Hunter Region Research Articles

Psychopathology and the Validity of Gastrointestinal Symptom Reporting as Revealed Through Cluster Analyses of MMPI-2-RF Results.

Psychological state, self-reported gut symptoms, and somatic complaints are recognized relationships that can impact health assessment and subsequent treatment. To investigate the impact of psychological state and personality on symptom self-reporting and somatization. Sixty-two (62) participants from the Hunter region of NSW (Australia) undertook a survey of health and lifestyle along with an MMPI-2-RF assessment of personality, psychopathology, and test-taking attitude. Participants also completed the Rome Criteria to assess functional gastrointestinal disorders (FGIDs). To assist the interpretation of MMPI-2-RF results, clustering was applied to identify similar responses and sub-cohort profiles of reporting. Cluster analysis revealed four sub-cohorts, stratified by psychopathology, gut-related symptoms, and the validity of self-reported somatic complaints. Sample clustering identified one sub-cohort defined by high rates of negative affectivity and suicidal ideation. Apart from these differences, clusters were uniform for age, sex, smoking, mental health diagnoses, as well as for gut-related conditions. Results provide further evidence of the interaction of the gut-brain axis and its relationship to serious mental health conditions. It also points to the need to assess the veracity of self-reported symptomatology that may be both pathognomonic for psychopathology but might also be a consequence of gut dysbiosis. Clustering assisted these investigations by defining distinct sub-cohorts based on participant MMPI-2-RF responses.

Visualising Daily PM10 Pollution in an Open-Cut Mining Valley of New South Wales, Australia—Part II: Classification of Synoptic Circulation Types and Local Meteorological Patterns and Their Relation to Elevated Air Pollution in Spring and Summer

Abstract: The Upper Hunter Valley is a major coal mining area in New South Wales (NSW), Australia. Due to the ongoing increase in mining activities, PM10 (air-borne particles with an aerodynamic diameter less than 10 micrometres) pollution has become a major air quality concern in local communities. The present study was initiated to quantitatively examine the spatial and temporal variability of PM10 pollution in the region. An earlier paper of this study identified two air quality subregions in the valley. This paper aims to provide a holistic summarisation of the relationships between elevated PM10 pollution in two subregions and the local- and synoptic-scale meteorological conditions for spring and summer, when PM10 pollution is relatively high. A catalogue of twelve synoptic types and a set of six local meteorological patterns were quantitatively derived and linked to each other using the self-organising map (SOM) technique. The complex meteorology–air pollution relationships were visualised and interpreted on the SOM planes for two representative locations. It was found that the influence of local meteorological patterns differed significantly for mean PM10 levels vs. the occurrence of elevated pollution events and between air quality subregions. In contrast, synoptic types showed generally similar relationships with mean vs. elevated PM10 pollution in the valley. Two local meteorological patterns, the hot–dry–northwesterly wind conditions and the hot–dry–calm conditions, were found to be the most PM10 pollution conducive in the valley when combined with a set of synoptic counterparts. These synoptic types are featured with the influence of an eastward migrating continental high-pressure system and westerly troughs, or a ridge extending northwest towards coastal northern NSW or southern Queensland from the Tasman Sea. The method and results can be used in air quality research for other locations of NSW, or similar regions elsewhere.

Machine Learning Identification of Attributes and Predictors for a Flash Drought in Eastern Australia

Flash droughts (FDs) are natural disasters that strike suddenly and intensify quickly. They occur almost anywhere, anytime of the year, and can have severe socio-economic, health and environmental impacts. This study focuses on a recent FD that began in the cool season of the Upper Hunter region of Eastern Australia, an important energy and agricultural local and global exporter that is both flood- and drought-prone. Here, the authors investigate the FD that started abruptly in May 2023 and extended to October 2023. The FD followed floods in November 2021 and much above-average May–October 2022 rainfall. Eight machine learning (ML) regression techniques were applied to the 60 May–October periods from 1963–2022, using a rolling windows attribution search from 45 possible climate drivers, both individually and in combination. The six most prominent climate drivers, and likely predictors, provide an understanding of the major contributors to the FD. Next, the 1963–2022 data were divided into two shorter timespans, 1963–1992 and 1993–2022, generally accepted as representing the early and accelerated global warming periods, respectively. The key attributes were markedly different for the two timespans. These differences are readily explained by the impacts of global warming on hemispheric and synoptic-scale atmospheric circulations.

