ORCID Profile
0000-0003-4449-4404
Current Organisation
Monash University
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Publisher: Wiley
Date: 27-02-2019
DOI: 10.1111/IJPO.12517
Abstract: Early childhood obesity prevention is gaining increasing importance, as the prevalence of children with overweight and obesity aged 5 years and under increases worldwide. Along with understanding the effectiveness of obesity interventions, it is important to understand the cost-effectiveness of interventions over time. To estimate the long-term health benefits and health care cost-savings of reductions in BMI for the Australian population of children aged between 2 and 5 years. A proportional multistate, multiple cohort lifetable model estimated the health benefits and health care cost-savings related to hypothetical reductions in BMI, informed by a scoping review of systematic reviews reporting the effectiveness of obesity prevention interventions in preschool aged children. Results suggest significant potential for cost-effectiveness of obesity prevention interventions in preschool-aged children if intervention effect can be maintained. A relatively small population level reduction in BMI z-score (-0.13 BMIz) in children aged 2 to 5 years would result in 36 496 health-adjusted life years saved (95% uncertainty interval [UI], 30 283-42 945) and health care cost-savings of approximately $301 million (95% UI $234 million-$369 million) if modelled over the lifetime. Scenario results highlight the importance of obesity intervention in the early years of life.
Publisher: Wiley
Date: 27-09-2022
DOI: 10.1002/OBY.23547
Abstract: This study aimed to conduct an economic evaluation of the Communicating Healthy Beginnings Advice by Telephone (CHAT) trial to prevent childhood obesity. Cost‐effectiveness analyses were conducted for the telephone and short message service (SMS) delivery of Healthy Beginnings advice, compared with usual care, which included child health services unrelated to Healthy Beginnings. Costs were valued in 2018 Australian dollars, and costs and outcomes were discounted at 5% per year. The costs of upscaling both delivery modes to all yearly births in New South Wales, Australia, were estimated and compared with the original Healthy Beginnings home‐visiting intervention. At child age 2 years, the SMS delivery was more cost‐effective ($5154 per unit BMI and $979 per 0.1 BMI z score units avoided) than the telephone delivery ($10,665 per unit BMI and $2017 per 0.1 BMI z score units avoided). The costs of upscaling the SMS ($7.64 million) and the telephone delivery modes ($37.65 million) were lower than the home‐visiting intervention ($108.45 million). SMS delivery of Healthy Beginnings advice was more cost‐effective than telephone delivery but less cost‐effective than the original home‐visiting approach ($4230 per unit BMI avoided, as calculated in an earlier study). Both the SMS and telephone interventions were more affordable than the home‐visiting approach.
Publisher: Wiley
Date: 17-03-2022
DOI: 10.1111/IJPO.12915
Abstract: Given the high prevalence of early childhood overweight and obesity, more evidence is required to better understand the cost‐effectiveness of community‐wide interventions targeting obesity prevention in children aged 0–5 years. To assess the cost‐effectiveness of the Romp & Chomp community‐wide early childhood obesity prevention intervention if delivered across Australia in 2018 from a funder perspective, against a no‐intervention comparator. Intervention costs were estimated in 2018 Australian dollars. The annual Early Prevention of Obesity in Childhood micro‐simulation model estimated body mass index (BMI) trajectories to age 15 years, based on end of trial data at age 3.5 years. Results from modelled cost‐effectiveness analyses were presented as incremental cost‐effectiveness ratios (ICERs): cost per BMI unit avoided, and cost per quality‐adjusted life year (QALY) gained at age 15 years. All Australian children aged 0–5 years ( n = 1 906 075) would receive the intervention. Total estimated intervention cost and annual cost per participant were AUD178 million and AUD93, respectively, if implemented nationally. The ICERs were AUD1 126 per BMI unit avoided and AUD26 399 per QALY gained (64% probability of being cost‐effective measured against a AUD50 000 per QALY threshold). Romp & Chomp has a fair probability of being cost‐effective if delivered at scale.
Publisher: Oxford University Press (OUP)
Date: 19-03-2018
DOI: 10.1093/IJE/DYY016
Publisher: Optica Publishing Group
Date: 13-04-2021
DOI: 10.1364/OE.414178
Abstract: We report on both experiments and theory of low-terahertz frequency range (up to 400 GHz) magnetoplasmons in a gated two-dimensional electron gas at low ( K) temperatures. The evolution of magnetoplasmon resonances was observed as a function of magnetic field at frequencies up to ∼400 GHz. Full-wave 3D simulations of the system predicted the spatial distribution of plasmon modes in the 2D channel, along with their frequency response, allowing us to distinguish those resonances caused by bulk and edge magnetoplasmons in the experiments. Our methodology is anticipated to be applicable to the low temperature ( K) on-chip terahertz measurements of a wide range of other low-dimensional mesoscopic systems.
