ORCID Profile
0000-0002-2822-2436
Current Organisations
South Australian Health and Medical Research Institute Limited
,
University of South Australia
,
University of Adelaide
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Publications
Identifying Opportunities, and Motivation to Enhance Capabilities, Influencing the Development of a Personalized Digital Health Hub Model of Care for Hip Fractures: Mixed Methods Exploratory Study
Publisher: JMIR Publications Inc.
Date: 28-10-2021
DOI: 10.2196/26886
Abstract: Most older people after a hip fracture injury never return to their prefracture status, and some are admitted to residential aged care facilities. Advancement of digital technology has helped in optimizing health care including self-management and telerehabilitation. This study aims to understand the perspectives of older patients with hip fracture and their family members and residential aged caregivers on the feasibility of developing a model of care using a personalized digital health hub. We conducted a mixed methods study in South Australia involving patients aged 50 years and older, their family members, and residential aged caregivers. Quantitative data analysis included basic demographic characteristics, and access to digital devices was analyzed using descriptive statistics. Spearman rank-order correlation was used to examine correlations between the perceived role of a personalized digital health hub in improving health and the likelihood of subsequent use. Findings from qualitative analysis were interpreted using constructs of capability, opportunity, and motivation to help understand the factors influencing the likelihood of potential personalized digital health hub use. This study recruited 100 participants—55 patients, 13 family members, and 32 residential aged caregivers. The mean age of the patients was 76.4 (SD 8.4, range 54-88) years, and 60% (33/55) of the patients were female. Approximately 50% (34/68) of the patients and their family members had access to digital devices, despite less than one-third using computers as part of their occupation. Approximately 72% (72/100) of the respondents thought that personalized digital health hub could improve health outcomes in patients. However, a moderate negative correlation existed with increasing age and likelihood of personalized digital health hub use (Spearman ρ=–0.50 P .001), and the perceived role of the personalized digital health hub in improving health had a strong positive correlation with the likelihood of personalized digital health hub use by self (Spearman ρ=0.71 P .001) and by society, including friends and family members (Spearman ρ=0.75 P .001). Most patients (54/55, 98%) believed they had a family member, friend, or caregiver who would be able to help them use a personalized digital health hub. Qualitative analysis explored capability by understanding aspects of existing knowledge, including willingness to advance digital navigation skills. Access could be improved through supporting opportunities, and factors influencing intrinsic motivation were considered crucial for designing a personalized digital health hub–enabled model of care. This study emphasized the complex relationship between capabilities, motivation, and opportunities for patients, their family members, and formal caregivers as a patient networked unit. The next stage of research will continue to involve a cocreation approach followed by iterative processes and understand the factors influencing the development and successful integration of complex digital health care interventions in real-world scenarios.
Vertical anthropometric measures and low back pain in adolescents
Publisher: Wiley
Date: 06-2006
DOI: 10.1002/PRI.218
Abstract: The present paper explores aspects of a large dataset of adolescent potentiates of low back pain. Standing, trunk and shoulder height, subischial height, weight and mean leg length are examined in relation to reports of low back pain in the last two weeks, in strata of age and gender. The present study examined 1254 adolescents, aged 11-18 years, drawn from 12 Adelaide public high schools during 1998. At each year of age, girls reported significantly more low back pain than boys. Girls and boys at each year of age provided different relationships between low back pain and anthropometric features, highlighting the unique nature of adolescent growth. The most consistent findings were anthropometric differences between 16-year-old boys, and 13- and 15-year-old girls, with and without low back pain, who may be at critical stages of the peak growth curve. We suggest a high prevalence of low back pain in adolescents, and that young sufferers with low back pain may be reflecting attributes of their stage of anthropometric growth.
The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: findings from NHANES
Publisher: Springer Science and Business Media LLC
Date: 22-06-2023
DOI: 10.1007/S00394-023-03191-Z
Abstract: To our knowledge, no studies have examined the association of diet quality and plant-based diets (PBD) with inflammatory-related mortality in obesity. Therefore, this study aimed to determine the joint associations of Healthy Eating Index-2015 (HEI-2015), plant-based dietary index (PDI), healthy PDI (hPDI), unhealthy PDI (uPDI), pro-vegetarian dietary index (PVD), and systemic inflammation with all-cause, cardiovascular disease (CVD), and cancer mortality risks by obesity status. Participants from NHANES were included in cross-sectional ( N = 27,915, cycle 1999–2010, 2015–2018) and longitudinal analysis ( N = 11,939, cycle 1999–2008). HEI-2015, PDI, hPDI, uPDI, and PVD were constructed based on the 24-h recall dietary interview. The grade of inflammation (low, moderate, and high) was determined based on C-reactive protein (CRP) values and multivariable ordinal logistic regression was used to determine the association. Cox proportional hazard models were used to determine the joint associations of diet and inflammation with mortality. In the fully adjusted model, HEI-2015 (OR T3vsT1 = 0.76, 95% CI 0.69–0.84 p -trend = 0.001), PDI (OR T3vsT1 = 0.83, 95% CI 0.75–0.91 p trend = 0.001), hPDI (OR T3vsT1 = 0.79, 95% CI 0.71–0.88 p trend = 0.001), and PVD (OR T3vsT1 = 0.85, 95% CI 0.75–0.97 p trend = 0.02) were associated with lower systemic inflammation. In contrast, uPDI was associated with higher systemic inflammation (OR T3vsT1 = 1.18, 95% CI 1.06–1.31 p-trend = 0.03). Severe inflammation was associated with a 25% increase in all-cause mortality (OR T3vsT1 = 1.25, 95% CI 1.03–1.53, p trend = 0.02). No association was found between PDI, hPDI, uPDI, and PVD with mortality. The joint association, between HEI-2015, levels of systemic inflammation, and all-cause, CVD and cancer mortality, was not significant. However, a greater reduction in mortality risk with an increase in HEI-2015 scores was observed in in iduals with low and moderate inflammation, especially those with obesity. Higher scores of HEI-2015 and increased intake of a healthy plant-based diet were associated with lower inflammation, while an unhealthy plant-based diet was associated with higher inflammation. A greater adherence to the 2015 dietary guidelines may reduce the risk of mortality associated with inflammation and may also benefit in iduals with obesity who had low and moderate inflammation.
