ORCID Profile
0000-0002-8570-5493
Current Organisations
University of Adelaide
,
University of South Australia
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Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.MSARD.2021.103412
Abstract: There is minimal information on the utilisation of Disease Modifying Treatment (DMTs) for multiple sclerosis. The appropriate and safe use of medicines is informed by utilisation studies. Outcomes can inform health interventions to improve appropriate use of medicines and post marketing surveillance activities to improve safety. To evaluate utilisation and treatment patterns of disease modifying treatments (DMTs) for relapsing remitting multiple sclerosis (RRMS). A representative s le of the Australian pharmaceutical benefits scheme data were analysed (2006-2016). Demographics of incident users and trends in incident and prevalent users were determined. In idual patient treatment pathways were determined by sequential initiation of medicines in two different periods (2006-2013 and 2014-2019). There were 20,660 patients with at least one dispensing of a DMT for RRMS during the study period (median age 41 years, 75% female). Incident and prevalent use increased by 20% and 88%, respectively. The market was responsive to 13 new listings of DMTs over the study period. Sequential treatment was found for 66% of initiators in 2006-2013 and 28.5% of initiators in 2014-2019. Diverse treatment pathways were found, with 278 and 93 unique sequences in 2006-2013 and 2014-2019, respectively. The availability of new DMTs has influenced both initial treatment choice and prevalence of users. In idualised treatment patterns and exposure to multiple medicines over time will challenge traditional pharmacovigilance systems.
Publisher: Springer International Publishing
Date: 2022
Publisher: Medical Journals Sweden AB
Date: 02-2010
Publisher: SAGE Publications
Date: 08-02-2010
Abstract: Analysis of saccadic eye movements (SEMs) has previously been used to detect drug- and sleep-deprivation-induced sedation, but never in combination. We compared the effects of sleep deprivation and opioids on 10 opioid-naive with nine opioid-tolerant participants. The naive-participant study evaluated the effects of sleep deprivation alone, morphine alone and the combination the tolerant-participant study compared day-to-day effects of alternate-daily-dosed buprenorphine and the combination of buprenorphine on the dosing day with sleep deprivation. Psychomotor impairment was measured using SEMs, a 5-minute pupil adaptation test (PAT), pupil light reflex (PLR) and alertness visual analogue scale (AVAS). The PAT and PLR did not detect sleep deprivation, in contrast to previous studies. Whilst consistently detecting sleep deprivation, the AVAS also detected buprenorphine in the tolerant study, but not morphine in the naive study. SEMs detected morphine alone and sleep deprivation alone as well as an additive interaction in the naive study and the effect of sleep deprivation in the tolerant study. The alternate-day buprenorphine dosing did not alter SEMs. The current study revealed greater SEMs, but not AVAS impairment in tolerant versus naive participants. The current study demonstrates that objective measures provide additional information to subjective measures and thus should be used in combination.
Publisher: Wiley
Date: 05-03-2016
DOI: 10.1111/AJD.12294
Abstract: We evaluated and compared patients' long-term adherence to biological therapies in a real-life clinical setting. Secondary aims included weight changes on biological therapy and reporting adverse effects. This prospective case-note review included 58 patients, undergoing 84 treatment series including etanercept (21), adalimumab (24), infliximab (14) and ustekinumab (25). Patients' adherence was greatest with ustekinumab (being 6.7-fold less likely to withdraw from treatment than etanercept, P = 0.014), while the difference in treatment adherence of adalimumab and infliximab compared to etanercept was not statistically significant. Adalimumab and infliximab were associated with an increase in weight, while ustekinumab was associated with weight loss compared with etanercept (not statistically significant). Long-term patient adherence to biologic therapy in patients with psoriasis is greatest with ustekinumab.
