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0000-0002-5138-2526
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Publisher: Elsevier BV
Date: 05-2017
Publisher: Elsevier BV
Date: 11-2018
Publisher: Oxford University Press (OUP)
Date: 06-08-2014
DOI: 10.1093/AJE/KWU201
Publisher: Informa UK Limited
Date: 25-11-2020
Publisher: Cambridge University Press (CUP)
Date: 12-05-2016
DOI: 10.1017/S0007114516001690
Abstract: The aims of the present study were to provide nationally representative data on fruit and vegetable consumption in Vietnam, and to assess the accuracy of the reported numbers of ‘standard servings’ consumed. Data analysed were from a multi-stage stratified cluster survey of 14 706 participants (46·5 % males, response proportion 64·1 %) aged 25−64 years in Vietnam. Measurements were made in accordance with the WHO STEPwise approach to surveillance of non-communicable diseases (STEPS) protocols. Approximately 80 % of Vietnamese people reported having less than five servings of fruit and vegetables daily in a typical week. Fruit and vegetable intake reported in ‘standard serving’ sizes was positively correlated with levels of education completed and household income ( P ·001 for trend). The correlations between summary values for each province reflect some known demographic, geographical and climatic characteristics of the country. For ex le, provinces at higher latitude had higher mean servings of vegetables ( r 0·90), and provinces with higher proportions of urban population had higher mean servings of fruit ( r 0·40). In conclusion, about eight in ten Vietnamese people aged 25–64 years did not meet WHO recommendations for daily consumption of at least five servings of fruit and vegetables. On the basis of the consistency of the data collected with other estimates and with physical and demographic characteristics of the country, the WHO STEPS instrument has construct validity for measuring fruit and vegetable intake, but with two issues identified. The issues were seasonal variation in reporting and a limitation on the usefulness of the information for associative analyses.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-07-2020
DOI: 10.1249/MSS.0000000000002108
Abstract: Child and adult muscular power have been shown to associate with contemporary cardiometabolic health. Muscular power typically persists (tracks) between childhood and adulthood. Few studies span childhood to adulthood, so we aimed to identify modifiable and environmental factors associated with the persistence or change in muscular power across the life course. Prospective study examining 1938 participants who had their muscular power (standing long jump distance) measured in 1985 as children 7–15 yr old and again 20 yr later in adulthood (26–36 yr old). A selection of objectively measured anthropometric characteristics (adiposity and fat-free mass), cardiorespiratory fitness (CRF), self-reported physical activity, dietary (quality and fruit, vegetable, and protein intake), and sociodemographic data were available at both time points. Muscular power was separated into thirds, and participants were reported as having persistently low, decreasing, persistently moderate, increasing, or persistently high muscular power. Higher adiposity, lower physical activity, diet quality and socioeconomic status (SES) across the life course, and lower adult CRF were associated with persistently low muscular power. Lower adult protein intake and an increase in adiposity over time were associated with decreasing muscular power. An increase in fat-free mass was associated with a reduced probability of decreasing or persistently high muscular power and an increased probability of increasing muscular power. Higher adult fruit intake was associated with increasing muscular power. Lower adiposity across the life course, higher adult CRF and SES, and higher child protein intake were associated with persistently high muscular power. Healthy weight, good CRF, greater protein intake, and high SES are important correlates of high muscular power maintained from childhood to adulthood.
Publisher: Oxford University Press (OUP)
Date: 15-04-2014
DOI: 10.1093/AJE/KWU050
Abstract: Few studies have examined longitudinal associations between fish consumption and depression none have defined depression using a diagnostic tool. We investigated whether fish consumption was associated with fewer new depression episodes in a national study of Australian adults. In 2004-2006, 1,386 adults aged 26-36 years (38% males) completed a 127-item (9 fish items) food frequency questionnaire. Fish intake was examined continuously (times/week) and dichotomously (reference group: <2 times/week). During 2009-2011, the lifetime version of the Composite International Diagnostic Interview was administered by telephone. New episodes of major depression/dysthymic disorder (since baseline) were defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. During follow-up, 160 (18.8%) women and 70 (13.1%) men experienced depression. For women, each additional weekly serving of fish consumed at baseline decreased the risk of having a new depressive episode by 6% (adjusted relative risk = 0.94, 95% confidence interval: 0.87, 1.01). Women who ate fish ≥2 times/week at baseline had a 25% lower risk of depression during follow-up than those who ate fish <2 times/week (adjusted relative risk = 0.75, 95% confidence interval: 0.57, 0.99). Reverse causation was also suggested but appeared to be restricted to persons with recent depression. Fish consumption was not associated with depression in men. These findings provide further evidence that fish consumption may be beneficial for women's mental health.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2005
DOI: 10.1161/01.STR.0000183621.32045.31
Abstract: Background and Purpose— Although much is known about the long-term outcome of stroke patients in terms of mortality and disability, there has been little research on the patient-centered outcome of health-related quality of life (HRQoL). There are limited natural history data on HRQoL beyond 2 years after stroke and no data on those factors present at stroke onset that predict HRQoL beyond 2 years after stroke. For these reasons, we aimed to examine these aspects of HRQoL in an unselected population of stroke patients. Methods— All cases of first-ever stroke from a prospective community-based stroke incidence study (excluding subarachnoid hemorrhage) were assessed 5 years after stroke. HRQoL was measured with the assessment of quality of life instrument. ANOVA was used to determine baseline predictors of HRQoL. Results— In total, 978 cases were recruited, 45% were male, and the mean age (±SD) was 75.5±13.8 years. Five years after stroke, 441 (45.1%) were alive and 356 were assessed (80.7%). Those assessed were more often born in Australia and older in age (both P .05). Seventy-one survivors (20%) had a very low HRQoL (score ≤0.1). The independent baseline predictors of low HRQoL at 5 years after stroke were increasing age, lower socioeconomic status, and markers of stroke severity. Conclusion— At 5 years after stroke, we found that a substantial proportion of survivors were suffering from poor HRQoL. As our population ages, the number of strokes and, thus, stroke survivors with poor HRQoL is likely to increase. Therefore, strategies to improve HRQoL should be vigorously pursued.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-09-2022
Abstract: Women have been reported to have worse health‐related quality of life (HRQoL) following stroke than men, but uncertainty exists over the reasons for the sex difference. We included all ischemic strokes registered with the BASIC (Brain Attack Surveillance in Corpus Christi) project (May 2010–December 2016), a population‐based stroke study, who completed a 90‐day outcome interview. Information on baseline characteristics was obtained from medical records and in‐person interviews. HRQoL was measured by the 12‐item short‐form Stroke Specific Quality of Life Scale. Multivariable Tobit regression was used to estimate the mean difference in overall HRQoL scores (range, 1–5 higher indicating better HRQoL) between sexes and to identify contributing factors to the differences. We included 1061 cases with complete data on HRQoL and covariates (median age, 67 years 51% women). In unadjusted analyses, women had poorer overall HRQoL than men (mean difference, −0.26 [95% CI, −0.40 to −0.13]). Contributors to this difference included sociodemographic restroke factors (eg, age, race and ethnicity, prestroke function), risk factors/comorbidities (eg, history of stroke, Alzheimer disease/dementia), and initial stroke severity. Sociodemographic restroke factors explained 62% of the sex difference (mean difference, −0.08 [95% CI, −0.21 to 0.04]). In a fully adjusted model that included adjustment for all confounding factors, the sex difference was eliminated and became nonsignificant (mean difference, −0.03 [95% CI, −0.16 to 0.09]). Poorer HRQoL in women compared with men was observed and explained by the combination of sociodemographic and prestroke factors, including physical function before stroke and stroke severity. The findings suggest potential subgroups of women who might benefit from more targeted interventions before and after stroke to improve HRQoL.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2022
DOI: 10.1186/S12889-022-13937-9
Abstract: Transport-related physical activity (TRPA) has been identified as a way to increase physical activity due to its discretionary and habitual nature. Factors thought to influence TRPA span multiple disciplines and are rarely systematically considered in unison. This systematic review aimed to identify cross-sectional and longitudinal factors associated with adult TRPA across multiple research disciplines. Using four electronic databases, a systematic search of English, peer-reviewed literature from 2010 – 2020 was performed. Studies quantitatively examining factors associated with the outcome of adult TRPA were eligible. Seventy-three studies ( n = 66 cross-sectional n = 7 longitudinal) were included, cumulatively reporting data from 1,278,632 observations. Thirty-six factors were examined for potential association with TRPA and presented in a social-ecological framework: in idual ( n = 15), social ( n = 3), and environmental ( n = 18). Seven factors were found to be consistently associated with higher adult TRPA: lower socio-economic status, higher self-efficacy, higher social normalization, lower distance of travel, higher destination concentration, more streetlighting, and higher public transportation frequency with a greater number of terminals near route start and endpoints. This is the first comprehensive compilation of the correlates and determinants of adult TRPA. Seven in idual, social, and environmental factors demonstrated consistent associations with TRPA. Models formed using these factors may facilitate more effective promotion of TRPA. There is a lack of longitudinal studies as well as studies assessing cognitive/attitudinal and social factors, highlighting gaps for further research. Those developing policies and strategies targeting TRPA need to consider a range of factors at the in idual, social, and environmental level to maximise the likelihood of effectiveness.
Publisher: Springer Science and Business Media LLC
Date: 27-08-2015
DOI: 10.1007/S11136-015-1112-6
Abstract: The possibility that tobacco use affects health-related quality of life (HRQoL) has attracted interest. However, a lack of prospective evidence weakens the case for a causal relationship. The aim was to examine the longitudinal relationship between change in smoking status and change in HRQoL in young adults. We conducted a population-based cohort study with data collected in 2004-2006 (aged 26-36) and 2009-2011 (aged 31-41). Exposure was change in self-reported smoking status during follow-up. Outcomes were changes in physical and mental HRQoL measured by SF-12. For physical HRQoL (n = 2080), quitters had a 2.12 (95 % confidence interval (CI) 0.73, 3.51) point improvement than continuing smokers, whereas former smokers who resumed smoking had a 2.08 (95 % CI 0.21, 3.94) point reduction than those who maintained cessation. Resumed smokers were 39 % (95 % CI 10, 75 %) more likely to have a clinically significant (>5 point) reduction of physical HRQoL than former smokers who maintained cessation. In contrast, quitters were 43 % (95 % CI 3, 98 %) more likely to have a clinically significant (>5 point) improvement in physical HRQoL than continuing smokers. Change in smoking status was not significantly associated with change in mental HRQoL (n = 1788). Smoking by young adults was cross-sectionally associated with lower physical HRQoL and longitudinally associated with reductions in physical HRQoL. The expectation of short- to medium-term gains in physical HRQoL as well as long-term health benefits may help motivate young adult smokers to quit.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2023
DOI: 10.1161/HYPERTENSIONAHA.122.19883
Abstract: Real-world evidence is limited on whether antihypertensive medications help avert major adverse cardiovascular events (MACE) after stroke without increasing the risk of falls. We investigated the association of adherence to antihypertensive medications on the incidence of MACE and falls requiring hospitalization after stroke. A retrospective cohort study of adults who were newly dispensed antihypertensive medications after an acute stroke (Australian Stroke Clinical Registry 2012–2016 Queensland and Victoria). Pharmaceutical dispensing records were used to determine medication adherence according to the proportion of days covered in the first 6 months poststroke. Outcomes between 6 and 18 months postdischarge included: (i) MACE, a composite outcome of all-cause death, recurrent stroke or acute coronary syndrome and (ii) falls requiring hospitalization. Estimates were derived using Cox models, adjusted for confounders using inverse probability treatment weights. Among 4076 eligible participants (median age 68 years 37% women), 55% had a proportion of days covered ≥80% within 6 months postdischarge. In the subsequent 12 months, 360 (9%) participants experienced a MACE and 337 (8%) experienced a fall requiring hospitalization. After achieving balance between groups, participants with a proportion of days covered ≥80% had a reduced risk of MACE (hazard ratio: 0.68 95% CI: 0.54–0.84) and falls requiring hospitalization (subdistribution hazard ratio: 0.78 95% CI: 0.62–0.98) than those with a proportion of days covered %. High adherence to antihypertensive medications within 6 months poststroke was associated with reduced risks of both MACE and falls requiring hospitalization. Patients should be encouraged to adhere to their antihypertensive medications to maximize poststroke outcomes.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2017
Publisher: Korean Society for Preventive Medicine
Date: 31-03-2021
DOI: 10.3961/JPMPH.20.559
Publisher: Elsevier BV
Date: 10-2013
Publisher: Mary Ann Liebert Inc
Date: 04-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2023
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Publisher: Cold Spring Harbor Laboratory
Date: 12-09-2021
DOI: 10.1101/2021.09.08.21263308
Abstract: Using a new approach to the analysis and synthesis of a clinically focused mixed-methods multiple case study of aneurysmal subarachnoid haemorrhage (aSAH), we explored barriers and facilitators to timely treatment. In this paper we provide guidance for the multiple steps of analysis and synthesis of qualitative and quantitative data from across and within 27 case studies. Results showed that median (IQR) time to treatment was 15.1 (9.0, 24.1) hours. Only 37% of cases had treatment within 12-hours of onset. Early recognition of aSAH, good coordination, and availability of resources for treatment were main facilitators for treatment within 12 hours from onset. Lack of recognition of aSAH at onset and lack of resources for immediate in-hospital treatment were major barriers.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.IJCARD.2022.11.045
Abstract: Valvular heart disease is becoming an increasingly prevalent with population ageing. We sought to define the current prevalence of valvular heart disease in Australia. The TasELF and VicELF studies prospectively recruited 962 asymptomatic participants ≥65 years, with at least one cardiovascular risk factor, from the Tasmanian and Victorian communities. People were excluded if they had a previous diagnosis of heart failure, or a life expectancy <1 year. All underwent baseline echocardiography. Those with moderate or severe valvular disease were identified. The current prevalence of clinically significant valve disease was applied to the Australian Bureau of Statistics population projections. Echocardiograms were interpretable in 943 participants (98%). Clinically significant valve disease was present in 5% of the population, and mitral regurgitation was the most common overall valvular lesion, present in 36% of the population. The projected numbers of people with clinically significant valvular disease is expected to increase significantly across all age groups by the year 2060. Clinically significant yet asymptomatic valvular disease was prevalent in a large community cohort of participants with at least one risk factor. The total burden of valvular heart disease is expected to increase dramatically over the coming decades.