PREVALENCE AND INCIDENCE OF CHRONIC CONDITIONS IN AN AUSTRALIAN POPULATION BASED COHORT STUDY: 2000 TO 2010
Publisher: BMJ
Date: 08-2011
CHRONIC DISEASE IN SPECIFIC POPULATIONS: AN EPIDEMIOLOGICAL ANALYSIS
Publisher: BMJ
Date: 08-2011
Waking to use technology at night, and associations with driving and work outcomes: a screenshot of Australian adults
Publisher: Oxford University Press (OUP)
Date: 05-02-2020
Abstract: The use of smartphones/electronic devices and their relationship with outcomes are understudied in adult populations. We determined daytime functional correlates of using technology during the night in a population s le of Australian adults. A cross-sectional, national online survey of sleep health was conducted in 2019 (n = 1984, 18–90 years). Nocturnal technology use was assessed with: “In the past seven days, how often did you wake or were woken to send or receive text messages, emails or other electronic communications?” Waking to use technology during all/most nights was reported by 4.9%, with 13.8% reporting two to three nights per week, and 12.7% reporting just one night per week. Technology users were more likely to be younger, employed, experience financial stress, and speak English as a second language. In adjusted analyses, compared to no use, technology use at least two to three nights per week was significantly associated with daytime problems (sleepiness, fatigue and impaired mood, motivation, and attention) and was more evident in participants not reporting erceiving a sleep problem. Technology use was independently associated with at least one drowsy driving-related motor vehicle accidents/near miss per month (odds ratio [OR] = 6.4, 95% CI = 3.8 to 10.7) and with missing work (OR = 4.8, 95% CI: 3.2 to 7.2) and making errors at work (OR = 2.2, 95% CI = 1.5 to 3.3) at least 1 day in the past 3 months due to sleepiness/sleep problem. These associations were not significantly modified by age. Public health implications of waking to engage with electronic devices at night may be significant in terms of safety, productivity, and well-being. Limiting sleep-disrupting technology use will require innovative language- erse strategies targeted broadly across age groups.
Predicting Slow Walking Speed From a Pooled Cohort Analysis: Sarcopenia Definitions, Agreement, and Prevalence in Australia and New Zealand
Publisher: Oxford University Press (OUP)
Date: 10-07-2023
Abstract: Recent operational definitions of sarcopenia have not been replicated and compared in Australia and New Zealand (ANZ) populations. We aimed to identify sarcopenia measures that discriminate ANZ adults with slow walking speed (& .8 m/s) and determine the agreement between the Sarcopenia Definitions and Outcomes Consortium (SDOC) and revised European Working Group for Sarcopenia in Older People (EWGSOP2) operational definitions of sarcopenia. Eight studies comprising 8 100 ANZ community-dwelling adults (mean age ± standard deviation, 62.0 ± 14.4 years) with walking speed, grip strength (GR), and lean mass data were combined. Replicating the SDOC methodology, 15 candidate variables were included in sex-stratified classification and regression tree models and receiver operating characteristic curves on a pooled cohort with complete data to identify variables and cut points discriminating slow walking speed (& .8 m/s). Agreement and prevalence estimates were compared using Cohen’s Kappa (CK). Receiver operating characteristic curves identified GR as the strongest variable for discriminating slow from normal walking speed in women (GR & .50 kg, area under curve [AUC] = 0.68) and men (GR & .05 kg, AUC = 0.64). Near-perfect agreement was found between the derived ANZ cut points and SDOC cut points (CK 0.8–1.0). Sarcopenia prevalence ranged from 1.5% (EWGSOP2) to 37.2% (SDOC) in women and 1.0% (EWGSOP2) to 9.1% (SDOC) in men, with no agreement (CK & .2) between EWGSOP2 and SDOC. Grip strength is the primary discriminating characteristic for slow walking speed in ANZ women and men, consistent with findings from the SDOC. Sarcopenia Definitions and Outcomes Consortium and EWGSOP2 definitions showed no agreement suggesting these proposed definitions measure different characteristics and identify people with sarcopenia differently.
