ORCID Profile
0000-0001-9782-8450
Current Organisations
Royal Statistical Society
,
University of Melbourne
,
Deakin University
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Publisher: Springer Science and Business Media LLC
Date: 22-05-2015
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.HEALTHPLACE.2013.08.006
Abstract: There remains a lack of consistent evidence linking food environments with eating behaviours. Studies to date have largely ignored the way different in iduals interact with their local food environment and have primarily focussed on exposures within the residential neighbourhood without consideration of exposures around the workplace, for ex le. In this study we firstly examine whether associations between the residential food environment and eating behaviours differ by employment status and, secondly, whether food environments near employed women's workplaces are more strongly associated with dietary behaviours than food environments near home. Employment status did not modify the associations between residential food environments and eating behaviours, however results showed that having access to healthy foods near the workplace was associated with healthier food consumption. Policies focused on supportive environments should consider commercial areas as well as residential neighbourhoods.
Publisher: JMIR Publications Inc.
Date: 29-10-2021
DOI: 10.2196/30768
Abstract: A 24-week self-directed digitally delivered intervention was found to improve pain and function in people with knee osteoarthritis (OA). However, it is possible that this intervention may be better suited to certain subgroups of people with knee OA compared to others. The aim of this study was to explore whether certain in idual baseline characteristics moderate the effects of a self-directed digitally delivered intervention on changes in pain and function over 24 weeks in people with knee OA. An exploratory analysis was conducted on data from a randomized controlled trial involving 206 people with a clinical diagnosis of knee OA. This trial compared a self-directed digitally delivered intervention comprising of web-based education, exercise, and physical activity program supported by automated exercise behavior change mobile phone text messages to web-based education alone (control). The primary outcomes were changes in overall knee pain (assessed on an 11-point numerical rating scale) and physical function (assessed using the Western Ontario and McMaster Universities Osteoarthritis Index function subscale [WOMAC]) at 24 weeks. Five baseline patient characteristics were selected as the potential moderators: (1) number of comorbidities, (2) number of other painful joints, (3) pain self-efficacy, (4) exercise self-efficacy, and (5) self-perceived importance of exercise. Separate linear regression models for each primary outcome and each potential moderator were fit, including treatment group, moderator, and interaction between treatment group and moderator, adjusting for the outcome at baseline. There was evidence that pain self-efficacy moderated the effect of the intervention on physical function compared to the control at 24 weeks (interaction P=.02). Posthoc assessment of the mean change in WOMAC function by treatment arm showed that each 1-unit increase in baseline pain self-efficacy was associated with a 1.52 (95% CI 0.27 to 2.78) unit improvement in the control group. In contrast, a reduction of 0.62 (95% CI –1.93 to 0.68) units was observed in the intervention group with each unit increase in pain self-efficacy. There was only weak evidence that pain self-efficacy moderated the effect of the intervention on pain and that number of comorbidities, number of other painful joints, exercise self-efficacy, or exercise importance moderated the effect of the intervention on pain or function. With the exception of pain self-efficacy, which moderated changes in function but not pain, we found limited evidence that our selected baseline patient characteristics moderated intervention outcomes. This indicates that people with a range of baseline characteristics respond similarly to the unsupervised digitally delivered exercise intervention. As these findings are exploratory in nature, they require confirmation in future studies.
Publisher: Cambridge University Press (CUP)
Date: 07-09-2017
DOI: 10.1017/S136898001700235X
Abstract: Meal skipping is a relatively common behaviour during adolescence. As peer influence increases during adolescence, friendship groups may play a role in determining eating patterns such as meal skipping. The current study examined cross-sectional and longitudinal associations between perceived friends’ support of healthy eating and breakfast and lunch skipping among adolescents. Survey of intrapersonal, social and environmental factors that may influence eating patterns at baseline (2004/05) and follow-up (2006/07). Thirty-seven secondary schools in Victoria, Australia. S le of 1785 students aged 12–15 years at baseline. Adolescents who reported that their friends sometimes or often ate healthy foods with them were less likely (adjusted OR 95 % CI) to skip breakfast (sometimes: 0·71 0·57, 0·90 often: 0·54 0·38, 0·76) or lunch (sometimes: 0·61 0·41, 0·89 often: 0·59 0·37, 0·94) at baseline than those who reported their friends never or rarely displayed this behaviour. Although this variable was associated with lunch skipping at follow-up, there was no evidence of an association with breakfast skipping at follow-up. There was no evidence of an association between perceived encouragement of healthy eating, and an inconsistent relationship between perceived discouragement of junk food consumption, and meal skipping. Friends eating healthy foods together may serve to reduce meal skipping during early adolescence, possibly due to the influence of directly observable behaviour and shared beliefs held by those in the same friendship group. Verbal encouragement or discouragement from friends may be less impactful an influence on meal skipping (than directly observable behaviours) in adolescents.
Publisher: Elsevier
Date: 2016
Publisher: Wiley
Date: 30-01-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-01-2020
DOI: 10.1249/MSS.0000000000002275
Abstract: This cross-sectional study aimed to i) identify and characterize youth according to distinct physical activity (PA) and sedentary (SED) accumulation patterns, and ii) investigate associations of these derived patterns with cardiometabolic risk factors. ActiGraph accelerometer data from 7- to 13-yr-olds from two studies were pooled ( n = 1219 843 (69%) with valid accelerometry included in analysis). Time accumulated in ≥5- and ≥10-min SED bouts, ≥1- and ≥5-min bouts of light, and ≥1-min bouts of moderate and vigorous PA was calculated. Frequency of breaks in SED was also obtained. Latent profile analysis was used to identify groups of participants based on their distinct accumulation patterns. Linear and logistic regression models were used to test associations of group accumulation patterns with cardiometabolic risk factors, including adiposity indicators, blood pressure, and lipids. Total PA and SED time were also compared between groups. Three distinct groups were identified: “prolonged sitters” had the most time in sustained SED bouts and the least time in vigorous PA bouts “breakers” had the highest frequency of SED breaks and lowest engagement in sustained bouts across most PA intensities and “prolonged movers” had the least time accumulated in SED bouts and the most in PA bouts across most intensities. Although breakers engaged in less time in PA bouts compared with other groups, they had the healthiest adiposity indicators. No associations with the remaining cardiometabolic risk factors were found. Youth accumulate their daily activity in three distinct patterns (prolonged sitters, breakers, and prolonger movers), with those breaking up sitting and least time in prolonged PA bouts across the day having a lower adiposity risk. No relationships with other cardiometabolic risk factors were identified.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.HEALTHPLACE.2011.07.003
Abstract: To examine the sociospatial patterning of access to recreational physical activity facilities in Scotland, we used negative binomial multilevel models to investigate associations between income deprivation at datazone level and the number of facilities available within 10, 20 and 30 min walking and cycling thresholds, adjusting for datazone population size and local authority. Accessibility was significantly (p<0.01) lower in the most affluent quintile for most thresholds tested in urban areas and for some thresholds tested in small towns. In general, more affluent areas had less good access to recreational physical activity facilities within walking or cycling distance.
Publisher: Springer US
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 05-05-2023
DOI: 10.1186/S12966-023-01460-Y
Abstract: Inference using standard linear regression models (LMs) relies on assumptions that are rarely satisfied in practice. Substantial departures, if not addressed, have serious impacts on any inference and conclusions potentially rendering them invalid and misleading. Count, bounded and skewed outcomes, common in physical activity research, can substantially violate LM assumptions. A common approach to handle these is to transform the outcome and apply a LM. However, a transformation may not suffice. In this paper, we introduce the generalized linear model (GLM), a generalization of the LM, as an approach for the appropriate modelling of count and non-normally distributed (i.e., bounded and skewed) outcomes. Using data from a study of physical activity among older adults, we demonstrate appropriate methods to analyse count, bounded and skewed outcomes. We show how fitting an LM when inappropriate, especially for the type of outcomes commonly encountered in physical activity research, substantially impacts the analysis, inference, and conclusions compared to a GLM. GLMs which more appropriately model non-normally distributed response variables should be considered as more suitable approaches for managing count, bounded and skewed outcomes rather than simply relying on transformations. We recommend that physical activity researchers add the GLM to their statistical toolboxes and become aware of situations when GLMs are a better method than traditional approaches for modeling count, bounded and skewed outcomes.