Publisher: Public Library of Science (PLoS)
Date: 20-10-2015
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JAND.2016.12.008
Abstract: Partnering and parenting are important life-stage transitions that often occur during young adulthood. Little is known about how these transitions affect two dietary behaviors linked to increased cardiometabolic disease risk: skipping breakfast and takeaway-food consumption. Our aim was to examine whether partnering and parenting transitions during a 5-year period were associated with change in diet quality, skipping breakfast, and takeaway-food consumption. We conducted a cohort study. Questionnaires were completed at baseline (2004 to 2006) and follow-up (2009 to 2011). Marital status and number of children were self-reported. Australian participants (n=1,402 [39% men]) aged 26 to 36 years were included. Diet quality was assessed using a Dietary Guideline Index. Breakfast skipping (not eating before 9 am the previous day) and frequent takeaway-food consumption (≥2 times/week) were reported. Linear regression (mean differences in Dietary Guideline Index) and log binomial regression (relative risks for skipping breakfast and frequent takeaway-food consumption) were adjusted for age, education, follow-up duration, day of the week (skipping breakfast only), the other transition, and baseline behavior. During the 5-year follow-up, 101 men and 93 women became married/living as married, and 149 men and 155 women had their first child. Diet quality improved among all groups and was similar at follow-up between those who experienced the transitions and those who did not. Compared to having no children, having a first child was associated with a lower risk of skipping breakfast for men (relative risk 0.65 95% CI 0.42 to 1.01) and women (relative risk 0.47 95% CI 0.31 to 0.72). Men who became partnered also had a lower risk of skipping breakfast than those who remained single (relative risk 0.64 95% CI 0.42 to 0.98). The transitions were not significantly associated with takeaway-food consumption. Life-stage transitions were not associated with better diet quality. Participants who became partnered or parents were more likely to eat breakfast at follow-up than those who remained single or had no children.
Publisher: Elsevier BV
Date: 12-2010
Abstract: The long-term effects of skipping breakfast on cardiometabolic health are not well understood. The objective was to examine longitudinal associations of breakfast skipping in childhood and adulthood with cardiometabolic risk factors in adulthood. In 1985, a national s le of 9-15-y-old Australian children reported whether they usually ate breakfast before school. During follow-up in 2004-2006, 2184 participants (26-36 y of age) completed a meal-frequency chart for the previous day. Skipping breakfast was defined as not eating between 0600 and 0900. Participants were classified into 4 groups: skipped breakfast in neither childhood nor adulthood (n = 1359), skipped breakfast only in childhood (n = 224), skipped breakfast only in adulthood (n = 515), and skipped breakfast in both childhood and adulthood (n = 86). Diet quality was assessed, waist circumference was measured, and blood s les were taken after a 12-h fast (n = 1730). Differences in mean waist circumference and blood glucose, insulin, and lipid concentrations were calculated by linear regression. After adjustment for age, sex, and sociodemographic and lifestyle factors, participants who skipped breakfast in both childhood and adulthood had a larger waist circumference (mean difference: 4.63 cm 95% CI: 1.72, 7.53 cm) and higher fasting insulin (mean difference: 2.02 mU/L 95% CI: 0.75, 3.29 mU/L), total cholesterol (mean difference: 0.40 mmol/L 95% CI: 0.13, 0.68 mmol/L), and LDL cholesterol (mean difference: 0.40 mmol/L 95% CI: 0.16, 0.64 mmol/L) concentrations than did those who ate breakfast at both time points. Additional adjustments for diet quality and waist circumference attenuated the associations with cardiometabolic variables, but the differences remained significant. Skipping breakfast over a long period may have detrimental effects on cardiometabolic health. Promoting the benefits of eating breakfast could be a simple and important public health message.
Publisher: Springer Science and Business Media LLC
Date: 08-2015
Publisher: Wiley
Date: 15-10-2020
DOI: 10.1111/ENE.14531
Publisher: Springer Science and Business Media LLC
Date: 07-05-2021
DOI: 10.1007/S00127-021-02086-W
Abstract: Many studies have reported associations between diet and depression, but few have used formal diagnoses of mood disorder as the outcome measure. We examined if overall diet quality was associated cross-sectionally or longitudinally with DSM-IV mood disorders among an adult cohort. Participants from the Australian Childhood Determinants of Adult Health study were followed up during 2004-06 (n = 1974, age 26-36 years), 2009-11 (n = 1480, 31-41 years), and 2014-19 (n = 1191, 36-49 years). Dietary Guidelines Index (DGI) scores were calculated from food frequency questionnaires at each time-point (higher DGI reflects better diet quality). DSM-IV mood disorders (dysthymia or depression) during the periods between, and 12 months prior to each follow-up were determined using the Composite International Diagnostic Interview. Sex-stratified risk and prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using log-binomial regression. Covariates included age, self-perceived social support index score, marital status, parenting status, education, occupation, physical activity, BMI, and usual sleep duration. A 10-point higher DGI was cross-sectionally associated with lower prevalence of mood disorders at the third follow-up only (females PR = 0.73, 95% CI = 0.56, 0.95 males PR = 0.72, 95% CI = 0.53, 0.97), but was attenuated after covariate adjustment (females PR = 0.92, 95% CI = 0.73, 1.16 males PR = 0.92, 95% CI = 0.69, 1.22). Adjustment for social support in the final model had attenuated the association for both sexes from 18% reduced prevalence to 8%. DGI scores were not longitudinally associated with mood disorder risk. Crude cross-sectional associations between diet quality and mood disorders at ages 36-49 years were explained by sociodemographic and lifestyle factors, particularly social support.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.ANNEPIDEM.2017.01.007
Abstract: This prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood. Participants aged 7-15 years in 1985 (n = 8498) were followed up in 2004-2006 (n = 3999, aged 26-36 years) and 2009-2011 (n = 3049, aged 31-41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009-2011). We tested which of three life-course models ("accumulation," "sensitive period," "mobility") best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework. Accumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m Greater cumulative exposure to rurality and exposure during the "sensitive period" of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.YPMED.2019.105861
Abstract: Much of what is known about childhood clusters of cardiovascular disease behavioural risk factors (RFs) comes from cross-sectional studies, providing little insight into the long-term health impacts of different behavioural cluster profiles. This study aimed to establish the longitudinal relationship between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs. Data were from an Australian prospective cohort study of 1265 participants measured in 1985 (ages 9-15 yrs), and in 2004-06 (ages 26-36 yrs). At baseline, children self-reported smoking status, alcohol consumption, physical activity (PA), dietary behaviour and psychological well-being. At follow-up, participants completed questionnaires and attended study clinics where the following component indicators of the metabolic syndrome (MetS) score were measured: waist circumference, blood pressure, fasting blood glucose and lipids. TwoStep cluster analyses were carried out to identify clusters in childhood. Linear regression was used to examine the longitudinal associations between cluster patterns of childhood behavioural RFs and adult cardio-metabolic RFs. Four childhood cluster patterns of behavioural RFs labelled 'most healthy', 'high PA', 'most unhealthy', and 'breakfast skippers' were identified. The unhealthier childhood clusters predicted a significantly higher adult MetS score ('most unhealthy': β = 0.10, 95%CI = 0.01, 0.19) and adult waist circumference ('most unhealthy': β = 2.29, 95%CI = 0.90, 6.67 'breakfast skippers': β = 2.15, 95%CI = 0.30, 4.00). These associations were independent of adult behavioural RFs and socio-economic position. These findings emphasise the impact of multiple childhood behavioural RFs on important adult health outcomes and may be useful for the development of early intervention strategies, where identification of children at higher risk of poorer adult cardio-metabolic health is vital.
Publisher: Cambridge University Press (CUP)
Date: 26-08-2021
DOI: 10.1017/S0007114521003317
Abstract: The impact of change in socio-economic status (SES) from childhood to adulthood (SES mobility) on adult diet is not well understood. This study examined associations between three SES mobility variables (area disadvantage, education, occupation) and adult diet quality. 1482 Australian participants reported childhood area-level SES in 1985 (aged 10–15 years) and retrospectively reported highest parental education and main occupation (until participant age 12) and own area-level SES, education, occupation and dietary intake in 2004–2006 (aged 26–36 years). A Dietary Guidelines Index (DGI) was calculated from food frequency and habit questionnaires. A higher score (range 0–100) indicated better diet quality. Sex-stratified linear regression models adjusted for confounders. Area-level SES mobility was not associated with diet quality. Compared with stable high (university) education, stable low (school only) was associated with lower DGI scores (males: β = –5·5, 95 % CI: −8·9, –2·1 females: β = –6·3, 95 % CI: −9·3, –3·4), as was downward educational mobility (participant’s education lower than their parents) (males: β = –5·3, 95 % CI: −8·5, –2·0 females: β = –4·5, 95 % CI: −7·2, –1·7) and stable intermediate (vocational) education among males ( β = –3·9, 95 % CI: −7·0, −0·7). Compared with stable high (professional/managerial) occupation, stable low (manual/out of workforce) males ( β = –4·9, 95 % CI: −7·6, –2·2), and participants with downward occupation mobility (males: β = –3·2, 95 % CI: −5·3, –1·1 females: β = –2·8, 95 % CI: −4·8, –0·8) had lower DGI scores. In this cohort, intergenerational low education and occupation, and downward educational and occupational mobility, were associated with poor adult diet quality.
Publisher: Wiley
Date: 08-2020
DOI: 10.1111/IMJ.14638
Abstract: Advances in stroke management such as acute stroke units and thrombolysis are not uniformly distributed throughout our population, with rural areas being relatively disadvantaged. It remains unclear, however, whether such disparities have led to corresponding differences in patient outcomes. To describe the regional differences in acute ischaemic stroke care and outcomes within the Australian state of Tasmania. A retrospective case note audit was used to assess the care and outcomes of 395 acute ischaemic stroke patients admitted to Tasmania's four major public hospitals. Sixteen care processes were recorded, which covered time-critical treatment, allied health interventions and secondary prevention. Outcome measures were assessed using 30-day mortality and discharge destination, both of which were analysed for differences between urban and rural hospitals using logistic regression. No patients in rural hospitals were administered thrombolysis these hospitals also did not have acute stroke units. With few exceptions, patients' access to the remaining care indicators was comparable between regions. After adjusting for confounders, there were no significant differences between regions in terms of 30-day mortality (odds ratio (OR) = 0.99, 95% confidence interval (CI) 0.46-2.18) or discharge destination (OR = 1.24, 95% CI 0.81-1.91). With the exception of acute stroke unit care and thrombolysis, acute ischaemic stroke care within Tasmania's urban and rural hospitals was broadly similar. No significant differences were found between regions in terms of patient outcomes. Future studies are encouraged to employ larger data sets, which capture a broader range of urban and rural sites and record patient outcomes at extended interval.
Publisher: SAGE Publications
Date: 19-08-2023
DOI: 10.1177/17474930231190745
Abstract: Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing and managing risk factors and promoting lifestyle changes for their patients. This is a mixed-methods cross-sectional two-phase survey using a largely positivist (quantitative and qualitative) framework. During Phase 1, a prototype of PreventS-MD was tested internationally by 59 of 69 consenting HCPs of different backgrounds, age, sex, working experience, and specialties using hypothetical data. Collected comments/suggestions from the study HCPs in Phase 1 were reviewed and implemented. In Phase 2, a near-final version of PreventS-MD was developed and tested by 58 of 72 consenting HCPs using both hypothetical and real patient (n = 10) data. Qualitative semi-structured interviews with real patients (n = 10) were conducted, and 1 month adherence to the preventive recommendations was assessed by self-reporting. The four System Usability Scale (SUS) groups of scores (0–50 unacceptable 51–68 poor 68–80.3 good .3 excellent) were used to determine usability of PreventS-MD. Ninety-nine HCPs from 27 countries (45% from low- to middle-income countries) participated in the study, and out of them, 10 HCPs were involved in the development of PreventS before the study, and therefore were not involved in the survey. Of the remaining 89 HCPs, 69 consented to the first phase of the survey, and 59 of them completed the first phase of the survey (response rate 86%), and 58 completed the second phase of the survey (response rate 84%). The SUS scores supported good usability of the prototype (mean score = 80.2 95% CI [77.0–84.0]) and excellent usability of the final version of PreventS-MD (mean score = 81.7 95% CI [79.1–84.3]) in the field. Scores were not affected by the age, sex, working experience, or specialty of the HCPs. One-month follow-up of the patients confirmed the high level of satisfaction/acceptability of PreventS-MD and (100%) adherence to the recommendations. The PreventS-MD web app has a high level of usability, feasibility, and satisfaction by HCPs and in iduals at risk of stroke/CVD. In iduals at risk of stroke/CVD demonstrated a high level of confidence and motivation in following and adhering to preventive recommendations generated by PreventS-MD.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
DOI: 10.1161/STROKEAHA.112.668905
Abstract: Smoking may exacerbate the risk of death or further vascular events in those with stroke, but data are limited. 1589 cases of first-ever and recurrent stroke were recruited between 1996 and 1999 from a defined geographical region in North East Melbourne. Both hospital and nonhospital cases were included. Over a 10-year period, all deaths, recurrent stroke events, and acute myocardial infarctions that were reported at follow-up interviews were validated using medical records. Cox proportional hazards regression was used to assess the association between baseline smoking status (never, ex, and current) and outcome (death, acute myocardial infarction, or recurrent stroke). Patients who were current smokers (Hazard Ratio [HR], 1.30 95% Confidence Interval [CI], 1.06–1.60 P =0.012) at the time of their stroke had poorer outcome when compared with those who had never smoked. Among those who survived the first 28 days of stroke, current smokers (HR, 1.42 95% CI, 1.13–1.78 P .003) and ex-smokers (HR, 1.18 95% CI, 1.01–1.39 P =0.039) at baseline had poorer outcome than those who had never smoked. Current smokers also had a greater risk of recurrent events than past smokers (HR, 1.23 95% CI, 1.00–1.50 P =0.050). Patients who smoked at the time of their stroke or had smoked before their stroke had greater risk of death or recurrent vascular events when compared with patients who were never smokers. There are benefits of smoking cessation, with ex-smokers appearing to have a lesser risk of recurrent vascular events than current smokers.