Publisher: Frontiers Media SA
Date: 03-2019
Publisher: Springer Science and Business Media LLC
Date: 16-01-2020
DOI: 10.1038/S41366-020-0529-3
Abstract: Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence. We used data from the Longitudinal Study of Australian Children (LSAC), a cohort study in which children were interviewed biennially from ages 4 to 17 years over seven waves of data. Measurements of HRQoL (using PedsQL Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P 0.05). Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.
Publisher: Springer Science and Business Media LLC
Date: 27-08-2022
DOI: 10.1007/S40519-022-01458-8
Abstract: Eating disorders (EDs) and high body mass index (BMI) are two important public health issues with significant health and cost impacts. The aim of this systematic review and meta-analysis was to establish whether interventions are effective in preventing both issues. Electronic databases were searched up to 10 May 2021. Studies were included if they were randomised or quasi-randomised controlled trials that evaluated a preventive intervention (regardless of its aim to prevent ED, high BMI or both) and reported both EDs and BMI-related outcomes. Both narrative synthesis and meta-analysis were used to synthesise the results. Publication bias was also investigated. Fifty-four studies were included for analysis. The primary aim of the studies was ED prevention ( n = 23), high BMI prevention ( n = 21) and both ED and high BMI prevention ( n = 10). Meta-analysis results indicated that preventive interventions had a significant effect on several ED outcomes including dieting, shape and weight concerns, body dissatisfaction, negative affect, eating disorder symptoms and internalization, with effect sizes ranging from – 0.16 (95% CI – 0.27, – 0.06) to – 0.61 (95% CI – 0.29, – 0.04). Despite several studies that demonstrated positive impacts on BMI, there was no significant effect on BMI-related measures in the meta-analysis. The risk of publication bias was low for the majority of the pooled effect results. Preventive interventions were effective for either high BMI or EDs. However, there is limited evidence to show that current preventive interventions were effective in reducing both outcomes. Further research is necessary to explore the risk factors that are shared by these weight-related disorders as well as effective prevention interventions. Level I: systematic review.
Publisher: Wiley
Date: 24-08-2020
DOI: 10.1111/COB.12391
Publisher: Royal Zoological Society of New South Wales
Date: 10-2008
DOI: 10.7882/AZ.2008.012
Publisher: AIP Publishing
Date: 06-2021
DOI: 10.1063/5.0046186
Abstract: Near-field microscopy techniques operating in the terahertz (THz) frequency band offer the tantalizing possibility of visualizing with nanometric resolution the localized THz fields supported by in idual resonators, micro-structured surfaces, and metamaterials. Such capabilities promise to underpin the future development and characterization of a wide range of devices, including THz emitters, detectors, optoelectronic modulators, sensors, and novel optical components. In this work, we report scattering-type scanning near-field optical microscopy using a THz-frequency quantum cascade laser (QCL) to probe coherently the localized field supported by in idual micro-resonator structures. Our technique demonstrates deep sub-wavelength mapping of the field distribution associated with in-plane resonator modes in plasmonic dipole antennas and split ring resonator structures. By exploiting electronic tuning of the QCL in conjunction with the coherent self-mixing effect in these lasers, we are able to resolve both the magnitude and the phase of the out-of-plane field. We, furthermore, show that the elliptically polarized state of the QCL field can be exploited for the simultaneous excitation and measurement of plasmonic resonances in these structures while suppressing the otherwise dominant signal arising from the local material permittivity.