Publisher: Frontiers Media SA
Date: 24-11-2022
DOI: 10.3389/FNHUM.2022.1051793
Abstract: Physical activity, sedentary behaviour and sleep are associated with cognitive function in older adults. However, these behaviours are not independent, but instead make up exclusive and exhaustive components of the 24-h day. Few studies have investigated associations between 24-h time-use composition and cognitive function in older adults. Of these, none have considered how the quality of sleep, or the context of physical activity and sedentary behaviour may impact these relationships. This study aims to understand how 24-h time-use composition is associated with cognitive function across a range of domains in healthy older adults, and whether the level of recreational physical activity, amount of television (TV) watching, or the quality of sleep impact these potential associations. 384 healthy older adults (age 65.5 ± 3.0 years, 68% female, 63% non-smokers, mean education = 16.5 ± 3.2 years) participated in this study across two Australian sites (Adelaide, n = 207 Newcastle, n = 177). Twenty-four-hour time-use composition was captured using triaxial accelerometry, measured continuously across 7 days. Total time spent watching TV per day was used to capture the context of sedentary behaviours, whilst total time spent in recreational physical activity was used to capture the context of physical activity (i.e., recreational accumulation of physical activity vs. other contexts). Sleep quality was measured using a single item extracted from the Pittsburgh Sleep Quality Index. Cognitive function was measured using a global cognition index (Addenbrooke’s Cognitive Examination III) and four cognitive domain composite scores (derived from five tests of the Cambridge Neuropsychological Test Automated Battery: Paired Associates Learning One Touch Stockings of Cambridge Multitasking Reaction Time Verbal Recognition Memory). Pairwise correlations were used to describe independent relationships between time use variables and cognitive outcomes. Then, compositional data analysis regression methods were used to quantify associations between cognition and 24-h time-use composition. After adjusting for covariates and false discovery rate there were no significant associations between time-use composition and global cognition, long-term memory, short-term memory, executive function, or processing speed outcomes, and no significant interactions between TV watching time, recreational physical activity engagement or sleep quality and time-use composition for any cognitive outcomes. The findings highlight the importance of considering all activities across the 24-h day against cognitive function in older adults. Future studies should consider investigating these relationships longitudinally to uncover temporal effects.
Publisher: Elsevier BV
Date: 06-2023
Publisher: JMIR Publications Inc.
Date: 17-10-2018
Abstract: o date, many online health behavior programs developed by researchers have not been translated at scale. To inform translational efforts, health researchers must work with marketing experts to design cost-effective marketing c aigns. It is important to understand the characteristics of end users of a given health promotion program and identify key market segments. his study aimed to describe the characteristics of the adopters of Active Team, a gamified online social networking physical activity app, and identify potential market segments to inform future research translation efforts. articipants (N=545) were Australian adults aged 18 to 65 years who responded to general advertisements to join a randomized controlled trial (RCT) evaluating the Active Team app. At baseline they provided demographic (age, sex, education, marital status, body mass index, location of residence, and country of birth), behavioral (sleep, assessed by the Pittsburgh Quality Sleep Index) and physical activity (assessed by the Active Australia Survey), psychographic information (health and well-being, assessed by the PERMA [Positive Emotion, Engagement, Relationships, Meaning, Achievement] Profile depression, anxiety and stress, assessed by the Depression, Anxiety, and Stress Scale [DASS-21] and quality of life, assessed by the 12-Item Short Form Health Survey [SF-12]). Descriptive analyses and a k-medoids cluster analysis were performed using the software R 3.3.0 (The R Foundation) to identify key characteristics of the s le. luster analyses revealed four clusters: (1) younger inactive women with poor well-being (218/545), characterized by a higher score on the DASS-21, low mental component summary score on the SF-12, and relatively young age (2) older, active women (153/545), characterized by a lower score on DASS-21, a higher overall score on the SF-12, and relatively older age (3) young, active but stressed men (58/545) with a higher score on DASS-21 and higher activity levels and (4) older, low active and obese men (30/545), characterized by a high body mass index and lower activity levels. nderstanding the characteristics of population segments attracted to a health promotion program will guide the development of cost-effective research translation c aigns. ustralian New Zealand Clinical Trial Registry ACTRN12617000113358 www.anzctr.org .au/Trial/Registration/TrialReview.aspx?id=371463 R2-10.1186/s12889-017-4882-7
Publisher: Elsevier BV
Date: 09-2022
Publisher: Cambridge University Press (CUP)
Date: 16-08-2016
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 11-2009
DOI: 10.1302/0301-620X.91B11.22100
Abstract: Dislocation is a common reason for revision following total hip replacement. This study investigated the relationship between the bearing surface and the risk of revision due to dislocation. It was based on 110 239 primary total hip replacements with a diagnosis of osteoarthritis collected by the Australian Orthopaedic Association National Joint Replacement Registry between September 1999 and December 2007. A total of 862 (0.78%) were revised because of dislocation. Ceramic-on-ceramic bearing surfaces had a lower risk of requiring revision due to dislocation than did metal-on-polyethylene and ceramic-on-polyethylene surfaces, with a follow-up of up to seven years. However, ceramic-on-ceramic implants were more likely to have larger prosthetic heads and to have been implanted in younger patients. The size of the head of the femoral component and age are known to be independent predictors of dislocation. Therefore, the outcomes were stratified by the size of the head and age. There is a significantly higher rate of revision for dislocation in ceramic-on-ceramic bearing surfaces than in metal-on-polyethylene implants when smaller sizes (≤ 28 mm) of the head were used in younger patients ( 65 years) (hazard ratio = 1.53, p = 0.041) and also with larger ( 28 mm) and in older patients (≥ 65 years) (hazard ratio = 1.73, p = 0.016).