Cardiovascular disease risk in Australians following plant-based dietary patterns compared to regular meat eaters

The adoption of dietary patterns emphasising higher intakes of plant foods and lower intakes of animal foods (plant-based diets, PBDs), continue to rise worldwide. PBDs have been associated with a lower risk of cardiovascular morbidity and mortality as well as major risk factors such as overweight/obesity and type 2 diabetes. Evidence regarding the dietary profile and disease risk associated with various PBDs in comparison to traditional meat-eating diets are scarce within the Australian population. The aim of this study is to investigate the 5-year and 10-year risk of developing cardiovascular disease (CVD) among Australians habitually following various PBDs compared to a regular meat diet (RMD). The Plant-based Diet (PBD) Study is a cross-sectional study consisting of healthy adults between aged 30-75 years from the Hunter Region (NSW) between 2021-2023. A validated FFQ was used to assess eligibility and categorise individuals who were habitually consuming one of five dietary patterns for at least 6 months into the following groups: vegan (nil animal products), lacto-vegetarian (LOV, including eggs and dairy), pesco-vegetarian (PV, including seafood with/without dairy and eggs), semi-vegetarian (SV, minimal consumption of animal products) or RMDs (including animal meat daily or multiple times/day)(1). 5-year and 10-year CVD risk was quantified using the Framingham Risk Equation(2) and the Australian Absolute CVD risk calculator, respectively. CVD risk and other quantitative measures was compared using One-way ANOVA or Kruskal Wallis, and Chi-square or Fisher’s Exact for qualitative data. Directed acyclic graphs displayed confounding variables and mediators and a regression model was used to adjust for these. A total of 240 participants (median age 55(16), 77.5% female) with 48 participants in each group showed a significant difference in predicted 5-year risk of CVD (P<0.05), however 10-year risk did not significantly differ across groups. 5-year CVD risk was significantly lower in the vegan group (1%) compared to the RMD, SV, PV, and LOV diet groups (all 2%). In comparison to a vegan diet, crude association showed those consuming a RMD had a 2.4% (95% CI 0.7, 4.1) higher 5-year risk of developing CVD, followed by 1.7% in LOV (95% CI 0.6, 2.9), 1.8% in PV (95% CI 0.5, 3), and 1.1% in SV (95% CI 0.2, 2.1). Significance was lost after adjusting for confounders such as age, gender, smoking status, alcohol intake, physical activity levels and BMI. This is the first study to purposefully sample Australians habitually following PBD, presenting novel population-based evidence for CVD risk. These findings suggest more restrictive PBDs such as vegan diets when compared to RMD may lead to lower CVD risk, however population-based longitudinal studies primary investigating the development of CVDs in the context of PBDs are warranted.

Social resilient networks for improving animal evacuation in emergencies: rural/isolated community perspectives

Effective animal evacuation strategies are imperative for comprehensive emergency management in rural and isolated communities. Community resilience significantly influences the success of these strategies. This research examined the critical role of social resilience networks to improve evacuation of livestock and community resilience in rural and isolated communities. The study took a qualitative approach to studied community members and animal emergency management stakeholders during 3 focus group discussions and workshops. These workshops were conducted in Moorland, Whittingham and the MidCoast Council area of the Hunter Region in New South Wales. The research confirmed that communities with existing strong and cohesive networks and relationships often create a safe and supportive environment when emergencies arise and evacuation is required. The themes from community-led initiatives encompass social connections, communication management, preparedness, sensitisation and situational awareness. Establishing networks for mutual aid, involving the community in planning, promoting animal welfare and improving preparedness through education are recommended. These recommendations facilitate smooth animal evacuation and safeguard animals and the community. Creating an inclusive, participatory evacuation plan that takes into consideration community networks enhances emergency preparedness and evacuation.