Publisher: S. Karger AG
Date: 15-07-2022
DOI: 10.1159/000517453
Abstract: b i Introduction and Aim: /i /b Internationally, women are underrepresented as leaders in major scientific organizations and conferences. We aimed to determine gender differences in leadership roles and annual scientific conferences of the Stroke Society of Australasia (SSA). b i Methods: /i /b In a retrospective review of SSA data (2014–2019), committee members were obtained through the SSA Web site, and moderators, speakers, and award recipients were identified from SSA annual scientific conference programs. Gender was determined by name inspection and Web search. Absolute numbers and proportions of women and men were recorded for all roles examined, overall and per year. Associations between representation of women in conferences and percentage of women in speaking roles were tested using multinomial regression. b i Results: /i /b Presidential leadership of the SSA was held by men in 2014–2016 and 2019 and women in 2017–2018. SSA committee membership was predominantly women (55%), being lowest (47%) in 2014 and 2019 and highest (65%) in 2017. There was a wide gender variation at scientific conferences, with 41% of keynote speakers being women overall, from 20% in 2016 to 75% in 2015. From 2014 to 2019, 55% of all speakers were women, ranging from 32% (in 2016) to 71% (in 2015). A higher percentage of women as speakers or moderators was associated with a program committee with over a third of its members composed of women ( i /i ≤ 0.044). b i Conclusions: /i /b Representation of women varied from 2014 to 2019 in the SSA organization and its conferences, although men are more often elected president in the organization and women are less often keynote speakers. When more women were included in the program committee, the representation of women as speakers increased.
Publisher: Wiley
Date: 20-01-2002
DOI: 10.1111/J.1360-0443.2008.02196.X
Abstract: To examine the long-term effects of childhood smoking experimentation and exposure to parental smoking on adult smoking risk. Data were from a 20-year follow-up of 9-15-year-olds who completed questionnaires in the 1985 Australian Schools Health and Fitness Survey (n=6559). The relative risks (RR) of adult current smoking in 2004-05 for childhood exposure to smoking experimentation (never, a few puffs, 10 cigarettes) and parental smoking (none, father, mother, both parents) in 1985, with adjustment for confounders, were estimated by log binomial modelling. Analyses were stratified by age (9-13 and 14-15 years) and sex. Participation at follow-up was 54% (n=3559). Childhood smoking experimentation increased the risk of being a current smoker particularly for 14-15-year-old experimenters of more than 10 cigarettes [males, RR 2.72, 95% confidence interval (CI) 1.74-4.25 females, RR 6.39, 95% CI 2.85-14.33]. Parental smoking was associated with adult current smoking risk, particularly for 9-13-year-olds with two smoking parents (males, RR 1.53, 95% CI 1.19-1.96 females, RR 1.99, 95% CI 1.52-2.61) and older males with smoking mothers (RR 1.82, 95% CI 1.22-2.73). Parental smoking was not associated with childhood smoking experimentation. These findings suggest that any childhood smoking experimentation increases the risk of being a smoker 20 years later. As exposure to parental smoking predicted current smoking, parents should be aware of the association between their own smoking behaviour and that of their children.
Publisher: Elsevier BV
Date: 2022
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.SAPHARM.2022.01.007
Abstract: It is unclear whether survivors of stroke or transient ischemic attack (TIA) routinely receive, and understand, education about secondary prevention medications. To investigate whether survivors of stroke/TIA understand explanations about their prescribed prevention medications and associations with medication adherence, control of risk factors, and unmet needs. A survey was administered among survivors of stroke/TIA (random s le N = 1500) from the Australian Stroke Clinical Registry (Victoria and Queensland, 2016). Participants reported whether they understood explanations about each prescribed medication, as well as their unmet needs, perceived control of risk factors, and 30-day medication adherence. Linked pharmacy claims data were also used to determine medication adherence in the previous two years (proportion of days covered ≥80%). Outcomes were analyzed using multivariable logistic regression or multivariable negative binomial regression for frequency of unmet needs. Overall, 630/1455 eligible survivors completed the survey at ≈2.5 years post-admission (median age 69 years 37% female). Most participants reported using prevention medications (76% antihypertensive 84% antithrombotic 76% lipid-lowering) but only 66-75% reported they understood explanations about their medication (75% antihypertensive 66% antithrombotic 74% lipid-lowering). Participants who understood explanations about their medication more often reported 30-day adherence for antihypertensive (adjusted odds ratios [aOR]: 1.96 95% CI: 1.20-3.19), antithrombotic (aOR: 2.03 95% CI: 1.31-3.14) and lipid-lowering medications (aOR: 1.73 95% CI: 1.08-2.76). Similar associations were observed for antihypertensive and antithrombotic medications when pharmacy claims data were used to infer 2-year medication adherence. Understanding explanations about medications was also associated with perceived control of risk factors (hypertension: aOR: 11.08 95% CI: 6.04-20.34 cholesterol aOR: 8.26 95% CI: 4.72-14.47) and up to 33% fewer unmet needs related to secondary prevention. Expanded efforts are needed to improve the delivery of information about prevention medications to promote medication adherence, control of risk factors, and potentially prevent unmet needs following stroke/TIA.
Publisher: Mary Ann Liebert Inc
Date: 03-2021
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.APMR.2018.04.012
Abstract: To examine whether change in rehabilitation environment (hospital or home) and other factors influence time spent sitting upright and walking after stroke. Observational study. Two inpatient rehabilitation units and community residences following discharge. Participants (N=34) with stroke were recruited. An activity monitor was worn continuously for 7 days during the final week in the hospital and the first week at home. Other covariates included mood, fatigue, physical function, pain, and cognition. Linear mixed models were performed to examine the associations between the environment (exposure) and physical activity levels (outcome) in the hospital and at home. Interaction terms between the exposure and other covariates were added to the model to determine whether they modified activity with change in environment. The mean age of participants was 68±13 years and 53% were male. At home, participants spent 45 fewer minutes sitting (95% CI -84.8, -6.1 P=.02), 45 more minutes upright (95% CI 6.1, 84.8 P=.02), and 12 more minutes walking (95% CI 5, 19 P=.001), and completed 724 additional steps (95% CI 199, 1250 P=.01) each day compared to in the hospital. Depression at discharge predicted greater sitting time and less upright time (P=.03 respectively) at home. Environmental change from hospital to home was associated with reduced sitting time and increased the time spent physically active, though depression modified this change. The rehabilitation environment may be a target to reduce sitting and promote physical activity.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2015
DOI: 10.1007/S11136-015-1016-5
Abstract: Health-related quality of life (HRQoL) is commonly used to assess outcomes after stroke. The Duke Health Profile (DHP) has been translated and culturally adapted for use in Vietnam, but its reliability and validity for use with stroke patients in Vietnam or elsewhere have not been assessed. First-ever stroke patients (n = 108) who were admitted to 115 People's Hospital between February and September 2012 and survived for 3 months after stroke had HRQoL assessed using the DHP and a comparison instrument (EQ-5D). Caregivers of 94 patients completed these questionnaires as a proxy. After 1 week, these questionnaires were re-administered to patients and proxies. The mean differences between test and retest assessments of HRQoL by patients were small and not clinically meaningful and were not consistently associated with sex, age, type of stroke or severity of impairment or disability. Direct assessments by the patient were on average greater than those obtained from the proxy. The ICCs ranged from 0.60 to 0.86 (patient test-retest) and from 0.55 to 0.98 (patient-proxy agreement). The ICCs were greatest for physical functioning components (patient test-retest 0.63-0.86, patient-proxy 0.69-0.98). The correlations between the DHP dimensions and EQ-5D were generally stronger when they measured similar constructs (r = 0.53-0.66) and were lower for less related constructs (r = 0.11-0.43). The DHP has moderate reliability and validity for use with stroke patients in Vietnam even when information is obtained from proxy respondents.
Publisher: SAGE Publications
Date: 27-05-2021
DOI: 10.1177/17474930211019568
Abstract: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization– Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JNS.2018.12.021
Abstract: To describe literature pertaining to urban-rural differences in both the quality of care and outcomes of acute stroke patients. We systematically searched CINAHL, PubMed, ProQuest Dissertations & Theses, and Scopus for published and unpublished literature until 9th December 2017. Studies were included if they compared the acute care provided to, or outcomes of, patients hospitalised for stroke in urban versus rural settings. Abstract, full-text review, and data extraction were conducted in duplicate. Findings are presented in the form of narrative syntheses. A total of 28 studies were included in the review (16 on care, 12 on outcomes). With few exceptions, studies addressing the provision of care suggested that rural patients have less access to most aspects of acute stroke care. Studies reporting urban-rural differences in patient outcomes were inconsistent in their findings, however, few of these studies were primarily focused on the issue of urban-rural disparities. Overall, study findings did not appear to differ in line with study quality ratings, stroke subtypes included, or how inter-facility patient transfers were accounted for. There is convincing, albeit not unanimous, evidence to suggest that stroke patients in rural areas receive less acute care than their urban counterparts. Despite this, the available data and methodology have largely not been used to study urban-rural differences in patient outcomes. PROSPERO registration information: URL: www.crd.york.ac.uk rospero. Unique identifier: CRD42017073262.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2012
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2017.07.008
Abstract: Exercise has established benefits following stroke. We aimed to describe self-reported exercise 5 and 10 years after stroke, change in exercise over time, and to identify factors associated with long-term exercise. Data on exercise (defined as 20 minutes' duration, causing sweating and increased heart rate) were obtained by questionnaire from a population-based stroke incidence study with 10-year follow-up. For change in exercise between 5 and 10 years (n = 276), we created 4 categories of exercise (no exercise, ceased exercising, commenced exercising, continued exercising). Multinomial regression determined associations between exercise categories and exercising before stroke, receiving exercise advice and functional ability and demographic factors. The prevalence of exercise at 5 years (n = 520) was 18.5% (n = 96) (mean age 74.7 [standard deviation {SD} 14] years, 50.6% male) and 24% (n = 78) at 10 years. In those with data at both 5 and 10 years (mean age 69 [standard deviation 14] years, 52.9% male), 15% (n = 42) continued exercising, 10% (n = 27) commenced exercising, 14% (n = 38) ceased exercising, and 61% (n = 169) reported no exercise. Continued exercise was associated with younger age (relative risk [RR] .47 95% confidence interval [CI] .25-0.89), greater Barthel score (RR 2.97 95% CI 1.00-8.86), independent walking (RR 2.32 95% CI 1.16-4.68), better quality of life (RR 10.9 95% CI 2.26-52.8), exercising before stroke (RR 16.0 95%CI 4.98-51.5), and receiving advice to exercise (RR 2.99 95% CI 1.73-5.16). Few people exercise after stroke and fewer commence exercise long term. Innovative interventions to promote and maintain exercise are required after stroke.
Publisher: Bentham Science Publishers Ltd.
Date: 07-2007
DOI: 10.2174/138945007781077418
Abstract: Stroke is a disease with impacts ranging from death and disability, to reduced health-related quality of life and depression. To truly understand the burden of this disease we must investigate not only the mortality and prevalence of stroke, but also its incidence within populations. Stroke mortality and incidence declined rapidly during the 1980s and early 1990s however, this trend appears to have slowed in more recent times. Despite many studies being conducted in Europe, and Australasia, there is a lack of reliable data from developing regions such as Asia and Africa. There are indications that although the mortality rate of stroke in such regions may be less than in developed countries, the simple fact that the populations are large means that the burden of stroke is considerable. Furthermore, as a result of epidemiological transition and rapid urbanization and industrialization many developing regions are exhibiting increased life expectancy, as well as changes in diet and other risk behaviors, such as smoking. This is contributing to a looming epidemic of stroke in these regions, as greater proportions of the population are now at risk of stroke. Fortunately, stroke is largely a preventable disease. The major risk factor for stroke, hypertension, can be controlled using both population-wide approaches, such as changes in the salt content of processed foods, and high-risk in idual approaches, such as use of antihypertensive medications. Implementation of effective primary and secondary prevention strategies is likely to have an enormous benefit in reducing the burden of stroke, particularly in developing regions.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.JADA.2011.05.011
Abstract: Previous research has shown that involvement in meal preparation is positively associated with better diet quality. However, it is unclear whether there is an association between involvement in meal preparation and being overweight or obese. This study investigated whether the level of involvement in meal preparation was associated with objectively measured weight status in young adults. During 2004-2006, a national s le of 1,996 Australian adults aged 26 to 36 years completed a self-administered questionnaire including questions on sociodemographic characteristics, diet, and physical activity. Participants were asked to report who usually prepared the main meal on working days and responses were categorized as "myself," "shared," or "someone else." Waist circumference, weight, and height were measured by trained staff. Moderate abdominal obesity was defined as waist circumference ≥94 cm for men and ≥80 cm for women. Overweight was defined as body mass index (calculated as kg/m(2)) ≥25. Prevalence ratios were calculated using log binomial regression. After adjusting for age, education, and leisure time physical activity, men who shared the meal preparation had a slightly lower prevalence of moderate abdominal obesity (prevalence ratio=0.92 95% confidence interval [CI]: 0.86 to 0.99) than those whose meals were usually prepared by someone else. There was no association with having sole responsibility (prevalence ratio=0.99 95% CI: 0.92 to 1.06). There were no associations between level of involvement in meal preparation and being overweight (shared responsibility prevalence ratio=0.99 95% CI: 0.92 to 1.07 sole responsibility prevalence ratio=0.98 95% CI: 0.91 to 1.05). For women, level of involvement was not associated with moderate abdominal obesity (shared responsibility prevalence ratio=0.93 95% CI: 0.84 to 1.03 sole responsibility prevalence ratio=0.94 95% CI: 0.86 to 1.03) or being overweight (shared responsibility prevalence ratio=0.93 95% CI: 0.84 to 1.02 sole responsibility prevalence ratio=0.93 95% CI: 0.85 to 1.02). In this s le of young adults, level of involvement in meal preparation was not strongly related to weight status.
