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Wayne Smith

Publications and source records attributed to Wayne Smith.

At least 19 recordsLinked to original sources
PubMed2026

Implementation factors shaping British Columbia's drug decriminalization pilot: A systematic review with narrative synthesis.

BACKGROUND: In January 2023, British Columbia (BC) became the first Canadian province to implement a legally sanctioned drug decriminalization policy, removing criminal penalties for adults possessing 2.5 g or less of opioids, cocaine, methamphetamine, and MDMA. Introduced as a three-year pilot, it aimed to reframe substance use as a public health issue, reduce stigma, and improve health and social service engagement. Criminal penalties were reintroduced for drug possession in most public spaces in May 2024, and the pilot ended in January 2026. Its termination has been interpreted as policy failure; this review aimed to examine how the pilot was implemented in practice and to identify factors that shaped its operationalization and early implementation-relevant outcomes. METHODS: We conducted a systematic review with narrative synthesis of peer-reviewed literature examining implementation-relevant aspects of BC's decriminalization pilot. Six databases were searched (January-February 2026) for studies published May 31, 2022-February 1, 2026. The protocol was registered in PROSPERO (CRD420251271694). RESULTS: Twenty-seven studies were included. Four cross-cutting implementation barriers were identified: pilot design features, public and cross-sector communication gaps, limited frontline training, and insufficient funding and infrastructure. Design features included the 2.5 g possession threshold, misalignment with real-world drug use patterns; the three-year timeframe, which constrained system-level effects; and the May 2024 amendment, which introduced additional instability. The pilot was implemented without commensurate investment in harm reduction, treatment, or housing infrastructure, within already constrained systems. CONCLUSION: BC's decriminalization pilot suggests the effects of legal reform are shaped by implementation context. Early outcomes may reflect design features, institutional readiness, and system capacity rather than legal change alone; longer-term impacts remain uncertain. Future reforms should align legal change with coordinated implementation, operational guidance, public communication, and adequate service infrastructure.

British Columbia↗
PubMed2007

Ten-year incidence and progression of age-related maculopathy: the blue Mountains Eye Study.

PURPOSE: To assess the 10-year incidence of age-related maculopathy (ARM) in an older Australian cohort. DESIGN: Population-based cohort study. PARTICIPANTS: Three thousand six hundred fifty-four Blue Mountains Eye Study participants > or =49 years old were examined during 1992 through 1994; 2335 (75% of survivors) were reexamined after 5 years (1997-1999) and 1952 (76% of survivors) after 10 years (2002-2004). METHODS: The same graders performed retinal photographic grading in all examinations, using the Wisconsin Age-Related Maculopathy Grading System. Photographs of participants with ARM lesions at any of the examinations were subsequently regraded using a side-by-side comparison method. MAIN OUTCOME MEASURES: The diagnosis of incident late ARM was given if neovascular ARM or geographic atrophy was detected at either follow-up examination in persons free of these lesions at baseline. Incident early ARM was diagnosed if early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was present in persons free of early and late ARM at baseline. Age-related maculopathy incidence was calculated using Kaplan-Meier methods to incorporate information from both 5- and 10-year examinations. Discrete logistic models were used to assess the risk of incident late ARM according to various baseline factors, including early ARM lesion characteristics. RESULTS: After excluding 72 late ARM cases present at baseline, 2395 of 3582 subjects at risk of late ARM (67%) were reexamined at either follow-up time point or both follow-up time points. Over the 10-year period, 72 of 2395 subjects (3.7%) developed late ARM and 266 of 2255 subjects (14.1%) developed early ARM. After age standardization to the Beaver Dam Eye Study population, our 10-year incidences of late and early ARM were 2.8% and 10.8%, respectively. Baseline age and early ARM lesion characteristics and severity were strong predictors of late ARM incidence. CONCLUSIONS: Long-term follow-up of this older population confirms that the risk of ARM progression is related strongly to the severity of early-stage lesions. The study provides evidence-based criteria for identifying persons at high risk of developing late ARM.