Publisher: Springer Science and Business Media LLC
Date: 21-01-2015
Abstract: Existing theoretical frameworks suggest that healthy eating is facilitated by an in idual's ability, motivation and environmental opportunities. It is plausible, although largely untested, that the importance of factors related to ability and motivation differ under varied environmental conditions. This study aimed to determine whether the magnitude of associations between fruit and vegetable consumption and intrapersonal factors (ability and motivation) were modified by differences in access to stores selling these items (environmental opportunities). Cross-sectional analysis of 4335 women from socioeconomically disadvantaged neighbourhoods in the state of Victoria, Australia. Self-reported fruit and vegetable consumption was assessed against a number of ability- and motivation-related factors. To examine whether associations were modified by store access, interactions with access to supermarkets and greengrocers within 2 km of participants' households were tested. Of the two factors related to ability and seven factors related to motivation, almost all were associated with fruit and vegetable consumption. In general, associations were not modified by store access suggesting that these factors were not tempered by environmental opportunities. This study provides little support for the hypothesis that the importance of intra-personal factors to fruit and vegetable consumption is modified by food store access. Further research on this topic is required to inform behaviour change interventions.
Publisher: Cambridge University Press (CUP)
Date: 22-01-2019
DOI: 10.1017/S1368980018003671
Abstract: To examine associations between maternal parenting style and pre-school children’s dietary intake and to test whether perceived maternal time pressures, parenting arrangements and employment status influence these relationships. This cross-sectional study examined mothers’ reports of their child’s frequency of consumption of eight food and drink groups, including sugar-sweetened beverages (SSB), unhealthy snacks, takeaway foods, fruit and vegetables. Parenting styles were classified as authoritative, authoritarian, permissive or disengaged using two parenting dimensions (warmth and control). The moderating roles of parenting arrangements, indexed by number of parents in the home and maternal employment status, were assessed. Associations were examined using multinomial regression. Data were from the infant and child cohorts in the Longitudinal Study of Australian Children. Children aged 4–5 years from both cohorts (infant: n 3607 child: n 4661) were included. Compared with children of disengaged mothers, children of authoritative mothers consumed most unhealthy foods less frequently, and fruit and vegetables more frequently. Results suggested parenting arrangements and mothers’ working status may moderate associations between parenting styles and SSB, takeaway foods, takeaway snacks and fruit consumption. These findings suggest that authoritative parenting style is associated with a higher consumption of fruit and vegetables and a lower consumption of unhealthy foods among children. However, parenting arrangements and the mothers’ working status may influence these relationships. Further research is required to examine the influence of other potential moderators of parenting style/food consumption relationships such as household time and resource limitations.
Publisher: Elsevier BV
Date: 12-2016
Publisher: Wiley
Date: 04-2014
DOI: 10.1111/RESP.12281
Abstract: This article provides a review of techniques for the analysis of survival data arising from respiratory health studies. Popular techniques such as the Kaplan-Meier survival plot and the Cox proportional hazards model are presented and illustrated using data from a lung cancer study. Advanced issues are also discussed, including parametric proportional hazards models, accelerated failure time models, time-varying explanatory variables, simultaneous analysis of multiple types of outcome events and the restricted mean survival time, a novel measure of the effect of treatment.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.VACCINE.2013.05.079
Abstract: The 7-valent pneumococcal conjugate vaccine (Prevenar(®), Wyeth PCV7) was introduced to the UK paediatric immunisation schedule in 2006. This study investigates trends in serotypes and multi locus sequence types (STs) among cases of invasive pneumococcal disease (IPD) in Scotland prior to, and following, the introduction of PCV7. Scottish Invasive Pneumococcal Disease Enhanced Surveillance has records of all cases of IPD in Scotland since 1999. Cases diagnosed from blood or cerebrospinal fluid isolates until 2010 were analysed. Logistic and poisson regression modelling was used to assess trends prior to and following the introduction of PCV7. Prior to PCV7 use, on average 650 cases of IPD were reported each year 12% occurred in those aged <5 years and 35% affected those aged over 65 years. Serotypes in PCV7 represented 47% of cases (68% in <5 year olds). The serotype and ST distribution was relatively stable with only serotype 1 and associated ST 306 showing an increasing trend. PCV7 introduction was associated with a 69% (95% CI: 50%, 80%) reduction in the incidence of IPD among those aged <5 years, a 57% (95% CI: 47%, 66%) reduction among those aged 5-64 years but no significant change among those aged 65 years and over where increases in non-PCV7 serotypes were observed. Serotypes which became more prevalent post-PCV7 are those which were associated with STs related to the PCV7 serotypes. Routine serotyping and sequence typing in Scotland allowed the assessment of the relationship between the capsule and the clones in the post vaccination era. Changes in the distribution of serotypes post PCV7 introduction appear to be driven by associations between serotypes and STs prior to PCV7 introduction. This has implications for the possible effects of the introduction of higher valency vaccines and could aid in predicting replacement serotypes in IPD.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.YPMED.2017.07.005
Abstract: This study aimed to investigate the bi-directional relationship between different domains of physical activity (PA), sedentary behaviour (SB) and depressive symptoms among women living in socioeconomically disadvantaged neighbourhoods in Victoria, Australia. Women (n=1033), aged 18-46years at Wave 1 (2007/08), completed self-report measures of PA (leisure-time, transport, occupational, domestic), SB (TV viewing, computer use, overall sitting time) and depressive symptoms (CES-D 10) at each study time-point (Wave 2: 2010/11, Wave 3: 2012/13). Separate linear mixed models were fitted to examine if change in depressive symptoms differed dependent on each of the baseline PA or SB measures. Similarly, baseline depressive symptoms were used as a predictor of change in PA and SB. In secondary analyses, associations between baseline PA or SB and odds of becoming 'at risk' of depression among those not 'at risk' at baseline were examined using logistic regression. There was no evidence that change in depressive symptoms differed depending on PA or SB at baseline. In general, there was also no evidence that change in PA or SB differed depending on baseline depressive symptoms. One exception was change in leisure-time PA, which declined more among those with heightened depressive symptoms at baseline (Interaction: β=-0.003, 95% CI=-0.007, -0.0003). Transport-related PA (adjusted OR=1.06, 95% CI=1.013, 1.101) and domestic PA (adjusted OR=1.02, 95% CI=1.003, 1.040) were associated with greater odds of becoming at risk of depression at wave 3. There was limited evidence of a bi-directional relationship between PA, SB and depressive symptoms in women living in socioeconomically disadvantaged neighbourhoods.
