ORCID Profile
0000-0003-3736-4337
Current Organisation
Deakin University
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Publisher: Elsevier BV
Date: 12-1999
DOI: 10.1016/S0048-9697(99)00362-9
Abstract: A diagnostic study was done on Melia azedarach L. in relation to atmospheric pollutants in Córdoba city, Argentina. The study area receives regional pollutants, and it was categorized taking into account traffic level, industrial level, location of the s le point in relation to the corner, treeless condition, building type, topographic level and distance to the river. Water content and Specific Leaf Area (SLA) were calculated and concentrations of soluble proteins, sulphur, hydroperoxy conjugated dienes (HPCD), chlorophylls (Total Chl) and pheophytins (Total Paeoph) were determined in leaf s les. HPCD correlated positively with industry, topographic level and distance to the river, and with a combination of the environmental variables (ECI) pigments correlated negatively with traffic level and with ECI Total Phaeoph/Total Chl ratio correlated positively with traffic, building and ECI. On the basis of our results, traffic level, industrial level, building type, topographic level and distance to the river are the environmental variables to bear in mind when selecting analogous s ling points in a passive monitoring program. An approximation to predict tree injury may be obtained by measuring water content, soluble proteins, sulphur, HPCD and pigments as they are responsible for the major variability of data. This study revealed that M. azedarach was sensitive to air pollutants from traffic and industry. Thus, in those s ling sites with the maximum score for traffic level, industrial level and ECI, the highest values of the parameters that indicate foliar damage together with the least pigment concentration were observed.
Publisher: Elsevier BV
Date: 08-2003
Publisher: SAGE Publications
Date: 13-12-2017
Abstract: Informal caregivers of people with motor neurone disease (MND) take on an extensive role. Caregivers are at increased risk of experiencing psychological distress and burden, yet, there is a lack of intervention programmes to support them. The aim of this study was to investigate the feasibility and acceptability of a therapeutic group intervention promoting self-care, problem-solving and mindfulness to informal caregivers of people with MND. Pilot study that utilised a one-arm pre- and post-design. Acceptability of the intervention was assessed 2 weeks post intervention with a questionnaire designed specifically for this study. Feasibility was assessed with consent, adherence and reasons for non-participation, refusal and attrition. Participants completed baseline and follow-up (6-week post intervention) questionnaires for psychological morbidity, burden, problem-solving, mindfulness and preparedness. Caregivers of people with a diagnosis of MND within the past 12 months who were 18 years or older who could speak, read and write in English and who were attending a progressive neurological diseases clinic were eligible. A total of 13 caregivers participated in one of three group intervention sessions which were focused on self-care, problem-solving and mindfulness. The intervention appeared to be feasible and acceptable. All participants stated that they would recommend the intervention to others. The group format appeared to be highly valued. There was no significant change in measures between pre-intervention and 6 weeks post intervention. This pilot serves as an initial step for examining interventions for MND caregivers, with the hope of identifying effective, efficient and sustainable strategies to best support this group.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2017
Publisher: Elsevier BV
Date: 02-2016
Publisher: Elsevier BV
Date: 02-2021
Publisher: JMIR Publications Inc.
Date: 09-05-2022
Abstract: n March 2020, the Australian Government expanded general practitioner (GP) telehealth services in response to the coronavirus disease 2019 pandemic. his study sought to assess utilisation patterns of GP telehealth services in response to changing circumstances (before and during the COVID-19 pandemic, with or without lockdown) in regional Victoria, Australia. e conducted a secondary analysis of monthly Medicare claims data from July 2019 to June 2021 from 140 regional GP practices in western Victoria. The longitudinal patterns of proportion of GP telehealth consultations stratified by type of consultation (videoconference vs. telephone) and by geographical, consumer and consultation characteristics were analysed. elehealth comprised 25.8% of GP consultations over the two-year period (n total = 2,025,615). After the introduction of the Australian telehealth expansion policy in March 2020, there was a rapid uptake in GP telehealth services (from 0% to 15% of all consultations), with a peak in August 2020 (55%). Thereafter, utilisation declined steadily to 31% in January 2021 and tapered off to 28% in June 2021. Telephone services and shorter consults were the most dominant form, and those aged 15-64 years had higher telehealth utilisation rates than younger or older age groups. The proportion of video consultations was higher during periods with government-imposed lockdown, and higher in the most socioeconomically advantaged areas compared to less socioeconomically advantaged areas. ur findings support the continuation of telehealth use in rural and regional Australia post-pandemic. Future policy must identify mechanisms to reduce existing equity gaps in video consultations and consider patient- and system-level implications of the dominant use of short telephone consults.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-04-2014
Abstract: This study aimed to determine whether feeding back patient-reported outcomes (PROs) to providers and families of children with advanced cancer improves symptom distress and health-related quality of life (HRQoL). This study was a parallel, multicentered pilot randomized controlled trial. At most once per week, children age ≥ 2 years old with advanced cancer or their parent completed the computer-based Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) survey consisting of age- and respondent-adapted versions of the Memorial Symptom Assessment Scale (MSAS), Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL4.0), and an overall Sickness question. In the intervention group (n = 51), oncologists and families received printed reports summarizing PROs e-mails were sent to oncologists and subspecialists when predetermined scores were exceeded. No feedback was provided in the control group (n = 53). Primary outcomes included linear trends of MSAS, PedsQL4.0 total and subscale scores, and Sickness scores during 20 weeks of follow-up, along with child, parent, and provider satisfaction with PediQUEST feedback. Feedback did not significantly affect average MSAS, PedsQL4.0, or Sickness score trends. Post hoc subgroup analyses among children age ≥ 8 years who survived 20 weeks showed that feedback improved PedsQL4.0 emotional (+8.1 95% CI, 1.8 to 14.4) and Sickness (−8.2 95% CI, −14.2 to −2.2) scores. PediQUEST reports were valued by children, parents, and providers and contributed at least sometimes to physician initiation of a psychosocial consult (56%). Although routine feedback of PROs did not significantly affect the child's symptoms or HRQoL, changes were in expected directions and improvements observed in emotional HRQoL through exploratory analyses were encouraging. Importantly, children, parents, and providers value PRO feedback.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.APPET.2019.104481
Abstract: Price is a key determinant of food choice, particularly for low-income households who may be more sensitive to price-lowering strategies such as price promotions and generic/retailer-owned brands. Price-lowering strategies may therefore represent important policy targets to improve population nutrition and reduce inequities. This study aimed to describe household purchasing patterns of price promoted and generic branded foods and beverages in New Zealand (2016-2017). One year of grocery purchase data from a national consumer research panel in New Zealand (n = 1778 households) were analysed. Purchases were classified by processing level and food type. Linear mixed models were fitted to estimate the mean proportion of annual household purchases (unique items and volumes (kg/L)) that were price promoted or generic branded (overall and by food category), and to assess whether purchasing patterns were modified by income level. On average, price promoted products constituted 50% (95%CIs 49,51) of all unique annual household grocery items purchased. Fifty-nine percent (95%CIs 58,60) of processed, 55% (95%CIs 54,56) of ultra-processed, 45% (95%CIs 44,46) of unprocessed and 45% (95%CIs 44,46) of ingredient purchases were price promoted. By volume, the proportion of purchases that were price promoted was highest for meat (65%[95%CIs 64,66]), sugar-sweetened beverages (64%[95%CIs 62,65]), dairy foods (64%[95%CIs 63,66]), confectionary (64%[95%CIs 63,66]), snack foods (63%[95%CIs 61,64]), oils (61%[95%CIs 60,62]) and non-sugar-sweetened beverages (60%[95%CIs 58,62]), and lowest for dairy beverages (30%[95%CIs 28,31]), sugar/honey (33%[95%CIs 32,35]) and sauces/spreads (39%[95%CIs 37,40]). On average, generic brands constituted 10% (95%CIs 9,10) of all household purchases. Overall, a significantly greater proportion of purchases made by low and middle-income households were price promoted and generic branded compared to high-income households (p < 0.001 for both), a pattern generally observed across food categories. This study supports recent calls to address unhealthy food and beverage price promotions in comprehensive policy strategies aiming to improve population diets and weight.
Publisher: Oxford University Press (OUP)
Date: 03-07-2020
Abstract: Retailers have the capacity to improve the food and beverage environment by making healthier options more affordable and attractive for their consumers. The perspectives of retailers on feasible and acceptable pricing strategies are not known. The aim of this study was to understand retailers’ perceptions of factors that are relevant to feasible and acceptable health-promoting food and beverage pricing interventions. A convenience s le of 11 aquatic and recreation centre managers in Victoria, Australia was recruited to participate in semi-structured interviews. We took a pragmatic approach with the aim of understanding retailers’ perceptions of factors that affect the feasibility and acceptability of pricing interventions within their facilities. Thematic analysis was used to synthesize and interpret retailers’ perceptions of pricing interventions. Key themes identified were: structural and organizational characteristics (the internal and external characteristics of aquatic and recreation centres), characteristics of feasible pricing changes (type, magnitude and products targeted by pricing strategies) and business outcomes (profits and customer feedback). Results suggest that pricing interventions to promote healthy food and beverage choices can be feasible and acceptable to retailers, though contextual considerations are likely to be important. Future studies should use these findings to design interventions most likely to be acceptable to retailers, work with retailers to implement health-promoting food and beverage pricing interventions, evaluate the impact on business outcomes including customer perspectives and profitability, and test transferability to other retail settings.
Publisher: Springer Science and Business Media LLC
Date: 13-04-2018
Publisher: Springer Science and Business Media LLC
Date: 12-03-2021
DOI: 10.1186/S12966-021-01104-Z
Abstract: Successful implementation and long-term maintenance of healthy supermarkets initiatives are crucial to achieving potential population health benefits. Understanding barriers and enablers of implementation of real-world trials will enhance wide-scale implementation. This process evaluation of a healthy supermarket intervention sought to describe (i) customer, retailer and stakeholder perspectives on the intervention (ii) intervention implementation and (iii) implementation barriers and enablers. Eat Well @ IGA was a 12-month randomised controlled trial conducted in 11 Independent Grocers of Australia (IGA) chain supermarkets in regional Victoria, Australia (5 intervention and 6 wait-listed control stores). Intervention components included trolley and basket signage, local area and in-store promotion, and shelf tags highlighting the healthiest packaged foods. A sequential mixed-methods process evaluation was undertaken. Customer exit surveys investigated demographics, and intervention recall and perceptions. Logistic mixed-models estimated associations between customer responses and demographics, with store as random effect. Supermarket staff surveys investigated staff demographics, interactions with customers, and intervention component feedback. Semi-structured stakeholder interviews with local government, retail and academic partners explored intervention perceptions, and factors which enabled or inhibited implementation, maintenance and scalability. Interviews were inductively coded to identify key themes. Of 500 customers surveyed, 33%[95%CI:23,44] recalled the Eat Well @ IGA brand and 97%[95%CI:93,99] agreed that IGA should continue its efforts to encourage healthy eating. The 82 staff surveyed demonstrated very favourable intervention perceptions. Themes from 19 interviews included that business models favour sales of unhealthy foods, and that stakeholder collaboration was crucial to intervention design and implementation. Staff surveys and interviews highlighted the need to minimise staff time for project maintenance and to regularly refresh intervention materials to increase and maintain salience among customers. This process evaluation found that interventions to promote healthy diets in supermarkets can be perceived as beneficial by retailers, customers, and government partners provided that barriers including staff time and intervention salience are addressed. Collaborative partnerships in intervention design and implementation, including retailers, governments, and academics, show potential for encouraging long-term sustainability of interventions. ISRCTN, ISRCTN37395231 Registered 4 May 2017.
