ORCID Profile
0000-0001-7204-2478
Current Organisations
University of Toronto
,
University of South Australia
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Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.IJNURSTU.2017.03.008
Abstract: No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. Prospective observational. Ten Greater London care homes. Nurses and carers administering medications. Between October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively s led care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). Over 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, p<0.001). Similar differences existed when comparing medication administration error rates between original medication packaging (from original medication packaging-only care homes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration systems (RR=4.3, 95%CI 2.7 to 6.8, p<0.001). A significant difference in error rate was not observed between use of a single or combination medication administration system (p=0.44). The significant difference in, and high overall, medication administration error rate between original medication packaging and multi-compartment compliance aids supports the use of the latter in care homes, as well as local investigation of tablet and capsule impact on medication administration errors and staff training to prevent errors occurring. As a significant difference in error rate was not observed between use of a single or combination medication administration system, common practice of using both multi-compartment compliance aids (for most medications) and original packaging (for medications with stability issues) is supported.
Publisher: Elsevier BV
Date: 05-2020
Publisher: JMIR Publications Inc.
Date: 09-05-2019
Abstract: he success of a mobile phone app in changing health behavior is thought to be contingent on engagement, commonly operationalized as frequency of use. his subgroup analysis of the 2 intervention arms from a 3-group randomized controlled trial aimed to examine user engagement with a 100-day physical activity intervention delivered via an app. Rates of engagement, associations between user characteristics and engagement, and whether engagement was related to intervention efficacy were examined. ngagement was captured in a real-time log of interactions by users randomized to either a gamified (n=141) or nongamified version of the same app (n=160). Physical activity was assessed via accelerometry and self-report at baseline and 3-month follow-up. Survival analysis was used to assess time to nonuse attrition. Mixed models examined associations between user characteristics and engagement (total app use). Characteristics of super users (top quartile of users) and regular users (lowest 3 quartiles) were compared using italic t /italic tests and a chi-square analysis. Linear mixed models were used to assess whether being a super user was related to change in physical activity over time. ngagement was high. Attrition (30 days of nonuse) occurred in 32% and 39% of the gamified and basic groups, respectively, with no significant between-group differences in time to attrition ( italic P /italic =.17). Users with a body mass index (BMI) in the healthy range had higher total app use (mean 230.5, 95% CI 190.6-270.5 italic F /italic sub /sub =8.67 italic P /italic & .001), compared with users whose BMI was overweight or obese (mean 170.6, 95% CI 139.5-201.6 mean 132.9, 95% CI 104.8-161.0). Older users had higher total app use (mean 200.4, 95% CI 171.9-228.9 italic F /italic sub /sub =6.385 italic P /italic =.01) than younger users (mean 155.6, 95% CI 128.5-182.6). Super users were 4.6 years older (t sub /sub =3.6 italic P /italic & .001) and less likely to have a BMI in the obese range (χ sup /sup sub /sub =15.1 italic P /italic & .001). At the 3-month follow-up, super users were completing 28.2 (95% CI 9.4-46.9) more minutes of objectively measured physical activity than regular users ( italic F /italic sub ,272 /sub =4.76 italic P /italic =.03). otal app use was high across the 100-day intervention period, and the inclusion of gamified features enhanced engagement. Participants who engaged the most saw significantly greater increases to their objectively measured physical activity over time, supporting the theory that intervention exposure is linked to efficacy. Further research is needed to determine whether these findings are replicated in other app-based interventions, including those experimentally evaluating engagement and those conducted in real-world settings.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2017
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2017-020895
Abstract: To describe objectively measured sleep characteristics in children aged 11–12 years and in parents and to examine intergenerational concordance of sleep characteristics. Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. Data were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns. Of the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years 88% mothers) and 1077 biological parent–child pairs. Survey weights were applied and statistical methods accounted for the complex s le design, stratification and clustering within postcodes. Parents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent–child concordance was quantified using Pearson’s correlation coefficients in unadjusted models and regression coefficients in adjusted models. The mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent–child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27). These normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent–child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 21-03-2202
DOI: 10.1111/IJPO.13029
Abstract: Evidence shows children gain more weight during the summer holidays versus the school year. To examine within‐child differences in activity and diet behaviours during the summer holidays versus the school year. Children (mean age 9.4 years 37% male) wore accelerometers (GENEActiv n = 133), reported activities (Multimedia Activity Recall for Children and Adolescents n = 133) and parents reported child diet ( n = 133) at five timepoints over 2 years capturing school and summer holiday values. Mixed‐effects models were used to compare school and summer holiday behaviours. Children spent less time in moderate‐ to vigorous‐physical activity (−12 min/day p = 0.001) and sleep (−12 min/day p 0.001) and more time sedentary (+27 min/day p 0.001) during summer holidays versus the school year. Screentime (+70 min/day p 0.001), domestic/social activities (+43 min/day p = .001), self‐care (+24 min/day p 0.001), passive transport (+22 min/day p = 0.001) and quiet time (+16 min/day p = 0.012) were higher during the summer holidays, compensating for less time in school‐related activities (−164 min/day p 0.001). Diet quality was lower (−4 points p 0.001) and children consumed fewer serves of fruit (−0.4 serves p 0.001) during the summer holidays versus the school year. Children are displaying poorer activity and diet behaviours during the summer holidays, which may contribute to accelerated weight gain over the holiday period.
Publisher: Elsevier BV
Date: 2021
Publisher: Informa UK Limited
Date: 21-10-2015
DOI: 10.1080/02640414.2014.951067
Abstract: Tudor-Locke and colleagues previously assessed steps/day for 1 year. The aim of this study was to use this data set to introduce a novel approach for the investigation of whether in idual's physical activity exhibits periodicity fluctuating round a mean and, if so, the degree of fluctuation and whether the mean changes over time. Twenty-three participants wore a pedometer for 365 days, recorded steps/day and whether the day was a workday. Fourier transform of each participant's daily steps data showed the physical activity had a periodicity of 7 days in half of the participants, matching the periodicity of the workday pattern. Activity level remained stable in half of the participants, decreased in ten participants and increased in two. In conclusion, the 7-day periodicity of activity in half of the participants and correspondence with the workday pattern suggest a social or environmental influence. The novel analytical approach introduced herein allows the determination of the periodicity of activity, the degree of variability in activity that is tolerated during day-to-day life and whether the activity level is stable. Results from the use of these methodologies in larger data sets may enable a more focused approach to the design of interventions that aim to increase activity.
Publisher: SAE International
Date: 12-06-2007
DOI: 10.4271/2007-01-2487
Publisher: Elsevier BV
Date: 08-2021
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.INJURY.2017.05.024
Abstract: Tibial plateau fractures are complex and the current evidence for postoperative rehabilitation is weak, especially related to the recommended postoperative weight bearing. The primary aim of this study was to investigate if loading in the first 12 weeks of recovery is associated with patient reported outcome measures at 26 and 52 weeks postoperative. We hypothesized that there would be no association between loading and patient reported outcome measures. Seventeen patients, with a minimum of 52-week follow-up following fragment-specific open reduction and internal fixation for tibial plateau fracture, were selected for this retrospective analysis. Postoperatively, patients were advised to load their limb to a maximum of 20kg during the first 6 weeks. Loading data were collected during walking using force platforms. A ratio of limb loading (affected to unaffected) was calculated at 2, 6 and 12 weeks postoperative. Knee Injury and Osteoarthritis Scores were collected at 6, 12, 26 and 52 weeks postoperative. The association between loading ratios and patient reported outcomes were investigated. Compliance with weight bearing recommendations and changes in the patient reported outcome measures are described. Fracture reduction and migration were assessed on plain radiographs. No fractures demonstrated any measurable postoperative migration at 52 weeks. Significant improvements were seen in all patient reported outcome measures over the first 52 weeks, despite poor adherence to postoperative weight bearing restrictions. There were no associations between weight bearing ratio and patient reported outcomes at 52 weeks postoperative. Significant associations were identified between the loading ratio at 2 weeks and knee-related quality of life at six months (R
Publisher: Wiley
Date: 28-07-2017
DOI: 10.1111/JGH.13750
Publisher: Therapeutic Guidelines Limited
Date: 06-2018
Publisher: Springer Science and Business Media LLC
Date: 03-2023
DOI: 10.1186/S12966-023-01416-2
Abstract: For adults, vacations represent a break from daily responsibilities of work – offering the opportunity to re-distribute time between sleep, sedentary behaviour, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) across the 24-h day. To date, there has been minimal research into how activity behaviour patterns change on vacation, and whether any changes linger after the vacation. This study examined how daily movement behaviours change from before, to during and after vacations, and whether these varied based on the type of vacation and vacation duration. Data collected during the Annual Rhythms In Adults’ lifestyle and health (ARIA) study were used. 308 adults (mean age 40.4 years, SD 5.6) wore Fitbit Charge 3 fitness trackers 24 h a day for 13 months. Minute-by-minute movement behaviour data were aggregated into daily totals. Multi-level mixed-effects linear regressions were used to compare movement behaviours during and post-vacation (4 weeks) to pre-vacation levels (14 days), and to examine the associations with vacation type and duration. Participants took an average of 2.6 (SD = 1.7) vacations of 12 (SD = 14) days’ ( N = 9778 days) duration. The most common vacation type was outdoor recreation (35%) followed by family/social events (31%), rest (17%) and non-leisure (17%). Daily sleep, LPA and MVPA all increased (+ 21 min [95% CI = 19,24] p 0.001, + 3 min [95% CI = 0.4,5] p 0.02, and + 5 min [95% CI = 3,6] p 0.001 respectively) and sedentary behaviour decreased (-29 min [95% CI = -32,-25] p 0.001) during vacation. Post-vacation, sleep remained elevated for two weeks MVPA returned to pre-vacation levels and LPA and sedentary behaviour over-corrected, with LPA significantly lower for 4 weeks, and sedentary behaviour significantly higher for one week. The largest changes were seen for “rest” and “outdoor” vacations. The magnitude of changes was smallest for short vacations ( 3 days). Vacations are associated with favourable changes in daily movement behaviours. These data provide preliminary evidence of the health benefits of vacations. The study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123).