Publisher: Springer Science and Business Media LLC
Date: 04-2020
DOI: 10.1186/S12966-020-00947-2
Abstract: Self-selection into residential neighbourhoods is a widely acknowledged, but under-studied problem in research investigating neighbourhood influences on physical activity and diet. Failure to handle neighbourhood self-selection can lead to biased estimates of the association between the neighbourhood environment and behaviour. This means that effects could be over- or under-estimated, both of which have implications for public health policies related to neighbourhood (re)design. Therefore, it is important that methods to deal with neighbourhood self-selection are identified and reviewed. The aim of this review was to assess how neighbourhood self-selection is conceived and accounted for in the literature. Articles from a systematic search undertaken in 2017 were included if they examined associations between neighbourhood environment exposures and adult physical activity or dietary behaviour. Exposures could include any objective measurement of the built (e.g., supermarkets), natural (e.g., parks) or social (e.g., crime) environment. Articles had to explicitly state that a given method was used to account for neighbourhood self-selection. The systematic review was registered with the PROSPERO International Prospective Register of Systematic Reviews (number CRD42018083593) and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of 31 eligible articles, almost all considered physical activity (30/31) few examined diet (2/31). Methods used to address neighbourhood self-selection varied. Most studies (23/31) accounted for items relating to participants’ neighbourhood preferences or reasons for moving to the neighbourhood using multi-variable adjustment in regression models (20/23) or propensity scores (3/23). Of 11 longitudinal studies, three controlled for neighbourhood self-selection as an unmeasured confounder using fixed effects regression. Most studies accounted for neighbourhood self-selection by adjusting for measured attributes of neighbourhood preference. However, commonly the impact of adjustment could not be assessed. Future studies using adjustment should provide estimates of associations with and without adjustment for self-selection consider temporality in the measurement of self-selection variables relative to the timing of the environmental exposure and outcome behaviours and consider the theoretical plausibility of presumed pathways in cross-sectional research where causal direction is impossible to establish.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.APPET.2021.105754
Abstract: Parents' feeding practices are associated with children's food intake. However, little is known about the patterns of feeding practices used by groups of mothers or how these groupings of practices influence children's dietary intake. Therefore, the aims of this study are to classify and describe groups of mothers according to their patterns of feeding practices and to examine the associations between the groups of maternal feeding practices and pre-school children's dietary quality. In 2018, 1349 mothers based in Australia of children aged 2-5 years completed an online survey including validated measures of nine feeding practices and dietary quality, measured using thirteen summed dietary items. Latent profile analysis was used to identify distinct groups of mothers who shared similar feeding practices. Linear regression models were fitted to examine associations between the feeding practice profiles and child dietary quality. A three-profile model was chosen based on interpretation, profile size and statistical model fit criteria. Profile 1 had lower mean scores of structure-related feeding practices than the other profiles profile 2 had mean scores reflecting slightly higher use of most structure-related feeding practices and lower mean scores of some non-responsive feeding practices profile 3 had higher mean scores of non-responsive feeding practices than the other profiles. Profile 1 (-2.95, CI: 3.97 -1.92) and profile 3 (-2.81, CI: 3.49 -2.13) had lower mean child dietary quality scores compared with profile 2. Profile 2, which reflected the most engagement in structure-related feeding practices combined with least non-responsive feeding practices, was associated with higher child diet quality, compared with the other two profiles. The identification of these unique profiles could help to tailor future interventions to consider patterns of feeding practices used by groups of mothers.
Publisher: BMJ
Date: 10-2023
Publisher: Cambridge University Press (CUP)
Date: 07-12-2017
DOI: 10.1017/S1368980016002986
Abstract: FFQs are a popular method of capturing dietary information in epidemiological studies and may be used to derive dietary exposures such as nutrient intake or overall dietary patterns and diet quality. As FFQs can involve large numbers of questions, participants may fail to respond to all questions, leaving researchers to decide how to deal with missing data when deriving intake measures. The aim of the present commentary is to discuss the current practice for dealing with item non-response in FFQs and to propose a research agenda for reporting and handling missing data in FFQs. Single imputation techniques, such as zero imputation (assuming no consumption of the item) or mean imputation, are commonly used to deal with item non-response in FFQs. However, single imputation methods make strong assumptions about the missing data mechanism and do not reflect the uncertainty created by the missing data. This can lead to incorrect inference about associations between diet and health outcomes. Although the use of multiple imputation methods in epidemiology has increased, these have seldom been used in the field of nutritional epidemiology to address missing data in FFQs. We discuss methods for dealing with item non-response in FFQs, highlighting the assumptions made under each approach. Researchers analysing FFQs should ensure that missing data are handled appropriately and clearly report how missing data were treated in analyses. Simulation studies are required to enable systematic evaluation of the utility of various methods for handling item non-response in FFQs under different assumptions about the missing data mechanism.
Publisher: Oxford University Press (OUP)
Date: 2009
DOI: 10.1093/QJMED/HCN139
Abstract: Scoring systems exist to assist rapid identification of acute stroke but not for the more challenging diagnosis of transient ischaemic attack (TIA). To develop a clinical scoring system to assist with diagnosis of TIA. We developed and validated a clinical scoring system for identification of TIA patients. Logistic regression analysis was employed. Our development cohort comprised 3216 patients. The scoring system included nine clinically useful predictive variables. After adjustment to reflect the greater seriousness of missing true TIA patients (a 2:1 cost ratio), 97% of TIA and 24% of non-TIA patients were accurately identified. Our results were confirmed during prospective validation. This simple scoring system performs well and could be used to facilitate accurate detection of TIA.
Publisher: American College of Physicians
Date: 10-2022
DOI: 10.7326/M22-1761
Publisher: Elsevier BV
Date: 02-2011
Publisher: Wiley
Date: 28-11-2022
Abstract: Limited research has explored associations between blue spaces and mental health, specifically in children. This study assessed links between coastal proximity and depression and anxiety among children in Australia and tested whether duration of residency at current address moderated associations. It also explored associations between within‐in idual changes in coastal proximity and changes in depression and anxiety. Data were from 2400 children aged 11–12 years in Wave 5 (2012) and aged 14–15 years in Wave 6 (2014) of the national Longitudinal Study of Australian Children. Outcomes were children’s self‐reported symptoms of depression and anxiety. Exposure was coastal proximity ( , 2– , 5– , 10– , 20– , and ≥50 km). Linear models were fitted to examine cross‐sectional associations and fixed effects models for within‐in idual associations. After adjustment for potential confounders, findings suggested that those living close to the coast ( km) had lower levels of depression than those living the furthest from the coast (≥50 km) during childhood (Wave 5) but not adolescence (Wave 6). No associations were observed with anxiety. There was weak evidence to suggest residency duration moderated associations. No associations were observed for within‐in idual changes. Further research is needed to understand whether and what characteristics of coastal environments may benefit children’s mental health.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Wiley
Date: 19-05-2015
DOI: 10.1111/PPE.12193
Publisher: BMJ
Date: 24-01-2020
DOI: 10.1136/ARCHDISCHILD-2019-317485
Abstract: As caesarean delivery and childhood allergy continue to rise, their inter-relationships may change. We examined whether caesarean delivery predicts allergic disease and impaired lung function in two contemporary harmonised population-based cohorts. Parent-reported asthma and eczema data were drawn from two prospective Australian infant cohorts, HealthNuts (n=5276, born 2006–2010) and the Longitudinal Study of Australian Children (LSAC, n=5107, born 2003–2004) at age 6–7 years, and spirometric lung function from LSAC’s Child Health CheckPoint (n=1756) at age 11–12 years. Logistic regression estimated associations between delivery mode and current asthma and eczema at 6–7 years, and linear regression examined lung function at 11–12 years. Models were adjusted for potential confounding factors. Complete case analysis included 3135 HealthNuts and 3654 LSAC children (32.2% and 30.9% born by caesarean, respectively). An association was evident between caesarean delivery and asthma at age 6–7 years in HealthNuts (adjusted OR (aOR) 1.25, 95% CI 1.00 to 1.57) but not in LSAC (aOR 1.05, 95% CI 0.86 to 1.28), while neither study showed clear associations with eczema (HealthNuts: aOR 1.09, 95% CI 0.88 to 1.35 LSAC: aOR 0.89, 95% CI 0.69 to 1.15). Spirometric lung function parameters at age 11–12 years were similar by delivery mode. Associations were not modified by duration of breast feeding, maternal history of asthma/eczema, childcare attendance, number of older siblings or pet exposure. In two unselected populations using harmonised protocols, the likely association of caesarean delivery with developing childhood allergy was small.