Aged↗
PubMed2006

Stanniocalcin-1 regulates endothelial gene expression and modulates transendothelial migration of leukocytes.

The mammalian counterpart of the fish calcium-regulating hormone stanniocalcin-1 (STC1) inhibits monocyte chemotactic protein-1- and stromal-derived factor-1alpha (SDF-1alpha)-mediated chemotaxis and diminishes chemokinesis in macrophage-like RAW264.7 and U937 cells in a manner that may involve attenuation of the intracellular calcium signal. STC1 is strongly induced in the kidney following obstructive injury. We hypothesized that STC1 may serve to attenuate the influx of inflammatory cells to the site of tissue injury. In this study, we examined the effect of STC1 on the migration of freshly isolated human macrophages, neutrophils, and T and B lymphocytes through quiescent or IL-1beta-treated human umbilical vein endothelial cell (HUVEC) monolayers. STC1 inhibited transmigration of macrophages and T lymphocytes through quiescent or IL-1beta-activated HUVECs but did not attenuate the transmigration of neutrophils and B lymphocytes. STC1 regulates gene expression in cultured endothelial cells and is detected on the apical surface of endothelial cells in vivo. The data suggest that STC1 plays a critical role in transendothelial migration of inflammatory cells and is involved in the regulation of numerous aspects of endothelial function.

Calcium↗
PubMed2006

Cataract surgery and the 10-year incidence of age-related maculopathy: the Blue Mountains Eye Study.

PURPOSE: To assess the long-term (10-year) risk of late age-related maculopathy (ARM) in eyes that had previously undergone cataract surgery (before the baseline examination). DESIGN: Population-based cohort study. PARTICIPANTS: In the Blue Mountains Eye Study (BMES) cohort, 2335 of 3654 baseline participants > or =49 years old (75% of survivors) were reexamined after 5 years and 1952 (76% of survivors) were reexamined after 10 years. METHODS: At the baseline examination, nonphakic (aphakic or pseudophakic) eyes were identified at slit-lamp examination and confirmed at lens photographic grading. Side-by-side grading of baseline and follow-up stereoretinal photographs was performed using the Wisconsin ARM grading system. Eye-specific data were analyzed using Kaplan-Meier estimates and generalized estimating equation models, adjusting for correlation between the 2 eyes. MAIN OUTCOME MEASURES: Incident late ARM was defined if either neovascular ARM or geographic atrophy developed in eyes without either lesion at baseline. RESULTS: After excluding eyes with either late ARM lesion at baseline or that had missing photographs at either examination, 4763 eyes were considered at risk of incident late ARM, including 132 eyes that had cataract surgery before the baseline examination. Late ARM developed in 10 of 132 nonphakic eyes (7.6%) compared to 96 of 4631 phakic eyes (2.1%). After adjusting for baseline age, gender, smoking, and presence of early ARM lesions, nonphakic (cataract surgical) eyes had a 3-fold risk of developing late-stage ARM (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.1-9.9) or neovascular ARM (OR, 3.4; 95% CI, 1.1-10.9) compared to phakic eyes. CONCLUSIONS: Our findings support the hypothesis that the long-term risk of developing late ARM is higher in cataract surgical eyes, consistent with findings from the Beaver Dam Eye Study.

Aged↗
PubMed2006

Association between apolipoprotein E polymorphisms and age-related macular degeneration: A HuGE review and meta-analysis.

A possible association between apolipoprotein E polymorphisms and age-related macular degeneration has been investigated numerous times, with conflicting results. A previous analysis pooling results from four studies (Schmidt et al., Ophthalmic Genet 2002;23:209-23) suggested an association, but those investigators did not document allele frequencies, the magnitude of the association, or the possible genetic mode of action. Thus, the authors searched MEDLINE from 1966 to December 2005 for any English-language studies reporting genetic associations. Data and study quality were assessed in duplicate. Pooling was performed while checking for heterogeneity and publication bias. Frequencies of the E2 and E4 alleles in Caucasians were approximately 8% and 15%, respectively. Allele- and genotype-based tests of association indicated a risk effect of up to 20% for E2 and a protective effect of up to 40% for E4. E2 appeared to act in a recessive mode and E4 in a dominant mode. There appears to be a differential effect of the E2 and E4 alleles on the risk of age-related macular degeneration, although the possibility of survivor bias needs to be ruled out more definitively.