Evaluation of animal safe places for emergency evacuation in the Hunter Region of New South Wales, Australia

PurposeThis project aims to improve understanding of disaster preparedness and resilience, as well as animal recovery during a disaster event. The purpose of this study is to determine the type and extent of repair/renovation work required to bring proposed animal safe places and their different components up to the minimum standard for an operational animal evacuation site.Design/methodology/approachOn-site survey using a five-point Likert scale questionnaire was used to collect data through a five stage processes beginning with the creation of a facility register and continuing with the development of assessment guidelines, assessment planning, actual assessment and reporting. In the Hunter Region of New South Wales, Australia, 25 potential animal evacuation sites, including saleyards, showgrounds, animal shelters and racecourses, were identified and accessed.FindingsThe findings of the study reveals that none of the facilities are of high standard. However, 16% would require cosmetic work, 76% would require minor work and the remaining facilities would require significant work. According to the characteristics of the facilities assessed, saleyards have a greater capacity to accommodate animals ranging in size from large to small. More than half of the facilities have average to excellent hay sheds and wash bays, whereas less than half have dedicated animal quarantine space.Research limitations/implicationsThe findings of this study should assist government agencies, local councils, emergency management teams and other stakeholders in planning for and considering renovation/upgrade of potential animal safe places.Originality/valueThe assessment guideline developed as part of this research can be included in the local council’s emergency management plan to improve adequate planning for safe animal evacuation.

Dietary metabolome profiles of a Healthy Australian Diet and a Typical Australian Diet: protocol for a randomised cross-over feeding study in Australian adults

IntroductionTraditional dietary assessment methods such as 24-hour recalls and food frequency questionnaires rely on self-reported data and are prone to error, bias and inaccuracy. Identification of dietary metabolites associated with...

Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study.

Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.

Severe Hypercalcemia in Pregnancy Presenting a Diagnostic Conundrum.

Journal Article Severe Hypercalcemia in Pregnancy Presenting a Diagnostic Conundrum Get access Emma E Croker, Emma E Croker Department of Clinical Chemistry; NSW Health Pathology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaDepartment of Diabetes and Endocrinology, John Hunter Hospital, New Lambton Heights, NSW, Australia Address correspondence to this author at: John Hunter Hospital, Locked Bag 1, Hunter Region, NSW, Australia, 2310. Tel +61-(2)-49214380; e-mail emma.croker@health.nsw.gov.au. https://orcid.org/0000-0003-4104-3923 Search for other works by this author on: Oxford Academic Google Scholar Carl Jenkinson, Carl Jenkinson Andrology, ANZAC Research Institute, Sydney NSW 2139, Australia Search for other works by this author on: Oxford Academic Google Scholar Richard Ruddell, Richard Ruddell Department of Clinical Chemistry; NSW Health Pathology, John Hunter Hospital, New Lambton Heights, NSW, Australia Search for other works by this author on: Oxford Academic Google Scholar Katie Wynne Katie Wynne Department of Diabetes and Endocrinology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia Search for other works by this author on: Oxford Academic Google Scholar The Journal of Applied Laboratory Medicine, jfad030, https://doi.org/10.1093/jalm/jfad030 Published: 21 June 2023 Article history Received: 08 February 2023 Accepted: 31 March 2023 Published: 21 June 2023

Meaningful coproduction with clinicians: establishing a practice-based research network with physiotherapists in regional Australia

BackgroundThe disconnect between research and clinical practice leads to research evidence that is often not useful for clinical practice. Practice-based research networks are collaborations between researchers and clinicians aimed at coproducing more useful research. Such networks are rare in the physiotherapy field. We aimed to describe (i) clinicians’ motivations behind, and enablers to, participating in a network, (ii) the process of network establishment and (iii) research priorities for a practice-based network of physiotherapists in the Hunter Region of New South Wales (NSW), Australia that supports research coproduction.MethodsWe describe the methods and outcomes of the three steps we used to establish the network. Step 1 involved consultation with local opinion leaders and a formative evaluation to understand clinicians’ motivations behind, and enablers to, participating in a network. Step 2 involved establishment activities to generate a founding membership group and codesign a governance model. Step 3 involved mapping clinical problems through a workshop guided by systems thinking theory with local stakeholders and prioritizing research areas.ResultsThrough formative evaluation focus groups, we generated five key motivating themes and three key enablers for physiotherapists’ involvement in the network. Establishment activities led to a founding membership group (n = 29, 67% from private practice clinics), a network vision and mission statement, and a joint governance group (9/13 [70%] are private practice clinicians). Our problem-mapping and prioritization process led to three clinically relevant priority research areas with the potential for significant change in practice and patient outcomes.ConclusionsClinicians are motivated to break down traditional siloed research generation and collaborate with researchers to solve a wide array of issues with the delivery of care. Practice-based research networks have promise for both researchers and clinicians in the common goal of improving patient outcomes.