Publisher: Springer Science and Business Media LLC
Date: 14-03-2023
DOI: 10.1186/S12966-023-01414-4
Abstract: Weather is a potentially important influence on how time is allocated to sleep, sedentary behaviour and physical activity across the 24-h day. Extremes of weather (very hot, cold, windy or wet) can create undesirable, unsafe outdoor environments for exercise or active transport, impact the comfort of sleeping environments, and increase time indoors. This 13-month prospective cohort study explored associations between weather and 24-h movement behaviour patterns. Three hundred sixty-eight adults (mean age 40.2 years, SD 5.9, 56.8% female) from Adelaide, Australia, wore Fitbit Charge 3 activity trackers 24 h a day for 13 months with minute-by-minute data on sleep, sedentary behaviour, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) collected remotely. Daily weather data included temperature, rainfall, wind, cloud and sunshine. Multi-level mixed-effects linear regression analyses (one model per outcome) were used. Ninety thousand eight hundred one days of data were analysed. Sleep was negatively associated with minimum temperature (-12 min/day change across minimum temperature range of 31.2 °C, p = 0.001). Sedentary behaviour was positively associated with minimum temperature (+ 12 min/day, range = 31.2 oC, p = 0.006) and wind speed (+ 10 min/day, range = 36.7 km/h, p 0.001), and negatively associated with sunshine (-17 min/day, range = 13.9 h, p 0.001). LPA was positively associated with minimum temperature (+ 11 min/day, range = 31.2 °C, p = 0.002), cloud cover (+ 4 min/day, range = 8 eighths, p = 0.008) and sunshine (+ 17 min/day, range = 13.9 h, p 0.001), and negatively associated with wind speed (-8 min/day, range = 36.7 km/h, p 0.001). MVPA was positively associated with sunshine (+ 3 min/day, range = 13.9 h, p 0.001) and negatively associated with minimum temperature (-13 min/day, range = 31.2 oC, p 0.001), rainfall (-3 min/day, range = 33.2 mm, p = 0.006) and wind speed (-4 min/day, range = 36.7 km/h, p 0.001). For maximum temperature, a significant ( p 0.05) curvilinear association was observed with sleep (half-U) and physical activity (inverted-U), where the decrease in sleep duration appeared to slow around 23 °C, LPA peaked at 31 oC and MVPA at 27 °C. Generally, adults tended to be less active and more sedentary during extremes of weather and sleep less as temperatures rise. These findings have the potential to inform the timing and content of positive movement behaviour messaging and interventions. The study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123).
Publisher: Springer Science and Business Media LLC
Date: 06-02-2016
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JPEDS.2018.12.030
Abstract: To evaluate how the reallocation of time between sleep, sedentary time, light, and moderate-vigorous activities is associated with children's body composition. Population-based cross-sectional Child Health CheckPoint within the Longitudinal Study of Australian Children (n = 938 11-12 year-olds, 50% boys). Twenty-four hour activity composition via accelerometry (minutes/day of sleep, sedentary time, light, and moderate-to-vigorous physical activity [MVPA]) and 3-part body composition (percentage truncal fat, percentage nontruncal fat, and percentage fat-free mass) via bioelectrical impedance analysis were measured. We estimated differences in 3-part body composition associated with the incremental reallocation of time between activities, using dual-compositional regression models adjusted for sex, age, puberty, and socioeconomic position. Reallocation of time between MVPA and any other activity was strongly associated with differences in body composition. Adverse body composition differences were larger for a given MVPA decrease than were the beneficial differences for an equivalent MVPA increase. For ex le, 15 minutes less MVPA (relative to remaining activities) was associated with absolute percentage differences of +1.7% (95% CI 1.2 2.4) for truncal fat, +0.8% (0.6 1.2) for nontruncal fat, and -2.6% (-3.5 -1.9) for fat-free mass, and a 15-minute increase was associated with -0.7% (-0.9 -0.5) truncal fat, -0.4% (-0.5 -0.3) nontruncal fat, and +1.1% (0.9 1.5) fat-free mass. Reallocations between sleep, sedentary time, and light physical activity were not associated with differences in body composition. Preventing declines in MVPA during inactive periods (eg, holidays) may be an important intervention goal. More MVPA, instead of other activities, may benefit body composition.
Publisher: Springer Science and Business Media LLC
Date: 23-10-2019
DOI: 10.1186/S12889-019-7671-7
Abstract: Emerging evidence suggests that children become fatter and less fit over the summer holidays but get leaner and fitter during the in-school period. This could be due to differences in diet and time use between these distinct periods. Few studies have tracked diet and time use across the summer holidays. This study will measure rates of change in fatness and fitness of children, initially in Grade 4 (age 9 years) across three successive years and relate these changes to changes in diet and time use between in-school and summer holiday periods. Grade 4 Children attending Australian Government, Catholic and Independent schools in the Adelaide metropolitan area will be invited to participate, with the aim of recruiting 300 students in total. Diet will be reported by parents using the Automated Self-Administered 24-h Dietary Assessment Tool. Time use will be measured using 24-h wrist-worn accelerometry (GENEActiv) and self-reported by children using the Multimedia Activity Recall for Children and Adults (e.g. chores, reading, sport). Measurement of diet and time use will occur at the beginning (Term 1) and end (Term 4) of each school year and during the summer holiday period. Fitness (20-m shuttle run and standing broad jump) and fatness (body mass index z -score, waist circumference, %body fat) will be measured at the beginning and end of each school year. Differences in rates of change in fitness and fatness during in-school and summer holiday periods will be calculated using model parameter estimate contrasts from linear mixed effects model. Model parameter estimate contrasts will be used to calculate differences in rates of change in outcomes by socioeconomic position (SEP), sex and weight status. Differences in rates of change of outcomes will be regressed against differences between in-school and summer holiday period diet and time use, using compositional data analysis. Analyses will adjust for age, sex, SEP, parenting style, weight status, and pubertal status, where appropriate. Findings from this project may inform new, potent avenues for intervention efforts aimed at addressing childhood fitness and fatness. Interventions focused on the home environment, or alternatively extension of the school environment may be warranted. Australia New Zealand Clinical Trials Registry, identifier ACTRN12618002008202 . Retrospectively registered on 14 December 2018.
Publisher: Wiley
Date: 07-05-2015
DOI: 10.1002/JOR.22905
Abstract: Tibial plateau fractures are common, but little evidence exists for their postoperative management, especially when recommending if patients should weight bear at all, partially, or as tolerated. In this study, we describe the loads passing through the fracture construct and the associated fracture migration over the first year following surgery. Nine patients were treated with open reduction and internal fixation and instructed to weight bear as tolerated. Fracture loading and migration were assessed at 2, 12, 26, and 52 weeks postoperative. Fracture loading was calculated as the knee joint reaction force (peak, average, the angle of the force vector, and the point of force application) using gait analysis and an inverse dynamics musculoskeletal model. Fracture migration was assessed using radiostereometric analysis. The fractures were progressively loaded during the rehabilitation phase. The point of application of the load shifted from neutral to medial by week 26 for all patients. Migration during the first postoperative year was within current clinical acceptable limits. The peak load during walking at each time point was not associated with fracture fragment migration and does not appear to exceed the elastic limit of the fracture construct.
Publisher: Wiley
Date: 20-10-2021
DOI: 10.1111/PAI.13383
Abstract: Previous research suggests that children who experience asthma may be less physically active however, results have been inconclusive. This study aimed to investigate whether the presence of asthma or wheeze is associated with lower physical activity levels in children, and whether sex, body mass index or earlier asthma or wheeze status modifies the association. This study was conducted in 391 HealthNuts participants in Melbourne, Australia. Asthma and wheeze data were collected via questionnaire at age 4 and 6, and physical activity was measured through accelerometry. Using adjusted linear regression models, the cross‐sectional and longitudinal associations were investigated. There was no evidence of a difference in time spent in moderate‐to‐vigorous physical activity (MVPA) at age 6 years between children with and without asthma at age 4 children with asthma spent 8.3 minutes more time physically active per day (95% CI: −5.6, 22.1, P = .24) than children without asthma. Similar results were seen for children with current wheeze (5.8 minutes per day more, 95% CI: −5.9, 17.5, P = .33) or ever wheeze or asthma (7.7 minutes per day more, 95% CI: −4.8, 20.2, P = .23) at age 4 years. Comparable null results were observed in the cross‐sectional analyses. Interaction with BMI could not be assessed however, previous asthma or wheeze status and sex were not found to modify these associations. This analysis found no evidence of asthma hindering physical activity in these young children. These results are encouraging, as they indicate that the Australian asthma and physical activity public health c aigns are being effectively communicated and adopted by the public.
