BackgroundAsthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993–94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010–2015 results with asthma data prior to 2010.MethodsHospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables.ResultsDuring the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0–14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0–14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas.ConclusionsWe demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient’s age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour.

Type 2 Diabetes Mellitus (T2DM) is a chronic, progressive metabolic disease that is an international epidemic. General Practitioners (GPs) are the cornerstones of T2DM management. The aim of this study was to determine the scope of care and management of patients with T2DM within General Practice, while highlighting domains of success and areas where improvement can be made. Demographic and laboratory cross sectional data were collected by examining electronic patient records at one rural General Practice to address the aims of the study. Data included key management parameters of Hemoglobin A1c (HbA1c), estimated Glomerular Filtration Rate (eGFR), microalbuminuria, blood pressure and cholesterol levels, in addition to age, sex, and residential postcode. Further, data regarding the use of insulin, antihypertensive medications and lipid-lowering medications were collected and analyzed. Descriptive and inferential statistics were used and significance was determined at p≤0.05. A total of 294 electronic patient records were examined. Glycaemic control was shown to have clinically improved over time, with only 10.8% of patients having poor control at their latest HbA1c test. Despite improvement in HbA1c, only 35.4% of patients had been referred for diabetes education to a diabetes clinic. eGFR showed an overall decline in patient kidney function above the level of decline consistent with aging. Males were significantly more likely to have microalbuminuria with increased severity than females. The study demonstrated an overall clinical improvement in the diabetic control of patients, while identifying key at risk sub-populations. The findings suggest the need for continuous patient orientated management, while highlighting areas for improvement that impact patient health outcomes and avenues for service sustainability greater.

The suppressor of cytokine signaling (SOCS) proteins play important roles in cytokine and growth factor signaling, where they act principally as negative feedback regulators, particularly of the downstream signal transducer and activator of transcription (STAT) transcription factors. This critical mode of regulation impacts on both development and homeostasis. However, understanding of the function of SOCS4 remains limited. To address this, we investigated one of the zebrafish SOCS4 paralogues, socs4a, analyzing its expression and the consequences of its ablation. The socs4a gene had a dynamic expression profile during zebrafish embryogenesis, with initial ubiquitous expression becoming restricted to sensory ganglion within the developing nervous system. The knockdown of zebrafish socs4a revealed novel roles in notochord development, as well as the formation of a functional sensory system.