Utilising Digital Health Technology to Support Patient-Healthcare Provider Communication in Fragility Fracture Recovery: Systematic Review and Meta-Analysis
Publisher: MDPI AG
Date: 22-10-2019
Abstract: The objective of this review is to evaluate the effectiveness of digital health supported targeted patient communication versus usual provision of health information, on the recovery of fragility fractures. The review considered studies including older people, aged 50 and above, with a fragility fracture. The primary outcome was prevention of secondary fractures by diagnosis and treatment of osteoporosis, and its adherence. This review considered both experimental and quasi-experimental study designs. A comprehensive search strategy was built to identify key terms including Medical subject headings (MeSH) and applied to the multiple electronic databases. An intention to treat analysis was applied to those studies included in the meta-analysis and odds ratio was calculated with random effects. Altogether, 15 studies were considered in the final stage for this systematic review. Out of these, 10 studies were Randomised controlled trials (RCT) and five were quasi experimental studies, published between the years 2003 and 2016 with a total of 5037 participants. Five Randomised control trails were included in the meta-analysis suggesting that digital health supported interventions were overall, twice as effective when compared with the usual standard care (OR 2.13, 95% CI 1.30–3.48), despite the population s le not being homogeneous. Findings from the remaining studies were narratively interpreted.
Identifying Opportunities, and Motivation to Enhance Capabilities, Influencing the Development of a Personalized Digital Health Hub Model of Care for Hip Fractures: Mixed Methods Exploratory Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 2021
Abstract: ost older people after a hip fracture injury never return to their prefracture status, and some are admitted to residential aged care facilities. Advancement of digital technology has helped in optimizing health care including self-management and telerehabilitation. his study aims to understand the perspectives of older patients with hip fracture and their family members and residential aged caregivers on the feasibility of developing a model of care using a personalized digital health hub. e conducted a mixed methods study in South Australia involving patients aged 50 years and older, their family members, and residential aged caregivers. Quantitative data analysis included basic demographic characteristics, and access to digital devices was analyzed using descriptive statistics. Spearman rank-order correlation was used to examine correlations between the perceived role of a personalized digital health hub in improving health and the likelihood of subsequent use. Findings from qualitative analysis were interpreted using constructs of capability, opportunity, and motivation to help understand the factors influencing the likelihood of potential personalized digital health hub use. his study recruited 100 participants—55 patients, 13 family members, and 32 residential aged caregivers. The mean age of the patients was 76.4 (SD 8.4, range 54-88) years, and 60% (33/55) of the patients were female. Approximately 50% (34/68) of the patients and their family members had access to digital devices, despite less than one-third using computers as part of their occupation. Approximately 72% (72/100) of the respondents thought that personalized digital health hub could improve health outcomes in patients. However, a moderate negative correlation existed with increasing age and likelihood of personalized digital health hub use (Spearman ρ=–0.50 i P /i & .001), and the perceived role of the personalized digital health hub in improving health had a strong positive correlation with the likelihood of personalized digital health hub use by self (Spearman ρ=0.71 i P /i & .001) and by society, including friends and family members (Spearman ρ=0.75 i P /i & .001). Most patients (54/55, 98%) believed they had a family member, friend, or caregiver who would be able to help them use a personalized digital health hub. Qualitative analysis explored capability by understanding aspects of existing knowledge, including willingness to advance digital navigation skills. Access could be improved through supporting opportunities, and factors influencing intrinsic motivation were considered crucial for designing a personalized digital health hub–enabled model of care. his study emphasized the complex relationship between capabilities, motivation, and opportunities for patients, their family members, and formal caregivers as a i atient networked unit /i . The next stage of research will continue to involve a cocreation approach followed by iterative processes and understand the factors influencing the development and successful integration of complex digital health care interventions in real-world scenarios.
Poor sleep and multiple sclerosis: associations with symptoms of multiple sclerosis and quality of life.
Publisher: BMJ
Date: 27-07-2022
Abstract: Sleep difficulties are common in people with multiple sclerosis (MS), but whether associations between poor sleep quality and quality of life are independent of MS symptoms, obesity and other MS-related factors remains unclear. Cross-sectional analyses of data from the Australian MS Longitudinal Study (n=1717). Sleep was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and International Restless Legs Syndrome Study Group Rating Scale health-related quality of life using the Assessment of Quality-of-Life 8-D. Poor sleep quality was common (67%), and more common than in community s les. Sleep measures clustered independently within MS symptoms. The clusters 'fatigue and cognitive', 'feelings of anxiety and depression', 'pain and sensory', were independently associated with poor sleep quality. Quality-of-Life utility scores were a clinically meaningful 0.19 units lower in those with poor sleep. Sleep quality, daytime sleepiness and restless leg syndrome were associated with reduced quality of life, independent of MS-related symptoms and body mass index. Poor sleep quality is common in MS and was strongly associated with worse health-related quality of life, independent of other MS symptoms and did not cluster with other common MS symptoms. Improving sleep quality may substantially improve quality of life in people with MS.
Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study
Publisher: World Scientific Pub Co Pte Lt
Date: 09-2019
DOI: 10.1142/S2661318219500154
Abstract: Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age ( 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31 adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.
