ORCID Profile
0000-0002-6269-6432
Current Organisations
The Hebrew University of Jerusalem
,
University of Melbourne
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Social policy | Public health | Public policy | Social determinants of health
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 03-11-2021
Publisher: Wiley
Date: 22-07-2019
DOI: 10.1002/PSP.2265
Publisher: SAGE Publications
Date: 07-2019
Abstract: This study explores privacy from the perspective of the user. It leverages a “framing in thought” approach to capture how users make sense of privacy in their social media use. It builds on a unique dataset of privacy definitions collected from a representative s le of 608 US social media users. The data are analyzed using topic modeling and semantic network analysis to unpack the multidimensionality of social media privacy. These dimensions are further examined in relation to established demographic antecedents of privacy concerns and behaviors. Results indicate the dominance of frames related to horizontal dimensions of privacy, or privacy vis-à-vis peers, as compared with the vertical dimensions, or privacy vis-à-vis institutions. In addition, the findings suggest that user conceptualization of privacy reflects a cognate-based approach that emphasizes control and limits to information access. Implications for privacy research, policy, and technology design are discussed.
Publisher: BMJ
Date: 27-06-2022
Abstract: Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman’s early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20 years of development in the field. It defines key concepts currently used in research, policy and practice to describe housing in relation to health and health inequalities. Definitions are organised by three overarching aspects of housing: affordability (including housing affordability stress (HAS) and fuel poverty), suitability (including condition, accessibility and sustainable housing) and security (including precarious housing and homelessness). Each of these inter-related aspects of housing can be either protective of, or detrimental to, health. This glossary broadens our understanding of the relationship between housing and health to further promote interdisciplinarity and strengthen the nexus between these fields.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.AMEPRE.2022.02.020
Abstract: Exposure to environmental noise from within homes has been associated with poor mental health. Existing evidence rests on cross-sectional studies prone to residual confounding, reverse causation, and small s le sizes, failing to adequately consider the causal nature of this relationship. Furthermore, few studies have examined the sociodemographic distribution of noise exposure at a country level. The study, conducted in 2021, examined the impact of environmental noise from road traffic, airplanes, trains, and industry on mental health and psychological distress as reported by 31,387 respondents using a 19-year longitudinal data set in Australia (2001‒2019). To improve the capacity to make causal inference and reduce bias from measurement error, reverse causation, and unobserved confounders, analyses used instrumental variables, fixed-effects models, and an aggregated area-level measure of noise exposure. Utilizing the large-scale national data set, sociospatial distributions of noise exposure were described. Private and public rental tenants, lone parents, residents of socioeconomically disadvantaged areas, and those with long-term health conditions were more likely to report residential noise exposure. This exposure to noise was consistently associated with poorer mental health (self-reported noise: β= -0.58 95% CI= -0.76, -0.39 area-level noise: β= -0.43 95% CI= -0.61, -0.26), with the relationship strongest for traffic noise (β= -0.79 95% CI= -1.07, -0.51). Notably, when noise exposure decreased over time, there was an increase in mental health (β= 0.43 95% CI= 0.14, 0.72). The study provides strong evidence of a negative mental health effect of perceived residential noise, and the results have implications for healthy home design and urban planning. These findings should be validated with further studies that measure noise intensity and housing quality.