Publisher: Wiley
Date: 29-04-2013
DOI: 10.1111/AEC.12034
Publisher: Springer Science and Business Media LLC
Date: 03-06-2020
DOI: 10.1038/S41586-020-2338-1
Abstract: High blood cholesterol is typically considered a feature of wealthy western countries 1,2 . However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world 3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health 4,5 . However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million in iduals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2023
DOI: 10.1186/S40337-022-00725-4
Abstract: There have been an increasing number of systematic reviews indicating the association between eating disorders (ED), including its risk factors, with mental health problems such as depression, suicide and anxiety. The objective of this study was to conduct an umbrella review of these reviews and provide a top-level synthesis of the current evidence in this area. A systematic search was performed using four databases (MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE). The inclusion criteria were systematic reviews (with or without meta-analysis), published in the English language between January 2015 and November 2022. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for use of JBI Systematic reviews. A total of 6,537 reviews were identified, of which 18 reviews met the inclusion criteria, including 10 reviews with meta-analysis. The average quality assessment score for the included reviews was moderate. Six reviews investigated the association between ED and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. A further 3 reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while 2 reviews focused on ED and suicidal-related outcomes. The remaining 7 reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems. Mental health problems such as depression, social anxiety and ADHD were found to be more prevalent among people suffering from eating disorders. Further research is necessary to understand the mechanism and health impacts of potential comorbidities of ED.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Public Library of Science (PLoS)
Date: 07-06-2012
Publisher: Elsevier BV
Date: 08-2019
Publisher: Springer Science and Business Media LLC
Date: 03-10-2019
DOI: 10.1038/S41366-018-0210-2
Abstract: Adult obesity has been shown to substantially heighten the risk of adverse health outcomes but its impact on life expectancy (LE) has not been quantified in Australia. Our aim is to estimate reductions in LE and years of life lost (YLL) associated with overweight and obesity, relative to those at a healthy weight for Australian adults aged 20-69 years. We used a microsimulation model of obesity progression in Australia that integrates annual change in BMI based on age and sex, with Australian life-table data and published relative risk of all-cause mortality for different BMI categories. Remaining LE and YLL compared to healthy weight were estimated using 10-year cohorts, by sex. A nationally representative s le of 12,091 adults aged 20-69 from the 2014/15 Australian National Health Survey were used to represent the input population of 14.9 million. Estimated remaining years of LE for healthy weight men and women aged 20-29 years was approximately 57.0 (95% CI 56.7-57.4) and 59.7 (95% CI 59.4-60.0) years, respectively. YLL associated with being overweight at baseline was approximately 3.3 years. For those obese and severely obese the loss in LE was predicted to be 5.6-7.6 years and 8.1-10.3 years for men and women aged 20-29 years, respectively. Across men and women, excess BMI in the adult population is responsible for approximately 36.3 million YLLs. Men stand to lose 27.7% more life years compared to women. Overweight and obesity is associated with premature mortality at all ages, for both men and women. Adults aged 20-39 years with severe obesity will experience the largest YLL, relative to healthy weight. More needs to be done in Australia to establish a coherent, sustained, cost-effective strategy to prevent overweight and obesity, particularly for men in early adulthood.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2019
Publisher: BMJ
Date: 03-2019
DOI: 10.1136/BMJOPEN-2018-026525
Abstract: To develop a model to predict future socioeconomic inequalities in body mass index (BMI) and obesity. Microsimulation modelling using BMI data from adult participants of Australian Health Surveys, and published data on the relative risk of mortality in relation to BMI and socioeconomic position (SEP), based on education. Australia. 74 329 adults, aged 20 and over from Australian Health Surveys, 1995–2015. The primary outcomes were BMI trajectories and obesity prevalence by SEP for four birth cohorts, born 10 years apart, centred on 1940, 1950, 1960 and 1970. Simulations projected persistent or widening socioeconomic inequality in BMI and obesity over the adult life course, for all birth cohorts. Recent birth cohorts were predicted to have greater socioeconomic inequality by middle age, compared with earlier cohorts. For ex le, among men, there was no inequality in obesity prevalence at age 60 for the 1940 birth cohort (low SEP 25% (95% CI 17% to 34%) high SEP 26% (95% CI 19% to 34%)), yet for the 1970 birth cohort, obesity prevalence was projected to be 51% (95% CI 43% to 58%) and 41% (95% CI 36% to 46%) for the low and high SEP groups, respectively. Notably, for more recent birth cohorts, the model predicted the greatest socioeconomic inequality in severe obesity (BMI kg/m 2 ) at age 60. Lower SEP groups and more recent birth cohorts are at higher risk of obesity and severe obesity, and its consequences in middle age. Prevention efforts should focus on these vulnerable population groups in order to avoid future disparities in health outcomes. The model provides a framework for further research to investigate which interventions will be most effective in narrowing the gap in socioeconomic disparities in obesity in adulthood.
Publisher: Wiley
Date: 03-10-2020
DOI: 10.1002/OBY.22989
Publisher: Elsevier BV
Date: 02-2012
Publisher: Elsevier BV
Date: 07-2021
Publisher: Wiley
Date: 03-2021
Publisher: Wiley
Date: 18-02-2011
Publisher: Wiley
Date: 21-01-2018
DOI: 10.1111/OBR.12672
Abstract: Rigorous estimates of preference-based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta-analysis was therefore undertaken, pooling data on preference-based health state utilities by weight status in children using a random-effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference-based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84-0.87), 0.83 (95% UI 0.81-0.85), 0.82 (95% UI 0.79-0.84) and 0.83 (95% UI 0.80-0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta-analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003-0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004-0.018). Study findings suggest that paediatric-specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost-effectiveness if weight loss in childhood/adolescence improves health or well-being.