Alleles↗
PubMed2006

Systematic review and meta-analysis of the association between complement factor H Y402H polymorphisms and age-related macular degeneration.

Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world and complement factor H (CFH) polymorphism has been found to associated with the AMD. We performed a meta-analysis to estimate the magnitude of the gene effect and the possible mode of action. A meta-analysis of eight studies assessing association between the CFH Y402H polymorphism and AMD was performed. Data extraction and study quality assessment were performed in duplicate, and heterogeneity and publication bias were explored. There was strong evidence for association between CFH and AMD, with those having CC and TC genotypes being roughly six and 2.5 times more likely to have AMD than patients with TT genotype, suggesting a co-dominant, multiplicative genetic model. The population attributable risk for the CC/TC genotype is 58.9%, i.e. the CFH polymorphism is involved in over half of all AMD. This meta-analysis summarizes the strong evidence for an association between CFH and AMD and indicates a multiplicative model with each C allele increasing the odds of AMD by approximately 2.5-fold. This result is at least as important at the population level as ApoE4 and Alzheimer's disease, playing a role in almost 60% of AMD at the population level.

Aged↗
PubMed2006

Dietary fatty acids and the 5-year incidence of age-related maculopathy.

OBJECTIVE: To assess longitudinal associations between dietary fat and incident age-related maculopathy (ARM) in an older, population-based, historical cohort. METHODS: A total of 3654 persons, 49 years or older, participated in the Blue Mountains Eye Study (1992-1994); 2335 (75.1% of survivors) were reexamined after 5 years (1997-1999). Dietary data were collected from 2895 people (79%) at baseline by means of a semiquantitative food frequency questionnaire to calculate dietary fat intakes. Presence of ARM was graded from retinal photographs (Wisconsin ARM Grading System). Logistic regression adjusted for age, sex, vitamin C intake, and smoking. RESULTS: Participants with the highest vs lowest quintiles of n-3 polyunsaturated fat intake had lower risk of incident early ARM (odds ratio [95% confidence interval], 0.41 [0.22-0.75). A 40% reduction of incident early ARM was associated with fish consumption at least once a week (odds ratio [95% confidence interval], 0.58 [0.37-0.90]), whereas fish consumption at least 3 times per week could reduce the incidence of late ARM (odds ratio [95% confidence interval], 0.25 [0.06-1.00]). We found no association between incident ARM and butter, margarine, or nut consumption. CONCLUSIONS: A regular diet high in n-3 polyunsaturated fat, especially from fish, suggests protection against early and late ARM in this older Australian cohort. Our study could not confirm deleterious effects of higher polyunsaturated fat intakes reported by other clinic-based studies.

Aged↗
PubMed2006

Grief and courage in a river town: a pilot project in the Aboriginal community of Kempsey, New South Wales.

OBJECTIVE: To describe a pilot project implemented in Kempsey, NSW, whereby a psychiatry registrar worked in a community-controlled Aboriginal medical service, Durri Aboriginal Corporation Medical Service, which provides mental health services for Aboriginal people. CONCLUSIONS: The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.

Catchment Area, Health↗
PubMed2006

Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients' experiences and perceptions.