Publisher: Elsevier BV
Date: 07-2016
Publisher: SAGE Publications
Date: 20-11-2019
Abstract: How people use their time has been linked with their health. For ex le, spending more time being physically active is known to be beneficial for health, whereas long durations of sitting have been associated with unfavourable health outcomes. Accordingly, public health messages have advocated swapping strategies to promote the reallocation of time between parts of the time-use composition, such as “Move More, Sit Less”, with the aim of achieving optimal distribution of time for health. However, the majority of research underpinning these public health messages has not considered daily time use as a composition, and has ignored the relative nature of time-use data. We present a way of applying compositional data analysis to estimate change in a health outcome when fixed durations of time are reallocated from one part of a particular time-use composition to another, while the remaining parts are kept constant, based on a multiple linear regression model on isometric log ratio coordinates. In an ex le, we examine the expected differences in Body Mass Index z-scores for reallocations of time between sleep, physical activity and sedentary behaviour.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Springer Science and Business Media LLC
Date: 23-01-2018
Publisher: JMIR Publications Inc.
Date: 03-06-2019
DOI: 10.2196/12484
Publisher: Wiley
Date: 20-05-2022
DOI: 10.1002/PDS.5450
Publisher: Public Library of Science (PLoS)
Date: 07-09-2022
DOI: 10.1371/JOURNAL.PONE.0272343
Abstract: Reallocations of time between daily activities such as sleep, sedentary behavior and physical activity are differentially associated with markers of physical, mental and social health. An in idual’s most desirable allocation of time may differ depending on which outcomes they value most, with these outcomes potentially competing with each other for reallocations. We aimed to develop an interactive app that translates how self-selected time reallocations are associated with multiple health measures. We used data from the Australian Child Health CheckPoint study ( n = 1685, 48% female, 11–12 y), with time spent in daily activities derived from a validated 24-h recall instrument, %body fat from bioelectric impedance, psychosocial health from the Pediatric Quality of Life Inventory and academic performance (writing) from national standardized tests. We created a user-interface to the compositional isotemporal substitution model with interactive sliders that can be manipulated to self-select time reallocations between activities. The time-use composition was significantly associated with body fat percentage (F = 2.66, P .001), psychosocial health (F = 4.02, P .001), and academic performance (F = 2.76, P .001). Dragging the sliders on the app shows how self-selected time reallocations are associated with the health measures. For ex le, reallocating 60 minutes from screen time to physical activity was associated with -0.8 [95% CI -1.0 to -0.5] %body fat, +1.9 [1.4 to 2.5] psychosocial score and +4.5 [1.8 to 7.2] academic performance. Our app allows the health associations of time reallocations to be compared against each other. Interactive interfaces provide flexibility in selecting which time reallocations to investigate, and may transform how research findings are disseminated.