Publisher: Wiley
Date: 06-10-2016
DOI: 10.1002/JPPR.1249
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.INJURY.2017.10.038
Abstract: Trans arterial embolization (TAE) can stem uncontrolled bleeding associated with pelvic fractures, but is associated with potential complications. This study investigated and compared the early to midterm complications in two patient cohorts: one who did and one who did not undergo TAE. The results of 14 patients who underwent TAE in the resuscitation phase, and then had their pelvic fractures managed non-operatively, the study group (Group 1), were compared with those of a control group (Group 2) of 14 patients matched for age, sex, injury and management, that did not undergo TAE. All patients were examined clinically and answered a questionnaire on bowel and urinary function, pain and limp. Gluteus medius structure and volume were assessed on MRI. The hip girdle muscle function was assessed using a hand held dynamometer, surface electromyography as well as quantitative gait analysis. Seven patients in Group 1 (50%), but none in Group 2, had persistent urological dysfunctions, in the absence of any recognized previous pathology or urologic trauma at the time of injury. No gluteal muscle demonstrated fibrosis or fatty infiltration. The median gluteal muscle volume was not significantly decreased compared with the uninjured side in either group (P=0.421). The muscle strengths of gluteus maximus, gluteus medius, tensor fasciae latae and iliopsoas when compared to the uninjured side were significantly less in Group 1 compared to Group 2. However, no patient had a discernable limp and gait analysis showed no significant differences between the left and right sides in the study and control groups in the gluteal activation timing (p=0.171 and 0.354) and duration (p=0.622 and 0.435). There were no skin complications, and no patient reported any persistent bowel dysfunction. TAE was associated with a high rate of persistent urological dysfunction. TAE could lead to decreased hip muscles strength, however this does not seem to affect gait.
Publisher: Wiley
Date: 04-09-2018
DOI: 10.1111/APT.14955
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2018
Publisher: JMIR Publications Inc.
Date: 03-03-2021
DOI: 10.2196/17023
Abstract: Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults ( years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2 %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. In this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Publisher: Wiley
Date: 21-10-2016
DOI: 10.1111/AJAG.12236
Publisher: Oxford University Press (OUP)
Date: 30-01-2021
Abstract: Sleep plays an important role in cardiometabolic health. Although the importance of considering sleep as a multidimensional construct is widely appreciated, studies have largely focused on in idual sleep characteristics. The association between actigraphy-derived sleep profiles and cardiometabolic health in healthy adults and children has not been examined. This study used actigraphy-measured sleep data collected between February 2015 and March 2016 in the Child Health CheckPoint study. Participants wore actigraphy monitors (GENEActiv Original, Cambs, UK) on their nondominant wrist for 7 days and sleep characteristics (period, efficiency, timing, and variability) were derived from raw actigraphy data. Actigraphy-derived sleep profiles of 1,043 Australian children aged 11–12 years and 1,337 adults were determined using K-means cluster analysis. The association between cluster membership and biomarkers of cardiometabolic health (blood pressure, body mass index, apolipoproteins, glycoprotein acetyls, composite metabolic syndrome severity score) were assessed using Generalized Estimating Equations, adjusting for geographic clustering, with sex, socioeconomic status, maturity stage (age for adults, pubertal status for children), and season of data collection as covariates. Four actigraphy-derived sleep profiles were identified in both children and adults: short sleepers, late to bed, long sleepers, and overall good sleepers. The overall good sleeper pattern (characterized by adequate sleep period time, high efficiency, early bedtime, and low day-to-day variability) was associated with better cardiometabolic health in the majority of comparisons (80%). Actigraphy-derived sleep profiles are associated with cardiometabolic health in adults and children. The overall good sleeper pattern is associated with more favorable cardiometabolic health.
Publisher: Copernicus GmbH
Date: 14-04-2016
Abstract: Abstract. The climatic impacts of black carbon (BC) aerosol, an important absorber of solar radiation in the atmosphere, remain poorly constrained and are intimately related to its particle-scale physical and chemical properties. Using particle-resolved modelling informed by quantitative measurements from a soot-particle aerosol mass spectrometer, we confirm that the mixing state (the distribution of co-emitted aerosol amongst fresh BC-containing particles) at the time of emission significantly affects BC-aerosol optical properties even after a day of atmospheric processing. Both single particle and ensemble aerosol mass spectrometry observations indicate that BC near the point of emission co-exists with hydrocarbon-like organic aerosol (HOA) in two distinct particle types: HOA-rich and BC-rich particles. The average mass fraction of black carbon in HOA-rich and BC-rich particle classes was 0.1 and 0.8, respectively. Notably, approximately 90 % of BC mass resides in BC-rich particles. This new measurement capability provides quantitative insight into the physical and chemical nature of BC-containing particles and is used to drive a particle-resolved aerosol box model. Significant differences in calculated single scattering albedo (an increase of 0.1) arise from accurate treatment of initial particle mixing state as compared to the assumption of uniform aerosol composition at the point of BC injection into the atmosphere.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.JBIOMECH.2014.09.003
Abstract: Numerous methods exist to estimate the pose of the axes of rotation of the forearm. These include anatomical definitions, such as the conventions proposed by the ISB, and functional methods based on instantaneous helical axes, which are commonly accepted as the modelling gold standard for non-invasive, in-vivo studies. We investigated the validity of a third method, based on regression equations, to estimate the rotation axes of the forearm. We also assessed the accuracy of both ISB methods. Axes obtained from a functional method were considered as the reference. Results indicate a large inter-subject variability in the axes positions, in accordance with previous studies. Both ISB methods gave the same level of accuracy in axes position estimations. Regression equations seem to improve estimation of the flexion-extension axis but not the pronation-supination axis. Overall, given the large inter-subject variability, the use of regression equations cannot be recommended.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.BONE.2018.04.011
Abstract: To examine cross-sectional associations of children's bone health (size, density, strength) with moderate-vigorous physical activity (MVPA) and sedentary behaviour by considering: (1) duration of activity, (2) fragmentation, and (3) duration/fragmentation combined. Design: Population-based cross-sectional study. 11-12 year-olds in the Longitudinal Study of Australian Children's Child Health CheckPoint. Exposures: MVPA and sedentary behaviour (7-day accelerometry), yielding (1) daily average durations (min/day) and (2) fragmentations (the parameter alpha, representing the relationship between activity bout frequency and bout length). Tibial peripheral quantitative computed tomography (bone density, geometry, strength). Multivariable regression models including activity durations and fragmentations separately and combined. Of 1357 children attending the CheckPoint, 864 (64%) provided both bone and accelerometry data (mean age 11.4 years (standard deviation (SD) 0.5) 49% male). Mean daily MVPA and sedentary behaviour durations were 34.4 min/day (SD 28.3) and 667.9 min/day (SD 71.9) respectively for boys and girls combined. Each additional daily hour of MVPA was associated with small bone health benefits comprising greater periosteal and endosteal circumference (standardised effect sizes 0.25, 95% CI 0.10 to 0.40 and 0.21, 95% CI 0.03 to 0.39, respectively) and bone strength (0.26, 95% CI 0.14 to 0.38). Sedentary duration and fragmentation of either MVPA or sedentary behaviour showed little association with bone health. In early adolescence, MVPA duration showed associations with better bone health that, while modest, could be of population-level importance. MVPA fragmentation and sedentary behaviour duration and fragmentation seemed less important.
Publisher: Oxford University Press (OUP)
Date: 08-2016
DOI: 10.2146/AJHP160261
Publisher: Frontiers Media SA
Date: 15-01-2021
DOI: 10.3389/FSPOR.2020.579278
Abstract: Purpose: This study aims to (1) establish GENEActiv intensity cutpoints in older adults and (2) compare the classification accuracy between dominant (D) or non-dominant (ND) wrist, using both laboratory and free-living data. Methods: Thirty-one older adults participated in the study. They wore a GENEActiv Original on each wrist and performed nine activities of daily living. A portable gas analyzer was used to measure energy expenditure for each task. Testing was performed on two occasions separated by at least 8 days. Some of the same participants ( n = 13) also wore one device on each wrist during 3 days of free-living. Receiver operating characteristic analysis was performed to establish the optimal cutpoints. Results: For sedentary time, both dominant and non-dominant wrist had excellent classification accuracy (sensitivity 0.99 and 0.97, respectively specificity 0.91 and 0.86, respectively). For Moderate to Vigorous Physical Activity (MVPA), the non-dominant wrist device had better accuracy (ND sensitivity: 0.90, specificity 0.79 D sensitivity: 0.90, specificity 0.64). The corresponding cutpoints for sedentary-to-light were 255 and 375 g · min (epoch independent: 42.5 and 62.5 mg), and those for the light-to-moderate were 588 and 555 g · min (epoch-independent: 98.0 and 92.5 mg) for the non-dominant and dominant wrist, respectively. For free-living data, the dominant wrist device resulted in significantly more sedentary time and significantly less light and MVPA time compared to the non-dominant wrist.
Publisher: JMIR Publications Inc.
