ORCID Profile
0000-0003-3897-2908
Current Organisation
University of Tasmania
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Research Square Platform LLC
Date: 11-02-2020
Abstract: Objective To describe associations between hand abnormalities on MRI or radiographs (X-ray) and pain and function in a cross-sectional study of community-based older adults. Methods Distal and proximal interphalangeal index finger joints (n=221) were examined using MRI, X-ray, and hand examination. Hand pain, function, and stiffness were assessed using Australian/Canadian hand osteoarthritis index (AUSCAN) questionnaire. Grip strength was assessed using dynamometer. Models were adjusted for age, sex, and other MRI or X-ray abnormalities. Results Absence of collateral ligament (CLs) on MRI (relative risk RR=3.15 (95% confidence interval 1.33, 7.50), and joint space narrowing (JSN) on X-ray (RR=2.96 (1.33, 6.58)) was associated with having a painful joint after adjustment for confounders. JSN was also associated with tender joints (RR=2.19 (1.01, 4.76)). Effusion-synovitis was associated with better AUSCAN pain scores (OR=0.51 (0.28, 0.94)) and JSN with worse AUSCAN pain scores (odds ratio OR=1.67 (1.13, 2.48)). Absent CLs were also associated with stiffer joints (OR=3.12 (1.26, 7.70)) and weaker grip strength (β=-1.69 (-2.95, -0.43)) independent of pain and other features JSN was also associated with weaker grip strength (β=-0.87 (-1.62, -0.14)). No other MRI or X-ray abnormalities were associated with pain or function independent of age, sex or pain. Conclusion Most MRI abnormalities were not associated with pain and function cross-sectionally. Absent CLs and JSN were associated with painful joints and weak grip strength independent of pain and other imaging features. JSN was also associated with tender joints and absent CLs with stiff joints. Unexpectedly, effusions were associated with reduced odds of pain.
Publisher: Wiley
Date: 08-10-2014
DOI: 10.1111/JOCN.12158
Abstract: To develop and test the content and face validity, and reliability of the quality clinical placement evaluation tool. The importance of clinical experience during undergraduate nursing degrees is undisputed. To date, tools available to measure quality of clinical placements have focused on single perspectives, that of the undergraduate or that of the supervising nurse. The quality clinical placement evaluation tool was proposed to provide an assessment of clinical placement experiences informed by supervising ward nurses and undergraduate stakeholders. The study employed a cross-sectional design. The internal validity of an existing instrument was evaluated by an expert panel and modified for use in the acute care sector. Surveys were completed by undergraduate students (n = 48) and supervising ward nurses (n = 47). Factor analysis was used to identify themes drawn from the literature and explore redundancy of items. Reliability was assessed using Cronbach's alpha for internal consistency and test-retest (five to seven days apart). Reliability testing showed good internal consistency for the tool test-retest reliability testing results were moderate to good for students and fair to moderate for nurses. Factor analysis identified three core themes related to supervising ward nurse responses that could also be applied to undergraduate nurses. The domains identified were the following: welcome and belonging support to meet learning needs and confidence and competence: reflections on learning. The quality clinical placement evaluation has shown statistically acceptable levels of reliability and validity for measuring the quality of clinical placement from perspectives of undergraduates and supervising ward nurses. The tool provides tertiary institutions, acute care facilities, wards and in iduals with the means to capture views of the quality of clinical placement which can also be used to undertake comparisons over time and between sites.
Publisher: Oxford University Press (OUP)
Date: 14-08-2018
Abstract: To describe the associations of between-person and within-person variability in serum 25-hydroxyvitamin D (25(OH)D), physical activity (PA), and knee pain and dysfunction with muscle mass, strength, and muscle quality over 10 years in community-dwelling older adults. Participants (N = 1033 51% women mean age 63 ± 7.4 years) were measured at baseline, 2.5, 5, and 10 years. Lower limb lean mass (LLM) was assessed using dual energy X-ray absorptiometry, lower limb muscle strength (LMS) using a dynamometer, and lower limb muscle quality (LMQ) calculated as LMS/LLM. Knee pain and dysfunction were assessed using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. PA was measured using pedometers. Linear-mixed effect regression models, with adjustment for confounders, were used to estimate the association of within-person and between-person variability in PA, 25(OH)D, and WOMAC scores with muscle mass, strength, and muscle quality. Both between-person and within-person increases in PA were associated with LLM, LMS, and LMQ (all P < 0.05). Within-person and between-person increases in knee pain and dysfunction were associated with LLS and LMQ, but not with LLM (all P < 0.05). Between-person effects showed that higher average 25(OH)D was associated with a higher 10-year average LLM, LMS, and LMQ (all P < 0.05), whereas within-person increases in average 25(OH)D were associated with a higher LMS and LMQ, but not with LLM. Variability in 25(OH)D, pain, and dysfunction within an in idual over time is related to muscle changes in that in idual. Increasing one's own PA level further increases muscle mass, strength, and quality supporting the clinical recommendation of promoting PA to reduce age-related muscle loss.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.EXGER.2019.01.008
Abstract: This study aims to describe the associations of low muscle mass, handgrip (HGS) and lower-limb muscle strength (LMS) with health-related quality of life (HRQoL) over 10 years in community-dwelling older adults. Participants (N = 1002 51% women mean age 63 ± 7.4 years) were prospectively followed for 10 years. HRQoL was measured using the validated assessment of quality of life (AQoL) instrument. Appendicular lean mass (ALM) was assessed using dual energy X-ray absorptiometry and normalized to body mass index (BMI). HGS and LMS were assessed using dynamometers. Low ALM/BMI (ALM/BMI Participants with LMS Lower-limb muscle strength and handgrip strength (in women only), which can be easily measured in clinical practice, appear more important than muscle mass for HRQoL.
Publisher: Research Square Platform LLC
Date: 27-03-2023
DOI: 10.21203/RS.3.RS-2651294/V1
Abstract: Aims/hypothesis: To determine whether health literacy is associated with an index diabetes-related foot ulcer (DFU). Methods: The SHELLED Study is a 4-year prospective study of people with diabetes aged over 40 with no history of DFU. The primary outcome was development of a first foot ulcer. Health Literacy was measured using the short form Test of Functional Health Literacy in Adults (s-TOFHLA) and nine domains of the Health Literacy Questionnaire (HLQ). Results : Of 222 participants, 191 (86.0%) completed the study, of whom 13 (5.9%) developed an incident ulcer. In multivariable models, every unit increase in S-TOFHLA score reduced the odds of foot ulcer development by 6% (OR 0.94, 95% CI 0.88 to 0.99). Better scores on two HLQ domains reduced the odds of foot ulcer ( actively managing my health (OR 0.23, 95% CI 0.08 to 0.65) and understanding health information well enough to know what to do (OR 0.39, 95% CI 0.19 to 0.78). This was independent of baseline risk for foot disease. Conclusions/interpretation : These data provide novel evidence that health literacy is an important clinical risk factor for index foot ulceration. People with poor health literacy should be identified for tailored educational programs for DFU prevention.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.JOCD.2014.07.008
Abstract: This is 12-yr follow-up of a randomized controlled trial aimed to evaluate the long-term effects of bone density feedback and osteoporosis education on osteoporosis knowledge and self-efficacy. We examined the effects of feedback of bone density-defined fracture risk (high [T-score <0] vs normal [T-score ≥0] risk) and 2 different educational interventions (the group-based Osteoporosis Prevention and Self-Management Course [OPSMC] vs an osteoporosis leaflet) on osteoporosis knowledge and self-efficacy in women aged 25-44. Seventy-four percent (N = 347) of 470 participants at baseline participated at 12 yr. Overall, the scores were higher for osteoporosis knowledge but lower for self-efficacy at 12 yr. However, neither intervention had an effect on the change in knowledge (T-score, β = 0.4, 95% confidence interval [CI] = -0.3 to 1.1 OPSMC, β = 0.2, 95% CI = -0.5 to 0.9) or self-efficacy (T-score, β = -1.1, 95% CI = -2.5 to 0.4 OPSMC, β = -0.2, 95% CI = -1.6 to 1.3). Women in households with an unemployed main financial provider had a decrease in knowledge at 12 yr compared with those in households with an employed main financial provider in whom knowledge increased (β = -1.95, 95% CI = -3.40 to -0.50), but there were no other predictors of change identified for knowledge or self-efficacy. In conclusion, beneficial effects of both OPSMC and feedback of high fracture risk on osteoporosis knowledge seen previously at 2 yr were not sustained after 12 yr although overall knowledge was still significantly higher than at baseline. Neither intervention improved osteoporosis self-efficacy. More frequent osteoporosis education and bone density feedback may be required to maintain knowledge, and other approaches to improve self-efficacy are necessary.
Publisher: MDPI AG
Date: 09-04-2020
Abstract: The relationship between maternal exposure to ambient air pollution and pregnancy complications is not well characterized. We aimed to explore the relationship between maternal exposure to ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) and hypertensive disorders of pregnancy, gestational diabetes mellitus (GDM) and placental abruption. Using administrative data, we defined a state-wide cohort of singleton pregnancies born between 1 March 2012 and 31 December 2015 in Victoria, Australia. Annual average NO2 and PM2.5 was assigned to maternal residence at the time of birth. 285,594 singleton pregnancies were included. An IQR increase in NO2 (3.9 ppb) was associated with reduced likelihood of hypertensive disorders of pregnancy (RR 0.89 95%CI 0.86, 0.91), GDM (RR 0.92 95%CI 0.90, 0.94) and placental abruption (RR 0.81 95%CI 0.69, 0.95). Mixed observations and smaller effect sizes were observed for IQR increases in PM2.5 (1.3 µg/m3) and pregnancy complications reduced likelihood of hypertensive disorders of pregnancy (RR 0.95 95%CI 0.93, 0.97), increased likelihood of GDM (RR 1.02 95%CI 1.00, 1.03) and no relationship for placental abruption. In this exploratory study using an annual metric of exposure, findings were largely inconsistent with a priori expectations and further research involving temporally resolved exposure estimates are required.
