS: A prospective longitudinal study was conducted. The sample consisted of 5771 participants in CES who had a GPMP within a two-year health service utilisation baseline period (2007-2009). The analysis used the 45 and Up Study questionnaire data linked to the MBS, hospitalisation, death and emergency department data for the period 2006-2014. FINDINGS: Of the eligible participants, 43% (2460) had at least one allied health service item claim in the subsequent 12 months. Allied health services were reported as physiotherapy, podiatry and other allied health services. The highest rates of allied health service use were among participants aged 85 years and over (49%). After controlling for confounding factors, a significant difference was found between having claimed for five or more physiotherapy services and emergency admissions (HR: 0.83; 95% CI: 0.72-0.95) and potentially preventable hospitalisations (HR: 0.79; 95% CI: 0.64-0.96) in the subsequent five years. Use of allied health service items was well targeted towards those with chronic and complex care needs, and use of physiotherapy services was associated with less avoidable hospitalisations.

DOI 10.1017/S146342361900077X
Citations Scopus - 2
2019 Akombi BJ, Agho KE, Renzaho AM, Hall JJ, Merom DR, 'Trends in socioeconomic inequalities in child undernutrition: Evidence from Nigeria demographic and health survey (2003 2013)', PLoS ONE, 14 (2019)

Objective The aim of this study was to examine the trend in socioeconomic inequalities in child undernutrition in Nigeria. Methods The study analysed cross-sectional data from the... [more]

Objective The aim of this study was to examine the trend in socioeconomic inequalities in child undernutrition in Nigeria. Methods The study analysed cross-sectional data from the Nigeria Demographic and Health Survey (NDHS) 2003 to 2013. The outcome variables were stunting, wasting and underweight among children under-five years. The magnitude of child undernutrition in Nigeria was estimated via a concentration index, and the socioeconomic factors contributing to child undernutrition over time were determined using the decomposition method. Results The concentration index showed an increase in childhood wasting and underweight in Nigeria over time. The socioeconomic factors contributing to the increase in child undernutrition were: child¿s age (0¿23 months), maternal education (no education), household wealth index (poorest household), type of residence (rural) and geopolitical zone (North East, North West). Conclusions To address child undernutrition, there is a need to improve maternal education and adopt effective social protection policies especially in rural communities in Nigeria.

DOI 10.1371/journal.pone.0211883
Citations Scopus - 16
2019 Li J, Shao D, Xu X, Zhang Y, Jiang Y, Hall J, 'Cognitive behavior stress management during pregnancy: a randomized controlled trial', Contemporary Nurse, 55 543-553 (2019)

Background: Pregnancy stress could lead to adverse health outcomes for both mother and child. Few studies have explored the effectiveness of stress management strategy among pregn... [more]

Background: Pregnancy stress could lead to adverse health outcomes for both mother and child. Few studies have explored the effectiveness of stress management strategy among pregnant women. Objectives/Aims/Hypotheses: To examine the effectiveness of cognitive-behavioral stress management for pregnant women. Design: Randomized Controlled Trial. Methods: 100 pregnant women (at 6¿8 week of pregnancy) were selected by convenience sampling. Participants in the control group (N = 50) received routine prenatal examination and health education, while those in the intervention group (N = 50) received cognitive-behavioral stress management. Pregnancy Pressure Scale was measured at baseline and 39th weeks of pregnancy. Results: Pregnancy Pressure Scale score increased in both intervention and control groups. However, the score in the intervention group was significantly lower than those in the control group (p < 0.01). Conclusions: Cognitive-behavioral stress managment can effectively reduce pregnant women's stress levels. Impact statement: Nurses and midwives should conduct cognitive-behavioral stress management to help pregnant women reduce their stress.

DOI 10.1080/10376178.2020.1729827
Citations Scopus - 2
2019 Hall JJ, Ambang T, Asante A, Mapira P, Craig A, Schuele E, Pervaz Iqbal M, 'Poliomyelitis outbreak in Papua New Guinea: health system and health security implications for PNG and Australia', Medical Journal of Australia, 211 161-162.e1 (2019)
DOI 10.5694/mja2.50283
Citations Scopus - 3
2018 Nyongesa C, Xu X, Hall JJ, Macharia WM, Yego F, Hall B, 'Factors influencing choice of skilled birth attendance at ANC: evidence from the Kenya demographic health survey.', BMC pregnancy and childbirth, 18 1-6 (2018) [C1]
DOI 10.1186/s12884-018-1727-z
Citations Scopus - 16Web of Science - 14
Co-authors Xiaoyue Xu
2018 Xu X, Parker D, Shi Z, Byles J, Hall J, Hickman L, 'Dietary pattern, hypertension and cognitive function in an older population: 10-year longitudinal survey', Frontiers in Public Health, 6 (2018) [C1]
DOI 10.3389/fpubh.2018.00201
Citations Scopus - 11Web of Science - 11
Co-authors Xiaoyue Xu, Julie Byles
2018 Liu H, Hall JJ, Xu X, Mishra GD, Byles JE, 'Differences in food and nutrient intakes between Australian- and Asian-born women living in Australia: Results from the Australian Longitudinal Study on Women's Health', Nutrition and Dietetics, 75 142-150 (2018) [C1]

Aim: To determine differences in food and nutrient intakes between Australian- and Asian-born women living in Australia. Methods: Data were obtained from the Australian Longitudin... [more]

Aim: To determine differences in food and nutrient intakes between Australian- and Asian-born women living in Australia. Methods: Data were obtained from the Australian Longitudinal Study on Women's Health, including 6461 women born in Australia or Asia who completed food frequency questionnaires in 2001 and 2013. Diet was assessed using the Dietary Questionnaire for Epidemiological Studies version 2. Longitudinal generalised estimating-equation modelling was performed to determine the effect of country of birth and survey year on fruit and vegetable intake. Results: Asian-born women ate more cereals, soybeans and fish but less vegetables, legumes, dairy, meat and meat products than Australian-born women both in 2001 and in 2013. Asian-born women ate less cereals, rice and noodles, meat and its products (P < 0.05) in 2013 than in 2001. The earlier people came to Australia, the less their rice and noodle intake per day. However, the reverse was demonstrated regarding vegetable intake. Asian-born women had a lower daily intake of fat, calcium, zinc, thiamin, riboflavin, folate and retinol compared with those born in Australia. Conclusions: Asian-born women living in Australia show different food and nutrient intakes from Australian-born women, although their diets tend to deviate from typical Asian characteristics and approach a Western diet.

DOI 10.1111/1747-0080.12397
Citations Scopus - 6Web of Science - 5
Co-authors Xiaoyue Xu, Julie Byles
2018 Xu X, Byles JE, Shi Z, Hall JJ, 'Dietary patterns, dietary lead exposure and hypertension in the older Chinese population', Asia Pacific Journal of Clinical Nutrition, 27 451-459 (2018) [C1]

Background and Objectives: With rapid population ageing and an increasing rate of hypertension in China, this study aims to examine the association between dietary patterns, dieta... [more]

Background and Objectives: With rapid population ageing and an increasing rate of hypertension in China, this study aims to examine the association between dietary patterns, dietary lead and hypertension among older Chinese population. Methods and Study Design: We analysed the 2009 China Health and Nutrition Survey data (2,634 individuals with dietary and hypertension measurement data, aged =60 years). Dietary data were obtained using 24 hour-recall over three consecutive days. Dietary lead intake is based on a published systematic review of food lead concentration and dietary lead exposure in China. Factor analysis was used to identify dietary patterns. Poisson regression and multinomial logistic regression models were used to explore the association between dietary patterns and hypertension. Results: The prevalence of hypertension was 47.0% in men and 48.9% in women. Traditional dietary pattern (high intake of rice, pork and vegetables) was significantly inversely associated with known hypertension. In the fully adjusted model, compared with the lowest quartile of traditional dietary pattern, the highest quartile had a lower risk of known hypertension, with Relative Risk Ratio=0.69 (95% CI: 0.50; 0.95). However, associations between modern dietary pattern and hypertension differed by urbanization; an inverse, positive and null association was seen in low, medium and high urbanization. Additionally, dietary lead showed a significant positive association with hypertension and known hypertension. Conclusions: Policies that facilitate and promote healthy diets, and the availability of healthy foods particularly at the regional and local levels, are important for the prevention of hypertension.