Publisher: Wiley
Date: 27-07-2015
DOI: 10.1002/PST.1700
Abstract: In cost-effectiveness analyses of drugs or health technologies, estimates of life years saved or quality-adjusted life years saved are required. Randomised controlled trials can provide an estimate of the average treatment effect for survival data, the treatment effect is the difference in mean survival. However, typically not all patients will have reached the endpoint of interest at the close-out of a trial, making it difficult to estimate the difference in mean survival. In this situation, it is common to report the more readily estimable difference in median survival. Alternative approaches to estimating the mean have also been proposed. We conducted a simulation study to investigate the bias and precision of the three most commonly used s le measures of absolute survival gain--difference in median, restricted mean and extended mean survival--when used as estimates of the true mean difference, under different censoring proportions, while assuming a range of survival patterns, represented by Weibull survival distributions with constant, increasing and decreasing hazards. Our study showed that the three commonly used methods tended to underestimate the true treatment effect consequently, the incremental cost-effectiveness ratio (ICER) would be overestimated. Of the three methods, the least biased is the extended mean survival, which perhaps should be used as the point estimate of the treatment effect to be inputted into the ICER, while the other two approaches could be used in sensitivity analyses. More work on the trade-offs between simple extrapolation using the exponential distribution and more complicated extrapolation using other methods would be valuable.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.HEALTHPLACE.2012.09.007
Abstract: This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for in idual level covariates, street connectivity was not significantly associated with either BMI or BMI category nor were there any significant interactions between age, sex or socioeconomic position and street connectivity.
Publisher: Informa UK Limited
Date: 07-04-2020
Publisher: BMJ
Date: 10-2017
DOI: 10.1136/BMJOPEN-2017-016594
Abstract: The residential neighbourhood fast-food environment has the potential to lead to increased levels of obesity by providing opportunities for residents to consume energy-dense products. This longitudinal study aimed to examine whether change in body mass index (BMI) differed dependent on major chain fast-food outlet availability among women residing in disadvantaged neighbourhoods. Eighty disadvantaged neighbourhoods in Victoria, Australia. S le of 882 women aged 18–46 years at baseline (wave I: 2007/2008) who remained at the same residential location at all three waves (wave II: 2010/2011 wave III: 2012/2013) of the Resilience for Eating and Activity Despite Inequality study. BMI based on self-reported height and weight at each wave. There was no evidence of an interaction between time and the number of major chain fast-food outlets within 2 (p=0.88), 3 (p=0.66) or 5 km (p=0.24) in the multilevel models of BMI. Furthermore, there was no evidence of an interaction between time and change in availability at any distance and BMI. Change in BMI was not found to differ by residential major chain fast-food outlet availability among Victorian women residing in disadvantaged neighbourhoods. It may be that exposure to fast-food outlets around other locations regularly visited influence change in BMI. Future research needs to consider what environments are the key sources for accessing and consuming fast food and how these relate to BMI and obesity risk.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.HEALTHPLACE.2014.07.012
Abstract: An aggregate index is potentially useful to represent neighbourhood obesogenicity. We created a conceptually-based obesogenicity index and examined its association with body mass index (BMI) among 3786 women (age 18-45y) in socio-economically disadvantaged neighbourhoods in Victoria, Australia. The index included 3 items from each of 3 domains: food resources (supermarkets, green grocers, fast food restaurants), recreational activity resources (gyms, pools, park space), and walkability (4+ leg intersections, neighbourhood walking environment, neighbourhood safety), with a possible range from 0 to 18 reflecting 0-2 for each of the 9 items. Using generalised estimating equations, neighbourhood obesogenicity was not associated with BMI in the overall s le. However, stratified analyses revealed generally positive associations with BMI in urban areas and inverse associations in rural areas (interaction p=0.02). These analyses are a first step towards combining neighbourhood characteristics into an aggregate obesogenicity index that is transparent enough to be adopted elsewhere and to allow examination of the relevance of its specific components in different settings.
Publisher: Wiley
Date: 11-08-2014
DOI: 10.1002/PBC.25164
Abstract: Behavioral and emotional difficulties are a recognised side effect of childhood acute lymphoblastic leukemia (ALL) treatment. Modifiable factors, such as parenting strategies, may be an appropriate target for interventions to assist families with managing their child's behavior, potentially leading to improved psychosocial and clinical outcomes. This study examined whether parenting strategies are associated with child behavioral and emotional problems in a pediatric oncology context, with the aim of establishing whether parenting is a potential modifiable target for psychosocial intervention. Participants included 73 parents of children aged 2-6 years who were either (i) in the maintenance phase of treatment for ALL at the Royal Children's Hospital Children's Cancer Centre, Melbourne (N = 43), or (ii) had no major medical history (healthy control group) (N = 30). Participants completed psychometrically validated questionnaires that assessed parenting strategies and child emotional and behavioral problems. Results revealed that the ALL group parents reported higher lax parenting and more spoiling and bribing of their child than the healthy control group. Results from regression models indicated that, after controlling for the significant contribution of illness status and child age on child emotional and behavioral difficulties, parental laxness and parental overprotection were significantly associated with child emotional and behavioral difficulties. Supporting parents to minimise sub-optimal parenting strategies, particularly lax parenting, may offer a fruitful avenue for future research directed toward modifiable factors associated with managing child emotional and behavioral problems in a pediatric oncology context.
Publisher: Public Library of Science (PLoS)
Date: 16-08-2018
Publisher: Elsevier BV
Date: 06-2016
Publisher: Public Library of Science (PLoS)
Date: 07-02-2013
Publisher: Informa UK Limited
Date: 2012
DOI: 10.1080/17513758.2011.592548
Abstract: We examine a mathematical model for the transmission of Streptococcus Pneumoniae amongst young children when the carriage transmission coefficient depends on the serotype. Carriage means pneumococcal colonization. There are two sequence types (STs) spreading in a population each of which can be expressed as one of two serotypes. We derive the differential equation model for the carriage spread and perform an equilibrium and global stability analysis on it. A key parameter is the effective reproduction number R (e). For R (e) ≤ 1, there is only the carriage-free equilibrium (CFE) and the carriage will die out whatever be the starting values. For R (e) > 1, unless the effective reproduction numbers of the two STs are equal, in addition to the CFE there are two carriage equilibria, one for each ST. If the ST with the largest effective reproduction number is initially present, then in the long-term the carriage will tend to the corresponding equilibrium.
Publisher: Elsevier BV
Date: 10-2015
Publisher: Springer Science and Business Media LLC
Date: 09-08-2016
Publisher: Elsevier BV
Date: 05-2016
Publisher: Elsevier BV
Date: 03-2022
Publisher: Cambridge University Press (CUP)
Date: 24-08-2020
DOI: 10.1017/S1368980020002785
Abstract: To explore differences in proportion of food budget and total food expenditure by dwelling type. A cross-sectional study using data from the Australian Bureau of Statistics 2015–2016 Household Expenditure Survey. Food expenditure was examined on multiple categories: fresh fruits, fresh vegetables, pre-prepared meals, meals in restaurants, hotels and clubs, and fast food and takeaway meals, using two-part models and zero-one inflated beta regression models. Dwelling types were categorised as separate house, semi-detached house, low-rise apartment and high-rise apartment. Australia, 2015–2016. Seven thousand three hundred and fifty-eight households from greater capital city areas. Households living in high-rise apartments were estimated to allocate a greater proportion of their food budget to meals in restaurants, hotels and clubs, and to spend more (actual dollars) on that category, compared with other dwelling types. No substantial differences were estimated in the proportion of food budget allocated to the other food categories across dwelling types. The dwelling type households live in may play a role in their food budget. Households living in a high-rise apartment may potentially spend more on meals in restaurants, hotels and clubs than those living in other dwelling types. Given the growth in urban population and the changes in living arrangements, findings point to the critical need for a better understanding of the influence of dwelling types on food expenditure and call for research investigating the relationship between the two.