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-025349
Abstract: Poor health literacy (HL) is associated with poorer health outcomes in diabetes but little is known about its effects on foot disease. This study was aimed to determine the associations between HL and diabetic foot disease. This is a cross-sectional analysis of baseline data from a prospective study of foot disease. Attendees of the Royal Hobart Hospital’s Diabetes outpatient clinics. 222 people with type 1 or type 2 diabetes aged years and without a history of foot disease, psychotic disorders or dementia. Outcomes were peripheral neuropathy, peripheral arterial disease and foot deformity according to published guidelines. The exposure, HL, was measured using the short form Test of Functional Health Literacy in Adults (S-TOFHLA) and the Health Literacy Questionnaire (HLQ). Covariates included demographic characteristics, medical history, psychological measures and foot care behaviour. Of 222 participants, 204 had adequate HL. (Mean (SD) S-TOFHLA scores were 31.9 (6.7)), mean(SD) HLQ scores were 134.4 (18.4)). In univariable but not multivariable analyses, higher S-TOFHLA scores were associated with lower overall risk for foot disease (OR 0.96, 95% CI 0.93 to 0.99) and loss of protective sensation (OR 0.95, 95% CI 0.91 to 0.995). These data provide little support for clinically important impacts of HL on risk factors for diabetic foot disease. However, in the absence of longitudinal data, such effects cannot be ruled out. Longitudinal studies measuring incident foot disease are needed to properly judge the potential for interventions improving HL to reduce the incidence of diabetic foot disease.
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/BT07150
Abstract: Ecological sorting of species along climate and landscape gradients is a fundamental global pattern. However, the extent to which functional traits reflect floristic turnover in response to interactions between climate and landscape gradients is rarely assessed. We tested whether floristic variation among sites within a bioregion was more strongly correlated with soil fertility or climate. We then examined the relationship between floristic composition, environment and the co-variation of selected vegetative and regenerative functional traits. This allowed us to assess the ecological sorting of species along soil fertility and rainfall gradients and to detect any resource compensation effects via interactions between these factors. Floristic differences were equally associated with soil fertility and climate contrasts but species’ trait patterns were more strongly associated with soil fertility than rainfall. No interactive effects, which would suggest resource compensation, were detected. Instead, more fertile sites consistently had more forbs, annuals and grasses in comparison with less fertile sites which were dominated by woody species and had a higher abundance of graminoids. Three broad mechanisms for sorting of species based on trait patterns are proposed (1) differences in the fundamental regenerative and growth niche, (2) resource competition during establishment and (3) disturbance-mediated sorting.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.CANEP.2018.05.005
Abstract: Subsequent primary cancers (SPCs) compete with first cancers and non-cancer events as the primary cause of death among cancer patients. We aimed to assess temporal trends in SPC mortality since 1980 among adult-onset cancer patients in competing risk models. Patients registered with a first cancer in the population-based Tasmanian Cancer Registry, Australia, between 1980-2009 were followed up to December 2014. Cumulative incidence function (CIF) was used to estimate the cumulative incidence of cause-specific deaths in the presence of competing risks. The hazard ratios of SPC-specific deaths were assessed in two regression models: subdistribution hazard ratios from competing risk models (SHRs) and hazard ratios from Cox models (CHRs). Overall, 5339 (9.3%) of 57,288 patients developed SPCs and 2494 died from SPCs during the follow-up. While the cumulative incidence of first cancer deaths at 5, 10, 15 and 20-years gradually decreased over periods of first cancer diagnosis, the cumulative incidence of SPC deaths did not. The SHRs for SPC-specific deaths increased from the reference period 1980-1984 to a peak for first cancers diagnosed in 1995-1999 (SHR = 1.18, 95%CI 1.03-1.35), before a decrease in 2005-2009 (SHR = 0.82, 95%CI 0.70-0.95) in competing risk models. However, this pattern was not consistent in CHRs. For in iduals with specific first cancers, those with a first prostate cancer in 1995-1999 ha d the greatest SPC mortality risk (SHR = 2.08, 95%CI 1.29-3.36). Competing risk models, but not Cox models, demonstrated temporal increases in SPC-specific mortality. Greater detection of non-fatal first prostate cancers appears to have contributed to this trend.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.AMEPRE.2017.10.018
Abstract: This study aimed to determine if beneficial effects of in idualized feedback of fracture risk on osteoporosis preventive behaviors and bone mineral density observed in a 2-year trial were sustained long-term. This was a 10-year follow-up of a 2-year RCT in 470 premenopausal women aged 25-44 years, who were randomized to one of two educational interventions (the Osteoporosis Prevention and Self-Management Course [OPSMC] or an osteoporosis information leaflet) and received tailored feedback of their relative risk of fracture in later life (high versus normal risk groups). Bone mineral density of lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical activity, dietary calcium intake, calcium and vitamin D supplements, and smoking status were measured by questionnaires. From 2 to 12 years, the high-risk group had a smaller decrease in femoral neck bone mineral density (β=0.023, 95% CI=0.005, 0.041 g/cm Feedback of high fracture risk to younger women was associated with long-term improvements in osteoporosis preventive behaviors and attenuated femoral neck bone mineral density loss. Therefore, this could be considered as a strategy to prevent osteoporosis. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
Publisher: Wiley
Date: 02-2022
DOI: 10.1111/IMJ.15066
Abstract: A socioeconomic gradient exists in the utilisation of total hip replacements (THR) and total knee replacements (TKR) for osteoarthritis. However, the relations between socioeconomic status (SES) and time to THR or TKR is unknown. To describe the association between SES and time to THR and TKR. One thousand and seventy-two older adults residing in Tasmania, Australia, were studied. Incident primary THR and TKR were determined by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry. At baseline, each participant's area-level SES was determined using the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) from the Australian Bureau of Statistics' 2001 census data. The IRSAD was analysed in two ways: (i) categorised into quartiles, whereby quartile 1 represented the most socioeconomically disadvantaged group and (ii) the cohort dichotomised at the quartile 1 cut-point. The mean age was 63.0 (±7.5) years and 51% were women. Over the median follow up of 12.9 (interquartile range: 12.2-13.9) years, 56 (5%) participants had a THR and 79 (7%) had a TKR. Compared with the most disadvantaged quartile, less disadvantaged participants were less likely to have a THR (i.e. less disadvantaged participants had a longer time to THR hazard ratio (HR): 0.56 95% confidence interval (CI) 0.32, 1.00) but not TKR (HR: 0.90 95% CI 0.53, 1.54). However, the former became non-significant after adjustment for pain and radiographic osteoarthritis, suggesting that the associations may be mediated by these factors. The present study suggests that time to joint replacement was determined according to the symptoms/need of the participants rather than their SES.
Publisher: Wiley
Date: 12-03-2008
DOI: 10.1111/J.1469-8137.2008.02419.X
Abstract: * Flowering is a critical stage in plant life cycles, and changes might alter processes at the species, community and ecosystem levels. Therefore, likely flowering-time responses to global change drivers are needed for predictions of global change impacts on natural and managed ecosystems. * Here, the impact of elevated atmospheric CO2 concentration ([CO2]) (550 micromol mol(-1)) and warming (+2 masculineC) is reported on flowering times in a native, species-rich, temperate grassland in Tasmania, Australia in both 2004 and 2005. * Elevated [CO2] did not affect average time of first flowering in either year, only affecting three out of 23 species. Warming reduced time to first flowering by an average of 19.1 d in 2004, acting on most species, but did not significantly alter flowering time in 2005, which might be related to the timing of rainfall. Elevated [CO2] and warming treatments did not interact on flowering time. * These results show elevated [CO2] did not alter average flowering time or duration in this grassland neither did it alter the response to warming. Therefore, flowering phenology appears insensitive to increasing [CO2] in this ecosystem, although the response to warming varies between years but can be strong.
Publisher: BMJ
Date: 18-10-2010
DOI: 10.1136/BMJ.C5462
Publisher: Wiley
Date: 25-02-2021
DOI: 10.1002/ACR.24128
Abstract: To describe cross-sectional associations between features observed on ultrasound (US) or clinical joint examination and hand symptoms among community-dwelling older adults (n = 519), and to determine whether such associations are independent of age, sex, body mass index, and other imaging features. Hand pain, function, and stiffness were assessed using a visual analog scale (VAS) and the Australian/Canadian Hand Osteoarthritis (AUSCAN) index. Standardized clinical and US examinations were performed, and grip strength was assessed using a dynamometer. Data were analyzed using hurdle and linear models and adjusted for demographic factors and other features. Abnormal findings on joint examination and on US imaging are common in older adults with and without hand pain. Greater numbers of tender joints were associated with greater pain (VAS: β = 2.63 [95% confidence interval (95% CI) 1.88, 3.39] AUSCAN pain: β = 10.57 [95% CI 4.00, 17.13]), poorer AUSCAN function (β = 4.07 [95% CI 1.28, 6.86]), and poorer grip strength (β = -0.15 [95% CI -0.27, -0.03]). Power Doppler imaging (PDI) synovitis was associated with greater pain (VAS: β = 2.61 [95% CI 1.03, 4.19] AUSCAN pain: β = 13.07 [95% CI 3.82, 22.32]), but not function. Joint deformity was associated with poorer function (β = 4.51 [95% CI 1.75, 7.26]) and grip strength (β = -0.23 [95% CI -0.40, -0.05]), but not pain. Gray-scale synovitis was associated only with poorer grip strength (β = -0.22 [95% CI -0.41, -0.04]). Associations with function and grip strength were partially mediated by pain. Joints that are tender on palpation or have US-identified PDI synovitis are potential treatment targets for hand pain. Treating tender joints and preventing hand deformity is required to improve hand function in community-dwelling older adults.