DOI 10.6133/apjcn.032017.20
Citations Scopus - 6Web of Science - 6
Co-authors Julie Byles, Xiaoyue Xu
2017 Akombi BJ, Agho KE, Merom D, Hall JJ, Renzaho AM, 'Multilevel Analysis of Factors Associated with Wasting and Underweight among Children Under-Five Years in Nigeria', NUTRIENTS, 9 (2017) [C1]
DOI 10.3390/nu9010044
Citations Scopus - 36Web of Science - 35
2017 Liu H, Byles JE, Xu X, Zhang M, Wu X, Hall JJ, 'Evaluation of successful aging among older people in China: Results from China health and retirement longitudinal study', Geriatrics and Gerontology International, 17 1183-1190 (2017) [C1]

Aim: China faces a ¿time-bomb¿ of the aging population. Successful aging has long been a goal in the field of gerontology. The present study aimed to evaluate successful aging amo... [more]

Aim: China faces a ¿time-bomb¿ of the aging population. Successful aging has long been a goal in the field of gerontology. The present study aimed to evaluate successful aging among Chinese older adults. Methods: Data on a total of 7102 people in the China Health and Retirement Study aged =60 years were analyzed in the present study. Successful aging is defined by the model of Rowe and Kahn including the following five indicators: ¿no major diseases,¿ ¿no disability,¿ ¿high cognitive functioning,¿ ¿high physical functioning¿ and ¿active engagement with life.¿ Using logistic regression analysis, crude and adjusted odds ratios with 95% confidence intervals were calculated to evaluate the relationship between sociodemographic parameters and successful aging. Results: The prevalence of successful aging was 13.2% among Chinese older people. The percentage of older people with the five indicators, ¿no major diseases,¿ ¿no disability,¿ ¿high cognitive functioning,¿ ¿high physical functioning,¿ and ¿active engagement with life¿ was 41.7%, 92.1%, 54.2%, 70.2% and 46.0%, respectively. Multiple logistic regression showed people who had received education of high/vocational school or above had significantly greater odds of successful aging compared with those with less than primary school education (P < 0.05). The effect of education to college level or above on cognitive functioning was 2.51-fold higher in women than men (P = 0.006). Older people from a non-agricultural Hukou had 1.85-fold higher odds of successful aging than those from an agricultural Hukou. Older people living in the central, northeast or western regions had lower odds of successful aging relative to those living in the east coast region (0.72, 0.72 and 0.56, respectively). Conclusions: The prevalence of successful aging is low among Chinese older people, and is affected by sociodemographic factors, such as education, Hukou and regions. Geriatr Gerontol Int 2017; 17: 1183¿1190.

DOI 10.1111/ggi.12848
Citations Scopus - 21Web of Science - 19
Co-authors Xiaoyue Xu, Julie Byles
2017 Xu X, Hall J, Byles J, Shi Z, 'Dietary pattern, serum magnesium, ferritin, C-reactive protein and anaemia among older people', Clinical Nutrition, 36 444-451 (2017) [C1]

Background &amp; aims Epidemiological data of dietary patterns and anaemia among older Chinese remains extremely scarce. We examined the association between dietary patterns and a... [more]

Background & aims Epidemiological data of dietary patterns and anaemia among older Chinese remains extremely scarce. We examined the association between dietary patterns and anaemia in older Chinese, and to assess whether biomarkers of serum magnesium, C-reactive protein (CRP) and serum ferritin can mediate these associations. Methods We analysed the 2009 China Health and Nutrition Survey data (2401 individuals aged =60 years for whom both dietary and biomarker data are available). Dietary data was obtained using 24¿h-recall over three consecutive days. Fasting blood samples and anthropometry measurement were also collected. Factor analysis was used to identify dietary patterns. Factor scores representing dietary patterns were used in Poisson regression models to explore the association between each dietary pattern and anaemia. Results Of the 2401 participants, 18.9% had anaemia, 1.9% had anaemia related to inflammation (AI), and 1.3% had iron-deficiency anaemia (IDA). A traditional dietary pattern (high intake of rice, pork and vegetables) was positively associated with anaemia; a modern dietary pattern (high intake of fruit and fast food) was inversely associated with anaemia. Progressively lower magnesium and BMI levels were associated with increasing traditional dietary quartiles; while a progressively higher magnesium and BMI levels were associated with increasing modern dietary quartiles (p¿<¿0.001). There were no significant differences (p¿>¿0.05) in CRP and serum ferritin across quartiles for either dietary pattern. In the fully adjusted model, the prevalence ratio (PR) of anaemia, comparing the fourth quartile to the first quartile, was 1.75 (95% CI: 1.33; 2.29) for a traditional dietary pattern, and 0.89 (95% CI: 0.68; 1.16) for a modern dietary pattern. The association between dietary patterns and anaemia is mediated by serum magnesium. Conclusion Traditional dietary pattern is associated with a higher prevalence of anaemia among older Chinese. Future studies need to examine whether correcting micronutrient deficiency (e.g. magnesium) by promoting overall healthy diet, rather than iron supplementation, is a suitable strategy for anaemia prevention in older Chinese people.

DOI 10.1016/j.clnu.2015.12.015
Citations Scopus - 14Web of Science - 15
Co-authors Julie Byles, Xiaoyue Xu
2017 Akombi BJ, Agho KE, Hall JJ, Merom D, Astell-Burt T, Renzaho AMN, 'Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis', BMC Pediatrics, 17 1-16 (2017) [C1]
DOI 10.1186/s12887-016-0770-z
Citations Scopus - 52Web of Science - 51
2017 Milton AH, Rahman M, Hussain S, Jindal C, Choudhury S, Akter S, et al., 'Trapped in Statelessness: Rohingya Refugees in Bangladesh.', Int J Environ Res Public Health, 14 (2017) [C1]
DOI 10.3390/ijerph14080942
Citations Scopus - 38Web of Science - 33
Co-authors Mdmijanur Rahman Uon
2017 Akombi BJ, Agho KE, Merom D, Renzaho AM, Hall JJ, 'Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016)', PLoS ONE, 12 (2017)

Background: Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions ... [more]

Background: Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. Methods: Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four subregions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2. Results: Stunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa. Conclusion: The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.

DOI 10.1371/journal.pone.0177338
Citations Scopus - 113
2017 Varol N, Hall JJ, Black K, Turkmani S, Dawson A, 'Evidence-based policy responses to strengthen health, community and legislative systems that care for women in Australia with female genital mutilation / cutting', Reproductive Health, 14 (2017)

Background: The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Aus... [more]

Background: The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C. Recommendations are made for policy reform in health, legislation, and community programs to provide the best healthcare, protect children, and help communities abandon this harmful practice. Main body: Midwives and doctors in Australia acknowledged a lack of knowledge on FGM/C, clinical guidelines and consequences for maternity care. In a metropolitan Australian hospital with specialised FGM/C care, women with FGM/C had similar obstetric outcomes as women without FGM/C, underlining the importance of holistic FGM/C clinics. Greater focus on integration of refugee and migrant populations into their new cultures may be an important way of facilitating the abandonment of this practice, as is education of communities that practise FGM/C, and experts involved in the care and protection of children. Men could be important advocates for protecting women and girls from violence and FGM/C through a man-to-man strategy with programs focussing on men¿s health and other personal issues, education, and communication. The Australian Government has identified gender-based violence as an area of priority and has been implementing a National plan to reduce violence against women and their children 2010-2022. A multidisciplinary network of experts on FGM/C could be established within this taskforce to develop well-defined and rapid referral pathways to care for and protect these children, as well as coordinate education and prevention programs to help communities abandon this harmful practice. Conclusion: Countries of migration can be part of the solution for abandonment of FGM/C through community interventions and implementation of national and coordinated training in FGM/C of experts involved in the care and protection of children and women. The global focus on collaboration on research, training and prevention programs should be fostered between countries of FGM/C prevalence and migration.

DOI 10.1186/s12978-017-0324-3
Citations Scopus - 11
2017 Akombi BJ, Agho KE, Hall JJ, Wali N, Renzaho AMN, Merom D, 'Stunting, wasting and underweight in Sub-Saharan Africa: A systematic review', International Journal of Environmental Research and Public Health, 14 (2017)

Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study wa... [more]

Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in SSA and contribute to the existing body of evidence needed for the formulation of effective interventions. Methods: This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Five computerized bibliographic databases were searched: Scopus, PubMed, PsycINFO, CINAHL and Embase. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. Results: Of a total of 2810 articles retrieved from the five databases, 49 studies met our inclusion criteria. The most consistent factors associated with childhood stunting, wasting and underweight in SSA were: low mother¿s education, increasing child¿s age, sex of child (male), wealth index/SES (poor household), prolonged duration of breastfeeding (>12 months), low birth weight, mother¿s age (<20 years), source of drinking water (unimproved), low mother¿s BMI (<18.5), birth size (small), diarrhoeal episode, low father¿s education and place of residence (rural). Conclusions: The factors that predispose a child to undernutrition are multisectoral. To yield a sustainable improvement in child nutrition in SSA, a holistic multi-strategy community-based approach is needed that targets the factors associated with undernutrition, thereby setting the region on the path to achieving the WHO global nutrition target by 2025.

