ORCID Profile
0000-0002-6170-2108
Current Organisations
Australian Catholic University
,
Singapore Institute for Clinical Sciences
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Publisher: Elsevier BV
Date: 07-2021
DOI: 10.1016/J.PLACENTA.2021.05.007
Abstract: Fetal growth restriction arising from placental insufficiency is a leading cause of stillbirth. We recently identified low maternal circulating SPINT1 concentrations as a novel biomarker of poor fetal growth. Here we measured SPINT1 in a prospective cohort in Singapore. Circulating SPINT1 concentrations were significantly lower among 141 pregnant women destined to deliver small-for-gestational age infants (birthweight <10th centile), compared to 772 controls (p < 0.01) at as early as 26 weeks' gestation. There were no correlations between infant body composition and circulating SPINT1 concentrations at 26 weeks. This provides validation that low maternal SPINT1 concentration is associated with poor fetal growth.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.NEPR.2019.102650
Abstract: Evidence-based practice underscores a modern approach to nursing to ensure delivery of safe, up-to-date and person-centred care in the evolving clinical environment. While most entry-to-practice nursing courses incorporate elements of evidence-based research curricula, nursing students commonly struggle to see the relevance of research in their training. This study sought to understand nursing students' satisfaction and perspectives on research after an undergraduate research subject was redesigned to make overt the connection between research and professional nursing practice. Satisfaction significantly improved on routinely collected satisfaction surveys over a one-year period (mean increase 0.57, 95% CI 0.40-0.77, P < 0.001 medium effect size, 0.64). Open-ended questions elicited five themes: change to preconceived ideas of research to something accessible and useful clear link between research and clinical and professional nursing practice comments on subject format and scaffolded learning increased skills in effective searching and extracting evidence and improvements for the future. Student satisfaction increased when the connection between research learning and professional practice was made overt in a core research subject. This approach, along with scaffolded activities to increase confidence, had a marked positive impact on student's attitude and understanding of the utility of evidence-based practice and confidence in scrutinising practice in the clinical environment.
Publisher: Elsevier BV
Date: 07-2017
Publisher: Wiley
Date: 02-03-2023
DOI: 10.1111/JAN.15600
Abstract: The number of adults living with two or more chronic conditions is increasing worldwide. Adults living with multimorbidity have complex physical, psychosocial and self‐management care needs. This study aimed to describe Australian nurses' experience of care provision for adults living with multimorbidity, their perceived education needs and future opportunities for nurses in the management of multimorbidity. Qualitative exploratory. Nurses providing care to adults living with multimorbidity in any setting were invited to take part in a semi‐structured interview in August 2020. Twenty‐four registered nurses took part in a semi‐structured telephone interview. Three main themes were developed: (1) The care of adults living with multimorbidity requires skilled collaborative and holistic care (2) nurses' practice in multimorbidity care is evolving and (3) nurses value education and training in multimorbidity care. Nurses recognize the challenge and the need for change in the system to support them to respond to the increasing demands they face. The complexity and prevalence of multimorbidity creates challenges for a healthcare system configured to treat in idual disease. Nurses are key in providing care for this population, but little is known about nurses' experiences and perceptions of their role. Nurses believe a person‐centred approach is important to address the complex needs of adults living with multimorbidity. Nurses described their role as evolving in response to the growing demand for quality care and believed inter‐professional approaches achieve the best outcomes for adults living with multimorbidity. The research has relevance for all healthcare providers seeking to provide effective care for adults living with multimorbidity. Understanding how best to equip and support the workforce to meet the issues and demands of managing the care of adults living with multimorbidity has the potential to improve patient outcomes. There was no patient or public contribution. The study only concerned the providers of the service.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2016
Publisher: Sciedu Press
Date: 02-09-2013
Publisher: Cambridge University Press (CUP)
Date: 14-04-2017
DOI: 10.1017/S0007114517000848
Abstract: Faster eating rates are associated with increased energy intake, but little is known about the relationship between children’s eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children ( n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning ( n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake ( r 0·61, P ·001) and a positive linear relationship between eating rate and children’s BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal) 95 % CI 107·6, 154·4, P ·001), and had higher whole-body ( P ·05) and subcutaneous abdominal adiposity (Δ118·3 cc 95 % CI 24·0, 212·7, P =0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal ( b 13·59 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z -score and adiposity.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.COLEGN.2013.10.005
Abstract: Competency assessment is a paradigm that is common in the healthcare environment and this being particularly true within the nursing profession. Demonstration of competence is necessary to meet the requirements of healthcare organisations and is a mandated requirement of nurses by the Nursing and Midwifery Board of Australia. Within the nursing education sector, one approach to determine competence, is through the use of competency assessment tools. Despite widespread use of competency assessment tools there remains ongoing concerns relating to the efficacy of competency assessment tools as a mean to demonstrate 'competency' amongst enrolled and registered nurses in the clinical environment. The authors of this paper ascertain that competency assessment tools run a serious risk of being nothing more than a 'quick-fix' means of assessment to demonstrate 'nursing competence' required for key performance indicators and clinical governance and that will provide evidence for accreditation standards. Based on this premise, the authors, provide an alternative approach to the use of competency assessment tools that moves away from a 'tick-box' approach to a 'patient-centred' competency model. This approach increases the reliability and validity of competency assessments, allows for the recognition of the knowledge, skills and experience of in idual nurses, offers a more satisfying and rewarding approach to demonstrating 'competency' for nurses and finally, demonstrates 'real-life' competency.