Publisher: MDPI AG
Date: 31-07-2022
DOI: 10.3390/JCM11154466
Abstract: Background: Real-world data on long-term ( 5 years) weight loss and obesity-related complications after newer bariatric surgical procedures are currently limited. The aim of this longitudinal study was to examine the effectiveness and sustainability of bariatric surgery in a cohort with clinically severe obesity in a multidisciplinary publicly funded service in two teaching hospitals in New South Wales, Australia. Methods: Patients were adults with complex clinically severe obesity with a BMI ≥ 35 kg/m2 and at least three significant obesity-related comorbidities, who underwent bariatric surgeries between 2009 and 2017. Detailed obesity-related health outcomes were reported from annual clinical data and assessments for up to 9 years of follow-up. Data were also linked with the national joint replacement registry. Results: A total of 65 eligible patients were included (mean, 7 range, 3–12 significant obesity-related comorbidities) 53.8% female age 54.2 ± 11.2 years, with baseline BMI 52.2 ± 12.5 kg/m2 and weight 149.2 ± 45.5 kg. Most underwent laparoscopic sleeve gastrectomy (80.0%), followed by laparoscopic adjustable gastric banding (10.8%) and one anastomosis gastric bypass (9.2%). Substantial weight loss was maintained over 9 years of follow-up (p 0.001 versus baseline). Significant total weight loss (%TWL ± SE) was observed (13.2 ± 2.3%) following an initial 1-year preoperative intensive lifestyle intervention, and ranged from 26.5 ± 2.3% to 33.0 ± 2.0% between 1 and 8 years following surgery. Type 2 diabetes mellitus (T2DM), osteoarthritis-related joint pain and depression/severe anxiety were the most common metabolic, mechanical and mental health comorbidities, with a baseline prevalence of 81.5%, 75.4% and 55.4%, respectively. Clinically significant composite cumulative rates of remission and improvement occurred in T2DM (50.0–82.0%) and hypertension (73.7–82.9%) across 6 years. Dependence on continuous positive airway pressure treatment in patients with sleep-disordered breathing fell significantly from 63.1% to 41.2% in 6 years. Conclusion: Bariatric surgery using an intensive multidisciplinary approach led to significant long-term weight loss and improvement in obesity-related comorbidities among the population with clinically complex obesity. These findings have important implications in clinical care for the management of the highest severity of obesity and its medical consequences. Major challenges associated with successful outcomes of bariatric surgery in highly complex patients include improving mental health in the long run and reducing postoperative opioid use. Long-term follow-up with a higher volume of patients is needed in publicly funded bariatric surgery services to better monitor patient outcomes, enhance clinical data comparison between services, and improve multidisciplinary care delivery.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2020-047041
Abstract: To determine whether the Perx app improves medication adherence and clinical outcomes over 12 months compared with standard care in patients requiring polypharmacy. Randomised controlled trial with 12-month follow-up. Outpatient clinics in three tertiary hospitals in Sydney, Australia. Eligible participants were aged 18–75 years, with at least one chronic condition, taking ≥3 different medications (oral medications or injections), with smartphone accessibility. Participants were randomised in a 1:1 ratio. The intervention group used the Perx app that contained customised reminders and gamified interactions to reward verified medication adherence. The primary outcome was medication adherence over 12 months measured using pill counts. Secondary outcomes included clinical outcomes (haemoglobin A1c (HbA1c), cholesterol, blood glucose, triglycerides, creatinine, thyroid function, blood pressure and weight). Of 1412 participants screened for eligibility, 124 participants were randomised 45 in the Perx arm and 40 in the control arm completed the study. The average age was 59.5, 58.9% were women, chronic conditions were cardiovascular disease (78%), type 2 diabetes (75%), obesity (65%) or other endocrine disorders (18%). On average, participants were taking six medications daily. The Perx group had greater improvements in adherence at month 2 (Coef. 8% 95% CI 0.01 to 0.15), month 3 (Coef. 7% 95% CI 0.00 to 0.14) and month 12 (Coef. 7% 95% CI 0.00 to 0.13). The probability of HbA1c ≤6.5% was greater in the Perx group at months 9 and 12 and cholesterol (total and low-density lipoprotein cholesterol) was lower in the Perx group at month 3. The intervention was particularly effective for those with obesity, taking medications for diabetes and taking ≤4 medications. This study provides evidence that app-based behavioural change interventions can increase medication adherence and produce longer-term improvements in some clinical outcomes in adults managing multimorbidity. More trials are needed to build the evidence base. ACTRN12617001285347.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 04-2021
Publisher: Elsevier BV
Date: 12-2021
Publisher: Springer Science and Business Media LLC
Date: 13-05-2019
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.PHYSBEH.2019.05.011