DOI 10.3390/ijerph14080863
Citations Scopus - 82
2016 Varol N, Dawson A, Turkmani S, Hall JJ, Nanayakkara S, Jenkins G, et al., 'Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006-2012: a descriptive study', BMC PREGNANCY AND CHILDBIRTH, 16 (2016)
DOI 10.1186/s12884-016-1123-5
Citations Scopus - 27Web of Science - 21
2016 Liu H, Xu X, Hall JJ, Wu X, Zhang M, 'Differences in depression between unknown diabetes and known diabetes: Results from China health and retirement longitudinal study', International Psychogeriatrics, 28 1191-1199 (2016) [C1]

Background: Both diabetes and depression have become serious public health problems and are major contributors to the global burden of disease. People with diabetes have been show... [more]

Background: Both diabetes and depression have become serious public health problems and are major contributors to the global burden of disease. People with diabetes have been shown to have higher risk of depression. The purpose of this study was to observe the differences in depression between older Chinese adults with known or unknown diabetes. Methods: Data came from the national baseline survey of China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression Scale was used to assess depression. Participants with a history of diabetes diagnosis were considered to have known diabetes, and those with newly-diagnosed diabetes were considered to have unknown diabetes. Multiple logistic regression analysis was applied to estimate odds ratio (OR) for depression in predictor variables. Results: Overall, 39.1% of the 2,399 participants with diabetes suffered from depression. The prevalence of depression was significantly higher (p < 0.001) in people with known diabetes (43.5%) than those with unknown diabetes (35.1%). The biggest differences between the two groups were found in the middle aged, in women, in the less educated and in married people. In known diabetes, people treated with traditional Chinese medicine (TCM) coupled with oral western medicine (WM) and/or insulin had two-fold odds of depression compared to those without treatment. Conclusion: The knowledge of having diabetes, treatments and suffering from other chronic diseases were associated with the higher prevalence of depression in people with known diabetes compared to those with unknown diabetes. Prevention of depression in diabetics should receive more attention in the middle aged, women and the less education.

DOI 10.1017/S104161021600020X
Citations Scopus - 6Web of Science - 6
Co-authors Xiaoyue Xu
2016 Xu X, Byles J, Shi Z, McElduff P, Hall J, 'Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study', BMC PUBLIC HEALTH, 16 (2016) [C1]
DOI 10.1186/s12889-016-3425-y
Citations Scopus - 22Web of Science - 23
Co-authors Xiaoyue Xu, Julie Byles, Patrick Mcelduff
2016 Chinwong S, Patumanond J, Chinwong D, Hall JJ, Phrommintikul A, 'Reduction in total recurrent cardiovascular events in acute coronary syndrome patients with low-density lipoprotein cholesterol goal < 70 mg/dL: a real-life cohort in a developing country', THERAPEUTICS AND CLINICAL RISK MANAGEMENT, 12 353-360 (2016) [C1]
DOI 10.2147/TCRM.S96016
Citations Scopus - 3Web of Science - 2
2016 Liu H, Byles JE, Xu X, Zhang M, Wu X, Hall JJ, 'Association between nighttime sleep and successful aging among older Chinese people', Sleep Medicine, 22 18-24 (2016) [C1]

Objective This study aims to assess the association between sleep and successful aging among Chinese¿=60 years of age. Methods Data were collected from the baseline survey of the ... [more]

Objective This study aims to assess the association between sleep and successful aging among Chinese¿=60 years of age. Methods Data were collected from the baseline survey of the China Health and Retirement Longitudinal Study. Two self-reported questions about sleep quality and duration were examined. Successful aging was defined following Rowe and Kahn's multidimensional model. To assess the adjusted association between sleep and successful aging, multivariable logistic regression was applied. Results The average number of self-reported hours of sleep was 6.2¿±¿2.0 among older Chinese people. Successful aging was related to sleep duration, with the proportion of those adults considered to be aging successfully falling into the following sleep duration categories (<6¿h ¿ 7.8%; 6¿h ¿ 16.3%; 7¿h ¿ 19.1%; 8¿h ¿ 14.7%; and¿=9¿h ¿ 12.8%). The plots between sleep duration and successful aging were an inverse U-shape. Participants who slept less than 6¿h per day had lower odds ratios of successful aging [odds ratio (OR)¿=¿0.52, 95% confidence interval (CI) 0.40¿0.67] relative to those who slept for 7¿h per day. Compared with those who reported poor sleep less than once a week, older people who reported poor sleep five to seven days a week showed a lower ratio of successful aging (OR¿=¿0.29, 95% CI 0.21¿0.39). Conclusion Older age, shorter or longer sleep, and poor sleep were related to lower odds of, rates of successful aging. Most older Chinese adults experience insufficient sleep and poor sleep quality, which could be an important influential factor in successful aging.

DOI 10.1016/j.sleep.2016.04.016
Citations Scopus - 17Web of Science - 15
Co-authors Julie Byles, Xiaoyue Xu
2015 Xu X, Hall J, Byles J, Shi Z, 'Dietary pattern is associated with obesity in older people in China: Data from China health and nutrition survey (CHNS)', Nutrients, 7 8170-8188 (2015) [C1]

Background: No studies have been conducted to explore the associations between dietary patterns and obesity among older Chinese people, by considering gender and urbanization leve... [more]

Background: No studies have been conducted to explore the associations between dietary patterns and obesity among older Chinese people, by considering gender and urbanization level differences. Methods: We analyzed data from the 2009 China Health and Nutrition Survey (2745 individuals, aged e 60 years). Dietary data were obtained using 24 h-recall over three consecutive days. Height, Body Weight, and Waist Circumference were measured. Exploratory factor analysis was used to identify dietary patterns. Multinomial and Poisson regression models were used to examine the association between dietary patterns and Body Mass Index (BMI) status/central obesity. Results: The prevalence of general and central obesity was 9.5% and 53.4%. Traditional dietary pattern (high intake of rice, pork and vegetables) was inversely associated with general/central obesity; modern dietary pattern (high intake of fruit, fast food, and processed meat) was positively associated with general/central obesity. The highest quartile of traditional dietary pattern had a lower risk of general/central obesity compared with the lowest quartile, while an inverse picture was found for the modern dietary pattern. These associations were consistent by gender and urbanization levels. Conclusions: Dietary patterns are associated with general/central obesity in older Chinese. This study reinforces the importance of a healthy diet in promoting healthy ageing in China.

DOI 10.3390/nu7095386
Citations Scopus - 59Web of Science - 61
Co-authors Julie Byles, Xiaoyue Xu
2015 Chinwong D, Patumanond J, Chinwong S, Siriwattana K, Gunaparn S, Hall JJ, Phrommintikul A, 'Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand', Therapeutics and Clinical Risk Management, 11 659-667 (2015) [C1]

Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy i... [more]

Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy in acute coronary syndrome (ACS) patients is controversial and varies among guidelines. This study aimed to assess the effect of reaching an LDL-C goal of <70 mg/dL (<1.8 mmol/L) on first composite cardiovascular outcomes in routine clinical practice in Thailand. Methods: A retrospective cohort study was conducted using medical charts and the electronic hospital database of patients diagnosed with ACS and treated with statins at a tertiary care hospital in Thailand between 2009 and 2012. After admission, patients were followed from the date of LDL-C goal assessment until the first event of composite cardiovascular outcomes (nonfatal ACS, nonfatal stroke, or all-cause death). Cox proportional hazard models adjusted for potential confounders were used. Results: Of 405 patients, mean age was 65 years (60% males). Twenty-seven percent of the patients attained an LDL-C goal of<70 mg/dL, 38% had LDL-C between 70 and 99 mg/dL, and 35% had LDL-C =100 mg/dL. Forty-six patients experienced a composite cardiovascular outcome. Compared with patients with an LDL-C =100 mg/dL, patients achieving an LDL-C of <70 mg/dL were associated with a reduced composite cardiovascular outcome (adjusted hazard ratio [HR]=0.42; 95% confidence interval [CI]=0.18¿0.95; P-value=0.037), but patients with an LDL-C between 70 and 99 mg/dL had a lower composite cardiovascular outcome, which was not statistically significant (adjusted HR=0.73; 95% CI=0.37¿1.42; P-value=0.354). Conclusion: ACS patients who received statins and achieved an LDL-C of <70 mg/dL had significantly fewer composite cardiovascular outcomes, confirming ¿the lower the better¿ and the benefit of treating to LDL-C target in ACS patient management.