Association between soft drink consumption and asthma and chronic obstructive pulmonary disease among adults in Australia
Publisher: Wiley
Date: 24-01-2012
DOI: 10.1111/J.1440-1843.2011.02115.X
Abstract: The aim of this study was to examine the association between soft drink consumption and self-reported doctor-diagnosed asthma and COPD among adults living in South Australia. Data were collected using a risk factor surveillance system. Each month a representative random s le of South Australians were selected from the electronic White Pages and interviews were conducted using computer-assisted telephone interviewing (CATI). Among 16 907 participants aged 16 years and older, 11.4% reported daily soft drink consumption of more than half a litre. High levels of soft drink consumption were positively associated with asthma and COPD. Overall, 13.3% of participants with asthma and 15.6% of those with COPD reported consuming more than half a litre of soft drink per day. By multivariate analysis, after adjusting for socio-demographic and lifestyle factors, the odds ratio (OR) for asthma was 1.26 (95% confidence interval (CI): 1.01-1.58) and the OR for COPD was 1.79 (95% CI: 1.32-2.43), comparing those who consumed more than half a litre of soft drink per day with those who did not consume soft drinks. There was a positive association between consumption of soft drinks and asthma/COPD among adults living in South Australia.
Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol
Publisher: BMJ
Date: 12-2019
DOI: 10.1136/BMJOPEN-2019-033128
Abstract: Older people with hip fractures often require long-term care and a crucial aspect is the provision of quality health information to patients and their carers to support continuity of care. If patients are well informed about their health condition and caring needs, particularly posthospital discharge into the community setting, this may support recovery and improve quality of life. As internet and mobile access reach every household, it is possible to deliver a new model of service using a digital education platform as a personal health hub where both patients and their providers of care can establish a more efficient information integration and exchange process. This protocol details proposed research, which aims to develop a ‘model of care’ by using a digital health solution that will allow delivery of high quality and patient-centred information, integrated into the existing process delivered within the community setting. This phase of the study uses a pragmatic mixed-methods design and a participatory approach through engagement of patients, their carers and healthcare providers from multiple disciplines to inform the development of a digital health platform. Quantitative methods will explore health literacy and e-health literacy among older people with hip fractures admitted to the two public tertiary care hospitals in Adelaide, South Australia. Qualitative methods will provide an understanding of aspects of content and context required for the digital health platform to be developed in order to deliver quality health information. The study will use appropriate theoretical frameworks and constructs to guide the design, analysis and overall conduct of the research study. The scope of the study intends to ultimately empower patients and their carers to improve self-management and to better use coordinated services at the community level. This could prevent further falls including associated injuries or new fractures reduce new hospital admissions and improve confidence and engagement by limiting the psychologically restrictive ‘fear of falls’. The study has been approved by the Human Research Ethics Committee of the Central Adelaide Local Health Network, South Australia (SA) Health, Government of South Australia and the University of Adelaide Human Research Ethics Committee. Findings from the study will be published in suitable peer-reviewed journals and disseminated through workshops or conferences.
Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial
Publisher: BMJ
Date: 11-2022
DOI: 10.1136/RMDOPEN-2022-002648
Abstract: Adhesive capsulitis is a common painful shoulder condition. Treatment for the condition remains unsatisfactory. Suprascapular nerve block (SSNB) shows promise as a treatment option for adhesive capsulitis but there are no randomised controlled trials that examine its effect on pain or duration of the condition. The objective of this study was to examine the efficacy of SSNB for the management of adhesive capsulitis. A randomised double-blind placebo-controlled trial of SSNB and standard therapy versus placebo and standard therapy was performed. In total, 54 patients were enrolled in the study. 27 patients received a glenohumeral joint (GHJ) injection and physiotherapy plus a 3-month SSNB, and 27 patients received a GHJ injection and physiotherapy plus a 3-month placebo injection. Patients were followed to resolution of their symptoms as measured by a combination of range of movement, pain scores, Shoulder Pain and Disability Index (SPADI) scores and perceived recovery scores. The primary outcome measure was time to resolution of symptoms. Participants who received the SSNB reduced the duration of their symptoms of adhesive capsulitis by an average of 6 months (mean time to resolution 5.4 (95% CI 4.4 to 6.3) months vs 11.2 (95% CI 9.3 to 13) months) in the placebo group. They also had reduced pain scores, improved range of movement and lower SPADI scores compared with the placebo group across all time points. SSNB reduced the duration of adhesive capsulitis and resulted in improved pain and disability experience for patients. Australian New Zealand Clinical Trials Registry (ANCTRN 12615001378516).
Sleep disorders and gout in Australian adults
Publisher: Springer Science and Business Media LLC
Date: 28-08-2021
DOI: 10.1186/S41927-021-00199-Y
Abstract: The aims of our study were two-fold. Firstly, to determine if there is an association between gout and OSA in a representative Australian adult population. Secondly, to explore associations between gout and patient reported sleep outcomes. A cross-sectional national online survey of a representative s le of Australian adults 18 years assessed self-reported doctor-diagnosed OSA, insomnia and patient reported sleep outcomes. Possible undiagnosed OSA was estimated using self-reported frequent loud snoring and witnessed apnoeas. Participants self-reported physician-diagnosed gout and other health conditions. Multivariable logistic regression analyses were performed for both objectives. Odds ratios with 95% confidence intervals were reported. There were 1948 participants of whom 126 (6.5%) had gout and 124 (6.4%) had diagnosed sleep apnoea. After adjusting for age, body mass index (BMI), sex, alcohol intake and the presence of arthritis, those with obstructive sleep apnoea diagnosed on polysomnography were twice as likely to report having gout compared to those without. (OR = 2.6, 95% CI 1.5–4.6). Additionally, participants with symptoms suggestive of sleep apnoea were also twice as likely to have gout compared to those without (OR = 2.8, 95%CI 1.6–5.1). There was also a higher likelihood of restless legs syndrome, insomnia and worry about sleep in patients with gout. Diagnosed and suspected OSA are associated with higher likelihood of gout. Participants with gout are also more likely to report suffering from restless legs syndrome, insomnia and worry about their sleep. Given the morbidity associated with sleep problems, we should be vigilant regarding sleep health in our patients with gout.