Publisher: Springer Science and Business Media LLC
Date: 10-07-2018
DOI: 10.1007/S11136-018-1932-2
Abstract: Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument. HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children's health status was scored across eight attributes of the HUI3-vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility. Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child's sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found. Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course. Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
Publisher: eLife Sciences Publications, Ltd
Date: 09-03-2021
DOI: 10.7554/ELIFE.60060
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
Publisher: Springer Science and Business Media LLC
Date: 14-06-2013
DOI: 10.1007/S10198-013-0492-1
Abstract: The literature is full of lively discussion on the determinants of population health outcomes. However, different papers focus on small and different sets of variables according to their research agenda. Because many of these variables are measures of different aspects of development and are thus correlated, the results for one variable can be sensitive to the inclusion/exclusion of others. We tested for the robustness of potential predictors of population health using the extreme bounds analysis. Population health was measured by life expectancy at birth and infant mortality rate. We found that only about half a dozen variables are robust predictors for life expectancy and infant mortality rate. Among them, adolescent fertility rate, improved water sources, and gender equality are the most robust. All institutional variables and environment variables are systematically non-robust predictors of population health. The results highlight the importance of robustness tests in identifying predictors or potential determinants of population health, and cast doubts on the findings of previous studies that fail to do so.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Wiley
Date: 18-06-2020
DOI: 10.1111/IJPO.12684
Publisher: Elsevier BV
Date: 03-2022
Publisher: American Chemical Society (ACS)
Date: 26-03-2021
Publisher: IOP Publishing
Date: 05-04-2023
Abstract: Terahertz (THz) radiation encompasses a wide spectral range within the electromagnetic spectrum that extends from microwaves to the far infrared (100 GHz–∼30 THz). Within its frequency boundaries exist a broad variety of scientific disciplines that have presented, and continue to present, technical challenges to researchers. During the past 50 years, for instance, the demands of the scientific community have substantially evolved and with a need for advanced instrumentation to support radio astronomy, Earth observation, weather forecasting, security imaging, telecommunications, non-destructive device testing and much more. Furthermore, applications have required an emergence of technology from the laboratory environment to production-scale supply and in-the-field deployments ranging from harsh ground-based locations to deep space. In addressing these requirements, the research and development community has advanced related technology and bridged the transition between electronics and photonics that high frequency operation demands. The multidisciplinary nature of THz work was our stimulus for creating the 2017 THz Science and Technology Roadmap (Dhillon et al 2017 J. Phys. D: Appl. Phys. 50 043001). As one might envisage, though, there remains much to explore both scientifically and technically and the field has continued to develop and expand rapidly. It is timely, therefore, to revise our previous roadmap and in this 2023 version we both provide an update on key developments in established technical areas that have important scientific and public benefit, and highlight new and emerging areas that show particular promise. The developments that we describe thus span from fundamental scientific research, such as THz astronomy and the emergent area of THz quantum optics, to highly applied and commercially and societally impactful subjects that include 6G THz communications, medical imaging, and climate monitoring and prediction. Our Roadmap vision draws upon the expertise and perspective of multiple international specialists that together provide an overview of past developments and the likely challenges facing the field of THz science and technology in future decades. The document is written in a form that is accessible to policy makers who wish to gain an overview of the current state of the THz art, and for the non-specialist and curious who wish to understand available technology and challenges. A such, our experts deliver a ‘snapshot’ introduction to the current status of the field and provide suggestions for exciting future technical development directions. Ultimately, we intend the Roadmap to portray the advantages and benefits of the THz domain and to stimulate further exploration of the field in support of scientific research and commercial realisation.