OBJECTIVES: The aim of this study was to explore the use of complementary and alternative medicine (CAM) therapies in patients with acne, psoriasis, or atopic eczema and the attitudes about CAM of these patients. DESIGN: This was a qualitative study, utilizing semistructured interviews and thematic analysis. SETTING: Patients were recruited from the practices of dermatologists and general practitioners in a noncapital Australian city. RESULTS: Twenty-six (26) interviews were conducted with patients with acne, 29 with psoriasis, and 7 with atopic eczema. Use of CAM therapies was common. Participants tended to value CAM over orthodox therapies because of their preference for natural approaches to their skin diseases and the perceived lesser potential for adverse effects of CAM therapies. Respondents with acne were more confident about the efficacy of CAM than were those with psoriasis or eczema. The resulting sense of control attenuated psychologic sequelae of acne. This was not apparent in psoriasis or eczema. CONCLUSIONS: Practitioners should be cognizant of the likely use of CAM and its implications (including the potential for attenuation of psychologic morbidity) in their patients who have skin diseases.

Acne Vulgaris↗
PubMed2006

Human lysozyme expressed in the mammary gland of transgenic dairy goats can inhibit the growth of bacteria that cause mastitis and the cold-spoilage of milk.

The addition of human milk components with intrinsic antimicrobial activity to livestock milk by genetic engineering has the potential to benefit milk safety and production as well as the health of the lactating animal. As a model for the dairy cow, we generated transgenic goats that expressed human lysozyme in their milk at 68% of the levels found in human milk. Milk from these transgenic animals had a bacteriostatic effect on both in vitro and in vivo growth of several microorganisms important to the dairy industry. In vitro, milk from transgenic animals was capable of slowing the growth of mastitis-causing strains of Escherichia coli (P < 0.02) and Staphylococcus aureus (P < 0.05) as well as the cold-spoilage organism Pseudomonas fragi (P < 0.02). The growth of an organism involved in cheese-making, Lactococcus lactis, was not affected by the presence of lysozyme in milk. The supplementation of control milk with purified lysozyme did not achieve the same inhibitory effect as milk from transgenic animals. In vivo, milk from transgenic animals supported less bacterial growth than control milk. This transgenic model demonstrates the possibilities offered by genetic engineering to enhance the antimicrobial nature of milk and the udder.

Animals↗
PubMed2006

Regular aspirin use and retinal microvascular signs: the Blue Mountains Eye Study.

OBJECTIVE: Hypertension is closely related to microvascular abnormalities and there is increasing interest in agents that target the microvasculature. The effect of aspirin on the microvasculature has not been well studied. We examined the cross-sectional and longitudinal associations between regular aspirin use and retinal microvascular signs. DESIGN AND METHODS: We digitized retinal photographs from participants of the Blue Mountains Eye Study cohort (1992-1994, n = 3654, aged over 49 years, and 1997-1999, n = 2335) and used a computer-assisted method to measure average retinal arteriolar and venular diameters. Information on the frequency of aspirin use was collected, with regular aspirin use defined as weekly or daily. RESULTS: Regular aspirin users comprised 21.2% (n = 775) of the baseline population. At baseline and in individuals who were on one or more antihypertensive medication, regular aspirin use was found to be associated with retinal arterioles on average 3.6 mum (95% confidence interval 1.0, 6.2) wider than those of non-users or occasional aspirin users, after adjusting for age, blood pressure, smoking, diabetes, non-steroidal anti-inflammatory drug use and other variables. Increasing frequency of aspirin use was associated with increasing retinal arteriolar diameter (Ptrend < 0.01). At 5-year follow-up, regular users of aspirin and antihypertensive medication(s) had wider retinal arterioles than those who used aspirin less regularly. Neither antihypertensive medication use alone nor aspirin use alone was associated with wider retinal vessels. CONCLUSION: Our finding of a possible association between the combined use of aspirin and antihypertensive agent(s) and wider retinal arteriolar diameter warrants further investigation into the effects of aspirin on the microvasculature.

Aged↗
PubMed2006

Variables determining perceived global health ranks: findings from a population-based study.