DOI 10.2147/TCRM.S78745
Citations Scopus - 11Web of Science - 9
2015 Rifat M, Hall J, Oldmeadow C, Husain A, Milton AH, 'Health system delay in treatment of multidrug resistant tuberculosis patients in Bangladesh', BMC Infectious Diseases, (2015) [C1]

© 2015 Rifat et al. Background: Bangladesh is one of the 27 high burden countries for multidrug resistant tuberculosis listed by the World Health Organization. Delay in multidrug ... [more]

© 2015 Rifat et al. Background: Bangladesh is one of the 27 high burden countries for multidrug resistant tuberculosis listed by the World Health Organization. Delay in multidrug resistant tuberculosis treatment may allow progression of the disease and affect the attempts to curb transmission of drug resistant tuberculosis. The main objective of this study was to investigate the health system delay in multidrug resistant tuberculosis treatment in Bangladesh and to explore the factors related to the delay. Methods: Information related to the delay was collected as part of a previously conducted case-control study. The current study restricts analysis to patients with multidrug resistant tuberculosis who were diagnosed using rapid diagnostic methods (Xpert MTB/RIF or the line probe assay). Information was collected by face-to-face interviews and through record reviews from all three Government hospitals providing multidrug resistant tuberculosis services, from September 2012 to April 2013. Multivariable regression analysis was performed using Bootstrap variance estimators. Definitions were as follows: Provider delay: time between visiting a provider for first consultation on MDR-TB related symptom to visiting a designated diagnostic centre for testing; Diagnostic delay: time from date of diagnostic sample provided to date of result; Treatment initiation delay: time between the date of diagnosis and date of treatment initiation; Health system delay: time between visiting a provider to start of treatment. Health system delay was derived by adding provider delay, diagnostic delay and treatment initiation delay. Results: The 207 multidrug resistant tuberculosis patients experienced a health system delay of median 7.1 weeks. The health system delay consists of provider delay (median 4 weeks), diagnostic delay (median 5 days) and treatment initiation delay (median 10 days). Health system delay (Coefficient: 37.7; 95 %; CI 15.0-60.4; p 0.003) was associated with the visit to private practitioners for first consultation. Conclusions: Diagnosis time for multidrug resistant tuberculosis was fast using the rapid tests. However, some degree of delay was present in treatment initiation, after diagnosis. The most effective way to reduce health system delay would be through strategies such as engaging private practitioners in multidrug resistant tuberculosis control.

DOI 10.1186/s12879-015-1253-9
Citations Scopus - 17Web of Science - 16
Co-authors Christopher Oldmeadow
2015 Chinwong D, Patumanond J, Chinwong S, Siriwattana K, Gunaparn S, Hall JJ, Phrommintikul A, 'Clinical indicators for recurrent cardiovascular events in acute coronary syndrome patients treated with statins under routine practice in Thailand: An observational study', BMC Cardiovascular Disorders, 15 (2015) [C1]

Background: Acute coronary syndrome (ACS) patients are at very high cardiovascular risk and tend to have recurrent cardiovascular events. The clinical indicators for subsequent ca... [more]

Background: Acute coronary syndrome (ACS) patients are at very high cardiovascular risk and tend to have recurrent cardiovascular events. The clinical indicators for subsequent cardiovascular events are limited and need further investigation. This study aimed to explore clinical indicators that were associated with recurrent cardiovascular events following index hospitalization. Methods: The data of patients hospitalized with ACS at a tertiary care hospital in northern Thailand between January 2009 and December 2012 were retrospectively reviewed from medical charts and the electronic hospital database. The patients were classified into three groups based on the frequency of recurrent cardiovascular events (nonfatal ACS, nonfatal stroke, or all-cause death) they suffered: no recurrent events (0), single recurrent event (1), and multiple recurrent events (=2). Ordinal logistic regression was performed to explore the clinical indicators for recurrent cardiovascular events. Results: A total of 405 patients were included; 60 % were male; the average age was 64.9 ± 11.5 years; 40 % underwent coronary revascularization during admission. Overall, 359 (88.6 %) had no recurrent events, 36 (8.9 %) had a single recurrent event, and 10 (2.5 %) had multiple recurrent events. The significant clinical indicators associated with recurrent cardiovascular events were achieving an LDL-C goal of < 70 mg/dL (Adjusted OR = 0.43; 95 % CI = 0.27-0.69, p-value < 0.001), undergoing revascularization during admission (Adjusted OR = 0.44; 95 % CI = 0.24-0.81, p-value = 0.009), being male (Adjusted OR = 1.85; 95 % CI = 1.29-2.66, p-value = 0.001), and decrease estimated glomerular filtration rate (Adjusted OR = 2.46; 95 % CI = 2.21-2.75, p-value < 0.001). Conclusion: The routine clinical practice indicators assessed in ACS patients that were associated with recurrent cardiovascular events were that achieving the LDL-C goal and revascularization are protective factors, while being male and having decreased estimated glomerular filtration rate are risk factors for recurrent cardiovascular events. These clinical indicators should be used for routinely monitoring patients to prevent recurrent cardiovascular events in ACS patients.

DOI 10.1186/s12872-015-0052-y
Citations Scopus - 4Web of Science - 2
2015 Xu X, Hall J, Byles J, Shi Z, 'Assessing dietary quality of older Chinese people using the Chinese Diet Balance Index (DBI)', PLoS ONE, 10 (2015) [C1]

Background/Objectives: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed d... [more]

Background/Objectives: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed dietary quality based on DBI for older people, and the associated factors, in four socioeconomically distinct regions in China. Methods: The China Health and Nutrition Survey (CHNS) involves 2745 older Chinese people, aged 60 or over, from four regions (Northeast, East Coast, Central and West) in 2009. Dietary data were obtained by interviews using 24 hour-recall over three consecutive days. Four indicators: Total Score (TS), Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) from DBI were calculated for assessing dietary quality in different aspects. Results: 68.9% of older people had different levels of excessive cereals intake. More than 50% of older people had moderate or severe surplus of oil (64.9%) and salt (58.6%). Intake of vegetables and fruit, milk and soybeans, water, and dietary variety were insufficient, especially for milk and soybeans. 80.8%of people had moderate or severe unbalanced diet consumption. The largest differences of DQD scores have been found for people with different education levels and urbanicity levels. People with higher education levels have lower DQD scores (p<0.001), and people living in medium and low urbanicity areas had 2.8 and 8.9 higher DQD scores than their high urbanicity counterparts (p<0.001). Also, significant differences of DQD scores have been found according to gender, marital status, work status and regions (p<0.001). Conclusion: DBI can reveal problems of dietary quality for older Chinese people. Rectifying unbalanced diet intake may lead to prevention of non-communicable diseases (NCDs). Dieticians and health care professionals need to increase dissemination and uptake of nutrition education, with interventions targeted at regions of lower socioeconomic status.

DOI 10.1371/journal.pone.0121618
Citations Scopus - 33Web of Science - 26
Co-authors Julie Byles, Xiaoyue Xu
2015 Xu X, E Byles J, Shi Z, J Hall J, 'Evaluation of older Chinese people's macronutrient intake status: Results from the China Health and Nutrition Survey', British Journal of Nutrition, 113 159-171 (2015) [C1]

Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older Chinese people (aged =A 60 year... [more]

Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older Chinese people (aged =A 60 years), investigated whether they had intake levels that met the Dietary Reference Intakes (DRI), and explored the associations between macronutrient intakes and age groups, sex, education levels, work status, BMI groups, urbanicity levels and four socio-economic regions of China (Northeast, East Coast, Central and Western). Dietary intake data of 2746 older Chinese with complete dietary intake data in the Longitudinal China Health and Nutrition Survey (2009 wave) carried out across four diverse regions were analysed. Dietary intake data were obtained by interviews using 24A h recalls over three consecutive days. The MUFA:SFA ratios were calculated based on the Chinese Food Composition Table. Less than one-third of the older Chinese people included in the present study had intake levels meeting the adequate intake for carbohydrate-energy and fat-energy; less than one-fifth had intake levels meeting the recommended nutrient intake for protein-energy; and more than half of the older people had fat-energy intakes higher than the DRI. There were strong associations between the proportions of energy from the three macronutrients and education levels, urbanicity levels and the four socio-economic regions of China, with older people living in the East Coast region having different patterns of macronutrient-energy intakes when compared with those living in the other three regions. Macronutrient intakes across different urbanicity levels in the four regions revealed considerable geographical variations in dietary patterns, which will affect the risk factors for non-communicable diseases. Clinical interventions and public health policies should recognise these regional differences in dietary patterns.