Acacia pendula (Fabaceae: Mimosoideae) in the Hunter Valley of New South Wales: Cunningham’s collection from April 1825 and its implications

Previous debate on the status of Acacia pendula A.Cunn. (Fabaceae: Mimosoideae) in the natural flora ofthe Hunter region of New South Wales remains unresolved. However, the discovery of a journal entry and aspecimen of Acacia pendula collected from ‘Hunter’s River’ by Allan Cunningham in April 1825 potentiallyprovide evidence for its long-term presence there. Close examination of a scan of this specimen reveals a poormatch to the lectotype for this species, and its infertile nature means that it cannot be positively identifiedusing taxonomic keys. Rediscovery of a small group of Acacia ‘pendula’ plants near to where Cunninghamtravelled in 1825 confirms the sterile and root-suckering habit of the species which is consistent with thosegrowing elsewhere in the region. Despite this find, Cunningham’s journal entry and collection provide noconfirmation that Acacia pendula naturally occurred extensively in the region (although it may have beenvery rare) but could suggest either that he had located one of the first introduced stands of the species in theregion (through indigenous people or European settlers), or that these sterile root-suckering plants representa currently un-named taxon or un-recognised hybrid. Final resolution of Hunter Valley populations of Acaciapendula s. lat. may only be attained through genetic studies.

WCN23-0088 PRESENTATION, PROGNOSIS AND OUTCOME OF PATIENTS WITH IGA NEPHROPATHY IN HUNTER REGION, NSW, AUSTRALIA

WCN23-0088 PRESENTATION, PROGNOSIS AND OUTCOME OF PATIENTS WITH IGA NEPHROPATHY IN HUNTER REGION, NSW, AUSTRALIA

Embodying debt: youth, consumer credit and its impacts for wellbeing

ABSTRACT Young people form the primary target demographic of new ‘buy now pay later’ (BNPL) and digital credit services. Despite consistent data showing young people as a cohort are particularly vulnerable to unsustainable levels of indebtedness, little is known about how young people define and make sense of the experience of being in debt through consumer credit services. This paper explores how indebtedness is experienced and understood in relation to wellbeing through a qualitative study using interviews alongside arts-based participatory methods of bodymapping and sandboxing with 24 young people in the Hunter region of NSW, Australia. These methods enabled particular attention to the embodied and affective elements related to the experience of indebtedness to understand debt’s significance for wellbeing for young people. The embodied and affective registers of indebtedness are integral for understanding the conditions informing how wellbeing is negotiated and felt in this context. This study considers the role of BNPL services in young people’s economic lives as part of broader processes of financialisation, and the significance of extended and ubiquitous forms of credit for young people’s wellbeing.

Estimating nutrient transport associated with water and wind erosion across New South Wales, Australia

Nutrient transported from soils to water bodies not only threatens agricultural productivity and food security but also causes the degradation of water quality and the environment in many parts of the world. However, nutrient transport through soil erosion is often ignored in nutrient cycle studies; there is little understanding of how much nutrient is lost through water and wind erosion. In this study, we attempted to assess soil nutrient transport due to both water and wind erosion and its spatial and temporal variability across New South Wales (NSW), Australia. We estimated the mass fraction (%) of total nitrogen (N), total phosphorus (P) and soil organic carbon (SOC) in the eroded soil, and the total nutrient stock of the soil layer down to 200 cm using water and wind erosion models and digital soil mapping. The estimated average N, P and SOC stocks in NSW topsoils (0–5 cm) are 160, 43, and 2970 kg ha−1 respectively. There are great variations in the transport of nutrients by erosion in space and time, ranging from near zero in the Western region to 395 kg ha−1 yr−1 in the North Coast region. The average total nutrient transport rate is about 2.4 % of the surface soil (0–5 cm) total stock in NSW due to both water and wind erosion. The total cost of nutrient transport is estimated at 4.2 billion Australian dollars for the entire state of NSW and 0.2 billion dollars from the cropping lands per year. The areas with the highest nutrient transport rates are the North Coast and Hunter regions due to the relatively high water erosion and nutrient content of the soils. On average, water erosion contributes up to 98 % of the total nutrient transport across the state as a whole, but wind erosion can contribute up to 12 % of the total transport in Spring (i.e., September). This study is the first attempt to investigate nutrient transport from both water and wind erosion in Australia. The methodology and findings contribute to the knowledge of nutrient transport due to erosion in broad nutrient cycle studies.