Abstract: Negative affect is shown consistently to promote unhealthy food choices and dietary intake in laboratory studies. However, this relationship in naturalistic settings is less clear and previous research is limited by dietary assessment methodology and neglects to account for several important moderating variables. This observational study aimed to examine the association of negative affect and other psychological factors associated with eating behaviour simultaneously with discretionary energy intake and total energy intake, and whether these were moderated by emotional eating predisposition or age, sex and weight status. One hundred adults completed a four-day food diary, a concurrent end-of-day questionnaire that assessed daily affect and experience of appetite, and the Three Factor Eating Questionnaire to assess trait eating behaviour. Food diaries provided data on participants' daily intake of total energy and of "discretionary items" (specific energy-dense and nutrient poor foods and beverages as defined by the Australian Guide to Healthy Eating). Stepwise random effects models were used to estimate the association of end-of-day ratings, trait eating behaviour and personal factors, and their interactions, with discretionary and total energy intake. Daily rated negative affect and appetite were significantly and positively associated with discretionary intake, such that a one unit increase in each scale was associated with eating 139 kJ/d [SE 61] and 194 kJ/d [SE 68] more discretionary energy, respectively. Negative affect and its interaction with emotional eating were consistently, positively associated with discretionary energy intake. This relationship was strongest in younger participants (β = -4.9 [SE 2.2], p < .05). There was no interaction with sex or weight status. Total energy intake was not associated with negative affect nor its interaction with emotional eating but was consistently associated with appetite. When personal factors (age, sex, BMI), trait eating behaviours and daily rated negative affect and appetite are considered simultaneously, daily discretionary intake is associated most strongly with negative affect. In iduals, particularly young adults, may be more likely to overeat discretionary energy on days that negative affect is rated more highly. However, this may not necessarily translate into greater total energy intake which was most consistently associated with daily rated appetite.
Publisher: Oxford University Press (OUP)
Date: 09-2021
Abstract: People in the private rental sector move more than people in other tenures. Yet we know little about the consequences for health of this instability. We are the first to use a nationally representative longitudinal survey of Australians (2000-2018) to causally examine mental health effects of residential instability for a low-income working-aged cohort of private renters. Mental health was measured using the SF-36 (MH) and Kessler Psychological Distress scale (K10). We examined effects of 1) cumulative time spent in private rental compared with other sectors (homeowner or social housing), 2) total numbers of transitions, and 3) average numbers of transitions within 5 years, using marginal structural models to account for complex confounding of tenure, socio-economic position, and mental health over time. The mental health of private renters was similar to homeowners at initial occupancy but became worse after one to five years. The more moves private renters made, the worse their mental health, with people who had & five moves in total reporting a -3.77-point (95%CI -6.79 -0.75) difference on MH and -3.84-point difference (95%CI -7.61 -0.07) on K10 (rescaled). If numbers of moves were small, the mental health of private tenants was better than social tenants. When moves were frequent, however, their mental health scores became similar. Residential instability negatively affects mental health. Frequent moves in private rental worsen tenants’ mental health compared to owners. Reducing housing instability in lower-income households in private rental with greater protection from forced moves will increase resident’s wellbeing.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.SOCSCIMED.2022.114778
Abstract: Using a population-based longitudinal dataset in Australia over nearly 20 years, this study examines the impact of tenure instability on mental health and psychological distress among a low-income working-age population. The analysis compares private renters (who are notable for their relative tenure insecurity in the Australian context) and homeowners with similar sociodemographic characteristics. To enhance group comparability and address the presence of time-varying covariates that confound and mediate the relationship between tenure exposure and mental health, marginal structural models were used applying weights estimated cumulatively over time. The results show that while private rental tenants report worse mental health than homeowners initially (mental health difference: Beta = -5.29, 95%CI -7.61 to -2.97 psychological distress difference: Beta = 1.77, 95%CI 0.55 to 2.99), this difference diminishes to become statistically indistinguishable by 5-6 years of occupancy (mental health difference at year 6: Beta = -2.09, 95%CI -4.31 to 0.13, predicted mental health increases: from 65.06 to 69.83 for private renters and from 70.46 to 72.02 for homeowners psychological distress difference at year 5: Beta = 0.81, 95%CI -0.09 to 1.71, predicted psychological distress decreases: from 19.85 to 18.04 for private renters and from 17.95 to 17.10 for homeowners). Residential stability is particularly beneficial for private renters in early middle adulthood (35-44 years), with each additional year of stable occupancy for private renters correlated with a 0.99 (95%CI 0.46 to 1.53) increase in mental health and a -0.47 (95%CI -0.69 to -0.24) decrease in psychological distress. The findings provide evidence that stable and secure rental tenure is protective of mental health, and the mental health of stable renters becomes comparable to that of homeowners over time. This adds support for housing policies that promote and improve the stability and security of rental tenure.