Publisher: The Endocrine Society
Date: 12-02-2022
Abstract: The kynurenine pathway generates metabolites integral to energy metabolism, neurotransmission, and immune function. Circulating kynurenine metabolites positively correlate with adiposity in children and adults, yet it is not known whether this relationship is present already at birth. In this prospective longitudinal study, we investigate the relationship between cord blood kynurenine metabolites and measures of adiposity from birth to 4.5 years. Liquid chromatography–tandem mass spectrometry was used to quantify cord blood kynurenine metabolites in 812 neonates from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fat percentage was measured by air displacement plethysmography and abdominal adipose tissue compartment volumes superficial (sSAT) and deep subcutaneous (dSAT) and internal adipose tissue were quantified by magnetic resonance imaging at early infancy in a smaller subset of neonates, and again at 4 to 4.5 years of age. Cord blood kynurenine metabolites appeared to be higher in female newborns, higher in Indian newborns compared with Chinese newborns, and higher in infants born by cesarean section compared with vaginal delivery. Kynurenine, xanthurenic acid, and quinolinic acid were positively associated with birthweight, but not with subsequent weight during infancy and childhood. Quinolinic acid was positively associated with sSAT at birth. Kynurenic acid and quinolinic acid were positively associated with fat percentage at 4 years. Several cord blood kynurenine metabolite concentrations were positively associated with birthweight, with higher kynurenic acid and quinolinic acid correlating to higher percentage body fat in childhood, suggesting these cord blood metabolites as biomarkers of early childhood adiposity.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2020
Publisher: Oxford University Press (OUP)
Date: 10-09-2022
DOI: 10.1093/IJE/DYAC177
Abstract: Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother–offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.NEDT.2019.104228
Abstract: Simulation is used widely in health education to develop healthcare providers' knowledge and skills. The use of simulation however, as an educational strategy among aged care worker is not well understood. This review sought to describe studies where simulation is used to educate healthcare providers working within aged care settings describe the method and structure used in simulations in residential aged care the key learning outcomes for the participants in this setting and identify any gaps in the current literature to illuminate future research opportunities. The review follows the Joanna Briggs Institute Scoping Review methodology and utilises the PRISMA-ScR Checklist. Searches of CINAHL Complete, PubMed and Scopus databases were completed using the search terms "Simulation" AND "training" AND "Aged Care" OR "Elderly" OR "Older People". Inclusion criteria were peer-reviewed, English, full-text articles published from database inception to July 2018. Twenty studies were included in this review. Studies differed in their methodology, s le size and participants and their findings varied significantly. Fourteen studies originated from the United States of America, five from Canada, and one from Taiwan. Studies were published between 1977 and July 2018. Clinical topics used in simulation were aggression and violence dementia aging death and dying range of motion exercises person-centred care sepsis and dressing residents. Simulation types were role play, simulated patients, and mannequins. Debrief was described in less than a third of studies. Just over half of the studies evaluated participant outcomes. This study demonstrated a large paucity of evidence utilising simulation for training within aged care settings. It highlights the need for future research in this area where simulation could be utilised to meet the unique learning needs of nurses working in aged care.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.CLNESP.2017.12.010
Abstract: Indigenous people experience a higher burden of nutrition-related conditions and are more likely to experience food insecurity compared to non-Indigenous people. Consequently, they remain at increased risk of malnutrition particularly when residing in regional or remote areas. This study aims to compare and characterise the burden and nature of malnutrition among a representative cohort of Indigenous and non-Indigenous Australians admitted to regional hospitals for medical inpatient care. This was a cross-sectional survey conducted in three regional hospitals in the Northern Territory and Far North Queensland of Australia from February 2015 to September 2015. A total of 1606 adult medical inpatients were screened for eligibility. Of these, 608 eligible patients were screened for malnutrition using the validated Malnutrition Screening Tool and assessed for malnutrition using the Subjective Global Assessment. Socio-economic and health-related variables and anthropometric measurements were collected to identify the correlates of