Rural versus metropolitan comparison of processes of care in the community-based management of TIA and minor stroke in Australia (an analysis from the INSIST study).

To compare processes of care and clinical outcomes of community-based management of TIAs and minor strokes (TIAMS) between rural and metropolitan Australia. Inception cohort study between 2012 and 2016 with 12-month follow-up after index event (sub-study of INSIST). Hunter and Manning valley regions of New South Wales, within the referral territory of the John Hunter Hospital Acute Neurovascular Clinic (JHHANC). Consecutive patients of 16 participating general practices, presenting with possible TIAMS to either primary or secondary care. Processes of care (referrals, key management processes, time-based metrics) and clinical outcomes. Of 613 participants with possible TIAMS who completed the baseline interview, 298 were adjudicated as having TIAMS (119 from rural, 179 from metropolitan). Mean age was 72.3 years (SD, 10.7) and 127 (43%) were women. Rural participants were more likely to be managed solely by a general practitioner (GP) than metropolitan participants (34% v 20%) and less likely to be referred to a JHHANC specialist (13% v 38%) or have brain magnetic resonance imaging (MRI) [24% v 51%]. Those rural participants who were referred, also waited longer (both p < 0.001). Recurrent stroke, myocardial infarction and death at 12 months were not significantly different between rural and metropolitan participants. Although TIAMS prognosis in rural settings where solely GP care is common is very good, the processes of care in such areas are inferior to metropolitan. This suggests there is further scope to support rural GPs to optimise care of TIAMS patients.

Assessing Emergency Animal Safe Sites for Evacuation

Providing shelters for animals during disasters such as floods, bushfires and storms requires adequate planning and preparedness. Planning for animals during the disaster response and recovery phases is critical to mitigating the negative effects that animal loss or separation can have. The human-animal bond has the potential to influence people’s decisions during emergencies, such as how they will respond and when or if they will evacuate. Evacuation with animals during a disaster event can be difficult and complicated. It is critical, however, that animals are rescued and kept safe during and after disasters. Any compromise can result in the death of such animals. Similarly, even in disaster-related situations, animal handling should be consistent with the Australian Animal Welfare Standards and Guidelines. This project aims to better understand disaster preparedness and resilience, as well as the recovery of animals during a disaster event. Twenty-five potential animal evacuation sites, including saleyards, showgrounds, animal shelters, and racecourses, were identified and accessed in nine local government areas (LGAs) across the Hunter region of New South Wales, Australia. On-site survey using a 5-point Likert scale questionnaire was used to collect data. While none of the facilities are of high standard, 16% would require cosmetic work, 76% would require minor work, and the remaining facilities would require significant work. The project’s implication is that the assessment guideline can be included in the local council’s emergency management plan to improve adequate planning for safe animal evacuation.

Fibrillary and immunotactoid glomerulopathies in the Hunter region: a retrospective cohort study.