Date: 27-11-2019
DOI: 10.2196/14645
Abstract: The success of a mobile phone app in changing health behavior is thought to be contingent on engagement, commonly operationalized as frequency of use. This subgroup analysis of the 2 intervention arms from a 3-group randomized controlled trial aimed to examine user engagement with a 100-day physical activity intervention delivered via an app. Rates of engagement, associations between user characteristics and engagement, and whether engagement was related to intervention efficacy were examined. Engagement was captured in a real-time log of interactions by users randomized to either a gamified (n=141) or nongamified version of the same app (n=160). Physical activity was assessed via accelerometry and self-report at baseline and 3-month follow-up. Survival analysis was used to assess time to nonuse attrition. Mixed models examined associations between user characteristics and engagement (total app use). Characteristics of super users (top quartile of users) and regular users (lowest 3 quartiles) were compared using t tests and a chi-square analysis. Linear mixed models were used to assess whether being a super user was related to change in physical activity over time. Engagement was high. Attrition (30 days of nonuse) occurred in 32% and 39% of the gamified and basic groups, respectively, with no significant between-group differences in time to attrition (P=.17). Users with a body mass index (BMI) in the healthy range had higher total app use (mean 230.5, 95% CI 190.6-270.5 F2=8.67 P .001), compared with users whose BMI was overweight or obese (mean 170.6, 95% CI 139.5-201.6 mean 132.9, 95% CI 104.8-161.0). Older users had higher total app use (mean 200.4, 95% CI 171.9-228.9 F1=6.385 P=.01) than younger users (mean 155.6, 95% CI 128.5-182.6). Super users were 4.6 years older (t297=3.6 P .001) and less likely to have a BMI in the obese range (χ22=15.1 P .001). At the 3-month follow-up, super users were completing 28.2 (95% CI 9.4-46.9) more minutes of objectively measured physical activity than regular users (F1,272=4.76 P=.03). Total app use was high across the 100-day intervention period, and the inclusion of gamified features enhanced engagement. Participants who engaged the most saw significantly greater increases to their objectively measured physical activity over time, supporting the theory that intervention exposure is linked to efficacy. Further research is needed to determine whether these findings are replicated in other app-based interventions, including those experimentally evaluating engagement and those conducted in real-world settings. Australian New Zealand Clinical Trials Registry ACTRN12617000113358 www.anzctr.org.au/ACTRN12617000113358.aspx
Publisher: JMIR Publications Inc.
Date: 12-11-2019
Abstract: obile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. his study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. n total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (& years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance ( i P /i ≤.05) assessed differences between nonclinical and clinical data sets. f the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I sup /sup & %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. n this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Publisher: Public Library of Science (PLoS)
Date: 03-03-2021
DOI: 10.1371/JOURNAL.PONE.0248008
Abstract: The COVID-19 pandemic has dramatically impacted lifestyle behaviour as public health initiatives aim to “flatten the curve”. This study examined changes in activity patterns (physical activity, sedentary time, sleep), recreational physical activities, diet, weight and wellbeing from before to during COVID-19 restrictions in Adelaide, Australia. This study used data from a prospective cohort of Australian adults (parents of primary school-aged children n = 61, 66% female, aged 41±6 years). Participants wore a Fitbit Charge 3 activity monitor and weighed themselves daily using Wi-Fi scales. Activity and weight data were extracted for 14 days before (February 2020) and 14 days during (April 2020) COVID-19 restrictions. Participants reported their recreational physical activity, diet and wellbeing during these periods. Linear mixed effects models were used to examine change over time. Participants slept 27 minutes longer (95% CI 9–51), got up 38 minutes later (95% CI 25–50), and did 50 fewer minutes (95% CI -69–-29) of light physical activity during COVID-19 restrictions. Additionally, participants engaged in more cycling but less swimming, team sports and boating or sailing. Participants consumed a lower percentage of energy from protein (-0.8, 95% CI -1.5–-0.1) and a greater percentage of energy from alcohol (0.9, 95% CI 0.2–1.7). There were no changes in weight or wellbeing. Overall, the effects of COVID-19 restrictions on lifestyle were small however, their impact on health and wellbeing may accumulate over time. Further research examining the effects of ongoing social distancing restrictions are needed as the pandemic continues.
Publisher: Informa UK Limited
Date: 29-11-2023
DOI: 10.1080/10749357.2021.2006982
Abstract: Appropriate sleep and physical activity are known to be important for positive neuroplastic changes in the brain and therefore may affect stroke recovery. To investigate the relationship between sleep and participation in different intensity levels of physical activity to investigate the convergent validity of a commercially available device (Fitbit Flex) in measuring sleep and physical activity in people with stroke. A cross-sectional observational study in people with stroke undergoing rehabilitation. Participants wore two accelerometers on their unaffected wrist for seven consecutive days and recorded a sleep log, the Pittsburgh Sleep Quality Index and Fatigue Assessment Scale. Any relationships between sleep and activity were assessed with linear regression. Pearson and intra-class correlation coefficients were used to assess the validity of the two accelerometers (Fitbit Flex against the validated GENEActiv). Twenty-three patients with stroke were recruited. Twenty complete data sets were analyzed. Participants had approximately 9 hours of sleep and 13 hours of sedentary behavior per day, with 99 minutes spent on physical activity (16 min spent on moderate to vigorous activity). Time spent on sleep was significantly related to sedentary, light and moderate physical activity time (r = -.67, .22, .20). The ICC of the Fitbit Flex in measuring light physical activity was .884 More sleep was related to less sedentary behavior and more time spent on physical activity. Fitbit Flex was only valid for measuring light physical activity.
Publisher: American Medical Association (AMA)
Date: 27-07-2023
DOI: 10.1001/JAMANETWORKOPEN.2023.26038
Abstract: Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with potential to alter obesity trajectories. To describe changes in daily weight across 12 months among Australian adults. This cohort study conducted between December 1, 2019, and December 31, 2021 in Adelaide, South Australia, involved 375 community-dwelling adults aged 18 to 65 years. Participants wore a fitness tracker and were encouraged to weigh themselves, preferably daily but at least weekly, using a body weight scale. Data were remotely gathered using custom-developed software. Time assessed weekly, seasonally, and at Christmas/New Year and Easter. Data were visually inspected to assess the overall yearly pattern in weight change. Data were detrended (to remove systematic bias from intrain idual gradual increases or decreases in weight) by calculating a line of best fit for each in idual’s annual weight change relative to baseline and subtracting this from each participant’s weight data. Multilevel mixed-effects linear regression analysis was used to compare weight across days of the week and seasons and at Christmas/New Year and Easter. Of 375 participants recruited, 368 (mean [SD] age, 40.2 [5.9] years 209 [56.8%] female mean [SD] baseline weight, 84.0 [20.5] kg) provided at least 7 days of weight data for inclusion in analyses. Across the 12-month period, participants gained a median of 0.26% body weight (218 g) (range, −29.4% to 24.0%). Weight fluctuated by approximately 0.3% (252 g) each week, with Mondays and Tuesdays being the heaviest days of the week. Relative to Monday, participants’ weight gradually decreased from Tuesday, although not significantly so (mean [SE] weight change, 0.01% [0.03%] P = .83), to Friday (mean [SE] weight change, −0.18% [0.03%] P & .001) and increased across the weekend to Monday (mean [SE] weight change for Saturday, −0.16% [0.03%] P & .001 mean [SE] weight change for Sunday, −0.10% [0.03%] P & .001). Participants’ weight increased sharply at Christmas/New Year (mean [SE] increase, 0.65% [0.03%] z score, 25.30 P & .001) and Easter (mean [SE] weight change, 0.29% [0.02%], z score, 11.51 P & .001). Overall, participants were heaviest in summer (significantly heavier than in all other seasons), were lightest in autumn (mean [SE] weight change relative to summer, −0.47% [0.07%] P & .001), regained some weight in winter (mean [SE] weight change relative to summer, −0.23% [0.07%] P = .001), and became lighter in spring (mean [SE] weight change relative to summer, −0.27% [0.07%] P & .001). In this cohort study of Australian adults with weekly and yearly patterns in weight gain observed across 12 months, high-risk times for weight gain were Christmas/New Year, weekends, and winter, suggesting that temporally targeted weight gain prevention interventions may be warranted.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.AUCC.2019.10.006
Abstract: Physical function is often poor in intensive care unit (ICU) survivors, yet objective descriptions of sedentary behaviour and physical activity during acute hospitalisation are lacking. The objective of this study was to examine sedentary and activity patterns during patients' hospital-based recovery from a critical illness and associations with physical function, muscle strength, and length of stay (LOS). This was a prospective cohort study in a tertiary ICU and acute hospital wards, which recruited 40 adults who required ≥5 days of mechanical ventilation. Data were collected at awakening (T1), ICU discharge (T2), and hospital discharge (T3), which included monitoring of body posture (sedentary behaviour) using the activPAL and activity intensity using the GENEActiv. Data were reported as time spent lying/sitting and upright, with the number of sit-to-stand transitions and upright bouts. Statistical analysis was conducted using repeated-measures analysis of variance and Spearman's rho. From awakening to hospital discharge (T1-T3, n = 23), there was a mean [95% confidence interval] decrease in % time spent lying/sitting (-3.0% [-4.6% to1.4%], p ≤ 0.001) corresponding to increased time spent upright (43.0 min [19.9, 66.1], p ≤ 0.001). Sit-to-stand transitions increased (18 [11, 28], p ≤ 0.001). The number of upright bouts ≥2 and ≥ 5 min increased (both p ≤ 0.001), but only from ICU to hospital discharge (T2-T3, 5.3 [3.1, 7.6] and 2.3 [0.9, 3.8] respectively). At ICU discharge (T2), less % of time spent lying/sitting, more minutes spent upright, and more transitions were associated with better physical function (Physical Function in Intensive Care Test-scored and de Morton Mobility Index all rho ≥+/-0.730, p ≤ 0.001) and muscle strength (hand grip, Medical Research Council sum-score all rho≥+/-0.505, p ≤ 0.001). There were no associations between accelerometry and hospital LOS. ICU survivors' transition from highly sedentary behaviour to low intensity activity over their acute hospitalisation. Sedentary breaks may be not spread over the day such that modifying sedentary behaviour to break up prolonged lying/sitting may be a focus for future research. NCT02881801.