Publisher: Wiley
Date: 17-11-2023
DOI: 10.1002/ACR.24887
Abstract: To determine associations between chronic plantar heel pain (CPHP) and imaging biomarkers derived from magnetic resonance imaging (MRI) and ultrasonography. We compared 218 participants with CPHP with 100 age- and sex-matched population controls. We assessed imaging biomarkers on MRI (calcaneal bone marrow lesions [BMLs], plantar fascia [PF] signal and thickness, spurs, and fat pad signal) and B-mode ower Doppler ultrasound (PF thickness, echogenicity, and vascularity). Covariate data collected included demographic characteristics, disease history, clinical measures, and physical activity by accelerometry. Data were analyzed using multivariable conditional logistic regression. Plantar calcaneal BML size (mm Calcaneal BMLs and PF imaging biomarkers are associated with CPHP. Further research is required to understand whether these different markers represent distinct phenotypes of heel pain, and if so, whether there are specific treatment implications.
Publisher: Wiley
Date: 04-06-2018
DOI: 10.1002/CNR2.1107
Publisher: Wiley
Date: 25-01-2018
DOI: 10.1002/CNCR.31247
Abstract: The authors' systematic review indicated an increasing trend in the risk of second primary cancers (SPCs) from the 1980s to 2000 when considering studies from the United States and Australia. It is uncertain whether this trend has continued to increase since 2000. The current study was a population-based study of 51,802 in iduals with adult-onset cancers identified in the Tasmanian Cancer Registry. Patients with a first cancer diagnosis made between 1980 and 2009 were followed up to December 2013. SPC risks were quantified using standardized incidence ratios (SIRs) and absolute excess risks (AERs). Trends in SPC risk were assessed using multivariable Poisson models. With a median follow-up of 4.8 years (mean, 6.9 years), a total of 5339 SPCs were observed. The SIRs for any SPC increased from 0.98 (95% confidence interval, 0.90-1.07) after a first cancer diagnosis in 1980 through 1984 to 1.12 (95% confidence interval, 1.05-1.20) in 2005 through 2009. In multivariable Poisson models accounting for patient sex, age at the time of the first cancer diagnosis, follow-up interval, and first cancer type, the trend in SIRs increased significantly from 1980 through 2009 for all SPCs (P for trend <.001) and for specific SPCs of the head and neck, lung, digestive tract, and prostate (all P for trend <.05). From 2000 onward, the AER for specific SPCs after specific first cancers was highest for prostate cancer after first cancers of the urinary tract (AER, 54.3 per 10,000 person-years). In Tasmania, the risk of SPCs among survivors of adult-onset cancers has increased with periods of first cancer diagnosis from 1980 through 2009. Increased cancer screening and improved medical imaging may have contributed to the greater risk in recent years. Cancer 2018 :1808-18. © 2018 American Cancer Society.
Publisher: Elsevier BV
Date: 09-2020
Publisher: Informa UK Limited
Date: 07-2012
DOI: 10.2147/COPD.S32222
Publisher: Springer Science and Business Media LLC
Date: 27-07-2023
DOI: 10.1186/S13047-023-00644-W
Abstract: To determine whether health literacy is associated with an index diabetes-related foot ulcer (DFU). The SHELLED Study is a 4-year prospective study of people with diabetes aged over 40 with no history of DFU. The primary outcome was development of a first foot ulcer. Health Literacy was measured using the short form Test of Functional Health Literacy in Adults (s-TOFHLA) and nine domains of the Health Literacy Questionnaire (HLQ). Of 222 participants, 191 (86.0%) completed the study, of whom 13 (5.9%) developed an incident ulcer. In multivariable models, every unit increase in S-TOFHLA was associated with a reduced odds of foot ulcer development by 6% (OR 0.94, 95% CI 0.88 to 0.99). Better scores on two HLQ domains reduced the odds of foot ulcer ( actively managing my health (OR 0.23, 95% CI 0.08 to 0.65) and understanding health information well enough to know what to do (OR 0.39, 95% CI 0.19 to 0.78). This was independent of baseline risk for foot disease. These data provide novel evidence that health literacy is an important clinical risk factor for index foot ulceration. This is an area of potential focus for research and development of educational programs or policy aimed at reducing development of incident foot ulceration.
Publisher: Wiley
Date: 12-10-2019
DOI: 10.1002/CNCR.31806
Abstract: With improved cancer survivorship, cardiovascular disease (CVD) and other noncancer events compete with cancer as the underlying cause of death, but the risks of mortality in competing-risk settings have not been well characterized. The authors identified 21,637 in iduals who had a first cancer registered between 2006 and 2013, with follow-up to 2015, in the Australian population-based Tasmanian Cancer Registry. The cumulative incidence of deaths from specific competing events was assessed in competing-risk analyses. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) for deaths from noncancer causes were calculated for comparison with the general population. Overall, 8844 deaths were observed, with 1946 (22%) from competing events. The cumulative incidence of deaths from CVD increased significantly with age at first cancer diagnosis and exceeded other competing events at age ≥65 years. The risk of death from CVD was more common than expected in the first year of follow-up (SMR, 1.44 [95% confidence interval, 1.26-1.64] AER, 36.8 per 10,000 person-years). The SMR and AER for CVD deaths varied by first cancer site, indicating increased risks after a first diagnosis of lung cancer, hematologic malignancy, and urinary tract cancer. For other noncancer events, the SMRs increased significantly for deaths from infectious disease and respiratory disease and were highest in the first year of follow-up. CVD was the leading cause of competing mortality among Tasmanian patients with cancer who were diagnosed from 2006 to 2013. The higher than expected occurrence of death from CVD and other noncancer events during the first year after a cancer diagnosis highlights the importance of early preventive interventions.
Publisher: Wiley
Date: 31-01-2008
Publisher: Springer Science and Business Media LLC
Date: 26-02-2016
DOI: 10.1007/S00198-016-3545-3
Abstract: This was the first study investigating both linear associations between lower limb muscle strength and balance in middle-aged women and the potential for thresholds for the associations. There was strong evidence that even in middle-aged women, poorer LMS was associated with reduced balance. However, no evidence was found for thresholds. Decline in balance begins in middle age, yet, the role of muscle strength in balance is rarely examined in this age group. We aimed to determine the association between lower limb muscle strength (LMS) and balance in middle-aged women and investigate whether cut-points of LMS exist that might identify women at risk of poorer balance. Cross-sectional analysis of 345 women aged 36-57 years was done. Associations between LMS and balance tests (timed up and go (TUG), step test (ST), functional reach test (FRT), and lateral reach test (LRT)) were assessed using linear regression. Nonlinear associations were explored using locally weighted regression smoothing (LOWESS) and potential cut-points identified using nonlinear least-squares estimation. Segmented regression was used to estimate associations above and below the identified cut-points. Weaker LMS was associated with poorer performance on the TUG (β -0.008 (95 % CI: -0.010, -0.005) second/kg), ST (β 0.031 (0.011, 0.051) step/kg), FRT (β 0.071 (0.047, 0.096) cm/kg), and LRT (β 0.028 (0.011, 0.044) cm/kg), independent of confounders. Potential nonlinear associations were evident from LOWESS results significant cut-points of LMS were identified for all balance tests (29-50 kg). However, excepting ST, cut-points did not persist after excluding potentially influential data points. In middle-aged women, poorer LMS is associated with reduced balance. Therefore, improving muscle strength in middle-age may be a useful strategy to improve balance and reduce falls risk in later life. Middle-aged women with low muscle strength may be an effective target group for future randomized controlled trials. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
Publisher: Public Library of Science (PLoS)
Date: 20-04-2022
DOI: 10.1371/JOURNAL.PONE.0267265
Abstract: To identify factors that predict poor health literacy amongst people with diabetes. Cross-sectional analysis of baseline data from a prospective study of diabetic foot disease. Patients attending a tertiary hospital diabetes outpatient clinic in Tasmania, Australia. 222 people with diabetes mellitus, aged years, with no history of foot ulceration, psychotic disorders or dementia. Health literacy was measured using the short form Test of Functional Health Literacy in Adults (functional health literacy), and the Health Literacy Questionnaire (HLQ), which measures nine domains of health literacy. Predictors included demographic characteristics, cognition, diabetes distress, depression, and educational attainment. In multivariable analysis, greater educational attainment (OR 0.88, 95% CI 0.76, 0.99) and poorer cognition (OR 0.71, 95% CI 0.63, 0.79) were associated with poorer functional health literacy. Age was negatively associated with domains of appraisal of health information and ability to find good health information (both beta = -0.01). Educational attainment was positively associated with four domains, namely having sufficient information to manage my health, actively managing my health, appraisal of and ability to find good health information (beta ranging from +0.03 to 0.04). Diabetes distress was negatively associated with five domains: having sufficient information to manage my health, social support for health, ability to actively engage with healthcare providers, navigating the healthcare system and ability to find good health information (beta ranging from -0.14 to -0.18). Poorer cognition and poorer educational attainment may be detrimental for an in idual’s functional health literacy, and education, diabetes distress and older age detrimental across multiple health literacy domains. Clinicians and policy makers should be attuned to these factors when communicating with people with diabetes and in designing healthcare systems to be more health-literacy friendly in order to improve diabetes outcomes.