Publisher: Medical Journals Sweden AB
Date: 02-2010
Publisher: Springer Science and Business Media LLC
Date: 28-08-2021
DOI: 10.1186/S12891-021-04561-6
Abstract: Despite well-established benefits of physical activity for knee osteoarthritis (OA), nine of ten people with knee OA are inactive. People with knee OA who are inactive often believe that physical activity is dangerous, fearing that it will further damage their joint(s). Such unhelpful beliefs can negatively influence physical activity levels. We aim to evaluate the clinical- and cost-effectiveness of integrating physiotherapist-delivered pain science education (PSE), an evidence-based conceptual change intervention targeting unhelpful pain beliefs by increasing pain knowledge, with an in idualised walking, strengthening, and general education program. Two-arm, parallel-design, multicentre randomised controlled trial involving 198 people aged ≥50 years with painful knee OA who do not meet physical activity guideline recommendations or walk regularly for exercise. Both groups receive an in idualised physiotherapist-led walking, strengthening, and OA/activity education program via 4x weekly in-person treatment sessions, followed by 4 weeks of at-home activities (weekly check-in via telehealth), with follow-up sessions at 3 months (telehealth) and 5 and 9 months (in-person). The EPIPHA-KNEE group also receives contemporary PSE about OA ain and activity, embedded into all aspects of the intervention. Outcomes are assessed at baseline, 12 weeks, 6 and 12 months. Primary outcomes are physical activity level (step count wrist-based accelerometry) and self-reported knee symptoms (WOMAC Total score) at 12 months. Secondary outcomes are quality of life, pain intensity, global rating of change, self-efficacy, pain catastrophising, depression, anxiety, stress, fear of movement, knee awareness, OA/activity conceptualisation, and self-regulated learning ability. Additional measures include adherence, adverse events, blinding success, COVID-19 impact on activity, intention to exercise, treatment expectancy erceived credibility, implicit movement/environmental bias, implicit motor imagery, two-point discrimination, and pain sensitivity to activity. Cost-utility analysis of the EPIPHA-KNEE intervention will be undertaken, in addition to evaluation of cost-effectiveness in the context of primary trial outcomes. We will determine whether the integration of PSE into an in idualised OA education, walking, and strengthening program is more effective than receiving the in idualised program alone. Findings will inform the development and implementation of future delivery of PSE as part of best practice for people with knee OA. Australian New Zealand Clinical Trials Registry: ACTRN12620001041943 (13/10/2020).
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Elsevier BV
Date: 03-2012
Abstract: Preterm human milk-fed infants often experience suboptimal growth despite the use of human milk fortifier (HMF). The extra protein supplied in fortifiers may be inadequate to meet dietary protein requirements for preterm infants. We assessed the effect of human milk fortified with a higher-protein HMF on growth in preterm infants. This is a randomized controlled trial in 92 preterm infants born at <31 wk gestation who received maternal breast milk that was fortified with HMF containing 1.4 g protein/100 mL (higher-protein group) or 1.0 g protein/100 mL (current practice) until discharge or estimated due date, whichever came first. The HMFs used were isocaloric and differed only in the amount of protein or carbohydrate. Length, weight, and head-circumference gains were assessed over the study duration. Length gains did not differ between the higher- and standard-protein groups (mean difference: 0.06 cm/wk 95% CI: -0.01, 0.12 cm/wk P = 0.08). Infants in the higher-protein group achieved a greater weight at study end (mean difference: 220 g 95% CI: 23, 419 g P = 0.03). Secondary analyses showed a significant reduction in the proportion of infants who were less than the 10th percentile for length at the study end in the higher-protein group (risk difference: 0.186 95% CI: 0.370, 0.003 P = 0.047). A higher protein intake results in less growth faltering in human milk-fed preterm infants. It is possible that a higher-protein fortifier than used in this study is needed. This trial was registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au/) as ACTRN12606000525583.
Publisher: SAGE Publications
Date: 30-05-2018
Abstract: The health effects of daily activity behaviours (physical activity, sedentary time and sleep) are widely studied. While previous research has largely examined activity behaviours in isolation, recent studies have adjusted for multiple behaviours. However, the inclusion of all activity behaviours in traditional multivariate analyses has not been possible due to the perfect multicollinearity of 24-h time budget data. The ensuing lack of adjustment for known effects on the outcome undermines the validity of study findings. We describe a statistical approach that enables the inclusion of all daily activity behaviours, based on the principles of compositional data analysis. Using data from the International Study of Childhood Obesity, Lifestyle and the Environment, we demonstrate the application of compositional multiple linear regression to estimate adiposity from children’s daily activity behaviours expressed as isometric log-ratio coordinates. We present a novel method for predicting change in a continuous outcome based on relative changes within a composition, and for calculating associated confidence intervals to allow for statistical inference. The compositional data analysis presented overcomes the lack of adjustment that has plagued traditional statistical methods in the field, and provides robust and reliable insights into the health effects of daily activity behaviours.
Publisher: Springer Science and Business Media LLC
Date: 02-03-2018
No related grants have been discovered for Tyman Stanford.