Publisher: Oxford University Press (OUP)
Date: 04-03-2014
Abstract: Recent evidence suggests that the exposure of children to their parents' smoking adversely effects endothelial function in adulthood. We investigated whether the association was also present with carotid intima-media thickness (IMT) up to 25 years later. The study comprised participants from the Cardiovascular Risk in Young Finns Study (YFS, n = 2401) and the Childhood Determinants of Adult Health (CDAH, n = 1375) study. Exposure to parental smoking (none, one, or both) was assessed at baseline by questionnaire. B-mode ultrasound of the carotid artery determined IMT in adulthood. Linear regression on a pooled dataset accounting for the hierarchical data and potential confounders including age, sex, parental education, participant smoking, education, and adult cardiovascular risk factors was conducted. Carotid IMT in adulthood was greater in those exposed to both parents smoking than in those whose parents did not smoke [adjusted marginal means: 0.647 mm ± 0.022 (mean ± SE) vs. 0.632 mm ± 0.021, P = 0.004]. Having both parents smoke was associated with vascular age 3.3 years greater at follow-up than having neither parent smoke. The effect was independent of participant smoking at baseline and follow-up and other confounders and was uniform across categories of age, sex, adult smoking status, and cohort. These results show the pervasive effect of exposure to parental smoking on children's vascular health up to 25 years later. There must be continued efforts to reduce smoking among adults to protect young people and to reduce the burden of cardiovascular disease across the population.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2012
DOI: 10.1161/ATVBAHA.111.243261
Abstract: Passive smoking has been associated with increased cardiovascular morbidity. The present study aimed to examine the long-term effects of childhood exposure to tobacco smoke on endothelium-dependent vasodilation in adults. The analyses were based on 2171 participants in the population-based Cardiovascular Risk in Young Finns (N=2067) and Childhood Determinants of Adult Health (N=104) studies who had measures of conventional risk factors (lipids, blood pressure, adiposity, socioeconomic status) and self-reported parental smoking status when aged 3 to 18 years at baseline. They were re-examined 19 to 27 years later when aged 28 to 45 years. Brachial artery flow-mediated dilatation was measured at follow-up with ultrasound. In analyses adjusting for age, sex, and childhood risk factors, flow-mediated dilatation was reduced among participants who had parents that smoked in youth compared to those whose parents did not smoke (Young Finns: 9.2±0.1% (mean±SEM) versus 8.6±0.1%, P =0.001 Childhood Determinants of Adult Health: 7.4±0.6% versus 4.9±0.9%, P =0.04). These effects remained after adjustment for adult risk factors including own smoking status (Young Finns, P =0.003 Childhood Determinants of Adult Health, P =0.03). Parental smoking in youth is associated with reduced flow-mediated dilatation in young adulthood measured over 20 years later. These findings suggest that passive exposure to cigarette smoke among children might cause irreversible impairment in endothelium-dependent vasodilation.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2006
DOI: 10.1161/01.HYP.0000230610.81947.04
Abstract: Control of blood pressure after stroke is important for reducing the risk of recurrent stroke. We examined the control of hypertension in a community-based population of 5-year stroke survivors. Cases of first-ever stroke from the North East Melbourne Stroke Incidence Study were interviewed at 5 years poststroke. Blood pressure, history of hypertension, and antihypertensive medications were recorded. In iduals were classified as normotensive (blood pressure /90 mm Hg, no history of hypertension, and no antihypertensive medications), controlled hypertensive (blood pressure /90 mm Hg, history of hypertension, and/or taking antihypertensive medications), uncontrolled hypertensive (blood pressure ≥140/90 mm Hg, history of hypertension, and/or taking antihypertensive medications), or uninformed hypertensive (blood pressure ≥140/90 mm Hg, no known history of hypertension, and no antihypertensive medications). At 5 years poststroke, 441 (45%) of 978 first-ever stroke cases were alive. Of these, 305 (69%) had complete data on blood pressure, antihypertensive medication use, and history of hypertension. No statistical differences existed between those with or without these data. Eight-two percent were hypertensive 63% had controlled hypertension, 30% had uncontrolled hypertension, and 7% were unaware that they were hypertensive. Overall, 67% of in iduals classified as uncontrolled or uninformed hypertensive subjects were receiving treatment that was insufficient to achieve target blood pressure levels. Uncontrolled hypertensive subjects were more likely to recall receiving advice to manage their hypertension with medication ( P .02) and diet ( P .09). Although the majority of hypertensive in iduals had controlled hypertension at 5 years poststroke, considerable improvement can be made in the control of hypertension after stroke.
Publisher: Wiley
Date: 09-09-2016
DOI: 10.1111/OBR.12448
Publisher: Elsevier BV
Date: 11-2021
Publisher: Massachusetts Medical Society
Date: 20-12-2018
Publisher: Informa UK Limited
Date: 24-06-2021
Publisher: Cambridge University Press (CUP)
Date: 24-06-2016
DOI: 10.1017/S0033291716000738
Abstract: Healthy lifestyles prevent cardiovascular disease and are increasingly recognized in relation to mental health but longitudinal studies are limited. We examined bi-directional associations between mood disorders and healthy lifestyles in a cohort followed for 5 years. Participants were aged 26–36 years at baseline (2004–2006) and 31–41 years at follow-up (2009–2011). At follow-up, lifetime mood disorders (depression or dysthymia) were retrospectively diagnosed with the Composite International Diagnostic Interview. A five-item lifestyle score (comprising body mass index, non-smoking, alcohol consumption, leisure time physical activity and healthy diet) was measured at both time points. Linear and log multinomial regression determined if mood disorder before baseline predicted changes in lifestyle ( n = 1041). Log binomial regression estimated whether lifestyle at baseline predicted new episodes of mood disorder ( n = 1233). Covariates included age, sex, socio-economic position, parental and marital status, social support, major life events, cardiovascular disease history, and self-rated physical and mental health. A history of mood disorder before baseline predicted unfavourable trajectories of lifestyle over follow-up, including somewhat lower risk of improvement [relative risk (RR) 0.76, 95% confidence interval (CI) 0.56–1.03] and greater risk of worsening (RR 1.46, 95% CI 0.99–2.15) of lifestyle independent of confounding factors. Higher lifestyle scores at baseline were associated with a 22% (RR 0.76, 95% CI 0.61–0.95) reduced risk of first episodes of mood disorder, independent of confounding factors. Healthy lifestyles and mood disorders are closely related. Our results suggest that healthy lifestyles may not only reduce cardiovascular disease but also promote mental health.
Publisher: S. Karger AG
Date: 08-11-2008
DOI: 10.1159/000170086
Abstract: i Background and Purpose: /i Incidence rates of stroke subtypes may be imprecise when s les are small. We aimed to determine the incidence of stroke subtypes in a large geographically defined population. i Methods: /i Multiple overlapping sources were used to ascertain all strokes occurring in 22 postcodes (population of 306,631) of Melbourne, Australia, between 1997 and 1999. Stroke subtypes were defined by CT, MRI and autopsy. The Mantel-Haenszel age-adjusted rate ratio (MH RR) was used to compare incidence rates between men and women. i Results: /i We identified 1,421 strokes among 1,337 residents, 1,035 (72.8%) being first-ever strokes. Incidence (number/100,000 population/year), adjusted to the European population 45–84 years, was 197 (95% confidence interval, CI, 169–224) for ischemic stroke (IS), 47 (95% CI 33–60) for intracerebral haemorrhage (ICH) and 19 (95% CI 10–27) for subarachnoid haemorrhage (SAH). Compared with women, men in this age group had a greater incidence of IS (MH RR 1.65, 95% CI 1.39–1.96, p 0.0001) and ICH (MH RR 1.46, 95% CI 1.01–2.10, p = 0.0420), but lesser rates of SAH (MH RR 0.34, 95% CI 0.16–0.69, p = 0.0031). i Conclusions: /i In this population-based study, the incidence of IS and ICH was greater among men than women, while women had a greater incidence of SAH. More effort may need to be directed at modifying risk factors for IS and ICH in men.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-01-2019
Abstract: Women have worse outcomes after stroke than men, and this may be partly explained by stroke severity. We examined factors contributing to sex differences in severity of acute stroke assessed by the National Institutes of Health Stroke Scale. We pooled in idual participant data with National Institutes of Health Stroke Scale assessment (N=6343) from 8 population‐based stroke incidence studies (1996–2014), forming part of INSTRUCT (International Stroke Outcomes Study). Information on sociodemographics, stroke‐related clinical factors, comorbidities, and pre‐stroke function were obtained. Within each study, relative risk regression using log‐binominal modeling was used to estimate the female:male relative risk ( RR ) of more severe stroke (National Institutes of Health Stroke Scale ) stratified by stroke type (ischemic stroke and intracerebral hemorrhage). Study‐specific unadjusted and adjusted RR s, controlling for confounding variables, were pooled using random‐effects meta‐analysis. National Institutes of Health Stroke Scale data were recorded in 5326 (96%) of 5570 cases with ischemic stroke and 773 (90%) of 855 participants with intracerebral hemorrhage. The pooled unadjusted female:male RR for severe ischemic stroke was 1.35 (95% CI 1.24–1.46). The sex difference in severity was attenuated after adjustment for age, pre‐stroke dependency, and atrial fibrillation but remained statistically significant (pooled RR adjusted 1.20, 95% CI 1.10–1.30). There was no sex difference in severity for intracerebral hemorrhage ( RR crude 1.08, 95% CI 0.97–1.21 RR adjusted 1.08, 95% CI 0.96–1.20). Although women presented with more severe ischemic stroke than men, much although not all of the difference was explained by pre‐stroke factors. Sex differences could potentially be ameliorated by strategies to improve pre‐stroke health in the elderly, the majority of whom are women. Further research on the potential biological origin of sex differences in stroke severity may also be warranted.
Publisher: Wiley
Date: 21-02-2013
DOI: 10.1002/BERJ.3031
Publisher: BMJ
Date: 07-05-2011
Abstract: Little is known about health-related quality of life (HRQoL) in the long term after stroke. The aim of this study was to assess the level of, and factors associated with, HRQoL at 7 years post-stroke. All stroke cases from a prospective community-based stroke incidence study (excluding subarachnoid haemorrhage) were assessed 7 years after stroke. HRQoL was measured with the Assessment of Quality of Life instrument. Proportional odds ordinal logistic regression was used to determine factors associated with HRQoL at 7 years post-stroke. Overall, 1321 stroke cases were recruited. Seven years after stroke, 413 (31.2%) were alive and 328 (79.4%) were assessed. Those assessed were less often current smokers pre-stroke than those not assessed (p<0.01). Seventy-six survivors (23%) had very poor HRQoL (range: -0.038 to 0.100). Factors present at 7 years that were associated with better 7-year HRQoL were independence in instrumental activities of daily living (IADL) (estimated OR=11.2, 95% CI 4.87 to 25.6, p<0.001), independence in basic activities of daily living (BADL) (OR=4.53, 95% CI 2.03 to 10.1, p<0.001), independence in IADL and BADL (OR=9.90, 95% CI 4.51 to 21.7, p<0.001), male gender (OR=1.89, 95% CI 1.21 to 2.96, p=0.005) and lesser handicap (trend: OR=3.47, 95% CI 2.51 to 4.79, p<0.001). Participants' HRQoL scores tended to be lower when HRQoL assessments were completed by proxy (OR=0.13, 95% CI 0.06 to 0.31, p<0.001). At 7 years post-stroke, 68.8% had died and a substantial proportion of survivors had poor HRQoL. Factors such as handicap, BADL and IADL could be targeted to improve HRQoL in long-term survivors of stroke.