Publisher: Springer Science and Business Media LLC
Date: 16-10-2018
DOI: 10.1007/S10689-017-0047-1
Abstract: Women carrying germline mutations in BRCA1 or BRCA2 have significantly increased lifetime risks of breast and tubo-ovarian cancer. To manage the breast cancer risk women may elect to have breast screening by MRI/mammogram from age 30, to take risk-reducing medication, or to have a prophylactic bilateral mastectomy. To manage the tubo-ovarian cancer risk, the only effective strategy is to have a bilateral salpingo-oophorectomy, recommended by age 40 (BRCA1) or 'around' age 40 (BRCA2). Early studies suggested that uptake of these cancer risk-reducing strategies was low. More recent studies have revealed higher rates of uptake, however it is unclear whether uptake is genuinely improving or whether the higher uptake rates reflect changes in the populations studied. In this study we surveyed 193 BRCA1/2 mutation carriers in the state of Tasmania to determine the uptake of cancer risk-reducing strategies and what factors might influence women's decisions in relation to both gynaecological and breast surgery. We observed that uptake of risk management strategies varied depending on the strength of the recommendation in the national guidelines. Uptake rates were > 90% for strategies which are strongly recommended, such as breast screening by MRI/mammogram and bilateral salpingo-oophorectomy, and were unaffected by demographic factors such as socio-economic disadvantage and educational achievement. Uptake rates were much lower for strategies which are presented in the guidelines as options for consideration and where patient choice and shared decision making are encouraged, such as prophylactic mastectomy (29%) and chemoprevention (1%) and in the case of prophylactic mastectomy, were influenced by both socio-economic advantage and educational achievement.
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/SB06004
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/BT04194
Abstract: The potential impacts of climate change on both natural and managed ecosystems are far-reaching and are only beginning to be understood. Here we describe a new experiment that aims to determine the impacts of elevated concentration of CO2 ([CO2]) and elevated temperature on a native Themeda–Austrodanthonia-dominated grassland ecosystem in south-eastern Tasmania. The experimental site contains 60 vascular plant species. The experiment combines the latest developments in free-air CO2 enrichment (FACE) technology with the use of infrared (IR) heaters to mimic environmental conditions expected to exist in the year 2050. The CO2 concentration in the FACE treatments is reliably maintained at 550 µmol mol–1 and leaf temperature is elevated by an average of 2.1°C by the IR treatment, with 1-cm soil temperature being elevated by 0.8°C. Measurements being made in the experiment cover plant ecophysiological responses, plant population dynamics and community interactions. Soil processes and ecosystem effects, including nutrient cycling and plant animal interactions, are also being investigated. Collaborations are invited from interested parties.
Publisher: Wiley
Date: 20-06-2018
DOI: 10.1111/DME.13694
Abstract: People with diabetes have low health literacy, but the role of the latter in diabetic foot disease is unclear. To determine, through a systematic review and meta-analysis, if health literacy is associated with diabetic foot disease, its risk factors, or foot care. We searched PubMed, EMBASE, CINAHL, Web of Science, Scopus and Science Direct. All studies were screened and data extracted by two independent reviewers. Studies in English with valid and reliable measures of health literacy and published tests of association were included. Data were extracted on the associations between the outcomes and health literacy. Meta-analyses were performed using random effects models. Sixteen articles were included in the systematic review, with 11 in the meta-analysis. In people with inadequate health literacy, the odds of having diabetic foot disease were twice those in people with adequate health literacy, but this was not statistically significant [odds ratio 1.99 (95% CI 0.83, 4.78) two studies in 1278 participants]. There was no statistically significant difference in health literacy levels between people with and without peripheral neuropathy [standardized mean difference -0.14 (95% CI -0.47, 0.18) two studies in 399 participants]. There was no association between health literacy and foot care [correlation coefficient 0.01 (95% CI -0.07, 0.10) seven studies in 1033 participants]. There were insufficient data to exclude associations between health literacy and diabetic foot disease and its risk factors, but health literacy appears unlikely to have a role in foot care. The contribution of low health literacy to diabetic foot disease requires definitive assessment through robust longitudinal studies.
Publisher: Wiley
Date: 20-07-2007
DOI: 10.1111/J.1469-8137.2007.02170.X
Abstract: DOI: 10.1111/j.1469-8137.2007.02224.x Commentary p 235
Publisher: Springer Science and Business Media LLC
Date: 10-08-2023
DOI: 10.1007/S11136-023-03498-8
Abstract: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic condition with a constellation of symptoms presenting as severe and profound fatigue of ≥ 6 months not relieved by rest. ME/CFS affects health-related quality of life (HRQoL), which can be measured using multi-attribute health state utility (HSU) instruments. The aims of this study were to quantify HSUs for people living with ME/CFS, and to identify an instrument that is preferentially sensitive for ME/CFS. Cross-sectional national survey of people with ME/CFS using the AQoL-8D and EQ-5D-5L. Additional questions from the AQoL-8D were used as ‘bolt-ons’ to the EQ-5D-5L (i.e., EQ-5D-5L-Psychosocial). Disability and fatigue severity were assessed using the De Paul Symptom Questionnaire-Short Form (DSQ-SF). HSUs were generated using Australian tariffs. Mean HSUs were stratified for sociodemographic and clinical factors. Bland–Altman plots were used to compare the three HSU instruments. For the 198 participants, mean HSUs (95% confidence intervals) were EQ-5D-5L: 0.46 (0.42–0.50) AQoL-8D: 0.43 (0.41–0.45) EQ-5D-5L-Psychosocial: 0.44 (0.42–0.46). HSUs were substantially lower than population norms: EQ-5D-5L: 0.89 AQoL-8D: 0.77. As disability and fatigue severity increased, HSUs decreased in all three instruments. Bland–Altman plots revealed interchangeability between the AQoL-8D and EQ-5D-5LPsychosocial. Floor and ceiling effects of 13.5% and 2.5% respectively were observed for the EQ-5D-5L instrument only. ME/CFS has a profound impact on HRQoL. The AQoL-8D and EQ-5D-5L-Psychosocial can be used interchangeably: the latter represents a reduced participant burden.
Publisher: The Royal Australian College of General Practitioners
Date: 06-2021
Publisher: Wiley
Date: 25-11-2017
DOI: 10.1002/JBMR.3028
Abstract: Associations between physical activity and time spent sedentary and musculoskeletal outcomes remain unclear in middle-aged adults. This study aimed to describe associations between objectively-measured physical activity and sedentary time and musculoskeletal health outcomes in middle-aged women. This cross-sectional study from a population-based s le of 309 women (age 36 to 57 years) examined associations of total physical activity (accelerometer counts/min of wear time), and time spent sedentary, in light physical activities and moderate-to-vigorous physical activities (MVPA) (by Actigraph GT1M accelerometer) with lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD) (by dual-energy X-ray absorptiometry), lower limb muscle strength (LMS), and functional mobility and balance tests (timed up and go test [TUG], functional reach test [FRT], lateral reach test [LRT], and step test [ST]) using linear regression. Total physical activity was beneficially associated with FN BMD (values are β 95% CI) (0.011 g/cm
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/BT07107
Abstract: Long-term effects of climate change on plant communities must be mediated by reproductive and recruitment responses of component species. From spring 2003 until autumn 2006, we monitored flowering and seed-production responses to free air CO2 enrichment (FACE) and 2°C warming in a species-rich, nutrient-poor southern temperate grassland, by using the TasFACE experiment. There were no effects of either FACE or warming on the proportion of species flowering in any year. Flowering, seed production and seed mass were not significantly affected by FACE, warming or their interaction in most species. Some species, however, did respond significantly to simulated global changes. These responses generally were not governed by life history, but there were two distinct trends. First, warming increased the proportion of the population that flowered in perennial grasses but not in other species types. Second, flowering and seed production of both perennial woody dicots responded strongly to the interaction of FACE and warming, with Bossiaea prostrata producing most seeds in warmed FACE plots and Hibbertia hirsuta producing the most in unwarmed FACE plots. FACE increased seed mass 4-fold in the perennial C3 grass Elymus scaber (P 0.01) but substantially reduced seed mass of the perennial C3 grass Austrodanthonia caespitosa (P 0.02) and the perennial forb Hypochaeris radicata (P 0.02), with the remainder of species unaffected. Our results indicate that warming and elevated CO2 had little effect on seed production in the temperate grassland ecosystem. The few significant affects there were, however, are likely to have substantial implications for community composition and structure.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.ENVINT.2019.03.028
Abstract: The Hazelwood coal mine fire was an unprecedented event in Australian history that resulted in the surrounding towns in regional Victoria being covered in plumes of smoke and ash for six weeks in 2014. Evidence concerning adverse reproductive impacts associated with maternal exposure to ambient air pollution is expanding. Gaps remain regarding the relative impact of acute changes in outdoor air quality lasting days to months, such as that resulting from coal mine fires. Routinely collected perinatal data was used to define a complete cohort of singleton babies born within the affected region. Maternal average, and peak, fine particulate matter (PM There were a total of 3591 singleton livebirths during the study period 763 of which were in utero during the coal mine fire. Average PM Maternal exposure to fine particulate matter resulting from the 2014 Hazelwood coal mine fire did not appear to adversely effect fetal maturity. However, there was weak evidence of a trophic response among babies born to exposed mothers with gestational diabetes, a possible susceptibility that requires further exploration.