Publisher: MDPI AG
Date: 16-11-2016
Publisher: SAGE Publications
Date: 03-03-2015
Abstract: Nearly 2 million people are infected with human immunodeficiency virus (HIV) in Latin America. However, information regarding population-scale outcomes from a regional perspective is scarce. We aimed to describe the baseline characteristics and therapeutic outcomes of newly-treated in iduals with HIV infection in Latin America. A Retrospective cohort study was undertaken. The primary explanatory variable was combination antiretroviral therapy based on either a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI). The main outcome was defined as the composite of all-cause mortality and the occurrence of an AIDS-defining clinical event or a serious non-AIDS-defining event during the first year of therapy. The secondary outcomes included the time to a change in treatment strategy. All analyses were performed according to the intention to treat principle. A total of 937 treatment-naive patients from four participating countries were included (228 patients with PI therapy and 709 with NNRTI–based treatment). At the time of treatment initiation, the patients had a mean age of 37 (SD: 10) years and a median CD4 + T-cell count of 133 cells/mm 3 (interquartile range: 47.5–216.0). Patients receiving PI-based regimens had a significantly lower CD4 + count, a higher AIDS prevalence at baseline and a shorter time from HIV diagnosis until the initiation of treatment. There was no difference in the hazard ratio for the primary outcome between groups. The only covariates associated with the latter were CD4 + cell count at baseline, study site and age. The estimated hazard ratio for the time to a change in treatment (NNRTI vs PI) was 0.61 (95% CI 0.47–0.80, p 0.01). This study concluded that patients living with HIV in Latin America present with similar clinical outcomes regardless of the choice of initial therapy. Patients treated with PIs are more likely to require a treatment change during the first year of follow up.
Publisher: Elsevier BV
Date: 02-1997
Publisher: FapUNIFESP (SciELO)
Date: 09-1997
DOI: 10.1590/S0102-311X1997000300015
Abstract: El objetivo de este trabajo fue indagar la existencia de diferentes "grupos" de jóvenes en función de sus representaciones alrededor de la salud y la enfermedad. En la construcción de estos "grupos" se busca incorporar conceptos tradicionalmente relegados al estudio de la subjetividad. Se trabajó con una encuesta cerrada que se aplicó sobre 400 jóvenes escolarizados. El procesamiento de los datos se realizó con el análisis de correspondencias múltiples, una técnica de análisis multivariado especialmente diseñada para trabajar con un alto número de variables cualitativas. El estudio permitió despejar ocho "tipos" de jóvenes los asustados, los que cierran los ojos, los hipocondríacos, los sensuales, los felices, los amargados, los que miran al mundo y los que miran su ombligo. Estos resultados indicarían la necesidad de ersificar las estrategias de indagación e intervención en terreno dirigidas a esta población.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.JAD.2018.08.011
Abstract: The aim of current study is to assess the cross-sectional association of chronic non-communicable diseases (diabetes mellitus, arthritis, asthma, chronic lung disease, angina, and stroke) with both diagnosed and undiagnosed depression in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1, a study of adults in six low- and middle-income countries. A total of 41,810 participants, aged ≥ 18 years, were included. Depression status was assessed by standard methods derived from the World Mental Health Survey (WHH-CIDI). Undiagnosed depression was defined as a depressed person who did not report history of diagnosis/treatment for depression. Associations between depression/undiagnosed depression and chronic diseases, adjusting for country of residence, demographics and chronic diseases risk factors were assessed. Depression was detected in 2508 (6.0%) cases, from whom 2098 (87%) were undiagnosed. Diabetes (Odds ratio:1.47[95%CI:1.24,1.75]), arthritis (2.14[1.82,2.52]), asthma (3.36[2.73,4.14]), chronic lung disease (3.74[3.10,4.51]), angina (3.20[2.66,3.85]), and stroke (3.14[2.55,3.86]) were associated with depression (p-values < 0.001). Being older, female, underweight, and having lower education, and lower income were positively associated with depression. The estimated odds ratios were similar for undiagnosed depression. Cross-sectional design of study prevent us to determine whether depression followed exposures in time. About 12% of the participant did not have data for depression status and were excluded from the study. Most depression cases were undiagnosed. Depression/undiagnosed depression were strongly associated with chronic diseases stronger than what has been reported in developed countries.
Publisher: Elsevier BV
Date: 06-2015
Publisher: Elsevier BV
Date: 02-2014
Publisher: Oxford University Press (OUP)
Date: 23-08-2020
Abstract: This study aimed to pilot the feasibility, acceptability and effectiveness of three co-developed healthy food and beverage pricing interventions in a community retail setting. Aquatic and recreation centres in Victoria, Australia were recruited to co-develop and pilot pricing interventions within their onsite cafés, for 15 weeks from January 2019. A mixed method intervention evaluation was conducted. Interviews were conducted with food retail managers to understand the factors perceived to influence implementation, maintenance and effectiveness. Customer surveys assessed support for, and awareness of, interventions. Interrupted time series analysis estimated the impact of pricing interventions on food and beverage sales. Three centres each implemented a unique intervention: (i) discounted healthy bundles (‘healthy combination deals’), (ii) offering deals at specific times of the day (‘healthy happy hours’) and (iii) increasing the prices of selected unhealthy options and reducing the prices of selected healthier options (‘everyday pricing changes’). Café team leaders did not identify any significant challenges to implementation or maintenance of interventions, though low staff engagement was identified as potentially influencing the null effect on sales for healthy combination deals and healthy happy hours interventions. Customers reported low levels of awareness and high levels of support for interventions. Everyday pricing changes resulted in a significant decrease in sales of unhealthy items during the intervention period, though also resulted in a decrease in café revenue. Co-developed healthy food and beverage pricing interventions can be readily implemented with broad customer support. Everyday pricing changes have demonstrated potential effectiveness at reducing unhealthy purchases.
Publisher: MDPI AG
Date: 11-04-2022
Abstract: Alcoholic beverages sold in Australia are largely exempt from requirements to display nutrition information on packages, unlike other food and beverages. However, alcoholic beverage manufacturers can provide nutrition-related information voluntarily. This study aimed to investigate the prevalence of nutrition-related information on packaged alcoholic beverages in Australia. An in-store audit of the largest alcohol retailer in Melbourne, Australia was conducted in July 2021. A systematic s ling method was used to assess the presence and format of nutrition information on 850 alcoholic beverages across 5 alcohol categories (wine (n = 200), beer (n = 200), spirits (n = 200), ready-to-drink beverages (n = 140) and ciders (n = 110)). Most products (n = 682, 80.2%) did not present nutrition-related information. Where information was presented (n = 168), it was most frequently on ready-to-drink beverages (n = 81, 57.9%) and least frequently on spirits (n = 9, 4.5%) and wines (n = 9, 4.5%). Nutrition information was most frequently in the format of a nutrition information panel (n = 150, 89.3%) and approximately half of labelled beverages (n = 86, 51.2%) included a nutrition content claim (e.g., ‘low in carbs’). Given limited voluntary implementation of nutrition labelling on alcoholic beverages in Australia and the substantial contribution of alcoholic beverages to energy intake, consideration of mandatory nutrition labelling, in a standardised format designed to maximise public health benefit, on alcoholic beverages is warranted.
Publisher: Cambridge University Press (CUP)
Date: 14-08-2020
DOI: 10.1017/S1368980020002505
Abstract: The current study aimed to investigate availability and placement of healthy and discretionary (less healthy) food in supermarkets in Victoria, Australia, and examine variation by supermarket chain and area-level socio-economic disadvantage. Cross-sectional supermarket audit. Measures included: (i) proportion of shelf space (in square metres) allocated to selected healthy and discretionary food and beverages (ii) proportion of end-of-aisle, checkout and island bin displays containing discretionary food and beverages and (iii) proportion of space within end-of-aisle, checkout and island bin displays devoted to discretionary food and beverages. Metropolitan areas of Melbourne and Geelong, Australia. Assessment: June–July 2019. Random s le of 104 stores, with equal numbers from each supermarket group (Coles, Woolworths, Aldi and Independent stores) within strata of area-level socio-economic position. Proportion of shelf space devoted to selected discretionary foods was greater for Independent stores (72·7 %) compared with Woolworths (65·7 %), Coles (64·8 %) and Aldi (63·2 %) (all P 0·001). Proportion of shelf space devoted to selected discretionary food for all Coles, Woolworths and Aldi stores was 9·7 % higher in the most compared with the least disadvantaged areas ( P = 0·002). Across all stores, 90 % of staff-assisted checkout displays and 50 % of end-of-aisle displays included discretionary food. Aldi was less likely to feature discretionary food in end-of-aisle and checkout displays compared with other supermarket groups. Extensive marketing of discretionary food in all Australian supermarket chains was observed, which is likely to strongly influence purchasing patterns and population diets. Findings should be used to inform private and public sector policies to reduce marketing of discretionary food in supermarkets.