Publisher: Oxford University Press (OUP)
Date: 07-2017
DOI: 10.2146/AJHP170094
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2019-036542
Abstract: Epidemiological studies indicate an inverse association between nut consumption and body mass index (BMI). However, clinical trials evaluating the effects of nut consumption compared with a nut-free diet on adiposity have reported mixed findings with some studies reporting greater weight loss and others reporting no weight change. This paper describes the rationale and detailed protocol for a randomised controlled trial assessing whether the inclusion of almonds or carbohydrate-rich snacks in an otherwise nut-free energy-restricted diet will promote weight loss during 3 months of energy restriction and limit weight regain during 6 months of weight maintenance. One hundred and thirty-four adults aged 25–65 years with a BMI of 27.5–34.9 kg/m 2 will be recruited and randomly allocated to either the almond-enriched diet (AED) (15% energy from almonds) or a nut-free control diet (NFD) (15% energy from carbohydrate-rich snack foods). Study snack foods will be provided. Weight loss will be achieved through a 30% energy restriction over 3 months, and weight maintenance will be encouraged for 6 months by increasing overall energy intake by ~120–180 kcal/day (~500-750kJ/day) as required. Food will be self-selected, based on recommendations from the study dietitian. Body composition, resting energy expenditure, total daily energy expenditure (via doubly labelled water), physical activity, appetite regulation, cardiometabolic health, gut microbiome, liver health, inflammatory factors, eating behaviours, mood and personality, functional mobility and pain, quality of life and sleep patterns will be measured throughout the 9-month trial. The effects of intervention on the outcome measures over time will be analysed using random effects mixed models, with treatment (AED or NFD) and time (baseline, 3 months and 9 months) being the between and within factors, respectively in the analysis. Ethics approval was obtained from the University of South Australia Human Research Ethics Committee (201436). Results from this trial will be disseminated through publication in peer-reviewed journals, national and international presentations. Australian New Zealand Clinical Trials Registry (ACTRN12618001861246).
Publisher: Springer Science and Business Media LLC
Date: 13-07-2021
DOI: 10.1186/S12889-021-11298-3
Abstract: Time spent in daily activities (sleep, sedentary behaviour and physical activity) has important consequences for health and wellbeing. The amount of time spent varies from day to day, yet little is known about the temporal nature of daily activity patterns in adults. The aim of this review is to identify the annual rhythms of daily activity behaviours in healthy adults and explore what temporal factors appear to influence these rhythms. Six online databases were searched for cohort studies exploring within-year temporal patterns (e.g. season effects, vacation, cultural festivals) in sleep, sedentary behaviour or physical activity in healthy 18 to 65-year-old adults. Screening, data extraction, and risk of bias scoring were performed in duplicate. Extracted data was presented as mean daily minutes of each activity type, with transformations performed as needed. Where possible, meta-analyses were performed using random effect models to calculate standardised mean differences (SMD). Of the 7009 articles identified, 17 studies were included. Studies were published between 2003 and 2019, representing 14 countries and 1951 participants, addressing variation in daily activities across season ( n = 11), Ramadan ( n = 4), vacation ( n = 1) and daylight savings time transitions ( n = 1). Meta-analyses suggested evidence of seasonal variation in activity patterns, with sleep highest in autumn (+ 12 min) sedentary behaviour highest in winter (+ 19 min) light physical activity highest in summer (+ 19 min) and moderate-to-vigorous physical activity highest in summer (+ 2 min) when compared to the yearly mean. These trends were significant for light physical activity in winter (SMD = − 0.03, 95% CI − 0.58 to − 0.01, P = 0.04). Sleep appeared 64 min less during, compared to outside Ramadan (non-significant). Narrative analyses for the impact of vacation and daylight savings suggested that light physical activity is higher during vacation and that sleep increases after the spring daylight savings transition, and decreases after the autumn transition. Research into temporal patterns in activity behaviours is scarce. Existing evidence suggests that seasonal changes and periodic changes to usual routine, such as observing religious events, may influence activity behaviours across the year. Further research measuring 24-h time use and exploring a wider variety of temporal factors is needed.
Publisher: Springer Science and Business Media LLC
Date: 06-07-2021
DOI: 10.1186/S12889-021-11420-5
Abstract: The inverse relationship between moderate-to-vigorous physical activity (MVPA) duration and childhood adiposity is well established. Less is known about how characteristics of MVPA accumulation may be associated with adiposity, independent of MVPA duration. This study aimed to investigate how the MVPA characteristics of children, other than duration (bout length, time of day, day-to-day consistency, intensity), were associated with adiposity. Cross-sectional study of the Australian arm of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) (participants: n = 424, age range 9–11, 44% male). Adiposity was determined by percent body fat via bioelectrical impedance. MVPA duration and characteristics (bout length, time of day, consistency, intensity) were derived from 7-day, 24-h accelerometry. Generalised estimating equations were used to examine the in idual and multivariate associations between MVPA characteristics and adiposity. Univariate analyses showed that higher MVPA duration (β range = − 0.26,-0.15), longer bouts of MVPA (β range = 0.15,0.22) and higher MVPA intensity (β range = − 0.20,-0.13) were all inversely associated with adiposity (all p 0.05). When models were adjusted for MVPA duration, only MVPA intensity (β range = − 0.16,-0.04) showed consistent significant associations with adiposity. Characteristics of MVPA other than duration and intensity appear to be unrelated to adiposity.
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: Elsevier BV
Date: 09-2016
Publisher: Informa UK Limited
Date: 2021
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Public Library of Science (PLoS)
Date: 17-02-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: Oxford University Press (OUP)
Date: 23-01-2014
DOI: 10.1111/IJPP.12091
Abstract: Dose administration aids (DAAs) organise medicines that have been repacked according to the day of the week and time of the day in which they must be taken. In Australia, DAAs are commonly prepared by pharmacy staff for residential aged care facility (RACF) medicine administration. Although the limited available literature indicates that DAA incidents of inaccurate or unsuitable medicine repacking do occur, there is a paucity of qualitative research identifying quality improvement strategies for this service. This study aims to investigate the perceived contributing factors to DAA incidents and strategies for quality improvement in RACFs and pharmacies. Health professional perceptions were drawn from three structured focus groups, including six pharmacists, five nurses, a pharmacy technician and a personal care worker. Participants were involved in the preparation, supply or use of DAAs at pharmacies or RACFs that were involved in a previous DAA audit. Transcripts were analysed using thematic analysis. Four major themes were identified as contributing to DAA incidents, with quality improvement strategies aligned to those same four themes: communication, knowledge and awareness, medicine handling and attitude. Strategies included improving interprofessional communication and addressing the limitations associated with RACF medicine records targeting medicine knowledge gaps and increasing awareness of DAA incidents encouraging greater care when preparing and checking DAAs and fostering a team mentality among members of the aged care team. Recommendations include using current findings to develop multidisciplinary quality improvement initiatives to prevent DAA incidents and to improve the quality of this pharmacy medicine supply service.