Publisher: Wiley
Date: 02-09-2008
DOI: 10.1111/J.1469-8137.2008.02563.X
Abstract: In a water-limited system, the following hypotheses are proposed: warming will increase seedling mortality elevated atmospheric CO2 will reduce seedling mortality by reducing transpiration, thereby increasing soil water availability and longevity (i.e. whether a species is annual or perennial) will affect the response of a species to global changes. Here, these three hypotheses are tested by assessing the impact of elevated CO2 (550 micromol mol(-1) and warming (+2 degrees C) on seedling emergence, survivorship and establishment in an Australian temperate grassland from autumn 2004 to autumn 2007. Warming impacts on seedling survivorship were dependent upon species longevity. Warming reduced seedling survivorship of perennials through its effects on soil water potential but the seedling survivorship of annuals was reduced to a greater extent than could be accounted for by treatment effects on soil water potential. Elevated CO2 did not significantly affect seedling survivorship in annuals or perennials. These results show that warming will alter recruitment of perennial species by changing soil water potential but will reduce recruitment of annual species independent of any effects on soil moisture. The results also show that exposure to elevated CO2 does not make seedlings more resistant to dry soils.
Publisher: Wiley
Date: 26-04-2017
DOI: 10.1002/JBMR.3103
Abstract: Poor balance is a risk factor for falls and fracture in older adults, but little is known about modifiable factors affecting balance in younger women. This study aimed to examine whether lower limb muscle strength (LMS) in young women and changes in LMS are independent predictors of balance in middle age. This was an observational 10-year follow-up of 470 women aged 25 to 44 years at baseline who had previously participated in a 2-year population-based randomized controlled trial of osteoporosis education interventions. Linear regression was used to examine the association between baseline LMS (by dynamometer) and change in LMS over 12 years with balance at 12 years (timed up and go test [TUG], step test [ST], functional reach test [FRT], and lateral reach test [LRT]). LMS declined by a mean of 17.3 kg over 12 years. After adjustment for potential confounders, baseline and change in LMS were independently beneficially associated with TUG (β = -0.008 sec/kg, 95% confidence interval [CI] -0.01 to -0.006, and β = -0.006 sec/kg, 95% CI -0.009 to -0.003 for baseline and change, respectively), FRT (β = 0.057 cm/kg, 95% CI 0.030 to 0.084, and β = 0.071 cm/kg, 95% CI 0.042 to 0.101, respectively), and LRT (β = 0.030 cm/kg, 95% CI 0.012 to 0.049, and β = 0.022 cm/kg, 95% CI 0.002 to 0.043, respectively) 12 years later. There was an association between baseline LMS and ST (β = 0.044 steps/kg, 95% CI 0.022 to 0.067) but not between change in LMS and ST. Among young women, greater LMS at baseline and slower decline over time are both associated with better balance in midlife. Analogous to the contributions of peak bone mass and bone loss to fracture risk in older adults, this suggests that both improvement of muscle strength in younger age and prevention of age-related loss of muscle strength could be potentially useful strategies to improve balance and reduce falls in later life. © 2017 American Society for Bone and Mineral Research.
Publisher: Springer Science and Business Media LLC
Date: 07-08-2019
DOI: 10.1038/S41430-018-0264-1
Abstract: We aimed to examine dietary patterns and their longitudinal associations with socio-demographic and lifestyle factors in older adults. A cohort of 1098 participants aged 50-80 years were followed for 5 years. Dietary intake was assessed at baseline, 2.6 and 5 years using a validated food frequency questionnaire. Dietary patterns were identified at baseline using exploratory factor analysis and pattern scores for each calculated using the weighted sum score method. Associations of dietary pattern scores with participants' characteristics were assessed using linear mixed-effects models. The three dietary patterns identified and the food groups of which they were predominantly composed were as follows: a healthy dietary pattern (vegetables, fruits, nuts, and whole grains) a western dietary pattern (pizza, hamburgers, chips, and potatoes) and a meat and vegetable dietary pattern (red meat, fish, poultry, vegetables, potatoes, and legumes). Being a man, unemployed, a current smoker, less educated, and residing in a socially disadvantaged area were associated with lower healthy dietary pattern scores, but these differences lessened over time, except in current smokers (p < 0.03 for interactions with time). Being a man was associated with higher, but being a current smoker with lower western dietary pattern scores (β = 8.0, 95% CI: 5.3,10.7 and - 6.7: - 10.1,- 3.3, respectively). For the meat and vegetable dietary pattern, being a man and a current smoker were associated with lower scores (β = - 24.9, 95% CI: - 44.9,- 4.9 and - 66.8: - 98.3,- 35.3, respectively), while being unemployed was associated with higher scores but this difference lessened over time (p = 0.018 for interaction with time). In older adults, men, smokers, and those experiencing social disadvantage could be target groups for interventions to improve diets.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2016
Publisher: Springer Science and Business Media LLC
Date: 05-12-2020
DOI: 10.1038/S41430-019-0541-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2022
DOI: 10.1186/S12889-022-13929-9
Abstract: ME/CFS is a disorder characterized by recurrent fatigue and intolerance to exertion which manifests as profound post-exertional malaise. Prevalence studies internationally have reported highly variable results due to the 20 + diagnostic criteria. For Australia, the prevalence of ME/CFS based on current case definitions is unknown. To report prevalence of ME/CFS in patients aged ≥ 13 years attending Australian primary care settings for years 2015–2019, and provide context for patterns of primary care attendance by people living with ME/CFS. Conducted in partnership with the Patient Advisory Group, this study adopted a mixed methods approach. De-identified primary care data from the national MedicineInsight program were analyzed. The cohort were regularly attending patients, i.e. 3 visits in the preceding 2 years. Crude prevalence rates were calculated for years 2015–2019, by sex, 10-year age groups, remoteness and socioeconomic status. Rates are presented per 100,000population (95% confidence intervals (CI)). Qualitative data was collected through focus groups and in-depth 1:1 interview. Qualitative evidence identified barriers to reaching diagnosis, and limited interactions with primary care due to a lack of available treatments/interventions, stigma and disbelief in ME/CFS as a condition. In each year of interest, crude prevalence in the primary care setting ranged between 94.9/100,000 (95% CI: 91.5–98.5) and 103.9/100,000 population (95%CI: 100.3–107.7), equating to between 20,140 and 22,050 people living with ME/CFS in Australia in 2020. Higher rates were observed for age groups 50-59 years and 40-49 years. Rates were substantially higher in females (130.0–141.4/100,000) compared to males (50.9–57.5/100,000). In the context of the qualitative evidence, our prevalence rates likely represent an underestimate of the true prevalence of ME/CFS in the Australian primary care setting. ME/CFS affects a substantial number of Australians. Whilst this study provides prevalence estimates for the Australian primary care setting, the qualitative evidence highlights the limitations of these. Future research should focus on using robust case ascertainment criteria in a community setting. Quantification of the burden of disease can be used to inform health policy and planning, for this understudied condition.
Publisher: Springer Science and Business Media LLC
Date: 05-03-2018
DOI: 10.1038/S41598-018-22385-8
Abstract: Repetitive transcranial magnetic stimulation (rTMS) is commonly used to modulate cortical plasticity in clinical and non-clinical populations. Clinically, rTMS is delivered to targeted regions of the cortex at high intensities ( T). We have previously shown that even at low intensities, rTMS induces structural and molecular plasticity in the rodent cortex. To determine whether low intensity rTMS (LI-rTMS) alters behavioural performance, daily intermittent theta burst LI-rTMS (120 mT) or sham was delivered as a priming or consolidating stimulus to mice completing 10 consecutive days of skilled reaching training. Relative to sham, priming LI-rTMS (before each training session), increased skill accuracy (~9%) but did not alter the rate of learning over time. In contrast, consolidating LI-rTMS (after each training session), resulted in a small increase in the rate of learning (an additional ~1.6% each day) but did not alter the daily skill accuracy. Changes in behaviour with LI-rTMS were not accompanied with long lasting changes in brain-derived neurotrophic factor (BDNF) expression or in the expression of plasticity markers at excitatory and inhibitory synapses for either priming or consolidation groups. These results suggest that LI-rTMS can alter specific aspects of skilled motor learning in a manner dependent on the timing of intervention.