Publisher: S. Karger AG
Date: 17-11-2015
DOI: 10.1159/000441544
Publisher: Springer Science and Business Media LLC
Date: 04-11-2022
DOI: 10.1007/S00701-022-05399-0
Abstract: DCI and hydrocephalus are the most common complications that predict poor outcomes after aSAH. The relationship between sex, DCI and hydrocephalus are not well established thus, we aimed to examine sex differences in DCI and hydrocephalus following aSAH in a systematic review and meta-analysis. A systematic search was conducted using the PubMed, Scopus and Medline databases from inception to August 2022 to identify cohort, case control, case series and clinical studies reporting sex and DCI, acute and chronic shunt-dependent hydrocephalus (SDHC). Random-effects meta-analysis was used to pool estimates for available studies. There were 56 studies with crude estimates for DCI and meta-analysis showed that women had a greater risk for DCI than men (OR 1.24, 95% CI 1.11–1.39). The meta-analysis for adjusted estimates for 9 studies also showed an association between sex and DCI (OR 1.61, 95% CI 1.27–2.05). For acute hydrocephalus, only 9 studies were included, and meta-analysis of unadjusted estimates showed no association with sex (OR 0.95, 95%CI 0.78–1.16). For SDHC, a meta-analysis of crude estimates from 53 studies showed that women had a somewhat greater risk of developing chronic hydrocephalus compared to men (OR 1.14, 95% CI 0.99–1.31). In meta-analysis for adjusted estimates from 5 studies, no association of sex with SDHC was observed (OR 0.87, 95% CI 0.57–1.33). Female sex is associated with the development of DCI however, an association between sex and hydrocephalus was not detected. Strategies to target females to reduce the development of DCI may decrease overall morbidity and mortality after aSAH.
Publisher: Springer Science and Business Media LLC
Date: 26-05-2023
DOI: 10.1186/S12966-023-01462-W
Abstract: Transport-related physical activity (TRPA) is recognised as a potential means of increasing total physical activity participation that may yield substantial health benefits. Public health c aigns focusing on promoting TRPA from a young age aim to develop life-long healthy habits. However, few studies have examined how TRPA changes across the lifecourse and whether childhood TRPA levels influence those observed later in life. Using the Australian Childhood Determinants of Adult Health study (baseline, 1985), latent class growth mixture modelling with adjustment for time-varying covariates was performed using four timepoints (ranging from 7 to 49 years) to assess behavioural patterns and retention of TRPA across the lifecourse. As child and adult adjusted TRPA measures could not be harmonised, trajectories of adult TRPA (n = 702) were instead identified, and log-binomial regression analysis was performed to determine whether childhood levels of TRPA (high/medium/low) influenced these trajectories. Two stable groups of adult TRPA trajectories were identified: persistently low (n = 520 74.2%), and increasingly high TRPA (n = 181 25.8%). There was no significant relationship between childhood TRPA levels and patterns in adulthood (relative risk of high childhood TRPA yielding high adult TRPA trajectory membership = 1.06 95% confidence interval = 0.95–1.09). This study found childhood TRPA levels were not associated with TRPA patterns in adulthood. These findings suggest that while TRPA in childhood may have health, social, and environmental benefits, it does not appear to impact adult TRPA directly. Therefore, further intervention is required beyond childhood to promote the implementation of healthy TRPA behaviours into adulthood.
Publisher: Oxford University Press (OUP)
Date: 19-10-2014
DOI: 10.1093/NTR/NTU202
Abstract: To supplement limited information on tobacco use in Vietnam, data from a nationally-representative population-based survey was used to estimate the prevalence of smoking among 25-64 year-olds. This study included 14,706 participants (53.5% females, response proportion 64%) selected by multi-stage stratified cluster s ling. Information was collected using the World Health Organization STEPwise approach to surveillance of risk factors for non-communicable disease (STEPS) questionnaire. Smoking prevalence was estimated with stratification by age, calendar year, and birth year. Prevalence of ever-smoking was 74.9% (men) and 2.6% (women). Male ever-smokers commenced smoking at median age of 19.0 (interquartile range [IQR]: 17.0, 21.0) years and smoked median quantities of 10.0 (IQR: 7.0, 20.0) cigarettes/day. Female ever-smokers commenced smoking at median age of 20.0 (IQR: 18.0, 26.0) years and smoked median quantities of 6.0 (IQR: 4.0, 10.0) cigarettes/day. Prevalence has decreased in recent cohorts of men (p = .001), and its inverse association with years of education (p < .001) has strengthened for those born after 1969 (interaction p < .001). At 60 years of age, 53.0% of men who had reached that age were current smokers and they had accumulated median exposures of 39.0 (IQR: 32.0, 42.0) years of smoking and 21.0 (IQR: 11.5, 36.0) pack-years of cigarettes. The proportion of ever-smokers has decreased consistently among successive cohorts of women (p < .001). Smoking prevalence is declining in recent cohorts of men, and continues to decline in successive cohorts of women, possibly in response to anti-tobacco initiatives commencing in the 1990s. Low proportions of quitters mean that Vietnamese smokers accumulate high exposures despite moderate quantities of cigarettes smoked per day.
Publisher: Springer Science and Business Media LLC
Date: 08-07-2020
DOI: 10.1186/S12966-020-00989-6
Abstract: Partnering and parenting are important life-stage transitions often accompanied by changes in social networks, roles and responsibilities. There have been no longitudinal studies examining associations of partnering and parenting with changes in domain-specific physical activity (PA) and sedentary behaviours, and our understanding of whether these transitions are associated with weight change is limited. Two thousand one hundred and twenty-four Australian adults from a national cohort (mean age 31.7 (2.7) years, 47.5% male) completed questionnaires at baseline (2004–06) and follow-up (2009–11), reporting marital and parental status. Weight (kg) was measured at baseline and self-reported at follow-up. PA and sedentary behaviours (sitting and television (TV) viewing) were self-reported in a subset ( n = 1221). Linear regression estimated the longitudinal associations of parenting and partnering transitions with PA, sedentary behaviours and weight at follow-up, adjusted for baseline value of the respective outcome variable, age, education, follow-up duration and other life-stage transition. During the 5-year follow-up, 17.3% men and 12.9% women partnered, and 27.3% men and 19.1% women had their first child. Compared to staying not partnered, partnering was associated with an increase in total PA (177.5mins/week, 95% Confidence Interval (CI) 18.0 to 337.0) among men and a greater weight gain (2.2 kg, 95% CI 0.6 to 3.7) among women. Compared to remaining child-free, having a first child was associated with greater reductions in total PA (− 123.9mins/week, 95% CI − 248.8 to 1.1) and TV viewing time (− 27.0mins/day, 95% CI − 50.6 to − 3.3) among men. Women who had their first child had greater weight gain (1.4 kg, 95% CI 0.1 to 2.7) but spent less time sitting (− 103.8mins/day, 95% CI − 135.5 to − 72.1) than those remaining child-free. For women, having additional children was associated with less sitting time (− 39.4mins/week, 95% CI − 66.0 to − 12.8) than having the same number of children. Partnering was associated with an increase in men’s total PA and women’s weight. Transitions into parenthood with a first child or additional children were associated with potentially health-impairing changes in weight and PA, but health-promoting changes in sedentary behaviours. Future PA promotion strategies should pay attention to men who had their first child to mitigate declining total PA.
Publisher: Springer Science and Business Media LLC
Date: 10-06-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-04-2015
DOI: 10.1161/CIRCULATIONAHA.114.013485
Abstract: The association between passive smoking exposure in childhood and adverse cardiovascular health in adulthood is not well understood. Using a 26-year follow-up study, we examined whether childhood exposure to passive smoking was associated with carotid atherosclerotic plaque in young adults. Participants were from the Cardiovascular Risk in Young Finns Study (n=2448). Information on childhood exposure to parental smoking was collected in 1980 and 1983. Carotid ultrasound data were collected in adulthood in 2001 or 2007. Childhood serum cotinine levels from 1980 were measured from frozen s les in 2014 (n=1578). The proportion of children with nondetectable cotinine levels was highest among households in which neither parent smoked (84%), was decreased in households in which 1 parent smoked (62%), and was lowest among households in which both parents smoked (43%). Regardless of adjustment for potential confounding and mediating variables, the relative risk of developing carotid plaque in adulthood increased among those children with 1 or both parents who smoked (relative risk, 1.7 95% confidence interval, 1.0–2.8 P =0.04). Although children whose parents exercised good “smoking hygiene” (smoking parents whose children had nondetectable cotinine levels) had increased risk of carotid plaque compared with children with nonsmoking parents (relative risk, 1.6 95% confidence interval, 0.6–4.0 P =0.34), children of smoking parents with poor smoking hygiene (smoking parents whose children had detectable serum cotinine levels) had substantially increased risk of plaque as adults (relative risk, 4.0 95% confidence interval, 1.7–9.8 P =0.002). Children of parents who smoke have increased risk of developing carotid atherosclerotic plaque in adulthood. However, parents who exercise good smoking hygiene can lessen their child’s risk of developing plaque.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2006
DOI: 10.1161/01.STR.0000202588.95876.A7
Abstract: Background and Purpose— Greater stroke mortality has been reported among lower socioeconomic groups. We aimed to determine whether fatal, nonfatal, and overall stroke incidence varied by socioeconomic status. Methods— All suspected strokes occurring in 22 postcodes (population of 306 631) of Melbourne, Australia, during a 24-month period between 1997 and 1999 were found and assessed. Multiple overlapping sources were used to ascertain cases with standard clinical definitions for stroke. Socioeconomic disadvantage was assigned in 4 bands from least to greatest using an area-based measure developed by the Australian Bureau of Statistics. Results— Overall stroke incidence (number per 100 000 population per year), adjusted to the European population 45 to 84 years of age, increased with increasing socioeconomic disadvantage: 200 (95% CI, 173 to 228) 251 (95% CI, 220 to 282) 309 (95% CI, 274 to 343) and 366 (95% CI, 329 to 403 χ 2 for ranks P .0001). Similar incidence patterns were observed for both fatal and nonfatal stroke. Nonfatal stroke contributed most to this incidence pattern: 146 (95% CI, 122 to 169) 181 (95% CI, 155 to 207) 223 (95% CI, 194 to 252) and 280 (95% CI, 247 to 313 χ 2 for ranks P .0001). Conclusions— In this population-based study, both fatal and nonfatal stroke incidence increased with increasing socioeconomic disadvantage. The greater contributor to this incidence pattern was nonfatal stroke incidence. This may have implications for service provision to those least able to afford it. Area-based identification of those most disadvantaged may provide a simple and effective way of targeting regions for stroke prevention strategies.
Publisher: SAGE Publications
Date: 22-07-2023
DOI: 10.1177/17474930221113430
Abstract: Theoretically, most strokes could be prevented through the management of modifiable risk factors. The Stroke Riskometer™ mobile phone application (hereon “The App”) uses an in idual’s data to provide personalized information and advice to reduce their risk of stroke. To determine the effect of The App on a combined cardiovascular risk score (Life’s Simple 7 ® , LS7) of modifiable risk factors at 6 months post-randomization. PERKS-International is a Phase III, multicentre, prospective, pragmatic, open-label, single-blinded endpoint, two-arm randomized controlled trial (RCT). Inclusion criteria are as follows: age ⩾ 35 and ⩽75 years ⩾2 LS7 risk factors smartphone ownership no history of stroke/myocardial infarction/cognitive impairment/terminal illness. The intervention group (IG) will be provided with The App, and the usual care group (UCG) is provided with generic online information about risk factors, but not be informed about The App. Face-to-face assessments will be conducted at baseline and 6 months, and online at 3 and 12 months. The RCT includes a process and economic evaluation. The primary outcome is a difference in the mean change in LS7 (seven in idual items: blood pressure, cholesterol, glucose, body mass index (BMI), smoking, physical activity, and diet) from baseline to 6 months post-randomization with intention-to-treat analysis. Secondary outcomes include: change in in idual LS7 items, quality of life stroke awareness, adverse events health service use and costs. Based on pilot data, 790 participants (395 IG, 395 UCG) will be required to provide 80% power (two-sided α = 0.05) to detect a mean difference in the LS7 of ⩾0.40 (SD 1.61) in IG compared to 0.01 (SD 1.44) in the UCG at 6 months post-randomization. Stroke is largely preventable. This study will provide evidence of the effectiveness of a mobile app to reduce stroke risk. ACTRN12621000211864.
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Springer Science and Business Media LLC
Date: 07-12-2011
Abstract: Takeaway food consumption is positively associated with adiposity. Little is known about the associations with other cardio-metabolic risk factors. This study aimed to determine whether takeaway food consumption is associated with fasting glucose, insulin, lipids, homeostasis model assessment (HOMA) and blood pressure. A national s le of 1896, 26-36 year olds completed a questionnaire on socio-demographics, takeaway food consumption, physical activity and sedentary behaviour. Waist circumference and blood pressure were measured, and a fasting blood s le was taken. For this analysis, takeaway food consumption was dichotomised to once a week or less and twice a week or more. Linear regression was used to calculate differences in the adjusted mean values for fasting lipids, glucose, insulin, HOMA and blood pressure. Models were adjusted for age, employment status, leisure time physical activity and TV viewing. Compared with women who ate takeaway once a week or less, women who ate takeaway twice a week or more had significantly higher adjusted mean fasting glucose (4.82 vs 4.88 mmol/l, respectively P=0.045), higher HOMA scores (1.27 vs 1.40, respectively, P=0.034) and tended to have a higher mean fasting insulin (5.95 vs 6.45 mU/l, respectively, P=0.054). Similar associations were observed for men for fasting insulin and HOMA score, but the differences were not statistically significant. For both women and men adjustment for waist circumference attenuated the associations. Consuming takeaway food at least twice a week was associated with cardio-metabolic risk factors in women but less so in men. The effect of takeaway food consumption was attenuated when adjusted for obesity.