Publisher: Elsevier BV
Date: 03-2018
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.JBIOMECH.2013.12.033
Abstract: Understanding the kinematics of the carpus is essential to the understanding and treatment of wrist pathologies. However, many of the previous techniques presented are limited by non-functional motion or the interpolation of points from static images at different postures. We present a method that has the capability of replicating the kinematics of the wrist during activities of daily living using a unique mechanical testing system. To quantify the kinematics of the carpal bones, we used bone pin-mounted markers and optical motion capture methods. In this paper, we present a hammering motion as an ex le of an activity of daily living. However, the method can be applied to a wide variety of movements. Our method showed good accuracy (1.0-2.6°) of in vivo movement reproduction in our ex vivo model. Most carpal motion during wrist flexion-extension occurs at the radiocarpal level while in ulnar deviation the motion is more equally shared between radiocarpal and midcarpal joints, and in radial deviation the motion happens mainly at the midcarpal joint. For all rotations, there was more rotation of the midcarpal row relative to the lunate than relative to the scaphoid or triquetrum. For the functional motion studied (hammering), there was more midcarpal motion in wrist extension compared to pure wrist extension while radioulnar deviation patterns were similar to those observed in pure wrist radioulnar deviation. Finally, it was found that for the litudes studied the amount of carpal rotations was proportional to global wrist rotations.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 04-2019
DOI: 10.1302/0301-620X.101B4.BJJ-2018-1240.R1
Abstract: The purpose of this exploratory study was to investigate if the 24-hour activity profile (i.e. waking activities and sleep) objectively measured using wrist-worn accelerometry of patients scheduled for total hip arthroplasty (THA) improves postoperatively. A total of 51 THA patients with a mean age of 64 years (24 to 87) were recruited from a single public hospital. All patients underwent THA using the same surgical approach with the same prosthesis type. The 24-hour activity profiles were captured using wrist-worn accelerometers preoperatively and at 2, 6, 12, and 26 weeks postoperatively. Patient-reported outcomes (Hip Disability and Osteoarthritis Outcome Score (HOOS)) were collected at all timepoints except two weeks postoperatively. Accelerometry data were used to quantify the intensity (sedentary, light, moderate, and vigorous activities) and frequency (bouts) of activity during the day and sleep efficiency. The analysis investigated changes with time and differences between Charnley class. Patients slept or were sedentary for a mean of 19.5 hours/day preoperatively and the 24-hour activity pattern did not improve significantly postoperatively. Outside of sleep, the patients spent their time in sedentary activities for a mean of 620 minutes/day (sd 143) preoperatively and 641 minutes/day (sd 133) six months postoperatively. No significant improvements were observed for light, moderate, and vigorous intensity activities (p = 0.140, p = 0.531, and p = 0.407, respectively). Sleep efficiency was poor ( 85%) at all timepoints. There was no postoperative improvement in sleep efficiency when adjusted for medications (p 0.05). Patient-reported outcome measures showed a significant improvement with time in all domains when compared with preoperative levels. There were no differences with Charnley class at six months postoperatively. However, Charnley class C patients were more sedentary at two weeks postoperatively when compared with Charnley class A patients (p 0.05). There were no further differences between Charnley classifications. This study describes the 24-hour activity profile of THA patients for the first time. Prior to THA, patients in this cohort were inactive and slept poorly. This cohort shows no improvement in 24-hour activity profiles at six months postoperative. Cite this article: Bone Joint J 2019 -B:415–425.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.INJURY.2018.01.025
Abstract: Classification systems such as the Schatzker and AO/OTA have been proposed for standardised assessment of tibial plateau fractures and to guide clinical decision making. However, there has been no comprehensive literature review of all classification systems for tibial plateau fractures, including assessment of their reliability. The aim of this systematic review was to identify and appraise previously established classification systems for tibial plateau fractures and determine their reliability for fracture classification. Six databases were searched from inception until October 2016. Classification systems for tibial plateau fractures were identified. No restriction was placed on imaging modality (plain film X-ray, CT, MRI). Data synthesis was performed to identify common features of the systems, their prevalence within the literature and studies of intra and inter-rater reliability of fracture classification using Kappa coefficient (κ). Thirty-eight classification systems were identified, five of which were a sub-classification of a single fracture type from a previous tool. The Schatzker and AO/OTA classification systems were the most commonly reported. Of the tools identified only five have been tested for inter and intra-observer reliability (Schatzker, AO/OTA, Duparc, Hohl and Luo). Reliability of more simplistic classification systems, such as that by Luo et al. (three-column) was typically high (intra-κ = 0.67-0.81, inter-κ = 0.71-0.87), but with the disadvantage of providing less information on fracture patterns and morphology. Intra and inter-observer reliability using plain film X-ray was frequently moderate (κ = 0.40-0.60), with 2D and 3D CT typically improving reliability of classification. Only 11 of the 32 complete classification systems identified association of fracture classification with clinical outcome. Frequently used systems for classification of tibial plateau fractures display moderate intra and inter-observer reliability. More sophisticated imaging modalities such as 2D and 3D CT typically improve reliability estimates. Using fracture classification based on imaging findings to predict clinical outcome was not a commonly reported goal of newly developed systems. More detailed assessment of fracture patterns and morphology, in conjunction with information on surgical fixation, may be desirable for predicting outcomes and to guide clinical decision making.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-02-2021
DOI: 10.1519/JSC.0000000000003945
Abstract: Salagaras, BS, Mackenzie-Shalders, KL, Nelson, MJ, Fraysse, F, Wycherley, TP, Slater, GJ, McLellan, C, Kumar, K, and Coffey, VG. Comparisons of daily energy intake vs. expenditure using the GeneActiv accelerometer in elite Australian Football athletes. J Strength Cond Res 35(5): 1273–1278, 2021—To assess validity of the GeneActiv accelerometer for use within an athlete population and compare energy expenditure (EE) with energy and macronutrient intake of elite Australian Football athletes during a competition week. The GeneActiv was first assessed for utility during high-intensity exercise with indirect calorimetry. Thereafter, 14 professional Australian Football athletes (age, 24 ± 4 [ SD ] y height, 1.87 ± 0.08 m body mass, 86 ± 10 kg) wore the accelerometer and had dietary intake assessed via dietitian-led 24-hour recalls throughout a continuous 7 days of competition period (including match day). There was a significant relationship between metabolic equivalents and GeneActiv g·min −1 ( SEE 1.77 METs r 2 = 0.64 p 0.0001). Across the in-season week a significant difference only occurred on days 3 and 4 (day 3: energy intake [EI] EI 137 ± 31 kJ·kg −1 ·d −1 11,763 ± 2,646 kJ·d −1 and EE: 186 ± 14 kJ·kg −1 ·d −1 16,018 ± 1973 kJ·d −1 p 0.05 d = −1.4 day 4: EI: 179 ± 44 kJ·kg −1 ·d −1 , 15,413 ± 3,960 kJ·d −1 and EE: 225 ± 42 kJ·kg −1 ·d −1 19,313 ± 3,072 kJ·d −1 d = −0.7). Carbohydrate intake (CI) was substantially below current sports nutrition recommendations on 6 of 7 days with deficits ranging from −1 to −7.2 g·kg −1 ·d −1 ( p 0.05), whereas daily protein and fat intake was adequate. In conclusion, the GeneActiv provides effective estimation of EE during weekly preparation for a professional team sport competition. Australian Footballers attempt to periodize dietary EI to varying daily training loads but fail to match expenditure on higher-training load days. Specific dietary strategies to increase CI may be beneficial to achieve appropriate energy balance and macronutrient distribution, particularly on days where athletes undertake multiple training sessions.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JBIOMECH.2016.08.005
Abstract: Estimation of joint reaction forces (JRF) is critical for the understanding of load-related pathologies, such as osteoarthritis (OA). Typically, singular components at discrete time-points are presented without knowledge of their orientation over time. The aim of this study was to develop and demonstrate the utility of a method for the concise and intuitive representation of JRF orientation. A scaled musculoskeletal model of the lower limbs was informed by walking gait data from adults with knee OA (n=10) and healthy controls (C) (n=10). Muscle forces and subsequently JRF were computed. The intersections of the JRF vector and a transverse plane proximal to the joint were computed. The 95% confidence ellipse was computed for these points. This allowed the following metrics to be calculated: the normalised area of the ellipse (A) the ratio of the long and short axes (R) the angle between the long axis of the ellipse and the anterior-posterior axis of the distal segment (α) and the position of the centre of the ellipse relative to the origin of the segment (X
Publisher: Elsevier BV
Date: 05-2017
Publisher: Oxford University Press (OUP)
Date: 19-10-2015
DOI: 10.1111/JPHS.12105
Abstract: Medicines maintain and improve care home (CH) residents' health and therefore, it is imperative that CH medicine management systems are regularly evaluated to ensure they continually provide a high standard of care. Multicompartment compliance aid (MCA) medicine management systems are often used to assist United Kingdom CH staff with managing the large volume of medicines used by residents. This study aimed to identify the factors that led to the widespread adoption of MCAs into United Kingdom CHs, limitations associated with their current use and their relevance in the future. In June and July 2014 semi-structured interviews were conducted with eight pharmacists who were purposively selected for their expertise in CH medicine management systems in the United Kingdom. A qualitative thematic approach was employed in the analysis of data. Findings indicated that MCAs were introduced into CHs to address unsafe medicine administration practices and because of pharmacy commercial interest. Identified limitations included reduced staff alertness during medicine administration, restricted ability to identify medicines, and medicine wastage. Participants predicted continued use of MCAs in the future due to their perceived benefits of improved safety and efficiency, although some pharmacists recommended that they be removed and CH staff trained to administer medicines from original packaging. These findings can contribute towards information used by health care providers when deciding on the relevance of MCAs in their current medicine management systems. Additionally, they can contribute towards information used by policy makers when revising United Kingdom CH medicine management guidelines.
Publisher: Wiley
Date: 24-08-2023
DOI: 10.1002/OBY.23860
Abstract: This study evaluated weight and cardiometabolic outcomes after a 3‐month energy‐restricted diet (−30%) containing almonds (almond‐enriched diet [AED]) or containing carbohydrate‐rich snacks (nut‐free control diet [NFD]) (Phase 1), followed by 6 months of weight maintenance (Phase 2). Participants (25–65 years old) with overweight or obesity (BMI 27.5–34.9 kg/m 2 ) were randomly allocated to AED ( n = 68) or NFD ( n = 72). Both groups lost weight during Phase 1 ( p 0.001) (mean [SE], −7.0 [0.5] kg AED vs. −7.0 [0.5] kg NFD, p = 0.858) and Phase 2 ( p = 0.009) (−1.1 [0.5] kg AED vs. −1.3 [0.6] NFD, p = 0.756), with improvements in percentage lean mass after Phase 2 (4.8% [0.3%], p 0.001). Reductions occurred in fasting glucose (−0.2 [0.07] mmol/L, p = 0.003), insulin (−8.1 [4.0] pmol/L, p = 0.036), blood pressure (−4.9 [0.8] mm/Hg systolic, −5.0 [0.5] mm/Hg diastolic, p 0.001), total cholesterol (−0.3 [0.1] mmol/L), low‐density lipoprotein (LDL) (−0.2 [0.1] mmol/L), very low‐density lipoprotein (−0.1 [0.03] mmol/L), and triglycerides (−0.3 [0.06] mmol/L) (all p 0.001), and high‐density lipoprotein increased (0.1 [0.02] mmol/L, p = 0.011) by the end of Phase 2 in both groups. There were group by time interactions for lipoprotein particle concentrations: very small triglyceride‐rich (−31.0 [7.7] nmol/L AED vs. −4.8 [7.9] nmol/L NFD, p = 0.007), small LDL (−109.3 [40.5] nmol/L AED vs. −20.7 [41.6] nmol/L NFD, p = 0.017), and medium LDL (−24.4 [43.4] nmol/L AED vs. −130.5 [44.4] nmol/L NFD, p = 0.045). An energy‐restricted AED resulted in weight loss and weight loss maintenance comparable to an energy‐restricted NFD, and both diets supported cardiometabolic health. The AED resulted in greater improvements in some lipoprotein subfractions, which may enhance reductions in cardiovascular risk.