Publisher: Springer Science and Business Media LLC
Date: 08-01-2020
DOI: 10.1007/S10067-019-04920-8
Abstract: To identify subgroups of community-dwelling older adults and to assess their longitudinal associations with long-term osteoarthritis (OA) outcomes. 1046 older adults aged 50-80 years were studied. At baseline, body mass index (BMI), pedometer-measured ambulatory activity (AA), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) determined knee pain and information on comorbidities were obtained. Tibial cartilage volume and bone-marrow lesions (BMLs) were assessed using MRI at baseline and 10 years and total knee replacements (TKR) by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry. Latent class analysis was used to determine participant subgroups, considering baseline BMI, AA, pain and comorbidities, and linear mixed-effects or log-binomial models were used to assess the associations. Three subgroups/classes were identified: subgroup 1 (43%): Normal/overweight participants with higher AA, lower pain and lower comorbidities subgroup 2 (32%): Overweight participants with lower AA, mild pain and higher comorbidities subgroup 3 (25%): Obese participants with lower AA, mild pain and higher comorbidities. Subgroup 3 had greater cartilage volume loss (β - 60.56 mm Our findings suggest the existence of homogeneous subgroups of participants and support the utility of identifying patterns of characteristics/risk factors that may cluster together and using them to identify subgroups of people who may be at a higher risk of developing and/or progressing OA. Key Points • Complex interplay among characteristics/factors leads to conflicting evidence between ambulatory activity and knee osteoarthritis. • Distinct subgroups are identifiable based on ambulatory activity, body mass index, knee pain, and comorbidities. • Identifying subgroups can be used to determine those who are at risk of developing rogressing osteoarthritis.
Publisher: BMJ
Date: 09-2013
Publisher: Human Kinetics
Date: 12-2021
Abstract: Background : Socioeconomically disadvantaged women are at an increased risk of sedentary behaviors including television (TV) viewing and computer use, so identifying determinants of these behaviors is important. Methods : Women (n = 4349) self-reported weekly TV and computer time (in minutes per week), sociodemographic, and health data at 3 time points (2007–2013). Mixed-effect negative binomial regression was used to determine the baseline determinants of TV viewing and computer use over time, adjusting for confounders. Results : Over 5 years, median TV viewing decreased while median computer time increased. Cross-sectionally TV viewing was highest among participants classified as obese, with poorer health, current smokers, with lower education, not working, with no income, without partners and with no children and computer time was greater among younger women, living in urban areas, working full time, with higher education, without partners and with no children. Average computer time per year increased among those not working (7%), with lower education (5%), and with children (5%) but decreased among those with higher education (1%). However, no factors were associated with a change in TV viewing over time. Conclusion : Among socioeconomically disadvantaged women, interventions aimed at preventing increases in computer time should consider women with lower education, not working, and with children in their design.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.EXGER.2018.01.026
Abstract: To describe the longitudinal associations between physiological falls risk, and between-person and within-person effects of 25-hydroxyvitamin D (25OHD), physical activity (PA), knee pain and dysfunction in community-dwelling older people. Data for 1053 participants (51% women mean age 63 ± 7.4 years) studied at baseline, 2.5, 5, and 10 years were analysed. Falls risk (Z-score) was measured using the Physiological Profile Assessment. Knee pain and dysfunction were assessed using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC). Moderate-to-vigorous PA (MVPA) was measured using accelerometer. Linear mixed-effect regression models, with adjustment for confounders, were used to estimate the association between physiological falls risk and between-person and within-person effects of PA, 25OHD and WOMAC score. Between-person effects showed that 10-year average physiological falls risk was lower in participants who had a higher 10-year average 25OHD (β = -0.005 per nmol/l, 95% CI: -0.008, -0.002), log-MVPA (β = -0.16 per minute, 95% CI: -0.22, -0.10) and lower mean WOMAC score (β = 0.005 per-unit score, 95% CI: 0.003, 0.01). Within-person effects showed that a higher physiological falls risk at any time-point was associated with higher than average WOMAC score (β = 0.002 per-unit score, 95% CI: 0.0003, 0.004) and lower than average log-MVPA (β = -0.15 per minute, 95% CI: -0.24, -0.06), but not 25OHD, at the same time-point. Having higher WOMAC global score above an in idual's average increases the risk of falling, whereas, increasing one's own MVPA level further reduces their risk of falling. The presence of between-person but not within-person associations for 25OHD suggests the former may be confounded by other factors.
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/BT08142
Abstract: Flowering is a critical stage in plant life cycles, and changes in phenology might alter processes at the species, community and ecosystem levels. Therefore, likely flowering-time responses to global-change drivers are needed for predictions of global-change impacts on natural and managed ecosystems. Predicting responses of species to global changes would be simplified if functional, phylogenetic or biogeographical traits contributed substantially to a species’ response. Here we investigate the role of growth form (grass, graminoid, forb, subshrub), longevity (annual, perennial), origin (native, exotic) and flowering time in determining the impact of elevated [CO2] (550 μmol mol−1) and infrared warming (mean warming of +2°C) on flowering times of 31 co-occurring species of a range of species-types in a temperate grassland in 2004, 2005 and 2007. Warming reduced time to first flowering by an average of 20.3 days in 2004, 2.1 days in 2005 and 7.6 days in 2007 however, the response varied among species and was unrelated to growth form, origin or longevity. Elevated [CO2] did not alter flowering times neither was there any [CO2] by species-type interaction. However, both warming and elevated [CO2] tended to have a greater effect on later-flowering species, with time to first flowering of later-flowering species being reduced by both elevated [CO2] (P 0.001) and warming (P 0.001) to a greater extent than that of earlier-flowering species. These results have ramifications for our predictions of community and ecosystem interactions in native grasslands in response to global change.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JOCA.2018.11.009
Abstract: To describe associations between presence of patellar tendon enthesis (PTE) abnormalities and symptoms, structural abnormalities, and total knee replacement (TKR) in older adult cohort. PTE abnormalities (presence of abnormal bone signal and/or bone erosion), were measured on T2-weighted magnetic resonance (MR) images at baseline in 961 community-dwelling older adults. Knee pain and function limitation were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Bone marrow lesions (BMLs), cartilage volume and defects score, and infrapatellar fat pad (IPFP) area were measured using validated methods. Incidence of TKR was determined by data linkage. Participants with abnormal PTE bone signal and/or erosion was 20%. Cross-sectionally, presence of PTE abnormalities was associated with greater pain intensity while going up and down stairs (β = 0.22 (95% confidence interval (CI) 0.03, 0.41)), greater risk of femoral BMLs (RR = 1.46 (1.12, 1.90)) and worse tibial cartilage defects score (RR = 1.70 (1.16, 2.47), and smaller IPFP area (β = -0.27 (-0.47, -0.06) cm PTE abnormalities are common in older adults. Presence of cross-sectional but not longitudinal associations suggests they are commonly co-exist with other knee structural abnormalities but may not play a major role in symptom development or structural change, excepting tibial BMLs.
Publisher: Springer Science and Business Media LLC
Date: 24-09-2022
DOI: 10.1186/S12889-022-14190-W
Abstract: Little is known about how life events such as changes in parental or employment status influence sedentary behaviour (SB). Women from disadvantaged neighbourhoods are at particular risk of poor health, therefore, in this population group this study aimed to determine between changes in parental and employment status with sitting, television viewing (TV), and computer time. Women (18–45 years) from socioeconomically disadvantaged neighbourhoods self-reported their employment status, number of children, sitting, TV, and computer time [(baseline ( n = 4349), three ( n = 1912) and 5 years ( n = 1560)]. Linear (sitting) and negative binomial (TV and computer time) multilevel models adjusted for confounders were used to estimate the SB association with changes in life events. Compared to women who never had children during the study period, less sitting and computer time was observed for women when number of children remained unchanged, had their first child or additional child, and fewer children ( 18 years). Less TV was observed for women when number of children remained unchanged. Compared to women who remained employed full-time during the study period, sitting and computer time decreased among women when they decreased or increased their working hours or when remained employed part-time/not working. TV time increased among women when they decreased their working hours. Among women, declines in SB were observed amongst those experiencing life events. Interventions to decrease SB may consider targeting women with no children, and future research should further explore how changes in employment type (e.g., non-manual to manual jobs) impact SB.
Publisher: Wiley
Date: 06-2005
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.BJA.2018.02.010
Abstract: Severely obese parturients have increased 'cannot intubate, cannot oxygenate' risk during Caesarean section under general anaesthesia. Front-of-neck access (FONA) at the cricothyroid membrane (CTM) is definitive management however, attempted FONA can fail. Point-of-care ultrasonography may provide useful information about CTM depth to aid FONA in obesity. This study determined the difference in CTM depth between severely obese and non-obese parturients, utilising ultrasonography. In this prospective observational study, two anaesthetists performed airway ultrasonography on 15 severely obese (BMI >45 kg m CTM depth measured in the transverse plane with head extended and nil transducer pressure was significantly greater in severely obese parturients, mean 18.0 mm (95% confidence interval 16.3-19.8), vs 10.6 mm (8.81-12.4) in non-obese (P<0.001) mean difference 7.4 mm (4.9-9.9 P<0.001). CTM depths were increased in the severely obese group regardless of scanning plane, head and neck position, or transducer pressure (all P<0.001). There was excellent inter-observer reliability. Cricothyroid membrane depth is significantly increased in severely obese vs normal-weight parturients independently of scanning plane, head and neck position, or transducer pressure.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.ARCHGER.2019.01.015
Abstract: To determine whether older adults with low muscle mass (sarcopenia) and strength (dynapenia), in the presence of osteoporosis/osteopenia, have an increased risk of fracture and mortality over 10 years, compared to those with low muscle or low bone mass alone or with neither condition. 1032 participants (52% women mean age 62.9 ± 7.4 years) were prospectively followed for 10 years. Mortality was ascertained from the death registry and fractures were self-reported. Baseline appendicular lean mass (ALM) was assessed using dual-energy X-ray absorptiometry and normalised to body mass index (BMI). Hand grip strength (HGS) was assessed by dynamometer. Osteosarcopenia and osteodynapenia were defined as having T-scores of the total hip and/or lumbar spine bone mineral density (BMD) < -1 combined with being in the lowest 20% of the sex-specific distribution for ALM/BMI or HGS respectively. Incident fracture risk was significantly higher in participants who were osteodynapenic (RR = 2.07, 95% CI: 1.26-3.39), dynapenic alone (RR = 1.74, 95% CI: 1.05-2.87), and osteopenic alone (RR = 1.63, 95% CI: 1.15-2.31), compared to those without dynapenia or osteopenia. Mortality risk was significantly higher only in participants with osteosarcopenia (RR = 1.49, 95% CI: 1.01-2.21) compared to those without sarcopenia or osteopenia. However, osteosarcopenia and osteodynapenia did not lead to a significantly greater fracture or mortality risk compared to having these conditions on their own. These findings suggest that the combined effect of osteopenia and sarcopenia or dynapenia on fracture and mortality risk, respectively, may not be greater than that of each in idual condition.