Publisher: Cambridge University Press (CUP)
Date: 16-10-2019
DOI: 10.1017/S0033291719002800
Abstract: Meal timing may influence food choices, neurobiology and psychological states. Our exploratory study examined if time-of-day eating patterns were associated with mood disorders among adults. During 2004–2006 (age 26–36 years) and 2009–2011 (follow-up, age 31–41 years), N = 1304 participants reported 24-h food and beverage intake. Time-of-day eating patterns were derived by principal components analysis. At follow-up, the Composite International Diagnostic Interview measured lifetime mood disorder. Log binomial and adjacent categories log-link regression were used to examine bidirectional associations between eating patterns and mood disorder. Covariates included sex, age, marital status, social support, education, work schedule, body mass index and smoking. Three patterns were derived at each time-point: Grazing (intake spread across the day), Traditional (highest intakes reflected breakfast, lunch and dinner), and Late (skipped/delayed breakfast with higher evening intakes). Compared to those in the lowest third of the respective pattern at baseline and follow-up, during the 5-year follow-up, those in the highest third of the Late pattern at both time-points had a higher prevalence of mood disorder [prevalence ratio (PR) = 2.04 95% confidence interval (CI) 1.20–3.48], and those in the highest third of the Traditional pattern at both time-points had a lower prevalence of first onset mood disorder (PR = 0.31 95% CI 0.11–0.87). Participants who experienced a mood disorder during follow-up had a 1.07 higher relative risk of being in a higher Late pattern score category at follow-up than those without mood disorder (95% CI 1.00–1.14). Non-traditional eating patterns, particularly skipped or delayed breakfast, may be associated with mood disorders.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.JASH.2018.06.015
Abstract: A single clinic measurement of blood pressure (BP) may be common in low- and middle-income countries because of limited medical resources. This study aimed to examine the potential misclassification error when only one BP measurement is used. Participants (n = 14,706, 53.5% females) aged 25-64 years were selected by multistage stratified cluster s ling from eight provinces, each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Data were analyzed using complex survey methods. For systolic BP, 62.7% had a higher first reading whereas 30.0% had a lower first reading, and 27.3% had a reduction of at least 5 mmHg whereas 9.6% had an increase of at least 5 mmHg. Irrespective of direction of change, increased variability in BP was associated with greater age, urban living, greater body size and fatness, reduced physical activity levels, elevated glucose, and raised total cholesterol. These measurement variations would lead to substantial misclassification in diagnosis of hypertension based on a single reading because almost 20% of subjects would receive a different diagnosis based on the mean of two readings.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Research Square Platform LLC
Date: 31-03-2022
DOI: 10.21203/RS.3.RS-1479732/V1
Abstract: Introduction - Transport-related physical activity (TRPA) has been identified as a way to increase physical activity due to its discretionary and habitual nature. Factors thought to influence TRPA span multiple disciplines and are rarely systematically considered in unison. This systematic review aimed to identify cross-sectional and longitudinal factors associated with adult TRPA across multiple research disciplines. Methods - Using four electronic databases, a systematic search of English, peer-reviewed literature from 2010 – 2020 was performed. Studies quantitatively examining factors associated with the outcome of adult TRPA were eligible. Results - Seventy-three studies (n=66 cross-sectional n=7 longitudinal) were included, cumulatively reporting data from 1,278,632 observations. Thirty-six factors were examined for potential association with TRPA and presented in a social-ecological framework: in idual (n=15), social (n=3), and environmental (n=18). Seven factors were found to be consistently associated with higher adult TRPA: lower socio-economic status, higher self-efficacy, higher social normalization, lower distance of travel, higher destination concentration, more streetlighting, and higher public transportation frequency with a greater number of terminals near route start and endpoints. Conclusions - This is the first comprehensive compilation of the correlates and determinants of adult TRPA. Seven in idual, social, and environmental factors demonstrated consistent associations with TRPA. Models formed using these factors may facilitate more effective promotion of TRPA. There is a lack of longitudinal studies as well as studies assessing cognitive/attitudinal and social factors, highlighting gaps for further research. Those developing policies and strategies targeting TRPA need to consider a range of factors at the in idual, social, and environmental level to maximise the likelihood of effectiveness.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2014
Publisher: Springer Science and Business Media LLC
Date: 08-02-2019
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.JADA.2010.06.011
Abstract: Involvement in meal preparation has the potential to affect diet quality, but has not been thoroughly investigated. The study aims were to describe the involvement of young adult men and women in meal preparation and to investigate whether extent of involvement was associated with diet quality. During 2004 to 2006, a national s le of 2,814 Australian adults aged 26 to 36 years completed a self-administered questionnaire on demographics, diet, and lifestyle factors. Participants were asked to report who was usually responsible for preparing the main meal on working days. Responses were categorized as "myself," "shared," or "someone else." Diet quality was assessed by calculating the mean number of daily servings for each food group. Analysis of variance was used to test for differences in means of dietary intake data. More women (65%) than men (29%) had sole responsibility for meal preparation. Shared meal preparation was reported by 23% of women and 27% of men. Factors associated with greater involvement in meal preparation included marital status, education, occupation, and physical activity. After adjusting for sociodemographic and lifestyle factors, men who prepared the main meal themselves had a higher intake of lean meat and alternatives. Women who shared the meal preparation had higher intakes of vegetables and dairy however, these differences in diet quality were only small. These results suggest that strategies seeking to motivate greater involvement in meal preparation might not be sufficient to markedly improve diet quality in young Australian adults.
Publisher: Oxford University Press (OUP)
Date: 08-07-2015
Abstract: To provide nationally representative data on alcohol consumption in Vietnam and to assess whether reported numbers of 'standard drinks' consumed have evidence of validity (particularly in rural areas where home-made alcohol is consumed from cups of varying size). A nationally representative population-based survey of 14,706 participants (46.5% males, response proportion 64.1%) aged 25-64 years in Vietnam. Measurements were made in accordance with WHO STEPS protocols. Data were analysed using complex survey methods. Among men, 80% reported drinking alcohol during the last year, and 40% were hazardous/harmful drinkers. Approximately 60% of men and <5% of women had consumed alcohol during the last week, with one-in-four of the men reporting having consumed at least five standard drinks on at least one occasion. Numbers of standard drinks reported by men were associated with blood pressure/hypertension, particularly in rural areas (P < 0.001 for trend). Most of the calibration and discrimination possible from self-reported information on alcohol consumption was provided by binary responses to questions on whether or not alcohol had been consumed during the reference period. Alcohol use and harmful consumption were common among Vietnamese men but less pronounced than in Western nations. Self-reports of quantity of alcohol consumed in terms of standard drinks had predictive validity for blood pressure and hypertension even in rural areas. However, using detailed measures of consumption resulted in only minor improvements in prediction compared to simple measures.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2017.09.055
Abstract: Aneurysmal subarachnoid hemorrhage (aSAH) incidence is not well studied. Varied definitions of "subarachnoid hemorrhage" have led to a lack of clarity regarding aSAH incidence. The impact of area-level socioeconomic disadvantage and geographical location on the incidence of aSAH also remains unclear. Using a population-based statewide study, we examined the incidence of aSAH in relation to socioeconomic disadvantage and geographical location. A retrospective cohort study of nontraumatic subarachnoid hemorrhages from 2010 to 2014 was undertaken. Researchers manually collected data from multiple overlapping sources including statewide administrative databases, in idual digital medical records, and death registers. Age-standardized rates (ASRs) per 100,000 person years were calculated using the 2001 Australian population. Differences in incidence rate ratios were calculated by age, sex, area-level socioeconomic status, and geographical location using Poisson regression. The cohort of 237 cases (mean age, 61.0 years) with a female predominance of 166 (70.04%) included 159 confirmed aSAH, 52 community-based deaths, and 26 probable cases. The ASR for aSAH was 9.99 (95% confidence interval [CI], 8.69-11.29). A significant association between area-level socioeconomic disadvantage and incidence was observed, with the rate of aSAH in disadvantaged geographical areas being 1.40 times higher than that in advantaged areas (95% CI, 1.11-1.82 P = .012). This study uses a comprehensive search of multiple data sources to define a new baseline of aSAH within an Australian population. This study presents a higher incidence rate of aSAH with socioeconomic variations. As a key risk factor that may explain this paradox, addressing socioeconomic inequalities is important for effective prevention and management interventions.
Publisher: SAGE Publications
Date: 2020
Abstract: In iduals living in rural areas have comparatively less access to acute stroke care than their urban counterparts. Understanding the local barriers and facilitators to the use of current best practice for acute stroke may inform efforts to reduce this disparity. A qualitative study featuring semi-structured interviews and focus groups was conducted in the Australian state of Tasmania. Clinical staff from a range of disciplines involved in acute stroke care were recruited from three of the state’s four major public hospitals (one urban and two rural). A semi-structured interview guide based on the findings of an earlier quantitative study was used to elicit discussion about the barriers and facilitators associated with providing acute stroke care. An inductive process of thematic analysis was then used to identify themes and subthemes across the data set. Two focus groups and five in idual interviews were conducted. Four major themes were identified from analysis of the data: systemic issues, clinician factors, additional support and patient-related factors. Acute stroke care within the study’s urban hospital was structured and comprehensive, aided by the hospital’s acute stroke unit and specialist nursing support. In contrast, care provided in the study’s rural hospitals was somewhat less comprehensive, and often constrained by an absence of infrastructure or poor access to existing resources. The identified factors help to characterise acute stroke care within urban and rural hospitals and will assist quality improvement efforts in Tasmania’s hospitals.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-02-2010
Publisher: Wiley
Date: 03-12-2020
DOI: 10.1111/BIRT.12515
Publisher: Public Library of Science (PLoS)
Date: 29-05-2018
Publisher: Informa UK Limited
Date: 15-10-2020
DOI: 10.1080/02640414.2019.1679575
Abstract: To help inform strategies aimed at increasing muscular fitness levels, we examined factors associated with childhood muscular fitness (strength and power) that preceded the recently observed secular decline. Data were available from a nationally representative s le of Australian children aged 7-15 years in 1985 (n = 8469). Muscular fitness measures included strength (right and left grip, shoulder extension and flexion, and leg strength) and power (standing long jump distance). Anthropometric (adiposity, fat-free mass), cardiorespiratory fitness (CRF), flexibility, speed capability, physical activity (in idual and parental), dietary quality and intake (fruit, vegetable, protein) and sociodemographic (area-level socioeconomic status (SES), school type) data were available. Statistical analyses included sex-stratified linear regression. Of all examined factors, measures of adiposity, fat-free mass, CRF, flexibility and speed capability were associated with muscular fitness at levels that met Cohen's threshold for important effects (r-squared = 0.02 to 0.28). These findings highlight the multifactorial relationship between muscular fitness and its determinants. Collectively, these factors were powerful in explaining muscular strength (females: r-squared = 0.32 males: r-squared = 0.41) and muscular power (females: r-squared = 0.36 males: r-squared = 0.42). These findings highlight modifiable and environmental factors that could be targeted to increase childhood muscular fitness.
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-040418
Abstract: To compare the processes and outcomes of care in patients who had a stroke treated in urban versus rural hospitals in Australia. Observational study using data from a multicentre national registry. Data from 50 acute care hospitals in Australia (25 urban, 25 rural) which participated in the Australian Stroke Clinical Registry during the period 2010–2015. Patients were ided into two groups (urban, rural) according to the Australian Standard Geographical Classification Remoteness Area classification. Data pertaining to 28 115 patients who had a stroke were analysed, of whom 8159 (29%) were admitted to hospitals located within rural areas. Regional differences in processes of care (admission to a stroke unit, thrombolysis for ischaemic stroke, discharge on antihypertensive medication and provision of a care plan), and survival analyses up to 180 days and health-related quality of life at 90–180 days. Compared with those admitted to urban hospitals, patients in rural hospitals less often received thrombolysis (urban 12.7% vs rural 7.5%, p .001) or received treatment in stroke units (urban 82.2% vs rural 76.5%, p .001), and fewer were discharged with a care plan (urban 61.3% vs rural 44.7%, p .001). No significant differences were found in terms of survival or overall self-reported quality of life. Rural access to recommended components of acute stroke care was comparatively poorer however, this did not appear to impact health outcomes at approximately 6 months.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.AUEC.2022.01.003
Abstract: Delays in treatment of aSAH appear to be common but the causes are not well understood. We explored facilitators and barriers to timely treatment of aSAH. We used a multiple case study with cases of aSAH surviving> 1 day identified prospectively. We conducted semi-structured interviews with the patient, their next-of-kin and health professionals involved in the case. Within-case analysis identified barriers and facilitators in 4 phases (pre-hospital, presentation, transfer, in-hospital) followed by thematic analysis across cases using a case-study matrix. Twenty-seven cases with 90 interviewees yielded five themes related to facilitators or barriers of timely treatment. "Early recognition" led to urgent response. "Accessibility to health care" depended on patient's location, transport, and environmental conditions. Good "Coordination" between and within health services was a key facilitator. "Complexity" of patient's condition affected time to treatment in multiple time periods. "Availability of resources" was identified most frequently during the diagnostic and treatment phases as both barrier and facilitator. The identified themes may be modifiable at the patient/health professional level and health system level and may improve timely treatment of aSAH through targeted interventions, subsequently contributing to improve morbidity and mortality of patients with aSAH.