Publisher: MDPI AG
Date: 03-05-4200
Publisher: Research Square Platform LLC
Date: 20-08-2020
DOI: 10.21203/RS.3.RS-60864/V1
Abstract: Objectives : To test the effectiveness of the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS) for behavioural, health related quality of life and Body Mass Index (BMI) outcomes. Design :Cluster randomized trial of ten communities randomly allocated (1:1) to start intervention in 2015(step one) or in 2019 (after 4-years). Setting :Community based trial in South West Victoria, Australia, including all major health and local council agencies. Participants : Data were collected from 59 participating primary schools April-June of 2015 (73% school participation rate) 2017 (69%), and 2019 (63%). Student participation rates were 80% in 2015 (1,792/2,516 invited), 81% in 2017 (2,411/2,963), and 79% in 2019 (2,177/2,720). Interventions: Local leaders, organisations and community members developed obesity prevention interventions and implementation measures using a five phase process to change existing conditions that lead to childhood obesity. Main outcome measures: Measured height and weight (Grades two, four and six), self-reported behavioural, and health-related quality of life (Grade four and six). Results: There was an intervention by time interaction in both age and sex standardizedBMI (BMIz) (p=0.031)and obesity/overweight prevalence (p=0.006). The control communities remained unchanged whereas BMIz and overweight/obesity prevalence decreased between 2015 and 2017 and increased between 2017 and 2019 in intervention communities. The intervention reduced take away food consumption (p=0.006) and improved physical (p=0.036) and global (p=0.036) health related quality of life. Water consumption increased among girls (p=0.019)as did energy-dense and nutrient poor snack consumption (p=0.015) and take-away food consumption among boys (p= 0.012). BMIz of the grade two cohort steadily increased. Conclusions : WHOSTOPS had a positive impact on takeaway food intake and health-related quality of life. Trial registration : Australian New Zealand Clinical Trials Registry (ANZCTR): 12616000980437.Registered 26 July 2016 - Retrospectively registered www.anzctr.org.au/Trial/Registration/
Publisher: MDPI AG
Date: 03-05-2022
DOI: 10.3390/NU14091919
Abstract: The supermarket environment impacts the healthiness of food purchased and consumed. Shelf tags that alert customers to healthier packaged products can improve the healthiness of overall purchases. This study assessed the potential value-for-money of implementing a three-year shelf tag intervention across all major supermarket chains in Australia. Cost–benefit analyses (CBA) and cost–utility analyses (CUA) were conducted based on results of a 12-week non-randomised controlled trial of a shelf tag intervention in seven Australian supermarkets. The change in energy density of all packaged foods purchased during the trial was used to estimate population-level changes in mean daily energy intake. A multi-state, multiple-cohort Markov model estimated the subsequent obesity-related health and healthcare cost outcomes over the lifetime of the 2019 Australian population. The CBA and CUA took societal and healthcare sector perspectives, respectively. The intervention was estimated to produce a mean reduction in population body weight of 1.09 kg. The net present value of the intervention was approximately AUD 17 billion (B). Over 98% of the intervention costs were borne by supermarkets. CUA findings were consistent with the CBA—the intervention was dominant, producing both health benefits and cost-savings. Shelf tags are likely to offer excellent value-for-money from societal and healthcare sector perspectives.
Publisher: Wiley
Date: 15-09-2018
DOI: 10.1002/CNCR.31639
Publisher: Public Library of Science (PLoS)
Date: 17-05-2021
DOI: 10.1371/JOURNAL.PONE.0251808
Abstract: To compare blood alkalosis, gastrointestinal symptoms and indicators of strong ion difference after ingestion of 500 mg.kg -1 BM sodium citrate over four different periods. Sixteen healthy and active participants ingested 500 mg.kg -1 BM sodium citrate in gelatine capsules over a 15, 30, 45 or 60 min period using a randomized cross-over experimental design. Gastrointestinal symptoms questionnaires and venous blood s les were collected before ingestion, immediately post-ingestion, and every 30 min for 480 min post-ingestion. Blood s les were analysed for blood pH, [HCO 3 - ], [Na + ], [Cl - ] and plasma [citrate]. Linear mixed models were used to estimate the effect of the ingestion protocols. For all treatments, blood [HCO 3 - ] was significantly elevated above baseline for the entire 480 min post-ingestion period, and peak occurred 180 min post-ingestion. Blood [HCO 3 - ] and pH were significantly elevated above baseline and not significantly below the peak between 150–270 min post-ingestion. Furthermore, blood pH and [HCO 3 - ] were significantly lower for the 60 min ingestion period when compared to the other treatments. Gastrointestinal symptoms were minor for all treatments the mean total session symptoms ratings (all times summed together) were between 9.8 and 11.6 from a maximum possible rating of 720. Based on the findings of this investigation, sodium citrate should be ingested over a period of less than 60 min (15, 30 or 45 min), and completed 150–270 min before exercise.
Publisher: MDPI AG
Date: 03-12-2020
Abstract: Supermarket environments can strongly influence purchasing decisions. Price promotions are recognised as a particularly persuasive tactic, but the healthiness of price promotions in prominent in-store locations is understudied. This study compared the prevalence and magnitude of price promotions on healthy and unhealthy food and beverages (foods) displayed at prominent in-store locations within Australian supermarkets, including analyses by supermarket group and area-level socio-economic position. A cross-sectional in-store audit of price promotions on foods at key display areas was undertaken in 104 randomly selected stores from major Australian supermarket groups (Woolworths, Coles, Aldi and independents) in Victoria, Australia. Of the display space dedicated to foods with price promotions, three of the four supermarket groups had a greater proportion of display space devoted to unhealthy (compared to healthy) foods at each promotional location measured (end of aisles: 66% island bins: 53% checkouts: 88%). Aldi offered very few price promotions. Few measures varied by area-level socio-economic position. This study demonstrated that price promotions at prominent in-store locations in Australian supermarkets favoured unhealthy foods. Marketing of this nature is likely to encourage the purchase of unhealthy foods, highlighting the need for retailers and policy-makers to consider addressing in-store pricing and placement strategies to encourage healthier food environments.
Publisher: BMJ
Date: 04-07-2022
DOI: 10.1136/BMJNPH-2022-000445
Abstract: Few studies have explored behavioural and financial impacts of retail initiatives after 2 years to address the unhealthy food environments common in local government sporting settings. To evaluate the impact of a 2-year local government capacity building intervention in sporting facility food outlets on (1) the healthiness of refrigerated drink choices available and visible to customers, (2) healthiness of refrigerated drinks sold and (3) refrigerated drink revenue. 52 sporting facilities within 8 local governments from Victoria, Australia, participated in an intervention between March 2018 and February 2020 by limiting ‘red’ (least healthy) drinks to ≤20% of refrigerator display and increasing ‘green’ (healthiest) drinks to ≥50% of display. Mixed models assessed changes in mean percentage of ‘red’, ‘amber’ and ‘green’ drinks displayed over time, compared with baseline. Facilities provided electronic weekly itemised sales data (December 2015 to February 2020). Weekly volume of ‘red’ or ‘green’ drinks sold as a proportion of total drinks sold, and total refrigerated drinks revenue were compared preimplementation and postimplementation using mixed models (seasonal facilities), and mixed-effect interrupted time series models (non-seasonal facilities). Display of ‘red’ drinks decreased by mean −17.1 percentage points (pp) (95% CI −23.9 to −10.3) and ‘green’ drinks increased 16.1 pp (95% CI 9.30, 22.9) between baseline and 18-month audits. At nine seasonal facilities, compared with the summer preimplementation, the mean volume of ‘red’ drinks sold decreased by −19.0 pp (95% CI −28.6, to –9.51) and refrigerated drink revenue decreased by−AU$81.8 (95% CI −AU$123 to –AU$40.8) per week. At 15 non-seasonal facilities, by February 2020, the volume of ‘red’ drinks sold decreased on average by −11.0 pp (95% CI −21.6 to –0.41) with no change in drink revenue. Reducing the display of unhealthy drinks can be an effective public health policy to improve the healthiness of customer purchases, provided there is consideration of potential impacts on revenue.
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 03-2013
Publisher: Elsevier BV
Date: 07-2021
Publisher: Wiley
Date: 08-02-2023
DOI: 10.1111/OBR.13555
Abstract: Obesity, undernutrition, and climate change constitute a global syndemic that disproportionately affects vulnerable populations, including children. Double‐ and triple‐duty actions that simultaneously address these pandemics are needed to prevent further health, economic, and environmental consequences. Evidence describing the implementation and evaluation of such actions is lacking. This review summarized the literature on whole‐of‐population actions targeting children that were designed or adapted to be double or triple duty. Six academic databases were searched (January 2015–March 2021) using terms related to ‘children’, ‘intervention’, ‘nutrition’, ‘physical activity’, and ‘climate change’. Data were extracted from 43/15,475 studies, including six randomized controlled trials. Most (58%) described triple‐duty actions targeting food systems in schools such as implementing guidelines for healthier and environmentally sustainable school meals programs, and 51% reported engaging community in the design, implementation, and/or evaluation of actions. Changes in dietary intake, diet composition, greenhouse gas emissions, and food waste were the most frequently reported outcomes and 21 studies (three randomized controlled trials) showed positive double‐ or triple‐duty effects. This review is the first to demonstrate that double‐ and triple‐duty actions for addressing the global syndemic in childhood have been implemented and can have a positive impact on obesity, undernutrition, and climate change.
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-029492
Abstract: To assess the impact of a sugar-sweetened beverage (SSB) reduction initiative on customer purchasing patterns, including volume sales of healthy and unhealthy packaged drinks and sales value of all packaged drinks, in a major Australian aquatic and recreation provider, YMCA Victoria. Prospective 16 aquatic and recreation centres in Victoria, Australia. The SSB-reduction initiative aimed to remove all SSBs (excluding sports drinks) and increase healthier drink availability over a 1-year period. Itemised monthly drink sales data were collected for 16 centres, over 4 years (2 years preimplementation, 1 year implementation and 1 year postimplementation). Drinks were classified as ‘green’ (best choice), ‘amber’ (choose carefully) or ‘red’ (limit). Interrupted time series analysis was conducted for each centre to determine the impact on volume sales of ‘red’ and ‘green’ drinks, and overall sales value. A novel meta-analysis approach was conducted to estimate the mean changes across centres. Following implementation, volume sales of ‘red’ drinks reduced by 46.2% across centres (95% CI: −53.2% to −39.2%), ‘green’ drink volume did not change (0.0%, 95% CI: −13.3% to 13.2%) and total drink sales value decreased by 24.3% (95% CI: −32.0% to −16.6%). The reduction of SSBs in health-promoting settings such as recreation centres is a feasible, effective public health policy that is likely to be transferable to other high-income countries with similarly unhealthy beverage offerings. However, complementary strategies should be considered to encourage customers to switch to healthier alternatives, particularly when translating policies to organisations with less flexible income streams.