Publisher: Springer Science and Business Media LLC
Date: 18-11-2017
DOI: 10.1007/S12603-016-0843-6
Abstract: Purpose: To compare the performance of low muscle mass and function with falls risk, incident fracture and mortality over 10 years. 1041 participants (50% women mean age 63±7.5 years) were prospectively followed for 10 years. Falls risk was measured using the Physiological Profile Assessment, fractures were self-reported and mortality was ascertained from the death registry. Appendicular lean mass (ALM) was assessed using dual energy X-ray absorptiometry. Four anthropometric: (ALM/height2, ALM/body mass index, ALM/weight×100, a residuals method of ALM on height and total body fat) and four performance-based measures: (handgrip strength, lower-limb muscle strength, upper and lower-limb muscle quality) were examined. Participants in the lowest 20% of the sex-specific distribution for each anthropometric and performance-based measure were classified has having low muscle mass or function. Regression analyses were used to estimate associations between each anthropometric and performance-based measure at baseline and 10-year falls risk, incident fractures and mortality. Mean falls risk z-score at 10 years was 0.64 (SD 1.12), incident fractures and mortality over 10 years were 16% and 14% respectively. All baseline performance-based measures were significantly associated with higher falls risk score at 10 years. Low handgrip (RR 1.55, 95% CI: 1.09, 2.20) and ALM/body mass index (RR 1.54, 95% CI: 1.14, 2.08) were the only significant predictors of fracture and mortality respectively. Low handgrip strength, a simple and inexpensive test could be considered in clinical settings for identifying future falls and fractures. ALM/ body mass index could be most suitable in estimating 10-year mortality risk, but requires specialised equipment.
Publisher: MDPI AG
Date: 27-04-2021
Abstract: Background: Our aim was to describe patterns of sitting over time and determine the sociodemographic predictors of sitting over time among women living in socioeconomically disadvantaged neighbourhoods. Methods: Women age between 18 and 45 years (mean = 34.4 ±8.1, n = 4349) reported their sitting time, sociodemographic (e.g., age), and health (e.g., body mass index) three times over 5 years. Linear mixed modelling was used to determine the predictors of change in sitting over time, adjusting for covariates. Results: Mean baseline sitting time was 40.9 h/week, decreasing to 40.1 h/week over five years. Greater sitting time was reported in participants ≤25 years of age, living with obesity, living in urban areas, self-reported poor/fair health, working full-time, with higher education, never married and with no children. Annually, the average sitting time decreased by 0.4 h/week (95% CI −0.7 to −0.05) in women working full-time but increased by 0.1 h/week (95% CI −0.2 to 0.6) who were not working. Similarly, annual sitting time decreased by 0.6 h/week (95% CI −0.2 to 1.3) in women with no children but increased by 0.4 h/week (95% CI −0.2 to 0.5) and 0.9 h/week (95% CI 0.3 to 1.3) among those with two and three/more children, respectively. Conclusion: Among disadvantaged women, those not working and with two or more children may be at particular risk for increased sitting time and warrant further attention.
Publisher: Wiley
Date: 09-2015
DOI: 10.1111/IMJ.12816
Abstract: To determine predictors of short- and long-term outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) presenting to hospital. A prospective clinical audit of AECOPD attendances to the only public acute general hospital in Southern Tasmania, Australia. Out of 416 attendances with AECOPD to the emergency department (ED) between November 2006 and July 2008, 150 patients with 218 attendances were followed to March 2009. Predictors of hospital admission from ED, in-hospital death, length of hospital stay, post-discharge mortality and re-attendance rate for AECOPD were the main outcomes. There were no clear differences between patients admitted to hospital and those sent home from ED. Predictors of in-hospital death were initial physiologic parameters, that is, arterial pH, PaCO2 , oxygen saturation and blood pressure. Longer hospital stay was associated with older age, current smoking, hyperglycaemia, lower blood pressure and lower oxygen saturation. Risk of mortality after discharge was associated with a history of myocardial infarction, nursing home residence and severity of COPD. Re-attendance rate was associated with osteoporosis, younger age and severity of COPD. Further investigation into the process of decision making about which AECOPD patients are admitted from the ED is required. Short-term outcomes, in-hospital death and length of hospital stay are mainly predicted by severity of the acute exacerbation and patient demographics. Although severity of COPD was a predictor of long-term outcomes, the main predictors of these were presence of co-morbidities.
Publisher: Springer Science and Business Media LLC
Date: 16-11-2021
Publisher: Springer Science and Business Media LLC
Date: 14-11-2021
Publisher: Wiley
Date: 26-03-2008
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 09-2021
Publisher: F1000 Research Ltd
Date: 07-06-2018
DOI: 10.12688/F1000RESEARCH.14577.1
Abstract: Background: Acute cardiogenic pulmonary edema (ACPE) is characterized by acute breathlessness and hypoxia and is associated with poor prognosis. Standard pre-hospital management of ACPE includes high-flow oxygen, nitroglycerin and, in severe cases, assisted ventilation. Patients with ACPE can be supported with newer modalities of non-invasive ventilation, specifically continuous positive airway pressure (CPAP). The aim of this study was to determine whether patients with ACPE treated with CPAP plus low-flow oxygen pre-hospitally have a lower mortality rate than those treated conventionally. Methods: This study was a pre-hospital randomised, non-blinded controlled trial conducted July 2009–July 2010. Included were all participants transported by ambulance and admitted to the Royal Hobart Hospital, Tasmania, Australia. The study population was consecutive persons ≥18 years of age with sudden onset of severe respiratory distress, diagnosed as ACPE. Patients were included if they required ventilatory assistance. Patients required a GCS and blood pressure mmHg systolic to safely receive CPAP. The primary outcome was pre- or in-hospital mortality. Results: In total, 50 patients were enrolled with mean age of 79.8 (±11.9) years. There were two deaths (8.3%) in the CPAP arm and nine (34.6%) in the control arm (RR, −0.24 95% CI, 0.06–1.00 p=0.051) with a number needed to treat of 4. CPAP plus low-flow oxygen was significantly less likely to result in respiratory acidosis (mean difference in pH, −0.11 95% CI, −0.04–−0.17 p=0.002), with elevated pCO 2 (mean difference, −10.0 mmHg 95% CI, −19.2–−0.78 p=0.026). The length of hospital stay was significantly shorter in the surviving patients who received CPAP (ratio of means, 0.45 95% CI, 0.29–0.70 p≤0.001). Discussion: This study, which provides interim results due to early termination of the trial, shows CPAP in the pre-hospital setting for ACPE is practicable and is associated with improved patient outcomes.
Publisher: Springer Science and Business Media LLC
Date: 13-02-2018
DOI: 10.1007/S00223-018-0402-8
Abstract: The aim of this study is to describe the association of bone marrow lesions (BMLs) present on two different MRI sequences with clinical outcomes, cartilage defect progression, cartilage volume loss over 2.7 years, and total knee replacement (TKR) over 13.3 years. 394 participants (50-80 years) were assessed at baseline and 2.7 years. BML presence at baseline was scored on T1-weighted fat-suppressed 3D gradient-recalled acquisition (T1) and T2-weighted fat-suppressed 2D fast spin-echo (T2) sequences. Knee pain, function, and stiffness were assessed using WOMAC. Cartilage volume and defects were assessed using validated methods. Incident TKR was determined by data linkage. BMLs were mostly present on both MRI sequences (86%). BMLs present on T2, T1, and both sequences were associated with greater knee pain and functional limitation (odds ratio = 1.49 to 1.70 all p < 0.05). Longitudinally, BMLs present on T2, T1, and both sequences were associated with worsening knee pain (β = 1.12 to 1.37, respectively p < 0.05) and worsening stiffness (β = 0.45 to 0.52, respectively all p < 0.05) but not worsening functional limitation or total WOMAC. BMLs present on T2, T1, and both sequences predicted site-specific cartilage defect progression (relative risk = 1.22 to 4.63 all p < 0.05) except at the medial tibial and inferior patellar sites. Lateral tibial and superior patellar BMLs present on T2, T1, and both sequences predicted site-specific cartilage volume loss (β = - 174.77 to - 140.67 p < 0.05). BMLs present on T2, T1, and both sequences were strongly associated with incident TKR. BMLs can be assessed on either T2- or T1-weighted sequences with no clinical predictive advantage of either sequence.