Publisher: Wiley
Date: 15-11-2020
DOI: 10.1002/EAT.23399
Publisher: American Medical Association (AMA)
Date: 17-11-2020
Publisher: Oxford University Press (OUP)
Date: 06-05-2021
Abstract: People with chronic conditions experience high psychological distress. Using the National Health Survey in Australia during 2017–18, the study assessed whether and which health literacies moderated the relationship between chronic conditions and psychological distress for diabetes, chronic kidney disease (CKD), cardiovascular disease (CVD), arthritis, other musculoskeletal conditions, asthma, other chronic lower respiratory diseases and cancer. Psychological distress was regressed on chronic diseases, health literacy domains and their interactions, controlling for demographic, socioeconomic and health factors. Of 5790 adults, 4212 (72.75%) aged 18–64 846 (14.6%) had high or very high psychological distress, 1819 (31.4%) had diabetes, CKD or CVD, 2645 (45.7%) musculoskeletal conditions, and 910 (15.7%) lower respiratory conditions. Having sufficient information from healthcare providers was associated with the lowest level of psychological distress for CKD and cancer. Social support was associated with significantly lower levels of psychological distress for cardiovascular, musculoskeletal and lower respiratory conditions. Understanding health information was associated with the largest improvement in psychological distress for diabetes. Higher health literacies were associated with reduced risks of psychological distress among in iduals managing chronic conditions. Interventions for improving self-management and health inequalities should incorporate disease-specific health literacy enhancement strategies at in idual and organizational levels.
Publisher: MDPI AG
Date: 23-12-2022
DOI: 10.3390/NU15010076
Abstract: Quantitative rankings of multiple dietary patterns for their effects on non-communicable disease (NCD) biomarkers is lacking and would inform primary prevention strategies. Accordingly, a network meta-analysis (NMA) was conducted to compare and rank the effects of different dietary patterns on NCD biomarkers, and associations of dietary patterns’ underlying macronutrient composition with NCD biomarkers were determined by a nutritional geometry approach. Randomised controlled trials (RCTs) were eligible for inclusion if they enrolled healthy participants, employed food-based dietary pattern interventions without energy restriction, and reported NCD biomarker outcomes. NCD biomarkers were included as an outcome if ≥10 trials were available. A systematic search of five electronic databases identified 4008 records. Sixty-eight articles from 59 RCTs reporting lipids, glycemic, and inflammatory biomarkers were included for quantitative syntheses. Risk-of-bias was predominantly categorized as low or having some concerns, and confidence-of-evidence low. Relative to western habitual diet, the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), dietary guidelines-based, plant-based, and low-fat diets reduced low-density lipoprotein cholesterol (mean difference range: −0.29 to −0.17 mmol/L), total cholesterol (−0.36 to −0.24 mmol/L), and apolipoprotein B (−0.11 to −0.07 g/L) (all p 0.05) the Paleo, plant-based and dietary guidelines-based diets reduced homeostasis model assessment of insulin resistance (−0.95 to −0.35, all p 0.05). No dietary pattern ranked consistently highest. The Paleo diet received the highest all-outcomes-combined average Surface Under the Cumulative Ranking Curve value (67%), followed by DASH (62%) and Mediterranean diets (57%), whereas western habitual diet was lowest (36%). Our findings were independent of macronutrient composition, highlighting the significance of dietary pattern-level analysis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2022
DOI: 10.1161/CIRC.145.SUPPL_1.P058