DOI 10.1017/S0007114514003444
Citations Scopus - 31Web of Science - 30
Co-authors Julie Byles, Xiaoyue Xu
2015 Rifat M, Hall J, Oldmeadow C, Husain A, Hinderaker SG, Milton AH, 'Factors related to previous tuberculosis treatment of patients with multidrug-resistant tuberculosis in Bangladesh', BMJ OPEN, 5 (2015) [C1]
DOI 10.1136/bmjopen-2015-008273
Citations Scopus - 14Web of Science - 12
Co-authors Christopher Oldmeadow
2015 Ezeh OK, Agho KE, Dibley MJ, Hall JJ, Page AN, 'Risk factors for postneonatal, infant, child and under-5 mortality in Nigeria: A pooled cross-sectional analysis', BMJ Open, 5 (2015) [C1]

Objectives: To identify common factors associated with post-neonatal, infant, child and under-5 mortality in Nigeria. Design, setting and participants: A cross-sectional data of t... [more]

Objectives: To identify common factors associated with post-neonatal, infant, child and under-5 mortality in Nigeria. Design, setting and participants: A cross-sectional data of three Nigeria Demographic and Health Surveys (NDHS) for the years 2003, 2008 and 2013 were used. A multistage, stratified, cluster random sampling method was used to gather information on 63 844 singleton live-born infants of the most recent birth of a mother within a 5-year period before each survey was examined using cox regression models. Main outcome measures: Postneonatal mortality (death between 1 and 11 months), infant mortality (death between birth and 11 months), child mortality (death between 12 and 59 months) and under-5 mortality (death between birth and 59 months). Results: Multivariable analyses indicated that children born to mothers with no formal education was significantly associated with mortality across all four age ranges (adjusted HR=1.30, 95% CI 1.01 to 1.66 for postneonatal; HR=1.38, 95% CI 1.11 to 1.84 for infant; HR=2.13, 95% CI 1.56 to 2.89 for child; HR=1.19, 95% CI 1.02 to 1.41 for under-5). Other significant factors included living in rural areas (HR=1.48, 95% CI 1.16 to 1.89 for postneonatal; HR=1.23, 95% CI 1.03 to 1.47 for infant; HR=1.52, 95% CI 1.16 to 1.99 for child; HR=1.29, 95% CI 1.11 to 1.50 for under-5), and poor households (HR=2.47, 95% CI 1.76 to 3.47 for postneonatal; HR=1.40, 95% CI 1.10 to 1.78 for infant; HR=1.72, 95% CI 1.19 to 2.49 for child; HR=1.43, 95% CI 1.17 to 1.76 for under-5). Conclusions: This study found that no formal education, poor households and living in rural areas increased the risk of postneonatal, infant, child and under-5 mortality among Nigerian children. Community-based interventions for reducing under-5 deaths are needed and should target children born to mothers of low socioeconomic status.

DOI 10.1136/bmjopen-2014-006779
Citations Scopus - 69Web of Science - 65
2015 Chinwong D, Patumanond J, Chinwong S, Siriwattana K, Gunaparn S, Hall JJ, Phrommintikul A, 'Statin therapy in patients with acute coronary syndrome: Low-density lipoprotein cholesterol goal attainment and effect of statin potency', Therapeutics and Clinical Risk Management, 11 127-136 (2015) [C1]

Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of coronary artery disease. Current guidelines recommend an LDL-C target of &... [more]

Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of coronary artery disease. Current guidelines recommend an LDL-C target of <70 mg/dL (< 1.8 mmol/L) for acute coronary syndrome (ACS) patients, and the first-line treatment to lower lipids is statin therapy. Despite current guidelines and the efficacious k'pid-lowering agents available, about half of patients at very high risk, including ACS patients, fail to achieve their LDL-C goal. This study assessed LDL-C goal attainment according to use of high and low potency statins in routine practice in Thailand. Methods: A retrospective cohort study was performed by retrieving data from medical records and the electronic hospital database for a tertiary care hospital in Thailand between 2009 and 2011. Included were ACS patients treated with statins at baseline and with follow-up of LDL-C levels. Patients were divided into high or low potency statin users, and the proportion reaching the LDL-C goal of <70 mg/dL was determined. A Cox proportional hazard model was applied to determine the relationship between statin potency and LDL-C goal attainment. Propensity score adjustment was used to control for confounding by indication. Results: Of 396 ACS patients (60% males, mean age 64.3+11.6 years), 229 (58%) were treated with high potency statins and 167 (42%) with low potency statins. A quarter reached their target LDL-C goal (25% for patients on high potency statins and 23% on low potency statins). High potency statins were not associated with increased LDL-C goal attainment (adjusted hazards ratio 1.22, 95% confidence interval 0.79-1.88; P=0.363). Conclusion: There was no significant effect of high potency statins on LDL-C goal attainment. Moreover, this study showed low LDL-C goal attainment for patients on either low or high potency statins. The reasons for the low LDL-C goal attainment rate warrants further investigation.

DOI 10.2147/TCRM.S75608
Citations Scopus - 18Web of Science - 14
2015 Varol N, Turkmani S, Black K, Hall J, Dawson A, 'The role of men in abandonment of female genital mutilation: a systematic review', BMC PUBLIC HEALTH, 15 (2015)
DOI 10.1186/s12889-015-2373-2
Citations Scopus - 31Web of Science - 28
2015 Xu X, Hall J, Byles J, Shi Z, 'Do older Chinese people's diets meet the Chinese Food Pagoda guidelines? Results from the China Health and Nutrition Survey 2009', PUBLIC HEALTH NUTRITION, 18 3020-3030 (2015) [C1]
DOI 10.1017/S1368980015000129
Citations Scopus - 15Web of Science - 13
Co-authors Xiaoyue Xu, Julie Byles
2014 Varol N, Fraser IS, Ng CHM, Jaldesa G, Hall J, 'Female genital mutilation/cutting - towards abandonment of a harmful cultural practice', Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 400-405 (2014) [C2]
DOI 10.1111/ajo.12206
Citations Scopus - 16Web of Science - 14
2014 Ezeh OK, Agho KE, Dibley MJ, Hall JJ, Page AN, 'The effect of solid fuel use on childhood mortality in Nigeria: evidence from the 2013 cross-sectional household survey', ENVIRONMENTAL HEALTH, 13 (2014) [C1]
DOI 10.1186/1476-069X-13-113
Citations Scopus - 30Web of Science - 25
2014 Agho KE, Hall J, Ewald B, 'Determinants of the Knowledge of and Attitude towards Tuberculosis in Nigeria', JOURNAL OF HEALTH POPULATION AND NUTRITION, 32 520-538 (2014) [C1]
Citations Scopus - 17Web of Science - 10
Co-authors Ben Ewald
2014 Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN, 'The Impact of Water and Sanitation on Childhood Mortality in Nigeria: Evidence from Demographic and Health Surveys, 2003-2013', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 11 9256-9272 (2014) [C1]
DOI 10.3390/ijerph110909256
Citations Scopus - 42Web of Science - 40
2014 Rifat M, Milton AH, Hall J, Oldmeadow C, Islam MA, Husain A, et al., 'Development of Multidrug Resistant Tuberculosis in Bangladesh: A Case-Control Study on Risk Factors', PLOS ONE, 9 (2014) [C1]
DOI 10.1371/journal.pone.0105214
Citations Scopus - 38Web of Science - 38
Co-authors Christopher Oldmeadow
2014 Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN, 'Determinants of neonatal mortality in Nigeria: Evidence from the 2008 demographic and health survey', BMC Public Health, 14 (2014) [C1]

Background: Nigeria continues to have one of the highest rates of neonatal deaths in Africa. This study aimed to identify risk factors associated with neonatal death in Nigeria us... [more]

Background: Nigeria continues to have one of the highest rates of neonatal deaths in Africa. This study aimed to identify risk factors associated with neonatal death in Nigeria using the 2008 Nigeria Demographic and Health Survey (NDHS). Methods. Neonatal deaths of all singleton live-born infants between 2003 and 2008 were extracted from the 2008 NDHS. The 2008 NDHS was a multi-stage cluster sample survey of 36,298 households. Of these households, survival information of 27,147 singleton live-borns was obtained, including 996 cases of neonatal mortality. The risk of death was adjusted for confounders relating to individual, household, and community level factors using Cox regression. Results: Multivariable analyses indicated that a higher birth order of newborns with a short birth interval = 2 years (hazard ratio [HR] = 2.19, confidence interval [CI]: 1.68-2.84) and newborns with a higher birth order with a longer birth interval > 2 years (HR = 1.36, CI: 1.05-1.78) were significantly associated with neonatal mortality. Other significant factors that affected neonatal deaths included neonates born to mothers younger than 20 years (HR = 4.07, CI: 2.83-5.86), neonates born to mothers residing in rural areas compared with urban residents (HR = 1.26, CI: 1.03-1.55), male neonates (HR = 1.30, CI: 1.12-1.53), mothers who perceived their neonate's body size to be smaller than the average size (HR = 2.10, CI: 1.77-2.50), and mothers who delivered their neonates by caesarean section (HR = 2.80, CI: 1.84-4.25). Conclusions: Our study suggests that the Nigerian government needs to invest more in the healthcare system to ensure quality care for women and newborns. Community-based intervention is also required and should focus on child spacing, childbearing at a younger age, and poverty eradication programs, particularly in rural areas, to reduce avoidable neonatal deaths in Nigeria. © 2014 Ezeh et al.; licensee BioMed Central Ltd.