Publisher: Microbiology Society
Date: 10-2010
Abstract: Data from 4727 invasive isolates of Streptococcus pneumoniae submitted to the Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory between 1999 and 2007 were analysed to establish susceptibility profiles to penicillin, erythromycin and cefotaxime. Pneumococcal resistance to penicillin over the study period remained low, with only 0.2 % ( n =7/4727) of isolates falling into this category (MIC ≥2 mg l −1 ). These isolates have been sporadic, and have mainly represented serogroup 14 (ST9) and 9 (ST156). In comparison, the ‘intermediate sensitivity’ group (MIC 0.12–1 mg l −1 ) ranged between 2 and 6 % per year, the majority from serogroup 9 (ST156). Over the study period, we found that 12 % ( n =585/4727) of isolates were erythromycin-resistant (MIC .5 mg l −1 ), with the majority ( n =467 80 %) of these isolates identified as serogroup 14 (ST9). Cephalosporin resistance (cefotaxime MIC mg l −1 ) was found in only 0.06 % ( n =2/3135) of isolates. Internationally recognized clones (Pneumococcal Molecular Epidemiology Network) accounted for 35 % ( n =28/81) of the penicillin non-susceptible isolates and 75 % ( n =248/330) of the macrolide-resistant isolates, with ST9 and ST306 predominating. Between 1999 and 2007 we found that 11.6 % ( n =18/155) of the penicillin non-susceptible isolates and 4.8 % ( n =28/585) of the macrolide-resistant isolates were from serogroups not covered by the 7-valent conjugate pneumococcal vaccine in use in the UK since 2006. Susceptibility to first-line antimicrobial agents for invasive pneumococcal disease in Scotland remained high over the period 1999–2007.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.HEALTHPLACE.2015.12.004
Abstract: This study examined relationships between three measures of park availability and self-reported physical activity (PA), television viewing (TV) time, and overweight/obesity among women from Australia and the United States. Having more parks near home was the only measure of park availability associated with an outcome. Australian women (n=1848) with more parks near home had higher odds of meeting PA recommendations and lower odds of being overweight/obese. In the US s le (n=489), women with more parks near home had lower odds of watching >4h TV per day. A greater number of parks near home was associated with lower BMI among both Australian and US women. Evidence across erse contexts provides support to improve park availability to promote PA and other health behaviors.
Publisher: BMJ
Date: 06-2017
Publisher: Springer Science and Business Media LLC
Date: 29-09-2017
Publisher: Springer Science and Business Media LLC
Date: 12-09-2020
Publisher: Frontiers Media SA
Date: 2013
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.YPMED.2018.03.003
Abstract: This study examined cross-sectional and prospective associations between typologies of neighbourhood food environment and dietary patterns among 10-12 year-old children. Baseline data were collected in 2003 and follow-up data in 2006 from children in Melbourne or Geelong. Parents completed a food frequency questionnaire at both time points. 'Healthful' and 'energy-dense' dietary pattern scores were computed. A Geographic Information System was used to determine the presence or absence of food outlets (cafés/restaurant fast food supermarkets/grocery stores convenience store greengrocer and butcher, seafood or poultry retailer) within an 800 m road network buffer of home. Three typologies were identified: 1-variety of food outlets, including those selling core/fresh foods (n = 96) 2-café/restaurant and convenience (n = 160) 3-few types of outlets (n = 208). Latent class analysis was used to identify underlying unobservable typologies of neighbourhood food outlet availability. Linear mixed models were fitted to determine cross-sectional (n = 439) and longitudinal (n = 173) associations between the three identified neighbourhood typologies and each (log-transformed) dietary pattern, accounting for clustering within families and schools. There was little evidence of cross-sectional associations. The longitudinal analyses showed that compared to those with a variety of food outlets, those with few types had 25% lower scores for the healthful dietary pattern (p < 0.05) three years later. For optimal dietary patterns, availability of a variety of food outlets close to home, particularly those where core/fresh foods are available, may be important.
Publisher: Elsevier BV
Date: 11-2023
Publisher: JMIR Publications Inc.
Date: 27-01-2020
DOI: 10.2196/15022
Abstract: Alternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. The aim of this study is to compare the effects and costs of the innovative Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) intervention with usual care CR. In this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. The trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. The innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. Australian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. DERR1-10.2196/15022
Publisher: BMJ
Date: 08-2020
DOI: 10.1136/BMJOPEN-2020-038178
Abstract: It is important to ascertain the cost-effectiveness of alternative services to traditional cardiac rehabilitation while the economic credentials of the Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) programme among people with coronary heart disease (CHD) are unknown. This economic protocol outlines the methods for undertaking a trial-based economic evaluation of SCRAM in the real-world setting in Australia. The within-trial economic evaluation will be undertaken alongside a randomised controlled trial (RCT) designed to determine the effectiveness of SCRAM in comparison with the usual care cardiac rehabilitation (UC) alone in people with CHD. Pathway analysis will be performed to identify all the costs related to the delivery of SCRAM and UC. Both a healthcare system and a limited societal perspective will be adopted to gauge all costs associated with health resource utilisation and productivity loss. Healthcare resource use over the 6-month participation period will be extracted from administrative databases (ie, Pharmaceutical Benefits Scheme and Medical Benefits Schedule). Productivity loss will be measured by absenteeism from work (valued by human capital approach). The primary outcomes for the economic evaluation are maximal oxygen uptake (VO 2 max, mL/kg/min, primary RCT outcome) and quality-adjusted life years estimated from health-related quality of life as assessed by the Assessment of Quality of Life-8D instrument. The incremental cost-effectiveness ratio will be calculated using the differences in costs and benefits (ie, primary and secondary outcomes) between the two randomised groups from both perspectives with no discounting. All costs will be valued in Australian dollars for year 2020. The study protocol has been approved under Australia’s National Mutual Acceptance agreement by the Melbourne Health Human Research Ethics Committee (HREC/18/MH/119). It is anticipated that SCRAM is a cost-effective cardiac telerehabilitation programme for people with CHD from both a healthcare and a limited societal perspective in Australia. The evaluation will provide evidence to underpin national scale-up of the programme to a wider population. The results of the economic analysis will be submitted for publication in a peer-reviewed journal. Australian New Zealand Clinical Trials Registry (ACTRN12618001458224).
Publisher: MDPI AG
Date: 16-06-2020
Abstract: Sedentary and physical activity patterns (bouts/breaks) may be important for cardiometabolic health in early life. This study aimed to examine cross-sectional associations of total daily volume and patterns across the activity spectrum with cardiometabolic risk factors in youth aged 7–13 years. Objectively measured accelerometer and cardiometabolic risk factor data were pooled from two studies (n = 1219 69% valid accelerometry). Total daily volume of sedentary time and light-, moderate-, and vigorous-intensity physical activity was determined. Time in sustained bouts and median bout lengths of all intensities and breaks in sedentary time were also calculated. Outcomes included body mass index, waist circumference, blood pressure, blood lipids, and a cardiometabolic summary score. Regression models revealed beneficial associations between total daily volumes of moderate- and vigorous-intensity physical activity and cardiometabolic risk. Time spent in ≥1 min vigorous-intensity physical activity bouts was beneficially associated with cardiometabolic risk, yet this disappeared after adjusting for total vigorous-intensity physical activity and confounders. Time accumulated in light- (≥1 min ≥5 min) and moderate-intensity (≥1 min) physical activity bouts was detrimentally associated with cardiometabolic risk. Total daily volume and activity patterns may have implications for cardiometabolic risk early in life. Sporadic physical activity may be more beneficial for health than sustained physical activity.