malnutrition. Of the 271 Indigenous patients and 337 non-Indigenous patients screened and assessed for malnutrition, 250/608 (41.7%, 95% CI 40.1-52.3%) were found to be malnourished. Significantly higher rates of malnutrition (46.1%, 95% CI 40.1-52.3% versus 37.1%, 95% CI 31.9-42.5%) were found in Indigenous patients compared to non-Indigenous patients (P = 0.024). Higher rates of malnutrition were observed in Indigenous patients residing in Central Australia (56.7%, 95% CI 46.7-66.4%) than in the Top End of the Northern Territory (40.7%, 95% CI 31.7-50.1%) and in Far North Queensland (36.7%, 95% CI 23.4-51.7%). Factors independently predictive of malnutrition for both Indigenous and non-Indigenous participants included residence in Central Australia (OR 4.31, 95% CI 2.63-7.90, P < 0.001) an increased Charlson Comorbidity Index prognostic score (OR 1.37 [per incremental score], 95% CI 1.19-1.59, P < 0.001) and an underweight Body Mass Index (OR 29.97, 95% CI 3.68-244.0, P < 0.001). Of the 250/608 patients who were malnourished, the positive predictor value (PPV) for malnourished patients who were underweight was 96.6% (95% CI 88.3-99.6%) for Indigenous Australians who were malnourished and underweight, the PPV was 100%. A mid-upper arm circumference of less than 23 cm demonstrated a strong PPV for all patients who were malnourished (96.1%, 95% CI 89.0-99.2%). This is the first study to characterise malnutrition in adult Indigenous Australians in a hospital inpatient setting. Compared to non-Indigenous patients the burden and pattern of malnutrition was both higher and markedly different among Indigenous patients. These data highlight the critical importance for actively screening for and responding to malnutrition in this vulnerable patient population in regional and remote settings.
Publisher: Cambridge University Press (CUP)
Date: 28-01-2021
Publisher: Oxford University Press (OUP)
Date: 20-01-2021
DOI: 10.1093/IJE/DYAB005
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 2017
DOI: 10.1194/JLR.D072298
Publisher: MDPI AG
Date: 19-05-2018
DOI: 10.3390/NU10050644
Publisher: Oxford University Press (OUP)
Date: 30-07-2022
DOI: 10.1093/IJE/DYAC154
Abstract: Early epidemiological studies have associated low birthweight with increased cardiovascular risk. We aimed to examine whether the fat and fat-free components of birthweight have differing relationships with childhood cardiovascular risk markers. In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, air displacement plethysmography was conducted within 24 h after delivery in 290 naturally conceived singletons. We investigated associations of newborn cohort-specific standardized z-score of fat mass, fat-free mass, body fat percentage and birthweight on child (at 6 years of age) carotid intima-media thickness, pulse wave velocity, blood pressure, prehypertension/hypertension (& /70 mmHg) and standardized systolic and diastolic blood pressure (SBP and DBP) trajectories (at 3–6 years of age), taking account of maternal education, height, tobacco exposure, parity, ethnicity, child’s sex, gestational age, age at follow-up, and other maternal factors. Clear inverse associations were seen for blood pressure with z-score of fat mass [SBP, β (95% CI): −1.31 mmHg (−2.57, −0.06) DBP: −0.79 mmHg (−1.74, 0.15)] and body fat percentage [SBP: −1.46 mmHg (−2.73, −0.19) DBP: −0.80 mmHg (−1.75, 0.16)], but not with fat-free mass [SBP: 0.27 mmHg (−1.29, 1.83)] DBP: −0.14 mmHg (−1.30, 1.03)]. Being in the lowest tertile of fat mass or body fat percentage was associated with higher blood pressure trajectories and prehypertension/hypertension risk [OR (95% CI), fat mass: 4.23 (1.41, 12.68) body fat percentage: 3.22 (1.09, 9.53)] without concomitantly higher overweight/obesity risk. At birth, low adiposity was associated with increased childhood blood pressure. Low newborn adiposity might serve as a marker of poor fetal growth or suboptimal intrauterine conditions associated with hypertension risk later in life.
Publisher: Cambridge University Press (CUP)
Date: 21-09-2020
DOI: 10.1017/S2040174420000884
Abstract: Advanced imaging techniques are enhancing research capacity focussed on the developmental origins of adult health and disease (DOHaD) hypothesis, and consequently increasing awareness of future health risks across various subareas of DOHaD research themes. Understanding how these advanced imaging techniques in animal models and human population studies can be both additively and synergistically used alongside traditional techniques in DOHaD-focussed laboratories is therefore of great interest. Global experts in advanced imaging techniques congregated at the advanced imaging workshop at the 2019 DOHaD World Congress in Melbourne, Australia. This review summarizes the presentations of new imaging modalities and novel applications to DOHaD research and discussions had by DOHaD researchers that are currently utilizing advanced imaging techniques including MRI, hyperpolarized MRI, ultrasound, and synchrotron-based techniques to aid their DOHaD research focus.
No related grants have been discovered for Navin Michael.