Suicidal Ideation The Clinical Utility of the K10
Publisher: Hogrefe Publishing Group
Date: 2009
DOI: 10.1027/0227-5910.30.1.39
Abstract: Background. Suicidal ideation is an important risk factor for suicide attempts and completions, and early identification of the likely presence of self-harm cognitions would benefit clients and clinicians alike. This study examined the clinical utility of the Kessler K10 psychological distress score as an indicator of suicidal ideation. Methods. Suicidal ideation was assessed on the basis of four relevant questions contained in the General Health Questionnaire (GHQ-28), and these were subsequently analyzed against the K10 scores. The data were collected using a monthly risk-factor surveillance system where each month a representative random s le of South Australians over the age of 16 years is interviewed. The cumulative data covered the period 2002 to 2007 (n = 12,884). Results. Psychological distress and suicidal ideation were reported by 9.9% and 5.1% of the participants, respectively. Univariate analysis demonstrated a positive linear relationship between the K10 score and suicidal ideation. Participants scoring in the very high range of the K10 were more likely to report suicidal ideation and this was experienced with greater frequency than by those who were less distressed. A logistic regression analysis revealed that even those in the moderate category were four times more likely to experience suicidal ideation than those in the low category, and those in the high and very high categories were 21 and 77 times more likely, respectively. Separate models based on sex and using odds-ratios based on very high vs. low K10 scores showed that males were 104 times more likely to report suicidal ideation compared to a 63 times higher rate for females. Both sexes had a 52% probability of experiencing suicidal ideation if they fell into the very high distress group. Conclusions. The K10 score is a clinically useful indicator of the presence of suicidal ideation.
Prevalence of Probable Shift Work Disorder in Non-Standard Work Schedules and Associations with Sleep, Health and Safety Outcomes: A Cross-Sectional Analysis
Publisher: Informa UK Limited
Date: 05-2021
DOI: 10.2147/NSS.S301493
<p>Associations of OSA and Nocturnal Hypoxemia with Strength and Body Composition in Community Dwelling Middle Aged and Older Men</p>
Publisher: Informa UK Limited
Date: 11-2020
DOI: 10.2147/NSS.S276932
A qualitative study of patient perspectives related to glucocorticoid therapy in polymyalgia rheumatica and giant cell arteritis
Publisher: Informa UK Limited
Date: 08-2019
The associations between adolescent head-on-neck posture, backpack weight, and anthropometric features
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-1999
DOI: 10.1097/00007632-199911010-00015
Abstract: A Cross-sectional, observational study, examining the effects of backpack weight on adolescent posture. To investigate the response of the craniovertebral angle to backpack load. There is a widely held belief that repeated carrying of heavy loads, such as school backpacks, places additional stress on rapidly growing adolescent spinal structures, making them prone to postural change. Ten volunteer state high schools in metropolitan Adelaide, South Australia, provided 985 students, aged 12 to 18 years and from five different high school years, for this study. Students' posture was measured with and without their school backpack. All data analyses were undertaken per school year level to account for specific load-carrying requirements and spinal development associated with the age group. A significant change in craniovertebral angle was found at every year level, when comparing standing posture with no backpack with posture when carrying a backpack. The change was greatest for the youngest students. Incremental change in craniovertebral angle was not strongly associated with backpack loads. The association became stronger for the oldest girls when controlled for body mass index and for weight. The results support a differential postural response per gender and per level of spinal development but also suggest that the craniovertebral angle may not be the most sensitive measure of head-on-neck postural change for adolescents.
Discharge planning quality from the carer perspective
Publisher: Springer Science and Business Media LLC
Date: 2000
Abstract: Discharge planning endeavours to assist the transition of patients from the acute hospital setting into the community. We examined the quality of discharge planning from the perspective of the carer. Spouses were the most common carers for the elderly patients in our study. Many carers were also elderly, with their own health problems. Using a new instrument (entitled PREPARED) (K. Grimmer and J. Moss, Int J Qual Health Care (in press)), carers rated the quality of planning for discharge much lower than did the patient, indicating that their needs were often not met when discharge was being planned. In free text responses, carers expressed their dissatisfaction over communication about how the family would cope once the patient went home. Carers generally had lower summary mental quality of life scores than the Australian norms (as measured by the SF-36 health survey (J. Ware and R. Sherbourne, Med Care 1992 30: 473-483)), suggesting that the caring role may have impacted upon their emotional wellbeing. The rate of use of community services in the first week post-discharge was low, suggesting that carers and patients carried the majority of the burden immediately after discharge. We suggest that planning for hospital discharge requires more consideration of the carer.