DOI 10.1186/1471-2458-14-521
Citations Scopus - 63Web of Science - 60
2013 Hall JJ, Gillespie JA, Rosewell A, Mapira P, 'The Papua New Guinea cholera outbreak: implications for PNG, Australia and the Torres Strait', MEDICAL JOURNAL OF AUSTRALIA, 199 576-577 (2013) [C1]
DOI 10.5694/mja13.10516
Citations Scopus - 2Web of Science - 2
2012 Asante AD, Negin J, Hall JJ, Dewdney J, Zwi AB, 'Analysis of policy implications and challenges of the Cuban health assistance program related to human resources for health in the Pacific', Human Resources for Health, 10 1-9 (2012) [C3]
Citations Scopus - 23Web of Science - 23
2012 Asante A, Roberts G, Hall J, 'A review of health leadership and management capacity in the Solomon Islands.', Pacific health dialog, 18 166-177 (2012)

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially i... [more]

ACCESS AND UTILISATION OF HEALTH CARE: The armed conflict that engulfed the Solomon Islands between 1998 and 2003 significantly disrupted the provision of health care especially in rural and remote areas. There is one doctor for 3,300 people and approximately 13 nurses and midwives for 10,000 people. Despite limitations 87% of people seek health care when sick. FINANCING THE HEALTH SYSTEM: The SIG placed a series of reservations on ministerial goods and services budgets that effectively the budget by 33%, severely impacting provincial budgets and resulting in acquired debts. Shortfalls have been addressed by allocating Health Sector Support Program funds to the provinces to allow services to continue, a strategy that will likely recur, but by which donor support replaces government provision Provincial health accountants have received training in MYOB in 2009 but acquittal systems require higher level accounting skills for reports to be submitted on time to permit the release of subsequent funding tranches. HUMAN RESOURCES FOR HEALTH: The shortage of doctors and specialists is a key challenge. As at December 2010, there were a total of 2,728 health workers in the public sector in Solomon Islands. Staff costs consume on average 55% of provincial health grants Filled Public Service Division staff establishments and budgetary reservations have reduced the ability to meet the salary and wage costs of new graduates. Solomon Islands is currently negotiating to assist Vanuatu in filling its nursing staff vacancies with its surplus The return of 75 Cuban trained medical officers from 2013 presents the management challenge of accessing budget provisions for so many new positions and in funding the infrastructure needed to house, equip and maintain them in service. HEALTH MANAGEMENT STRUCTURE: Provincial health managers are operationally responsive to local needs, managerially responsible to provincial governments, while being concerned with adherence to central MHMS policy and to Ministry of Finance and Public Service Division regulations. The delineation of central and provincial health authorities' responsibilities requires guidelines in a changing system, where both population-based and targeted vertical programs are implemented at local levels. NUMBER AND DISTRIBUTION OF MANAGERS: Nine of the 10 positions of Provincial Health Director have experienced high turnover, which reportedly occurs without adequate handover to incoming appointees, most of whom are recent clinical graduates. Health services in the Honiara urban area are provided through the Honiara City Council. Church health services are staffed by government employees. COMPETENCE OF DISTRICT HEALTH MANAGERS: Management skills are reportedly weak at the provincial level. The Regional Assistance Mission to Solomon Islands provides governance training inputs to provincial government staff. Provincial health departments have limited financial and human resource management capacity. They also have clinical backgrounds and no training in public health planning or health services management, other than that provided by donors, the Regional Assistance Mission itself and the MHMS. MANAGEMENT WORKING ENVIRONMENT: Provincial health directors have limited control over health staff. Little supportive supervision in management is provided to new provincial health directors. No performance management systems are in place to ensure that staff are properly assessed and supported to do their best Large numbers of non-government organisations working at the provincial level in youth and women's programs require coordination by Provincial health directors to avoid duplication or implementation of programs that will require ongoing funding, but this is not done. FUNCTIONING OF MANAGEMENT SUPPORT SYSTEMS: Management support systems for budgeting and finance, management information and procurement and supply do not function adequately to support provincial health directors to manage...

Citations Scopus - 8
2011 Ongugo K, Hall JJ, Attia JR, 'Implementing tuberculosis control in Papua New Guinea: A clash of culture and science?', Journal of Community Health, 36 423-430 (2011) [C1]
DOI 10.1007/s10900-010-9324-8
Citations Scopus - 11Web of Science - 13
Co-authors John Attia
2010 Titaley CR, Dibley MJ, Roberts CL, Hall J, Agho K, 'Iron and folic acid supplements and reduced early neonatal deaths in Indonesia', BULLETIN OF THE WORLD HEALTH ORGANIZATION, 88 500-508 (2010)
DOI 10.2471/BLT.09.065813
Citations Web of Science - 49
2010 Kellie S, Li M, Hall J, 'GLOBAL PERSPECTIVES ON PEDIATRIC ONCOLOGY & NEURO-ONCOLOGY TRAINING: CAREER DEVELOPMENT OF INTERNATIONAL PEDIATRIC ONCOLOGY FELLOWS TRAINED IN SYDNEY', PEDIATRIC BLOOD & CANCER, 55 974-974 (2010)
2009 Titaley CR, Dibley MJ, Roberts CL, Hall J, Agho K, 'IRON/FOLIC ACID SUPPLEMENTS PROTECT AGAINST EARLY NEONATAL MORTALITY IN INDONESIA', ANNALS OF NUTRITION AND METABOLISM, 55 553-553 (2009)
2009 Williams PCM, Martina A, Cumming RG, Hall J, 'Malaria prevention in sub-saharan Africa: A field study in rural Uganda', Journal of Community Health, 34 288-294 (2009)

Malaria, a completely preventable and treatable disease, remains one of the biggest killers in Sub-Saharan Africa today. The objectives of this study were to describe the impact o... [more]

Malaria, a completely preventable and treatable disease, remains one of the biggest killers in Sub-Saharan Africa today. The objectives of this study were to describe the impact of malaria on a small rural community in Uganda (Bufuula) and to implement and evaluate a malaria prevention program (subsidised insecticide treated nets with an accompanying education session). In January 2006, a survey of 202 households (100% response rate) was conducted, and meetings held with the Village Council, which revealed that malaria was the community's major cause of morbidity and mortality, and showed there was a lack of access to preventative measures. Furthermore, 34% of each household's income was allocated to the burden of malaria. A malaria education and mosquito net distribution session was held in January 2006, which was attended by over 500 villagers who purchased 480 heavily-subsidised long lasting insecticide treated nets (LLINs). Home visits were conducted 1 week later to ensure the LLINs were hung correctly. A follow-up survey was conducted in January 2007. There was a rise in net ownership following the program (18% to 51%, P < 0.0001) and lower rates of childhood malaria prevalence (14%) than reported in Ugandan national statistics (40%). However, only half the nets owned were being used correctly by those most vulnerable to the illness. The findings suggest that mosquito nets must be provided with an effective education program and may be more successful if conducted in whole districts simultaneously rather than on a per-community basis. The evidence for super-targeting strategies for those most vulnerable is also considered. These findings provide important lessons and considerations for other wide-scale malaria prevention programs. © 2009 Springer Science+Business Media, LLC.

DOI 10.1007/s10900-009-9151-y
Citations Scopus - 9
2008 Titaley CR, Dibley MJ, Agho K, Roberts CL, Hall J, 'Determinants of neonatal mortality in Indonesia', BMC Public Health, 8 (2008)

Background. Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important ... [more]

Background. Neonatal mortality accounts for almost 40 per cent of under-five child mortality, globally. An understanding of the factors related to neonatal mortality is important to guide the development of focused and evidence-based health interventions to prevent neonatal deaths. This study aimed to identify the determinants of neonatal mortality in Indonesia, for a nationally representative sample of births from 1997 to 2002. Methods. The data source for the analysis was the 2002-2003 Indonesia Demographic and Health Survey from which survival information of 15,952 singleton live-born infants born between 1997 and 2002 was examined. Multilevel logistic regression using a hierarchical approach was performed to analyze the factors associated with neonatal deaths, using community, socio-economic status and proximate determinants. Results. At the community level, the odds of neonatal death was significantly higher for infants from East Java (OR = 5.01, p = 0.00), and for North, Central and Southeast Sulawesi and Gorontalo combined (OR = 3.17, p = 0.03) compared to the lowest neonatal mortality regions of Bali, South Sulawesi and Jambi provinces. A progressive reduction in the odds was found as the percentage of deliveries assisted by trained delivery attendants in the cluster increased. The odds of neonatal death were higher for infants born to both mother and father who were employed (OR = 1.84, p = 0.00) and for infants born to father who were unemployed (OR = 2.99, p = 0.02). The odds were also higher for higher rank infants with a short birth interval (OR = 2.82, p = 0.00), male infants (OR = 1.49, p = 0.01), smaller than average-sized infants (OR = 2.80, p = 0.00), and infant's whose mother had a history of delivery complications (OR = 1.81, p = 0.00). Infants receiving any postnatal care were significantly protected from neonatal death (OR = 0.63, p = 0.03). Conclusion. Public health interventions directed at reducing neonatal death should address community, household and individual level factors which significantly influence neonatal mortality in Indonesia. Low birth weight and short birth interval infants as well as perinatal health services factors, such as the availability of skilled birth attendance and postnatal care utilization should be taken into account when planning the interventions to reduce neonatal mortality in Indonesia. © 2008 Titaley et al; licensee BioMed Central Ltd.