Publisher: Wiley
Date: 28-08-2008
DOI: 10.1002/SIM.3301
Abstract: We review recent developments in the estimation of an optimal treatment strategy or regime from longitudinal data collected in an observational study. We also propose novel methods for using the data obtained from an observational database in one health-care system to determine the optimal treatment regime for biologically similar subjects in a second health-care system when, for cultural, logistical, or financial reasons, the two health-care systems differ (and will continue to differ) in the frequency of, and reasons for, both laboratory tests and physician visits. Finally, we propose a novel method for estimating the optimal timing of expensive and/or painful diagnostic or prognostic tests. Diagnostic or prognostic tests are only useful in so far as they help a physician to determine the optimal dosing strategy, by providing information on both the current health state and the prognosis of a patient because, in contrast to drug therapies, these tests have no direct causal effect on disease progression. Our new method explicitly incorporates this no direct effect restriction.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2017
Publisher: Springer Science and Business Media LLC
Date: 09-1997
Abstract: / A diagnostic study was done on Ligustrum lucidum Ait. f. tricolor (Rehd.) Rehd. in relation to atmospheric pollutants in Cordoba city, Argentina. The study area receives regional pollutants and was categorized taking into account traffic level, industrial density, type of industry, location of the s le point in relation to the street corner, treeless condition, and topographic level. Dried weight/fresh weight ratio (DW/FW) and specific leaf area (SLA) were calculated, and concentrations of chlorophylls, carotenoids, total sulfur, soluble proteins, malondialdehyde (MDA), and hydroperoxy conjugated dienes (HPCD) were determined in leaf s les. Sulfur content correlates positively with traffic density and SLA correlates negatively with some combinations of the categorical variables MDA correlates positively with topographic level and total protein concentration correlates negatively with treeless condition. On the basis of our results, traffic, location of trees, type of industry, situation of a tree with respect to others, and topographic level are the environmental variables to bear in mind when selecting analogous s ling points in a passive monitoring program. An approximation to predict tree injury may be obtained by measuring DW/FW ratio, proteins, pigments, HPCD, and MDA as they are responsible for the major variability of data.KEY WORDS: L. lucidum Ait. f. tricolor (Rehd.) Rehd. Air pollution Sulfur accumulation Pigments Urban environment Argentina
Publisher: Springer Science and Business Media LLC
Date: 12-02-2021
DOI: 10.1038/S41598-021-83129-9
Abstract: We aimed to determine the efficacy of multiple micronutrient supplementation on the biomarkers of iron, zinc, and vitamin A status across anthropometric status categories in Vietnamese school children. In this 22-week randomised controlled trial, 347 undernourished, normal weight, or overweight/obese children aged 6–9 years were allocated to receive every school day a multiple micronutrient supplement (10 mg iron, 10 mg zinc, 400 µg vitamin A) or a placebo. Haematological indices circulating ferritin, zinc, and retinol (corrected for inflammation) and C-reactive protein were measured at baseline and 22 weeks. At week 22, linear mixed models showed that mean corpuscular volume increased by 0.3 fL, serum ferritin by 9.1 µg/L, plasma zinc by 0.9 µmol/L, and plasma retinol by 15%, and the prevalence of zinc deficiency decreased by 17.3% points in the intervention group compared to placebo. No intervention effects were found for other haematological indices, or the prevalence of anaemia. Multiple micronutrient supplementation for 22 weeks improved the biomarkers of zinc and vitamin A status and some biomarkers of iron status, and reduced the prevalence of zinc deficiency in Vietnamese school children. Trial registration: This trial was registered on 06/09/2016 at www.anzctr.org.au as ACTRN12616001245482.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1093/AJCN/NQY022
Abstract: In iduals with impaired fat taste (FT) sensitivity have reduced satiety responses after consuming fatty foods, leading to increased dietary fat intake. Habitual consumption of dietary fat may modulate sensitivity to FT, with high consumption decreasing sensitivity [increasing fatty acid taste threshold (FATT)] and low consumption increasing sensitivity (decreasing FATT). However, some in iduals may be less susceptible to diet-mediated changes in FATT due to variations in gene expression. The objective of this study was to determine the effect of an 8-wk low-fat or high-fat diet on FATT while maintaining baseline weight (<2.0 kg variation) to assess heritability and to explore the effect of genetics on diet-mediated changes in FATT. A co-twin randomized controlled trial including 44 pairs (mean ± SD age: 43.7 ± 15.4 y 34 monozygotic, 10 dizygotic 33 women, 10 men, 1 gender-discordant) was conducted. Twins within a pair were randomly allocated to an 8-wk low-fat ( 35% of energy from fat) diet. FATT was assessed by a 3-alternate forced choice methodology and transformed to an ordinal scale (FT rank) at baseline and at 4 and 8 wk. Linear mixed models were fit to assess diet effect on FT rank and diet effect modification due to zygosity. A variance components model was fit to calculate baseline heritability. There was a significant time × diet interaction for FT rank after the 8-wk trial (P < 0.001), with the same conclusions for the subset of participants maintaining baseline weight (low-fat n = 32 high-fat: n = 35). There was no evidence of zygosity effect modification (interaction of time × diet × zygosity: P = 0.892). Heritability of baseline FT rank was 8%. There appears to be little to no genetic contribution on heritability of FATT or diet-mediated changes to FATT. Rather, environment, specifically dietary fat intake, is the main influencer of FT sensitivity, regardless of body weight. This trial was registered with the Australian New Zealand Clinical Trials Registry at www.anzctr.org.au/ as ACTRN12613000466741.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2006
Publisher: Springer Science and Business Media LLC
Date: 12-06-2019
DOI: 10.1007/S40279-019-01132-7
Abstract: Resistance training is essential for health and performance and confers many benefits such as increasing skeletal muscle mass, increasing strength and power output, and improving metabolic health. Resistance training is a major component of the physical activity guidelines, yet research in female populations is limited. Recent increases in the promotion of, and the participation by, females in sport and exercise, highlight the need for an increase in understanding of evidence-based best practice exercise prescription for females. The aim of this review is to provide an overview of the current research regarding resistance training performance and skeletal muscle adaptation in females, with a focus on the hormonal variables that may influence resistance training outcomes. Findings suggest that the menstrual cycle phase may impact strength, but not skeletal muscle protein metabolism. In comparison, oral contraception use in females may reduce skeletal muscle protein synthesis, but not strength outcomes, when compared to non-users. Future research should investigate the role of resistance training in the maintenance of skeletal muscle protein metabolism during pregnancy, menopause and in athletes experiencing relative energy deficiency in sport. The review concludes with recommendations for researchers to assist them in the inclusion of female participants in resistance training research specifically, with commentary on the most appropriate methods of controlling for, or understanding the implications of, hormonal fluctuations. For practitioners, the current evidence suggests possible resistance training practices that could optimise performance outcomes in females, although further research is warranted.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2019
Publisher: MDPI AG
Date: 19-02-2020
Abstract: Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.
Publisher: Springer Science and Business Media LLC
Date: 19-08-2016
Publisher: Springer Science and Business Media LLC
Date: 11-03-2017
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.SLEEP.2017.05.004
Abstract: Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. From the Sleep Heart Health Study, we selected in iduals who were: (1) 40-64 years old, with (2) body mass index (BMI) ≥18.5 kg/m At baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m Weight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness.
Publisher: MDPI AG
Date: 02-01-2022
DOI: 10.3390/NU14010205
Abstract: This study aimed to explore the diagnostic accuracy of the Patient-Generated Subjective Global Assessment (PG-SGA) malnutrition risk screening tool when used to score patients based on their electronic medical records (EMR), compared to bedside screening interviews. In-patients at a rural health service were screened at the bedside (n = 50) using the PG-SGA, generating a bedside score. Clinical notes within EMRs were then independently screened by blinded researchers. The accuracy of the EMR score was assessed against the bedside score using area under the receiver operating curve (AUC), sensitivity, and specificity. Participants were 62% female and 32% had conditions associated with malnutrition, with a mean age of 70.6 years (SD 14.9). The EMR score had moderate diagnostic accuracy relative to PG-SGA bedside screen, AUC 0.74 (95% CI: 0.59–0.89). The accuracy, specificity and sensitivity of the EMR score was highest for patients with a score of 7, indicating EMR screen is more likely to detect patients at risk of malnutrition. This exploratory study showed that applying the PG-SGA screening tool to EMRs had enough sensitivity and specificity for identifying patients at risk of malnutrition to warrant further exploration in low-resource settings.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Springer Science and Business Media LLC
Date: 20-04-2016
Publisher: Springer Science and Business Media LLC
Date: 22-06-2021
DOI: 10.1186/S12966-021-01151-6
Abstract: Environments within schools including the physical, social-cultural and policy ractice environments have the potential to influence children’s physical activity (PA) behaviours and weight status. This Australian first study comprehensively examined the association(s) of physical, social-cultural and policy ractice environments with PA, active transport (AT) and weight status among regional primary school children. Data were from two childhood obesity monitoring systems in regional Victoria, Australia. Measured height and weight were collected from students in Year 2 (aged approx. 7–8 years), Year 4 (9–10 years), and Year 6 (11–12 years). Self–reported PA behaviour, including AT were collected from students in Year 4 and 6 and a sub-s le wore an ActiGraph (wGT3X-BT) accelerometer for 7-days. A school physical activity environment audit was completed by the school principal and responses were used to calculate school physical activity environment scores (PAES) and active transport environment scores (ATES). Mixed effects logistic regression was used to assess the relationship between the proportion of students meeting the PA guidelines (≥60mins/day of moderate-to-vigorous PA) and PAES tertiles (low, medium, high) and those using AT and school ATES tertiles, controlling for gender, school size/type and socioeconomic composition. The analysed s le included 54/146 (37%) schools and 3360/5376 (64%) students. In stratified analysis, girls in schools with a medium PAES score were more likely to meet the objectively measured PA guideline compared to low PAES score (OR 2.3, 95%CI 1.27, 4.16). Similarly, students in schools with a medium or high ATES score had higher odds of self-reported AT (medium OR 3.15, 95%CI 1.67, 5.94 high OR 3.71, 95%CI: 1.80, 7.64). No association between PAES or ATES and weight status were observed. Self-reported AT among boys (OR 1.59, 95%CI 1.19, 2.13) and girls (OR 1.56, 95%CI 1.08, 2.27) was associated with higher odds of meeting self-reported PA guidelines on all 7-days than those who did not report using AT. In this study of regional Victorian primary schools, PA environments were only associated with girls’ adherence to PA guidelines. School AT environments were strongly associated with students’ AT behaviours and with increased likelihood of students being physically active.
Publisher: Cambridge University Press (CUP)
Date: 14-06-2017
DOI: 10.1017/S0007114517001507
Abstract: Resistance training (RT) and increased dietary protein are recommended to attenuate age-related muscle loss in the elderly. This study examined the effect of a lean red meat protein-enriched diet combined with progressive resistance training (RT+Meat) on health-related quality of life (HR-QoL) in elderly women. In this 4-month cluster randomised controlled trial, 100 women aged 60–90 years (mean 73 years) from self-care retirement villages participated in RT twice a week and were allocated either 160 g/d (cooked) lean red meat consumed across 2 meals/d, 6 d/week or ≥1 serving/d (25–30 g) carbohydrates (control group, CRT). HR-QoL (SF-36 Health Survey questionnaire), lower limb maximum muscle strength and lean tissue mass (LTM) (dual-energy X-ray absorptiometry) were assessed at baseline and 4 months. In all, ninety-one women (91 %) completed the study (RT+Meat ( n 48) CRT ( n 43)). Mean protein intake was greater in RT+Meat than CRT throughout the study (1·3 ( sd 0·3) v . 1·1 ( sd 0·3) g/kg per d, P ·05). Exercise compliance (74 %) was not different between groups. After 4 months there was a significant net benefit in the RT+Meat compared with CRT group for overall HR-QoL and the physical component summary (PCS) score ( P ·01), but there were no changes in either group in the mental component summary (MCS) score. Changes in lower limb muscle strength, but not LTM, were positively associated with changes in overall HR-QoL (muscle strength, β : 2·2 (95 % CI 0·1, 4·3), P ·05). In conclusion, a combination of RT and increased dietary protein led to greater net benefits in overall HR-QoL in elderly women compared with RT alone, which was because of greater improvements in PCS rather than MCS.