The burden of pancreatic cancer in Australia attributable to smoking
Publisher: AMPCo
Date: 18-01-2019
DOI: 10.5694/MJA2.12108
Abstract: To estimate the burden of pancreatic cancer in Australia attributable to modifiable exposures, particularly smoking. Prospective pooled cohort study. Seven prospective Australian study cohorts (total s le size, 365 084 adults) participant data linked to national registries to identify cases of pancreatic cancer and deaths. Associations between exposures and incidence of pancreatic cancer, estimated in a proportional hazards model, adjusted for age, sex, study, and other exposures future burden of pancreatic cancer avoidable by changes in exposure estimated as population attributable fractions (PAFs) for whole population and for specific population subgroups with a method accounting for competing risk of death. There were 604 incident cases of pancreatic cancer during the first 10 years of follow-up. Current and recent smoking explained 21.7% (95% CI, 13.8-28.9%) and current smoking alone explained 15.3% (95% CI, 8.6-22.6%) of future pancreatic cancer burden. This proportion of the burden would be avoidable over 25 years were current smokers to quit and there were no new smokers. The burden attributable to current smoking is greater for men (23.9% 95% CI, 13.3-33.3%) than for women (7.2% 95% CI, -0.4% to 14.2% P = 0.007) and for those under 65 (19.0% 95% CI, 8.1-28.6%) than for older people (6.6% 95% CI, 1.9-11.1% P = 0.030). There were no independent relationships between body mass index or alcohol consumption and pancreatic cancer. Strategies that reduce the uptake of smoking and encourage current smokers to quit could substantially reduce the future incidence of pancreatic cancer in Australia, particularly among men.
Microenvironmental Reactive Oxygen Species in Colorectal Cancer: Involved Processes and Therapeutic Opportunities
Publisher: MDPI AG
Date: 09-10-2021
Abstract: Colorectal cancer (CRC) is the fourth most common cause of cancer deaths worldwide. Although screening programs have reduced mortality rates, there is a need for research focused on finding the main factors that lead primary CRC to progress and metastasize. During tumor progression, malignant cells modify their habitat, corrupting or transforming cells of different origins and creating the tumor microenvironment (TME). Cells forming the TME like macrophages, neutrophils, and fibroblasts generate reactive oxygen species (ROS) that modify the cancer niche. The effects of ROS in cancer are very erse: they promote cellular proliferation, epithelial-to-mesenchymal transition (EMT), evasion of cell death programs, migration, and angiogenesis. Due to the multifaceted role of ROS in cancer cell survival and function, ROS-modulating agents such as antioxidants or pro-oxidants could have therapeutic potential in cancer prevention and/or as a complement to systemic treatments. In this review, we will examine the main ROS producer cells and their effects on cancer progression and metastasis. Furthermore, we will enumerate the latest clinical trials where pro-oxidants and antioxidants have therapeutic uses in CRC.
Association between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index and the Risk of Obesity
Publisher: MDPI AG
Date: 02-05-2021
DOI: 10.3390/NU13051536
Abstract: Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent dietary pattern (RRQ5 vs. Q1 = 0.38 95% CI: 0.15–0.96), healthy PDI (RR = 0.31 95% CI: 0.12–0.77) and overall PDI (RR = 0.56 95% CI: 0.23–1.33) were inversely associated with obesity risk. Conversely, the DII (RR = 1.59 95% CI: 0.72–3.50), a Western dietary pattern (RR = 2.16 95% CI: 0.76–6.08) and unhealthy PDI (RR = 1.94 95% CI: 0.81–4.66) were associated with increased risk of obesity. Based on the cubic spline analysis, the association between an unhealthy PDI or diet quality with the risk of obesity was non-linear. In conclusion, an anti-inflammatory diet, healthy diet or consumption of healthy plant-based foods were all associated with a lower risk of developing obesity.
Does leisure time physical activity protect against shoulder pain at work?
Publisher: Oxford University Press (OUP)
Date: 07-05-2010
Abstract: Shoulder pain is a common problem that can impact on work. Leisure time physical activity (LTPA) has the potential to reduce the impact of shoulder pain through its physiological, psychological and social benefits. To determine whether LTPA reduces the prevalence of shoulder pain in a working population. Participants were selected from a longitudinal population-based cohort study, the North West Adelaide Health Study. Information was gathered by questionnaire on LTPA, smoking, depression and socio-economic factors. Body mass index was measured in a clinic setting. Occupational physical activity (OPA) estimated by job title and shoulder pain was measured using the Shoulder Pain and Disability Index. Workers with and without shoulder pain were compared using logistic regression analysis. Of the 1502 working participants, 16% reported having current shoulder pain. Shoulder pain was associated with older age (OR 1.98, 95% CI: 1.31-2.99) (age >50 years), smoking (OR 1.44, CI: 1.02-2.04), secondary-level educational attainment (OR 1.68, 95% CI: 1.07-2.65), high body mass index (BMI) (OR 1.54, 95% CI: 1.14-2.08) and depression (OR 2.42, 95% CI: 1.60-3.64). There was no effect of LTPA on shoulder pain. In this community-based cohort, there was no statistically significant association seen between LTPA, OPA and shoulder pain. There was, however, an association between smoking, BMI, secondary-level education, depression and shoulder pain. These modifiable factors may be better targets for preventive efforts than LTPA to reduce the risk of shoulder pain.