Publisher: Springer Science and Business Media LLC
Date: 14-04-2015
DOI: 10.1007/S00221-015-4276-Y
Abstract: This study examined the effects of handedness on the inter-digit coordination of force variability with and without concurrent visual feedback during sustained precision pinch. Twenty-four right-handed subjects were instructed to pinch an instrumented apparatus with their dominant and non-dominant hands, separately. During the pinch, the subjects were required to maintain a stable force output at 5 N for 1 min. Visual feedback was given for the first 30 s and removed for the second 30 s. Coefficient of variation and detrended fluctuation analysis were employed to examine the amount and structural variability of the thumb and index finger forces. Similarly, correlation coefficient and detrended cross-correlation analysis were applied to quantify the inter-digit correlation of force amount and structural variability. Results showed that, compared to the non-dominant hand, the dominant hand had higher inter-digit difference in the amount of digit force variability. Without visual feedback, the dominant hand exhibited lower digit force structural variability but higher inter-digit force structural correlation than the non-dominant hand. These results implied that the dominant hand would be more independent, less flexible and with lower dynamic degrees of freedom than the non-dominant hand in coordination of the thumb and index finger forces during sustained precision pinch. The effects of handedness on inter-digit force coordination were dependent on sensory condition, which shed light on higher-level sensorimotor mechanisms that may be responsible for the asymmetries in coordination of digit force variability.
Publisher: Elsevier BV
Date: 09-2020
Publisher: Elsevier BV
Date: 07-2015
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.JHSA.2014.09.019
Abstract: To assess carpal kinematics in various ranges of motion in 3 dimensions with respect to lunate morphology. Eight cadaveric wrists (4 type I lunates, 4 type II lunates) were mounted into a customized platform that allowed controlled motion with 6 degrees of freedom. The wrists were moved through flexion-extension (15°-15°) and radioulnar deviation (RUD 20°-20°). The relative motion of the radius, carpus, and third metacarpal were recorded using optical motion capture methods. Clear patterns of carpal motion were identified. Significantly greater motion occurred at the radiocarpal joint during flexion-extension of type I wrist than a type II wrist. The relative contributions of the midcarpal and radiocarpal articulations to movement of the wrist differed between the radial, the central, and the ulnar columns. During wrist flexion and extension, these contributions were determined by the lunate morphology, whereas during RUD, they were determined by the direction of wrist motion. The midcarpal articulations were relatively restricted during flexion and extension of a type II wrist. However, during RUD, the midcarpal joint of the central column became the dominant articulation. This study describes the effect of lunate morphology on 3-dimensional carpal kinematics during wrist flexion and extension. Despite the limited size of the motion arcs tested, the results represent an advance on the current understanding of this topic. Differences in carpal kinematics may explain the effect of lunate morphology on pathological changes within the carpus. Differences in carpal kinematics due to lunate morphology may have implications for the management of certain wrist conditions.
Publisher: Wiley
Date: 23-07-2018
DOI: 10.1111/CCH.12497
Abstract: The 3 "movement behaviours" of sleep, screen time, and physical activity are associated with a wide range of health outcomes in children. This study examined whether these behaviours cluster together within in iduals in Australian primary school children. Three datasets including 4,449 9- to 11-year-old children were interrogated-(a) Obesity Prevention and Lifestyle (OPAL), (b) the International Study of Children, Obesity, Lifestyle and Environment (ISCOLE), and (c) the National Children's Nutrition and Physical Activity Survey (NCNPAS). The surveys measured movement behaviours using different instruments (accelerometry, use of time recall, and questionnaires) and different operationalizations of compliance. Observed frequencies of compliance with various combinations of guidelines were compared with expected frequencies based on the assumption of independence, using chi-square tests. Compliance with the sleep guidelines was relatively high (72%, 75%, and 79% in the OPAL, ISCOLE, and NCNPAS datasets, respectively), and compliance with the screen (18%, 35%, and 22%) and physical activity (33%, 57%, and 87%) guidelines was generally lower. Against expectation, there was no evidence of clustering in any of the datasets (p > .99). Compliance with movement behaviour guidelines does not cluster within in iduals in 9- to 11-year-old Australian children. It may be unlikely that fostering compliance with one guideline will have a flow-on effect to the others. Temporal trade-offs (i.e., the need to choose one movement behaviour above another) in the 24-hr day may contribute to the lack of clustering.
Publisher: Elsevier BV
Date: 02-2015
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.JBIOMECH.2009.06.056
Abstract: A three-dimensional musculoskeletal model of the lower limb was developed to study the influence of biarticular muscles on the muscle force distribution and joint loads during walking. A complete walking cycle was recorded for 9 healthy subjects using the standard optoelectronic motion tracking system. Ground contact forces were also measured using a 6-axes force plate. Inverse dynamics was used to compute net joint reactions (forces and torques) in the lower limb. A static optimization method was then used to estimate muscle forces. Two different approaches were used: in the first one named global method, the biarticular muscles exerted a torque on the two joints they spanned at the same time, and in the second one called joint-by-joint method, these biarticular muscles were ided into two mono-articular muscles with geometrical (insertion, origin, via points) and physiological properties remained unchanged. The hip joint load during the gait cycle was then calculated taking into account the effect of muscle contractions. The two approaches resulted in different muscle force repartition: the biarticular muscles were favoured over any set of single-joint muscles with the same physiological function when using the global method. While the two approaches yielded only little difference in the resultant hip load, the examination of muscle power showed that biarticular muscles could produce positive work at one joint and negative work at the other, transferring energy between body segments and thus decreasing the metabolic cost of movement.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 27-05-2021
Abstract: This article was updated on July 19, 2021, because of a previous error. On page 1172, in the Results section entitled “Sedentary Activity,” the sentence that had read “Postoperatively, 32% at 1 year and 14% at 2 years were sedentary for hours per day.” now reads “Postoperatively, 32% at 1 year and 41% at 2 years were sedentary for hours per day.” Despite marked improvements in self-reported pain, perceived functional ability, and gait function following primary total hip arthroplasty (THA), it remains unclear whether these improvements translate into improved physical activity and sleep behaviors. The aim of this study was to determine the change in 24-hour activity profile (waking activities and sleep) and laboratory-based gait function from preoperatively to 2 years following the THA. Fifty-one patients undergoing primary THA at a single public hospital were recruited. All THAs were performed using a posterior surgical approach with the same prosthesis type. A wrist-worn accelerometer was used to capture 24-hour activity profiles preoperatively and at 1 and 2 years postoperatively. Three-dimensional gait analysis was performed to determine changes in temporospatial and kinematic parameters of the hip and pelvis. Patients showed improvements in all temporospatial and kinematic parameters with time. Preoperatively, patients were sedentary or asleep for a mean time (and standard deviation) of 19.5 ± 2.2 hours per day. This remained unchanged up to 2 years postoperatively (19.6 ± 1.3 hours per day). Sleep efficiency remained suboptimal ( %) at all time points and was worse at 2 years (77% ± 10%) compared with preoperatively (84% ± 5%). More than one-quarter of the s le were sedentary for hours per day at 1 year (32%) and 2 years (41%), which was greater than the preoperative percentage (21%). Patients accumulated their activity performing light activities however, patients performed less light activity at 2 years compared with preoperative levels. No significant differences (p = 0.935) were observed for moderate or vigorous activity across time. Together with improvements in self-reported pain and perceived physical function, patients had significantly improved gait function postoperatively. However, despite the opportunity for patients to be more physically active postoperatively, patients were more sedentary, slept worse, and performed less physical activity at 2 years compared with preoperative levels. Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
Publisher: Springer Science and Business Media LLC
Date: 30-10-2018
Publisher: Springer Science and Business Media LLC
Date: 26-03-2018
DOI: 10.1007/S40266-018-0537-3
Abstract: Residents of long-term care facilities (LTCFs) are at high risk of hospitalization. Medications are a potentially modifiable risk factor for hospitalizations. Our objective was to systematically review the association between medications or prescribing patterns and hospitalizations from LTCFs. We searched MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and International Pharmaceutical Abstracts (IPA) from inception to August 2017 for longitudinal studies reporting associations between medications or prescribing patterns and hospitalizations. Two independent investigators completed the study selection, data extraction and quality assessment using the Joanna Briggs Institute Critical Appraisal Tools. Three randomized controlled trials (RCTs), 22 cohort studies, five case-control studies, one case-time-control study and one case-crossover study, investigating 13 different medication classes and two prescribing patterns were included. An RCT demonstrated that high-dose influenza vaccination reduced all-cause hospitalization compared with standard-dose vaccination (risk ratio [RR] 0.93 95% confidence interval [CI] 0.88-0.98). Another RCT found no difference in hospitalization rates between oseltamivir as influenza treatment and oseltamivir as treatment plus prophylaxis (treatment = 4.7%, treatment and prophylaxis = 3.5% p = 0.7). The third RCT found no difference between multivitamin/mineral supplementation and hospitalization (odds ratio [OR] 0.94 95% CI 0.74-1.20) or emergency department visits (OR 1.05 95% CI 0.76-1.47). Two cohort studies demonstrated influenza vaccination reduced hospitalization. Four studies suggested polypharmacy and potentially inappropriate medications (PIMs) increased all-cause hospitalization. However, associations between polypharmacy (two studies), PIMs (one study) and fall-related hospitalizations were inconsistent. Inconsistent associations were found between psychotropic medications with all-cause and cause-specific hospitalizations (11 studies). Warfarin, nonsteroidal anti-inflammatory drugs, pantoprazole and vinpocetine but not long-term acetylsalicylic acid (aspirin), statins, trimetazidine, digoxin or β-blockers were associated with all-cause or cause-specific hospitalizations in single studies of specific resident populations. Most cohort studies assessed prevalent rather than incident medication exposure, and no studies considered time-varying medication use. High-quality evidence suggests influenza vaccination reduces hospitalization. Polypharmacy and PIMs are consistently associated with increased all-cause hospitalization.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
DOI: 10.1186/S12889-020-10054-3
Abstract: Almost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for ex le, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children’s cohort study, we aim to examine whether changes in children’s body mass index, activity and diet are related to those of their parents. A community-based s le of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent’s and children’s weight, activity and diet will be investigated using multi-level models. Temporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy. Australia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123 . Prospectively registered on 16 October 2019.