Publisher: Springer Science and Business Media LLC
Date: 14-05-2019
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.JCLINEPI.2014.03.006
Abstract: To describe the use of risk-difference curves for communicating time-dependent absolute treatment effects. Three ex les based on in idual patient data meta-analyses for adjuvant treatments for early-stage breast cancer are presented. Unit record datasets were re-created from the published Kaplan-Meier curves and numbers at risk or person-years at risk. Risk-difference curves, with corresponding 95% confidence bands, are presented and discussed. Risk-difference curves are useful for communicating the results from trials of adjuvant treatments for early-stage cancer when standard measures of the absolute treatment effect for survival data (ie, difference-in-mean and difference-in-median survival) can be difficult to estimate. They also avoid the problem of "evolving selection bias", which can affect interval-specific hazard ratio (HR)s in trials with long follow-up and where the participants are heterogeneous with respect to prognosis. Clinical epidemiologists should consider reporting risk-difference curves in addition to Kaplan-Meier curves and the HR.
Publisher: Microbiology Society
Date: 06-2011
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 2010
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2022-061627
Abstract: To determine if motion control walking shoes are superior to neutral walking shoes in reducing knee pain on walking in people with lateral knee osteoarthritis (OA). Participant-blinded and assessor-blinded, comparative effectiveness, superiority randomised controlled trial. Melbourne, Australia. People with symptomatic radiographic lateral tibiofemoral OA from the community and our volunteer database. Participants were randomised to receive either motion control or neutral shoes and advised to wear them hours/day over 6 months. The primary outcome was change in average knee pain on walking over the previous week (11-point Numeric Rating Scale (NRS), 0–10) at 6 months. The secondary outcomes included other measures of knee pain, physical function, quality of life, participant-perceived change in pain and function, and physical activity. We planned to recruit 110 participants (55 per arm) but ceased recruitment at 40 (n=18 motion control shoes, n=22 neutral shoes) due to COVID-19-related impacts. All 40 participants completed 6-month outcomes. There was no evidence that motion control shoes were superior to neutral shoes for the primary outcome of pain (mean between-group difference 0.4 NRS units, 95% CI −1.0 to 1.7) nor for any secondary outcome. The number of participants experiencing any adverse events was similar between groups (motion control shoes: n=5, 28% neutral shoes: n=4, 18.2%) and were minor. Motion control shoes were not superior to neutral shoes in improving knee pain on walking in symptomatic radiographic lateral tibiofemoral joint OA. Further research is needed to identify effective treatments in this important but under-researched knee OA subgroup. ACTRN12618001864213.
Publisher: BMJ
Date: 05-2022
DOI: 10.1136/BMJOPEN-2021-056212
Abstract: Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-in idual associations between changes in work and commute hours with changes in food practices. Longitudinal study Australia Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The s le for this analysis included in iduals who were in paid employment in at least one of the four waves. Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption. Results indicated the longer in iduals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: β=−0.002 (95% CI −0.003 to –0.001), vegetables: β=−0.002 (95% CI −0.003 to –0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-in idual changes (IRR=1.006 (95% CI 1.005 to 1.007)). Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.
Publisher: Springer Science and Business Media LLC
Date: 02-11-2021
Publisher: Springer Science and Business Media LLC
Date: 19-08-2015
DOI: 10.1007/S10880-015-9429-4
Abstract: The aim of this study was to examine whether parenting behaviors are associated with child nutrition amongst pre-school children receiving treatment for acute lymphoblastic leukemia (ALL), and to determine whether this association differs from that observed amongst a healthy population. Participants were 73 parents of children aged 2-6 years. The children were either a) receiving treatment for ALL (n = 43), or b) had no major medical history (n = 30). Participants completed psychometrically validated questionnaires that assessed parenting behaviors and child diet. Increased parental overprotection was associated with higher fruit and vegetable consumption for the control group but lower fruit and vegetable consumption for the ALL group. Parental overprotection, inconsistent discipline and emotional feeding were positively associated with non-core ("junk") food consumption for the ALL group, particularly those who had recently received steroid treatment. To the best of our knowledge, this is the first study to show that certain parenting behaviors may be associated with poor nutrition during treatment for ALL. In light of these results, parenting interventions, specifically targeting parenting behaviors such as assertive discipline, may be a mechanism for nutrition promotion amongst this vulnerable group.
Publisher: Research Square Platform LLC
Date: 13-05-2020
DOI: 10.21203/RS.3.RS-28611/V1
Abstract: Background The consequences for youth cardiometabolic risk might depend on whether sedentary time and physical activity are accumulated sporadically (in shorter bouts) or in a sustained pattern (in longer bouts). This study aimed to: 1) describe daily time-use compositions of youth, including time spent in shorter and longer bouts of sedentary behaviour and physical activity and 2) examine associations between time-use compositions with cardiometabolic biomarkers. Methods Accelerometer and cardiometabolic biomarker data (adiposity, blood pressure, lipids) from 7–13 year olds (mean ± SD: 10.4 ± 1.7) from two Australian studies were pooled (complete cases adiposity n = 772). A time-use composition of nine components was formed using compositional data analysis: time in shorter and longer bouts of sedentary behaviour, light-, moderate- and vigorous-intensity physical activity, and “other time” (i.e., non-wear/sleep). Shorter and longer bouts of sedentary time were defined as 5 and ≥ 5 min, respectively. Longer light-, moderate- and vigorous-intensity physical activity bouts were defined as ≥ 1 min. Linear regression models examined associations between overall time-use composition and cardiometabolic biomarkers. Then, associations between ratios of longer relative to shorter activity patterns, and each intensity relative to more intense activities and/or “other time”, with cardiometabolic biomarkers were derived. Results Confounder-adjusted models showed that the overall time-use composition was associated with zBMI, waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and a combined cardiometabolic risk score. Specifically, more time in longer relative to shorter bouts of light-intensity physical activity was associated with greater zBMI (β = 1.79, SE = 0.70, p = 0.010) and waist circumference (β = 17.28, SE = 4.87, p 0.001). More time in longer relative to shorter bouts of vigorous-intensity physical activity was also associated with higher waist circumference (β = 2.54, SE = 1.14, p = 0.026). More relative time in total light- and vigorous-intensity physical activity (including longer and shorter bouts) was associated with lower waist circumference. In contrast, more relative time in sedentary behaviour and moderate-intensity physical activity was detrimental for waist circumference. Conclusions Accumulating physical activity in frequent short bursts may be beneficial for adiposity compared to engaging in the same amount of these intensities in longer bouts. Trial registration: 'Lifestyle Of Our Kids’ (ACTRN12615000066583 [23/01/2015]) and ‘Transform-Us!’ (ACTRN12609000715279 [19/08/2009], ISRCTN83725066 [30/06/2010]).