Publisher: BMJ
Date: 05-08-2017
DOI: 10.1136/OEMED-2017-104308
Abstract: Stress pathways can have origins in childhood, but few early predictors have been explored in relation to adult job stress. This study examined whether childhood school, health or socioeconomic factors were associated with adult job stress. Data came from the Childhood Determinants of Adult Health study that began in 1985 with children aged 7–15 years who reported effortreward imbalance (ERI) scales at ages 31–41 years. Linear regression assessed the association between childhood factors and adult ERI adjusted for age and socioeconomic position (SEP) in childhood and adulthood. There were between 999 and 1390 participants in each analysis. Lower adulthood ERI, indicating less job stress, was predicted by several school-related factors in men. For ex le, each higher category of learner self-concept was associated with a 19% (95% CI – 32% to 6%) reduction in adult ERI, and each unit increase in academic attainment was associated with a 15% (95% CI –28% to 3%) reduction in adult ERI. Childhood health was associated with adult ERI. For ex le, in women, overweight children had 14% (95% CI 5% to 22%) higher adult ERI scores compared with healthy weight children, and each unit of negative affect was associated with 2% (95% CI 1% to 4%) increase in adult ERI. Adult SEP had no effect on these associations for men but explained some of the effect in women. Childhood SEP had inconsistent associations with adult ERI. Our findings suggest that a range of childhood socioeconomic, school- and health-related factors might contribute to the development of job stress in adulthood.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2006
DOI: 10.1161/01.STR.0000244806.05099.52
Abstract: Background and Purpose— There are few data on the prevalence or treatment of depression from unselected populations long-term poststroke. We assessed the prevalence of depression and antidepressant use at 5-years poststroke in an unselected stroke population. Methods— Five-year survivors from a prospective community-based stroke incidence study were assessed for depression with the Irritability, Depression and Anxiety Scale. Medications indicated primarily for treatment of depression were recorded. Results— At 5-years poststroke, 441 (45%) of 978 incident cases were alive (mean age=74±15 years, 49% female). Seventeen percent of those assessed were depressed. Twenty-two percent with depression were taking an antidepressant medication. Of those taking an antidepressant, 72% were not depressed. Conclusions— Although nearly one-fifth of survivors were depressed, few were taking antidepressants. Further exploration of this low level of treatment is warranted.
Publisher: S. Karger AG
Date: 2009
DOI: 10.1159/000195689
Abstract: i Background/Aims: /i There is limited knowledge about smoking cessation after stroke. We examined smoking cessation and recall of smoking cessation advice among 5-year stroke survivors. i Methods: /i Interviews were conducted between May 2002 and May 2004 with 5-year survivors from a population-based stroke incidence study undertaken from May 1 1997 to April 30 1999 in Melbourne, Australia. Data were gathered on smoking status at stroke onset, cessation advice recalled and periods of cessation up to 5 years after stroke. Cessation was determined by examining smoking status at stroke onset and at 5 years after stroke. i Results: /i Of the 441 5-year stroke survivors, 343 (78%) had smoking data at follow-up. Fifty-one people were current smokers at stroke onset and 19 (37%) had quit smoking by 5 years after stroke. Of the 40 ever smokers who responded to a question regarding cessation advice, 40% (n = 16) could not recall receiving any such advice since their stroke. i Conclusion: /i The majority of smokers continued to smoke at 5 years after stroke. Few smokers recalled smoking cessation advice. Given that receiving such advice can be the first step towards cessation, improvements in the delivery of advice to this high-risk group are needed
Publisher: Cambridge University Press (CUP)
Date: 16-12-2011
DOI: 10.1017/S0007114511006398
Abstract: Eating frequency may be important in the development of overweight and obesity and other cardiometabolic risk factors however, the evidence is inconsistent. The aim of the present study was to examine the associations between the number of eating occasions and cardiometabolic risk factors in a national population-based s le of young adults. A cohort of 1273 men and 1502 women, aged 26–36 years, completed a meal pattern chart to record when they had eaten during the previous day (in hourly intervals). The total number of eating occasions was calculated. Diet quality was assessed, waist circumference was measured and a fasting blood s le was taken. Dietary intake was compared with the Australian Guide to Healthy Eating. The associations between the number of eating occasions and cardiometabolic risk factors were calculated using linear regression. Analyses were adjusted for age, education and physical activity. Most men ate three to five times per d and most women ate four to six times. The proportion of participants meeting dietary recommendations increased with the number of eating occasions. For men, an additional eating occasion was associated with reductions in mean values for waist circumference ( − 0·75 cm), fasting glucose ( − 0·02 mmol/l), fasting insulin ( − 0·34 mU/l 2·04 pmol/l), TAG ( − 0·03 mmol/l), total cholesterol ( − 0·08 mmol/l) and LDL-cholesterol ( − 0·06 mmol/l). Adjustment for waist circumference attenuated the results. Significant trends were not observed for women. In conclusion, a higher number of eating occasions were associated with reduced cardiometabolic risk factors in men. Many associations were mediated by waist circumference.
Publisher: Wiley
Date: 26-06-2015
DOI: 10.1111/OBR.12304
Abstract: This systematic review and meta-analysis aimed to quantify weight gain after smoking cessation and the difference in weight gain between quitters and continuing smokers. Five electronic databases were searched before January 2015. Population-based prospective cohort studies were included if they recorded the weight change of adult smokers from baseline (before smoking cessation) to follow-up (at least 3 months after cessation). Thirty-five cohort studies were identified, including 63,403 quitters and 388,432 continuing smokers. The mean weight gain was 4.10 kg (95% confidence interval [CI]: 2.69, 5.51) and body mass index (BMI) gain was 1.14 kg m(-2) (95% CI: 0.50, 1.79) among quitters. Compared with continuing smoking, quitting smoking was significantly associated with absolute weight (adjusted mean difference [MD]: 2.61 kg 95% CI: 1.61, 3.60) and BMI gain (adjusted MD: 0.63 kg m(-2) 95% CI: 0.46, 0.80). Subgroup analyses using geographic region found that the difference in weight gain was considerably greater in studies from North America than from Asia. Follow-up length was identified as a source of heterogeneity, such that studies with longer follow-up showed greater difference in weight gain. Effective strategies are needed to encourage smokers to quit irrespective of potential weight gain and to help quitters avoid excess weight gain.
Publisher: Mary Ann Liebert Inc
Date: 05-2019
Publisher: American Psychological Association (APA)
Date: 04-2019
DOI: 10.1037/HEA0000718
Abstract: This research examined if childhood health motivation was associated with adult health behaviors and objectively measured health outcomes. Data were from the Childhood Determinants of Adult Health study. Children aged 9 to 15 years in 1985 completed a questionnaire with health motivation items. In 2004-2006, when aged 26 to 36, participants completed assessments of health behaviors (smoking, diet, alcohol consumption, and physical activity) and cardiometabolic outcomes (body mass index, carotid intima-media thickness from ultrasound, and HOMA insulin resistance from fasting blood s les). Structural path regression analyses examined pathways from health motivation in childhood to adult cardiometabolic outcomes, mediated via adult health behaviors measured concurrently, controlling for age, sex and socioeconomic position. There were 6,230 (49% female) children with data on health motivation. There were two latent constructs: health motivation (4 items: visiting a dentist, visiting a doctor, knowing about your body, and eating a good diet) and risk motivation (3 items: not being a smoker, not being fat, and not drinking alcohol). Greater health motivation was directly associated with nonsmoking, lower carotid intima-media thickness, and lower body mass index in adulthood. Greater risk motivation was directly associated with smoking, higher alcohol consumption, and poorer diets in adulthood. It was also indirectly associated with higher carotid intima-media thickness and higher HOMA insulin resistance via poorer health behaviors. Health motivation during childhood appears important to maintain health across the life course. It could be a target for interventions to improve cardiovascular health in children and adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.JNS.2019.116446
Abstract: Aneurysmal subarachnoid haemorrhage (aSAH) disproportionally affects women. We conducted a systematic review and meta-analysis to explore sex differences in aSAH risk factors. Case-control/cohort studies were searched to November 2017 with sex-specific risk factors for aSAH. Meta-analysis was performed when a risk factor was reported in ≥2 studies. Of 31 studies, 22 were eligible for meta-analysis. Female sex was associated with greater odds of aSAH (HR We recommend sex-specific re-analysis of existing studies of aSAH risk factors. Known aSAH risk factors (hypertension, smoking and alcohol consumption) should be targeted to prevent aSAH in men and women. Registration PROSPERO (ID: CRD42018091521).
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2021.106201
Abstract: There are few large population-based studies of outcomes after subarachnoid hemorrhage (SAH) than other stroke types. We pooled data from 13 population-based stroke incidence studies (10 studies from the INternational STRroke oUtComes sTudy (INSTRUCT) and 3 new studies N=657). Primary outcomes were case-fatality and functional outcome (modified Rankin scale score 3-5 [poor] vs. 0-2 [good]). Harmonized patient-level factors included age, sex, health behaviours (e.g. current smoking at baseline), comorbidities (e.g.history of hypertension), baseline stroke severity (e.g. NIHSS >7) and year of stroke. We estimated predictors of case-fatality and functional outcome using Poisson regression and generalized estimating equations using log-binomial models respectively at multiple timepoints. Case-fatality rate was 33% at 1 month, 43% at 1 year, and 47% at 5 years. Poor functional outcome was present in 27% of survivors at 1 month and 15% at 1 year. In multivariable analysis, predictors of death at 1-month were age (per decade increase MRR 1.14 [1.07-1.22]) and SAH severity (MRR 1.87 [1.50-2.33]) at 1 year were age (MRR 1.53 [1.34-1.56]), current smoking (MRR 1.82 [1.20-2.72]) and SAH severity (MRR 3.00 [2.06-4.33]) and at 5 years were age (MRR 1.63 [1.45-1.84]), current smoking (MRR 2.29 [1.54-3.46]) and severity of SAH (MRR 2.10 [1.44-3.05]). Predictors of poor functional outcome at 1 month were age (per decade increase RR 1.32 [1.11-1.56]) and SAH severity (RR 1.85 [1.06-3.23]), and SAH severity (RR 7.09 [3.17-15.85]) at 1 year. Although age is a non-modifiable risk factor for poor outcomes after SAH, however, severity of SAH and smoking are potential targets to improve the outcomes.
Publisher: Public Library of Science (PLoS)
Date: 20-08-2021
DOI: 10.1371/JOURNAL.PONE.0256589
Abstract: The mid-life emergence of higher levels of total cholesterol (TC) for women than for men has been observed in different Western and Asian populations. The aim of this study was to investigate whether there is evidence of this in Vietnam and, if so, whether it can be explained by ageing, by body size and fatness, or by socio-demographic characteristics and behavioural factors. Participants (n = 14706, 50.9% females) aged 25–64 years were selected by multi-stage stratified cluster s ling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Linear regression was used to assess the independent contributions of potential explanatory factors to mean levels of TC. Data were analysed using complex survey methods. Men and women had similar mean levels of body mass index (BMI), and men had modestly higher mean levels of waist circumference (WC), in each 5-year age category. The mean TC of women increased more or less continuously across the age range but with a step-up at age 50 years to reach higher concentrations on average than those of their male counterparts. The estimated step-up was not eliminated by adjustment for anthropometric indices including BMI or WC, or by adjustment for socio-demographic characteristics or behavioural factors. The estimated step-up was least for women with the greatest weight. There is a marked step-up in TC at age 50 years for Vietnamese women that cannot be explained by their age, or by their body fatness or its distribution, or by their socio-demographic characteristics or behavioural factors, and which results in greater mean levels of TC for middle-aged women than for their male counterparts in Vietnam.
Publisher: Informa UK Limited
Date: 05-01-2020
DOI: 10.1080/09638288.2020.1867656
Abstract: We aimed to understand from the perspective of stroke survivors and their carers (1) factors contributing to sedentary time and physical activity during inpatient rehabilitation and the transition home, and (2) actual and perceived opportunities to reduce sedentary time and increase physical activity. Qualitative study with 7 stroke survivor/carer dyads and 8 stroke survivors. Semi-structured interviews were conducted 2-4 weeks after hospital discharge, audio recorded and transcribed prior to thematic analysis. Stroke survivors were mean age 69 [SD15] years (53% male). Carers were mean age 62 [SD15] years (86% were female). Five themes were identified: (1) Education and guidance about physical activity and sedentary behaviour after stroke is important to build understanding of recovery and secondary prevention, (2) Stroke survivors need clear communication about safety and risk, (3) Return to life participation supports motivation for and engagement in physical activity, 4) Social and professional influences and 5) Opportunities to be physically active. Stroke survivors and their carers need a clearer understanding of the role of physical activity and risks of sedentary time during stroke recovery. Physical activity enablers included consistent communication, building confidence and skills to self-manage activity before discharge.Implications for RehabilitationInpatient rehabilitation and early after discharge may be an important time-point to support stroke survivors to establish long term physical activity behaviours before contact with healthcare professionals reduces.To reduce sedentary behaviour, people need to understand the health benefits of breaking up sedentary time and people who need physical support to stand up will need greater support from health professionals.Being able to imagine a future post-stroke self is important motivation to get up and move. Rehabilitation should help develop a person's vision of their post-stroke self.Managing potential risks in hospital without overly restricting physical activity is important and requires consistent communication from the multi-disciplinary team.Building a person's confidence and skills to self-manage physical activity in the community prior to discharge home may be another key enabler for activity.
Publisher: Oxford University Press (OUP)
Date: 11-03-2020
Abstract: Metabolomic analysis may help us to understand the association between alcohol consumption and cardio-metabolic health. We aimed to: (i) replicate a previous study of alcohol consumption and metabolic profiles, (ii) examine associations between types of alcoholic beverages and metabolites and (iii) include potential confounders not examined in previous studies. Cross-sectional data of 1785 participants (age 26–36 years, 52% women) from the 2004–2006 Childhood Determinants of Adult Health study were used. Consumption of beer, wine and spirits was assessed by questionnaires. Metabolites were measured by a high-throughput nuclear magnetic resonance platform and multivariable linear regression examined their association with alcohol consumption (combined total and types) adjusted for covariates including socio-demographics, health behaviours and mental health. Alcohol consumption was associated with 23 out of 37 lipids, 12 out of 16 fatty acids and six out of 20 low-molecular-weight metabolites independent of confounders with similar associations for combined total alcohol consumption and different types of alcohol. Many metabolites (lipoprotein lipids in high-density lipoprotein (HDL) subclasses, HDL cholesterol, apolipoprotein A-1, phosphotriglycerides, total fatty acids, monounsaturated fatty acids, omega-3 fatty acids) had positive linear associations with alcohol consumption but some showed negative linear (low-density lipoprotein particle size, omega-6 fatty acids ratio to total fatty acids, citrate) or U-shaped (lipoprotein lipids in very-low-density lipoprotein (VLDL) subclasses, VLDL triglycerides) associations. Our results were similar to those of the only previous study. Associations with metabolites were similar for total and types of alcohol. Alcohol consumption in young adults is related to a erse range of metabolomic signatures associated with benefits and harms to health.