Publisher: Informa UK Limited
Date: 10-2015
DOI: 10.2147/IPRP.S91014
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-023194
Abstract: To describe the epidemiology and parent–child concordance of objectively measured physical activity in a population-based s le of Australian parent–child dyads. Cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. Assessment centres in seven Australian cities and eight regional towns or home visits February 2015–March 2016. Of all CheckPoint families (n=1874), 1261 children (50% girls) and 1358 parent (88% mothers) provided objectively measured activity data, comprising 1077 parent–child dyads. Activity behaviour was assessed by GENEActiv accelerometer. Duration of moderate-to-vigorous physical activity (MVPA) and vigorous physical activity and sedentary behaviour (SB) were derived using Cobra custom software, along with MVPA/SB fragmentation and mean daily activity. Pearson’s correlation coefficients and linear regression estimated parent–child concordance. Survey weights and methods accounted for the complex s le design and clustering. Although parents had average lower accelerometry counts than children (mean [SD] 209 [46] vs 284 [71] g.min), 93% of parents met MVPA daily duration guidelines on published cutpoints (mean [SD] 125 [63] min/day MVPA), compared with only 15% of children (mean 32 [27] min). Parents showed less daily SB duration (parents: 540 [101], children: 681 [69] minutes) and less fragmented accumulation of MVPA (parents: α=1.85, children: α=2.00). Parent–child correlation coefficients were 0.16 (95% CI 0.11 to 0.22) for MVPA duration, 0.10 (95% CI 0.04 to 0.16) for MVPA fragmentation, 0.16 (95% CI 0.11 to 0.22) for SB duration and 0.18 (95% CI 0.12 to 0.23) for SB fragmentation. Standardised cutpoints are needed for objective activity measures to inform activity guidelines across the lifecourse. This may reflect large amounts of time in non-shared environments (school and work).
Publisher: Informa UK Limited
Date: 15-04-2016
DOI: 10.1080/00140139.2016.1158324
Abstract: Load restraint systems in automobile transport utilise tie-down lashings placed over the car's tyres, which are tensioned manually by the operator using a ratchet assembly. This process has been identified as a significant manual handling injury risk. The aim of this study was to gain insight on the current practices associated with tie-down lashings operation, and identify the gaps between current and optimal practice. We approached this with qualitative and quantitative assessments and one numerical simulation to establish: (i) insight into the factors involved in ratcheting (ii) the required tension to hold the car on the trailer and (iii) the tension achieved by drivers in practice and associated joint loads. We identified that the method recommended to the drivers was not used in practice. Drivers instead tensioned the straps to the maximum of their capability, leading to over-tensioning and mechanical overload at the shoulder and elbow. We identified the postures and strategies that resulted in the lowest loads on the upper body during ratcheting (using both hands and performing the task with their full body). This research marks the first step towards the development of a training programme aiming at changing practice to reduce injury risks associated with the operation of tie-down lashings in the automobile transport industry. Practitioner Summary: The study investigated current practice associated with the operation of tie-down lashings through qualitative (interviews) and quantitative (biomechanical analysis) methods. Operators tended to systematically over-tension the lashings and consequently overexert, increasing injury risks.
Publisher: Oxford University Press (OUP)
Date: 27-02-2015
DOI: 10.1111/IJPP.12183
Abstract: The purpose of this article is to identify information that is currently available to pharmacists concerning the stability of medications repackaged into multicompartment compliance aids (MCAs). This article explores the potential risks associated with repackaging medications into MCAs for pharmacists who supply and patients who use them. There is a paucity of information currently available to pharmacists concerning the stability of medications repackaged into MCAs as it is not routinely provided by pharmaceutical manufacturers. However, some studies have identified the potential for adverse effects on safety, bioavailability and stability that may have a clinical impact. There are also professional and legal implications of removing medications from their original packaging for storage in MCAs. There is a growing need for further information concerning the stability of medications repackaged into MCAs to guide pharmacists who are supplying these compliance aids to primary and secondary care. Pharmaceutical manufacturers and researchers should be advised to conduct stability testing in MCAs for orally administered medications. This information should be readily available, and pharmacists should be made aware of it via their pharmaceutical bodies. As a result, decisions regarding MCA preparation can be more informed, and pharmacist and patient risks associated with repackaging potentially unstable medications can be minimised.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.JSAMS.2016.04.013
Abstract: Choice of accelerometer wear-site may facilitate greater compliance in research studies. We aimed to test whether a simple method could automatically discriminate whether an accelerometer was worn on the hip or wrist from free-living data. Cross-sectional. Twenty-two 10-12y old children wore a GENEActiv at the wrist and at the hip for 7-days. The angle between the forearm and the total acceleration vector for the wrist-worn monitor and between the pelvis and the total acceleration vector for the hip-worn monitor (i.e. the angle between the Y-axis component of the acceleration and the total acceleration vector) was calculated for each 5s epoch. The standard deviation of this angle (SDangle) was calculated over time for the wrist-worn and hip-worn monitor for windows of varying lengths. We hypothesised that the wrist angle would be more variable than the hip angle. Wear site could be discriminated based on SDangle the shorter the time window the lower the optimal threshold and Area under the Receiver-Operating-Characteristic curve (AUROC) for discrimination of wear-site (AUROC=0.833 (1min) - 0.952 (12h)). Classification accuracy was good for windows of 8min (sensitivity=90%, specificity=87%, AUROC=0.92) and plateaued for windows of ≥60min (sensitivity and specificity >90%, AUROC=0.95-0.96). We have presented a robust, computationally simple method that detects whether an accelerometer is being worn on the hip or wrist from 8 to 60min of data. This facilitates the use of wear-site specific algorithms to analyse accelerometer data.
Publisher: Springer Science and Business Media LLC
Date: 25-10-2023
Publisher: Springer Science and Business Media LLC
Date: 19-10-2023
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: Elsevier BV
Date: 2015
DOI: 10.1016/J.GAITPOST.2014.09.002
Abstract: To investigate in-shoe foot kinematics, holes are often cut in the shoe upper to allow markers to be placed on the skin surface. However, there is currently a lack of understanding as to what is an appropriate size. This study aimed to demonstrate a method to assess whether different diameter holes were large enough to allow free motion of marker wands mounted on the skin surface during walking using a multi-segment foot model. Eighteen participants underwent an analysis of foot kinematics whilst walking barefoot and wearing shoes with different size holes (15 mm, 20mm and 25 mm). The analysis was conducted in two parts firstly the trajectory of the in idual skin-mounted markers were analysed in a 2D ellipse to investigate total displacement of each marker during stance. Secondly, a geometrical analysis was conducted to assess cluster deformation of the hindfoot and midfoot-forefoot segments. Where movement of the markers in the 15 and 20mm conditions were restricted, the marker movement in the 25 mm condition did not exceed the radius at any anatomical location. Despite significant differences in the isotropy index of the medial and lateral calcaneus markers between the 25 mm and barefoot conditions, the differences were due to the effect of footwear on the foot and not a result of the marker wands hitting the shoe upper. In conclusion, the method proposed and results can be used to increase confidence in the representativeness of joint kinematics with respect to in-shoe multi-segment foot motion during walking.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JSAMS.2018.07.002
Abstract: Rural Australian adults are consistently identified as insufficiently active, likely due to challenges implementing community-based physical activity programs in rural settings. On-line strategies to promote physical activity may be particularly effective in rural settings where isolation and scarcity of qualified support are potential barriers. The Rural Environments and Community Health (REACH) study evaluated the effectiveness of an online-delivered walking intervention among South Australian rural adults. Randomised controlled study design. A twelve-week intervention, with six- and twelve-month follow-up, was conducted. Participants (n=171 50.6±12.5years), recruited through flyers, local newspapers and radio, were randomised to comparison or intervention groups and received a pedometer. The intervention group received access to the REACH website and personalised step goals based on ratings of perceived exertion and daily affect. The comparison group received a paper diary and generic step goals. Outcome measures were accelerometry-assessed sedentary, light (LPA) and moderate-to-vigorous (MVPA) physical activity. Linear mixed models assessed changes over the intervention and follow-ups. Sedentary time decreased, and LPA and MVPA increased in both groups across the intervention (p<0.05). The intervention group demonstrated a larger increase in LPA at six-month follow-up relative to comparison (p<0.05). Both groups decreased sedentary time, overall and in bouts ≥30min, between baseline and twelve-month follow-up (p<0.05). From baseline to twelve-month follow-up, MVPA (total min and bouts ≥10min) declined more in the comparison group than the intervention group (p<0.05). While increased physical activity and decreased sedentary time were observed in both groups during the intervention period, maintenance was only observed for LPA at six-month follow-up in the intervention group. By twelve-month follow-up, post-intervention improvements had largely disappeared, suggesting that additional research is needed to identify ways to improve long-term adherence.
Location: Indonesia
No related grants have been discovered for François Fraysse.