Publisher: Springer Science and Business Media LLC
Date: 30-11-2019
DOI: 10.1007/S00520-018-4574-6
Abstract: This study assessed the feasibility and acceptability of an online mindfulness-based intervention (MBI) for people diagnosed with melanoma. The potential benefit of the MBI on fear of cancer recurrence (FCR), worry, rumination, perceived stress and trait mindfulness was also explored. Participants who have completed treatment for stage 2c or 3 melanoma were recruited from an outpatient clinic and randomly allocated to either the online MBI (intervention) or usual care (control). The 6-week online MBI comprised short videos, daily guided meditations and automated email reminders. Participants were asked to complete questionnaires at baseline and at 6-week post-randomisation. Study feasibility and acceptability were assessed through recruitment rates, retention and participant feedback. Clinical and psychosocial outcomes were compared between groups using linear mixed models. Sixty-nine (58%) eligible participants were randomised (46 in the intervention 23 in the control group) mean age was 53.4 (SD 13.1) 54% were female. Study completion rate across both arms was 80%. The intervention was found helpful by 72% of the 32 respondents. The intervention significantly reduced the severity of FCR compared to the control group (mean difference = - 2.55 95% CI - 4.43, - 0.67 p = 0.008). There was no difference between the intervention and control groups on any of the outcome measures. This online MBI was feasible and acceptable by people at high risk of melanoma recurrence. It significantly reduced FCR severity in this s le. Patients valued accessing the program at their own pace and convenience. This self-guided intervention has the potential to help survivors cope with emotional difficulties. An adequately powered randomised controlled trial to test study findings is warranted.
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-06-2015
Abstract: Thousands of children are living with advanced cancer yet patient-reported outcomes (PROs) have rarely been used to describe their experiences. We aimed to describe symptom distress in 104 children age 2 years or older with advanced cancer enrolled onto the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) Study (multisite clinical trial evaluating an electronic PRO system). Symptom data were collected using age- and respondent-adapted versions of the PediQUEST Memorial Symptom Assessment Scale (PQ-MSAS) at most once per week. Clinical and treatment data were obtained from medical records. In idual symptom scores were dichotomized into high/low distress. Determinants of PQ-MSAS scores were explored using linear mixed-effects models. During 9 months of follow-up, PQ-MSAS was administered 920 times: 459 times in teens (99% self-report), 249 times in children ages 7 to 12 years (96% child arent report), and 212 times in those ages 2 to 6 years (parent reports). Common symptoms included pain (48%), fatigue (46%), drowsiness (39%), and irritability (37%) most scores indicated high distress. Among the 73 PQ-MSAS surveys administered in the last 12 weeks of life, pain was highly prevalent (62% 58% with high distress). Being female, having a brain tumor, experiencing recent disease progression, and receiving moderate- or high-intensity cancer-directed therapy in the prior 10 days were associated with worse PQ-MSAS scores. In the final 12 weeks of life, receiving mild cancer-directed therapy was associated with improved psychological PQ-MSAS scores. Children with advanced cancer experience high symptom distress. Strategies to promote intensive symptom management are indicated, especially with disease progression or administration of intensive treatments.
Publisher: MDPI AG
Date: 14-08-2019
Abstract: (1) Background: Childhood overweight and obesity is a significant and preventable problem worldwide. School environments have been suggested to be plausible targets for interventions seeking to improve the quality of children’s dietary intake. The objective of this study was to determine the extent to which the current characteristics of the school food environment were associated with primary school students’ dietary intake and Body Mass Index (BMI) z scores in a representative s le in regional Victoria. (2) Methods: This study included 53 schools, comprising a s le of 3,496 students in year levels two (aged 7–8 years), four (9–10 years) and six (11–12 years). Year four and six students completed dietary questionnaires. Principals from each school completed a survey on school food environment characteristics. Mixed-effects logistic regression was used to assess the relationship between students’ dietary intake and school food environment scores, controlling for confounders such as socio-economic status, school size and sex. Food environment scores were also analysed against the odds of being healthy weight (defined as normal BMI z score). (3) Results: Mixed associations were found for the relationship between students’ dietary intake and food environment scores. Meeting the guidelines for vegetable intake was not associated with food environment scores, but students were more likely (OR: 1.68 95% CI 1.26, 2.24) to meet the guidelines if they attended a large school ( enrolments) and were female (OR: 1.28 95% CI: 1.02, 1.59). Healthy weight was not associated with school food environment scores, but being a healthy weight was significantly associated with less disadvantage (OR: 1.24 95% CI 1.05, 1.45). Conclusion: In this study, the measured characteristics of school food environments did not have strong associations with dietary intakes or BMI among students.
Publisher: Elsevier BV
Date: 05-1998
Publisher: FapUNIFESP (SciELO)
Date: 09-2004
DOI: 10.1590/S1020-49892004000900002
Abstract: To estimate antigen-specific and series-complete vaccination coverage among children aged 13 to 59 months in Buenos Aires to compare the results of a community-based household survey with coverage rates obtained from administrative records and to identify risk factors for incomplete vaccination. Census tracts in Buenos Aires were surveyed systematically in March and April, 2002. Three children aged 13 to 24 months and 25 to 59 months were surveyed per block in each census tract. Written documentation of vaccination was required. Risk factors associated with incomplete vaccination were identified with univariate analysis and multivariate logistic regression. A total of 1391 children were surveyed. Antigen-specific coverage ranged from 69.4% (95% CI 66.7%-72%) for Haemophilus influenzae type b vaccination to 99% (95% CI 98.4%-99.6%) for BCG vaccination. Except for measles, coverage estimates found in the survey did not differ substantially from those obtained from city health authority records. Multivariate logistic regression analysis showed child's age (P < 0.001) and vaccination provider (public or private) (P = 0.001) to be risk factors associated with incomplete vaccination. Not being the first child (P < 0.001) was associated with incomplete coverage under the long-standing program. Living in the Northern zone of the city (P = 0.001), being uninsured (P = 0.02), and lower educational level of the primary caregiver (P = 0.04) were risk factors associated with incomplete coverage under the current vaccination program. Although coverage rates for some vaccines were high, complete vaccination coverage remains low among children aged 13 to 59 months in Buenos Aires. Increasing coverage will require better access to vaccination, particularly in sections of the community with risk factors.
Publisher: Birkhäuser Basel
Date: 2001
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.IJCARD.2021.12.051
Abstract: This study aimed to develop a risk prediction model (AUS-HF model) for 30-day all-cause re-hospitalisation or death among patients admitted with acute heart failure (HF) to inform follow-up after hospitalisation. The model uses routinely collected measures at point of care. We analyzed pooled in idual-level data from two cohort studies on acute HF patients followed for 30-days after discharge in 17 hospitals in Victoria, Australia (2014-2017). A set of 58 candidate predictors, commonly recorded in electronic medical records (EMR) including demographic, medical and social measures were considered. We used backward stepwise selection and LASSO for model development, bootstrap for internal validation, C-statistic for discrimination, and calibration slopes and plots for model calibration. The analysis included 1380 patients, 42.1% female, median age 78.7 years (interquartile range = 16.2), 60.0% experienced previous hospitalisation for HF and 333 (24.1%) were re-hospitalised or died within 30 days post-discharge. The final risk model included 10 variables (admission: eGFR, and prescription of anticoagulants and thiazide diuretics discharge: length of stay>3 days, systolic BP, heart rate, sodium level ( 10 prescribed medications, prescription of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and anticoagulants prescription. The discrimination of the model was moderate (C-statistic = 0.684, 95%CI 0.653, 0.716 optimism estimate = 0.062) with good calibration. The AUS-HF model incorporating routinely collected point-of-care data from EMRs enables real-time risk estimation and can be easily implemented by clinicians. It can predict with moderate accuracy risk of 30-day hospitalisation or mortality and inform decisions around the intensity of follow-up after hospital discharge.
Publisher: Elsevier BV
Date: 02-2015
Publisher: MDPI AG
Date: 13-04-2018
Publisher: Springer Science and Business Media LLC
Date: 26-02-2019
Publisher: Elsevier BV
Date: 08-2020
Publisher: Springer Science and Business Media LLC
Date: 13-07-2009
DOI: 10.1038/NM.2004
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JSAMS.2017.06.002
Abstract: To explore the impact of uninterrupted sitting versus sitting with resistance-type activity breaks on adolescents' postprandial glucose responses while consuming a diet varying in energy. Cross-over randomised trial. Thirteen healthy participants (16.4±1.3years) completed a four-treatment cross-over trial: (1) uninterrupted sitting+high-energy diet (2) sitting with breaks+high-energy diet (3) uninterrupted sitting+standard-energy diet and (4) sitting with breaks+standard-energy diet. For all four conditions, two identical meals were consumed at 0h and 3h. A continuous glucose monitoring system (CGM) recorded interstitial glucose concentrations every five minutes. Linear mixed models examined differences in glucose positive incremental area under the curve (iAUC) and total AUC between the sitting and diet conditions for the first meal, second meal and entire trial period. Compared to the uninterrupted sitting conditions, the breaks condition elicited a 36.0mmol/L/h (95%CI 6.6-65.5) and 35.9mmol/L/h (95%CI 6.6-65.5) lower iAUC response after the first and second meal, respectively, but not for the entire trial period or for total AUC. Compared to the standard-energy diet, the high-energy diet elicited a 55.0mmol/L/h (95%CI 25.8-84.2) and 75.7mmol/L/h (95%CI 8.6-142.7) higher iAUC response after the first meal and entire trial, respectively. Similar response to the high-energy diet were observed for total AUC. According to iAUC, interrupting sitting had a significant effect on lowering postprandial glucose for both dietary conditions, however, it was not significant when examining total AUC. Larger studies are needed to confirm these findings. ACTRN12615001145594.
Publisher: Oxford University Press (OUP)
Date: 22-11-2022
Abstract: Heart failure nurse practitioners (HF NPs) are an emerging component of the heart failure (HF) specialist workforce but their impact in an inpatient setting is untested. The aim of this paper is to explore the impact of an inpatient HF NP service on 12-month all-cause rehospitalizations, emergency department (ED) presentations, and mortality in patients hospitalized with HF compared with usual hospital care. Retrospective, two-group comparative design involving patients (n = 408) admitted via ED with acute HF to a metropolitan quaternary hospital between January 2013 and August 2017. Doubly robust estimation with augmented inverse probability weighting (DR-AIPW) was used to account for the non-random allocation of patients to usual hospital care or the HF NP service in addition to usual in-hospital care. Among 408 patients (186 usual care and 222 HF NP service) admitted with acute HF, the mean age was 76.5 [standard deviation (SD) 12.0] years and 56.4% (n = 230) were male. After IPW adjustment, patients seen by the HF NP service had a lower risk of 12-month rehospitalization (61.3 vs. 78.3% usual care difference –16.9%, 95% CI: −26.4%, −6.6%) and ED presentations (12.6 vs. 22.0% difference –9.4%, 95% CI: –17.3%, –1.4%) with no difference in 6- or 12-month mortality. The HF NP service improved referrals to a home visiting programme that was available to HF patients (64.4 vs. 45.4% difference 19%, 95% CI: 8.8%, 28.8%). Additional support by an inpatient HF NP service has the potential to significantly reduce rehospitalizations and ED presentations over 12 months. Further evidence from a multicentre randomized control trial is warranted.