Publisher: Elsevier BV
Date: 08-2021
DOI: 10.1093/JN/NXAB106
Abstract: Our understanding of meal choices is limited by methodologies that do not account for the complexity of food choice behaviors. Discrete choice experiments (DCEs) rank choices in a decision-making context. This study aimed to rank the relative importance of influences on meal choices in young adults and examine interactions by subgroups. Adults (18-30 y) living in Australia were recruited via social media to complete an Internet-based DCE and survey. Participants were presented with 12 choice sets about a typical weekday meal, consisting of 5 attributes (taste, preparation time, nutrition content, cost, and quality). Diet quality (Dietary Guideline Index) was calculated from brief dietary questions. Conditional logit models ranked meal attributes, including interactions by sex, education, area-level disadvantage, diet quality, and weight status. In total, 577 adults (46% female, mean ± SD age 23.8 ± 3.8 y) completed the DCE and survey. Nutrition content was the most important influence on meal choice (B: 1.48 95% CI: 1.31, 1.64), followed by cost (B: -0.75 95% CI: -0.87, -0.63), quality (B: 0.58 95% CI: 0.49, 0.67), taste (B: 0.55 95% CI: 0.45, 0.65), and preparation time (B: -0.42 95% CI: -0.52, -0.31). Females, those with higher diet quality, and those with a BMI (in kg/m2) <25 had higher preferences for better nutrition content. Females had higher preferences for better taste and lower preferences for higher-cost meals. Participants with higher education had higher preferences for better nutrition content. Participants living in higher area-level disadvantage areas had higher preferences for longer preparation time. Nutrition content was the most important influence on young adults' meal choices. Preferences differed by sex, socioeconomic position, diet quality, and weight status. Findings show the suitability of DCEs for understanding food choice behaviors in young adults and support the need for meal-based interventions to be tailored according to demographic and health characteristics.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S12966-020-01059-7
Abstract: The diet of young adults is poor, yet little is known about the relative importance of influences on healthy eating in a decision-making context. The aim of this exploratory study was to understand the relative ranking of influences on meal choices in young adults and to investigate interactions between meal preferences and demographic and health characteristics. Adults aged 18–30 years ( n = 92, mean age: 23.9 (SD 3.4) years) completed an online discrete choice experiment. Participants were presented with 12 choice sets reflecting a typical weekday meal and were asked to choose between four meal options. Each meal consisted of a combination of five meal attributes (preparation time, cost, taste, familiarity and nutrition content) that each had three attribute levels. Data were analysed using conditional logit models. Subgroup analyses were performed by sex, education, income, weight status and meeting fruit and vegetable recommendations. Comparing the highest and lowest attribute levels, meal preferences were higher for better taste (B = 0.38 95% CI: 0.12, 0.63), familiarity (B = 0.37 95% CI: 0.21, 0.54) and nutrition content (B = 1.11 95% CI: 0.81, 1.41) and lower for increased preparation times (B = −0.33 95% CI: − 0.53, − 0.12) and cost (B = −0.50 95% CI: − 0.75, − 0.24). Nutrition content was the most important influence on meal choice. Cost was the second most important, followed by taste, familiarity and preparation time. Compared to males, females had a higher preference for better nutrition content, taste and familiarity and a lower preference for increased cost. Higher educated participants had a higher preference for better nutrition content, familiarity and taste compared to lower educated participants. Young adults who met recommendations for fruit and vegetable intake had a higher preference for better nutrition content compared to participants who did not meet recommendations. Nutrition content was the most important influence on young adults’ meal choices, followed by cost, taste, familiarity and preparation time. Preferences varied by demographics and health characteristics, suggesting that the focus of dietary interventions may benefit from being tailored to specific young adult groups.
Publisher: Springer Science and Business Media LLC
Date: 17-11-2021
DOI: 10.1186/S12889-021-12131-7
Abstract: Diabetes mellitus represents a substantial global health challenge, with prevalence rising in low- and middle-income countries (LMICs). Although diabetes is known to follow a socioeconomic gradient, patterns in LMICs are unclear. This study examined associations between education and diabetes, and diabetes self-management behaviours, in six LMICs. Cross-sectional data for 31,780 participants from China, Ghana, India, Mexico, Russia, and South Africa from the World Health Organization Study on Global AGEing and adult health (SAGE) study were used. Participants aged ≥50 years completed face-to-face interviews between 2007 and 2010. Participants self-reported diabetes diagnosis, physical activity, sedentary time, fruit and vegetable consumption, any special diet rogram for diabetes, whether they were taking insulin for diabetes and number of years of education. Height, weight, waist, and hip circumference were measured. Country-specific survey-weighted log-binomial regression models were fitted to examine associations between the number of years of education and self-reported diabetes diagnosis (primary analysis). In secondary analyses, among those with a self-reported diabetes diagnosis, generalised linear regression models were fitted to examine associations between education and i) physical activity, ii) sedentary time, iii) fruit and vegetable consumption, iv) special diet for diabetes, v) taking insulin, vi) BMI, vii) waist circumference and viii) hip circumference. There was strong evidence of an association between years of education and diabetes diagnosis in Ghana (RR = 1.09, 95% CI: 1.06–1.13) and India (RR = 1.09, 95% CI: 1.07–1.12) only. In India, greater years of education was associated with higher leisure physical activity, fruit and vegetable intake, rates following a special diet or taking insulin, but also higher mean BMI, waist and hip circumference. Relationships between education and self-management behaviours were rarely seen in the other countries. Associations between education and diabetes, and behavioural self-management (India only) was more evident in the two least developed (Ghana and India) of the WHO SAGE countries, indicating increasing diabetes diagnosis with greater numbers of years of education. The lack of gradients elsewhere may reflect shifting risk from higher to lower educated populations. While there was some suggestion that self-management behaviours were greater with increased education in India, this was not observed in the other countries.
Publisher: Cambridge University Press (CUP)
Date: 29-03-2023
DOI: 10.1017/S1368980023000587
Abstract: To examine associations between work and commute hours with food consumption and test whether neighbourhood type (20-minute neighbourhood (20MN)/non-20MN) moderate associations. Cross-sectional analysis of the Places and Locations for Activity and Nutrition study (ProjectPLAN). Exposures were work hours (not working (0 h), working up to full-time (1–38 h/week), working overtime ( 38 h/week)), and among those employed, combined weekly work and commute hours (continuous). Outcomes were usual consumption of fruit, vegetables, takeaway food, snacks and soft drinks, and number of discretionary food types (takeaway, snacks and soft drinks) consumed weekly. Generalised linear models were fitted to examine associations between each exposure and outcome. The moderating role of neighbourhood type was examined through interaction terms between each exposure and neighbourhood type (20MN/non-20MN). Melbourne and Adelaide, Australia, 2018–2019. Adults ≥ 18 years old ( n 769). Although all confidence intervals contained the null, overall, patterns suggested non-workers and overtime workers have less healthy food behaviours than up-to-full-time workers. Among those employed, analysis of continuous work and commute hours data suggested longer work and commute hours were positively associated with takeaway consumption (OR = 1·014, 95 % CI 0·999, 1·030, P -value = 0·066). Patterns of better behaviours were observed across most outcomes for those in 20MN than non-20MN. However, differences in associations between work and commute hours with food consumption across neighbourhood type were negligible. Longer work and commute hours may induce poorer food behaviours. There was weak evidence to suggest 20MN moderate associations between work and commute hours with food consumption, although behaviours appeared healthier for those in 20MN.
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 07-03-2017
Publisher: Springer Science and Business Media LLC
Date: 21-09-2020
DOI: 10.1186/S12966-020-01019-1
Abstract: The food stores within residential environments are increasingly investigated as a possible mechanism driving food behaviours and health outcomes. Whilst increased emphasis is being placed on the type of study designs used and how we measure the outcomes, surprisingly little attention gets erted to the measures of the food environment beyond calls for standardised approaches for food store coding and geographic scales of exposure. Food environments are a challenging concept to measure and model and the use of ratio and proportion measures are becoming more common in food environment research. Whilst these are seemingly an advance on single store type indicators, such as simply counting the number of supermarkets or fast food restaurants present, they have several limitations that do not appear to have been fully considered. In this article we report on five issues related to the use of ratio and proportion food environment measures: 1) binary categorisation of food stores 2) whether they truly reflect a more or less healthy food environment 3) issues with these measures not reflecting the quantity of food stores 4) difficulties when no stores are present and 5) complications in statistical treatment and interpretation of ratio and proportion measures. Each of these issues are underappreciated in the literature to date and highlight that ratio and proportion measures need to be treated with caution. Calls for the broader adoption of relative food environment measures may be misguided. Whilst we should continue to search for better ways to represent the complexity of food environments, ratio and proportion measures are unlikely to be the answer.