Publisher: South African Medical Association NPC
Date: 23-09-2015
DOI: 10.7196/SAJCH.7940
Publisher: Informa UK Limited
Date: 05-2014
DOI: 10.2147/COPD.S63911
Publisher: Springer Science and Business Media LLC
Date: 10-02-2018
Publisher: Springer Science and Business Media LLC
Date: 09-09-2017
DOI: 10.1007/S00198-016-3754-9
Abstract: This was the first study examining optimal vitamin D status for musculoskeletal health in middle-aged women. A 25-hydroxyvitamin D level of at least 29 to 33 nmol/L appears required for optimal musculoskeletal health, but the current cut-off of 50 nmol/L may be warranted. This study aimed to determine whether cut-points exist for associations between serum 25-hydroxyvitamin D (25OHD) and musculoskeletal health outcomes in middle-aged women, below which greater 25OHD levels are associated with musculoskeletal health benefits and above which no such associations exist. This is a cross-sectional study of 344 women aged 36-57 years. Cut-points for associations of serum 25OHD with lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD), lower limb muscle strength (LMS), timed up and go test (TUG), functional reach test (FRT), lateral reach test (LRT), and step test (ST) were explored using locally weighted regression smoothing and nonlinear least-squares estimation, and associations above and below the identified cut-points were estimated using segmented regression. The prevalence of low 25OHD was 28 % (<50 nmol/L). Significant cut-points (nmol/L) were identified for FN BMD 31 (95 % confidence interval (CI): 18, 43), LS BMD 31 (17, 45), TUG 30 (24, 36), ST 33 (24, 31), FRT 31 (18, 43), and LMS 29 (8, 49) but not LRT (42 (-8, 93). Below these cut-points, there were beneficial associations between higher 25OHD level and each outcome, while above the cut-points, there were no beneficial associations. In middle-aged women, there are thresholds for associations between serum 25OHD concentrations and bone density and most balance measures, suggesting that 25OHD levels of at least 29 to 33 nmol/L are required for optimal musculoskeletal health in this population. The current cut-off of 50 nmol/L may be higher than needed for some outcomes but appears warranted overall.
Publisher: Springer Science and Business Media LLC
Date: 28-05-2014
DOI: 10.1038/NATURE13281
Abstract: The rising atmospheric concentration of carbon dioxide (CO2) should stimulate ecosystem productivity, but to what extent is highly uncertain, particularly when combined with changing temperature and precipitation. Ecosystem response to CO2 is complicated by biogeochemical feedbacks but must be understood if carbon storage and associated d ening of climate warming are to be predicted. Feedbacks through the hydrological cycle are particularly important and the physiology is well known elevated CO2 reduces stomatal conductance and increases plant water use efficiency (the amount of water required to produce a unit of plant dry matter). The CO2 response should consequently be strongest when water is limiting although this has been shown in some experiments, it is absent from many. Here we show that large annual variation in the stimulation of above-ground biomass by elevated CO2 in a mixed C3/C4 temperate grassland can be predicted accurately using seasonal rainfall totals summer rainfall had a positive effect but autumn and spring rainfall had negative effects on the CO2 response. Thus, the elevated CO2 effect mainly depended upon the balance between summer and autumn/spring rainfall. This is partly because high rainfall during cool, moist seasons leads to nitrogen limitation, reducing or even preventing biomass stimulation by elevated CO2. Importantly, the prediction held whether plots were warmed by 2 °C or left unwarmed, and was similar for C3 plants and total biomass, allowing us to make a powerful generalization about ecosystem responses to elevated CO2. This new insight is particularly valuable because climate projections predict large changes in the timing of rainfall, even where annual totals remain static. Our findings will help resolve apparent differences in the outcomes of CO2 experiments and improve the formulation and interpretation of models that are insensitive to differences in the seasonal effects of rainfall on the CO2 response.
Publisher: Public Library of Science (PLoS)
Date: 09-12-2021
DOI: 10.1371/JOURNAL.PONE.0260925
Abstract: Chronic plantar heel pain (CPHP) is associated with calcaneal bone spurs, but its associations with other calcaneal bone features are unknown. This study therefore aimed to determine associations between having CPHP and bone density and microarchitecture of the calcaneus. We assessed 220 participants with CPHP and 100 age- and sex-matched population-based controls. Trabecular bone density, thickness, separation and number, BV/TV, and cortical density, thickness and area were measured using a Scanco Xtreme1 HR-pQCT scanner at a plantar and mid-calcaneal site. Clinical, physical activity and disease history data were also collected. Associations with bone outcomes were assessed using multivariable linear regression adjusting for age, sex, physical activity, BMI and ankle plantarflexor strength. We assessed for potential effect modification of CPHP on these covariates using interaction terms. There were univariable associations at the plantar calcaneus where higher trabecular bone density, BV/TV and thickness and lower trabecular separation were associated with CPHP. In multivariable models, having CPHP was not independently associated with any bone outcome, but modified associations of BMI and ankle plantarflexor strength with mid-calcaneal and plantar bone outcomes respectively. Beneficial associations of BMI with mid-calcaneal trabecular density (BMI-case interaction standardised X/unstandardised Y beta -10.8(mgHA/cm 3 ) (se 4.6), thickness -0.002(mm) (se 0.001) and BV/TV -0.009(%) (se 0.004) were reduced in people with CPHP. Beneficial associations of ankle plantarflexor strength with plantar trabecular density (ankle plantarflexor strength -case interaction -11.9(mgHA/cm 3 ) (se 4.4)), thickness -0.003(mm) (se 0.001), separation -0.003(mm) (se 0.001) and BV/TV -0.010(%) (se 0.004) were also reduced. CPHP may have consequences for calcaneal bone density and microarchitecture by modifying associations of BMI and ankle plantarflexor strength with calcaneal bone outcomes. The reasons for these case-control differences are uncertain but could include a bone response to entheseal stress, altered loading habits and/or pain mechanisms. Confirmation with longitudinal study is required.
Publisher: Cambridge University Press (CUP)
Date: 09-10-2017
DOI: 10.1017/S0007114517002483
Abstract: Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36–57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: ‘Healthy’ (high consumption of a plant-based diet – vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), ‘high protein, high fat’ (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and ‘Processed foods’ (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age-related loss of muscle and deterioration in balance, the exploratory nature of the analyses means that confirmation in longitudinal studies and/or trials with pre-specified hypotheses is needed.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.ENVPOL.2018.10.086
Abstract: Little is known about the impacts of maternal exposure to acute episodes of outdoor air pollution, such as that resulting from wildfires, on obstetric and neonatal outcomes. This systematic review aims to synthesise the existing literature exploring the relationship between maternal exposure to short-to medium-term changes in outdoor air quality and obstetric and neonatal outcomes. A systematic search of peer-reviewed articles using PubMed, Cochrane Library, EMBASE, ScienceDirect, Web of Science, ProQuest, GreenFILE and Scopus was conducted in January 2018 using selected search terms. Quality of included studies were assessed using the Newcastle Ottawa Scale. Eleven studies were included eight assessed the impact of maternal exposure to air pollution exacerbation events, such as wildfires, oil well fires and volcanic eruptions, and three assessed the impact of improvement events, such as the 2018 Beijing Olympics and closure of industrial activities, on obstetric and neonatal outcomes. Studies were highly heterogenous in methodology. Six studies found a significant association between acute changes in air quality and markers of fetal growth restriction, while two did not. Three studies found an adverse association between acute changes in air quality and markers of gestational maturity, and one did not. Overall, there is some evidence that maternal exposure to acute changes in air quality of short-to medium-term duration increases the risk of fetal growth restriction and preterm birth. The relationship for other adverse obstetric or neonatal outcomes is less clear.
Publisher: CSIRO Publishing
Date: 2000
DOI: 10.1071/SB99007
Abstract: The taxonomy ofHomopholis C.E.Hubb. is revised, and anew genus Whalleya K.E.Wills & J.J.Bruhl isdescribed. Relationships among the known species ofHomopholis (H. belsonii C.E.Hubb.,H. proluta F.Muell., and a putative species,H. sp. nov.), and the relationships betweenHomopholis and other genera within the Paniceae were investigated. Morphological and anatomical data forHomopholis and selected species ofDigitaria and Panicum were analysed phenetically and cladistically. The value and contribution ofcharacters to the findings were assessed. In the phenetic analyses, threedistinct clusters of species were formed. The first cluster includedDigitaria coenicola (F.Muell.) Hughes,D. aricatissima (R.Br.) Hughes andD. papposa (R.Br.) P.Beauv. the second,Panicum effusum R.Br.,P. queenslandicum Domin var.queenslandicum and P. simileDomin and the third, H. sp. nov.,H. proluta, H. belsonii andP. subxerophilum Domin. Specimens ofH. belsonii noticeably separated from the other threespecies. For the cladistic analyses, species ofEntolasia and Thyridolepis were used as outgroup taxa. One most parsimonious tree was produced.Homopholis belsonii was well supported as the most basalmember of the ingroup. The three species ofDigitariaformed a well-supported clade.Panicum effusum, P. queenslandicumvar. queenslandicum and P. simileformed a well-supported clade, and were the sister group toEntolasia marginata (R.Br.) Hughes andE. stricta (R.Br.) Hughes.Panicum subxerophilum was in a clade (=Whalleya) with H. sp. nov. andH. proluta, with P. subxerophilumand H. proluta as sister species.
No related grants have been discovered for Karen Wills.