Publisher: Public Library of Science (PLoS)
Date: 27-07-2021
DOI: 10.1371/JOURNAL.PONE.0255203
Abstract: Behavioural patterns are typically derived using unsupervised multivariate methods such as principal component analysis (PCA), latent profile analysis (LPA) and cluster analysis (CA). Comparability and congruence between the patterns derived from these methods has not been previously investigated, thus it’s unclear whether patterns from studies using different methods are directly comparable. This study aimed to compare behavioural patterns derived across diet, physical activity, sedentary behaviour and sleep domains, using PCA, LPA and CA in a single dataset. Parent-report and accelerometry data from the second wave (2011/12 child age 6-8y, n = 432) of the HAPPY cohort study (Melbourne, Australia) were used to derive behavioural patterns using PCA, LPA and CA. Standardized variables assessing diet (intake of fruit, vegetable, sweet, and savoury discretionary items), physical activity (moderate- to vigorous-intensity physical activity [MVPA] from accelerometry, organised sport duration and outdoor playtime from parent report), sedentary behaviour (sedentary time from accelerometry, screen time, videogames and quiet playtime from parent report) and sleep (daily sleep duration) were included in the analyses. For each method, commonly used criteria for pattern retention were applied. PCA produced four patterns whereas LPA and CA each generated three patterns. Despite the number and characterisation of the behavioural patterns derived being non-identical, each method identified a healthy, unhealthy and a mixed pattern. Three common underlying themes emerged across the methods for each type of pattern: (i) High fruit and vegetable intake and high outdoor play (“healthy”) (ii) poor diet (either low fruit and vegetable intake or high discretionary food intake) and high sedentary behaviour (“unhealthy”) and (iii) high MVPA, poor diet (as defined above) and low sedentary time (“mixed”). Within this s le, despite differences in the number of patterns derived by each method, a good degree of concordance across pattern characteristics was seen between the methods. Differences between patterns could be attributable to the underpinning statistical technique of each method. Therefore, acknowledging the differences between the methods and ensuring thorough documentation of the pattern derivation analyses is essential to inform comparison of patterns derived through a range of approaches across studies.
Publisher: Elsevier BV
Date: 05-2017
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1002/OBY.23130
Publisher: Public Library of Science (PLoS)
Date: 08-11-2022
DOI: 10.1371/JOURNAL.PONE.0277212
Abstract: The Pediatric Quality of Life and Evaluation of Symptoms Technology Response to Pediatric Oncology Symptom Experience (PQ-Response) intervention aims to integrate specialized pediatric palliative care into the routine care of children, adolescents, and young adults (AYAs) with advanced cancer. To evaluate whether PQ-Response, compared to usual care, improves patient’s health related quality of life (HRQoL) and symptom burden (aim 1), parent psychological distress and symptom-related stress (aim 2), and family and symptom treatment activation (aim 3). Multisite , randomized (1 : 1) , controlled , un-blinded , effectiveness trial comparing PediQUEST Response (intervention) vs usual cancer care (control). Five US large, tertiary level pediatric cancer centers. Children (≥2 years old)/AYAs who receive care at any of the participating sites because of advanced cancer or any progressive/recurrent solid or brain tumor and are palliative care “naïve.” Target: 200 enrolled patient-parent dyads (minimum goal: 136 dyads randomized, N = 68/arm). PediQUEST Response : combines patient-mediated activation (weekly feedback of patient- and parent-reported symptoms and HRQoL to families and providers using the PediQUEST web system) with integration of the palliative care team. Usual Cancer Care : participants receive usual care, which can include palliative care consultation, and use PediQUEST web to answer surveys, with no feedback. Following enrollment, patients (if ≥5 years) and one parent receive weekly PediQUEST-Surveys assessing HRQoL (Pediatric Quality of Life Inventory 4.0) and symptom burden (PediQUEST-Memorial Symptom Assessment Scale). After a 2-week run-in period, dyads who answer ≥2 PediQUEST surveys per participant (responders), are randomized (concealed allocation) and followed up for 16-weeks. Parents answer six additional surveys (parent outcomes). Primary: mean patient HRQoL score over 16-weeks as reported by a) the parent and b) the patient if ≥5 years-old. Secondary: patient’s symptom burden parent’s anxiety, depressive symptoms, symptom-related stress family activation and symptom treatment activation. ClinicalTrials.gov ( NCT03408314 ) 1/24/18. t2/show/NCT03408314 .
Publisher: SAGE Publications
Date: 24-03-2017
Abstract: Aim: To explore the knowledge, attitudes, and practices associated with meditation among people with melanoma and investigate the relationship between perceived stress, trait mindfulness, and meditation. Factors associated with interest to participate in an online meditation program were also explored. Methods: A survey-based cross-sectional study of 291 patients attending a melanoma outpatient clinic assessed knowledge of meditation, attitudes toward meditation using Determinants of Meditation Practice Inventory (DMPI), and meditation experience. Perceived stress and trait mindfulness were measured using the Perceived Stressed Scale and Cognitive and Affective Mindfulness Scale, respectively. Results: Participants who had tried meditation (43%) were likely to be younger, female, and have completed higher education or be employed. Perceived stress score was higher among women, younger participants, and those treated in the past year but did not differ by melanoma stage. Participants reported a good understanding of the potential benefits of meditation, but even among people with meditation experience, common misconceptions prevailed. The main barrier to meditation was a perceived lack of knowledge about meditation . Higher DMPI scores were associated with lower education, moderate to low access to service centers, or living in disadvantaged neighborhoods . Participants practicing meditation that involved self-reflection reported less stress and higher trait mindfulness compared with participants practicing another type of meditation. People interested in participating in an online meditation-based program reported higher perceived stress than those not interested. Conclusion: A meditation-based intervention teaching self-reflective practices, targeted at people with melanoma, may have the potential to assist them with managing their stress.
Publisher: Wiley
Date: 11-04-2014
DOI: 10.1002/PBC.25048
Abstract: An increased incidence of retinoblastoma in some developing countries has been reported but no conclusive data are available from population-based studies at national level. To report the incidence and survival of retinoblastoma in Argentina from the National Pediatric Cancer Registry (ROHA) and the influence of socio-economical indicators on outcome. Cases reported to the ROHA (2000-2009) were analyzed. Incidence rates were calculated using National Vital Statistics and survival was estimated. The extended human development index (EHDI) was used as a socio-economical indicator. With 438 patients reported, an incidence of 5.0 cases per million children 0-14 years old (95% CI 3.5-6.4) was calculated. Median age at diagnosis was significantly higher for children from provinces with lower EHDI (24 vs. 35 months for unilateral, (P = 0.003) and 9 versus 11.5 months for bilateral retinoblastoma (P = 0.027). The 3-year probability of survival was 0.87 and 0.94 for unilateral and bilateral retinoblastoma, respectively. Residents in provinces with higher EHDI had a better 3-year survival (0.93 vs. 0.77 for lower EHDI, P < 0.0001). Probability of survival was higher for patients treated at tertiary level institutions (P = 0.0015). The combination of low EHDI residence province with no treatment at a tertiary institution was associated with the worst survival outcome. For both, unilateral and bilateral disease, children who died were in average diagnosed at older age. The incidence of retinoblastoma in Argentina is comparable to that of developed countries. Retinoblastoma is diagnosed later and survival is lower in the less developed areas of the country.
Publisher: Mary Ann Liebert Inc
Date: 08-2014
Publisher: Oxford University Press (OUP)
Date: 18-01-2006
DOI: 10.1093/AJE/KWJ074
Abstract: Assessment of delay in age-appropriate vaccination provides more information about timeliness of vaccination than up-to-date vaccination coverage. The authors applied survival analysis methods to data from a vaccination coverage survey among children aged 13-59 months conducted in Argentina in 2002. By age 19 months, 43% of children (95% confidence interval (CI): 40, 46) were vaccinated with the fourth dose of diphtheria, tetanus, and pertussis (DTP4). By age 13 months, 55% of children (95% CI: 52, 57) were vaccinated with measles-containing vaccine. By age 7 months, 33% of children (95% CI: 27, 40) were vaccinated with the third dose of hepatitis B. Compared with firstborn children, third children were more likely to be delayed for DTP4 (relative risk (RR) = 1.41, 95% CI: 1.22, 1.62), measles-containing vaccine (RR = 1.54, 95% CI: 1.32, 1.78), and the third dose of hepatitis B (RR = 1.31, 95% CI: 1.03, 1.67). Children whose caregivers had completed secondary school were less likely to be delayed for DTP4 (RR = 0.68, 95% CI: 0.52, 0.90) compared with those whose caregivers had not completed primary school. Survival analysis methods were helpful in measuring vaccine uptake and should be considered in future surveys when assessing delay in age-appropriate vaccination.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.EJIM.2019.05.021
Abstract: The Medical Emergency Team (MET) has enhanced the recognition and response to clinical deterioration in acute healthcare. However, patients reviewed by the MET are at increased risk of in-hospital death. Identifying patients at risk of deterioration may improve patient outcomes. AIM: To identify patient demographic, medical characteristics and healthcare systems and processes at the time of admission (baseline), associated with Medical Emergency Team (MET) review within 48 h (MET-48 h) of admission. METHODS: Single-site, year-long, retrospective cohort comprising patients admitted for at least 24 h, using routinely collected hospital data. A three-stage modelling approach was used to identify baseline factors associated with MET-48 h RESULTS: The study included 15,695 patients with mean age 62.1 years (SD 19.6), male (53.5%), born in Australia or New Zealand (60.9%) and 51.6% held a low-income concession card. A total of 4.3% of patients received a MET review within 48 h of admission. Variables independently associated with MET-48 h in a fully adjusted logistic model included age of 80 years or more (OR = 1.37) ≥3 previous emergency admissions (OR = 1.59) Charlson Comorbidity Index 1 or 2 (OR = 1.47), or ≥ 3 (OR = 1.99) history of alcohol-related behaviour concerns (OR = 2.04), chronic heart failure (OR = 1.48) chronic obstructive pulmonary disease (OR = 1.35) admission for colorectal (OR = 2.66) or upper gastro-intestinal (OR = 1.94) surgery, respiratory or tracheostomy (OR = 2.24) immunology and infections (OR = 1.90) emergency admission (OR = 1.36) admission at night (OR = 1.74), or summer (OR = 1.41) CONCLUSIONS: This is the first study to demonstrate the potential to predict clinical deterioration using data that is readily accessible at the time of admission to hospital.