DOI 10.1186/1471-2458-8-232
Citations Scopus - 134
2006 Peiris D, Wirtanen C, Hall J, 'Aeromedical evacuations from an east Arnhem Land community 2003-2005: The impact on a primary health care centre', Australian Journal of Rural Health, 14 270-274 (2006)

Objective: To understand the profile and impact of aeromedical evacuations in remote Indigenous communities. Design: Descriptive study. Setting: A primary health care centre in ea... [more]

Objective: To understand the profile and impact of aeromedical evacuations in remote Indigenous communities. Design: Descriptive study. Setting: A primary health care centre in east Arnhem Land, Northern Territory, Australia. Participants: Four hundred and ten evacuations from a total population of more than 2200 were analysed from February 2003 to August 2005. Mainoutcome measures: Patient demographics, seasonal variations, diagnostic categories, utilisation of staff resources. Results: On average 6.5% of the community were evacuated to hospital every year with an evacuation occurring every 2.2 days. Children aged under five years were 3.3-fold overrepresented in evacuations (comprising 37.7% of those evacuated versus 11.3% of the community, P < 0.001). Four diagnostic categories accounted for 61% of evacuations: respiratory disease (21%), obstetric conditions (15%), gastroenteritis (14%) and injury/poisoning (11%). Over the study period four patients required intubation at the clinic. Evacuation rates were higher in the monsoon season. Forty-seven per cent of evacuations occurred after hours. The waiting time for plane arrival ranged from one hour to 21 hours with a median wait-time of three hours. Conclusion: Aeromedical evacuations place a heavy burden on primary health centres. Clinic staff are regularly required to provide hospital-level acute care, often for several hours at a time. Meeting this burden competes with primary prevention programs and regular clinic duties. The age and diagnostic profiles encountered in this study have significant implications for the range of skills required to provide an adequate acute care service. This study highlights the need for remote area health centres to be well resourced to meet these needs. © 2006 The Authors Journal Compilation © 2006 National Rural Health Alliance Inc.

DOI 10.1111/j.1440-1584.2006.00828.x
Citations Scopus - 6
2006 Lyle DM, Phillips AR, Balding WA, Burke H, Stokes D, Corbett S, Hall J, 'Dealing with lead in Broken Hill - Trends in blood lead levels in young children 1991-2003', Science of the Total Environment, 359 111-119 (2006)

The objective of the study was to investigate trends in blood lead concentrations in preschool children between 1991 and 2003, as part of the evaluation strategy of a public healt... [more]

The objective of the study was to investigate trends in blood lead concentrations in preschool children between 1991 and 2003, as part of the evaluation strategy of a public health lead management program in Broken Hill, Australia. Since 1991, all Broken Hill children aged 1-4 years have been offered at least annual blood lead screening as part of a community-wide lead management program. Recruitment of children was promoted throughout the period using local media and distribution of promotional material from health care centres and preschool, childcare, and educational facilities around the city. Venous blood samples were collected using standard procedures and analyses were subjected to internal and external quality control programs. Because the frequency distribution of blood lead levels are skewed, geometric rather than arithmetic means were used for comparative purposes. Trend analysis was based on age and sex standardised mean blood lead levels. The number of 1- to 4-year-old children screened ranged between 496 and 948 in any one year and response rates varied between 39% and 73%. The age-sex standardised mean blood lead level decreased from 16.3 µg/dL to 7.1 µg/dL between 1991 and 2003. Overall, blood lead levels declined by 56% over 13 years. These reductions were consistently observed irrespective of age or where a child lived in the town. The rate of decline has slowed since 1997. We conclude that substantial progress has been made in dealing with the lead problem in Broken Hill children, although the rate of decline of blood lead levels has slowed. Continued public health action is still needed to bring the proportion of young children with significantly elevated blood lead levels (> 15 µg/dL) down from the 2003 figure of 12% to the NHMRC community-based target for lead in young Australians of 5%. © 2005 Elsevier B.V. All rights reserved.

DOI 10.1016/j.scitotenv.2005.04.022
Citations Scopus - 25
2003 Hall JJ, Taylor R, 'Health for all beyond 2000: The demise of the Alma-Ata Declaration and primary health care in developing countries', Medical Journal of Australia, 178 17-20 (2003)

Access to basic health services was affirmed as a fundamental human right in the Declaration of Alma-Ata in 1978. The model formally adopted for providing healthcare services was ... [more]

Access to basic health services was affirmed as a fundamental human right in the Declaration of Alma-Ata in 1978. The model formally adopted for providing healthcare services was "primary health care" (PHC), which involved universal, community-based preventive and curative services, with substantial community involvement. PHC did not achieve its goals for several reasons, including the refusal of experts and politicians in developed countries to accept the principle that communities should plan and implement their own healthcare services. Changes in economic philosophy led to the replacement of PHC by "Health Sector Reform", based on market forces and the economic benefits of better health. It is time to abandon economic ideology and determine the methods that will provide access to basic healthcare services for all people.

DOI 10.5694/j.1326-5377.2003.tb05033.x
Citations Scopus - 154
2003 Taylor R, King K, Vodicka P, Hall J, Evans D, 'Screening for leprosy in immigrants - A decision analysis model', Leprosy Review, 74 240-248 (2003)

Almost all leprosy cases reported in industrialized countries occur amongst immigrants or refugees from developing countries where leprosy continues to be an important health issu... [more]

Almost all leprosy cases reported in industrialized countries occur amongst immigrants or refugees from developing countries where leprosy continues to be an important health issue. Screening for leprosy is an important question for governments in countries with immigration and refugee programmes. A decision analysis framework is used to evaluate leprosy screening. The analysis uses a set of criteria and parameters regarding leprosy screening, and available data to estimate the number of cases which would be detected by a leprosy screening programme of immigrants from countries with different leprosy prevalences, compared with a policy of waiting for immigrants who develop symptomatic clinical diseases to present for health care. In a cohort of 100,000 immigrants from high leprosy prevalence regions (3.6/10,000), screening would detect 32 of the 42 cases which would arise in the destination country over the 14 years after migration; from medium prevalence areas (0.7/10,000) 6.3 of the total 8.1 cases would be detected, and from low prevalence regions (0.2/10,000) 1.8 of 2.3 cases. Using Australian data, the migrant mix would produce 74 leprosy cases from 10 years intake; screening would detect 54, and 19 would be diagnosed subsequently after migration. Screening would only produce significant case-yield amongst immigrants from regions or social groups with high leprosy prevalence. Since the number of immigrants to Australia from countries of higher endemnicity is not large routine leprosy screening would have a small impact on case incidence.

Citations Scopus - 6
1993 Maher CP, Hall JJ, Yakam W, Naupa M, Leonard D, 'Improving vaccination coverage: the experience of the Expanded Programme on Immunization in Vanuatu.', Papua and New Guinea medical journal, 36 228-233 (1993)

This paper looks at the success of measures adopted to improve vaccination coverage of infants in the Republic of Vanuatu. In 1982 the Department of Health introduced an Expanded ... [more]

This paper looks at the success of measures adopted to improve vaccination coverage of infants in the Republic of Vanuatu. In 1982 the Department of Health introduced an Expanded Programme on Immunization (EPI). Since the republic has over 80 inhabited islands, a scattered population, rough terrain and a lack of transport and communications infrastructure, achieving a high vaccination coverage rate proved difficult. Coverage of infants remained low until 1987. From that year onwards various strategies were employed to increase coverage, including 1) adopting the WHO-recommended diphtheria-pertussis-tetanus (DPT) and oral polio vaccine (OPV) vaccination schedule (6, 10 and 14 weeks) instead of the former schedule (3, 6 and 9 months); 2) improving the training, support and supervision of staff delivering maternal and child health (MCH) services; and 3) improving community involvement through social mobilization activities in areas of low coverage. Data on vaccination coverage of infants for the period 1984 to 1990 were compared. Over this period coverage of infants with 3 doses of DPT rose from 29% to 76%, with 3 doses of OPV from 29% to 78%, and with measles vaccine from 19% to 66%. These dramatic improvements have largely occurred since 1987. The results demonstrate the success of the measures adopted, and the experience of Vanuatu offers lessons in improving vaccination coverage for other countries in the region.