Fibrillary (FGN) and immunotactoid (IT) glomerulonephritis are uncommon. To evaluate the prevalence, clinicopathological correlations and outcomes of FGN and IT in our regional centre in Australia. We interrogated a renal biopsy database for cases of FGN and IT from 2000 to 2020. Data included demographics, serum creatinine, haematuria status, proteinuria, comorbidities and histopathological findings. We had 14 cases of FGN and t of IT. The mean presenting age was 59.8 years, and 42.9% were males. No patients with FGN had dysproteinaemia, whereas both patients with IT had chronic lymphocytic leukaemia. At presentation, 75% of patients with FGN and both patients with IT had haematuria; all had proteinuria. Mean albumin-creatinine ratio at presentation was 254 mg/mmol for FGN and 604 mg/mmol for IT. Mean presenting serum creatinine was 149 μmol/L for FGN and 95 μmol/L for IT. Four patients with FGN (28.6%) received immunomodulatory therapy. The prognosis of FGN was poor, with six patients (46.2%) reaching end-stage kidney disease after a median of 42 months (range 1-96 months). All patients presenting with proteinuria <30 mg/mmol entered complete remission; patients with higher-grade proteinuria exhibited progressive chronic kidney disease. Patients with IT had complete remission with treatment of underlying haematological disease. FGN is rare, with poor response to immunomodulatory therapy. It carries poor renal prognosis. Less proteinuria at diagnosis may predict a more benign disease course. IT is associated with haematological malignancy and carries better prognosis and response to treatment.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

History, Current Practice, and the Future of Wound Care for Occupational and Physical Therapists.

Coal, Steel and the Holy Cross: Post-War Churches and Chapels of the Hunter Region, NSW

ABSTRACT This paper contributes to the growing body of scholarly research into the boom in church construction that took place in Australia in the 1950s and 1960s. Building on recent work by Lisa Marie Daunt and others, it focuses on a regional location as a noteworthy arena of this activity and seeks to understand the forces behind the appearance of a number of striking examples of modern church and chapel architecture. Due to its development as a major mining and industrial manufacturing centre, the Hunter region of New South Wales became a place of significant church construction. After the Second World War the region experienced a wave of church building activity as authorities looked to accommodate expanding congregations and as new religious territories emerged, particularly within the suburban growth areas of Newcastle. This paper examines key developments in church design and construction within the Hunter region in the post-war decades by considering three areas of architectural change and innovation: the simplification of traditional form, the introduction of new spatial arrangements, and the creation of physically and visually rich interior environments through the use of textured materials. Structuring the study around these areas clearly reveals how change took place in the transition from a conservative modernism to a range of innovative designs. The paper argues that not only do these changes reflect the impact of liturgical reform and the desire to enhance the church-going experience of modern-day worshippers, they also need to be understood in terms of a shift away from the patronage of established local architectural practices to the commissioning of Sydney architects who were employing new ideas for church and chapel design.

Transition in Incidence Rate of Hospitalised Stroke and Case Fatality Rate in the Hunter Region, Australia, 2001-2019: A Prospective Hospital-Based Study

Introduction: Continuous surveillance of stroke admissions has been conducted in the Hunter region, Australia, over the past two decades. We aimed to describe the trends in incidence rates of hospitalised stroke and case-fatality rates in this region, 2001-2019. Methods: From a hospital-based stroke registry, data for admitted adult stroke patients residing in the Hunter region were collected using ICD-10 codes for ischemic and haemorrhagic stroke. Negative binomial regression and logistic regression analysis were used to analyse trends for age-standardised and age-specific incidence rates of hospitalised stroke and 28-day case-fatality rates. Results: A total of 14,662 hospitalisations for stroke in 13,242 individuals were registered. The age-standardised incidence rate declined from 123 per 100,000 population in the 2001-2005 epoch to 96 in the 2016-2019 epoch (mean annual change -2.0%, incidence rate ratio (IRR) = 0.980 [95%CI: 0.976-0.984]). Age-specific analyses identified significant reduction in the group aged 75-84 (1039 per 100,000 population in 2001-2005 to 633 in 2016-2019, annual change -3.5%, IRR= 0.965 [95%CI: 0.960-0.970]). The 28-day case-fatality rates fluctuated over time (18.5% in 2001-2005, 20.8% in 2010-2015, and 17.8% in 2016-2019). Projected population aging suggests annual volume of patients with new stroke will increase by 77% by 2041 if incidence rates remain unchanged at the 2016-2019 level. Conclusion: Although age-standardised hospitalised stroke incidence rates have declined in the Hunter region, the health system will face an increase in stroke hospitalisations related to the aging population.