Publisher: MDPI AG
Date: 14-08-2020
Abstract: In-patient malnutrition leads to poor outcomes and mortality, and it is largely uninvestigated in non-urban populations. This study sought to: (1) retrospectively estimate the prevalence of malnutrition as diagnosed by dietetics in the rural Australian setting (2) establish the proportion of all patients at “nutritional risk” and (3) explore associations between demographic and clinical factors with malnutrition diagnosis and nutritional risk. A retrospective census was undertaken of medical files of all patients aged ≥18 years admitted to a rural hospital setting over a 12-month period. Logistic regression was used to explore associations between malnutrition diagnosis, nutritional risk and patient-related factors. In total, 711 admissions were screened during the 12-month period comprising 567 patients. Among the 125 patients seen by dietitians, 70.4% were diagnosed with malnutrition. Across the total s le, 77.0% had high levels of nutrition related symptoms warranting a need for further assessment by dietitians. Malnutrition diagnosis by dietitians was associated with being over the age of 65 years, and patients had higher odds of being admitted to a residential aged care facility following discharge. In this rural s le, the diagnosis rate of malnutrition appeared to be high, indicating that rural in-patients may be at a high risk of malnutrition. There was also a high proportion of patients who had documentation in their files that indicated they may have benefited from dietetic assessment and intervention, beyond current resourcing.
Publisher: Elsevier BV
Date: 08-2016
Publisher: Springer Science and Business Media LLC
Date: 04-09-2020
DOI: 10.1186/S13063-020-04692-6
Abstract: Community-based interventions have shown promise in addressing the childhood obesity epidemic. Such efforts rely on the knowledge of key community members and their engagement with the drivers of obesity in their community. This paper presents the protocol for the measurement and evaluation of knowledge and engagement among community leaders within a whole-of-community systems intervention across 10 large intervention communities in Australia. We will investigate the role of stakeholder knowledge and engagement in the implementation and effectiveness of the stepped wedge cluster randomised trial in ten communities in Victoria, Australia. Data will be collected using the Stakeholder-driven Community Diffusion Survey (SDCD) to measure levels of knowledge and engagement prior to commencement (2019), across the three separate levels of governance within the intervention at five time points. Primary outcomes will be baseline overall knowledge and engagement scores across the three levels of governance and change in overall knowledge and engagement over time. We hypothesise there will be heterogeneity between intervention sites on levels of knowledge and engagement and that these differences will be associated with variability in implementation success. Australian New Zealand Clinical Trials Registry ACTRN12618001986268 . Registered on 11 December 2018
Publisher: Wiley
Date: 03-09-2010
DOI: 10.1111/J.1468-1293.2010.00824.X
Abstract: Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort. Cases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV-associated factors on non-AIDS-defining conditions. Among 6007 patients in follow-up, 130 had an SNA event (0.86 events/100 person-years of follow-up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non-AIDS-defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T-cell count prior to index date (P = 0.0056, with an average difference of more than 100 cells/μL) and area under the CD4 cell curve in the year previous to index date (P = 0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors. The incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.
Publisher: BMJ
Date: 05-2018
Publisher: Wiley
Date: 04-12-2020
DOI: 10.1111/OBR.12941
Abstract: There is strong support across multiple sectors for the implementation of policies to create healthier food environments as part of comprehensive strategies to address obesity and improve population diets. The existing evidence base describing food retail environments and their relationship with health outcomes is limited in several respects. This systematic review examines the current evidence regarding food retail environments in Australia, including associations with diet and people with obesity, and socioeconomic and geographic disparities. Three databases were searched and independently screened. Studies were included if they were undertaken in Australia and objectively measured the food retail environment. Sixty papers were included. The broad range of methodological approaches used across studies limited the ability to synthesize the evidence and draw conclusions. Results indicated that there is some evidence that disparities exist in food retail environments across measures of socioeconomic position and geographic area in parts of Australia. Overall, there were inconsistent findings regarding the association between the healthiness of food retail environments and diet or people with obesity. Findings support previous calls for standardized tools and measures for monitoring the healthiness of food retail environments. This is imperative to inform evidence-based policy and evaluation in this critical component of recommended obesity prevention strategies.
Publisher: Elsevier BV
Date: 05-2004
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-07-2020
Abstract: Waist circumference and hip circumference are both strongly associated with risk of death however, their joint association has rarely been investigated. The MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project was conducted in 30 cohorts from 11 countries 90 487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease, were recruited in 1986 to 2010 and followed up for up to 24 years. Hazard ratios were estimated using sex‐specific Cox models, stratified by cohort, with age as the time scale. Models included baseline categorical obesity measures, age, total and high‐density lipoprotein cholesterol, systolic blood pressure , antihypertensive drugs, smoking, and diabetes mellitus. A total of 9105 all‐cause deaths were recorded during a median follow‐up of 10 years. Hazard ratios for all‐cause death presented J‐ or U‐shaped associations with most obesity measures. With waist and hip circumference included in the same model, for all hip sizes, having a smaller waist was strongly associated with lower risk of death, except for men with the smallest hips. In addition, among those with smaller waists, hip size was strongly negatively associated with risk of death, with ≈20% more people identified as being at increased risk compared with waist circumference alone. A more complex relationship between hip circumference, waist circumference, and risk of death is revealed when both measures are considered simultaneously. This is particularly true for in iduals with smaller waists, where having larger hips was protective. Considering both waist and hip circumference in the clinical setting could help to best identify those at increased risk of death.
Publisher: Public Library of Science (PLoS)
Date: 11-01-2011
Publisher: BMJ
Date: 08-2020
DOI: 10.1136/BMJOPEN-2020-038050
Abstract: Limited evidence exists on the cost-effectiveness of interventions to prevent obesity and promote healthy body image in adolescents. The SHINE (Supporting Healthy Image, Nutrition and Exercise) study is a cluster randomised control trial (cRCT) aiming to deliver universal education about healthy nutrition and physical activity to adolescents, as well as targeted advice to young people with body image concerns who are at risk of developing disordered eating behaviours. This paper describes the methods for the economic evaluation of the SHINE cRCT, to determine whether the intervention is cost-effective as an obesity prevention measure. A public payer perspective will be adopted, with intervention costs collected prospectively. Within-trial cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) will quantify the incremental costs and health gains of the intervention as compared with usual practice (ie, teacher-delivered curriculum). CEA will present results as cost per body mass index unit saved. CUA will present results as cost per quality-adjusted life year gained. A modelled CUA will extend the target population, time horizon and decision context to provide valuable information to policymakers on the potential for incremental cost offsets attributable to disease prevention arising from intervention. Intervention costs and effects will be extrapolated to the population of Australian adolescents in Grade 7 of secondary school (approximate age 13 years) and modelled over the cohort’s lifetime. Modelled CUA results will be presented as health-adjusted life years saved and healthcare cost-savings of diseases averted. Incremental cost-effectiveness ratios will be calculated as the difference in costs between the intervention and comparator ided by the difference in benefit. Semi-structured interviews with key intervention stakeholders will explore the potential impact of scalability on cost-effectiveness. These data will be thematically analysed to inform sensitivity analysis of the base case economic evaluation, such that cost-effectiveness evidence is reflective of the potential for scalability. Ethics approval was obtained from the Deakin University Human Research Ethics Committee (#2017–269) and the Victorian Department of Education and Training (#2018_003630). Study findings will be disseminated through peer-reviewed academic papers and participating schools will receive annual reports over the 3 years of data collection. ACTRN 12618000330246 Pre-results.
Publisher: MDPI AG
Date: 20-07-2017
DOI: 10.3390/NU9070781
Publisher: Figshare
Date: 2016
Publisher: MDPI AG
Date: 28-06-2019
DOI: 10.3390/NU11071478
Abstract: Little is known about the prevalence of anaemia and associated factors in school children in Vietnam. In this cross-sectional study, we aimed to determine the prevalence of anaemia and its subtypes, and the associations of types of anaemia with demographic, socio-economic and anthropometric factors among 6–9-year-old primary school children in rural areas of Hai Phong City, Vietnam. Haemoglobin (Hb) and mean corpuscular volume (MCV) were measured, and demographic, socio-economic and anthropometric data were collected in 893 children from eight primary schools. The prevalence of anaemia (Hb 115 g/L) was 12.9% (95% CI: 8.1%, 19.9%), microcytic anaemia (Hb 115 g/L and MCV 80 fL) was 7.9% (95% CI: 5.3%, 11.6%) and normocytic anaemia (Hb 115 g/L and MCV 80–90 fL) was 5.3% (95% CI: 2.9%, 9.5%). No child presented with macrocytic anaemia (Hb 115 g/L and MCV 90 fL). Children who were underweight, wasted, or in anthropometric failure (either underweight, stunted or wasted) were more likely to be anaemic (all p ≤ 0.004), and specifically, to have normocytic anaemia (all p ≤ 0.006), than those who were not underweight, wasted or in anthropometric failure. Stunted children were more likely to be anaemic (p = 0.018) than those who were not stunted. Overweight/obese children were less likely to be anaemic (p = 0.026) or have normocytic anaemia (p = 0.038) compared with children who were not overweight/obese. No anthropometric status indicator was associated with the risk of microcytic anaemia. No demographic or socio-economic factor was associated with any type of anaemia. Anaemia remains a public health issue in rural areas in Hai Phong City, Vietnam, and future approaches for its prevention and control should target undernourished primary school children.
Publisher: MDPI AG
Date: 04-10-2018
DOI: 10.3390/NU10101431
Abstract: A double burden of malnutrition in Vietnamese children has emerged as a key challenge: childhood undernutrition remains a public health concern while childhood overweight/obesity has gradually increased. This study aimed to (1) estimate the prevalence of undernutrition and overnutrition among 6–9-year-old primary school children in rural areas of Vietnam, and (2) identify sociodemographic factors associated with undernutrition and overnutrition in this population. A cross-sectional survey was conducted in October 2016 in 2334 children from eight primary schools in rural areas in Hai Phong City, Vietnam. Anthropometric and demographic data were collected. The prevalence of underweight, stunting, wasting, and anthropometric failure was 8.0%, 5.1%, 5.3%, and 11.9%, respectively. Up to 22.1% of children were affected by overweight/obesity, and 31.0% by abdominal overweight/obesity. Low maternal education was associated with higher odds of underweight and anthropometric failure, whereas overweight/obesity or abdominal overweight/obesity were more likely in boys and children of mothers with a high education level. This study provides evidence for a double burden of diseases among primary school children in rural areas in Hai Phong City. Future interventions for the prevention and control of childhood undernutrition and overweight/obesity should take into account child sex and maternal education level.