Publisher: Springer Science and Business Media LLC
Date: 26-05-2023
DOI: 10.1007/S11136-023-03441-X
Abstract: This paper aims to systematically identify reported health state utility values (HSUVs) in children and adolescents with mental health problems (MHPs) aged less than 25 years to summarise the techniques used to elicit HSUVs and to examine the psychometric performance of the identified multi-attribute utility instruments (MAUIs) used in this space. A systematic review was conducted following PRISMA guidelines. Peer-reviewed studies published in English, reporting HSUVs for children and adolescents with MHPs using direct or indirect valuation methods were searched in six databases. We found 38 studies reporting HSUVs for 12 types of MHPs across 12 countries between 2005 and October 2021. Attention deficit hyperactivity disorder (ADHD) and depression are the most explored MHPs. Disruptive Behaviour Disorder was associated with the lowest reported HSUVs of 0.06 while cannabis use disorder was associated with the highest HSUVs of 0.88. Indirect valuation method through the use of MAUIs (95% of included studies) was the most frequently used approach, while direct valuation methods (Standard Gamble, Time Trade-Off) were only used to derive HSUVs in ADHD. This review found limited evidence of the psychometric performance of MAUIs used in children and adolescents with MHPs. This review provides an overview of HSUVs of various MHPs, the current practice to generate HSUVs, and the psychometric performance of MAUIs used in children and adolescents with MHPs. It highlights the need for more rigorous and extensive psychometric assessments to produce evidence on the suitability of MAUIs used in this area.
Publisher: Wiley
Date: 09-11-2018
DOI: 10.1111/JPC.14292
Abstract: To describe patterns of health-care utilisation and costs of a cohort of Australian children in the first 5 years of life and to investigate demographic factors associated with high health-care utilisation. This was a secondary data analysis of prospectively linked health-care utilisation data, including primary and secondary health-care consults, hospitalisations and emergency. The subjects were 350 children from a disadvantaged area of Sydney. Outcomes were the frequency and cost of all health-care consults from birth to 5 years of age. Multivariable logistic regression examined the odds of being a high health-care user in relation to child and family characteristics. Children had more health-care consults and higher annual health-care costs in the first 2 years of life (mean 12 health-care visits per year, mean cost Australian dollars (AUD) 1400 per child) than in the next 3 years (8 visits per year, AUD 900 per child). Primary care consults formed 86% of all health-care encounters but only contributed to 30% of the total costs. Factors positively associated with frequent use of health care in the first 2 years of life included being male, mother not married/de facto and annual household income of less than AUD 40000. Frequent users mostly accessed primary care services. There was no association between demographic factors and frequent use of health care in years 3-5 of life. Children from low-income or single-parent families may require additional support services during the first 2 years of life. Maintaining or increasing access to free or very low-cost primary health-care services for disadvantaged families will promote equity in health.
Publisher: Springer Science and Business Media LLC
Date: 19-03-2022
DOI: 10.1186/S12966-022-01276-2
Abstract: Strong evidence indicates that excessive time spent sitting (sedentary behaviour) is detrimentally associated with multiple chronic diseases. Sedentary behaviour is prevalent among adults in Australia and has increased during the COVID-19 pandemic. Estimating the potential health benefits and healthcare cost saving associated with reductions in population sitting time could be useful for the development of public health initiatives. A sedentary behaviour model was developed and incorporated into an existing proportional, multi-state, life table Markov model (ACE-Obesity Policy model). This model simulates the 2019 Australian population (age 18 years and above) and estimates the incidence, prevalence and mortality of five diseases associated with sedentary behaviour (type 2 diabetes, stroke, endometrial, breast and colorectal cancer). Key model inputs included population sitting time estimates from the Australian National Health Survey 2014–2015, healthcare cost data from the Australian Institute of Health and Welfare (2015) and relative risk estimates assessed by conducting literature reviews and meta-analyses. Scenario analyses estimated the potential change in disease incidence as a result of changes in population sitting time. This, in turn, resulted in estimated improvements in long term health outcomes (Health-adjusted life years (HALYs)) and healthcare cost-savings. According to the model, if all Australian adults sat no more than 4 h per day, the total HALYs gained would be approximately 17,211 with health care cost savings of approximately A$185 million over one year. Under a more feasible scenario, where sitting time was reduced in adults who sit 4 or more hours per day by approximately 36 min per person per day (based on the results of the Stand Up Victoria randomised controlled trial), potential HALYs gained were estimated to be 3,670 and healthcare cost saving could reach A$39 million over one year. Excessive sedentary time results in considerable population health burden in Australia. This paper describes the development of the first Australian sedentary behaviour model that can be used to predict the long term consequences of interventions targeted at reducing sedentary behaviour through reductions in sitting time. These estimates may be used by decision makers when prioritising healthcare resources and investing in preventative public health initiatives.
Publisher: Springer Science and Business Media LLC
Date: 29-03-2023
DOI: 10.1038/S41586-023-05772-8
Abstract: Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1–6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was .1 kg m –2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have lified.
Publisher: Springer Science and Business Media LLC
Date: 05-2019
Publisher: Springer International Publishing
Date: 2023
Publisher: AME Publishing Company
Date: 04-2023
No related grants have been discovered for Eng Joo Tan.