Publisher: Springer Science and Business Media LLC
Date: 13-08-2018
Publisher: Springer Science and Business Media LLC
Date: 17-01-2017
Publisher: Elsevier BV
Date: 11-2012
Publisher: Wiley
Date: 20-10-2017
DOI: 10.1111/OBR.12632
Publisher: Springer Science and Business Media LLC
Date: 15-02-2015
Publisher: Human Kinetics
Date: 04-2018
Abstract: Little is known about whether physical activity compensation occurs. This study experimentally explored the activitystat hypothesis by investigating children's short-term responses to imposed or restricted physical activity. A total of 156 children (46 boys mean age = 11.3 y) from 9 schools wore an ActiGraph accelerometer for 5 days (Monday-Friday) across 2 consecutive weeks. In addition, 145 children (49% boys) simultaneously wore a SenseWear Armband. Schools were randomized to participate in 1 of the 3 experimental conditions that took place on 1 occasion: additional moderate- to vigorous-intensity physical activity (3 schools), additional light-intensity physical activity (3 schools), or restriction of light-intensity physical activity and moderate- to vigorous-intensity physical activity (3 schools). Multilevel linear regression models were conducted to examine associations between the day the condition took place and the following day and week (baseline and experiment) for each condition. There was no evidence of a difference between children's activity levels on the day after the experiment condition compared with their usual activity for that day. The findings suggest that children do not compensate their sedentary time and/or physical activity levels following imposed or restricted physical activity in the short term.
Publisher: JMIR Publications Inc.
Date: 13-06-2019
Abstract: lternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. he aim of this study is to compare the effects and costs of the innovative i Smartphone Cardiac Rehabilitation, Assisted self-Management /i (SCRAM) intervention with usual care CR. n this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. he trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. he innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. ustralian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. ERR1-10.2196/15022
Publisher: MDPI AG
Date: 28-04-2019
Abstract: Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, 800, 1000- and 1500-m road network buffers). The associations between the three built environment measures and five measures of physical activity (mean accelerometer counts per hour, percentage time in moderate–vigorous physical activity, self-reported walking for transport, self-reported walking for recreation and self-reported walking for all purposes) were modelled for each neighbourhood definition. The combination of the choice of neighbourhood definition, built environment measure, and physical activity measure determined whether evidence of an association was detected or not. Results demonstrated that, while there was no single ideal neighbourhood definition, the built environment was most consistently associated with a range of physical activity measures when the 800-m and 1000-m road network buffers were used. For the street connectivity and destination accessibility measures, associations with physical activity were less likely to be detected at smaller scales (less than 800 m). In line with some previous research, this study demonstrated that the choice of neighbourhood definition can influence whether or not an association between the built environment and adults’ physical activity is detected or not. This study additionally highlighted the importance of the choice of built environment attribute and physical activity measures. While we identified the 800-m and 1000-m road network buffers as the neighbourhood definitions most consistently associated with a range of physical activity measures, it is important that researchers carefully consider the most appropriate type of neighbourhood definition and scale for the particular aim and participants, especially at smaller scales.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.YPMED.2014.06.019
Abstract: Built environment attributes may be important determinants of physical activity. Greater street connectivity has been shown in several studies to be associated with adults' walking for transport (WFT). We examined the extent to which this association can be explained by the availability of utilitarian destinations. Adults (n=2544) participating in the Physical Activity in Localities and Community Environments (PLACE) study in Adelaide, Australia during 2003-2004, reported their WFT and perceived distances to 16 utilitarian destinations. Connectivity was calculated as the ratio of the number of intersections to Census Collection District land area. Marginal models via generalized estimating equations were used and the product-of-coefficients test was used to test mediation effects. Connectivity was significantly associated with destination availability and with WFT frequency. The connectivity-WFT relationship was attenuated after taking availability of destinations into account, but remained significant. Availability of destinations accounted for 16% of the total effect of connectivity on WFT. Higher connectivity can be associated with more frequent WFT, partly because more utilitarian destinations are available in areas with well-connected street networks. Further clarification of these relationships and other pathways through which connectivity influences residents' walking can inform urban design initiatives to promote physical activity.
Publisher: Wiley
Date: 10-07-2023
Abstract: A synthetic method to prepare 1,2‐diamines efficiently that relies on the 4CzPN‐catalysed α ‐aminoalkylation of azomethine imines by secondary and tertiary α ‐silylamines under blue light emitting diode (LED) light (456 nm) is described. Achieved under metal‐ and additive‐free reaction conditions at room temperature, the synthetic protocol was shown to afford product yields up to 99% and applicable to the late‐stage functionalisation of three drug molecules and the gramme‐scale preparation of one ex le.
Publisher: JMIR Publications Inc.
Date: 06-2021
Abstract: 24-week self-directed digitally delivered intervention was found to improve pain and function in people with knee osteoarthritis (OA). However, it is possible that this intervention may be better suited to certain subgroups of people with knee OA compared to others. he aim of this study was to explore whether certain in idual baseline characteristics moderate the effects of a self-directed digitally delivered intervention on changes in pain and function over 24 weeks in people with knee OA. n exploratory analysis was conducted on data from a randomized controlled trial involving 206 people with a clinical diagnosis of knee OA. This trial compared a self-directed digitally delivered intervention comprising of web-based education, exercise, and physical activity program supported by automated exercise behavior change mobile phone text messages to web-based education alone (control). The primary outcomes were changes in overall knee pain (assessed on an 11-point numerical rating scale) and physical function (assessed using the Western Ontario and McMaster Universities Osteoarthritis Index function subscale [WOMAC]) at 24 weeks. Five baseline patient characteristics were selected as the potential moderators: (1) number of comorbidities, (2) number of other painful joints, (3) pain self-efficacy, (4) exercise self-efficacy, and (5) self-perceived importance of exercise. Separate linear regression models for each primary outcome and each potential moderator were fit, including treatment group, moderator, and interaction between treatment group and moderator, adjusting for the outcome at baseline. here was evidence that pain self-efficacy moderated the effect of the intervention on physical function compared to the control at 24 weeks (interaction i P /i =.02). Posthoc assessment of the mean change in WOMAC function by treatment arm showed that each 1-unit increase in baseline pain self-efficacy was associated with a 1.52 (95% CI 0.27 to 2.78) unit improvement in the control group. In contrast, a reduction of 0.62 (95% CI –1.93 to 0.68) units was observed in the intervention group with each unit increase in pain self-efficacy. There was only weak evidence that pain self-efficacy moderated the effect of the intervention on pain and that number of comorbidities, number of other painful joints, exercise self-efficacy, or exercise importance moderated the effect of the intervention on pain or function. ith the exception of pain self-efficacy, which moderated changes in function but not pain, we found limited evidence that our selected baseline patient characteristics moderated intervention outcomes. This indicates that people with a range of baseline characteristics respond similarly to the unsupervised digitally delivered exercise intervention. As these findings are exploratory in nature, they require confirmation in future studies.
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2015
Publisher: Royal Society of Chemistry (RSC)
Date: 2023
DOI: 10.1039/D3NJ03780K
Publisher: Oxford University Press (OUP)
Date: 24-05-2022
Abstract: Significance bills itself as “a magazine about statistics and data science, written by experts for everyone”. But too few of its featured experts are women, as an analysis by Karen Lamb, Jessica Kasza, Sophie Calabretto, Rushani Wijesuriya and Linda McIver shows
Publisher: Oxford University Press (OUP)
Date: 07-04-2017
DOI: 10.1093/IJE/DYX040
Publisher: Elsevier BV
Date: 06-2016
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2016
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2017
End Date: 2019
Funder: Australian Research Council
View Funded ActivityStart Date: 2018
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2018
Funder: Deakin University
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: National Health and Medical Research Council
View Funded Activity