Citations Scopus - 12
1992 Reeve PA, Ala J, Hall JJ, 'Dapsone syndrome in Vanuatu: A high incidence during multidrug treatment (MDT) of leprosy', Journal of Tropical Medicine and Hygiene, 95 266-270 (1992)

Side-effects of leprosy treatment with dapsone are said to be uncommon, with drug allergy occurring in only one of every several hundred patients treated with dapsone. The dapsone... [more]

Side-effects of leprosy treatment with dapsone are said to be uncommon, with drug allergy occurring in only one of every several hundred patients treated with dapsone. The dapsone or sulphone syndrome (DDS) has been recognized since the earliest days of sulphone therapy but until recently its incidence had been decreasing. In Vanuatu, during the years 1988-1991, nine leprosy patients have developed the dapsone syndrome, four of whom have died. During the last 4 years only 37 patients were started on treatment, which is an incidence of the dapsone syndrome of 24% with a fatality rate of 11%. All the patients were being given multi-drug treatment (MDT) of daily dapsone (100mg) and clofazimine (50mg) and monthly rifampicin (600mg) and clofazimine (300mg). There has been speculation that the increased incidence of what was previously described as a rare reaction is due to the use of MDT, and the reasons for this are discussed. We feel the increase in the number of reactions in Vanuatu since starting MDT is probably due to the high starting dose of 100mg of dapsone, possibly enhanced by the combination with clofazimine and rifampicin and a genetic susceptibility of the Melanesian population.

Citations Scopus - 23
1992 Reeve PA, Ala J, Hall JJ, 'Modification of multidrug treatment of leprosy in Vanuatu [2]', International Journal of Leprosy, 60 655-656 (1992)
Citations Scopus - 2
1992 Reeve PA, Toaliu H, Kaneko A, Hall JJ, Ganczakowski M, 'Acute intravascular haemolysis in Vanuatu following a single dose of primaquine in individuals with glucose-6-phosphate dehydrogenase deficiency', Journal of Tropical Medicine and Hygiene, 95 349-351 (1992)

In 1989 and 1990 several patients were admitted to hospitals in Vanuatu with acute intravascular haemolysis following standard malaria treatment. This included a single 45-mg dose... [more]

In 1989 and 1990 several patients were admitted to hospitals in Vanuatu with acute intravascular haemolysis following standard malaria treatment. This included a single 45-mg dose of primaquine given as a malaria control measure for its gametocytocidal effect. Seven of them (all those tested) were subsequently confirmed to have glucose-6-phosphate dehydrogenase (G6PD) deficiency, using a visual colorimetric test kit (Sigma Chemical Co. Ltd). The case reports of four patients admitted to Vila Central Hospital and managed by one of us (PAR) are discussed in detail.

Citations Scopus - 33
Show 62 more journal articles

Conference (3 outputs)

Year Citation Altmetrics Link
2016 Hasnat MA, Rifat M, Hall J, Oldmeadow C, 'Experience from Research projects on multi-drug resistant tuberculosis (MDR-TB) in Bangladesh.', Kathmundu, Nepal (2016)
Co-authors Christopher Oldmeadow
2015 Hasnat MA, Rifat M, Hall J, Oldmeadow C, Hasnat MA, 'Treatment delay among the tuberculosis patients of Bangladesh', Program Book, Brisbane, Queensland (2015) [E3]
Co-authors Christopher Oldmeadow
2010 Kellie SJ, Li M, Hall J, 'GLOBAL PERSPECTIVES ON PEDIATRIC ONCOLOGY & NEURO-ONCOLOGY TRAINING: CAREER DEVELOPMENT OF INTERNATIONAL PEDIATRIC ONCOLOGY FELLOWS TRAINED IN SYDNEY', NEURO-ONCOLOGY, Vienna, AUSTRIA (2010)

Report (3 outputs)

Year Citation Altmetrics Link
2016 Bonevski B, Bryant J, Carey M, Considine R, D'Este C, Doran C, et al., 'Chronic care service enhancements program evaluation. Final report.', NSW Ministry of Health (2016)
Co-authors Catherine Deste, Rob Sanson-Fisher, Jamie Bryant, Liz Holliday, Billie Bonevski, Mariko Carey, Amy Waller
2016 Bonevski B, Bryant J, Carey M, Considine R, D'Este C, Doran C, et al., 'Chronic care service enhancements program evaluation. Summary report.', NSW Ministry of Health (2016)
Co-authors Catherine Deste, Rob Sanson-Fisher, Jamie Bryant, Liz Holliday, Amy Waller, Mariko Carey, Chris Paul, Billie Bonevski
2014 Byles JE, Curryer CA, Edwards N, Weaver N, D'Este C, Hall J, Kowal P, 'The health of older people in selected countries of the Western Pacific Region', World Health Organisation, 54 (2014) [R1]
Co-authors Natasha Weaver, Catherine Deste, Paul Kowal, Julie Byles
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Grants and Funding

Summary

Number of grants 6
Total funding $590,792

Click on a grant title below to expand the full details for that specific grant.


20151 grants / $19,684

Updating the Directory of Research on Ageing in Africa$19,684

Funding body: United Nations Department of Economic and Social Affairs

Funding body United Nations Department of Economic and Social Affairs
Project Team Professor Julie Byles, Doctor Paul Kowal, Associate Professor John Hall, Doctor Masuma Khanam
Scheme Research Grant
Role Investigator
Funding Start 2015
Funding Finish 2015
GNo G1501160
Type Of Funding International - Competitive
Category 3IFA
UON Y

20131 grants / $258,129

Building Health Systems Research Capacity to evaluate and monitor the implementation of the Millennium Development Goals.$258,129

Funding body: AusAID (Australian Agency for International Development)

Funding body AusAID (Australian Agency for International Development)
Project Team Associate Professor John Hall
Scheme Australian Leadership Awards Fellowships
Role Lead
Funding Start 2013
Funding Finish 2013
GNo G1200812
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

20122 grants / $57,010

Comparative Study on Health of Older Persons in Selected Countries in the Western Pacific Region$47,010

Funding body: World Health Organisation

Funding body World Health Organisation
Project Team Professor Julie Byles, Associate Professor John Hall, Conjoint Professor Cate d'Este, Doctor Paul Kowal, Professor Hal Kendig, Dr Joel Negin, Dr Nawi Ng
Scheme Research Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1201053
Type Of Funding International - Non Competitive
Category 3IFB
UON Y

Risk factors for MDR-TB in Bangladesh: a population based case-control study.$10,000

Funding body: Australian Respiratory Council (ARC)

Funding body Australian Respiratory Council (ARC)
Project Team Doctor Milton Hasnat, Dr Mahfuza Rifat, Associate Professor John Hall
Scheme Research Project
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1200030
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

20102 grants / $255,969

HMRI MRSP Infrastructure Grant (2010-11) Health Behaviour$252,219

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Laureate Professor Robert Sanson-Fisher, Associate Professor John Hall
Scheme NSW MRSP Infrastructure Grant
Role Investigator
Funding Start 2010
Funding Finish 2011
GNo G1100409
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

New Staff Grant - Pacific Island country (PIC) medical graduate career decisions and choices cohort study$3,750

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Associate Professor John Hall
Scheme New Staff Grant
Role Lead
Funding Start 2010
Funding Finish 2010
GNo G1000916
Type Of Funding Internal
Category INTE
UON Y
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Research Supervision

Number of supervisions

Completed3
Current1

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2017 PhD Factors Associated with Hospital-Based Adverse Events in Older Patients - A Retrospective Study of Australian Women PhD (Gender & Health), College of Health, Medicine and Wellbeing, The University of Newcastle Co-Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2019 Masters Economic Evaluation of a Pre-Hospital Protocol for Patients with Suspected Acute Stroke in Australia M Philosophy (ComMed&ClinEpid), College of Health, Medicine and Wellbeing, The University of Newcastle Co-Supervisor
2016 PhD Multidrug Resistance Tuberculosis (MDR-TB) in Community Setting of Bangladesh PhD (CommunityMed & ClinEpid), College of Health, Medicine and Wellbeing, The University of Newcastle Co-Supervisor
2016 PhD Dietary Intake, Dietary Quality, Dietary Pattern and Non-Communicable Diseases Among Older Chinese Population PhD (Gender & Health), College of Health, Medicine and Wellbeing, The University of Newcastle Principal Supervisor
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Associate Professor John Hall

Position

Conjoint Professor
Centre for Clinical Epidemiology & Biostatistics
School of Medicine and Public Health
College of Health, Medicine and Wellbeing

Focus area

Public Health

Contact Details

Email john.hall@newcastle.edu.au
Phone (02) 4042 0561
Fax (02) 4042 0044

Office

Room Room 4110, Level 4 West
Building HMRI Building
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