Publisher: Cambridge University Press (CUP)
Date: 21-06-2022
DOI: 10.1017/S1368980021002688
Abstract: To assess the price promotions offered by major quick service restaurant (QSR) chains in Australia from an obesity prevention perspective. Cross-sectional audit of ten of the largest QSR chains in Australia. We collected information regarding temporary price promotions and ‘combination deals’ offered by each chain over thirteen consecutive weeks in 2019–2020. We assessed the type of promotions, the magnitude of discount, and the energy content and healthiness of items promoted (based on Victorian Government criteria). Melbourne, Australia. Ten major QSR chains. Temporary price promotions ( n 196) and combination deals ( n 537 on regular menus, n 36 on children’s menus) were observed across the ten selected QSR chains. In relation to temporary price promotions, the mean magnitude of discount for main menu items ( n 75) was 41·7 %. The price reductions and energy content of combination deals varied substantially the by chain, the meal size and the sides/drinks selected as part of the ‘deal’. When the lowest-energy options (e.g. small chips, small sugar-free drink) were included as part of each combination deal, the mean energy content was 2935 kJ, compared to 5764 kJ when the highest-energy options (e.g. large fries, large sugar-sweetened drink) were included. Almost all available products were classified as unhealthy. Price promotions are ubiquitous in major QSR chains in Australia and provide incentives to consume high levels of energy. The action to restrict price promotions on unhealthy foods and ensure lower-energy default items as part of combination deals should be included as part of efforts to improve population diets and address obesity in Australia.
Publisher: Wiley
Date: 25-11-2020
DOI: 10.1002/CAM4.2718
Publisher: MDPI AG
Date: 24-10-2023
DOI: 10.3390/NU15214503
Publisher: Springer Science and Business Media LLC
Date: 13-10-2011
Publisher: Walter de Gruyter GmbH
Date: 03-01-2010
Publisher: Springer Science and Business Media LLC
Date: 26-11-2018
Publisher: Springer Science and Business Media LLC
Date: 15-05-2018
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.CANEP.2015.04.010
Abstract: Information on the epidemiology of childhood cancer in Latin America is limited. The Argentinean Oncopaediatric Registry (ROHA) is a population-based registry active since 2000. This paper describes the 3-year survival experience of children diagnosed with cancer in Argentina during 2000-2007 by major morphological subgroup, age, sex, and geographical region of residence. Newly diagnosed paediatric cancer cases are registered in ROHA (estimated coverage is 93% of the country's cases). Three-year overall survival was estimated using Kaplan-Meier methods. Univariate Cox models were used to compare subgroup survival. Between 2000 and 2007, a total of 10,181 new cancer diagnoses in children aged 0-14 years were reported to the registry. Three-year overall survival (95%CI) for all cancers was 61.7% (60.7 62.7). Specific survival for the most frequent morphological types was: leukaemias 63.3% (61.6 64.9), lymphomas and related neoplasms 75.3% (72.7 77.7), brain neoplasms 46.3% (43.9 48.7), soft-tissue sarcomas 52.3% (48.0 56.5), neuroblastomas 49.6% (44.6 54.3), renal tumours 76.7% (72.2 80.6), and malignant bone tumours 47.2% (42.3 51.9). Overall survival was associated with age but not sex and varied by geographical region. Compared to other regions, patients who resided in the capital city had a significantly higher survival: 69.6% (65.8 73.0) versus 63.5% (59.4 67.4) in Patagonia, 63.2% (61.9 64.5) in the central region, 58.0% (54.2 61.7) in Cuyo, 55.6% (52.5 58.6) in the north-east, and 55.4% (52.4 58.2) in the north-west (all P values <0.005). Of children diagnosed with cancer in Argentina, 62% survived at least 3 years after diagnosis. Even though this figure is lower than that reported for more developed countries, survival patterns by diagnosis, age and sex were quite similar. Survival was lower in the two northern regions, which are areas with higher poverty levels.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
Publisher: Elsevier BV
Date: 06-2021
Publisher: American Society of Clinical Oncology (ASCO)
Date: 20-09-2014
Abstract: Concordance between parents of children with advanced cancer and health care providers has not been described. We aimed to describe parent-provider concordance regarding prognosis and goals of care, including differences by cancer type. A total of 104 pediatric patients with recurrent or refractory cancer were enrolled at three large children's hospitals. On enrollment, their parents and providers were invited to complete a survey assessing perceived prognosis and goals of care. Patients' survival status was retrospectively abstracted from medical records. Concordance was assessed via discrepancies in perceived prognosis, κ statistics, and McNemar's test. Distribution of categorical variables and survival rates across cancer type were compared with Fisher's exact and log-rank tests, respectively. Data were available from 77 dyads (74% of enrolled). Parent-provider agreement regarding prognosis and goals of care was poor (κ, 0.12 to 0.30). Parents were more likely to report cure was likely (P .001). The frequency of perceived likelihood of cure and the goal of cure varied by cancer type for both parents and providers (P .001 to .004). Relatively optimistic responses were more common among parents and providers of patients with hematologic malignancies, although there were no differences in survival. Parent-provider concordance regarding prognosis and goals in advanced pediatric cancer is generally poor. Perceptions of prognosis and goals of care vary by cancer type. Understanding these differences may inform parent-provider communication and decision making.
Publisher: MDPI AG
Date: 09-06-2022
DOI: 10.3390/NU14122394
Abstract: Introduction: Most people in Australia buy most of their food in supermarkets. Marketing techniques promoting healthy foods in supermarkets can be important to encourage healthy eating at a population level. Shelf tags that highlight the healthiness of products have been identified as one such promising initiative. The aim of this study was to assess changes in the healthiness of foods sold in an Australian supermarket chain following implementation of a shelf tag intervention based on the Australian Health Star Rating (HSR) system. Methods: A controlled, non-randomised trial was undertaken in seven supermarkets (intervention: n = 3 control: n = 4) of a single chain in Victoria, Australia, over 12 weeks (4 weeks baseline, 8 weeks intervention period) between August and November 2015. The intervention involved provision of a shelf tag indicating the HSR of all packaged products that scored 4.5 or 5 stars (‘high-HSR products’) using the Australian HSR system. Posters indicating the healthiness of fresh fruits and vegetables (not eligible for an HSR rating, as they are not packaged) were also installed. Weekly per store sales data were provided by the retailer. In an intention-to-treat analysis (with intervention status of in idual products based on their eligibility to be tagged), the proportion (%) of all ‘high-HSR’ packaged food sold and the volume of key nutrients (saturated fat, total fat, sodium, total sugar, protein, carbohydrates and energy) per 100 g sold were assessed. Difference-in-difference analyses were conducted to determine the difference between intervention and control stores in terms of mean outcomes between baseline and intervention periods. Customer exit surveys (n = 304) were conducted to evaluate awareness and use of the shelf tags and posters. Results: The proportion of ‘high-HSR products’ sold increased in the intervention period compared to the baseline period in each of the three intervention stores (average increase of 0.49%, 95% CI: −0.02, 0.99), compared to a decrease of −0.15% (−0.46, 0.15) in control stores (p = 0.034). The overall increase in intervention compared to control stores (difference-in-difference) of 0.64% represents an 8.2% increase in the sales of ‘high-HSR products’. Sales of total sugar, total fat, saturated fat, carbohydrates, sodium, protein and total energy in packaged food all decreased significantly more in intervention stores compared to control stores. Sales of fresh fruits and vegetables decreased in intervention stores compared to control stores. Customer surveys found that 34.4% noticed the shelf tags. Of those who noticed the tags, 58% believed the shelf tags influenced their purchases. Conclusions: With this study, we found that the use of shelf tags that highlight the healthiest packaged foods in a supermarket setting showed promise as a mechanism to improve the healthiness of purchases. Opportunities to scale up the intervention warrant exploration, with further research needed to assess the potential impact of the intervention on overall population diets over the longer term.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2019
Publisher: JMIR Publications Inc.
Date: 07-02-2023
DOI: 10.2196/39384
Abstract: In March 2020, the Australian Government expanded general practitioner (GP) telehealth services in response to the COVID-19 pandemic. This study sought to assess use patterns of GP telehealth services in response to changing circumstances (before and during the COVID-19 pandemic and with or without a lockdown) in regional Victoria, Australia. We conducted a secondary analysis of monthly Medicare claims data from July 2019 to June 2021 from 140 regional GP practices in Western Victoria. The longitudinal patterns of proportion of GP telehealth consultations stratified by type of consultation (ie, videoconference vs telephone) and by geographical, consumer, and consultation characteristics were analyzed. Telehealth comprised 25.8% (522,932/2,025,615) of GP consultations over the 2-year period. After the introduction of the Australian telehealth expansion policy in March 2020, there was a rapid uptake in GP telehealth services (including telephone and video services), from 0% before COVID-19 to 15% (11,854/80,922) of all consultations in March 2020, peaking at 55% (50,828/92,139) in August 2020. Thereafter, the use of telehealth declined steadily to 31% (23,941/77,344) in January 2021 and tapered off to 28% (29,263/103,798) in June 2021. Telephone services and shorter consultations were the most dominant form, and those aged 15-64 years had higher telehealth use rates than younger or older age groups. The proportion of video consultations was higher during periods with government-imposed lockdowns and higher in the most socioeconomically advantaged areas compared to less socioeconomically advantaged areas. Our findings support the continuation of telehealth use in rural and regional Australia post pandemic. Future policy must identify mechanisms to reduce existing equity gaps in video consultations and consider patient- and system-level implications of the dominant use of short telephone consultations.
Publisher: Wiley
Date: 10-2019
DOI: 10.14814/PHY2.14216
Publisher: Elsevier BV
Date: 11-2002
DOI: 10.1016/S0269-7491(02)00128-8
Abstract: The atmospheric quality and distribution of heavy metals were evaluated throughout a wide region of Argentina. In addition, the biomonitor performance of Tillandsia capillaris Ruiz & Pav. f. capillaris was studied in relation to the accumulation of heavy metals and to its physiologic response to air pollutants. A s ling area of 50,000 km2 was selected in the central region of the Argentine Republic. This area was sub ided into grids of 25 x 25 km. Pools of T. capillaris, where present, were collected at each intersection point. From each pool three sub-s les were analyzed independently. Furthermore, five replicates were collected at 20% of the points in order to analyze the variability within the site. The content of Co, Cu, Fe, Ni, Mn, Pb and Zn was determined by Atomic Absorption Spectrometry. Chemical-physiological parameters were also determined to detect symptoms of foliar damage. Chlorophylls, phaeophytins, hydroperoxy conjugated dienes, malondialdehyde and sulfur were quantified in T. capillaris. Some of these parameters were used to calculate a foliar damage index. Data sets were evaluated by one-way ANOVA, correlation analysis, principal component analysis and mapping. Geographical distribution patterns were obtained for the different metals reflecting the contribution of natural and anthropogenic emission sources. According to our results it can be inferred that Fe, Mn and Co probably originated in the soil. For Pb, the highest values were found in the mountainous area, which can be attributed to the presence of Pb in the granitic rocks. Ni showed mainly an anthropogenic origin, with higher values found in places next to industrial centers. For Zn the highest values were in areas of agricultural development. The same was observed for Cu, whose presence could be related to the employment of pesticides. The foliar damage index distribution map showed that the central and southeastern zones were the ones where the major damage in the bioindicator was found. The central zone coincides with the city of Córdoba whereas the southeastern area is strictly agricultural, so the high values found there could be related to the use of pesticides.
No related grants have been discovered for Liliana Orellana.