OBJECTIVE: To assess variables associated with different perceived global health ranks in an older population. MATERIALS AND METHODS: The Blue Mountains Eye Study was a populationbased survey of residents aged >or=49 years in an area west of Sydney, Australia. Questions relating to demographic and socioeconomic indicators, limitations of daily living activities, medical history, hearing problems, exercise, smoking and alcohol consumption were asked in a standardised questionnaire at interview. Comprehensive eye examinations were performed. Self-rated health was assessed from a standard question and categorised as excellent, good, fair or poor. Associations were assessed using logistic regression models. RESULTS: After exclusions, 714/3589 (19.9%) participants rated their health as excellent, 1969 (54.9%) as good, 766 (21.3%) as fair and 140 (3.9%) as poor. A wide array of study variables assessed showed significant associations with self-rated health. Compared with a self-ranking of good or excellent health, variables significantly associated in a multivariate model with a rank of poor health included: regular use of community support services, more than one hospital admission in the last 12 months, perceived inability to go out alone, difficulty walking, or history of angina, asthma or cancer. Variables significantly associated with a rank of fair health were broader and included socioeconomic status, sensory impairment, tinnitus, many chronic diseases and negative health behaviours, including smoking and heavy alcohol consumption. CONCLUSIONS: Our findings suggest that different sets of variables may influence people to rank their global health at different perceived levels.

Activities of Daily Living↗
PubMed2006

Water consumption patterns in rural Bangladesh: are we underestimating total arsenic load?

Risk related to the ingestion of any water contaminants depends on many factors, including the daily per capita amount of consumed water relative to body weight. This study explored the water consumption pattern of a rural arsenic-affected population in Bangladesh. The study findings are likely to contribute to the risk estimation attributable to ingestion of arsenic and other drinking water contaminants. A total of 640 individuals participated in this cross-sectional study carried out in an arsenic-affected rural population in Bangladesh. In this study daily per capita water consumption for drinking purposes was found to be 73.04 ml/kg/d (range = 71.24-74.84 ml/kg/d), which is higher than for both the US and Taiwan populations. This difference in per capita drinking water consumption might contribute to much higher lifetime cancer mortality and other morbidity risks from arsenic among the Bangladesh population compared to either the US or Taiwan populations. Arsenic is also ingested through cooking water which, if considered, might increase the risk further. The findings of this study highlight the urgent need for a holistic water supply programme for Bangladesh, with special emphasis on the arsenic-affected population.

Adolescent↗
PubMed2005

Low hemoglobin, chronic kidney disease, and risk for coronary heart disease-related death: the Blue Mountains Eye Study.

A recent report found that chronic kidney disease (CKD) increased the risk for coronary heart disease (CHD) events in people with anemia but not in those without anemia. This study aimed to verify these findings in the Blue Mountains Eye Study cohort, a prospective Australian population-based study of 3654 residents aged 49 to 97 yr. Fasting blood samples were obtained at baseline and confirmed CHD-related deaths over 9 yr with the Australian National Death Index. "Low hemoglobin" was defined as levels in the lowest quintile of the cohort. Body surface area-adjusted GFR was estimated using a variety of methods (Cockcroft-Gault, abbreviated Modification of Diet in Renal Disease, and Bjornsson equations). People with CKD (GFR <60 ml/min per 1.73 m2 as estimated using the Cockcroft-Gault equation) and low hemoglobin (mean 13.2 g/dl; range 7.6 to 14.6 g/dl) had an increased risk for CHD-related death (multivariable-adjusted hazard risk ratio 1.49; 95% confidence interval 1.08 to 2.06) compared with people with CKD but in higher hemoglobin quintiles. This effect was not evident in people without CKD. The interaction between GFR and hemoglobin was significant (P = 0.05) when GFR was estimated using either the Cockcroft-Gault or Bjornsson equations or when serum creatinine instead of GFR was used in the analyses but not when GFR was estimated using the abbreviated Modification of Diet in Renal Disease equation. In conclusion, this study found that low hemoglobin, even within the normal range, together with CKD increased the risk for CHD-related death.

Aged↗
PubMed2005

A systematic review of the evidence for 'myths and misconceptions' in acne management: diet, face-washing and sunlight.