Predicting Australian Adults at High Risk of Cardiovascular Disease Mortality Using Standard Risk Factors and Machine Learning
Publisher: MDPI AG
Date: 19-03-2021
Abstract: Effective cardiovascular disease (CVD) prevention relies on timely identification and intervention for in iduals at risk. Conventional formula-based techniques have been demonstrated to over- or under-predict the risk of CVD in the Australian population. This study assessed the ability of machine learning models to predict CVD mortality risk in the Australian population and compare performance with the well-established Framingham model. Data is drawn from three Australian cohort studies: the North West Adelaide Health Study (NWAHS), the Australian Diabetes, Obesity, and Lifestyle study, and the Melbourne Collaborative Cohort Study (MCCS). Four machine learning models for predicting 15-year CVD mortality risk were developed and compared to the 2008 Framingham model. Machine learning models performed significantly better compared to the Framingham model when applied to the three Australian cohorts. Machine learning based models improved prediction by 2.7% to 5.2% across three Australian cohorts. In an aggregated cohort, machine learning models improved prediction by up to 5.1% (area-under-curve (AUC) 0.852, 95% CI 0.837–0.867). Net reclassification improvement (NRI) was up to 26% with machine learning models. Machine learning based models also showed improved performance when stratified by sex and diabetes status. Results suggest a potential for improving CVD risk prediction in the Australian population using machine learning models.
Complex problems require complex solutions: the utility of social quality theory for addressing the Social Determinants of Health
Publisher: Springer Science and Business Media LLC
Date: 05-08-2011
Impact of musculoskeletal conditions among those in residential aged care in Australia
Publisher: Wiley
Date: 05-10-2022
DOI: 10.1111/AJAG.13001
Abstract: To determine the prevalence of musculoskeletal conditions, co‐morbidity and functional limitations in older people in residential aged care in Australia and the association of musculoskeletal conditions with mortality. A retrospective cohort study using data from 490 325 people in the Registry of Senior Australians was conducted between 2004 and 2014. The association of co‐morbidity, health risk factors and functional limitations with musculoskeletal conditions was evaluated using logistic regression. Cox regression was used to examine the association with mortality. Overall, 40.2% [95% CI 40.1‐40.4]) of residents had a musculoskeletal condition, which was associated with limited social (OR 1.16 [95% CI 1.14‐1.19]) and domestic activities (OR 1.44 [95% CI 1.39‐1.49]). Residents with musculoskeletal conditions had a 15% lower risk of mortality (aHR 0.85 [95% CI 0.85‐0.86], P 0.001) compared to residents without. The presence of musculoskeletal conditions in older people in residential aged care negatively impacts activities of daily living and quality of life rather than mortality.
Use of Insomnia Treatments and Discussions About Sleep with Health Professionals Among Australian Adults with Mental Health Conditions
Publisher: Informa UK Limited
Date: 08-2023
DOI: 10.2147/NSS.S412468
Prevalence and associations of co-morbid insomnia and sleep apnoea in an Australian population-based sample
Publisher: Elsevier BV
Date: 06-2021
Impact of the New National Health Standard for Rail Safety Workers on Ischaemic Heart Disease (IHD) Risk Factors in Train Drivers
Publisher: Wiley
Date: 06-2013
DOI: 10.1111/J.1445-5994.2012.02923.X
Abstract: In 2004, a compulsory National Standard for the Australian rail industry was introduced outlining health standards that drivers must meet to be deemed fit to drive. To examine the trend in ischaemic heart disease (IHD) risk factors in train drivers between 2004 and 2009, following the introduction of a National Standard. A retrospective analysis of IHD risk factors of drivers (n = 386) of an Australian train company, who underwent health assessments between February 2004 and November 2009, was performed. The Framingham Score for 10-year risk of coronary artery disease, body mass index (BMI), cigarette smoking, diabetes, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein and total cholesterol were compared with that of controls at these two time periods. There were significant reductions in the rates of 10-year coronary heart disease risk/year (OR = 0.47 95% CI 0.19, 0.75) in the train drivers compared with the control population. This was driven by a reduction in the rate of cigarette smoking (OR = 0.87 95% CI 0.79, 0.96) and total cholesterol (OR = -0.05 95% CI -0.09, 0.003) and an increase in HDL cholesterol levels (OR = 0.02 95% CI 0.006, 0.03) between groups over time. This was despite an increase in BMI (OR = 0.10 95% CI 0.01, 0.19). Following the introduction of a National Standard for drivers in Australia, there has been a significant improvement in the health of drivers. Such a programme may have a significant impact in this group of safety critical workers.