Publisher: Oxford University Press (OUP)
Date: 08-2017
Abstract: Introduction The benefits of alcohol consumption for cardiovascular and metabolic health may have been overstated due to inappropriate comparisons with abstainers and inadequate control for confounding factors including physical activity and mental health. We examined alcohol consumption and cardio-metabolic health in a cohort of young Australian adults overcoming these limitations. Methods Cross-sectional data of a cohort of 2200 participants (age range 25-36 years) from the 2004-06 Childhood Determinants of Adult Health were used. Alcohol consumption was assessed from questionnaire and cardio-metabolic risk factors were measured in clinics. Linear and log binomial regression were used to examine total alcohol consumption (categories: none 0 g/day light >0-10 g/day [reference] moderate >10-20 g/day heavy >20-30 g/day very heavy >30 g/day) against dichotomous metabolic syndrome and its components: waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure and glucose. Covariates included socio-demographics, smoking, diet, physical activity, fitness, depression and anxiety. Results Of the 2220 participants (48% males, mean (standard deviation) age 29.5 (2.5) years), most were classified in the 'light drinking' group (54.2%), less were in the 'non-drinking' (13.2%), 'heavy' (5.2%) or 'very heavy' (5.5%) drinking groups. Only moderate drinking was associated with a significantly lower prevalence of metabolic syndrome (prevalence ratio = 0.64, p < 0.05) compared with light drinking. Higher levels of alcohol consumption were associated with higher high-density lipoprotein cholesterol (β = 0.05, p
Publisher: Springer Science and Business Media LLC
Date: 12-02-2197
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
Publisher: Springer Science and Business Media LLC
Date: 2009
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.JNS.2016.03.013
Abstract: To provide novel information on outcomes after first-ever stroke in Vietnam, case-fatality and functional status were assessed 3months after stroke onset. First-ever stroke patients admitted to the stroke unit of a tertiary teaching hospital in Ho Chi Minh City, Vietnam were recruited, examined and interviewed. Functional status was assessed on the modified Rankin Scale (mRS) at admission and again at 3months. We recruited 450 consecutive first-ever stroke patients (99.6% participation, 47.9% female, mean age 62.5 [SD 14.0] years, 76.2% ischaemic stroke). Three-month observed case-fatality was 10.4%. Under plausible assumptions about deaths among non-recruited participants, the estimated case-fatality would be higher (16.4%) Those who had died were mostly older patients compromised by comorbidities and pre-existing disability, and who had severe impairment or severe disability due to stroke at the time of admission. At 3-month follow-up of 376 patients, 34% had least severe disability (mRS=0/1), 39% had intermediate disability and 28% had most severe disability (mRS=4/5). Those with least severe disability were mostly men younger than 65years of age and principally with ischemic stroke. Those with most severe disability were predominantly women aged ≥65years and those with severe disability, mainly attributable to intracerebral haemorrhage. At 3months, 50% had better functional status than at stroke onset, and 27% had poorer function. Case-fatality was relatively low in this study, possibly because of cultural preferences for end-of-life care at home. The dependency burden was relatively high, placing pressure on the healthcare system and society.
Publisher: Springer Science and Business Media LLC
Date: 30-06-2020
Publisher: Springer Science and Business Media LLC
Date: 23-05-2017
DOI: 10.1007/S00038-017-0984-3
Abstract: To examine the effects of partnering and parenting transitions on smoking continuity in young adults. A prospective cohort study was conducted involving 1084 young smokers and former smokers who completed questionnaires at baseline (2004-2006, aged 26-36 years) and 5 years later. 233/570 (40.9%) smokers quit and 58/514 (11.3%) former smokers resumed smoking during follow-up. For partnering transitions, compared with remaining not partnered, the likelihood of quitting was higher among men who became (RR 2.84 95% CI 1.62, 4.98) or stayed (RR 2.12, 95% CI 1.18, 3.80) partnered and women who became partnered (RR 1.50, 95% CI 1.03, 2.18). People who became (RR 0.14, 95% CI 0.03, 0.58) or stayed (RR 0.51, 95% CI 0.27, 0.95) partnered had a lower risk of resuming smoking than their continuously not partnered peers. For parenting transitions, having a first child born increased women's probability of quitting smoking relative to remaining childless (RR 1.74, 95% CI 1.30, 2.33), while having additional children did not. The benefits of partnering were greater for men than women and transition into parenthood was of greater benefit to women.
Publisher: Elsevier BV
Date: 12-2017
Abstract: Skipping breakfast has been linked with poor diet quality, higher BMI and adverse cardiometabolic outcomes. This study aimed to determine the prevalence and correlates of skipping breakfast among Australian children and adolescents. A total of 1,592 2-17-year-olds completed two 24-hour recalls, collected via face-to-face and telephone interview, in the 2011-12 National Nutrition and Physical Activity Survey. Breakfast was an eating occasion of ≥210kJ named as 'breakfast' by the participant. Child, household and adult correlates of skipping breakfast were reported. Odds ratios were calculated using ordinal regression. Linear regression was used to examine differences in dietary intake. Survey weights were applied to give nationally representative estimates. Most (86.8% of boys, 81.4% of girls) ate breakfast on both days, 11.8% of boys and 14.8% girls skipped on one day and 1.4% boys and 3.8% girls skipped on both days. Characteristics associated with skipping breakfast were being female, being older, being underweight or overweight/obese, poorer diet, lower physical activity, inadequate sleep, lower household income, greater socioeconomic disadvantage, and being from a single-parent home. Skipping breakfast was common among Australian adolescents but few consistently skipped. Implications for public health: Interventions to increase breakfast should target adolescents, particularly girls, and low SEP households.
Publisher: S. Karger AG
Date: 28-11-2008
DOI: 10.1159/000177919
Abstract: i Background: /i Handicap is rarely comprehensively examined after stroke. We examined handicap among 5-year stroke survivors from an ‘ideal’ stroke incidence study. i Methods: /i Survivors were assessed with the London Handicap Scale [LHS, score range: 0 (greatest handicap) to 100 (least handicap)]. Multivariable regression was used to examine demographic, risk and stroke-related factors associated with handicap. i Results: /i 351 of 441 (80%) survivors were assessed. Those assessed were more often Australian born than those not assessed (p 0.05). The mean LHS score was 73 (SD = 21). The greatest handicap was present for physical independence and occupation/leisure items. Handicap was associated with older age, manual occupations, smoking, initial stroke severity, recurrent stroke and mood disorders. i Conclusion: /i Reducing recurrent stroke, through better risk factor management, is likely to reduce handicap. The association between handicap and mood disorders, which are potentially modifiable, warrants further investigation.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2023
DOI: 10.1186/S12966-023-01500-7
Abstract: Public transport users tend to accumulate more physical activity than non-users however, whether physical activity is increased by financially incentivising public transport use is unknown. The trips4health study aimed to determine the impact of an incentive-based public transport intervention on physical activity. A single-blinded randomised control trial of a 16-week incentive-based intervention involved Australian adults who were infrequent bus users (≥ 18 years used bus ≤ 2 times/week) split equally into intervention and control groups. The intervention group were sent weekly motivational text messages and awarded smartcard bus credit when targets were met. The intervention group and control group received physical activity guidelines. Accelerometer-measured steps/day (primary outcome), self-reported transport-related physical activity (walking and cycling for transport) and total physical activity (min/week and MET-min/week) outcomes were assessed at baseline and follow-up. Due to the COVID pandemic, the trial was abandoned prior to target s le size achievement and completion of all assessments ( N = 110). Steps/day declined in both groups, but by less in the intervention group [-557.9 steps (-7.9%) vs.-1018.3 steps/week (-13.8%)]. In the intervention group, transport-related physical activity increased [80.0 min/week (133.3%) 264.0 MET-min/week (133.3%)] while total physical activity levels saw little change [35.0 min/week (5.5%) 25.5 MET-min/week (1.0%)]. Control group transport-related physical activity decreased [-20.0 min/week (-27.6%) -41.3 MET-min/week (-17.3%)], but total physical activity increased [260.0 min/week (54.5%) 734.3 MET-min/week (37.4%)]. This study found evidence that financial incentive-based intervention to increase public transport use is effective in increasing transport-related physical activity These results warrant future examination of physical activity incentives programs in a fully powered study with longer-term follow-up. This trial was registered with the Australian and New Zealand Clinical Trials Registry August 14th, 2019: ACTRN12619001136190 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377914& isReview=true
Publisher: Springer Science and Business Media LLC
Date: 16-01-2021
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.NUTRES.2019.01.007
Abstract: Measuring diet quality over time is important due to health impacts, but to our knowledge, a Dietary Guidelines Index (DGI) with consistent scoring across childhood/adolescence (youth) and adulthood has not been validated. We hypothesized that a DGI that reflected age- and sex-specific guidelines would be a valid measure of diet quality in youth and adulthood. The DGI is based on the 2013 Australian Dietary Guidelines to reflect current understanding of diet quality and comprises 9 indicators, with a maximum score of 100 points. DGI scores were calculated for participants of the Australian Childhood Determinants of Adult Health study, which included a 24-hour food record during youth (1985, n = 5043, age: 10-15 years) and a 127-item food frequency questionnaire during adulthood (2004-2006, n = 2689, age: 26-36 years). We evaluated construct validity (distribution of scores, principal components analysis, correlation with nutrient density of intakes) and criterion validity (linear regression with population characteristics). DGI scores were multidimensional in underlying structure and normally distributed. Among youth, a lower DGI was significantly associated (P < .05) with smoking and with lower academic achievement and socioeconomic status. DGI scores were negatively correlated with energy, sugar, and fat and positively correlated with fiber, protein, and micronutrients. Among adults, a lower DGI was associated with lower education and self-reported health and higher waist circumference, insulin resistance, and total and low-density lipoprotein serum cholesterol. The DGI is an appropriate measure of diet quality in youth and adulthood because higher scores reflect nutrient-dense, rather than energy-dense, intake and discriminate between population characteristics consistent with the literature.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12888-019-2385-Z
Abstract: To investigate whether there are bi-directional associations between anxiety and mood disorders and body mass index (BMI) in a cohort of young adults. We analysed data from the 2004–2006 (baseline) and 2009–2011 (follow-up) waves of the Childhood Determinants of Adult Health study. Lifetime DSM-IV anxiety and mood disorders were retrospectively diagnosed with the Composite International Diagnostic Interview. Potential mediators were in idually added to the base models to assess their potential role as a mediator of the associations. In males, presence of mood disorder history at baseline was positively associated with BMI gain (β = 0.77, 95% CI: 0.14–1.40), but baseline BMI was not associated with subsequent risk of mood disorder. Further adjustment for covariates, including dietary pattern, physical activity, and smoking reduced the coefficient (β) to 0.70 (95% CI: 0.01–1.39), suggesting that the increase in BMI was partly mediated by these factors. In females, presence of mood disorder history at baseline was not associated with subsequent weight gain, however, BMI at baseline was associated with higher risk of episode of mood disorder (RR per kg/m 2 : 1.04, 95% CI: 1.01–1.08), which was strengthened (RR per kg/m 2 = 1.07, 95% CI: 1.00–1.15) after additional adjustment in the full model. There was no significant association between anxiety and change in BMI and vice-versa. The results do not suggest bidirectional associations between anxiety and mood disorders, and change in BMI. Interventions promoting healthy lifestyle could contribute to reducing increase in BMI associated with mood disorder in males, and excess risk of mood disorder associated with BMI in females.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-03-2023
Abstract: The origins of sex differences in cardiovascular diseases are not well understood. We examined the contribution of childhood risk factors to sex differences in adult carotid artery plaques and intima‐media thickness (carotid IMT). Children in the 1985 Australian Schools Health and Fitness Survey were followed up when they were aged 36 to 49 years (2014–19, n=1085–1281). Log binomial and linear regression examined sex differences in adult carotid plaques (n=1089) or carotid IMT (n=1283). Childhood sociodemographic, psychosocial, and biomedical risk factors that might contribute to sex differences in carotid IMT laques were examined using purposeful model building with additional adjustment for equivalent adult risk factors in sensitivity analyses. Women less often had carotid plaques (10%) than men (17%). The sex difference in the prevalence of plaques (relative risk [RR] unadjusted 0.59 [95% CI, 0.43 to 0.80]) was reduced by adjustment for childhood school achievement and systolic blood pressure (RR adjusted 0.65 [95% CI, 0.47 to 0.90]). Additional adjustment for adult education and systolic blood pressure further reduced sex difference (RR adjusted 0.72 [95% CI, 0.49 to 1.06]). Women (mean±SD 0.61±0.07) had thinner carotid IMT than men (mean±SD 0.66±0.09). The sex difference in carotid IMT (β unadjusted −0.051 [95% CI, −0.061 to −0.042]) reduced with adjustment for childhood waist circumference and systolic blood pressure (β adjusted −0.047 [95% CI, −0.057 to −0.037]) and further reduced with adjustment for adult waist circumference and systolic blood pressure (β adjusted −0.034 [95% CI, −0.048 to −0.019]). Some childhood factors contributed to adult sex differences in plaques and carotid IMT. Prevention strategies across the life course are important to reduce adult sex differences in cardiovascular diseases.
No related organisations have been discovered for Seana Gall.
Start Date: 2016
End Date: 2016
Funder: The Sax Institute
View Funded ActivityStart Date: 2014
End Date: 2014
Funder: University of Tasmania
View Funded ActivityStart Date: 2007
End Date: 2007
Funder: World Health Organisation
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