BACKGROUND: Lay perceptions that diet, hygiene and sunlight exposure are strongly associated with acne causation and exacerbation are common but at variance with the consensus of current dermatological opinion. OBJECTIVES: The objective of this study was to carry out a review of the literature to assess the evidence for diet, face-washing and sunlight exposure in acne management. METHODS: Original studies were identified by searches of the Medline, EMBASE, AMED (Allied and Complementary Medicine), CINAHL, Cochrane, and DARE databases. Methodological information was extracted from identified articles but, given the paucity of high quality studies found, no studies were excluded from the review on methodological grounds. RESULTS: Given the prevalence of lay perceptions, and the confidence of dermatological opinion in rebutting these perceptions as myths and misconceptions, surprisingly little evidence exists for the efficacy or lack of efficacy of dietary factors, face-washing and sunlight exposure in the management of acne. Much of the available evidence has methodological limitations. CONCLUSIONS: Based on the present state of evidence, clinicians cannot be didactic in their recommendations regarding diet, hygiene and face-washing, and sunlight to patients with acne. Advice should be individualized, and both clinician and patient cognizant of its limitations.

Acne Vulgaris↗
PubMed2005

Methods for a population-based study of myopia and other eye conditions in school children: the Sydney Myopia Study.

PURPOSE: The Sydney Myopia Study will establish the prevalence of myopia and other eye diseases in a large representative sample of Sydney school children. It will also examine the relationship between myopia and potential modifiable risk factors and will assess potential gene-environment interactions by examining parents and siblings. METHODS: The target population is a stratified random cluster sample of 1750 Year 1 (age 6 years) and 1500 Year 7 (age 12 years) students from Sydney metropolitan schools. Procedures (comprehensive parent-administered questionnaire and examination) involve standardized protocols to allow for comparison with international population-based data. Examinations include a detailed assessment of visual acuity, cover testing for strabismus, identification of amblyopia, slit-lamp examination, non-contact ocular biometry and cycloplegia (cyclopentolate) followed by autorefraction, optical coherence tomography, retinal thickness measurement, digital mydriatic retinal photography and aberrometry. CONCLUSIONS: The Sydney Myopia Study design and methodology will ensure valid findings on ocular development and health in a large representative sample of Sydney school children, for comparison with other population-based refraction data.

Adolescent↗
PubMed2005

Development and evaluation of a real-time fluorescent polymerase chain reaction assay for the detection of bovine contaminates in cattle feed.

A real-time fluorescent polymerase chain reaction assay for detecting prohibited ruminant materials such as bovine meat and bone meal (BMBM) in cattle feed using primers and FRET probes targeting the ruminant specific mitochondrial cytochrome b gene was developed and evaluated on two different types of cattle feed. Common problems involved with PCR based testing of cattle feed include the presence of high levels of PCR inhibitors and the need for certain pre-sample processing techniques in order to perform DNA extractions. We have developed a pre-sample processing technique for extracting DNA from cattle feed which does not require the feed sample to be ground to a fine powder and utilizes materials that are disposed of between samples, thus, reducing the potential of cross contamination. The DNA extraction method utilizes Whatman FTA card technology, is adaptable to high sample throughput analysis and allows for room temperature storage with established archiving of samples of up to 14 years. The Whatman FTA cards are subsequently treated with RNAse and undergo a Chelex-100 extraction (BioRad, Hercules, CA), thus removing potential PCR inhibitors and eluting the DNA from the FTA card for downstream PCR analysis. The detection limit was evaluated over a period of 30 trials on calf starter mix and heifer starter ration feed samples spiked with known concentrations of BMBM. The PCR detection assay detected 0.05% wt/wt BMBM contamination with 100% sensitivity, 100% specificity, and 100% confidence. Concentrations of 0.005% and 0.001% wt/wt BMBM contamination were also detected in both feed types but with varying levels of confidence.

Animal Feed↗