Abstract: Each year, there are millions non-communicable diseases (NCDs) related deaths that are attributed to dietary risk factors. Dietary pattern describes the overall combination of dietary components, therefore is a more proximate representation of real-world dietary intake. The comparisons of different dietary patterns have been largely limited by the traditional pair-wise meta-analysis. We conducted a systematic review and network meta-analysis of randomised trials with healthy participants to compare major dietary patterns in NCD prevention, using biomarkers of NCDs as outcomes. For each biomarker outcome, a random effects network meta-analysis was conducted to estimate all possible pair-wise relative effects and to obtain a relative ranking of the dietary patterns in a connected network. The relative effects were estimated by calculating the summary mean differences (MD) with corresponding 95% CI. The relative ranking was assessed using the distribution of the ranking probabilities and the surface under the cumulative ranking curves (SUCRA). Of the 4008 records identified from the systematic literature search, 72 articles met our inclusion criteria and 68 were included in the quantitative synthesis. We compared up to 11 dietary patterns (Mediterranean diet, DASH diet, Paleo diet, dietary guidelines-based diet, low GI / GL diet, plant based diet, low fat diet, low carbohydrate high fat diet, traditional Mexican diet, high GI / GL diet and western habitual diet) for their effects on 11 NCD biomarkers (HDL, TG, LDL, TC, glucose, insulin, hsCRP, apoB, apoA1, HOMA-IR, and IL-6). Compared to western habitual diet, the Mediterranean diet, DASH diet, dietary guidelines based diet, plant based diet and low fat diet reduced LDL, TC, and apoB (MD range: -0.29 to -0.17 mmol/L, -0.36 to -0.24 mmol/L, and -0.11 to -0.07 g/L, respectively, all p .05) the Paleo diet, plant based diet and dietary guidelines based diet reduced HOMA-IR (MD range: -0.95 to -0.35, all p .05). While no dietary pattern ranked consistently highest across all NCD biomarkers, the Mediterranean diet was best to improve lipid profile (LDL, HDL, TC, TG, apoB and apoA1 combined average SUCRA: 63.1%) low carbohydrate high fat diet was best for glycaemic control (glucose, insulin and HOMA-IR combined average SUCRA: 66.4%) and Paleo diet was best in inflammation reduction (hsCRP and IL-6 combined average SUCRA: 87.0%). The Paleo diet had the highest all-outcomes-combined ranking (average SUCRA: 63.1%), followed by the Mediterranean diet (58.9%) and DASH diet (58.8%), while the western habitual diet (37.8%) and high GI / GL diet (38.5%) received the lowest all-outcomes-combined SUCRAs. Our findings suggest that the Paleo diet may provide potential health benefit and warrants further consideration for NCD prevention.
Publisher: Elsevier BV
Date: 2021
Publisher: MDPI AG
Date: 22-03-2019
DOI: 10.3390/NU11030683
Abstract: Background: Many dietary recommendations for weight control rely on the assumption that greater core food intake will displace intake of energy-dense discretionary foods and beverages. However, there is little evidence to support these assumptions. This study examined the naturalistic relationship between daily core and discretionary energy intake, and with discretionary food and discretionary beverage intake, separately. The impact of weight status on these associations was also examined. Method: One hundred participants completed a four-day (non-consecutive) estimated food diary. Discretionary foods and beverages were identified by reference to the Australian Dietary Guidelines. Non-discretionary items were considered core items. Simultaneous-equation random effects models using disaggregated dietary data controlling for sociodemographic variables were used to determine the association between various dietary components. Result: Core energy intake correlated negatively with discretionary energy intake (cross-equation correlation, ρ = −0.49 (95% CI: −0.57, −0.39)). Its correlation with discretionary foods (−0.47 (−0.56, −0.37)) was stronger than that with discretionary beverages (−0.19 (−0.30, −0.07)) The correlation between core energy intake and discretionary energy intake was significantly stronger in participants who did not have obesity (−0.67 (−0.71, −0.50)) than those with obesity (−0.32 (−0.46, −0.17)) (p = 0.0002). Conclusions: Core and discretionary energy intake share an inverse and potentially bidirectional, relationship that appears to be stronger with discretionary foods than discretionary beverages. These relationships were significantly weaker in participants with obesity which may indicate less precise dietary compensation in these in iduals. While strategies that promote greater intake of core foods may assist with weight maintenance in in iduals of healthy weight, its impact in in iduals with obesity may be limited. These strategies should be accompanied by direct messages to reduce commensurately the intake of discretionary items, with special attention paid to discretionary beverage consumption.
Start Date: 2024
End Date: 12-2026
Amount: $440,665.00
Funder: Australian Research Council
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