The Future Burden of Head and Neck Cancers Attributable to Modifiable Behaviors in Australia: A Pooled Cohort Study
Publisher: American Association for Cancer Research (AACR)
Date: 21-05-2021
DOI: 10.1158/1055-9965.EPI-21-0003
Abstract: Estimates of future burden of cancer attributable to current modifiable causal exposures can guide cancer prevention. We quantified future head and neck cancer burden in Australia attributable to in idual and joint causal exposures, and assessed whether these burdens differ between population subgroups. We estimated the strength of the associations between exposures and head and neck cancer using adjusted proportional hazards models from pooled data from seven Australian cohorts (N = 367,058) linked to national cancer and death registries and estimated exposure prevalence from the 2017 to 2018 Australian National Health Survey. We calculated population attributable fractions (PAF) with 95% confidence intervals (CI), accounting for competing risk of death, and compared PAFs for population subgroups. Contemporary levels of current and former smoking contribute 30.6% (95% CI, 22.7%–37.8%), alcohol consumption exceeding two standard drinks per day 12.9% (95% CI, 7.6%–17.9%), and these exposures jointly 38.5% (95% CI, 31.1%–45.0%) to the future head and neck cancer burden. Alcohol-attributable burden is triple and smoking-attributable burden is double for men compared with women. Smoking-attributable burden is also at least double for those consuming more than two alcoholic drinks daily or doing less than 150 minutes of moderate or 75 minutes of vigorous activity weekly, and for those aged under 65 years, unmarried, with low or intermediate educational attainment or lower socioeconomic status, compared with their counterparts. Two-fifths of head and neck cancers in Australia are preventable by investment in tobacco and alcohol control. Targeting men and other identified high-burden subgroups can help to reduce head and neck cancer burden disparities.
Insomnia Prevalence Varies with Symptom Criteria Used with Implications for Epidemiological Studies: Role of Anthropometrics, Sleep Habit, and Comorbidities
Publisher: Informa UK Limited
Date: 04-2022
DOI: 10.2147/NSS.S359437
The OMERACT Core Domain Set for Clinical Trials of Shoulder Disorders
Publisher: The Journal of Rheumatology
Date: 02-2019
Abstract: To reach consensus on the core domains to be included in a core domain set for clinical trials of shoulder disorders using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1 Core Domain Set process. At OMERACT 2018, the OMERACT Shoulder Working Group conducted a workshop that presented the OMERACT 2016 preliminary core domain set and its rationale based upon a systematic review of domains measured in shoulder trials and international Delphi sessions involving patients, clinicians, and researchers, as well as a new systematic review of qualitative studies on the experiences of people with shoulder disorders. After discussions in breakout groups, the OMERACT core domain set for clinical trials of shoulder disorders was presented for endorsement by OMERACT 2018 participants. The qualitative review (n = 8) identified all domains included in the preliminary core set. An additional domain, cognitive dysfunction, was also identified, but confidence that this represents a core domain was very low. The core domain set that was endorsed by the OMERACT participants, with 71% agreement, includes 4 “mandatory” trial domains: pain, function, patient global — shoulder, and adverse events including death and 4 “important but optional” domains: participation (recreation/work), sleep, emotional well-being, and condition-specific pathophysiological manifestations. Cognitive dysfunction was voted out of the core domain set. OMERACT 2018 delegates endorsed a core domain set for clinical trials of shoulder disorders. The next step includes identification of a core outcome measurement set that passes the OMERACT 2.1 Filter for measuring each domain.
Dietary inflammatory index (DII®) and the risk of depression symptoms in adults
Publisher: Elsevier BV
Date: 05-2021
Shoulder range of movement in the general population: age and gender stratified normative data using a community-based cohort
Publisher: Springer Science and Business Media LLC
Date: 12-10-2020
DOI: 10.1186/S12891-020-03665-9
Abstract: An understanding of the average range of movement of the shoulder that is normally achievable is an important part of treatment for shoulder disorders. The average range of active shoulder flexion, abduction and external rotation was measured in a population cohort aged 20 years and over without shoulder pain and/or stiffness in order to provide normative shoulder range data. Cross-sectional analysis using participants in a community-based longitudinal cohort study. There have been three stages of data collection – Stage 1 (1999–2003), Stage 2 (2004–2006) and Stage 3 (2008–2010). Each stage has consisted a of broad ranging computer assisted telephone interview, a self-complete questionnaire and a clinic assessment. Participants in this study are those who undertook assessments in Stage 2. The main outcome measures were active shoulder range of movement (flexion, abduction and external rotation) measured as part of the clinic assessment using a Plurimeter V inclinometer. Mean values were determined and analyses to examine differences between groups (sex and age) were undertaken using non-parametric tests. There were 2404 participants (51.5% male), mean age 45.8 years (SD 17.3, range 20–91). The average range of active right shoulder flexion was 161.5° for males and 158.5° for females, and active right shoulder abduction was 151.5° and 149.7° for males and females respectively. Shoulder range of movement declined with age, with mean right active shoulder flexion decreasing by 43° in males and 40.6° in females and right active shoulder abduction by 39.5° and 36.9° respectively. External rotation range also declined, particularly among females. To our knowledge this is the largest community-based study providing normative data for active shoulder range of movement. This information can be used to set realistic goals for both clinical practice and clinical trials.
Smoking, body weight, physical activity and risk of lower limb total joint replacement in a population-based cohort of men: Comment on the article by Mnatzaganian et al.
Publisher: Wiley
Date: 27-03-2011
DOI: 10.1002/ART.34325
Association between dietary patterns and adult depression symptoms based on principal component analysis, reduced-rank regression and partial least-squares
Publisher: Elsevier BV
Date: 09-2020
Sleep Duration Moderates the Relationship Between Perceived Work-Life Interference and Depressive Symptoms in Australian Men and Women from the North West Adelaide Health Study
Publisher: Springer Science and Business Media LLC
Date: 24-02-2020
Related Organisations
South Australian Health And Medical Research Institute Limited
Location: Australia
Related Funding Activities
No related grants have been discovered for Tiffany Gill.